NHMRC investigator grants - over $40m awarded to Monash MNHS researchers

Federal Health Minister, The Honourable Greg Hunt MP, announced almost $47M in funding for Monash researchers across all areas of health and medical research including : biomedical, clinical, public health and health services research.

NHMRC Investigator grants provide researchers with flexibility to pursue important new research directions as they arise and to form collaborations as needed, to create innovative and creative research solving pressing health and medical problems.

Congratulations to our twenty six researchers from the Faculty of Medicine, Nursing and Health Sciences that received funding for their projects.

Medicine, Nursing and Health Sciences funded projects include:

Preventing illness and death from severe influenza in Australia - Professor Allen Cheng, Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine

Professor Allen Cheng is an expert in respiratory diseases and a member of government advisory committees, including those involved with COVID-19. His research is focused on severe influenza and pneumonia; strengthening systems to assess how well the vaccine is working each year, including the new enhanced vaccines for older Australians. In order to respond to COVID-19, the surveillance systems and trials that have focused on influenza and pneumonia have now been pivoted to provide information on severe COVID-19.

The role of a low emulsifier diet to treat Crohn's disease - Dr Emma Halmos, Gastroenterology, Central Clinical School

Dr Emma Halmos received funding to deliver new treatments for Crohn’s disease, an inflammatory bowel condition. The only current dietary treatment for Crohn's disease is removing food and replacing it with nutritional complete liquid.  While it is highly effective for Crohn's disease treatment, the dietary treatment is short-term and not always a patient-friendly option. More targeted diets are needed. There is strong evidence in animals that emulsifiers, commonly added to food to stabilise a product, induces inflammation in the bowel, but evidence is lacking in humans. Dr Halmos will  explore the effects of emulsifiers on the intestines of humans through designing low and high emulsifier diets and analysing their effects on health in healthy and Crohn's disease participants across three trials.

Optimizing the management of osteoarthritis through research and innovation - Professor Flavia Cicuttini, Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine

2.2 million Australians are afflicted with osteoarthritis, with prevalence set to skyrocket alongside an ageing population and projected increases in obesity. Costly joint replacements are the only treatment for painful and debilitating end stage disease.  Professor Flavia Cicuttini will use her funding to develop new disease modifying treatments with the potential to reduce pain and disability in those with the condition, and reduce associated healthcare costs.

Better evidence more rapidly implemented for people with musculoskeletal conditions - Professor Rachelle Buchbinder AO, Epidemiology and Preventive Medicine, School of Public health and Preventive Medicine

Professor Rachelle Buchbinder AO has been awarded a grant to drive translation of evidence into clinical practice within the musculoskeletal health sphere. While nearly one in three Australians present with at least one painful musculoskeletal condition, the field is subject to gaps in evidence and misconceptions about best care among practitioners. Rachelle is a passionate advocate for evidence-based care, and this research will focus on filling evidence gaps, ensuring new important evidence reaches clinicians and patients more rapidly, and reducing low-value care.

Improving patient outcomes through better use of blood products - Associate Professor Zoe McQuilten, Epidemiology and Preventive Medicine, School of Public health and Preventive Medicine

Managing the safety and security of our national blood stocks, and ensuring best practice around use of precious blood products is vital to our health system. This grant will enable haematology researcher Associate Professor Zoe McQuilten to explore novel interventions that might reduce the need for transfusion, such as drugs that inhibit the destruction of clots, drugs to boost platelet production and different treatments for people with blood diseases. She’ll also evaluate the efficacy and safety of novel blood components, such as cryopreserved (frozen) platelets and a new storage system for red blood cells.

Patient centred volunteer program for people with dementia: a stepped wedge cluster randomised controlled trial of the MyCare Ageing program - Dr Darshini Ayton Epidemiology and Preventive Medicine, School of Public health and Preventive Medicine

As our population ages, reducing falls, dehydration and distress among hospitalised people with dementia and/or delirium will become increasingly important to shorten hospital stays and achieve better health and wellbeing outcomes. This vulnerable cohort requires a level of medical supervision that can be difficult to achieve due to resourcing. MyCare Ageing is a collaborative program co-designed with a range of stakeholders that provides companionship and practical assistance from trained volunteers. The program was implemented in three Melbourne hospitals in 2019; this funding will allow Dr Darshini Ayton to conduct a randomised controlled trial, process evaluation and cost analysis to provide an evidence base for expanding the program throughout other health services.

Revolutionising Multiple Sclerosis care and trials through e-health - Professor Helmut Butzkueven, Neuroscience, Central Clinical School

Professor Helmut Butzkueven's research focuses on people with Multiple Sclerosis (MS) using smartphones to self-monitor their disease. The program involves over 20 large specialist MS centres all over the world, and will include more than 4000 people with MS. There are two ambitious aims. The first is to re-invent the way we conduct clinical trials to make them much cheaper, faster and more accessible. Secondly, we believe smartphone-based neurological self-evaluations can detect treatment failure faster than standard care. If this is correct, a simple test on a smartphone will optimize treatment decisions and result in much less MS disability.

Brain stimulation therapeutics for mental health disorders: from concept to clinical application - Professor Paul Fitzgerald Alfred Psychiatry Research Centre (MAPrc), Central Clinical School

Common mental health disorders such as major depressive disorder (MDD) affect large numbers of Australians but are poorly treated with existing therapies.  Various non-invasive brain stimulation therapies have demonstrated value in the treatment of MDD and transcranial magnetic stimulation (TMS) is now being used widely in clinical practice. However, there are significant limitations with TMS therapy that the Professor Paul Fitzgerald’s research will address: 1) improving the clinical use of repetitive TMS (rTMS); 2) developing a more sophisticated version of treatment for more treatment-resistant patients; 3) testing a highly accelerated version of rTMS therapy for patients who need a very rapid clinical response, such as those with substantial suicidal ideation; 4) developing a new therapy using closed-loop transcranial alternating current stimulation for use at home in a much broader spectrum of patients with MDD.

Optimising patient & health system outcomes in chronic respiratory disease - Professor Anne Holland, Immunology Alfred Hospital, Central Clinical School

Chronic lung disease is Australia's most common cause of avoidable hospital admissions. A range of non-drug treatments is recommended to reduce health care utilisation and improve patient wellbeing. However, they are grossly underutilised, due to implementation barriers and evidence gaps. Professor Anne Holland's research program aims to improve the health and wellbeing of people with chronic lung disease by optimising the delivery and uptake of evidence-based, non-drug treatments. This will include clinical trials (pulmonary rehabilitation, oxygen therapy, self-management), health economic analyses and implementation studies.

Leaving no-one behind: community-driven approaches to eliminate HIV in Australia - Dr Jason Ong Melbourne Sexual Health Clinic, Central Clinical School

Eliminating HIV from Australia is possible with effective HIV prevention methods like treatment as prevention (TasP) and pre-exposure prophylaxis (PrEP). However there are inequities in our HIV response with declines of new infections in Australian-born men who have sex with men but not in overseas-born Australian men. Dr Jason Ong's Investigator Grant will fund a program of research to inform HIV policy by using crowdsourcing methods to identify and share solutions from the community and evaluating the value of the proposed solutions.

Multi-dimensional monitoring of cognition and cerebellar function to prospectively define disease progression in multiple sclerosis (MS) - Professor Anneke van der Walt Neuroscience, Central Clinical School

People with MS commonly develop cognitive and cerebellar function changes that are known to predict loss of employment, earlier onset of significant disability and lower quality of life. These clinical domains represent wide neural network inefficiency and failure and are frequently, and more severely, impaired in secondary progressive MS (SPMS). Neither cognitive nor cerebellar decline is currently included in standard monitoring and treatment-failure paradigms. Professor van der Walt's research program aims to systematically validate and implement digital and neuroimaging biomarkers of cognition and cerebellar function in MS to detect progression earlier and improve medical decision-making and long-term outcomes of MS. This program will be implemented as a multi-centre study of 1000 people with MS with accumulated disability.

Developing immune-based therapies for cancer - Professor Nicholas Huntington, Biochemistry and molecular biology, School of Biomedical Sciences

Cancer is an enormous disease burden in Australia and claims around 10 million lives worldwide each year. Recent development of therapies that exploit a patient's own immune response to combat cancer has revolutionised patient outcomes in selected cancers. Professor Nicholas Huntington is an international authority on an immune cell that detects and destroys cancers aptly named "Natural Killer" cells. His project focuses on understanding the regulatory mechanisms that prevent Natural Killer cells from attacking healthy tissue but promotes their ability to find and eradicate cancer cells in order to develop novel immune-based therapies for cancer.

Pathways to vision following lesions of the primary visual cortex - Professor Marcello Rosa, Physiology, School of Biomedical Science

Lesions of the primary visual area, located in the occipital cortex, lead to loss of conscious vision, even though the eyes may remain unaffected. This "cortical blindness” affects as many as 10-20% of stroke patients. Professor Marcello Rosa will investigate ways to recover visual function following such lesions, and aims to identify cellular populations that are possible targets for the development of therapies to preserve visual function.  His project will capitalise on well-established interdisciplinary links with biomedical engineers and computer scientists, and will use Monash’s unique infrastructure to conduct coordinated studies encompassing in vivo imaging, electrophysiology and behavioural studies in animal models of visual function and dysfunction.

A mechanistic study to open paths for therapeutic opportunities - Dr Qi Zhang, Biochemistry and Molecular Biology, School of Biomedical Sciences

Gene expression needs to be precisely regulated and its dysregulation causes a broad range of human diseases. Dr Qi Zhang’s research focuses on two vital epigenetic modifying complexes, PRC2 and G9A, which contribute heavily to healthy gene expression. The investigator grant will enable her to develop a basic research program into the interplay between PRC2 and G9A. The program will open a path for the development of future therapeutic strategies for targeting these two enzymes.

Optimising Engagement in Cardiac Secondary Prevention: A Health Literacy Approach - Dr Alison Beauchamp, School of Rural Health

This study will follow over 400 people with myocardial infarction to explore the role of health literacy in self-management of cardiac risk factors. Baseline data will include a comprehensive health literacy questionnaire, and participants will be followed for 2 years to determine the association between health literacy and lifestyle changes. The study will also co-design health literacy interventions with patients and clinicians across three health services. These interventions will aim to increase patients’ long-term engagement with cardiac secondary prevention including uptake of cardiac rehabilitation.

Harnessing the extracellular matrix to fight obesity-induced cognitive impairment -  Dr Amy Reichelt, Physiology, School of Biomedical Sciences

Two-thirds of the Australian population are overweight or obese. Critically, obesity and the excessive consumption of high fat and high sugar foods can cause cognitive impairment and increase neurodegeneration. Understanding how the excessive consumption of high fat and high sugar foods impact brain function is critical to protect brain function. In this project, Dr Amy Reichelt will take an innovative approach to understand the pathogenesis of obesity-induced cognitive impairment by looking beyond neurons to define the impact of obesity on specialised extracellular matrix structures called perineuronal nets (PNNs) that encase neurons. These structures can regulate neuroplasticity and protect neurons essential for cognitive processes. Unlocking the capacity of the brain’s extracellular matrix will provide an innovative candidate therapy for treatment of diet-induced cognitive impairment.

Counteracting age-associated neurodegenerative diseases using chaperone-based amyloid disaggregases - Dr Nadinath Nillegoda Australian Regenerative Medicine Institute

Progressive neurodegenerative disorders such as Alzheimer’s disease (AD) and Parkinson’s disease (PD) show distinct clinical features, but at molecular level, these conditions are characterized by protein misfolding/aggregation that modulate disease progression and severity by a gain-of-toxicity mechanism. >60 million people worldwide are living with AD and PD. Dementia is one of the prominent pathological symptoms of these diseases. >500,000 Australians are currently diagnosed and 6 million new cases will be identified at a cost of one trillion dollars in the next 40 years. Despite global efforts to bolster dementia research, there are currently no effective treatments or cures. Dr Nadinath Nillegoda's pioneering research program studies a novel chaperone-based cellular repair machinery in humans that clears toxic aggregates and promote neuronal healing, which will provide invaluable new directions for the treatment of a broad range of neurodegenerative disorders.

Improving outcomes - Systemic Lupus Erythematosus - Professor Eric Morand, Medicine Monash Health, School of Clinical Sciences at Monash Health

Unlike most autoimmune diseases, and indeed other major diseases like cancer and cardiovascular disease, there has been no significant breakthrough in the treatment of Systemic Lupus Erythematosus (SLE) for over 50 years. Treatment therefore continues to rely on non-specific immunosuppressant drugs and glucocorticoids (GC, or ‘steroids’), and the impact on patients, who are mostly young women, includes high mortality and poor quality of life. The study led by Professor Eric Morand will validate novel evidence-based endpoints which will break the impasse in SLE drug development. In parallel, Professor Morand will exploit preliminary data to develop a marker for use in directing GC dosing in SLE, and pursue the development of novel compounds with the potential to replace GC in SLE in the future.

Identification of Molecular Signatures in Indigenous and Non-Indigenous Australians with Systemic Lupus Erythematosus to Enable a Precision Medicine Approach - Dr Fabien Vincent, Medicine Monash Health, School of Clinical Sciences at Monash Health

Lupus is an incurable autoimmune illness which is more common and severe in Indigenous Australians, though the reason for this is not yet known. To understand this better, Dr Fabien Vincent's study will take blood samples and measure many thousands of genes and proteins in the blood. Using complex data analysis methods, known as bioinformatics, Dr Vincent will analyse the ‘stack’ of these blood markers. This study will be a first in Indigenous Australians with lupus, and will help in identifying the right drug for the right patient.

Optimise primary aldosteronism detection for better health outcomes - Dr Jun Yang Medicine Monash Health, School of Clinical Sciences at Monash Health

Dr Jun Yang’s grant will support her research into demonstrating Australia’s high prevalence of primary aldosteronism (PA) or Conn’s Syndrome – a condition of excessive aldosterone production from the adrenal gland. Hypertension is a leading risk factor for death and disability globally and affects close to 6 million Australian adults. PA is the second most common cause of hypertension, affecting 5-10 percent of hypertensive patients in primary care. However, the condition is substantially underdiagnosed in Australia with data suggesting that over half a million hypertensive Australians are missing out on a targeted treatment or cure. The diagnosis of PA remains challenging, time-consuming and costly, and involves hospital stays. There is a need for alternative diagnostic tests that are simpler, less operator dependent and outpatient based. Dr Yang’s goal is to establish recommendations for the best strategy to screen and accurately diagnose PA to achieve optimal cardiovascular and renal health outcomes.

Increasing osteoporosis treatment uptake - Professor Peter Ebeling Medicine Monash Health, School of Clinical Sciences at Monash Health

Osteoporosis treatment is in crisis. A fear of rare complications like atypical femur fractures (AFF) from treatment with the most commonly used anti-resorptive drugs, bisphosphonates, has led to a 50 percent decline in treatment rates of patients with fractures. This study aims to increase osteoporosis treatment uptake and reassure a large proportion of the population that they are not at risk of AFF based on a favourable femoral alignment (Femoral Alignment Score from hip DXA). In the remaining minority of the population starting anti-osteoporosis drugs, the study will identify patients with genetic or bone microarchitectural risk factors for AFF, based on an inexpensive genetic test and bone density (HRpQCT) scans. Professor Peter Ebeling will also enhance the ascertainment of AFF by using artificial intelligence and machine learning approaches, so software is incorporated into routine radiological practice.

Dangerous Dreams: the next era in paediatric sleep research - Professor Rosemary Horne Paediatrics Monash Health, School of Clinical Sciences at Monash Health

The amount of time and the quality of our sleep affects every aspect of our health and well-being. The amount of time spent asleep is maximal in infants and children and is particularly important because it promotes normal brain development. Professor Horne's study will focus on sleep and breathing in preterm infants and how short pauses in breathing, which are currently not considered of clinical importance, are related to developmental outcomes. The studies will also identify if sleep can be improved in children with Down syndrome and cancer and if brain changes associated with obstructive sleep apnoea are ameliorated with treatment. These studies will identify and improve treatment of sleep problems to improve overall physical health and quality of life for children and their families.

Transforming access to addiction treatment: overcoming system barriers and developing effective early intervention approaches - Professor Dan Lubman, Eastern Health Clinical School

Addiction is one of the most highly stigmatised disorders in our community, resulting in a near two decade delay before people seek treatment. Although individuals with alcohol and drug problems present many times to health services, there are multiple missed opportunities for intervention. Professor Lubman’s research program will identify opportunities to facilitate early help-seeking and treatment via insights through data linkage and machine learning, as well as testing novel telephone-based models of care.

A network approach to mapping and modifying brain changes in psychosis - Professor Alex Fornito, Turner Institute for Brain & Mental Health

Psychosis is a devastating neuropsychiatric syndrome that affects around 3% of the population and costs the Australian economy billions of dollars annually. Professor Alex Fornito has been at the forefront of developing new methods for mapping brain changes in people with psychosis using non-invasive techniques such as Magnetic Resonance Imaging (MRI), however MRI lacks the cellular and molecular resolution required to understand underlying disease mechanisms, limiting the potential for new treatments. With his investigator grant, Professor Fornito will address this ‘resolution gap’ by incorporating next-generation, multimodal imaging technologies with molecular genetics and sophisticated mathematical modelling of disease processes, allowing the research to move beyond mere mapping of disease effects, to uncovering the underlying mechanisms of the disease and developing modifiers of psychosis onset.

Using a purpose-built digital assessment tool to determine the mechanisms driving addictive behaviours and its utility to improve treatment engagement and outcomes - Dr Rico Sze Chun Lee, Turner Institute for Brain & Mental Health

Australians with an addiction lose an average of 14 years in life expectancy, with less than 1 in 4 people receiving care due to factors such as a lack of awareness, perceived stigma or shame, or barriers to services. Partnering with industry and specialised addiction clinics, Dr Rico Sze Chun Lee will innovate, engage and provide access to a neuroscience-informed assessment tool that is purpose-built for people across all stages of addiction. Specifically, he will implement the BrainPAC app (BrainPark Assessment of Cognition app) to detect, track, and provide personalised feedback on the decision-making abilities that drive problem drinking, drug use, and gambling. BrainPAC is fun to use, low-cost, and easy to access on smartphones and tablets. The delivery of this tool will transform the way we predict risk of, and relapse back into addictions. It will demonstrate how we can empower and engage more Australians currently without access to services, who are often young, live in rural or remote communities, or socioeconomically disadvantaged. In short, Dr Lee’s work will ensure more people experiencing addictions have access to effective assessment technologies based on the latest neuroscience.

Computational modelling to understand early-stage neurodegeneration - Dr Adeel Razi, Turner Institute for Brain & Mental Health

Dr Adeel Razi’s research will develop mathematical models for tracking early stage dementia using noninvasive brain imaging. This research will lead to better understanding of dementia progression, and will assist in the development of new pharmaceutical interventions. Although rare, familial Alzheimer‘s disease (FAD) and Huntington’s disease provide the opportunity to study individuals who are cognitively normal but are destined to develop the disease. Dr Razi will investigate how information processing among brain regions in these individuals changes over time to develop sensitive neuronal markers to help predict the onset and spread of the disease. Understanding the mechanisms underlying the early stages of dementia will provide valuable insights which will translate to detecting disease change more robustly, less variably, and earlier in the disease course, with consequent impact on the search for disease modifying treatments.


For Monash University media release highlighting projects from other faculties, please visit: Monash News

For a full list of recipients, please visit: NHMRC website

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