Story by Erin Peterson  |  Illustration by Aldo Crusher | Photographs by Maximilian Franz and Stephanie Cordle

Peter Kofinas has seen the consequences of hyperammonemia, a metabolic condition in which patients have too much ammonia in their blood, when it has been diagnosed too late. “I’ve gone to the hospital and seen young kids—aged 10, 13—who had intellectual disabilities as a result of the condition,” he says. 

For years, the only available tests required hospital visits or anxiety-fueled waits of up to two weeks for the tests to be sent to outside laboratories for analysis. It’s one reason that his decision to help develop a simple at-home test, in collaboration with experts at the NIH’s National Center for Advancing Translational Science and Children’s National Hospital in Washington, D.C., felt so personal. “Finding problems with solutions that have an impact on people—that’s what drives me and interests me,” he says.

As a polymer expert, Kofinas felt confident that he could build a test that needed just a few drops of blood. It would require him to create a polymer membrane to isolate ammonia from the blood, and a way to measure its concentration to diagnose the condition.

Partnering with hospital and NIH experts, Kofinas and his team at Maryland Engineering got to work. They built a handheld microfluidic device—similar to those that measure blood sugar levels for people with diabetes—that parents could use to quickly measure their babies’ ammonia levels at home. 

The device was so promising that Kofinas and his team filed for, and received, a patent for the technology. Today, a company called Archimedes Bioengineering is working to commercialize the device: Omar Ayyub Ph.D. ’14, co-inventor and a graduate of Kofinas’ lab, serves as the company’s chief scientific officer. Kofinas, meanwhile, now department chair of chemical and biomolecular engineering, continues to take aim at pressing medical challenges that can benefit from his engineering expertise.

He isn’t alone. 

Kofinas is one of dozens of engineering faculty at Maryland who are building tools and advancing technologies designed to improve patients’ health, both here and around the world. They’re leveraging every advantage that Maryland offers—collaborative opportunities (including a novel and trendsetting partnership with the School of Medicine to embed engineers with clinicians), proximity to top federal agencies, cutting-edge technology, and commercialization support—to accelerate the process from idea to impact.

It’s working.

Here are just a few of the ways that Maryland Engineering is built for the breakthrough.

Built to… detect troubling gastrointestinal conditions earlier

As the prevalence of gastrointestinal (GI) diseases continues to skyrocket—the American Cancer Society predicts colorectal cancer will be the leading cause of cancer death for people under 50 by 2030, and both inflammatory bowel disease (IBD) and gastroesophageal reflux disease (GERD) are on the rise—finding new ways to monitor our GI health has become imperative. 

One area that holds particular promise: sensor-packed ingestible capsules that patients can swallow as easily as their morning vitamins.

Depending on the need, the capsules could be developed to gather valuable information—or even to precisely deliver drugs, says Reza Ghodssi, Herbert Rabin Distinguished Chair in Engineering and executive director of research and innovation at UMD’s MATRIX Lab in southern Maryland. “PillCams can already take pictures as they travel through patients’ GI tracts, but similar technologies could have electrochemical sensing capabilities,” he says. “They could survey GI tissue for the harmful thinning of the mucosal layer, which can’t always be observed with a PillCam, or to identify the onset of a potentially cancerous tumor.”

Ghodssi, who has been building miniature devices, sensors, and actuators for more than three decades, has gathered researchers with diverse expertise from across the university—electrical engineers, mechanical engineers, bioengineers, chemists, computer scientists, and data scientists, for starters—to create tiny devices that contain electrochemical sensing electrodes, communications electronics, and batteries inside tiny 3D-printed shells; data collected from the device can be transmitted wirelessly to a cell phone. His students are fueling further insights: Just this year, Ph.D. student and Clark Doctoral Fellow Joshua Levy was recognized for award-winning work linked to microneedle drug deliveries in the context of ingestible capsules. 

The challenges of creating a device small enough to be swallowed that contains sensors to collect and share meaningful data are myriad, but Ghodssi sees a future where these devices won’t just find problems, but help us sidestep them entirely. “When you understand how your body is working,” he says, “you can prevent the diseases before they occur.”

Built to… customize medication for every age

One of the vexing problems facing doctors: A patient’s characteristics can influence the efficiency of a prescribed drug. A treatment that works effectively for an 18-year-old, for example, might have little impact on an 80-year-old; another medication with high success rates among men may show little promise for women.

Assistant Professor of bioengineering Erika Moore’s research investigates how ancestry and sociocultural data affect disease development and treatment. She is particularly interested in how these differences express themselves in macrophages, a specific type of cell that plays a role in the wound healing process. She’s found that these cells tend to become less effective at their job as people get older, and that these macrophages are less affected by the treatments targeting them. 

To learn more, she builds biomaterial models—3D tissues that Moore affectionately describes as looking like “little Jell-O tissues”—to study the wound-healing therapeutic Metformin. And unlike many researchers, she accounts for diverse populations when building regenerative tissue models to create more equitable disease models.

Her findings have been illuminating: Cells from donors under the age of 35 exposed to Metformin healed far faster than those from donors over the age of 65. “That means that we don’t think that Metformin is the most effective drug to restore wound healing for older adults—or that we need to consider a different dose or exposure time,” she says.

While age is the key variable in this specific work, Moore says it is the tip of the iceberg in a world where we can increasingly personalize the treatments that patients receive: “Too often, we take a one-size-fits-all approach,” she says, “but there’s a real need to be more intentional and aware of things like biological sex, age, and other demographic descriptors. We need a much more in-depth and holistic understanding of how our experiences and background contribute to our maladies.”

Fibroid insights

Allison Moses ’23, a Ph.D. student and graduate researcher in Erika Moore’s lab, is building models to understand the complexities of uterine fibroid development by analyzing the interactions between macrophages and fibroid cells. “I aim for my research to bring us one step closer to understanding uterine fibroid pathogenesis so that we may develop key targets for screening, treating, or preventing fibroids,” she says.

Erika Moore at TED: Uncovering How Personalized Medicine Can Bridge Health Disparities

Built to… prevent preterm birth

More than one in 10 babies in the United States are born at least three weeks before their due date. For these families, what should be a time of joy can instead lead to deep anxiety and a sense of helplessness. The economic consequences are enormous, too: The annual medical and associated costs of these preterm births add up to a staggering $25 billion in the United States alone. 

Even worse, progress on the problem has stalled: Accelerated FDA approval for a progesterone-based injection used to prevent preterm birth was withdrawn in late 2023 because it was not shown to be effective. Today, there is not a single FDA-approved treatment available.

Chemical and biomolecular engineering Assistant Professor Hannah Zierden hopes to create one. 

Zierden is currently testing the use of tiny particles known as bacterial extracellular vesicles (bEVs), which are produced by vaginal microbes, as a drug delivery mechanism. These particles, which are released by bacteria, function something like biological “mail”: They deliver biological materials and communications from the cell to other parts of the body. Zierden says they could also be loaded with drugs or other materials and targeted to specific cells or tissues.

These bEVs hold particular promise not only because they can move drugs through vaginal mucus, a biological barrier that has proven to be a formidable challenge for scientists in the past, but because they can deliver drugs more precisely than injections, which can get diluted in circulation.

Currently, she is teaming up with chemical and biomolecular engineering Assistant Professor Po-Yen Chen on a machine learning and AI project to help her identify bEV formulations that can be manufactured at scale and have the greatest potential for success.

Zierden says that advances in bEV drug delivery could re-open the door to the use of progesterone to prevent preterm birth. “When you can deliver drugs directly to the female reproductive tract, you can increase the payload to target tissues while decreasing off-target side effects,” she says.

Bio Innovation at Maryland Engineering

The Bio Innovation program supports innovators working in fields like bioengineering, medtech, healthtech, and biotech. By offering access to top-tier resources, such as cutting-edge scientific instruments, incubators, accelerators, and collaboration with renowned researchers, it aims to advance breakthrough technologies in diagnostics, therapeutics, and medical devices, and more. The program fosters collaboration to create solutions that improve healthcare outcomes and promote sustainable commercialization.

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Built to… stop vision loss before it starts

Keratoconus, an eye disease that causes the cornea to thin and bulge into a cone shape, affects more than 150,000 people in the U.S. alone. It can lead to severe vision loss and is a leading cause of corneal transplants.

But technologies advanced by Associate Professor of bioengineering Giuliano Scarcelli can now pinpoint corneal softening before the destructive bulging begins.

Scarcelli’s work, which is a significant advancement in what is known as Brillouin microscopy, “sees” cell stiffness in much the same way that a thermal camera can “see” heat. Instead of each pixel of the camera measuring the temperature of a structure, Brilliouin microscopy techniques use light to measure the stiffness of structures, including cells, without disrupting them in any way.

“Our technique allows us to detect corneal softening before a patient has a vision problem,” Scarcelli explains. Once detected, an ophthalmologist can use already developed treatments to prevent the disease’s progression.

While corneal stiffness measurements are the most advanced current use case for the technology, its impact is likely to grow: Giuliano and his lab have developed a microscope based on Brillouin scattering that is being used in other researchers’ labs.

Scarcelli adds that there is an array of conditions that might ultimately be able to be diagnosed earlier or more effectively through similar measurements of cell stiffness, as well, including Alzheimer’s disease and metastatic cancer.

Best of the best

Giuliano Scarcelli’s breakthroughs in Brillouin microscopy were named one of The Guardian’s “10 biggest science stories” of 2022, as identified by fellow scientists.