Traumatic brain injury expert Jess Gill returns to Johns Hopkins as Bloomberg Distinguished Professor

In her clinical training with the Veterans Administration during her master's program, Jessica Gill noticed that some veterans impacted by trauma—brain injuries in particular—seemed to recover well while others were left with lasting effects on their physical and mental health.

Questions about trauma and resiliency and a desire to understand the reasons for these divergent responses to brain injury led her to pursue a career in research, and she earned a PhD at the Johns Hopkins School of Nursing in 2007. Gill, a national leader in the biological mechanisms of traumatic brain injuries, or TBIs, has since dedicated her career to investigating different responses in military personnel, athletes, and other patients that have experienced TBIs and the mechanisms underlying these divergent responses—why some patients recover better from TBIs while others are left with long-term neurological and psychological symptoms.

"I've always been inspired by my patients," Gill says. "To be committed to something so wholeheartedly that you devote your life to it is really inspiring. But many veterans remain impacted by their service years after returning home. Veterans would come to me and say 'I feel sick all the time, as if I had a cold or flu.' I wanted to understand why that was, and how we can improve their health care."

Specifically, Gill looks for ways to use biomarkers—such as proteins or extracellular vesicles also known as exosomes—to identify which patients with TBIs are at high risk for poor recovery and long-term effects including post-traumatic stress disorder, depression, and post-concussive syndrome, and how to develop treatments and support recovery.

"Ultimately, the end goal of my research is to use biomarkers to monitor people over time and to detect risk, and then to design interventions to mitigate those risks," she adds. "For instance, we've seen that elevated levels of the protein tau in athletes about 24 hours after a concussion actually indicates that those individuals will have a prolonged return-to-play compared to teammates with lower levels of tau accumulation. Learning more about which individuals may be at greater risk can help athletes make important decisions about their health and their careers."

Gill will soon return to Johns Hopkins University as a Bloomberg Distinguished Professor of Trauma Recovery Biomarkers, with primary appointments in the School of Nursing and the School of Medicine's Department of Neurology. She comes to JHU from the National Institutes of Health, where she was a senior investigator and acting deputy scientific director of the National Institute of Nursing Research, and deputy director of the Center for Neuroscience and Regenerative Medicine.

"Jessica Gill's experience across many levels of the health care system, along with her distinguished career as a researcher, will provide one more strong bridge between the School of Nursing and the School of Medicine," JHU Provost Sunil Kumar says. "We are elated to welcome Dr. Jessica Gill back to Johns Hopkins as a Bloomberg Distinguished Professor."

The first in her family to go to college, Gill obtained her BS in nursing with a minor in biology from Linfield College, and her MS in psychiatric nursing from Oregon Health and Sciences University. After earning her PhD from Hopkins, she went to NIH to complete a postdoctoral fellowship at the National Institute of Nursing Research that focused on the biological mechanisms of PTSD and depression. This line of research led her to become a clinical investigator in the Center for Neuroscience and Regenerative Medicine. Now, after 14 years at NIH, Gill looks forward to the potential that returning to Johns Hopkins has for her research and its translation into clinical practice.

"So many research doors have opened for me especially because of Johns Hopkins," Gill says. "I was able to benefit from amazing training and just kept moving from there. Coming back, I'm really excited for this opportunity to expand the way that I think about science and my line of research. My work has been very focused for the last few years, and I'm excited to now go back and expand and think about different directions that I could take on in my work."

A line of research that Gill is particularly enthusiastic about building on is her groundbreaking work using sweat patches to collect biomarkers. The adhesive patches collect sweat over several hours until they are taken off and sent to the lab using regular mail. This allows biomarkers to be collected by the patients themselves in home and work settings, providing researchers with unprecedented information about individuals who have suffered traumatic brain injuries.

"To me, the most exciting moments in my research are when we use a new technology to find something new," Gill says. "A lot of our science is based on blood samples, so over the past year, we've had to find alternative methods to continue our work. We've found that sweat shows the same biomarkers that we look at in blood, and that the levels correspond to those found in blood."

These findings have important implications for patients with recent traumatic brain injuries, as the sweat patches will make collecting information about biomarker levels that correlate to brain activity quicker and less invasive. Next, Gill hopes that the ability to work closely with patients in the ICU at Johns Hopkins will allow her to advance this sweat biomarker technology to enable continuous and instantaneous monitoring of ICU patients.

"If you take a sample of blood, it has to go through various steps in the lab to be prepared and analyzed," Gill explains. "Over the next several years we hope to refine the sweat patches that patients can wear in the ICU that can give us real-time measurements of biomarkers. There is so much potential at Johns Hopkins for translation and usability of our protocols and technologies that is going to catalyze this type of technology development and propel this research forward."

In addition to the ability to work directly with patients, Gill says the increased opportunity for collaboration across departments and even schools will greatly impact her research and its potential for translation to interventions that will directly benefit patients with traumatic brain injuries.

"My work has always been inherently interdisciplinary, even back in the days of my PhD program at Johns Hopkins," Gill says. "Having this opportunity to be within the School of Medicine and the School of Nursing, and to collaborate with experts in such a range of fields, will allow my science to catalyze in completely new ways, and help make this research program more diverse and focused on improving care for clinical patients. When you have all these great minds come together, you have the chance to make something that wouldn't even be possible without that particular combination of people in the room."

"We're thrilled to have Dr. Gill back at the School of Nursing as a faculty member and a well-recognized leader in the field of neurology," says Sarah Szanton, dean of the Johns Hopkins School of Nursing. "Her work showcases the breadth and innovation of nursing and fosters greater interprofessional sharing and impact."

Adds Paul Rothman, dean of the medical faculty at the Johns Hopkins School of Medicine and CEO of Johns Hopkins Medicine: "Traumatic brain injury is a complex and frustrating problem that affects hundreds of thousands of Americans, including many veterans. Jessica Gill has devoted her career to better understanding this issue, and has developed innovative and exciting approaches to help unravel some of its mysteries. We are so excited that she will be returning to Johns Hopkins to continue her groundbreaking research on this worthwhile topic."

As a Bloomberg Distinguished Professor, Gill joins an interdisciplinary cohort of scholars working to address major world problems and teach the next generation. The program is backed by a gift from Michael R. Bloomberg, a Johns Hopkins alumnus, founder of Bloomberg LP and Bloomberg Philanthropies, World Health Organization Global Ambassador for Noncommunicable Diseases, United Nations Secretary-General's Special Envoy for Climate Ambition and Solutions and 108th mayor of New York City.