2020: Ioannis Akoumianakis

Ioannis Akoumianakis's keen interest in cardiovascular research was expressed early on during his training as a medical student at the University of Crete, Greece. It was during that time when he developed an interest in cardiovascular physiology and pathophysiology, and understand the immense global burden of cardiovascular disease in terms of mortality and morbidity.   This inspired a committed interest towards exploring cardiovascular disease mechanisms, hoping to ultimately improve the life of millions of people suffering from cardiovascular disease.

In 2014, after completing his medical studies, he came to Oxford to read for a DPhil in Cardiovascular Medicine under the supervision of Professors Charalambos Antoniades and Keith Channon. The subject of his project was the exploration of the crosstalk between metabolism and vascular disease, a relationship of great importance with many unknown layers. Building on from previous work of our group, which had proposed mutual crosstalk pathways between the vascular wall and perivascular fat, he further explored novel ligands that could facilitate endocrine and paracrine adipose tissue-vascular wall cross talk, and how local and systemic insulin resistance could influence vascular biology.

In order to address the aforementioned goals, Ioannis made extensive use of data and tissue samples from the Oxford Cohort for Heart, Vessels and Fat (OxHVF), one of the largest, biologically phenotyped cohorts of patients undergoing cardiac surgery. He employed a number of advanced ex vivo models of fresh human tissue, which was complemented by appropriate in vitro cell culture experiments and relevant mouse models. His research revealed a novel vascular signalling pathway involving Wnt5a and downstream USP17 activation, which had multiple adverse redox-sensitive effects on vascular biology. Ioannis proposed that Wnt5a is therefore a novel, adipose tissue-derived paracrine and endocrine mediator of vascular disease which could promote vascular complications of obesity. 

Ioannis' research was also the first to characterise the consequences of vascular insulin signalling in humans with atherosclerosis, where he found that insulin had a detrimental, Janus-like effect on the vascular wall, which was determined by the presence of vascular insulin resistance, and it was reversed by dipeptidyl peptidase 4 inhibitors, a class of drugs commonly used in the treatment of diabetes. This work was the first to confirm the presence of vascular insulin resistance as a characteristic of atherosclerosis, and suggested the need for local insulin-sensitising strategies prior to insulin treatment in diabetic patients with vascular disease.

His individual two first-author papers were both published in Science Translational Medicine,  whilst the relevant work resulted in multiple distinctions such as being a finalist in the Elaine W Raines Early Career Award of the Atherosclerosis Thrombosis and Vascular Biology Council at the American Heart Association Scientific Sessions 2019, the Young Investigator Award in the Coronary Pathophysiology & Microcirculation Session, European Society Cardiology (ESC) Congress 2018, and poster prizes from the ESC, British Cardiovascular Society and British Atherosclerosis Society.

Ioannis' DPhil produced several high-impact publications, describing findings that help us understand the pathogenesis of cardiometabolic disease, with the potential of influencing future strategies, therapies and prognostic tools to successfully treat cardiovascular disease. More importantly, they have managed to further enhance his enthusiasm and dedication to cardiovascular research, particularly novel, translational approaches and technologies dominating current-day research, with the hope to change the fate of millions of people living with cardiovascular disease.