Advancing Clinical, Translational and Basic Research in Pulmonology

Major Areas of Research

The Pulmonary, Critical Care and Sleep Medicine Division at University Hospitals Cleveland Medical Center and Case Western Reserve University has an active research program spanning clinical, translational and basic investigation. The entire division participates in its research mission, and its internationally known faculty of physician-investigators are leaders in their field.

The success of the division's research efforts can be seen in its outstanding mentoring of fellows to faculty positions, supporting junior faculty to independent research careers, and the international reputation of its senior investigators. The impact of the division's research programs can be seen in its outstanding publication record and grant support. The division continues to grow its research portfolio with numerous grants continuing into next year and many submissions for future grants.

Control of Breathing

The control of breathing research group has been a major focus of the division for more than 20 years. Currently, six faculty members have active research programs in this area with independent, but overlapping areas of interest and strong collaboration as seen through their joint publication record.

Dr. Kingman Strohl's research is in sleep disordered breathing. He is currently investigating the genetic basis of differences in rat ventilatory patterns. He has just completed a comprehensive QTL analysis looking at two informative rat strains with varying respiratory patterns. With this information, he is now embarking on a high density mapping project of informative areas identified in the rat genome. Dr. Pingfu Feng's expertise is in the development of sleep patterns with age, and small animal neural recording. His work seeks to explain the behavioral and biochemical basis of sleep/wake cycle ontogeny. His laboratory is unique in its ability to study continuous, long-term, neural recordings in small animals in their natural state and environment. Dr. Ted Dick's research is in pontine control of ventilation. His recent work involves the recording of multiple neurons from entire neural regions of the pons instead of single cells to identify their connections and cross-talk, and develop computer models of these interactions to understand the pontine diaphragmatic pacemaker. There is significant collaboration and complementation between Drs. Dick and Strohl with recent studies on the effect of CPAP on pontine regulation of breathing and cardiac function. Dr. Frank Jacono was a fellow in the Division's Pulmonary and Critical Care Fellowship program. During the research component of his fellowship and while a junior faculty member, he worked on carotid body oxygen sensing with Nanduri Prabhakar, PhD, Vice Chair of Physiology and Biophysics and an international expert in carotid body oxygen sensing. His current projects focus on understanding respiratory variability, its mechanism and its prognostic meaning.

Immunology/Inflammation

Currently, Richard Silver, MD, is actively working in pulmonary immunology and inflammation. Dr. Silver's research program is based on the study of human immunity to M. tuberculosis. He has developed an antigen stimulation system using direct bronchoscopic instillation of PPD into the lung, followed by bronchoalveolar lavage cell recovery from the "immunized" area, as well as the contra-lateral "non-immunized" lung. The development of this novel approach is yielding important information about how protective immune responses are mobilized to the lung in response to inhaled pathogens. In addition, organ-specific responses are being studied as the preliminary evaluation of the efficacy of tuberculosis vaccines. As an extension of Dr. Silver's interest in innate immunity, he also is studying the granulomatous inflammation that develops during tuberculosis infections and sarcoidosis. Studying the response of individuals with sarcoidosis to inflammatory agents, and similar responses in mouse models, he is exploring the hypothesis that the host's abnormal immune response to a number of different pathogens results in granulomatous inflammation.