We study relationships among inflammatory cells and mediators, acute and chronic infection, mucus secretion and quality of life, as well as the causes and therapy for squamous metaplasia and goblet cell hyperplasia. We are investigating the mechanisms of immune tolerance and immune adaptation in the airway, and we have developed tools to differentiate immunomodulatory therapies from those that are immunosuppressive. We develop new therapies and carry them through testing, from cell and tissue cultures to animal studies to clinical trials.
Excessive mucus secretion and decreased clearance is characteristic of diseases like asthma, COPD, cystic fibrosis, middle lobe syndrome, ventilator-associated tracheitis and pneumonia. We study the mechanisms of mucus secretion and clearance and have developed unique tools to characterize the biophysical and transport properties of mucus and to evaluate new therapies.
Nasal and sinus disease
We have studied the physical and transport properties of mucus and sputum for three decades. We have formed a sino-nasal research group with investigators from the Rubin lab and scientists and clinicians from the departments of Otolaryngology – Head and Neck Surgery , Radiology , Critical Care, Emergency Medicine , the divisions of Critical Care and Rheumatology, Allergy and Immunology , and the schools of Nursing and Engineering to develop new ways to measure the impact of sinus disease and test new therapies including novel aerosol delivery systems. In our first 18 months as a group, we have been awarded three investigator-initiated research grants to study sinus disease.
We have taken a keen interest in understanding the mechanisms behind the devastating airway disease called plastic bronchitis. In this disease, the airways completely fill with rigid mucus casts that occlude the airway. We developed and published the classification system for PB that is now widely used. We have developed novel techniques to analyze the polymer structure of these casts.
We also have initiated research projects to help us understand why this disease is diagnosed most commonly in persons with three completely different underlying disease mechanisms: post-congenital heart surgery with Fontan physiology, severe asthma and sickle cell disease acute chest syndrome.
Most reports of this disease are single-case reports making it difficult to understand the natural history, disease associations and response to therapy. We have established the International Plastic Bronchitis Registry, to collect clinical and demographic data on patients with plastic bronchitis along with, in many cases, their expectorated airways casts. This research has led to new understanding of related disorders, specifically near-fatal asthma.