The Section of Pediatric Pulmonology, Allergy and Sleep Medicine is involved in basic, translational and clinical research. Mentorship of fellows is a top priority for the Section and the faculty has extensive expertise in helping fellows achieve research goals. Specific areas of interest within the Section include cystic fibrosis, asthma and allergic diseases, bronchopulmonary dysplasia and specialized physiologic testing. The Section has successfully been awarded funding from the NIH, Cystic Fibrosis Foundation, and ALA.
The Department of Pediatrics at Riley Hospital for Children at Indiana University Health has consistently ranked in the top 8 – 10% of all pediatric departments for NIH funding for the last decade. Our research environment is strong, enhanced by the Herman B. Wells Center for Pediatric Research and the recently developed Pediatric Translational Research Center located within the hospital. In addition, the Section of Pediatric Pulmonology, Allergy and Sleep Medicine at Riley Hospital for Children has a history of participating in NIH sponsored studies including those that are investigator initiated as well as studies that are part of large networks. The Section consists of 21 faculty members: 14 Pediatric Pulmonologists, 2 Allergists and 5 Ph.D. scientists. Dr. Stephanie Davis serves as the Director of the Section.
The Herman B Wells Center for Pediatric Research
The Herman B Wells Center for Pediatric Research conducts basic science and translational research within the Department of Pediatrics, offering opportunities for collaborations between basic scientists, translational scientists and physicians. There are 34 investigators and 230 staff members within this center. There are several specific areas of interest including asthma and allergic diseases. Five of these investigators are part of the Pediatric Pulmonology, Allergy and Sleep Medicine Section. Mark Kaplan, PhD., Professor of Pediatrics and Microbiology and Immunology and Basic Science Director of Asthma and Allergic Diseases maintains a basic science laboratory and has successfully led this group for several years. This program is exploring the pathogenesis and progression of allergic and asthma diseases. Early infant wheeze is another important focus as well as RSV bronchiolitis.
The Pediatric Translational Research Center
The Pediatric Translational Research Center is newly developed and includes bioinformatics, rooms for patient exams, a wet laboratory for processing of specimens, biobanking, freezer space and administrative/office space. Integration is part of this research center and Pediatric Pulmonology, Allergy and Sleep Medicine will have space in this area. Advanced diagnostics are also part of this area including genomic and proteomic work, cell phenotyping and mass spectrometry.
Section Leadership and Research
Dr. Stephanie Davis has extensive expertise in leading NIH sponsored research projects including large multicenter trials. She also has extensive expertise in evaluating outcome measures in children with lung disease. She has co-led three large multicenter trials in children with cystic fibrosis and has also led consensus groups that have established guidelines for infant and preschool lung function measurements. She currently serves as PI on three multi-PI NIH sponsored R01s; one that is evaluating early predictors of the bronchopulmonary dysplasia phenotype, another evaluating airway modeling of the upper airway in children and a recently awarded grant evaluating the viral etiology of early cystic fibrosis lung disease. Finally, she is one of three PIs that recently completed a NHLBI and Cystic Fibrosis Foundation funded 30 site study evaluating the efficacy of hypertonic saline in preschoolers with cystic fibrosis.
Allergic diseases are increasing in frequency in Western society and represent a significant health concern and are an area of research for this program. Atopic dermatitis, allergic skin inflammation or eczema, is often the first step on the allergic march, a series of allergic responses localized to the nares (allergic rhinitis), esophagus (eosinophilic esophagitis) and the airways (allergic asthma). The severity of these diseases can vary from mild annoyances to life-threatening illness. The overall goal of this research program is to understand the initiation, pathogenesis and progression of these allergic diseases in the hopes of identifying better ways to treat or prevent allergic symptoms. Research spans many areas from examining the regulation of genes important for the development of T cells involved in allergic inflammation, to the biology of cytokines and other factors that promote allergic disease, to examining lung development and function and how changes contribute to lung reactivity to allergens. Research involves animal models of allergic inflammation, as well as patient studies of infants and children with atopic dermatitis and developing airway disease. For detailed information about the types of research being conducted, see Pulmonary Inflammation/Asthma & Allergic Diseases in the Wells Center for Pediatric Research.
As asthma is characterized by airway hyper-responsiveness, our research program also evaluates novel mechanisms that can reduce airway smooth muscle contractility, as potential therapeutic interventions to treat patients with asthma. One approach has been to decrease airway smooth muscle contractility by applying mechanical strain to the airways, by the application of continuous positive airway pressure (CPAP), which decreases airway responsiveness. Another approach has been to inhibit p21-activated protein kinases (PAKs), which can inhibit airway smooth muscle contractility, as well as inhibit the atopic pulmonary inflammatory response, makes it a unique target in its potential to suppress both bronchoconstriction and allergic inflammatory responses.
Other Areas of Research
Lung growth and development is another important area of current research. Our laboratories have focused upon understanding the pulmonary pathophysiology of the lung disease that occurs following premature birth. Our research is also evaluating biomarkers associated with the pulmonary dysfunction that occurs following premature birth. In addition, we have a unique collaboration in Argentina, where we evaluate the effects of chronic hypoxia upon lung growth and development in infants living at very high altitude.
Another area of interest includes bronchopulmonary dysplasia (BPD). The Section works closely with neonatology to evaluate the natural history of this disease and to better understand early markers that define the BPD phenotype. Investigators within the Section participate in both single center and multi-center work; thereby, providing another opportunity for fellows. A strength of the Section is the ability to perform novel imaging and physiologic measurements in these young children with different types of lung disease. We believe that early lung disease likely tracks into adulthood; therefore, highlighting the importance of better understanding pathophysiology and potential therapeutic markers.
The Section participates in a number of research trials within the cystic fibrosis community and is part of the Therapeutic Development Network. In addition, investigator initiated trials evaluating early lung disease in cystic fibrosis is a priority and the Section has a long history of performing lung function testing in both infants and preschoolers. Some investigators within the Section specifically focus on cystic fibrosis and early pathogenesis. Many fellows choose to focus within this area and successfully obtain funding from the Cystic Fibrosis Foundation for these projects.