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Multifaceted approach to respiratory disease

Physician-scientists at Washington University School of Medicine are seeking better treatments for patients with respiratory diseases

November 26, 2012

Division of Pulmonary and Critical Care Medicine is using a multidisciplinary approach to identify new therapeutics for respiratory disease.

Headed by Michael Holtzman, MD, division chief and pulmonary specialist at Barnes-Jewish Hospital, this academic drug discovery (ADD) program is identifying new drugs using a fully automated and robotically controlled high-throughput screening system with specialized capabilities for work on viruses and lung cells. The program also includes new medicinal chemistry, protein chemistry-structure, and pharmacology labs.

Altering the course of respiratory illness

The overall approach will help to identify therapeutics likely to affect the course of respiratory illnesses such as influenza, asthma and chronic obstructive pulmonary disease (COPD), a group of lung diseases that blocks the airway and makes it hard to breathe.

One project aims to find compounds that enhance the body’s natural virus-killing mechanisms by modifying a signaling pathway to overcome a broad range of respiratory viruses. Another project seeks to develop small molecules that control overproduction of airway mucus, a major clinical target in respiratory illnesses such as asthma, COPD, cystic fibrosis and even the common cold. A third project is concentrating on new anti-inflammatory therapeutics that would more fully correct the underlying abnormality in asthma and COPD.

In addition to these studies, Roger Yusen, MD, is a lead investigator in a multi-center study sponsored by the National Heart, Lung, and Blood Institute to find out whether oxygen therapy earlier in the course of COPD will help patients stay out of the hospital, live longer, and have a better quality of life. Yusen also leads a team treating severe emphysema and COPD.

This group runs Washington University’s lung-volume reduction surgery program at Barnes-Jewish Hospital, which was recently recertified with the Joint Commission’s Gold Seal of ApprovalTM for meeting the highest standards of care.

All of these studies are conducted in collaboration with the lung-imaging group. One of the leaders in this area, radiologist David Gierada, MD, has refined ways to more reliably measure changes in the lungs due to a variety of respiratory conditions. Methods under ongoing study include low dose CT scans to reduce radiation exposure when quantifying abnormalities in COPD, and MRI scans using helium as a contrast agent.