Respiratory Physiology and Sleep Disorders
The Bellevue Pulmonary Function Laboratory has an active research program in ventilatory control, respiratory failure, and obesity hypoventilation syndrome. State-of-the-art techniques and imaging modalities are being used to investigate the involvement of small airways in obstructive lung diseases. Clinical trials of enzyme replacement and gene therapy are being developed to address respiratory failure due to acid maltase de?ciency (glycogen storage disease). Current investigations at the Sleep Disorders Center include treatment modalities for sleep disorders and the use of computer technologies to score and interpret polysomnography studies.
Tuberculosis
Recent clinical investigations have focused on techniques to enhance the host response to infection with tuberculosis, including the use of targeted delivery of interferon-gamma. The division continues to conduct extensive studies on the expression of cytokines and genes during infection with M. tuberculosis. Many of these studies have focused on site-speci?c immune responses using techniques of bronchoalveolar lavage. Other research areas include studies of the immune response to evaluate vaccine candidates, of the effect of co-infection with tuberculosis and HIV, and of transcription factors, such as C/EBP beta that control HIV replication. The division is also collaborating with the University of Cape Town in South Africa on studies of the mechanisms and treatment of combined HIV/tuberculosis co-infection.
Lung Cancer
The division directs the NYU Lung Cancer Biomarker Center in collaboration with the Departments of Radiology and Environmental Medicine. Screening studies to detect early-stage lung cancer in high-risk populations are being performed using helical CT scans and ?uorescence bronchoscopy. Investigations are under way to evaluate p53 DNA adducts, methylation, and mutations using GeneChip microarray technology in bronchial epithelial cells derived from smokers. Transgenic murine models are being used to model potential cancer gene mutations in the lung and to develop prevention strategies. Also under way are basic and clinical studies of adenoviral gene therapy as well as basic science research to target lung cancer and induce selective apoptosis.
Asthma
In collaboration with the Department of Environmental Medicine, the Pulmonary Medicine Division is conducting epidemiologic studies based on information provided by the Bellevue Hospital Asthma Clinic. An integral part of the American Lung Association Asthma Clinical Research Centers, Bellevue's Asthma Clinic serves as a clinical core for studies in particulate-matter pollution and asthma. A gene-banking program has been developed to study disease-modifying genes in asthma. Other areas of investigation include the role of environmental pollutants in the mucosal immune response in asthma and the use of human bronchial epithelial cells to study signaling pathways, gene transcription, and effector pathways to elicit dendritic cell and lymphocyte involvement. These studies have been funded by the National Institutes of Health, the Centers for Disease Control and Prevention, the American Lung Association, the Stony-Wold Herbert Foundation, the Chest Foundation, and the Colton Family Foundation.
Occupational and Environmental Lung Disease
Investigators from the NYU Division of Pulmonary and Critical Care Medicine implemented many of the studies that assessed the respiratory health of ?re?ghters who responded to the destruction of the World Trade Center, the workers who cleaned the surrounding area, and residents who lived near the site. Other investigations currently under way include a large-scale screening study of a cohort of asbestos-exposed workers monitored with high-resolution CT scans; the use of an inhalation model of silicosis in transgenic mice to study the mechanisms of lung damage, including the pathways of apoptosis; the use of transgenic mice to study the mechanisms of TGF-beta-activation in environmentally induced lung diseases, including radiation injury; the use of human lung cells obtained through bronchoalveolar lavage to study growth factors released in response to environmental exposures; and clinical trials of anti-?brotic therapy. These studies have been funded by the National Institutes of Health and the U.S. Army. The division is also developing an Environmental Lung Health Center in collaboration with Bellevue Hospital Center and NYU School of Medicine.
Critical Care
The research program in Critical Care at Tisch and Bellevue hospitals focuses on clinical and basic science research. Currently under way are clinical trials of new agents for treating and monitoring Adult Respiratory Distress Syndrome (ARDS); evaluations of new methods to ventilate and treat respiratory failure; and studies of in?ammatory chemokine and cytokine gene and protein expression in sepsis, using transgenic murine models. These investigations are funded by the National Institutes of Health.