Work in my laboratory aims to understand the molecular and cellular mechanisms underlying cell and whole organ dysfunction in response to pulmonary insults. This work emphasizes the functional interconnections between cellular metabolism and injury/repair mechanisms in various lung cell types including epithelium, endothelium and alveolar macrophages. We apply a broad range of experimental approaches to characterize changes in energy metabolism after acute (e.g., LPS, bleomycin, radiation) or chronic (e.g., obesity, alcohol ingestion) lung insults. We also aim to understand the influence that genetics, aging and environmental factors have on the ability of lung cells to metabolically adapt to, and recover from these insults. As a practicing physician, my overarching goals are to better understand the molecular mechanisms underlying the diseases that I see in clinic, including pulmonary fibrosis and the acute respiratory disease syndrome, and to identify new and more effective ways to treat these conditions.
Pulmonary Fibrosis is a metabolic disorder of the lung
Idiopathic pulmonary fibrosis (IPF) is a chronic lung disease that causes progressive scarring of the lung and usually leads to death within a few years of diagnosis. One major risk factor for the development of IPF is advanced age and this believed to contribute to disease by comprising the ability of lung epithelial cells to regenerate after injury. In my lab, we study how aging affects the ability of the lung epithelium to metabolically adapt to pulmonary insults. We and others have shown that the aging epithelium does not properly divert nutrients/energy to areas of the cell in greatest need after injury, leading to persistent cellular damage that ultimately drives cells toward either an apoptotic or cellular senescence phenotype. Studies in my lab aim to understand how young cells metabolically adapt to injury so as to better understand how aging compromises these responses. Our hope is that by better understanding responses in young cells we can develop novel treatment approaches for age-related diseases like IPF.
Antifibrotic therapies for the treatment of pulmonary fibrosis
Pulmonary fibrosis is not a single disease but rather a group of conditions that cause scarring of the lung. Because collagen I-rich fibrils comprise the majority of all pulmonary scars, we are testing whether blocking a key step in type collagen I production is effective in limiting the progression of scar tissue in pulmonary fibrosis. The novel biological that is being tested was developed by Dr. Fertala at Thomas Jefferson University and works by blocking one of the earliest steps in the formation of collagen fibrils. Our pilot and published data indicate that this antibody not only binds to its intended target in the lung but also exhibits limited side effects. In ongoing studies, we are applying this antibody to the treatment pulmonary fibrosis using several animal models of disease and we are testing whether this therapy works synergistically with other clinically-relevant benchmark drugs. Because the target we have identified is identical in mice and humans, this therapy has real potential to help patients.