Research

1. Clinical Research
2. Basic Science Research
3. Publications

The Centre for Lung Health team is multi disciplinary and the investigators are involved in multiple areas of research. The major lung health research interests at the VCHRI Pulmonary and Critical Care Research Program are respiratory sleep and neuromuscular disease, environmental and occupational lung disease, lung cancer, tuberculosis and a broad program of clinical research in asthma, COPD, interstitial lung disease and pulmonary hypertension. An emerging program of research in respiratory health outcomes in these different disease categories is also being developed in collaboration with the Centre for Clinical Epidemiology and Evaluation  at VGH and Centre for Health Evaluation Outcomes Sciences at St.Paul's Hospital (CHEOS) and there are substantial strengths in epidemiology and translational research at both Centres. The iCapture Centre at St. Paul's was created with CFI funds to examine how abnormal genes change the structure and function of cells, tissues and organs to cause lung disease. The prevention and early diagnosis of lung cancer is the primary research focus at the Vancouver Cancer Centre and research into tuberculosis and mycobacterial disease is the major interest at the BC Centre for Disease Control. Research in lung transplantation takes place at both Vancouver Acute and the BC Transplant Society. Finally, there is a established research link with Critical Care Medicine, and members are now holders of a joint Michael Smith Foundation grant on patient safety in Critical Care Units.

Clinical Research

The Centre for Lung Health has a comprehensive clinical research program. Areas of focus include: asthma, COPD, bronchiectasis, pulmonary hypertension, interstitial lung disease, cystic fibrosis, tuberculosis, sleep disordered breathing and lung cancer. These research programs are directed by very successful clinician scientists.  Many faculty members are trained in clinical epidemiology. There are multiple phase 2 -4 drug and device trials completed each year. The Centre closely collaborates with the Centre for Clinical Epidemiology and Evaluation (C2E2) at Vancouver Coastal Health Research Institute, the Centre for Applied Health Research (CAHR) at Children's Hospital and Centre for Health Evaluation Outcomes Sciences (CHEOS) at St. Paul's Hospital. These clinical epidemiology units are staffed by experience biostatisticians, methodologists, health economists and data managers. Dr. FitzGerald has obtained funding for a web based data capture system, in his capacity, as founding chair of the Canadian Respiratory Clinical Research Consortium,http://www.crcrc.ca/

Basic Science Research

COPD (Theme Leader-Sin)

• Gender relation to COPD and lung cancer
• Gender relation to systemic inflammation.
• Systemic inflammation and blood and BAL biomarkers using proteomics.
• Novel therapeutics to these biomarkers and other components using proteomics.

Asthma, Cystic Fibrosis, COPD and Cardiovascular Disorder Degenerative Aortic Valve Stenosis (AVS)  (Theme leader: Pare, Knight)

• Genetics, epigenetics, and environmental interactions in the pathogenesis of chronic inflammatory disease of the heart and lungs.
• Grow cells, examine DNA for polymorphisms and epigenetic modification, measure mRNA using real time PCR and microarray and measure the amount and distribution of protein using proteomic and immunohistochemistry techniques from bio banked samples.
• Single gene disorders and linkage studies of families and sibling pairs, candidate genes.
• Common single nucleotide polymorphisms (SNPs) in genes involved in the inflammatory and repair responses genotyping.
• Detailed knowledge of the patients' environment to test for gene X environment interaction.

Tuberculosis, lung infection and immunity (Theme leaders: Basic science- Eltis and Turvey; Clinical and epidemiological Cook)

• CCFF-funded basic science program investigating Inflammation in CF with the ultimate goal of developing novel anti-inflammatory therapies for CF that will augment current treatment focused on antimicrobials and airway clearance.
•  Novel new candidate antibiotics for TB as there is concern re the emergence of extreme as well as multiple drug resistant TB.
•  Multiple clinical trials and epidemiological studies in TB
•  Interaction of HIV and TB.
•  Mortality, risk factors for recurrence and social networking in TB.
•  Evaluating quality of life and economic outcomes in TB.

Lung cancer: (Theme leader: Lam)

• Pioneering work in developing new and novel techniques for the detection of lung cancer.
• Comprehensive strategy to improve the survivorship as well as the quality of life of lung cancer patients.
• A lung cancer risk prediction model that incorporates socio-demographic factors, clinical data and biomarkers for validation in prospective clinical trial.
• Prgnostic DNA signatures to determine if patients with resectable lung cancer require adjuvant chemotherapy.
• Identification of chemo-resistance pathways by integration of DNA copy, number changes, methylation and gene expression profiles.
• Study of pathogenesis of lung cancer in former and non-smokers, development and testing of agents to reduce lung cancer risk.
• Lung cancer risk in women.

Sleep disordered breathing (Theme leaders: Fleetham, Ayas)

The UBC sleep program provides regional clinical care for sleep disordered breathing  and the sleep program under the leadership of Drs Fleetham and Ayas is involved in various research projects.

• MSFHR funded Sleep registry -includes clinical data, linkage to provincial DBs, biobanking etc.
• Sleep disease and health economics studies.
• Sleep disease and cardiovascular risk studies.
• RCTs using CPAP machines.
• Polysomnogram vs CPAP in ambulatory care.
• Chronic hypoxia and inflammatory markers studies.
• Sleep apnea and ARTISYNTH studies.

Environment and lung health (Theme leader: Brauer)

1.  Health impacts of exposure to air pollution.

• Air pollution from such sources as traffic, forest fires and residential wood combustion.
• Personal and micro-environmental monitoring, land use regression modeling, and the use of satellite imagery in combination with Geographic Information Systems.
• Administrative health data, surveys and measurements of sub-clinical effects,
• Links between air pollution and the development of asthma in children, respiratory and middle ear infections, birth outcomes and adult cardiovascular disease.

2. Bio-erosol research, i.e., airborne exposures to microorganisms.

• Discover the environmental niche and document airborne transmission of the pathogenic yeast, Cryptococcus gattii, which is the cause of an ongoing epidemic in coastal BC.
• Study of microbial growth on building materials, vital for understanding the release of bio-aerosols in indoor air.

3. Occupational lung diseases

• ‘Gassings' contribution to asthma.
• Exposures to dusts from wood and grain.
• Exposure to cobalt during saw filing.
• Linked administrative databases to investigate the association between asthma rates and work characteristics in order to identify high-risk groups and target prevention activities.
• Occupational lung cancer-exposure to workplace and environmental carcinogens and cancer risk in the Canadian population.

4. Exposure assessment

• Empirical models to understand factors associated with increased and decreased exposure levels epidemiological studies in the community and workplace environments.

5. Diesel fume exposure and the risk of asthma.

Clinical research and health outcomes (Theme leaders:FitzGerald and Marra)

• Evaluating health outcomes in asthma, sleep, tuberculosis, pulmonary hypertension.
• Staging lung cancer.
• Web based data capture system for respiratory clinical research.
• Number of clinical trials in asthma, COPD, ILDs, PHT, TBs etc.

Acute lung injury (Theme Leaders: Dr Walley, and Russell)

• Haplotypes of susceptibility genes in cardiac, pulmonary and vascular disease.
• Translational research studies examining the association of genotype with phenotype in SIRS in the critically ill, SIRS after cardiopulmonary bypass, in ARDS and in acute lung injury.
• Cardiac dysfunction in sepsis, pathophysiology of oxygen uptake in sepsis.
• Pathophysiology of cardiovascular dysfunction in acute respiratory failure.
• Genetic determinants of neurocognitive function after cardiopulmonary bypass surgery.
• Association of genotype with phenotype and in clinical trials investigating the use of vasopressin in septic shock.
• SNP's and haplotypes of key inflammatory and innate immunity genes with a focus initially on refining the clinical phenotypes of organ dysfunction in the critically ill.
• Gene association studies of candidate genetic markers (specific haplotypes and single nucleotide polymorphisms (SNPs)) of protein C, IL-6, IL-10 and fibrinogen with increased risk of death.
• Genetic variants of key innate immune genes CD14, MBL, TLR-2 VS severe infections (sepsis). genes in: (1) critically ill ICU patients who have SIRS, sepsis, and septic shock and (2) cardiovascular surgery patients.
• Clinical trials in -ibuprofen in sepsis (NIH grant-funded), antioxidants in ARDS and in sepsis, interleukin-1 receptor antagonist in sepsis, endotracheal tobramycin in pneumonia, anti-tumor necrosis factor in sepsis, interleukin-10 in ARDS, tissue factor pathway inhibitor, vasopressin in septic shock and activated protein C in sepsis.
• Animal model studies of vasopressin for septic shock.

For 2007 and selected 2008 publications please click here.