Thank you for participating!

Thank you to all who contributed to the National Heart, Lung, and Blood Institute (NHLBI) Strategic Visioning Forum. Ultimately, over 1,000 ideas were submitted, with more than 42,000 votes. This remarkable response exceeded expectations and provided a wealth of ideas to draw upon as NHLBI moves forward. Please visit the NHLBI Strategic Visioning page to find out more about the NHLBI Strategic Visioning process.


Welcome to the National Heart, Lung, and Blood Institute (NHLBI) Strategic Visioning Forum. The Institute is gathering ideas for the most compelling scientific priorities in the four NHLBI Strategic Goals to address over the next decade.

Goal 2: Reduce Human Disease

Pathobiology of Lung Fibrosis

End organ fibrosis accounts for up to 45% of deaths in developed countries. In particular, lung fibrosis is a devastating disease with poor prognosis. Despite development of two new drugs, their efficacy is still limited, highlighting the need to better understand the pathobiology that accounts for fibrotic disease progression in the presence and absence of acute exacerbation or infectious drivers.

Submitted by (@bmoore)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

A better understanding of the pathogenesis of lung fibrosis may uncover new targets for therapy or identify biomarkers of disease progression.

Feasibility and challenges of addressing this CQ or CC :

Approaches should include new and established animal models and experiments utilizing patient-based samples and novel mullti-center clinical trials. Ancillary studies should accompany any clinical trial to provide biologic insight into treatment responses and failures.

Name of idea submitter and other team members who worked on this idea : Beth Moore

Voting

19 net votes
30 up votes
11 down votes
Active

Goal 1: Promote Human Health

Evaluation of large-scale regulatory efforts in the US and elsewhere

A number of cities(e.g Berkeley), states and countries (e.g Mexico's SSB tax, Chiles SSB and soon marketing controls and food package front of package label) will go into effect. Rigorous evaluations of the efforts will provide some sense of their potential to effect food purchase and dietary pattern and ultimately cardiometaboiic changes. Serious rigorous independent evaluations are needed to learn if these options--pushed ...more »

Submitted by (@popkin)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

We must learn what we can from the natural experiments not only in the US but globally about both the effects of these efforts on food industry behavior as well as household and individual food purchases and dietary patterns and subsequently their effects on obesity and key cardiometabolic outcomes. This requires serious rigorous teams of scholars to utilize a combination of commercial data sets on food purchases, individual diet, body composition measures of obesity and fat composition and biomarkers.

Feasibility and challenges of addressing this CQ or CC :

These efforts are occurring and will be accelerating across many countries in Asia and Latin America. At the same time many cities or states in the US are moving to implement limited sets of key changes. There is a pressing need to learn if these efforts truly will matter and what changes would be needed to enhance their impact, if any. Finding large-scale regulatory ways to reduce improve our diets, prevent/reduce the prevalence of obesity and all the diet and obesity-related NCD's is critical.

Name of idea submitter and other team members who worked on this idea : Barry Popkin

Voting

22 net votes
42 up votes
20 down votes
Active

Goal 2: Reduce Human Disease

Redox regulation of cardiovascular and lung disease through thiols

Redox imbalance as represented by alterations in oxidative versus reductive stresses are well appreciated to occur during nearly all forms of cardiovascular and lung diseases. However, specific molecular mechanisms responsible for these changes remain largely unknown and poorly organized. Study of redox biology principals has revealed that protein cysteine thiols are a unique target for redox posttranslational modifications ...more »

Submitted by (@ckevil)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Details on the impact of addressing this CQ or CC :

Protein cysteine thiols are recognized to be important for multiple signaling and cell biology functions due to unique properties of oxidation/reduction resulting in a 'thiol switch'. However, oxidative modifications of thiols are highly complex involving nitrosation, sulfhydration, sulfenylation, and glutathiolyation among many others. It has become increasingly clear that these posttranslational modifications are associated with cardiovascular and pulmonary pathophysiology. Yet, many important questions remain such as: how these thiol modifications occur during disease and differ from health? How do these thiol switches impact protein function involved in cellular pathophysiology? And can thiol switch manipulation be exploited for therapeutic purposes to maintain cellular and organ health or treat disease? In order to begin to answer these questions, careful and comprehensive investigations are required to understand thiol-switching principals employing a host of molecular, biochemical and pathophysiological approaches.

Feasibility and challenges of addressing this CQ or CC :

Given the significant advances in quantitative analytical chemical and molecular techniques, molecular redox mediators and pathways, non-invasive imagine modalities and comprehensive translational study designs; multiple fields are uniquely poised that could provide significant insight into this critical challenge. Primary objectives would be to establish consensus analytical methodologies, chemical and molecular biology approaches, and cellular and animal models in conjunction with rigorous clinical investigations. Results from efforts at understanding the importance of ‘thiol switches’ will make significant clinical impact on cardiovascular and lung pathogenesis and would feasibly be accomplished in 5-10 years.

Voting

-5 net votes
5 up votes
10 down votes
Active

Goal 1: Promote Human Health

Trans-kingdom regulation of HLBS systems

What is the interplay of the micro- and macroenvironment and their effect on gene and protein expression and overall effect on phenotypes in HLBS systems?

 

Need for unbiased approaches for information capture. Technologies for capturing real time, dynamic and contextual information

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

Increase and gain novel understanding of heart, lung, and blood physiologic systems

Feasibility and challenges of addressing this CQ or CC :

Emerging technologies, databases and merging of disciplines in the context of big data has the potential to make this feasible in the next 5-10 years

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

Voting

-6 net votes
3 up votes
9 down votes
Active

Goal 2: Reduce Human Disease

Hosting International Studies on Rare Diseases

A programmatic initiative that would transform the NHLBI for rare diseases is to host some international studies.

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Details on the impact of addressing this CQ or CC :

The rest of the world is far ahead of the US in Registry science (e.g.. OrphaNet). To take a very rare disease (e.g.. Bechet’s pulmonary aneurysms, or hypocomplementemic urticarial vasculitis associated COPD) and establish an RFA to blend an international Registry with capability for hosting a clinical trial, and 3 years later an RFA to use the biorepository for proof of principal studies and a clinical trial would accelerate the international science agenda to a degree that might be unimaginable. Once established for 1 disease, the infrastructure should be kept intact for other diseases.

Name of idea submitter and other team members who worked on this idea : ATS Member

Voting

2 net votes
2 up votes
0 down votes
Active

Goal 3: Advance Translational Research

More involvement of patients and patient advocates in the process of research

More involvement of patients and patient advocates in the process of research at the NHLBI should be encouraged.

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Name of idea submitter and other team members who worked on this idea : Research Advocacy Committee, American Thoracic Society

Voting

1 net vote
1 up votes
0 down votes
Active

Goal 2: Reduce Human Disease

Clinical trials of AAT augmentation therapy

Alpha-1 antitrypsin augmentation therapy is widely used for PI ZZ subjects, but randomized clinical trials of AAT augmentation therapy have not been adequately powered to assess the efficacy of this treatment. A clinical trial using COPD exacerbation frequency as the primary outcome, rather than decline in lung function, in PI ZZ subjects with moderate-to-severe COPD could provide definitive evidence for the utility of ...more »

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Name of idea submitter and other team members who worked on this idea : American Thoracic Society member

Voting

1 net vote
1 up votes
0 down votes
Active

Goal 2: Reduce Human Disease

Cardiac Arrhythmia Factors

What are the genetic and neurohormonal factors associated with cardiac arrthymias, and how might these factors be controlled to reduce arrhythmia incidence? How do we identify patients who are at imminent risk of arrhythmic death?

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

Voting

9 net votes
23 up votes
14 down votes
Active

Goal 3: Advance Translational Research

Unconventional beliefs and negative attitudes to 'smart' asthma therapy

Systematically examine the contribution of unconventional beliefs and negative attitudes to inadequate clinical outcomes for asthma.

 

Budesonide/fomoterol controller/reliever therapy ('smart' therapy) in large US studies - adults

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Name of idea submitter and other team members who worked on this idea : American Thoracic Society member

Voting

1 net vote
1 up votes
0 down votes
Active

Goal 2: Reduce Human Disease

COPD exacerbations

COPD exacerbations

a. Better tools for early recognition

b. More research in self-management and communications technology to assist patients

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Name of idea submitter and other team members who worked on this idea : American Thoracic Society member

Voting

3 net votes
3 up votes
0 down votes
Active

Goal 3: Advance Translational Research

Research Opportunities in HLB to Facilitate Aging in Place

There is a need for greater evidence-based research over the next 5-10 years to reduce healthcare costs, reduce hospitalizations, and support older persons with significant heart, lung, blood, sleep conditions to remain in their private homes if feasible, if technology is utilized that fosters clinical and epidemiologic research.

Submitted by (@nhlbiforumadministrator1)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Details on the impact of addressing this CQ or CC :

No other force will have as big of an impact on our health system as the unalterable rate of our aging population and subsequent increased rate of heart, lung and blood diseases. The impact of doing nothing is unforeseeable.

Feasibility and challenges of addressing this CQ or CC :

Evidence-based research over the next 5-10 years to reduce healthcare costs, reduce hospitalizations, and support older persons with significant heart, lung and blood conditions remain in their private homes is feasible if technology is utilized that fosters clinical and epidemiologic research.

Many cardiovascular risk factors increase as the population ages including uncontrolled systolic hypertension and atherosclerosis both contributing to the well-being of our society and increasingly high health care costs (Izzo, Levy, & Black, 2012). No other force will have as big of an impact on our health system as the unalterable rate of our aging population and subsequent increased rate of heart, lung and blood diseases. The impact of doing nothing is unforeseeable.

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

Voting

17 net votes
35 up votes
18 down votes
Active

Goal 3: Advance Translational Research

Identification of autoantigens that elicit pathogenic immune responses in cardiovascular diseases

Pathogenic immune responses participate in the pathogenesis of many cardiovascular diseases. However, the autoantigens and foreign antigens that elicit the pathogenic immune responses have been poorly identified. Currently, the regulatory mechanisms on immune responses associated with diseases got some attentions. But, without detailed characterizations of this wide spectrum of autoantigens and foreign antigens in patients ...more »

Submitted by (@xfyang)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Feasibility and challenges of addressing this CQ or CC :

1) use peptide/protein based microarray to antibody autoimmune responses associated with each major cardiovascular diseases;

2) use MHC tetra-mers or similar techniques to characterize T cell autoimmune responses associated with each major cardiovascular diseases;

3) determine autoantigen repertoire changes in patients' responses to current therapies, especially therapies with immune modulating effects;

4) develop autoantigens-based immune therapies for clinical trials

Name of idea submitter and other team members who worked on this idea : Professor Xiaofeng Yang, MD, PhD, Professor Hong Wang, MD, PhD, Professor Klaus Ley, MD

Voting

26 net votes
28 up votes
2 down votes
Active