What are systems-based approaches to better define disease endotypes and develop more effective therapies, especially in multiple chronic conditions?

Many lung diseases (IPF, COPD) are characterized by marked heterogeneity at the tissue level. Unfortunately, most of the tools we currently employ to understand lung disease are unable to elucidate the mechanisms that result in regional heterogeneity. Clinical studies and animal models, while invaluable, generally assume that all lung tissue is similarly affected based on the presence or absence of diagnostic criteria... more »

Research in sickle cell disease (SCD) has mostly focused on preventing or treating acute medical events, such as vaso-occlusive pain, acute chest syndrome, and, in pediatric patients, acute strokes. Chronic SCD complications such as chronic kidney disease or pulmonary hypertension, develop over decades, thus are poor choices for clinical trial endpoints. There is a great need to develop surrogate endpoints that predict... more »

What is the relationship between exacerbations and progression of chronic lung diseases?

There are many significant questions in CVD prevention that cross the disciplines represented by the different institutes. For example, the obesity epidemic, poor nutrition, and physical inactivity are relevant to CVD, neurological disease, diabetes, and cancer. Tobacco use is directly relevant to cancer and CVD. Social determinants and disparities affect multiple diseases and outcomes. Reducing obesity will require interventions... more »

How can guideline recommendations be implemented into community practice in a way that is feasible, usable, relevant, and cost-effective? (examples are use of care management, translation of chronic care model, and EMR based tools)

How should providers coordinate management strategies and treatment goals in patients with COPD and other co-existing chronic diseases?

There is a need to build a robust coordinated surveillance system on the incidence and prevalence of chronic diseases. Surveillance data are needed to:

•Describe and monitor the burden, trends, and patterns of these diseases

•Set parameters and metrics of research priorities

•Identify where to target resources for prevention, treatment, and delivery of care

•Track and monitor progress toward public health disease... more »

There are various reasons responsible for patients’ non-adherence. One of them is insufficient or lack of education about medications and equipment required for their treatment.

There are diverse diseases that share similar features. For example, many chronic airways diseases (chronic aspiration, ciliary dyskinesia, some COPD) "phenocopy" cystic fibrosis in terms of infectious agents, mucus clearance problems, progressive loss of lung function, etc. Use multiplatform "omics" approaches and Big Data bioinformatics to identify common nodes for therapeutic targeting. Other examples: emphysema and... more »

With the advent of HAART HIV-infected subjects are living longer. Lung infectious complications so common in the early stages of the HIV epidemic have been replaced by those associated with chronic inflammation (COPD, pulmonary hypertension, lung cancer). Furthermore, this chronic inflammation is likely contributing to premature vascular complications (i.e coronary disease) seen in this population. All of these complications... more »

Patients with chronic kidney disease (CKD) have an extremely high risk of death from cardiovascular cause. The prognosis of patients with chronic kidney disease who also have coronary artery disease is worse than certain cancer. While great strides have been made to create awareness about breast cancer, there is paucity of knowledge about the cardiovascular risk of CKD patients among both physicians and patients. Moreover,... more »

Chronic Kidney Disease (CKD) affects millions in the US, and is one of the new diseases on the rise globally. New therapies to slow CKD and to repair and regenerate failing kidneys are drastically needed to reduce health care costs and improve lives.

Examine the mechanisms of POTS and develop effective treatments.