Showing 77 ideas for tag "lung"

Goal 1: Promote Human Health

Lung Anatomy and Environmental Exposure

How does human lung anatomical structure (e.g., angles of branch points, luminal diameter, etc.) affect exposure to environmental factors?

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

-5 net votes
6 up votes
11 down votes
Active

Goal 2: Reduce Human Disease

Can transcutaneous carboxyhemoglobin measure endogenous heme oxygenase activity?

Non-invasive measurement of transcutaneous carboxyhemoglobin (SpCO) by CO-oximetry has been shown to reflect disease activity in asthma, allergic rhinitis, Staphylococcal pneumonia/sepsis and to correlate positively with lung function in cystic fibrosis. Given published studies of heme oxygenase activity in these diseases as a reflection of oxidant or inflammatory activity, does measurement of SpCO reflect endogenous... more »

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

Details on the impact of addressing this CQ or CC

Laboratory measurement of heme oxygenase activity in inflammatory and states of oxidative activity in multiple disease states, lung diseases for instance, has become important in measuring disease severity and activity as well as being an indicator of disease modification by gene polymorphisms of heme oxygenase. The simple measurement of transcutaneous carboxyhemoglobin if correlated with heme oxygenase activity would provide a ready assessment for clinicians in the clinical setting.

Feasibility and challenges of addressing this CQ or CC

In a setting in which heme oxygenase activity is measured and clinical patients of varying diseases are available, this question could be answered reasonably easily without technical difficulty.

Name of idea submitter and other team members who worked on this idea Lawrence E. Kurlandsky, MD

Voting

-24 net votes
1 up votes
25 down votes
Active

Goal 1: Promote Human Health

Environmental Exposures and Atopic Disease trending idea

As the current chair of the Research and Training Division, I would like to convey that the AAAAI membership would like the NHLBI to consider the following in the development of its strategic plan:

 

What are the molecular and cellular responses in the lung that occur after environmental stimuli (including allergens) that predict homeostatic resilience or transition to atopic diseases?

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 Mitchell Grayson on behalf of the American Academy of Allergy, Asthma, and Immunology

Voting

-7 net votes
8 up votes
15 down votes
Active

Goal 2: Reduce Human Disease

Persistent Burden of HIV Infection on Lung Health in the U.S. and Globally

Despite the advent of HAART the lung and vascular compartment continue to bear the brunt of complications associated with HIV infection. Potential causes include the establishment of HIV latency in the lung, inability of current therapeutic agents to treat latent reservoirs, inadequate immune reconstitution in the lung, and persistent impairment of normal lung homeostasis after treatment (i.e. persistent alterations... more »

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

Details on the impact of addressing this CQ or CC

Lung disease remains a major contributor to HIV morbidity in the HAART era. In fact, the lung continues to bear the burden of chronic HIV complications. The cause of this is likely multifactorial, including:

  1. Persistence of HIV reservoirs. The lung is populated by long lived cells which makes them uniquely situated to serving as reservoirs. A better understanding of viral latency in the lung is needed.

  2. Inadequate immune reconstitution. This can lead to persistent increased risk to chronic infections and poor tumor surveillance. It is well recognized that earlier initiation of antiretroviral therapy, rather than waiting till immune exhaustion, leads to better immune reconstitution. Thus to improve lung immune reconstitution will need better approaches to diagnosing HIV early. Furthermore, studies are needed to better define when adequate lung immune reconstitution has occurred.

  3. Persistent abnormalities in normal lung homeostasis. Despite the absence of detectable replicating HIV in the lung there appears to be persistent alterations in the lung inflammatory state. Abnormalities in the lung microbiome and virome could also remain. Lastly, risk factors that may have contributed to HIV infection and lung disease in the first place (i.e. smoking, IVDU) persist in patients on therapy. Contributions of these risk factors towards lung disease in the HIV-infected population are sorely needed.

Feasibility and challenges of addressing this CQ or CC

Given the continued large burden of the HIV population in the U.S. and globally these studies are certainly feasible. One of the biggest challenges will be the identification of an appropriate control nonHIV-infected cohort that shares the same risk factors (i.e. smoking, IVDU) as the HIV-infected population. Historically this has been problematic given the known demographic differences in the HIV population (i.e. increased prevalence of smoking, greater male to female ratio, differences in other HIV risk factors). The second major challenge is the recognition that the new spectrum of lung complications in HIV-infection are chronic in nature and thus will require long term longitudinal studies to adequately assess the critical questions raised here. Finally, it must be recognized that the greatest burden of HIV infection lies outside our borders in third world countries. In addition to the high prevalence of HIV infection in these regions, the major infections complications, which have been largely controlled in the U.S. through early antiretroviral therapy, continue to play a major role in HIV morbidity and mortality. Thus one cannot forget that first and foremost untreated HIV infection leads to profound immunosuppression with an associated increased risk of usual and opportunistic infections.

Name of idea submitter and other team members who worked on this idea Homer L. Twigg III on behalf of the INHALD Consortium

Voting

-14 net votes
8 up votes
22 down votes
Active

Goal 2: Reduce Human Disease

Impact of Successive Acute Lung Injury on Subsequent Challenge

A great deal of focus has been placed on understanding chronic lung diseases such as asthma and CF. Long term changes in inflammatory and epithelial processes are well documented in this area. However, less research has addressed the impact of successive pulmonary injuries and how these seemingly acute events shape the lung response. This is the crux of the multi-hit theory regarding interstitial lung disease. Many acute... more »

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

Details on the impact of addressing this CQ or CC

While chronic lung disease has been an important focus, the impact of multiple acute injuries, be it pathogen, environmental, or other, on the lung over a lifetime is largely unknown. It is likely that early life infections and exposures robustly alter later life immunity and lung injury. There is greater impact to be considered if expanded to the context of polymicrobial infections which would reflect "real-world" situations. Lessons that we have learned from disease like CF should instruct us to consider pathogen-pathogen interactions, in addition to distal events that were sent in motion by prior lung injury.

Feasibility and challenges of addressing this CQ or CC

This question is difficult to model due to the temporal framing of acute events. However, it is clear that even one acute infection can significantly alter responses to a second challenge. Complex model development is needed to better model human infection where a pathogen is not likely to be the first that the lung has seen (like it is in barrier housed mice).

Name of idea submitter and other team members who worked on this idea John Alcorn

Voting

-10 net votes
4 up votes
14 down votes
Active

Goal 3: Advance Translational Research

What are the most effective strategies for reducing alarm fatigue and optimizing cardiorespiratory monitor alarm management?

Hospital cardiorespiratory monitors have great potential to save lives, but are hampered by high false alarm rates that contribute to alarm fatigue. While the long term solution is developing new medical devices that will do this better, few hospitals will benefit from new device innovations in the next decade. In order to better identify early signs of cardiorespiratory deterioration in the hospital at an early stage... more »

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

Details on the impact of addressing this CQ or CC

Improved strategies for optimally detecting deterioration using existing bedside cardiorespiratory monitoring technologies has the potential to impact the care of hundreds of thousands of hospitalized adults and children each year.

Feasibility and challenges of addressing this CQ or CC

This is highly feasible with a fairly modest allocation of resources. This work falls under heart and lung disease, hospital medicine, nursing research, and implementation science.

Name of idea submitter and other team members who worked on this idea Chris Bonafide, MD, MSCE

Voting

-6 net votes
4 up votes
10 down votes
Active

Goal 2: Reduce Human Disease

Cellular senescence and age-related lung disease?

What is the role of cellular senescence in age-related lung disease? Do environmental factors, including smoking, contribute to the pathogenesis of lung disease through their ability to induce premature senescence? Does the accumulation of senescent cells in distal organs contribute to age-related lung disease through systemic inflammation?

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 Ferruccio Galbiati

Voting

-6 net votes
4 up votes
10 down votes
Active

Goal 2: Reduce Human Disease

Sex and Race Differences in Replacement Lung Surfactant Efficacy

Baby boys and girls can respond quite differently to replacement lung surfactants given in response to neonatal respiratory distress syndrome. There are also variations in efficacy between babies of different races, in addition to the generally increased risk of NRDS in minority populations overall to lack of prenatal care or access to neonatal intensive care units. Increasing the availability of surfactant treatment... more »

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

Details on the impact of addressing this CQ or CC

Infant mortality varies dramatically across racial and economic status, and prematurity and its accompanying diseases is one important aspect of this discrepancy. Replacement surfactant therapy dramatically decreased the infant mortality rate when it was originally initiated, but certain populations are less served, and variations in efficacy of treatment are poorly understood. New methods of delivering surfactant, such as aerosols combined with CPAP and a better understanding of the properties of surfactant might be two ways to address this issue.

Feasibility and challenges of addressing this CQ or CC

This challenge requires a broad, multidisciplinary approach including engineers, neonatologists and biophysicists to produce the necessary materials and tools to properly synthesize and deliver surfactant. A larger challenge is to simplify the process enough that surfactant replacement therapy could be introduced into less developed countries where prematurity is of epidemic proportion.

Name of idea submitter and other team members who worked on this idea Joe Zasadzinski

Voting

-7 net votes
3 up votes
10 down votes
Active

Goal 2: Reduce Human Disease

Improving Outcomes for Lung Transplantation

How can the relatively poor outcomes of lung transplantation be improved through better understanding of basic biology and/or clinical care?

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 Cystic Fibrosis Foundation

Voting

-1 net votes
3 up votes
4 down votes
Active