Gary H. Gibbons, M.D. - October 28, 2013
From Health Disparities in Asthma to the Microbiome, Clinician-Scientist Explores the Cutting Edge of Lung Research
Estimates place the number of people worldwide living with asthma at 300 million. In the U.S., one in every 11 children and one in every six African American children has asthma. The prevalence of this condition and its disproportionate impact on minorities and families at or below the poverty line make it a priority research area for the NHLBI, which supports a broad asthma research portfolio and the National Asthma Education and Prevention Program to translate research into improved clinical practice and quality of life.
Asthma research also is a priority for Dr. Monica Kraft, Professor of Medicine, Duke University School of Medicine and Past President, American Thoracic Society (ATS), who recently told me she sees first-hand the incredible health disparities and poorer health outcomes for Durham’s African Americans and Hispanic Latinos suffering from asthma. What she witnesses daily is leading her and her team to begin discussions and research about what types of therapies and interventions change these disparities.
While her team continues to develop that line of inquiry, her current research into the basic immune mechanisms in asthma is leading researchers to embrace the fact that asthma, like many chronic diseases, is not homogenous, but instead driven by a number of different molecular phenotypes. Dr. Kraft and her team also are digging deeper into the remodeling process and the innate immune factors tied to asthma exacerbations. Their work in this space is particularly exciting because it could lead to a novel pathway for therapy in humans, which is the ultimate goal for clinician-scientists.
Implicating the Microbiome in Asthma
Dr. Kraft is also intrigued by how the microbiome may play a role in lung diseases like asthma or COPD and the potential for it as a key to future research and progress in this space. The microbiome has been implicated as a potential player in a number of medical conditions, from obesity to diabetes to cardiovascular disease.* During our discussion, she talked about some provocative data on early microbial exposures through the gut and how one’s gut immune development ultimately may impact immune tolerance in the lung and susceptibility to asthma.
Reflections on Mentorship
Many of these exciting new areas of research that Dr. Kraft discussed will be explored by the next generation of clinician-scientists. And for this next generation to thrive, mentorship is key, especially when it comes to ensuring greater diversity in the biomedical workforce. That commitment is evident both in Dr. Kraft’s current lab, where she mentors three junior female scientists, and in the programs she is helping create at the ATS.
In any scientific discipline, the unanswered questions outnumber the answered questions. New technologies provide us new ways to approach old problems, and new knowledge gives us all the opportunity to expand our thinking. No one knows this more than Dr. Kraft, who admitted that she herself has considered taking a sabbatical to learn more about the systems biology approach to research, which she believes is critical for anyone looking to translate basic science into improvements in public health.
After spending 30 minutes with Dr. Kraft, one thing is clear: Whether she has the time for a sabbatical to learn more about systems biology or not, our scientific knowledge will continue to advance thanks to her leadership.
* For more on the connection between the microbiome, gut bacteria, and cardiovascular disease, listen to my interview with NHLBI grantee Dr. Stanley Hazen from the Cleveland Clinic.