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Lung Diseases

Description:

The NHLBI Division of Lung Diseases (DLD) maintains surveillance over developments in pulmonary research and assesses the Nation's need for research on the causes, prevention, diagnosis, and treatment of pulmonary diseases. Also within the purview of the Division are: technology development, application of research findings, and research training and career development in pulmonary diseases. The DLD plans and directs the research and training programs which encompass basic research, applied research and development, clinical investigations, clinical trials, and demonstration and education research. The Division has three branches: the Airway Biology and Disease Branch, the Lung Biology and Disease Branch, and the National Center on Sleep Disorders Research.

Airway Biology and Disease Branch . Focuses on basic and clinical research, education and training related to chronic obstructive pulmonary disease, asthma, cystic fibrosis, bronchiolitis, lung imaging, and airway function in health and disease.

Lung Biology and Disease Branch . Supports research, education, and training programs in lung cell and vascular biology, including pulmonary hypertension, lung development and pediatric lung diseases, stem cell biology, acute lung injury and critical care medicine, lung immunobiology and interstitial lung diseases, lung transplantation, lymphangioleiomyomatosis, lung imaging, and pulmonary conditions associated with AIDS including tuberculosis.

National Center for Sleep Disorders Research . Focuses on basic research using state-of-the-art approaches to elucidate the functions of sleep including the fundamental regulation of genomic function and circadian timing in peripheral tissues; patient-oriented research to improve the diagnosis and treatment of sleep disorders; and applied research to evaluate the scope and health consequences of sleepiness and sleep disorders, especially sleep disordered breathing.

Research topics of interest to the Division of Lung Diseases include but are not limited to the following:

A. Diagnostic Tools

1. Computer algorithms for reading and comparing chest radiographs and scans (computed tomography, radioisotopes, etc.) using digitized images

2. Tools to diagnose and treat respiratory abnormalities during sleep in infants, children, and adults

3. Diagnostic proteomics and metabolomics, including methods for early diagnosis of lung disease and characterization of the function/dysfunction of particular cell types

4. Non-invasive measurement of blood gases, hemodynamics and respiratory function in infants, in children, and in adults

5. Non-invasive methodologies for measuring airways inflammation in asthma

6. Non-invasive markers of lung disease activity

7. Non-invasive methods to detect pulmonary thromboembolism, hypertension, and edema

8. Probes to monitor peripheral tissue oxygenation in vivo

9. Probes to non-invasively monitor arterial carbon dioxide

10. Use of ambulatory monitoring techniques to diagnose and manage respiratory disorders of sleep

11. Ambulatory monitoring of oxygenation in infants

12. Computerized tomography to quantify and monitor pulmonary disease processes

13. Virtual bronchoscopy (this is a radiologic 3D reconstruction of the lungs with imaging to approximate bronchoscopy)

14. Novel methods for bioassays

15. Methodologies that provide an objective and semi-quantitative assessment of sleepiness in children and adults

16. Non-invasive imaging technologies to assess neurophysiological and regional brain blood flow changes associated with sleep disorders and other causes of excessive daytime sleepiness

17. Develop placebos for inhaled medications used in clinical trials of lung diseases

18. Detection of injury and repair of the lungs (e.g. after aspiration, near drowning, ARDS)

19. Develop a spectrum of clinically relevant biomarkers (biosensors, bioimaging) on rate-limiting and downstream effects of CF and COPD pathophysiology (mucus production, hydration, inflammation, ion transport, lung disease heterogeneity)

20. Develop new sensitive markers of CF lung disease onset and progression in infants and young children that link to clinically meaningful outcomes and are suitable for showing a response to disease intervention. This might include radiographic (or other imaging) measures of structural lung disease in concert with measures of physiologic function at the macroscopic level

B. Information and Health Education Tools

1. Health information technologies to promote adoption and implementation of asthma clinical practice guidelines in medical practice

2. Health education methodologies for patients, families, or communities to prevent or cope with lung diseases or to reduce their impact, especially among people with asthma who are minorities or living in poverty

3. Information systems to coordinate patient management and monitoring among patients and health care professionals

4. Innovative smoking cessation programs

5. Interventions to reduce passive smoking exposure in infants and children

6. Use of interactive and computer technology to teach self management to asthma and chronic obstructive lung disease patients

7. Educational interventions to reduce the risk of cardiopulmonary disease and improve worksite productivity and school performance through the prevention and management of insufficient sleep and poor sleep environment conditions

8. Methods to improve patient adherence with sleep disordered breathing treatments

9. Develop and test novel and effective approaches to educate the public, physicians, and/or health care systems to increase patient and provider participation in lung and sleep research

10. Develop and test novel and effective approaches to increase patient and/or provider adherence to clinical practice guidelines for management of lung diseases and respiratory sleep disorders

11. Develop and test novel and effective approaches to build capacity for self-management of chronic lung diseases and sleep disorders

C. Materials and Devices

1. Blood substitutes to improve gas exchange

2. Emergency, portable, and servo-controlled ventilatory support devices

3. Improved aerosol delivery systems, particularly for young infants and/or children

4. Improved aerosol delivery systems for ventilated patients

5. Improved devices for continuous oxygen administration, including airline travel

6. Improved extracorporeal or implantable devices for blood gas exchange (artificial lung)

7. New approaches and technologies that can be used to engineer functional tissue, in vitro, for replacement or repair of damaged or diseased lung tissue, in vivo

8. Thrombo-resistant materials for extracorporeal or implantable devices for blood gas exchange and for indwelling catheters

9. Development of miniaturized devices for home monitoring and assessment of periodic breathing, infant apneas associated with hypoxemia, and sleep disordered breathing in adults.

10. Improved CPAP interfaces (i.e., nasal, face masks) for young children and individuals with craniofacial abnormalities

11. Devices to correct congenital disorders of the upper airway

12. Improved low-flow oxygen delivery systems (including cannula) that permit mobility for young children

13. Devices/materials for chest wall disorders (including scoliosis), such as minimally invasive spinal growth modulation instrument; implantable devices for self expansion (child to adult); absorbable biomaterials (rather than metal plates) for fracture repair

14. Develop placebos for inhaled medications used in clinical trials of lung disease

D. Methods

1. ?Clean? animal models for Pneumocystis carinii infections

2. Culture Pneumocystis carinii in vitro

3. Determine viability and enumeration of infectious Pneumocystis carinii organisms

4. Development and standardization of in vitro systems for the study of pulmonary epithelial (airway) cells and pulmonary endothelial (vascular) cells

5. Identification of genes causing and modifying lung diseases

6. Identify and detect lung cell specific differentiation markers

7. Identify loss of epithelial integrity

8. Measurement of exhaled nitric oxide

9. Measurement of airway surface liquid

10. Measurement of pH in airways

11. Identify lung stem cell types

12. Identify species and strain differences of Pneumocystis carinii

13. Isolate, identify, and characterize cells found in pulmonary granulomas

14. Three-dimensional static, mathematical, cell culture models of airways and alveoli to define parameters determining aeropollutant absorption, deposition, and effects

15. Develop technologies and tools for use in genomic or proteomic investigations of pulmonary diseases

16. New technologies and instrumentation scaled for high-throughput phenotypic characterization of sleep in animal models

17. Development of high throughput screening methods of pharmaceuticals for lung diseases; for example, using induced pluripotent stem cells derived from lungs of patients with genetic lung disorders

18. High volume, inexpensive assays to assess variations in gene expression related to circadian and behavioral state (sleep and wakefulness)

19. Simultaneous assessment of physical activity and sleep. Dual-purpose ambulatory devices, equally suitable for the objective assessment of physical activity and sleep in population-based cohorts

20. Develop nanotechnology for non-invasive airway sampling

E. Treatments

1. Delivery of specific drugs (e.g., antioxidants, artificial proteinase inhibitors, surfactant) and cell-based reagents to the lungs for treatment of pulmonary and non-pulmonary diseases

2. Gene therapy for cystic fibrosis, alpha-1-antitrypsin deficiency, primary pulmonary hypertension, and other inborn errors of metabolism affecting the lungs

3. Improved aerosol delivery systems

4. Novel pharmacologic and gene therapy approaches for asthma, acute lung injury, idiopathic pulmonary fibrosis, and bronchopulmonary dysplasia

5. Pharmacological means of stimulating growth and repair of alveoli and reparative or restorative elastogenesis in lungs suffering emphysematous changes

6. Countermeasures for excessive daytime sleepiness, including methods that alter the output of the circadian clock to optimize sleep and wakefulness

7. New pharmacological agents for the treatment of sleep disorders, especially sleep disordered breathing

8. New vaccination/immunomodulatory strategies to prevent exacerbations of Chronic Lung Disease

9. Design of new and effective non-viral vectors and delivery systems for gene therapy targeted to lung disease.

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