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Research Asthma & Airway Translational Research Unit (AATRU)
Mario Castro, M.D.Our research focuses on understanding the origins of asthma and how we can decrease asthma morbidity and mortality using translational methods. We currently have > 20 ongoing studies, all of which have opportunities for students, residents, fellows, and junior faculty to perform a focused research in an area of interest: In RSV Bronchiolitis in Early Life (RBEL, NIH funded), at least 40% of infants with serious viral lung infections, such as RSV, may go on to develop asthma. The study enrolled 206 patients who are at substantial risk of developing asthma. The goal of the study is to determine how specific genetic, biologic, and immunologic characteristics interact to predispose these individuals to develop asthma. We need investigators interested in analyzing these data using epidemiologic and statistical methods. For more information contact Toni Schweiger at 314-362-8163. In our St. Louis Asthma Clinical Research Center (ACRC, ALA funded) we are performing clinical research in adult and pediatric asthma through a national network of 19 centers. We are currently enrolling participants in the "Study of Acid Reflux in Asthma" (SARA). Subsequent study of this same issue in children is planned (SARCA). Trials completed: "Study of Inactiviated Influenza Vaccaine in Asthma" SIIVA), "Effectiveness of Low Dose Theophylline as Add-On Therapy in the Treatment of Asthma" (LODO), "Trial of Asthma Patient Education" (TAPE), and "The Leukotriene Modifier Or Corticosteriod or Corticosteroid-Salmeterol Trial" (LOCCS). We need investigators interested in performing analysis of substudies from these clinical data. For example, using a variety of clinical and physiologic measures, what baseline characteristic will predict who will experience an asthma exacerbation? For more information contact Jaime Tarsi at (314) 747-3074. Our Severe Asthma Research Program (SARP, NIH funded) is a multi-center study to investigate how severe asthma differs from mild-to-moderate asthma. The study compares genetic and physical characteristics (as measured by bronchial biopsies and CT airway wall measurements) to help determine what makes severe asthma different. We need investigators interested in analyzing these data using morphometric methods, then performing an analysis together with physiologic and clinical data. For more information contact Jaime Tarsi at (314) 747-3074. In our Specialized Clinical Center of Research (SCCOR, NIH funded) - Alveolar and Airway Methanisms for COPD, we are seeking to identify the alveolar and airway events that are critical to the diagnosis, pathogenesis and treatment of COPD. If you would like more information you can contact: Steven P. DeMartinoat 314-362-3845 In our Asthma and Nocturnal Hypoxemia in Sickle Cell Anemia study (SAC, NIH funded) is an observational cohort study to elucidate the physiologic, genetic, and molecular aspects of two comorbid conditions, asthma and nocturnal oxygen desaturation, and their relationship to sickle cell anemia (SCA)-related morbidity. In this combined clinical and basic science project, we will determine whether phenotypic and genotypic features associated with asthma increase the rate of pain. The ATTRU in this project is specifically evaluating the biologic and histologic aspects of children and adults with SCA and recurrent acute chest syndrome and how they are similar to matching cohorts with asthma. (PI: Michael DeBaun) In our Long-Term Oxygen Treatment Trial (LOTT, NIH funded) we wish to test the efficacy of supplemental oxygen treatment in patients with COPD. (PI: Roger Yusen) In our Asthma and Allergic Diseases Cooperative Research Center (AADCRC, NIH funded) - Innate and adaptive immune signaling in asthma, we wish to understand the how innate and adaptive immune signals contribute to the pathogenesis of asthma. We are evaluating the role of antiviral and allergic responses as critical elements in asthma using isolated cell and mouse models to translate our findings to children and adults with asthma. Specifically the AATRU is studying the development of wheezing/asthma phenotypes in children recruited into a study of Methapneumovirus bronchiolitis. (PI: Michael Holtzman) Our Asthma Clinical Research Network (ACRN, NIH funded) is a multi-center group designed to conduct clinical research studies in asthma. The ACRN is dedicated to conducting well designed clinical trials for rapid evaluation of new and existing therapeutic approaches for asthma and for dissemination of laboratory and clinical findings to the health care community. We have finished enrolling participants in the "Long Acting b-agonists Response by Genotype" (LARGE) study to study the effects of regular use of long acting b-agonist in subjects receiving inhaled corticosteroids stratified by genotype. We are currently enrolling participants in the "Macrolides in Asthma" (MIA) trial, to study the effect of macrolide antibiotics on suboptimal-controlled asthmatics with chronic Mycoplasma pneumoniae or Chlamydia pneumoniae airway infection, and will soon begin enrollment for 2 additional studies: "Best Adjustment Strategy for Asthma over the Long Term" (BASALT) and "Tiotroprium bromide as an Alterative to increased inhaled Corticosteriod for patients inadequately controlled on a Lower dose" (TALC). For mor information, contact: Our Community Asthma Program (CAP, funded by our Controlling Asthma in St. Louis grant from the CDC and the St. Louis Regional Consortium (website)) is a community-based study that emphasizes preventative asthma care to improve the quality of life for the person living with asthma. We believe by enhancing education and patient communication skills for the primary care physicians we can achieve this goal. CAP also utilizes schools, emergency departments, community pharmacies and third party payers to improve asthma control in St. Louis. For more information contact,: Vanessa Curtis at 454-8776.
In the Childhood Asthma Management Program (CAMP) Biomarker Ancillary Asthma Study we wish to evaluate gene expression profiles (using microarrays) that predict response to asthma medications and classify asthma severity. Study performed in collaboration with Channing Laboratory, Harvard Medical School.
Pharmaceutical studies in the AATRU:
1. Centocor: Anti-TNF antibody (infliximab) vs. placebo control in severe asthma
2. AsthmaTx: Bronchial thermoplasty (Alair) vs. sham control in severe asthma
3. Amgen: Anti-IL 4 receptor in moderate to severe asthma
4. Sepracor: Arformoterol safety/efficacy in COPD
5. GSK: Futicasone/salmeterol vs. fluticasone effect on asthma control in African-American asthmatics
6. GSK: Fluticasone/salmeterol vs. salmeterol on exacerbations in COPD
7. GSK: Anti-inflammatory effect of fluticasone/salmeterol in COPD using bronchoalveolar lavage, blood and induced sputum
Intervention & Support Programs for Asthmatics:
The Asthma Intervention Program
The Asthma Intervention Program at Barnes-Jewish Hospital aims to improve health care delivery for
adults with asthma during a hospitalization. The asthma education coordinator
and respiratory therapists provide asthma education consultations at the
request of the admitting physician or members of the healthcare team.
Carmen Smith, RRT, AE-C, is the asthma education coordinator of the Asthma
Intervention Program. She works closely with patients, respiratory therapy
and their physicians to develop individualized treatment programs, as well
as address barriers to care. For more information about this program,
contact Carmen Smith, RRT
at 314-362-1516 or 314-454-8793.
IN-HALE Asthma Support Group Division of Pulmonary and Critical Care
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