Research Accomplishments: Well-established and robust basic and clinical investigation programs are directed by our faculty. Basic studies are constellated in two main areas—airway biology and oxygen utilization/critical care. Research training is supported by an NHLBI-sponsored training grant which provides training for both PhD and MD post-doctoral investigators. Active clinical investigation programs exist, with studies centered in our intensive care units and outpatient clinics. Clinical investigators participate in both multi-center trials as well as protocols conceived and conducted entirely at The University of Chicago. The success of the faculty in securing support for their research has been remarkable but well deserved, with significant growth over time.

In FY 07, research by the Pulmonary/Critical Care faculty led to these new advances:

• Discovered that the gene encoding acyloxyacyl hydroxylase , an enzyme that hydrolyzes secondary fatty acyl chains of LPS is a novel innate immunity candidate gene associated with asthma and related phenotypes of African ancestry ( Garcia et al)
• Discovered novel gene variants which confer risk of acute lung injury in both patients of European descent and African Americans. (Garcia, Ma)
• Demonstrated a novel mechanism by which transforming growth factor beta modulates the activity of serum response factor, a transcription factor important in the activation of smooth muscle contractile apparatus genes. (Camoretti Mercado et al )
• Discovered novel interactions between protein complexes that form endothelial cell-cell adhesions and play a critical role in the maintenance of endothelial barrier ( Birukova et al)
• Found that mechanically ventilated ICU patients with risk factors for coronary artery disease have a high incidence of occult myocardial ischemia and that sedative interruption does not impact the occurrence of myocardial ischemia ( Kress, Hall et al )
• Determined that in-hospital mortality accounts for only one-third of all deaths from asthma and the higher overall risk of death from asthma in black patients compared with white patients in the U.S. is not explained by race differences in-hospital deaths. These findings indicate that more research is necessary to understand risk factors for out-of-hospital asthma deaths, as well as to develop and test interventions to improve outcomes in high-risk populations. (Krishnan et al )
• Determined that real life pathological signals depolarize cell membrane that open hemichannels and allow direct entry of pathological signals that induce cell pathology ( Lal et al)
• Developed a new Chip-based TIRF (Total Internal Reflection Fluoresccence) microscopy that is efficient, highly sensitive and considerably cheaper which allows imaging structure and biochemical and physiological processes within 100-200 nm from the cell membrane ( Lal)
• Demonstrated that segmental allergen challenge increased lysophosphatidic acid levels in asthmatics, compared to non-segmental allergen challenged asthmatics suggesting a role for the bioactive lipid in asthama and inflammation (Natarajan et al).
• Showed that the intensity of non-REM sleep, as quantified by EEG slow-wave activity is a major determinant of insulin resistance and diabetes risk and observed reductions in SWA in African American as compared to Whites ( Tasali et al )

Education and Training: The faculty of our Section view themselves as 'teachers of teachers', and they are actively engaged in the instruction of medical students, residents, fellows, graduate and post-doctoral students, and practicing clinicians. We offer a four year fellowship in Pulmonary and Critical Care Medicine with clinical and scientific training components. The success of our efforts is measured by the success of our students. Of the graduates of our fellowship in the past 15 years, more than two thirds selected and remained in academic medicine. Their superb preparation for their careers is signaled by their evolution to leaders in the field, with this group now including 21 assistant professors of medicine, 8 associate professors of medicine, 7 full professors, and one medical school dean.

Patient Care: Our clinicians are devoted to providing the highest quality care to patients with critical illness and lung disease. We provide around-the-clock care to adult patients in the intensive care units of The University of Chicago. In addition to numerous other scholarly pursuits, the critical care faculty have authored a leading textbook, Principles of Critical Care, helping to define and direct this new and exciting field of medicine. Our faculty also direct a consultation service providing senior and experienced supervision of invasive procedures conducted on both our hospital wards as well as outpatient clinics. Patients with new and chronic lung diseases are evaluated in our ambulatory clinic, and characterization of their lung function is performed in a state-of-the-art pulmonary function laboratory. The depth and breadth of these patient care activities has been recognized by the prestigious U.S. News and World Report "Best Hospitals" survey, which has consistently ranked our program as best in Illinois and among the top 50 in the nation.