The research in my laboratory is focused on two major areas of investigation; pulmonary infection and lung cancer. In the area of pulmonary infection, I am interested in pneumonia that affects immunocompromised patients. This group of patients includes individuals infected with HIV or receiving immunosuppressive medications and/or chemotherapy.
Pneumocystis carinii (PC) is an unusual and poorly characterized opportunistic fungal pathogen responsible for causing severe pneumonia in patients with impaired immunity, especially in patients with AIDS. It is also an increasingly common and difficult problem in immunocompromised patients without AIDS. This group of patients is a fast growing segment of health care consumers. The life cycle of PC is poorly understood, and the inability to cultivate PC has hindered the development of new therapeutic agents and made it difficult to study this organisms cell biology. I have been identifying cell cycle molecules, mitogen-activated protein kinase (MAPK) molecules, and sterol metabolism molecules to better understand components of the PC life cycle and to understand requirements for its growth and proliferation.
Mycobacterium avium complex (MAC) consists of several nontuberculous mycobacteria which are ubiquitous in nature. There is a wide spectrum of disease caused by MAC, affecting both immunocompetent and immunocompromised individuals. The treatment of patients with chronic pulmonary disease or disseminated infection from MAC is difficult due to the long duration necessary for treatment and the high frequency of drug intolerances or toxicity. In comparison with the treatment of tuberculosis, drug therapy for patients with MAC infection has been disappointing due to drug resistance or intolerance. The difficulties of treating chronic and disseminated MAC infections highlight the urgent need to identify novel targets for the development of antimycobacterial medications.
In the area of lung cancer, I am interested in the biology of neuroendocrine lung carcinoma, which includes pulmonary typical and atypical carcinoid tumors, large cell neuroendocrine, and small cell lung cancer. These cancers have received relatively little research attention and the neuroendocrine biology of these cancers sets them apart from non-small cell lung cancer. My current focus is to understand the molecular mechanisms involved in their growth and proliferation with the goal to develop novel mechanisms to inhibit their growth.
My research is funded by the National Institutes of Health (NIH) and Mayo Foundation. I am currently the Research Chair for Pulmonary and Critical Care Medicine, the Director of the Lung Cancer Clinic, and the Program Leader for the Lung Defense and Infection Program of the Mayo Clinic Heart, Lung and Blood Center. I am a Co-Director of the National Institutes of Health Respiratory Biology Research Training Grant at Mayo Clinic Rochester for the training of post-doctoral fellows in Respiratory Biology.