Below are current projects that showcase the department's involvement and advancement in pulmonary medicine.
Pulmonary hypertension (PH) — high blood pressure in the lungs — can’t be treated with standard hypertension drugs. “It’s a relatively young field as far as treatment goes. Prior to the early ‘90s there was no therapy at all,” says Abby Poms, RRT and manager of the Center for Pulmonary Vascular Disease. Now there are more than a dozen approved therapies, and others are being investigated through clinical trials at Duke. Read more →
In the area of critical care, several projects are underway addressing the emotional needs of patients and their families.
“What I’ve been interested in for a few years is dealing with some of the problems that patients and their families face in a situation of critical illness or after they leave the ICU,” says Christopher Cox, MD, MPH, associate professor of medicine (Pulmonary, Allergy and Critical Care Medicine). “Aside from a severe illness, there is difficulty in decision-making and end-of-life care, and the data show that, as doctors, our communication skills are often not stellar. These limitations translate into long-term psychological problems for families as well as a short-term concern that we may not lead families to the treatment plan that’s best aligned with what the patient values and believes.” Read more →
COPD (chronic obstructive pulmonary disease), which occurs almost exclusively in smokers and ex-smokers, is the third-leading cause of death in the United States, behind heart disease and cancer. Although fewer adults are smoking now than in the past, the incidence of COPD is continuing to rise because of the often decades-long lag time between when people start smoking and when they contract the disease.
Neil MacIntyre, MD, professor of medicine (Pulmonary, Allergy and Critical Care Medicine) worked on one of the first studies showing the benefits for COPD patients of pulmonary rehabilitation—cardiovascular exercise combined with tools to address anxiety and depression. That study took place about 20 years ago at Duke, and today pulmonary rehab is standard of care for COPD patients all around the country. Read more →
Asthma research at Duke is aimed at developing more targeted asthma treatment, preventing asthma attacks, and perhaps one day being able to prevent the disease from developing in the first place. Read more →
Interstitial Lung Disease
Interstitial lung disease refers to a group of conditions where scarring of the lungs interferes with breathing. Sometimes the scarring is the result of autoimmune disease or environmental exposure to things such as coal dust, grain dust, animal droppings, bird feathers, or other substances. In these cases, treatment may consist of immune-suppressing drugs, anti-inflammatories, and/or removing the exposure.
However, often there’s no known cause of interstitial lung disease. In this case, the disease falls into a class called idiopathic interstitial pneumonias, the most common of which is idiopathic pulmonary fibrosis (IPF). “It’s a disease where people get scarring in their lungs without inflammation preceding it,” say Lake Morrison, MD, assistant professor of medicine (Pulmonary, Allergy and Critical Care Medicine). “It’s an unusual situation: scarring begets scarring. It’s a devastating disease that not a lot of people know about.” Read more →
In 2013, Duke performed more lung transplants than any other hospital in the country, with excellent survival rates. Duke researchers are continuing to work to make lung transplant even more successful. The key to that success is reducing the risk of chronic rejection, also called bronchiolitis obliterans syndrome, a condition in which the lung tissue deteriorates over time. There are currently no medications to treat chronic rejection.
Laurie Snyder, MD, MHS, assistant professor of medicine (Pulmonary, Allergy and Critical Care Medicine) and one of the associate medical directors of the Duke Lung Transplant Program, says she and her colleagues are pursuing several avenues to address chronic rejection. Read more →