The Lungs

Regenerative medicine is just one of many ways that researchers at Boston University School of Medicine are attacking lung disease.

Research groups at the medical school are exploring many aspects of lung health. The lung and its diseases are not completely understood, but what is clear is their impact on human health.

Lung cancer kills more patients than any other cancer. Emphysema and chronic bronchitis, collectively called Chronic Obstructive Pulmonary Disease, are the fourth leading cause of death in the U.S. Asthma impacts 23 million Americans, including 7 million children. Infectious diseases of the lungs, such as influenza, pneumonia, and tuberculosis, are persistent global killers.

Boston University is home to internationally-renowned researchers dedicated to the advancement of lung disease knowledge and treatment.

Hope for fresh start

Replacing damaged cells or organs with healthy ones is the goal of regenerative medicine, which is being developed in laboratories at Boston University School of Medicine. Investigators in this field take cells from the skin of lung patients, manipulate those cells in the laboratory and transform them into stem cells, which can both renew themselves and differentiate into other cells. Today, adult stem cells are being used to test drugs. Someday, they may be used to repair or re-grow lungs damaged by disease.

“We are not there yet, but we are pretty far along,” says Professor David Center, the medical school’s chief of Pulmonary, Allergy and Critical Care Medicine. “In lung diseases that are genetic, like cystic fibrosis, we can take skin cells from people with the disease, de-differentiate the cells, then differentiate them back into cells that have the defect. We can use those cells to test drugs.”

Regenerative medicine is an emerging field, which has seen important advances in recent years. Pulmonary researchers at Boston University School of Medicine are on the leading edge of this promising area of medical research.

Determining who is susceptible

Emphysema, chronic bronchitis, and lung cancer—diseases associated with cigarette smoking but affecting non-smokers as well—are the focus of some BUSM research teams. Investigators are pursuing the causes of these diseases with a combination of genetic research and the emerging field of bioinformatics, or the application of statistics and computer science to biology.

Researchers have found genetic markers that allow doctors to identify who is most vulnerable, as well as the most effective ways to treat or prevent these diseases. A team led by Associate Professor Avrum Spira has identified genetic abnormalities in lung cancer patients. These genes can be found in cells outside the lungs. This makes possible testing that is inexpensive and painless. With the promise of early detection, providers can start treatment in the early stages of the disease.

Building a healthy immune system

Some pulmonary diseases, including asthma and pneumonia, involve overreactions of the immune system. Dr. Joseph Mizgerd, director of the medical school’s Pulmonary Center, leads a team investigating how the immune system can be regulated so that it does not harm the body. In experiments with animals and with human cells in test tubes, these investigators have pinpointed an enzyme that controls production of cytokines, a hormone-like substance the body’s immune system uses to fight infection. This enzyme could be a key to controlling how the immune system responds and, ultimately, to saving patients’ lives.

Researchers at the Pulmonary Center are using a variety of approaches to attack the growing problem of asthma. Teams of investigators are going into communities, surveying people to identify behaviors and conditions in the environment that are associated with asthma. These findings, coupled with laboratory research into the immune system, offer hope for prevention and treatment of asthma.