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Experimental Therapeutics in Critical Illness

PI: Michael R. Pinsky, MD

Co-Investigators: Arthur M Feldman, MD, John Gorcsan, III, MD, Edwin K Jackson, PhD, Candace S Johnson, PhD, John P Johnson, MD; Judith R Lave, PhD; Bruce R Pitt, PhD; Theresa L Whiteside, MD PhD; Mark L Ziedel, MD

Funding: NIH T32HL007820

The goal of this proposal is to provide post-doctoral fellows (Trainees) with research training in the basic sciences relevant to unsolved problems in the treatment of various cardiopulmonary insufficiency states.  The primary goal is to train clinicians to redefine clinical problems in terms of essential biological questions that can be answered through laboratory investigation.  In general, however, such questions are so complex that even sophisticated approaches using immunology, molecular biology, cell biology, or biochemistry alone cannot resolve them.  Time-dependent factors, organ-specific changes, and organ-organ interactions necessitate the integration of these powerful basic science molecular- and cellular-based tools with large-animal acute physiological models and clinical outcome-based studies.  Significant strides forward in our understanding of the processes of cardiovascular insufficiency, multiple organ dysfunction and their response to specific therapies will require more than detailed physiological monitoring of precise animal models with specific therapies or identification of a specific regulator gene in cultured cells.  Despite efforts to understand the time course and host response to cardiopulmonary insufficiency, and to improve knowledge of the molecular basis for many aspects of diseases, we still have little tangible evidence of benefit in terms of the quality or length of patients' lives.  A basic science approach alone is insufficient to address the complexity that continues upward through macroscopic interactions.  Integration of various levels of investigation is essential for the efficient and rational development of effective treatment strategies for the critically ill.