Something New in the Air, Division of Respiratory Medicine

Jim Hagood, MD

San Diego, October 8th, 2009 – This year, over 3 million children have died from respiratory problems worldwide. According to the World Health Organization, respiratory complications are the leading killer of children today, especially children under five years old. Considering 6 children die per minute from respiratory conditions alone, the number one priority for improving child mortality should be renewed biomedical innovation in pediatric respiratory medicine. With a breath of fresh air, this is exactly what UC San Diego’s Department of Pediatrics is after.

The Division of Respiratory Medicine in the Department of Pediatrics is off to a great start. Until recently it consisted of four pediatric pulmonologists and a few researchers - a small program by most standards. In 2004, the arrival of Dr. Gabriel Haddad, Chair of the Department of Pediatrics, and Physician-in-Chief at Rady Children’s Hospital, added a world-class physician-scientist and several basic research faculty to boost the Division’s strength in basic research. This year, the U.S. News and World Report ranked the Division among the Top 25 in the country, outranking most Ivy Leagues in the running. Capitalizing on its strong clinical-research foundations, the Division has begun leveraging its tremendous opportunity to grow and help children with respiratory problems.

Professor James Hagood, the newly appointed Chief of the Division of Respiratory Medicine in the Department of Pediatrics, joins us from the University of Alabama School of Medicine. Dr. Hagood is an established physician-scientist with interests both in the clinical management of childhood chronic lung diseases, and in basic cellular and molecular investigations of chronic lung remodeling. He was the Director of the Pediatric Pulmonary Center, and Founder and Co-Director of the Translational Research in Normal and Disordered Development (TReNDD) Program at the University of Alabama-Birmingham (UAB).

Dr. Hagood has been recognized for his leadership as a physician-scientist and educator in pediatric respiratory medicine, and has been named one of America’s Top Pediatricians and Best Doctors in America. Among his numerous accolades, Dr. Hagood is a two-time recipient of the Rud Polhill Senior Investigator Award (basic research), and winner of the Ralph E. Tiller Distinguished Faculty Award (clinical teaching) and the Dean’s Award for mentoring at UAB. One of Dr. Hagood’s clinical interests is Childhood Interstitial Lung Disease (ChILD), a collection of rare disorders which cause diffuse alterations in the lungs. He has worked closely with the ChILD Foundation to develop educational materials for families living with ChILD. The NIH and the American Lung Association have funded Dr. Hagood’s studies over the past 15 years on the role of fibroblasts in lung fibrosis. Although his major research focus has been idiopathic pulmonary fibrosis (IPF), a disease which affects only adults, recent data has shown that many of the molecular pathways which control the development of the lung in infancy and childhood are re-expressed in IPF and other lung diseases in adults. Dr. Hagood’s lab recently made the observation that epigenetic regulation, which has been shown to control such diverse processes as obesity and cancer, is also important in lung fibrosis. Dr. Hagood is excited about continuing this work at UCSD, and taking advantage of the opportunities to collaborate with the world-class scientists here.

But that’s not the only reason he came to San Diego. “I was extremely impressed by Dr. Haddad’s vision and enthusiasm, and the remarkable prior achievements of the Division of Pediatric Respiratory Medicine at UC San Diego,” Dr. Hagood remarks. “We have a strong group with amazing potential. We have an opportunity not only to maintain our ranking, but to move to the top.”

Bringing together the incredible basic research at UC San Diego and the top-ranked clinical enterprise at Rady Children’s is vital to Hagood’s vision. Faculty like Dr. Haddad and Dr. Paul Quinton are legends in the international arena of respiratory medicine. Dr. Haddad’s research focuses on the biology of how the body responds to low oxygen levels. Dr. Quinton’s expertise is in electrolyte transport abnormalities in cystic fibrosis (CF). His contributions were featured in recent articles in both Nature and Science reviewing the past two decades of progress in CF research. Dr. Julie Ryu, a physician-scientist who was recruited with Dr. Haddad, studies the response of the lung to carbon dioxide. Dr. Mark Pian, the former Co-Director of the Division, engages in clinical studies, patient care, and molecular research in cystic fibrosis, and directs the Division’s fellowship program. The Division has a strong reputation for patient care and education, with experienced clinicians such as Dr. Sung Park and Meerana Lim. Dr. Dan Lesser, a newly-recruited faculty member, will focus on respiratory problems in neuromuscular diseases, and on resident and fellow education. Over the next few years, the Division will be recruiting additional faculty to meet the clinical demand, and take advantage of the basic and translational research opportunities.

Dr. Hagood’s vision is bold as it is broad – he wants to extend the borders of translational research by engaging the biotech community, local families, and international collaborators. By fostering collaboration with some of the research institutes and biotech companies in the San Diego area, Hagood’s hope is to launch new interdisciplinary clinical trials in order to promote rapid and safe development of new drug therapies to help kids with respiratory conditions. The other important aspect of the Division’s mission is to actively engage patients and their families.

“I would like to foster a Family Advisory Board,” Dr. Hagood announces. “We want input from parents whose children have respiratory conditions, and from adolescents with respiratory problems themselves. Their input will help us to understand their suffering, to improve our patient care, improve our research goals, and improve our education. We want families to present their perspective at academic seminars, and contribute to educational materials on rare lung disease. Patient and family engagement will improve every aspect of what we do.”

In addition to its world-class clinical and research strengths, Dr. Hagood touts the Division’s educational mission. The faculty has a keen interest in training future clinicians and physician-scientists, from medical students to residents and fellows, in respiratory medicine and research. There is a united effort across the Division to develop the fellowship program to train future physicians in pediatric respiratory medicine.

“We are working as hard as we can to meet the needs of the patient population at all levels – providing care, providing education for future physicians and scientists, and carrying out innovative science that will lead to new treatments,” Dr. Hagood concludes. “San Diego has a large, diverse and intelligent population with a world-class scientific and medical community, and has all the makings to support a top-tier operation. Whether we are working with fruit flies in the laboratory or helping kids in the clinic, each of us in the Division play a critical role in combating the leading cause of child death. We’re not just in the race for the next big breakthrough. We’re here to improve children’s lives in the most basic of areas – breathing.”

The American Lung Association had a slogan that puts things in perspective, “If you can’t breathe, nothing else matters.”

Welcome, Dr. Hagood – there is something new in the air.

MEDIA CONTACT : Shivani Singh, Sr. Writer, Dept of Pediatrics, UC San Diego.

SCIENTIFIC CONTACT: Prof. James Hagood, MD, Chief, Division of Respiratory Medicine, Dept of Pediatrics, UC San Diego.

All Images Courtesy of Department of Pediatrics, School of Medicine, UC San Diego.