In addition to our regular CRI Activities Update, this month’s Research Focus highlights collaborative work from David B. Peden, MD, MS Andrews Distinguished Professor of Pediatrics, Professor of Medicine and Microbiology/Immunology and Toxicology, Division Chief of Pediatric Allergy, Immunology and Rheumatology, Interim Director of the Institute for the Environment.

Activities Update: We hired a new Infectious Disease Administrative Assistant this month who will also be assisting us with the CRI, Kate Matthews. She is a graduate of UNC and was previously working in the UNC Children’s Hospital Specialty Clinic. In her first 2-weeks with the CRI, Kate has already become a valuable resource to us, assisting with web site updates, the Pediatric Scholars Program, and CRI Seminar Series arrangements, along with many other moving parts as we make connections across the university to build collaborations. Please help us in giving Kate a warm welcome.

This past month we held our first patient registry meeting with working group members Michelle Hernandez, MD; Michael Kappelman, MD, MPH; Jeannette Bensen, PhD, MS; and Rebecca Fry, PhD, where we began discussions on feasibility considerations and data sources. Next steps include the development of a survey to identify existing and proposed pediatric registries/repositories to speak to and potentially build upon with future funding.

Also this month, researchers met with the Corporate and Foundation Relations (CFR) team so that the CFR could further learn about our research, which will assist them in formation or enhancement of relationships with foundations and industry to generate additional pediatric research funds. In turn, researchers learned about CFR resources for identifying and pursuing funding outside of the NIH.

Finally, we had a Board of Visitors (BOV) meeting this past month, where Suzanne Kennedy, PhD presented on behalf of the CRI, providing background and updates, and outlining our needs for philanthropic funding. At this meeting, we also had the treat of hearing Dr. Hernandez speak to her research, along with Joseph Piven, MD, Thomas E. Castelloe Distinguished Professor of Psychiatry, Pediatrics and Psychology, Director of the Carolina Institute for Developmental Disabilities (CIDD); and Ben Philpot, PhD, Kenan Distinguished Professor, Associate Director UNC Neuroscience Center.

ReminderDavid Peden, MD, MS, is presenting at our next CRI monthly luncheon seminar series, on Tuesday, November 14 at 12:15pm in the Bioinformatics Auditorium (room 1131). Please mark your calendars. We look forward to seeing you there.

Research Focus of the MonthTo inform each other of the research interactions in pediatrics, and in the spirit of CRI’s mission to promote collaboration, each CRI update will continue to highlight different investigators’ collaborative efforts. Below is a summary on the collaborative research from David B. Peden, MD, MS, Professor of Pediatrics, Professor Department of Microbiology & Immunology; Division Chief of Pediatric Allergy, Immunology and Rheumatology; Senior Associate Dean for Translational Research; Director Center for Environmental Medicine, Asthma, & Lung Biology; Interim Director of the Institute for the Environment; President American Academy of Allergy, Asthma & Immunology (AAAAI).

David Peden, MD, MS

Dr. Peden’s research and collaborations center around his long-held interest in inflammatory processes and disorders. The inflammatory process is the body’s quick response to injury and infections, mediated by immune cells and platelets. However, inflammation can also damage normal tissues and cells, and inflammatory disorders occur when inflammation becomes uncontrolled. Chronic inflammation is not only a symptom but also a cause and stimulus of many diseases. In addition, molecular and epidemiological research suggests that inflammation may be linked with a broad range of, if not all, non-infectious diseases, including allergies and asthma, and cardiovascular disease.

Collaboration across disciplines, departments, and universities and institutions has been instrumental in Dr. Peden’s research. As the director of the Environmental Protection Agency (EPA)-funded Center for Environmental Medicine, Asthma and Lung Biology (CEMALB), Dr. Peden uses exposure chamber facilities to study respiratory and immune responses to various environmental agents in adults who are healthy and adults with asthma. Recent publications focus on alternative nonsteroidal treatments to asthma. Corticosteroids are the evidence-based standard treatment and their advent greatly changed the long-term management of asthma for the better. However, concerns about immune and growth suppression persist, there is an initial lag period of 4-6 hours or more for therapeutic effect, and they are often ineffective at treating the neutrophilic component of viral- and allergen-induced airway inflammation. A National Institute of Environmental Health Sciences-funded study with Dr. Peden, Principal Investigator; Michelle Hernandez, MD Associate Professor of Pediatrics UNC Children’s, Associate Medical Director, N.C. Children’s Allergy & Asthma Center; and Alison Burbank, MD, Assistant Professor of Pediatrics; demonstrated that when compared to control, gama tocopherol (a vitamin E isoform) reduced inflammatory markers of asthma (ie, sputum eosinophils and mucins) and acute airway response to inhaled lipopolysaccharide (LPS).[https://www.ncbi.nlm.nih.gov/pubmed/28736267] This response was similar to that published with inhaled corticosteroids. This suggests that gama tocopherol may be a nonsteroidal option to treat airway inflammation and mucous production/clearance seen with asthma. Further largescale studies are needed for efficacy and long-term safety.

Additional work done through CEMALB includes Dr. Peden’s collaboration with:

  • Hernandez and Haibo Zhou, PhD, Department of Biostatistics Gillings School of Public Health, where they demonstrated that the IL-1 receptor antagonist, anakinra, significantly reduced airway neutrophilia and LPS-induced markers of inflammation (IL-1, IL-6, IL-8) compared to placebo, making anakinra a potential therapeutic candidate for treating asthma with neutrophil predominance.[https://www.ncbi.nlm.nih.gov/pubmed/?term=25195169]
  • The National Institute of Allergy and Infectious Disease-funded Immune Tolerance Network (ITN), which is a multi-center trial collaborative of which CEMALB serves as a site with Dr. Peden as site Principal Investigator. The ITN study CATNIP evaluated the safety and efficacy of cat immunotherapy combined with Anti-TLSP in participants with cat allergy.
  • The EPA, whereby studying ozone in healthy adults in the CEMALB facilities in 2011 they reported detrimental health effects of ozone exposure concentrations that were well below the US National Ambient Air Quality Standards at the time. This led to a regulatory change, lowering the ozone standard from 75 to 70 parts per billion.

Additional collaborations include those with UNC researchers Dr. Zhou, Terry Noah, MD, and Ilona Jaspers, PhD Department of Pediatrics; Bruce Cairns, MD, Director NC Jaycee Burn Center, John Stackhouse Distinguished Professor of Surgery; Rob Maile, PhD, and Samuel Jones, MD, Department of Surgery and NC Jaycee Burn Center. They found in an observational study of patients admitted to the North Carolina Jaycee Burn Center that local organ-specific Damage-Associated Molecular Patterns (DAMP) release in the central airways after acute burn/inhalation injury is correlated with later occurrence of bacterial infections. This supports further investigation of DAMP markers as either predictors of, or having a role in, the pathophysiology of bacterial infection.[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4421787/)

Dr. Peden also serves in various capacities within and outside of UNC. He is the primary medical consultant at UNC to the National Center for Advancing Translational Sciences (NCATS)-funded “Carolina Biomedical Data Translator” project, one of 16 leading universities and research institutions awarded across the country. This project is led by Principal Investigators Stanley Ahalt, PhD, director of RENCI (Renaissance Computing Institute) and professor in the UNC-Chapel Hill Department of Computer Science, and Alexander Tropsha, PhD, associate dean for pharmacoinformatics and data science and the K.H. Lee Distinguished Professor at the UNC Eshelman School of Pharmacy. The aim is to integrate multiple types of existing data sources to provide information to guide clinical care, inform clinical and translational research, stimulate drug discovery, and repurpose and motivate public-health decisions.

Dr. Peden also serves as Medical Director to the National Science Foundation-funded Nanosystems Engineering Research Center for Advanced Self-Powered Systems of Integrated Sensors and Technologies (ASSIST), headquartered at NC State. This collaboration is working to develop and test wearable sensors for physiologic and environmental exposures. He also serves as the Director of Research, Cardiopulmonary Disease for the Gillings School of Public Health Center for Environmental Health and Susceptibility, and as Director Team Science NC TraCS. Outside of UNC, he serves on several EPA pollutant advisory committees and is a member of the FDA Allergenic Products Advisory Committee.

Most recently, he was part of a team of researchers at UNC awarded to lead a 5-year, $61-million national asthma treatment project. Funded by the National Heart, Lung and Blood Institute, 10 medical centers across the US aim to identify effective treatments for attacks by combining precision medicine and big data analyses. UNC serves at the Data Coordinating Center, led by Anastasia Ivanova, PhD, associate professor of biostatistics at the UNC Gillings School of Global Public Health. Dr. Peden serves as a Co-principal investigator with David Couper, PhD, clinical professor of biostatistics at UNC Gillings. Wanda O’Neal, PhD, associate professor of medicine at the UNC School of Medicine and member of the UNC Marsico Lung Institute, is also a key investigator.

All of this experience serves Dr. Peden well in his newly appointed role as interim director of the Institute of the Environment; he is well positioned to maximize collaborations across UNC campus and beyond.