I have had an interest in Pulmonary Immunology for over 20 years. I began by looking at basic mechanisms of lymphocyte accumulation in response to cytokine signals, and I have gradually turned my interest to clinical and translational research. In the past ten years I have divided my time between basic and translational investigations involving the novel cytokine, osteopontin, and clinical research involving patients with Sarcoidosis.

My interest in osteopontin (Opn) began upon hearing a report that OPN was the most prevalent message upregulated in macrophages upon exposure to mycobacterium. It is an odd duck amongst cytokines, in that it is prominently expressed in bone and is involved in disparate processes such as bone remodeling, wound healing, inflammation, and tumor metastasis. I have been interested in the immunologic and inflammatory aspects of Opn, and my laboratory has been involved in research linking Opn to T cell function, granuloma formation and interstitial pulmonary fibrosis.

My interest in Sarcoidosis rose out of my 20-year involvement in the Tuberculosis Clinic at the Boston City Hospital and an affiliated homeless shelter. Viewing Sarcoidosis as a “companion” disease to TB, I was intrigued by the mysteries behind this granulomatous disease. I gradually built a Sarcoid population within the TB clinic and 10 years ago spun off my current Sarcoid Clinic. My colleague, David Serlin, and I see approximately 150 new patients each year, some referred for second opinions and other referred for ongoing diagnosis or management. We have a number of clinical research projects ongoing, including the examination of the impact of atopy and nasal disease on Sarcoid clinical course, the use of nasal lavage and brushing for biopsy and prognostication in Sarcoidosis, diagnosis of cardiac disease, and management of calcium and bone metabolism in Sarcoidosis. We share clinic space and collaborate with Dr. Hap Farber and the Pulmonary Hypertension Center in the diagnosis and care of patients with Sarcoidosis who develop pulmonary arterial hypertension. We hope to soon be involved in a large national study of Sarcoidosis in African American women with Sarcoidosis.