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Piecing together the inflammation puzzle
By Ruth SoRelle, MPH

David Huston's interest in the inflammatory process began long before he came to Baylor College of Medicine in 1980. Huston, an MD, did his residency at Baylor, but then went to the National Institutes of Health for more training.

There he worked in both the National Institute of Allergy and Infectious Diseases and the National Institute of Arthritis and Musculoskeletal and Skin Diseases, which allowed him to be double-boarded in both specialties. It also allowed him to begin a lifelong study of the importance of inflammation in many diseases processes.

With this kind of background, it is not surprising that he now heads the Biology of Inflammation Center at Baylor and holds the Cullen Chair in Immunology at the school. The move toward an interdisciplinary program in inflammation came from both national and internal sources, he said.

"My background made me more appreciative of the opportunity to be interactive," said Huston. "Inflammation is a broad area that impacts so many things," he said. "I wanted to have a strategy that brought all parties to the table."

David Huston, MD, and Margie Moczygemba, PhD, watch doctoral student Tony Nguyen pipette a protein at the lab bench.

While most people consider inflammation something that occurs when there is an injury or a disease, it is also the way the body reacts to molecules it perceives as foreign. Inflammation is a necessary and protective force that allows an organism to survive. When the organism loses the ability to control the inflammatory response, the result can be catastrophic. Because of its wide-ranging influence, inflammation is involved in a host of diseases - from allergies and asthma to infections and heart disease, from cancer to autoimmune ailments such as rheumatoid arthritis and lupus.

In order to attack the many areas in which inflammation plays a part, Huston felt that many different disciplines had to be involved. Merging the divisions of allergy/immunology and rheumatology was just a start that set a precedent that other schools have followed, said Huston. It also made it possible to put together unique programs in education and research.

For one thing, the new division gives residents an opportunity to train in both disciplines - allergy/immunology and rheumatology, said Huston.

"That is the only way we train," he said. It takes an extra three years, but the specialists come out eligible for both boards.

"Then we wanted to pursue the Baylor initiative to have an interdisciplinary center," he said. While the Biology of Inflammation Center brings together many people who work in different physical areas of the College, Huston felt that some consolidated space was a necessity.

"It would provide a real core - a physical core - to the Center," he said. However, if the laboratories on the fifth and sixth floors of the Anderson building are the hardware of the Center, its brain is the group of more than 40 faculty members who represent a variety of research and clinical areas of the school. The leaders are Huston, and members of the center's executive committee, which includes Richard G. Cook, PhD, professor of immunology; Mark Entmann, MD, professor of medicine, biochemistry and molecular biology and pathology and chief, cardiovascular sciences section; C. Wayne Smith, MD, professor of pediatrics and immunology and head, leukocyte biology section; and David J. Tweardy, MD, professor of medicine and chief, infectious diseases section.

The heart of the Center is its advisory council, which provides community involvement and assists in management of the fund-raising process. Members include donors, medical residents, postdoctoral trainees, faculty advisers and development staff.

Some members of the advisory council are patients of physicians who work with the Biology of Inflammation Center, said Huston. In many instances, the diseases involved in inflammation are considered "orphan" because they afflict only a few. Others are monumental public health problems that affect millions of people worldwide. The interests of those on the executive committee range wide, and many are interested because they know an individual with a particular ailment or because they are concerned about the worldwide effect of diseases such as those that affect the heart, lungs or musculoskeletal system.

While the numbers of diseases involved are many, "there are a finite number of mechanisms involved that play a role in the various disease states," said Huston.

The Center received a big boost in 2001 when it received a challenge grant of $750,000 from the Kresge Foundation. The Center's advisory board set its challenge at $20 million and had more than met the goal by Dec. 31, 2001, said Huston.

This month, the Center will celebrate its official opening with a health forum from 3-6 p.m. Nov. 7 featuring Peter E. Lipsky, MD, scientific director of the intramural research program at the National Institute of Arthritis and Musculoskeletal and Skin Diseases, and Dean D. Metcalfe, MD, chief of the laboratory of allergic diseases at the National Institute of Allergy and Infectious Diseases. Robert R. Rich, MD, a former member of the Baylor faculty and current associate executive dean at Emory University School of Medicine will also speak. The formal opening begins at 6 p.m.

In the future, Huston hopes to make his dream of "gene to bedside" come true with innovative forms of translational research.

"We are targeting allergies and asthma, the arthritis and musculoskeletal diseases and working with gastroenterology to target inflammatory bowel disease," he said. "Those play to some our strengths and the interests of our advisory council."

As the Center progresses and grows, he expects it to branch out into other areas. However, he said, the work that will be done in the early years will have broad applications in understanding and treating many kinds of diseases.

"We want to delve into the molecular basis of inflammation," he said. "What are the genes and how are they activated? How do the cells and molecules communicate among themselves at a tissue level and throughout the body? We want to target these molecules in a specific way to learn how to shut off the inflammatory responses or to turn them on, enhancing them as a vaccine does."

"These are major paradigms in immunology and translational research," he said. Already, he said, monoclonal antibodies with therapeutic potential have been patented in his laboratory.

"The fun part for us will be taking our concepts from the gene all the way to the therapy," he said. "It's the concept on the logo and the mission of our center."

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