EXPERIMENTAL THERAPEUTICS IN CRITICAL ILLNESS

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This postdoctoral training program proposal is designed to train fellows, for a period of three years each, in basic science research relevant to cardiovascular and pulmonary responses to stress. Funds to support two fellows for the first year, four the second and all subsequent years, are requested. The overall research focus of the trainees is the cardiovascular and pulmonary response to stress on four inter-related levels of basic science investigation: 1) cell and molecular immunobiology; 2) cellular basis of organ injury; 3) organ-system interactions; and 4) outcomes-based research. This approach underscores the essential basis of critical care medicine, requiring an integration of cell and molecular biology to organ-system monitoring, and following therapies to define their effects on socially relevant outcomes. These areas of research coincide with extramural research grants on which the faculty collaborate. The research training efforts can be staged. The faculty reflect an experienced and dedicated group of senior academicians, and all the principal trainers have extramural research training support and training experience in those areas of research. Upon completion of the training program, the fellow will understand how to design, execute, and complete experiments to answer specific questions derived from critically ill patients. Thus, the fellow will be trained not only in advanced laboratory methodology in molecular biology, cell biology and immunology, organ-system physiology, and epidemiology, but also in the thought processes needed to apply future experimental problems as they relate to real life problems in critically ill patients. All trainees will take formal postgraduate courses offered by the basic science departments of the University of pittsburgh. Some may complete coursework necessary to receive PhD and MPH degrees in these basic science programs. Most training will take place in the laboratories of the principal trainers using a carefully thought-out version of the time-honored master-apprentice system. This training technique combines weekly meetings between the trainee and trainer as well as hour long research training seminars each week at which the trainer group, including of the principal trainer and the extended research trainer group, whose special skills and interests are chosen to supplement the principal trainer and concurrently guide and monitor the trainee's research program. Furthermore, formal research presentations by the trainees will be given biannually to the local research community. This flexible but intense degree of supervision permits the simultaneous completion of efficient, cordial, and cooperative research and training. The individual fellows choose a principal trainer with the support and guidance of the Executive Training Committee. Then collectively, they fashion an individualized training program, trainer group, and coursework program to allow the fellow to accomplish the educational and research goals of the program. Affirmative action recruitment efforts are already in place. The training facilities can serve more fellows than will be funded by this training proposal. All training will be carried out in the more than 20,000 square feet of fully equipped laboratory space available and with ancillary technical support.