Mentoring in Chronic Rhinosinusitis Pathophysiology and Mechanisms of Disease

项目摘要 慢性鼻窦炎（CRS）是一种常见的炎症性疾病，影响美国大部分地区。 造成受影响者的生活质量差，并使用数十亿美元的医疗保健 资源我实验室的努力集中在理解大CRS中炎症异质性的模式 目标是改善疾病内定型和开发个性化护理途径。我是 致力于指导下一代的临床科学家在泌尿学和慢性鼻窦炎领域 research.从事临床或转化研究的内科医生和其他外科医生的数量正在下降， 这在耳鼻喉科和耳鼻喉科领域尤其如此。保持一个强大的受训人员管道 研究相关的职业道路是至关重要的发展的子专业和科学进步 的领域。这将是一项前瞻性转化队列研究，以确定临床意义和纵向 慢性鼻窦炎内型的稳定性。我们将通过我们完善的 生物标本库，并确定炎症介质水平和相关内型的稳定性 分配在多个季节，并确定这些变化是否与鼻窦微生物 社区结构我们还将证实两种常用的免疫修饰剂的纵向效应。 干预（内窥镜鼻窦手术和抗IL 4/13 R生物治疗）对炎症介质水平的影响， 内型分配总的来说，这些翻译研究将大大提高基础知识的一个 影响数百万患者的常见气道疾病，同时提供一系列调查机会 对CRS和上呼吸道炎症机制感兴趣的学员。我的研究项目主要集中在 围绕以患者为导向的方法，包括患者来源的标本，患者报告的结果 措施和个性化的护理方法。我预计学员参与这项研究计划 将为以患者为导向的研究带来新的令人兴奋的途径，以进一步表征CRS内型， 评估靶向治疗的效果;因此，该项目将为开发 下一代临床科学家我有一个持续的校外资金的历史，超过一个 十年的经验，作为一个导师，学员在各级，和机构的支持，以提高我自己的技能， 将通过K24机制增加拟议的支助。

PROJECT SUMMARY Chronic rhinosinusitis (CRS) is a common inflammatory disease that affects a large portion of the U.S. population, resulting in poor quality of life for those affected and utilizing billions of dollars of health care resources. Efforts in my lab have focused on understanding patterns of inflammatory heterogeneity in large CRS populations with a goal of improving disease endotyping and developing personalized care pathways. I am devoted to mentoring the next generation of clinician-scientists in the field of rhinology and chronic rhinosinusitis research. The number of physicians and other surgeons pursuing clinical or translational research is declining, and this is particularly true in the fields of rhinology and otolaryngology. Maintaining a strong pipeline of trainees on research-related career paths is crucial for the development of the subspecialty and scientific advancement of the field. This will be a prospective translational cohort study to identify the clinical implications and longitudinal stability of chronic rhinosinusitis endotypes. We will enroll CRS patients through our well-established biospecimen repository and determine the stability of inflammatory mediator levels and associated endotype assignment over multiple seasons and determine whether these changes are associated with sinonasal microbial community structure. We will also confirm the longitudinal effects of two commonly used immune-modifying interventions (endoscopic sinus surgery and anti-IL4/13R biologic therapy) on inflammatory mediator levels and endotypic assignment. Collectively, these translational studies will substantially advance basic knowledge of a common airway disease that impacts millions of patients, while providing a range of investigative opportunities for mentees interested in CRS and mechanisms of upper airway inflammation. My research program is centered around a patient-oriented approach that incorporates patient-derived specimens, patient-reported outcome measures, and personalized approaches to care. I anticipate that mentee participation in this research program will lead to new and exciting avenues for patient-oriented research to further characterize CRS endotypes and evaluate the effects of targeted therapies; thus, this project will provide a conducive setting for developing the next generation of clinician-scientists in the field. I have a history of continual extramural funding, more than a decade of experience as a mentor to trainees at all levels, and institutional support to enhance my own skills that will augment the support proposed through the K24 mechanism.