Research in the Joseph Gallo Lab focuses on the form and course of depression in older adults; treatment in primary care settings; the use of mixed methods in health services research; and the epidemiology of psychiatric disorders in the population. Using NIMH Epidemiologic Catchment Area survey data, we have conducted studies using novel statistical modeling (the MIMIC model) to explore how depression presents differently among older adults versus younger people. We are taking part in the long-term follow-up of PROSPECT (Prevention of Suicide in Primary Care Elderly – Collaborative Trial) — a randomized study of depression management in primary care practices — and have examined mortality as an outcome in the context of medical comorbidity.

Research in the Cynthia Boyd Lab concentrates on the clinical care of comorbid chronically ill and frail older adults, both chronically and during acute illnesses. Current projects focus on the treatment burden among older adults with multimorbidity, the importance of competing risks in decision-making for the elderly, the effects of guided care on the quality of care and the improvement of clinical practice guidelines for the elderly.

Research in the Elizabeth Tucker Lab aims to find treatments that decrease neuroinflammation and improve recovery, as well as to improve morbidity and mortality in patients with infectious neurological diseases. We are currently working with Drs. Sujatha Kannan and Sanjay Jain to study neuroinflammation related to central nervous system tuberculosis – using an animal model to examine the role of neuroinflammation in this disease and how it can differ in developing brains and adult brains. Our team also is working with Dr. Jain to study noninvasive imaging techniques for use in monitoring disease progression and evaluating treatment responses.

The C. Kwon Lab studies the cellular and molecular mechanisms governing heart generation and regeneration. The limited regenerative capacity of the heart is a major factor in morbidity and mortality rates: Heart malformation is the most frequent form of human birth defects, and cardiovascular disease is the leading cause of death worldwide. Cardiovascular progenitor cells hold tremendous therapeutic potential due to their unique ability to expand and differentiate into various heart cell types. Our laboratory seeks to understand the fundamental biology and regenerative potential of multi-potent cardiac progenitor cells – building blocks used to form the heart during fetal development — by deciphering the molecular and cellular mechanisms that control their induction, maintenance, and differentiation. We are also interested in elucidating the maturation event of heart muscle cells, an essential process to generate adult cardiomyocytes, which occurs after terminal differentiation of the progenitor cells. We believe this knowledge will contribute to our understanding of congenital and adult heart disease and be instrumental for stem cell-based heart regeneration. We have developed several novel approaches to deconstruct the mechanisms, including the use of animal models and pluripotent stem cell systems. We expect this knowledge will help us better understand heart disease and will be instrumental for stem-cell-based disease modeling and interventions for of heart repair. Dr. Chulan Kwon is an assistant professor of medicine at the Johns Hopkins University Heart and Vascular Institute.

Research in the Daniel Ford Lab seeks to understand the relationships between depression and various chronic medical conditions. Recently, we've focused on depression and coronary artery disease as well as tactics for improving care for patients with medical comorbidity. Our research was among the first to document depression as a risk factor for myocardial infarction and stroke. Our team is also interested in exploring how information technology can be used to improve the care of patients with depression and tobacco abuse.

Research in the Nadia Hansel Lab investigates the clinical, pathophysiologic and public health aspects of pulmonary diseases, with a focus on asthma and chronic obstructive pulmonary disease (COPD). We have explored how environmental exposures, nutrition and diet, comorbidity and other factors influence the outcomes of diseases such as asthma and COPD.

The Hoffmann Lab is focused on reducing TB and HIV morbidity and mortality in the low and middle income settings through behavioral and implementation science approaches. Work has focused on understanding individual-level behavior towards linkage to care and continued care engagement for HIV and TB and using this knowledge to develop approaches to increase HIV testing, linkage to care, HIV viral load suppression, and retention in care. Other work has focused on health system strategies to improve service delivery and improve adherence to best practice to guidelines-based care. The group's research includes work on the general population, corrections inmates and ex-inmates, men at risk for HIV, and recently hospitalized individuals. Most of the research has been in South Africa and elsewhere in sub-Saharan Africa.

Secretory diarrhea is a leading cause of childhood morbidity and mortality in developing countries. While diarrhea can be treated with oral rehydration solution (ORS), inclusion of zinc with oral ORS has been shown to reduce the duration of diarrhea. However, how zinc improves diarrhea is not known. It has been shown that zinc acts as an intestinal epithelial cell basolateral potassium channel blocker of cyclic AMP-mediated chloride secretion. We discovered that zinc also stimulates intestinal sodium and water absorption via the epithelial Na/H exchanger, NHE3. Zinc reverses the effect of cyclic AMP inhibition of NHE3 activity. The effect of zinc on NHE3 cannot be duplicated with other divalent metal ions. It has been well established that Na/H exchanger regulatory proteins are involved in NHE3 regulation. Whether these regulatory proteins are involved in zinc stimulation of NHE3 is a focus of our study. Our goal is to reveal mechanisms to explain how zinc improves diarrhea and to understand the role of zinc in salt and water homeostasis in the gut. Our study will provide a scientific basis to justify the inclusion of zinc in ORS for the treatment of secretory diarrhea.

Chronic rhinosinusitis (CRS) is a leading cause of morbidity globally and is the single most common self-reported chronic health condition and accounts for billions of dollars in health care costs and lost work days annually. Exposure to air pollutants is thought to be a critical modifier of CRS susceptibility. Despite marked reductions in air pollution levels in the United States, the fine particulate component of air pollution (PM2.5) and ultrafine pollutants secondary to traffic continue to remain a recalcitrant issue globally and in the United States. The Ramanathan Lab focuses on studying the role of air pollution (PM2.5) in CRS. In collaboration with scientists at the Bloomberg School of Public Health, we have utilized a state of the art air pollution exposure system to develop a novel mouse model of air pollution induced rhinosinusitis that mimics many of the features of CRS in humans. Our lab uses transgenic mouse models and novel immunologic/genomic techniques to study the mechanisms by which PM2.5 causes eosinophilic inflammation and sinonasal epithelial barrier dysfunction. We are also interested in the role of the antioxidant transcription factor, Nrf2, which has shown to stabilize the epithelial barrier and reduce eosinophilia in PM induced rhinosinusitis as a potential therapeutic target.

Research in the Robert Siliciano Laboratory focuses on HIV and antiretroviral therapy (ART). ART consists of combinations of three drugs that inhibit specific steps in the virus life cycle. Though linked to reduced morbidity and mortality rates, ART is not curative. Through our research related to latently infected cells, we've shown that eradicating HIV-1 infection with ART alone is impossible due to the latent reservoir for HIV-1 in resting CD4+ T cells. Our laboratory characterized the different forms of HIV-1 that persist in patients on ART. Currently, we are searching for and evaluating drugs that target the latent reservoir. We are also developing assays that can be used to monitor the elimination of this reservoir. We are also interested in the basic pharmacodynamic principles that explain how antiretroviral drugs work. We have recently discovered why certain classes of antiretroviral drugs are so effective at inhibiting viral replication. We are using this discovery along with experimental and computational approaches to develop improved therapies for HIV-1 infection and to understand and prevent drug resistance. Finally, we are studying the immunology of HIV-1 infection, and in particular, the ability of some patients to control the infection without ART.