Frendl Research Program

Overview

The Clinical Research Program directed by Dr. Frendl focuses on improving perioperative and critical care outcomes through a combination of clinical trials, testing innovative imaging technologies, and multidisciplinary collaboration. Research efforts span acute respiratory distress syndrome (ARDS), perioperative lung-protective ventilation strategies, lung transplant and related critical care nutrition, and device-based novel diagnostics. By integrating translational and clinical research approaches, the program aims to improve patient outcomes and test and deploy novel diagnostic capabilities in the critically ill and peri-operative patient population.

Research Projects

Dr. Frendl’s group is part of the NIH and PICORI-funded Perioperative Research Network, the US PETAL and LUNG-SAFE international trial networks.

Federally Funded Research (NIH & PICORI)

1. An Anesthesia-Centered Bundle to Reduce Post-Operative Pulmonary Complications: The PRIME-AIR Study Trial (NCT 04108130) – BWH (PI: Marcos Vidal-Melo, MD. PhD, UTMB; Site PI: Gyorgy Frendl, MD, PhD, BWH
   Funding: NIH (NHLBI)
   Grant #: HL140177
   An NIH-funded multicenter randomized trial evaluating an anesthesia-centered perioperative care bundle to reduce postoperative pulmonary complications.
2. PRIME-AIR Lipidomics Substudy (2024P000219) – PI: Gyorgy Frendl, MD, PhD, BWH
   Funding: NIH (NHLBI) and Internal funds
   Grant #: HL140177
   A PRIME-AIR sub-study, secondary analysis examining lipid mediator profiles to better understand inflammatory pathways in perioperative lung injury and recovery.
3. PRIME-AIR Mechanical Power Substudy – PI: Gyorgy Frendl, MD, PhD, BWH
   Funding: NIH (NHLBI) and Internal funds
   Grant #: HL140177
   A secondary study evaluating mechanical power and its relationship to lung-protective ventilation strategies and clinical outcomes.
4. Preoperative Fasting vs. Not Fasting in Mechanically Ventilated Patients who Receive Tube Feeding (FEEDS): A Pragmatic Comparative Safety Trial (NCT06751043) – PI: Alexander Nagrebetsky, MD, MGH, Site-PI: Gyorgy Frendl, MD, PhD, BWH
   Funding: PCORI
   Grant #: BPS-2023C1-31273
   A multicenter randomized controlled trial evaluating preoperative fasting versus not fasting in critically ill patients.
5. Continuous monitoring of pain using facial expressions in ICU environment (COMPANION) Trial -- PI: Hao Deng, MD, MGH; Site-PI: Gyorgy Frendl, MD, PhD, BWH
   Funding: NIH (NINDS)
   Grant #: 1UG3NS143749
   A federally funded study evaluating continuous monitoring of pain using facial expressions in the ICU to improve real-time assessment and clinical decision-making.

Industry-Sponsored Clinical Trial Research

1. Bone Marrow Mesenchymal Stem Cell Derived Extracellular Vesicles for Hospitalized Patients with Moderate-to-Severe ARDS: A Phase III Clinical Trial (ExoFlo). (DB-EF-PHASEIII-0001)– Site-PI: Gyorgy Frendl, MD, PhD. BWH
   Funding: Direct Biologics, Inc.
   A Phase III randomized, double-blind trial evaluating the efficacy of mesenchymal stem cell-derived extracellular vesicle therapy for moderate-to-severe ARDS (lead enroller into the study).

Investigator-Initiated / Institutional Research

1. Clinical trial for the validation of the clinical utility of portable Dynamic Digital X-ray (pDDR) technology. (ClinicalTrials.gov: NCT06538376) – PI: Gyorgy Frendl, MD, PhD, Co-PI: Hiroto Hatabu. MD,PhD, BWH
   Funding: Konica Minolta, Inc.
   A clinical study assessing the utility of portable dynamic digital radiography (pDDR) for real-time, point-of-care quantitative evaluation of diaphragmatic function and semiquantitative lung ventilation, perfusion, and as a novel point-of -care diagnostic technique.
2. AMPLIT study: Identification of a rejection signature and distinct inflammatory alveolar macrophage populations post lung transplantation. PI: Gyorgy Frendl, MD, PhD, BWH; Co-PI: Jianzhu Chen.PhD, MIT
   Funding: Internal
   A clinical study is aimed at understanding the role of brocho-alveolar macrophages (BAL/AM) in post-lung transplant outcomes. We performed a comprehensive prospective analysis of BAL leukocyte phenotypes and transcriptomic profiles for up to one-year post-lung transplantation, focusing on rejection-associated gene signatures and related alveolar macrophage subtypes. We identified and characterized unique foamy (FM) and accompanying non-foamy macrophages (No-FMs) in transplant recipients and examined their correlation with clinical outcomes. Furthermore, we identified distinct gene expression signatures for FMs, No-FMs, and lung rejection across two independent cohorts of locally recruited patients and characterized longitudinal alterations in BAL leukocyte phenotypes following transplantation. The follow-up study will examine the expression of these rejection and FM gene signatures in a large cohort of lung transplant patient biopsies from multiple US and international transplant centers.

Training of Fellows & Residents

Fellows and residents are actively integrated into the research program through direct participation in patient enrollment, data collection, and protocol implementation across ICU and perioperative studies. Trainees contribute to data analysis, manuscript development, and presentation of findings at regional and national conferences. All participants receive training in IRB processes and regulatory compliance, supporting development as clinician-investigators.

Research Team

Principal Investigator

Dr. Gyorgy Frendl, MD, PhD
Associate Professor, Brigham and Women’s Hospital and Harvard Medical School

Faculty & Physician Investigators

Dr. Elana Folbe, MD Clinical Fellow in Anesthesia Critical Care Medicine
Dr. Grace Lee, MD Clinical Fellow in Anesthesia Critical Care Medicine
Dr. Colby Gray, DO Attending Anesthesiologist, Thoracic Anesthesia Division
Dr. Emi Hirsh, MD Anesthesia Resident
Dr. Maegan Neilson, MD Anesthesia Resident
Dr. Adhil Sheikh, MD BWPO Physician and Dept. of Medicine, Pulmonary Critical Care Faculty, BWG/MGB
Dr. Hiroto Hatabu, MD, PhD Professor of Radiology; Thoracic Imaging, Department of Radiology, BWH/MGB
Dr. Mizuki Nishino, MD, PhDProfessor of Radiology; Thoracic Imaging, Department of Radiology, BWH/MGB

Research Staff

Parnika Agrawal, BS Clinical Research Coordinator
Poorva Bagchee, BS Clinical Research Coordinator
Ava BenDavid, BA Clinical Research Coordinator