Hunninghake Laboratory for the Study of Early Pulmonary Fibrosis Detection

Overview

Dr. Hunninghake, “Matt”, is a pulmonologist, genetic epidemiologist, associate director for the Center for Pulmonary Functional Imaging, and the director of the Interstitial Lung Disease Program at the Brigham and Women's Hospital. He completed medical school at the University of Iowa, residency and chief residency at Virginia Commonwealth University, and a pulmonary fellowship and a Masters of Public Health at Harvard where he is now a Professor of Medicine and the Watkins Family Endowed Professor of Autoimmune Lung Disease.

In addition, to caring for patient’s in the Intensive Care Unit, and in the Interstitial Lung Disease Clinic his research has been focused on identifying the factors that will help to diagnose early stages of pulmonary fibrosis. The overarching goal of this work is to target specific groups most likely to progress to pulmonary fibrosis with the hope preventing the more advanced stages of this incurable disease. He has been the Principal Investigator or co-Principal Investigator on 3 R01 grants (three which have been renewed) as well as the site-PI on numerous pharmaceutical sponsored clinical trials.  This work has helped to change our understanding of early stages of pulmonary fibrosis and has led to international guidelines for the recommendation on reporting and following patients with evidence for early stages of this disease.

My current research is focused on identifying factors that will help to diagnose early stages of pulmonary fibrosis. My goal is to identify methods that can target groups most likely to progress to pulmonary fibrosis with the hope of preventing the more advanced stages of this incurable disease. I have had PI roles on three RO1 grants that are directed towards this effort. The first study is designed to detect the critical epidemiologic, genetic, and epigenetic determinants of early-stage pulmonary fibrosis in multiple different populations. I am multi-PI (and contact PI) on an R0l designed to test the role of clinical genetic testing and screening for pulmonary fibrosis in undiagnosed relatives of patients with pulmonary fibrosis. This is the first funded grant whose goal is to identify early-stages of PF in undiagnosed first-degree relatives of patients with known disease. I am also a multi-PI on a grant designed to identify the genetic and genomic determinants that best help to predict early PF development and progression in five unique cohorts. I also serve, or have served, as the site-PI on multiple NIH and pharmaceutical sponsored clinical trials for patients with IPF and progressive pulmonary fibrosis.

Through this funding, my group has made seminal discoveries in the field of early disease detection for pulmonary fibrosis. Our work has demonstrated that there are significant numbers of undiagnosed people with specific patterns of increased lung densities on chest CT, which we termed interstitial lung abnormalities (ILA). Our evidence suggests that ILA identified on chest imaging may, in some cases, represent an early or mild form of IPF. In addition to the imaging correlations, this evidence includes our analyses showing that research participants with ILA are more likely to have respiratory symptoms and physiologic decrements, genetic abnormalities, and histopathologic findings apparent in patients with the most common form of pulmonary fibrosis, IPF. We have published papers showing that people with ILA have an increased rate of decline in pulmonary function over time and increased mortality. These findings are consistent with the concept that IPF may represent an advanced stage of a relatively common, and often minimally symptomatic, pulmonary fibrosis syndrome that progresses at various rates. The recognition of these research accomplishments is reflected in my frequent invitations to present my work at national and international meetings, at the National Institutes of Health, invited presentations at international academic medical centers, membership in editorial boards and international consortia. This work has led to the first international guidelines for the recommendation on reporting and following patients with early stages of pulmonary fibrosis, and new updated American Thoracic Society Clinical Statement. I will also be the corresponding investigator on the first clinical trial attempting to reduce the rate of progression in relatives of patients with early-stages of PF.

Publications

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