The Breath of Life
New Center for Pulmonary Biology brings together science and medicine to help kids breathe easier

BY MARK SHWARTZ

FALL 2006 -- Few experiences are as awe-inspiring as the sight of a newborn child taking its first breath of air. But this "breathtaking" introduction to the outside world also triggers a series of dramatic physical changes inside the infant's body, says David Cornfield, MD, one of the country's leading pediatric pulmonologists.

"A baby's first breath is a remarkable moment," he explains. "The lungs become functional for the first time, pulmonary blood flow suddenly increases 8- to 10-fold and the baby is quickly transformed into a vibrant, breathing person."

Prior to his arrival as director of Packard's new Center for Pulmonary Biology last November, David Cornfield had served nearly a decade as director of the highly regarded Division of Pediatric Pulmonary and Critical Care at the University of Minnesota Medical School A member of the Minnesota faculty since 1994, Cornfield earned his MD at the University of Wisconsin in 1986. He completed his internship and residency at Children's Mercy Hospital in Kansas City, Mo., between 1987 and 1993, when he enrolled in a fellowship at Denver's Children's Hospital.

A child's pulmonary health must be closely monitored from infancy, he adds, to assure that the lungs are developing normally and that respiratory diseases are caught early. Some children, unfortunately, are plagued by pulmonary difficulties throughout their lives.

To find new treatments, and provide the highest level of care for kids with cystic fibrosis and other debilitating respiratory conditions, Packard Hospital recruited Cornfield in late 2005 as director of the new Center for Pulmonary Biology.

"Our vision is to bring science and medicine together to tackle these difficult diseases, while remaining firmly and squarely focused on the humanity of each patient," says Cornfield, the Anne T. and Robert M. Bass Professor in Pediatric Pulmonary Medicine at Stanford.

The Center unites three major programs at Packard -- cystic fibrosis and pulmonary medicine; allergy, asthma and immunology; and pediatric critical care -- to create what Cornfield calls a multidisciplinary "synergy" that takes advantage of Stanford's world-class expertise in biology, chemistry and other fields. This collaborative research effort will bring a diverse range of experimental techniques, from 3-D medical imaging to comparative genetics, under one umbrella.

A successful example of this kind of cross-disciplinary approach, says Cornfield, is Stanford's Vera Moulton Wall Center for Pulmonary Vascular Disease, where Marlene Rabinovitch, MD, and other scientists conduct pioneering studies of pediatric pulmonary hypertension -- a serious disease in which the heart's ability to pump blood to the lungs is severely reduced because of abnormally high pressure in the pulmonary arteries. "One reason I came to Stanford was to have the opportunity to work with Marlene, one of the preeminent vascular biologists in the world," Cornfield says.

While substantial progress has been achieved in treating some pulmonary disorders,much more work needs to be done, adds Richard Moss, MD, professor of pediatrics and director of the Packard Cystic Fibrosis Clinic.

"Today, one of the biggest challenges we face is asthma, which is the leading cause of school absence and has been increasing in recent years, although we don't know why," Moss says. "It will be hugely important to have asthma, immunology and pulmonology research together in one center."

Another vital component of the new Center is the integration of critical care for children with life-threatening diseases -- such as pulmonary hypertension -- and those with chronic breathing problems, including premature babies.

"I came to Packard to create the Center that would provide a platform for the next generation of discoveries," Cornfield says. "Together, we should be able to achieve goals in pulmonary medicine that are quite lofty and grand, and at the same time make every patient feel as though they're the whole focus of our attention."