by Amy Vaerewyck
He introduces himself as “Kurt” instead of “Dr. Stenmark.” He’ll don a hot pink lab coat to give his researchers a laugh. He comes to work each day with a mission: to eliminate cardiovascular pulmonary disease in both children and adults.
Kurt Stenmark, MD, is director of the Developmental Lung Biology and Cardiovascular Pulmonary Research (CVP) Laboratories. In this position, he leads the longest-running lung research project funded by the National Institutes of Health (NIH) in the United States, called “Adaptations to Hypoxia.”
The "Adaptations to Hypoxia" project focuses on:
- Investigating mechanisms of lung vascular and cardiac dysfunction,
- Developing treatments for individuals who have disease where low oxygen levels and inflammation are common, and
- Training fellows in either basic biological or medical sciences, for careers in lung vascular biology research or university-level teaching.
“Adaptations to Hypoxia” is a 37-year-old research project. Stenmark has been involved for the past 30 years and leading the charge for the past 10. He also serves as principal investigator of another two-decade-old project—which is part of NIH Specialized Centers of Research (SCOR) and Specialized Centers of Clinically Oriented Research (SCCOR)—focused on the treatment of infants and children with pulmonary hypertension.
Pulmonary Hypertension (PH)
PH is a rare disorder of the blood vessels in the lungs. It occurs when there is abnormally high blood pressure in the lungs, and it affects the arteries in the lungs and the right side of the heart. PH is caused when pulmonary arteries and capillaries become narrowed, blocked or destroyed, making it harder for blood to flow through the lungs. This raises blood pressure within the arteries in the lungs. As the pressure in the lungs rises, the heart must continue to work harder, which can cause the heart to weaken and eventually fail completely.
“Our colleagues around the country know [the Anschutz Medical Campus] is the place to be for pulmonary vascular research.”
While completing his pediatric residency at CU School of Medicine
in the late 1970s, Dr. Stenmark often cared for newborns whose lungs couldn’t oxygenate properly outside of the womb. One in a thousand babies experienced this severe pulmonary hypertension during the neonatal period. They would turn blue, and unfortunately, many would succumb to the disease.
“There was no treatment for the condition,” Dr. Stenmark said. Once he joined CU’s CVP laboratory, he and his colleagues began bringing together physicians and researchers from different backgrounds to try to understand this problem. They gathered not only infant lung vasculature and hypoxia experts but also adult pulmonologists, cardiologists, cellular biologists and neonatologists.
The use of a new therapy treatment, inhaled nitric oxide (iNO), which was normally used only on adults, was proposed to evaluate the effects on infants with persistent pulmonary hypertension. The use of iNO proved so effective that it has become standard treatment for infants with pulmonary hypertension. Thanks to the work of this diverse group of specialists, this treatment has saved hundreds of lives and millions of dollars by replacing more costly and less efficacious treatments.
“Our group deserves a great deal of credit for forwarding a scientific idea to save hundreds, if not thousands of lives, not just in Denver but around the world,” Stenmark said. “We’re among the very first programs in the country to integrate the study of both pulmonary and cardiovascular issues.”
Twenty years after it was first funded, the “Impact of Injury on the Developing Circulation” research project is still going strong, investigating new treatments for premature infants with lung injury. In addition, the SCOR/SCCOR has had tremendous impact on the development of programs at the university, including the Pediatric Heart Lung Center
, headed by Steven Abman, MD, at the University of Colorado Hospital—a large, integrative center comprised of clinical and basic science investigators who facilitate bench-to-bedside translational work.
It is the longest running SCCOR program for children, consistently procuring solid funding in spite of the fact that only 10 percent of grant proposals are accepted these days, Dr. Stenmark said.
“There’s no place else with so many experts working as a team to help patients with pulmonary hypertension.”
If you visit Dr. Stenmark’s lab, you sense that the group’s continuing success has a lot to do with teamwork. There is a feeling of family among them. Dr. Stenmark strolls up and down the lab benches, greeting the researchers, and they look up from their microscopes and share their latest project news.
One member of his “family,” Maria Frid, PhD, a senior instructor of pediatrics, came to the lab from Russia on a 6-month assignment; that was 20 years ago, and she’s still there. Stenmark has also garnered the expertise of researchers from other specialty labs—such as Karim El Kasmi
, MD, PhD, assistant professor of pediatrics, whose primary work is studying macrophages in gastroenterology—creating a truly integrative approach to the project.
“We have retained a core of exceptional people across the pediatric and adult disciplines. They are the best in the United States,” Stenmark said.
“Our work never stops.”
As these research projects meet intermediary goals of improving treatment and increasing life expectancy and quality of life in patients, the work continues toward its ultimate goal: eliminating cardiopulmonary vascular disease altogether.
“In science, your goal is always lofty,” Stenmark said. “Because we’ve had success, we can keep asking new questions, forming new relationships and monitoring new therapies to help patients.”
Currently, Dr. Stenmark and his fellow “Adaptations to Hypoxia” researchers are narrowing in on the question of how lung vascular disease in animals relates to that in humans. They have formed relationships with veterinarians around the state of Colorado to pursue an answer.
“What makes this institution and program so good is all the different types of people who can make contributions on so many levels,” he said. “People should know: If you have lung vascular disease issues, this is the place to be.”