Dr. Jennifer K. Mulligan performs translational research in collaboration with Rhinologists Dr. Jeb M. Justice and Dr. Brian C. Lobo to focus on understanding the immunopathology of Chronic Rhinosinusitis (CRS). CRS is present in 16% of the US population with direct costs of $22 billion per year. CRS quality of life reduction is similar to that in patients with severe COPD, congestive heart failure, and patients on dialysis. Furthermore, there is a known association of upper airway disease (CRS, allergic rhinitis) with lower airway disease (asthma), and asthma is known to be one of the most common factors associated with CRS severity and recalcitrance. Dr. Mulligan’s lab uses a multidisciplinary approach to focus on 4 main areas:
- Vitamin D: Given vitamin D’s ability to promote anti-viral and anti-microbial immune responses, while simultaneously preventing an overreaction of the immune system, it is well suited as a therapeutic target for a number of airway diseases. Our laboratory focuses on how oral vitamin D supplementation, local airway vitamin D metabolism, and local delivery of active vitamin D may all play roles in respiratory health.
- Airway Epithelial cell dysfunction: One cell population identified as a therapeutic target, for a number of airway diseases, are respiratory epithelial cells. Environmental insults including; fungi, bacteria, viruses, and allergens, as well as topically delivered therapeutic agents interact initially with epithelial cells in the respiratory tract. In patients with CRS and/or asthma, epithelial cells have altered functions including cytokine/chemokine production and are hyper-responsive to antigen stimulation. What remains unclear and is a focus of our investigations, is to identify a means by which to reduce their intrinsically pro-inflammatory nature.
- Olfactory loss: Sinusitis is the most common cause of temporary and permanent olfactory loss, and in CRS with nasal polyps, up to 50% of patients suffer from anosmia even after medical or surgical treatment. Our research group had identified a number of factors in humans related to CRS and non-CRS olfactory loss. Many of these factors could be targeted with intranasal delivery of existing drugs approved for other diseases, which is a focus of our ongoing investigations.
Nasal mucus biomarkers: Our laboratory was the first to establish a standardized method from the collection of nasal mucus and demonstrate its utility as a surrogate for tissue biopsies to study immunological changes in the upper airway. Nasal mucus biomarker research has now evolved into an invaluable research tool that has revolutionized the research of upper airway inflammation. So much so that in the recent report “Clinical Research Needs for the Management of Chronic Rhinosinusitis with Nasal Polyps in the New Era of Biologics. A National Institute of Allergy and Infectious Diseases Workshop” nasal mucus biomarkers were highlighted as playing a critical role in clinical trials for the first biological treatments for CRS in the US. Through partnerships across UF and the US, we are investigating how nasal mucus immune signatures can be used to identify novel therapies for the treatment of CRS.
Opportunities to collaborate with other basic science laboratories may be provided and include:
Carl Atkinson, PhD – Transplant immunology, complement biology, innate immunity
Reza Forghani MD, PhD- Radiomics and augmented intelligence laboratory
Frank Bova, PhD – Neurosurgery, radiosurgery biology laboratory
Use of Puragel (RADA16) to Reduce Mucosal Inflammation
Sometimes the newest innovations emerge from a fortunate stroke of serendipity. The simplest observation leads to the development of a major and beneficial breakthrough in a field.
Dr. Jennifer Mulligan, a mucosal immunologist in the Department of Otolaryngology at the UF College of Medicine, and Dr. Carl Atkinson developed RADA16, a hydrogel made of amino acids to help better treat patients with chronic rhinosinusitis (CRS), an inflammatory condition affecting the sinuses and nasal passages.
Patients with CRS experience symptoms, such as having a runny nose or cold, persistently for months, if not years. This often leads to a loss of sense of smell and a poor quality of life. Common treatments are steroids, which have long-term negative consequences.
But, with RADA16, it may be possible to control inflammation by applying it directly to the mucosal site of injury or inflammation.