The objective of this application is to support the career development of Dr. Alicia Gerke. Dr. Gerke's long term career goal is to become a nationally recognized clinical investigator in identifying clinical and genetic risk factors for diagnosis and prognosis of rare diseases using novel internet-based research techniques. Dr. Gerke has assembled a team of experienced mentors (Drs. James Torner, Jeffrey Murray, Philip Polgreen, and Martha Monick) who bring expertise in complementary methodological areas and experience in nurturing young investigators. Using a recently developed national sarcoidosis registry, she will describe characteristics of the disease across the nation and identify clinical and genetic markers associated with outcomes. During the award, Dr. Gerke will become an expert in: 1) Patient-based investigation using internet-assisted (e-health) research, 2) Advanced clinical epidemiology methods for use in internet research, and 3) Identifying genetic markers of risk for disease prognosis and outcomes. These goals will be accomplished by coursework, readings, and research experiences guided by her mentors. Because clinical trials are difficult to perform in rare diseases such as sarcoidosis, much of clinical management is dictated by expert opinion. To date, the outcomes of varying diagnostic and treatment practices across the nation are largely unknown. Dr. Gerke will be using a sarcoidosis disease registry to aggregate data on a large national cohort of sarcoidosis patients in order to, first, understand the variability of diagnostic and treatment practices across the nation, and then, to identify clinical and genetic markers associated with progressive disease requiring long-term treatment.
For Aim 1, Dr. Gerke will be expanding recruitment on an existing registry using internet and e-health based research approaches.
Aim 2 will use registry data to define the pathways of diagnosis for sarcoidosis patients and establish risks associated with delays in diagnosis.
Aim 3 will describe the treatment variability across the nation and identify treatment related practices associated with adverse outcomes.
Aim 4 will be using DNA specimens from the registry biorepository to identify DNA methylation patterns that are associated with diagnosis and prognosis of patients with sarcoidosis. These projects are important to explore the characteristics of sarcoidosis patients on a national scale and identifying appropriate clinical an genetic markers of appropriate phenotypes for future clinical trials. Completion of these aims will provide the foundation for an independent research career for Dr. Gerke. Dr. Gerke's mentors and institution are committed to her success with resources and the environment in place to facilitate her career development.

Public Health Relevance

Because clinical trials are difficult to perform in rare diseases such as sarcoidosis, there is a lack of knowledge regarding diagnostic and treatment approaches and how to predict which patients will need prolonged therapy. The goal of this research proposal is to use a national registry to characterize the disease and improve the management and treatment of patients with sarcoidosis.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Mentored Patient-Oriented Research Career Development Award (K23)
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Special Emphasis Panel (ZHL1-CSR-X (M1))
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Colombini-Hatch, Sandra
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University of Iowa
Internal Medicine/Medicine
Schools of Medicine
Iowa City
United States
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Jain, Snigdha; Khera, Rohan; Girotra, Saket et al. (2017) Comparative Effectiveness of Pharmacologic Interventions for Pulmonary Arterial Hypertension: A Systematic Review and Network Meta-Analysis. Chest 151:90-105
Chan, Kung-Sik; Jiao, Feiran; Mikulski, Marek A et al. (2016) Novel Logistic Regression Model of Chest CT Attenuation Coefficient Distributions for the Automated Detection of Abnormal (Emphysema or ILD) Versus Normal Lung. Acad Radiol 23:304-14
Khera, Rohan; Cram, Peter; Lu, Xin et al. (2015) Trends in the use of percutaneous ventricular assist devices: analysis of national inpatient sample data, 2007 through 2012. JAMA Intern Med 175:941-50
Gerke, Alicia K; Tang, Fan; Cavanaugh, Joseph E et al. (2015) Increased trend in extracorporeal membrane oxygenation use by adults in the United States since 2007. BMC Res Notes 8:686
Gerke, Alicia K; Pezzulo, Alejandro A; Tang, Fan et al. (2014) Effects of vitamin D supplementation on alveolar macrophage gene expression: preliminary results of a randomized, controlled trial. Multidiscip Respir Med 9:18
Gerke, Alicia K; Tang, Fan; Pendergast, Jane et al. (2014) The high frequency of healthcare use in patients one year prior to a sarcoidosis diagnosis. Sarcoidosis Vasc Diffuse Lung Dis 31:256-61
Gerke, Alicia K; Yang, Ming; Tang, Fan et al. (2014) Association of hospitalizations for asthma with seasonal and pandemic influenza. Respirology 19:116-21
Gerke, Alicia K (2014) Morbidity and mortality in sarcoidosis. Curr Opin Pulm Med 20:472-8
Gerke, Alicia K; Tang, Fan; Yang, Ming et al. (2013) Predicting chronic obstructive pulmonary disease hospitalizations based on concurrent influenza activity. COPD 10:573-80
Gerke, A K; Tangh, F; Yang, M et al. (2012) An analysis of seasonality of sarcoidosis in the United States veteran population: 2000-2007. Sarcoidosis Vasc Diffuse Lung Dis 29:155-8