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NHLBI Strategic Visioning

The National Heart, Lung, and Blood Institute (NHLBI) is in the midst of a Strategic Visioning process that will help determine its future direction. NHLBI is guided by four strategic goals that span the NHLBI mission. To focus its efforts, NHLBI is seeking input on the most Compelling Questions (CQs) it must answer and the Critical Challenges (CCs) it must overcome to achieve these goals.

Read more about the NHLBI Strategic Visioning process.

May 4, 2015
The AAAAI Research & Training Division reviewed the NHLBI Strategic Visioning information and submitted the following CQs and CCs that best represent what AAAAI members would want included in the NHLBI Strategic Vision. NHLBI has indicated that submissions will be reviewed and synthesized into a draft document of Strategic Vision Scientific Priorities, which will then be released later this year for public comment.  

Asthma and Allergies
CQ: Given the development of specific biologic therapy for asthma, what are the biomarkers and predictors of response that will allow clinicians to choose the best therapeutic combination of medications (biologic and otherwise) for patients with asthma?

CQ: What role should sublingual immunotherapy play in the treatment of asthma?

CQ: Will integration of behavior science in clinical research improve effectiveness of interventions for asthma associated with behavioral risk factors?

CQ: What are the molecular and cellular responses in the lung that occur after environmental stimuli (including allergens) that predict homeostatic resilience or transition to atopic diseases?

CQ: Are the current methodologies for clinical trials still the best practices for conducting efficient clinical trials?

CC: Asthma appears to be due to heterogenous etiologies. To better characterize the various phenotypes and potential etiologies, it would be important to create more epidemiologic and biomarker focused databases, which could then better inform clinical trials with more defined patient populations.  This will aid in the development of more tailored therapy for asthma.

Drug Allergy
CQ: Given that more patients are treated with newer and better targeted medications including chemotherapy, monoclonal antibodies, small molecules and others that have increased the number of hypersensitivity reactions, which genetic and molecular tools will be available to identify and protect patients against these potentially life threatening reactions?

CQ: Given that increasing number of patients allergic to their best medications are treated with desensitization, which allows improved quality of life and prolongs their lives, what personalized, effective and safe protocols will be available to provide first line therapies to these patients?  

CC: Drug Hypersensitivity is a growing concern for patients who are unprotected against potentially severe and lethal reactions. It would be important to generate databases to characterize the different drug reactions, their presentation and outcomes and to analyze blood and cells for genetic and molecular markers associated with drug hypersensitivity.

CC: There has been a decline in research-based faculty in the past few years. The challenge is two-fold. First, increase the research faculty pipeline with increased focus on training and recruitment of research focused fellows (T32s and similar), through early junior faculty transition (K awards), and the first major research grant (R01 or similar). Second, strategies need to be developed to retain viable research based physicians especially early in their careers. Additionally, since the focus of research has changed over the past decade, training programs need to be encouraged to use newer models of research in their training and mentoring of potential research faculty. NHLBI should also be challenged on how best to provide career development grants to junior faculty involved in “group based” clinical and bench science.