Nadine Al-Naamani, M.D., M.S., University of Pennsylvania, and Andrew Sweatt, M.D., Stanford University, were the research awardees of the 2017 Aldrighetti Research Award for Young Investigators and PHA/ATS Research Fellowship in Pulmonary Arterial Hypertension, respectively.

In this two-part series, the 2017 PHA Research Program awardees detail their journey to PH, and their hopes for the future of PH research. Nadine Al-Naamani, M.D., M.S. University of Pennsylvania, has been involved in PH research since 2006. Thanks to the Aldrighetti Research Award for Young Investigators, she will learn more about the relationship between body size and treatment for PH.

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I got involved and interested in PH research even before I practiced PH clinically. After completing my internal medicine residency at the American University of Beirut, I joined Dr. Steven Kawut’s research team as a post-doctoral research scientist at Columbia University in New York City. His main research focus was PH and I was the coordinator for the NIH-funded trial of aspirin and simvastatin in pulmonary arterial hypertension (PAH), ASA-STAT.  The functional changes of PH were very intriguing to me. I had a unique opportunity in meeting and getting to know PH patients that I approached and recruited for research studies. I learned a lot from my interactions with PH patients and decided that I needed to be part of the team of researchers trying to improve the lives of these patients. I trained in pulmonary and critical care with a special focus on PH and am continuing to build my research portfolio with a focus on pulmonary vascular diseases and PH.

I was lucky to join Dr. Kawut’s research team, and could conduct high-quality research studies that used precise and robust methods of data collection. Fascinated with the pathophysiology of PH and the relationship between the blood vessels in the lungs and the right heart, I was interested in exploring the risk factors associated with PAH. In doing so, I searched for modifiable risk factors (factors like female sex and age, things that you cannot change are non-modifiable) and that’s how I became very interested in studying body size and PH outcomes.

After attending my first PHA International PH Conference and Scientific Sessions, I was very impressed by the resources at the PHA Research Room and participating patients’ motivation to help advance PH research. In 2016, I submitted a proposal to the PHA Research Room and conducted a small cross-sectional, or “snapshot,” study. After completing my pulmonary and critical care fellowship and my master program, I was exploring research funding opportunities and my mentor, Dr. Kawut, thought that applying for the grant award would be a good opportunity.

As I was reviewing the PAH literature, I came across many studies that showed a protective effect of obese patients when compared to normal weight patients. In a disease with high morbidity and mortality, you want to follow any trail that might lead to better survival; but we wouldn’t recommend that patients gain weight and become obese as obesity is associated with its own risks. So, to explore this association, we must examine whether obese patients have a different disease mechanism or whether they respond to drugs differently. The Aldrighetti Research Award for Young Investigators will allow me to explore whether the obese patients have the same, better or worse response from the PAH-specific treatments as compared to the non-obese patients. This will be the initial step in further exploring why the obese patients are doing better and how we can translate that benefit to all PAH patients.

Clinical trials report the average response to treatments; however, we know that some patients gain greater benefit than others. I am hoping that I can explore some of that diversity of response to help personalize treatment for patients. My goal is to improve outcomes for patients by providing the treatments that will have the greatest benefit and least side effects based on their personal disease phenotype.

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Sponsorship support for the Aldrighetti Research Award for Young Investigators provided by Actelion Pharmaceuticals US, Inc.

The data and research conducted in the PHA Research Room have helped scientists make discoveries about PH that have improved quality of life for many living with the disease and will one day bring us closer to a cure. Learn more on how you can contribute to the study of this rare disease.