DR. ROBYN J. BARST PEDIATRIC PH RESEARCH AND MENTORING FUND GRANT WINNER 2015

Kara Nicole Goss, MDKara Nicole Goss, MD

Assistant Professor, Pulmonary and Critical Care
University of Wisconsin
Title: “Right ventricular-pulmonary vascular interactions following postnatal hyperoxia exposure”
Term: December 1, 2015- November 30, 2016

The Joel Belt Pediatric PH Research and Mentoring Grant

This Barst Fund Award is made possible through a generous donation to PHA from Josh and Lindsey Belt in honor of their son Joel, a pediatric PH patient.

Summary of Research Project:

Each year, roughly 12% of infants are born premature, or after completing less than 36 weeks of pregnancy. As the severity of prematurity increases, so does the risk for medical complications, including chronic lung disease of prematurity (also known as bronchopulmonary dysplasia). Chronic lung disease of prematurity is associated with an inhibited development of the pulmonary blood vessels. This can then cause increased blood pressure in the lungs leading to stress on the heart, a syndrome known as pulmonary hypertension. Although prematurity is a known risk factor for development of pulmonary hypertension in the neonatal window, little is known regarding the long term risk for pulmonary hypertension or heart failure as these formerly premature infants reach adulthood. Adult pulmonary hypertension is a devastating disease of the pulmonary blood vessels that leads to severe heart failure and death. It is thought to be the consequence of a “two hit” phenomenon, implying that multiple factors must align for development. We believe prematurity and its associated lung disease represents a first hit, thus priming the pulmonary vasculature for later malfunction following previously identified second insults such as low oxygen levels. This priming effect of prematurity has previously been described in adult heart and kidney disease. The goal of this proposal is to better understand how neonatal lung injury and oxygen exposure affects the health of the lung blood vessels and heart long term, using rats as a model system. We will mimic prematurity by exposing infant rats to a short course of excess oxygen. When mature, half will be exposed to a course of low oxygen, simulating the low oxygen levels that are known to be one cause of adult pulmonary hypertension. We will use state of the art catheters to measure pressures within the lung blood vessels and to monitor the heart’s response and interaction with the vessels. We anticipate these oxygen exposed rats, compared to normal rats, will have evidence of more severe pulmonary hypertension. Interestingly, some of our preliminary work in this field also suggests that these oxygen exposed rats may demonstrate important heart adaptations that allow them to tolerate the high lung blood pressures. We are actively trying to understand how the heart can adapt to such stress, and hope that understanding these mechanisms will allow us to develop new therapies to both prevent and treat prematurity-related pulmonary hypertension.

Curriculum Vitae

Education/Training

1999-2003: BA in University Scholars at Baylor University, Waco, TX
2003-2007: MD in Medicine at Baylor College of Medicine, Houston, TX
2007-2011: Resident in Internal Medicine and Pediatrics at the Indiana University School of Medicine, Indianapolis, IN
2011-2014: Fellow in Pulmonary and Critical Care at the Indiana University School of Medicine, Indianapolis, IN
2013-2014: Chief Fellow in Pulmonary and Critical Care at the Indiana University School of Medicine, Indianapolis, IN

Honors/Awards

1999-2007: Baylor University-Baylor College of Medicine Medical Track Program & Scholarship Recipient, Waco, TX
2009: First Place Poster Presentation, Indiana Chapter American College of Physicians Annual Meeting, Indianapolis, IN
2011: Mindie Bailie Red Shoes Award, Riley Hospital for Children, Indianapolis, IN
2011-2012: Sunnyside Guild Pulmonary Fellow, Eskenazi Health, Indianapolis, IN
2013: Best Case Report Award, American College of Chest Physicians CHEST 2013 Annual Meeting, Atlanta, GA
2014: American Thoracic Society Fellows Track Symposium Award, San Diego, CA
2014: Pulmonary Hypertension Association Travel Award, Indianapolis, IN
2014: First Place Indiana University Fellows Research Competition, Indianapolis, IN
2015: NIH Loan Repayment Program Recipient

Research Support

2015-2017
University of Wisconsin Department of Medicine Pilot Funding
Title: Long Term Cardiopulmonary Consequences of Premature Lung Disease
PI: Kara Goss, MD
Role: Primary Investigator, responsible for project design and implementation
Goal: Identify short and long term alterations in metabolic function following postnatal hyperoxia exposure in an animal model of premature lung disease

2014-2015
NIH R01 Supplement – HL1150613
Title: Influence of Sex and Maturation on Right Heart-Pulmonary Vascular
Coupling in Bronchopulmonary Dysplasia
PI: Marlowe Eldridge, MD
Role: Co-Investigator; responsible for project design and implementation
Goal: Identify short and long term gender effects on right ventricular and pulmonary vascular dysfunction in an animal model of premature lung disease

2013-2014
Indiana University Showalter Research Trust Fund Grant
Title: Premature Lung Disease Predisposes to Adult Onset Pulmonary Hypertension
PI: Shawn Ahlfeld, MD
Role: Proposal development, conductance of all experiments, grant administration under mentorship of PI (Shawn Ahlfeld) and co-investigators Tim Lahm, MD, and Robert Tepper, MD/PhD (Fellows not eligible for this funding mechanism)
Goal: Identify the role of postnatal hyperoxic lung injury in predisposing the adult pulmonary vasculature to late dysfunction in the setting of further known pulmonary vascular insults

2013-2014
T32 Training Grant
PI: David S Wilkes, MD
Grant 5T32HL091816-05
Role: Professional development, research design, ongoing coursework in translational research
Goal: Foster development of laboratory skills leading to independent research design and implementation

Selected Publications

  1. Goss KN, Cucci AR, Fisher AJ, Albrecht M, Frump AL, Tursunova R, Gao Y, Brown MB, Petrache I, Tepper RS, Ahlfeld SK, Lahm T. Neonatal Hyperoxic Lung Injury Favorably Alters Adult Right Ventricular Remodeling Response to Chronic Hypoxia Exposure. American Journal of Physiology: Lung Cellular and Molecular Physiology. 2015: 308(8): L797-L806.
  2. Goss KN, Tepper RS, Lahm T, Ahlfeld SK. Increased Cardiac Output and Preserved Gas Exchange Despite Decreased Alveolar Surface Area in Rats Exposed to Neonatal Hyperoxia and Adult Hypoxia. American Journal of Respiratory Cell and Molecular Biology. In press, accepted May 13, 2015.
  3. Frump AL, Goss KN, Vayl A, Albrecht M, Fisher AJ, Tursunova R, Fierst J, Whitson J, Cucci AR, Brown MB, Lahm T. Estradiol Improved Right Ventricular Function In Rats With Severe Angioproliferative Pulmonary Hypertension: Effects Of Endogenous And Exogenous Sex Hormones. American Journal of Physiology: Lung Cellular and Molecular Physiology. 2015; 308(9):L873-L890.