Immunopharmacology Laboratory at National Jewish Medical and Research Center

Director:
Stanley J. Szefler, MD
Joseph Spahn, MD
Phone: 303-398-1244
E-mail: spahnj@njc.org

This Laboratory performs pharmacokinetic studies to evaluate absorption and elimination of systemic steroids by high-performance liquid chromatography. In addition, cortisol analysis is preformed in body fluids to define cortisol suppression following administration of topical corticosteroids. Enzyme immunoassay methodology is also used for determination of free cortisol in saliva.

The Laboratory also provides assays for assessing cellular steroid response by evaluating dose-response relationships of various corticosteroids using suppression of PHA-induced lymphocyte proliferation with various corticosteroids. Two related and routinely performed assays, glucocorticoid pharmacokinetic studies and glucocorticoid lymphocyte stimulation assay (performed nowhere else) are used to determine whether a patient displays a pharmacokinetic abnormality and delineate steroid responsiveness in vitro. The Laboratory also performs special projects utilizing lymphocyte proliferation assay and other drugs along with glucocorticoids.

The Laboratory also is involved in identifying potential surrogate markers of inflammation and evaluates clinical utility of serum, bronchial lavage fluid, and sputum eosinophil cationic protein.

The Immunopharmacology Laboratory serves both clinical and investigative research roles. The laboratory developed and routinely performs two clinically available assays designed to help delineate glucocorticoid response. Both assays [glucocorticoid pharmacokinetic studies and glucocorticoid lymphocyte stimulation (GCLS) assay] are unavailable elsewhere. These assays have been developed to gain a better understanding of glucocorticoid responsiveness in patients referred to National Jewish with severe steroid dependent asthma. These assays are performed upon request by clinicians from both pediatrics and medicine. Specifically, glucocorticoid pharmacokinetics studies (prednisone and methylprednisolone) are often performed to determine whether a patient displays a pharmacokinetic abnormality (i.e., impaired absorption and/or abnormally rapid clearance of the glucocorticoid) as an etiology for lack of glucocorticoid-associated adverse effects and/or higher than expected glucocorticoid requirement. The GCLS assay is performed to help delineate steroid responsiveness in vitro. We presently perform over 500 of these assays per year. The lab is also interested in identifying potential surrogate markers of inflammation and has evaluated the clinical utility of serum eosinophil cationic protein (ECP).

Ongoing consultations and monitoring are available for National Jewish inpatients or outpatients, thereby facilitating long-term care. The lab's services also are available to physicians seeking support for patients not seen at the Center.

Immunopharmacology Requisition Forms

Please call 303-398-1244 to request testing, requisition forms and questionnaires.