Fellowships in Allergy and Clinical Immunology

University of Colorado at Denver and Health Sciences Center – Allergy and Immunology-Adult

In Conjunction with National Jewish Medical and Research Center

Goals of the Fellowship Program
The Curriculum
Consultations
Teaching
Salaries, Vacations, Leave
The Application Process
Faculty

Goals of the Fellowship Program

To accomplish this we have developed a two-stage training program with the first two years devoted to fulfillment of the requirements for certification by the American Board of Allergy and Immunology. The first year is primarily devoted to clinical training. The second and third year of fellowship is dedicated to research training, which involves coursework, laboratory research, writing manuscripts and grants and is designed to provide the foundation of skills and experience that are necessary for success in academic medicine. During the first year of training the fellow is expected to select a faculty preceptor, who will provide mentorship in research in subsequent years. The program is open to physicians who are either certified by or eligible to sit for the certification examinations of the American Board of Internal Medicine. Currently, two to three fellows enter the program each year.

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The Curriculum

The fellowship training is conducted on the campuses of the National Jewish Medical and Research Center (NJMRC) and the University of Colorado at Denver Health Sciences Center (UCDHSC). The Allergy, Asthma and Immunology Clinics for the University are held at the new Anschutz Center on the Fitzsimons Campus. Cross training in Pediatrics is done at the National Jewish Center and the Children’s Hospital.

During the first year the fellows rotate between the two campuses every three months. At National Jewish one receives experience in management of severe asthma as well as experience in management of patients with allergic rhinitis, urticaria, angioedema, food and drug allergy, and adult immunodeficiency diseases. The UCDHSC Clinics also provide experience in diagnosis and management of asthma, allergic rhinitis, urticaria, anaphylaxis, angioedema and immune deficiency diseases. The UCDHSC Allergy and Immunology Clinics, in addition to the full-time faculty, are attended by physicians in private practice. This gives the fellow the opportunity to witness diverse approaches to recognition and management of allergic and immunologic diseases. The UCHSC rotations also provide experience in clinics that are important to the practice of Allergy and Clinical Immunology such as dermatology. Cross training in care of otorhinolaryngology and pediatric age patients is done during both rotations. In addition, fellows are required to rotate in the Clinical Immunology Laboratories to learn the methods used and applications of assays such as flow cytometry, immunoglobulin and antibody quantitation, interpretation of protein electrophoresis patterns and assays of complement activity and cell-mediated immunity.

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Consultations

The fellows are the first to respond to requests for consultations from other departments in the Health Sciences Center. These consultations may involve different questions that are relevant to Allergy and Clinical Immunology. Examples include immune deficiency disorders, difficult asthma, adverse drug reactions, anaphylaxis and urticaria.

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Teaching

The case-by-case teaching that is done in the clinics and is supplemented by several formal-teaching conferences:

Allergy Journal Club

Allergy Journal Club is a monthly forum for surveying the published literature regarding specific topics relevant to the clinical practice of allergy. First and second year residents present summaries of assigned articles. The articles offer a historical perspective of the particular issue being discussed and highlight controversial issues. 10-12 articles are typically covered per session and a faculty preceptor guides the discussion.

Immunology Journal Club

The is a monthly journal club which involves review of two articles from top immunology journals. The residents present the articles with focus on experiment design, validity of methods and conclusions. The residents are forced to offer alternative methodologies which could be used to better answer the scientific question.

Immunology Journal Club at UCH

Resident and faculty discuss one or two articles that have been published recently on clinical immunologic topics.  The purpose of this journal club is to carefully critique an article regarding hypothesis testing, methodology, statistics, and conclusions.

Denver Allergy Rounds

Denver Allergy Rounds is a weekly, city-wide meeting of allergists from the private practices and academic centers. Lecturers include local allergists and invited guest speakers of national prominence. A curriculum format is used to cover topics in basic and clinical allergy and immunology.

Second Opinion Conference

Second Opinion Conference is a weekly Department of Medicine meeting where interesting cases are presented and treatment discussed.

Division Meeting

There are approximately 6-8 business meetings per year where issues of concern to the fellows and training program are discussed and the applicants for fellowships are reviewed both for interviewing purposes and for acceptance purposes. The fellows are evaluated twice yearly, the program is evaluated once a year, and other Division business is discussed. The fellows are required to attend the first 15 minutes of each business meeting as scheduled throughout the year.

Resident Didactic Series

This is a weekly meeting with both pediatric and adult residents where they review a major immunology textbook. Additionally, the faculty present didactic lectures on various allergy and immunology topics. The residents also review board type questions on the topic of the week.

M&M Conference

Morbidity and Mortality Conference, held quarterly where complicated cases are discussed and serves as a QI activity for the department. Core competencies of Medical Knowledge and Practice-Based Learning and Improvement are addressed.

Airways Forum

This is a weekly conference that review current concepts.

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Salaries, Vacations, Leave

Salaries are determined according to the fiftieth percentile of the Western Region according to ACGME guidelines and then Stipends are set by the Dean of the University of Colorado Denver. Stipends are increased each year according to the consumer price point index. Currently house staff are given 21 calendar days of vacation annually. Up to 7 days of educational leave are given each year. Our goal is to allow each fellow to attend two meetings during the year.

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The Application Process

All applications will now be submitted online through ERAS (Electronic Residency Application Service).

Program Director information:

You can start applying to our fellowship program on November 15, 2006 using the ERAS system.  We will download applications around December 1 2006.  Interviews will start January 2007 through March 2007 for the 2008 year.

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Faculty

Rafeul Alam, MD. PhD, Professor of Medicine, and Veda and Chauncey Ritter Chair in Immunology. He is the Director of the Division of Allergy & Immunology at National Jewish Medical & Research Center. His research interest includes signal transduction mechanism of cytokines in eosinophils and of the antigen receptor in T cells. He studies how signaling molecules contribute to the pathogenesis of asthma in a holistic model.

Selected publications:
Stafford S, Lowell C, Sur S, Alam R . Lyn tyrosine kinase is important for IL-5-stimulated eosinophil differentiation. J.Immunol. 168(4):1978-83, 2002

Cen O, Gorska, MM, Stafford SJ, Sur S, Alam R . Identification of Unc119 as a novel activator of Src family tyrosine kinases. J. Biol. Chem. 2003;278(10):8837-8845

Gorska MM, Stafford S, Cen O, Sur S, Alam R . Unc119, a novel Src kinase activator is essential for T cell receptor signal generation. J. Exp. Med. 199:369-379, 2004.

Gorska MM, Cen O, Stafford SJ, Liang Q, Alam R. Differential Regulation of IL5-Stimulated Signaling Pathways by Dynamin. J. Biol. Chem. 281(20):14429-39,2006.

Henry N. Claman, M.D ., Distinguished Professor of Medicine and Immunology and Director of the Medical Humanties Program.

Selected publications:
Claman HN. To our students. Medicine and the two brains. Pharos Alpha Omega Alpha Honor Med Soc. 1999 Fall;62(4):37-9. No abstract available.

Claman HN. Creativity and illness: Christopher Smart and Samuel Johnson. Pharos Alpha Omega Alpha Honor Med Soc. 2001 Summer;64(3):4-7. No abstract available.

Palmer GW, Claman HN . Pregnancy and immunology: selected aspects. Ann Allergy Asthma Immunol. 2002 Oct;89(4):350-9; quiz 359-60, 428. Review.

Stephen C. Dreskin, MD, PhD is Professor of Medicine and Immunology, Director of the University of Colorado Allergy, Immunology and Rheumatology Practices, and Co-Director of the joint University of Colorado/National Jewish training program in allergy and clinical immunology for internists. His clinical interests include chronic urticaria, angioedema, anaphylaxis, and severe food allergies. His research interests include the study of functional IgE-allergen interactions as they pertain to food allergies and investigation of the molecular basis of chronic urticaria. Currently, the main goal of Dr. Dreskin's laboratory is to use functional assays to characterize the major allergenic proteins in peanuts. In work funded by NIH, his lab explores peanut allergens from a functional perspective and has identified previously unappreciated aspects of the human IgE response to peanuts.

Selected publications:
Palmer GW, Dibbern DA, Jr., Burks AW, Bannon GA, Bock SA, Porterfield, HS, Mc Dermott RA, and Dreskin SC . Comparative Potency of Ara h 1 and Ara h 2 in Immunochemical and Functional Assays of Allergenicity. Clinical Immunology , 115:302-312, 2005.

Dreskin SC and Andrews, KY:. The Thyroid and Urticaria. Current Opinions in Allergy and Clinical Immunology, 5:408-412, 2005.

Yasnowsky KM, Dreskin SC, Efaw B, Schoen D, Vedantahan PK, Alam R, and Harbeck R. Chronic Urticaria Sera Increase Basophil CD203c Surface Expression. J Allergy and Clin Immunol, 117:1430-1434, 2006.

Dreskin SC. Genetics of Food Allergy, Current Allergy & Asthma Reports, 6:58-64, 2006.

Brian M. Freed, PhD, Professor of Medicine and Immunology.  Dr. Freed is the Executive Director of ClinImmune Labs at the University of Colorado Denver. His research interests include the mechanisms of immune suppression by cigarette smoke.

Selected publications:
Freed BM. Ouyand Y, McCue JM. Mechanisms of altered transcription by cigarette smoke. Toxicol Sciences 2001;59:1.

McCue JM, Lazis S, Modiano J, Freed BM. Hydroquinone and catechol interfere with T cell cycle entry and progression through the G1 phase. Mol Immunol 2003; 39:995.

Lambert C, McCue J, Portas M, Ouyang Y, Li J, Rosano TG, Lazis A, Freed BM. Acrolein in cigarette smoke inhibits T cell activation. J Allergy Clin Immunology 116:916-22,2005.

Frazer-Abel A, McCue J, Lazis S, Portas M, Lambert C, Freed BM. Cigarette tar phenols impede T cell cycle progression by inhibiting cyclin-dependent kinases, Mol Immunol, 2006 (in press).

Magdalena M. Gorska, MD, Assistant Professor in the Department of Medicine, Division of Allergy and Immunology at National Jewish Medical & Research Center. Her research focuses on the mechanism of signal initiation by the T cell receptor. Specifically, she is studying the involvement of Src kinases – Lck and Fyn in this process.

Selected publications:
Alam R, Gorska M. 3. Lymphocytes. J Allergy Clin Immunol . 111:S476-S485,2003.

Cen O, Gorska MM, Stafford SJ, Sur S, Alam R. Identification of UNC119 as a novel activator of SRC-type tyrosine kinases. J Biol Chem . 278:8837-8845,2003.

Gorska MM, Stafford SJ, Cen O, Sur S, and Alam R. Unc119, a Novel Activator of Lck/Fyn, is Essential for T Cell Activation. J. Exp. Med . 199:369-379,2004.

Gorska MM, Cen O, Liang Q, Stafford SJ, Alam R. Differential regulation of interleukin 5-stimulated signaling pathways by dynamin. J Biol Chem. 281(20):14429-39,2006.

Ronald J. Harbeck, PhD, Professor of Medicine and Immunology. Dr. Harbeck is Medical Director of the Clinical Reference Laboratories as well as the Director of the Clinical Immunology, Clinical Microbiology and Clinical Flow Cytometry Laboratories. His clinical interests include establishing and validating laboratory assays that aid the clinical immunologist/allergist in defining and characterizing disorders of the immune and host defense systems. His research interests include animal models of airway inflammation following mycoplasma infection, the microbiology of chronic sinusitis and the role of NK cells in atopic dermatitis.

Selected publications:
Piboonpocanum S, Chiba H, Mitsuzawa H, Martin W, Murphy RC, Harbeck RJ adn Voelker DR. Surfactant protein A binds Mycoplasma pneumoniae with high affinity and attenuates its growth by recognition of disaturated-phosphatidylglycerols.  J Biol Chem. 280(1):9-17, 2005.

Chu HW, Jeyaseelan S, Rino JG, Wexler RB, Campbell K, Harbeck RJ and RJ Martin.  TLR2 signaling is critical for Mycoplasma pneumoniae  - induced airway mucin expression. J Immunol. 174(9):5713-9, 2005.

Martyny JW, Harbeck RJ, Pacheco K, Barker EA, Sills M, Arbuckle S, and Newman L.  The ability of household bleach (sodium hypochlorite) to kill and denature Aspergillus fumigatus growth on environmental surfaces. J. Allergy Clin. Immunol. 116(3):630-5, 2005.

Yasnowsky KM, Dreskin SC, Efaw B, Schoen D, Vedanthan PK, Alam R, Harbeck RJ. Chronic Urticaria Sera Increase Basophil CD203c Expression. J Allergy Clin Immunol , 117(6):1430-4,2006.

Hua Huang, MD, PhD.  Dr. Huang's interest are Cytokine signaling.  T helper cell differentiation and animal model of asthma.

Yongkang Zhang, Ron Apilado, John Coleman, S.Z. Ben-Sasson, Sharon Tsang, Jane Hu-Li, William E. Paul, Hua Huang .  IFN Stabilize the Th1 Cell Phenotype. J. Exp. Med. 194:165-172, 2001.

Luqui Chen, Kristy Grabowski, Junping Xin, John Coleman, Zan Huang, Yuechun Zhu, Baltazar Espiritu, William Xia, Serhan Alkan, John Clancy JR, Hua Huang .  IL-4 induces differentiation and expansion of Th2 cytokine-producing eosinophils. J. Immunol, 172:2059-2066,2004.

Zhu Y.C., L. Chen, Z. Huang, S. Alkan, K.D. Bunting, R.R. Wen, D. Wang, and H Huang .  IL-5 primes Th2 cytokine-producing capacity in eosinophils through a STAT5-dependent mechanism.  Cutting Edge, J. Immunol. 173:2918-2922,2004.

Z. Huang, J.P. Xin, J.M. Coleman, H Huang .  IFN-g suppresses phosphorylation of STAT6 by inhibiting its recruitment the IL-4 Receptor in Th1 Cells.  J. Immunol 174:1332-1337,2005.

 Ro hit Katial, MD, Training Program Director of the Allergy and Clinical Immunology Fellowship Program on the National Jewish Campus. Associate Professor of Medicine at National Jewish and the University of Colorado Denver. Primarily works in the clinic at National Jewish serving as a preceptor for residents during their rotation and conducts clinical research. His interests include immunotherapy, aspirin induced respiratory disease, nitric oxide exhaled breath condensate, Clinical Diagnostic Immunology and vaccinology particularly in the area of bioterrorism.

Selected publications:
Katial RK, Brandt B, Moran EE, Agnello V, Marks S, Zollinger WD. Immunogenicity and Safety Testing of an Intranasal Group B Meningococcal Native Outer Membrane Vesicle Vaccine. Infection and Immunity 2002; 70:702-707.

Katial RK. Diagnostic Laboratory Immunology. Allergy-Immunology Medical Knowledge Self Assessment Program, 3rd ed. Allergy & Immunology. 2003:347-364.

Ales NC, Katial RK, Vaccines against biologic agents: Uses and developments. Respir Care Clin N Am. 2004 Mar;10(1):123-46.

Song B, Katial R. Update on side effects form common vaccines. Current Allergy and Asthma Reports 2004, 4:447-453

Charles H. Kirkpatrick, MD, Professor of Medicine and Director of the Adult Immunodeficiency Program. Dr. Kirkpatrick also serves as co-director of the Fellowship Program. His primary clinical interests are adult immunodeficiencies and abnormalities of host defense mechanisms. His research is focused on alternative strategies for treatment of antibody deficiencies, B-lymphocyte physiology and mechanisms of immunologically-based treatments for patients with recurrent or persistent infectious diseases.

Selected publications:
Kirkpatrick CH. Immunoglobulin abnormalities in patients with IgA deficiency. Canad J Allergy Clin Immunol, 1999; 4:226-230.

Kirkpatrick CH. Transfer Factors: Identification of conserved sequences in transfer factor molecules. Molec Med 2000; 6:332-341.

Kirkpatrick CH. Chronic Mucocutaneous Candidiasis. Pediatr Inf Dis J 2001; 20:197-206.

Kirkpatrick CH. Chronic Mucocutaneous Candidiasis, in Stiehm, ER, Immunologic Disorders in Infants and Children, 5th Edition, W.B. Saunders, 2003, in press

Harold S. Nelson, MD, Professor of Medicine. Dr. Nelson's research involves pharmacologic and immunologic therapy of asthma and allergic rhinitis and allergen immunotherapy. He is Co-Director of the Department of Medicine's Weinberg Clinical Research Unit.

Selected publications:
Nanda A, O'Connor M, Anand M, Dreskin SC, Zhang L, Hines B, Lane D, Wheat W, Routes JM, Sawyer R, Rosenwasser LJ, Nelson HS. Dose dependence and time course of the immunologic response to administration of standardized cat allergen extract. J Allergy Clin Immunol. 114:1339-44,2004.

Thongngarm T, Silkoff PE, Kossack WS, Nelson HS. Hydrofluoroalkane-134A beclomethasone of chlorofluorocarbon fluticasone: effect on small airways in poorly controlled asthma. J Asthma. 42:257-63,2004.

Nathan RA, Yancey SW, Waitkus-Edwards K, Prillaman BA, Stauffer JL, Philpot E, Dorinsky PM, Nelson HS. Fluticasone propionate nasal spray is superior to montelukast for allergic rhinitis while neither affects overall asthma control. Chest. 128:1910-20,2005.

Nelson HS, Weiss ST, Bleecker ER, Yancey SW, Dorinsky PM. The Salmeterol Multicenter Asthma Research Trial: A comparison of usual pharmacotherapy for asthma or usual pharmacotherapy plus salmeterol. Chest. 129:15-26,2006.

Richard W. Weber, MD, Co-Training Program Director of the Allergy and Clinical Immunology Fellowship Program on the National Jewish Campus. His research interests include aerobiology, allergy cross-reactivity and urticaria.

Selected publications:
Ellingson AR, LeDoux RA, Vedanthan PK, Weber, RW. The prevalence of Dermatophagoides mite allergen in Colorado homes utilizing central evaporative coolers. J Allergy Clin Immuol 1995;96:473-9.

Katial RK, Lin FL, Stafford WW, Ledoux RA, Westley CR, Weber, RW. Mugwort and sage (Artemisia) pollen cross-reactivity: ELISA inhibition and immunolbot evaluation. Ann Allergy Asthma Immunol 1997;79:340-6.

Weber, RW. Cross-Reactivity of Plant and Animal Allergens. Clinical Reviews in Allergy and Immunology 2001;21:153-202.

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