Research Highlights During fiscal year 2016, National Jewish Health faculty and staff published 395 peer-reviewed scientific articles on topics ranging from basic immunology to diagnostic tests and experimental medications. Below is a sample of published research findings that highlight the range and diversity of investigations at National Jewish Health. Cells Identified in Transplant Rejection In order to improve the odds of a successful organ transplant, transplant teams try to match the major histocompatibility complex (MHC) proteins of both the donor and recipient. Even when the MHC proteins match, however, a mismatch of other proteins, known as minor histocompatibility antigens, can cause rejection. Until now, no one had identified the cell type responsible for transplant rejection due to mismatched minor histocompatibility antigens. Claudia Jakubzick, PhD, and her National Jewish Health colleagues studied antigen-presenting cells, which take up proteins in the body and hold fragments on their cell surface for recognition by the immune system. Dr. Jakubzick reported in the Journal of Immunology that Batƒ3-dependent antigen presenting cells cause transplant rejection due to mismatched minor histocompatibility antigens. The findings hold promise for improving the organ transplants. Finding a Hole in the Heart In the womb, a developing fetus has a hole in the wall between the two upper chambers of the heart, which allows blood to bypass the fetal lungs. After birth, the hole closes in about three quarters of people. The unclosed hole causes no symptoms in most people, but can cause significant shortness of breath in some. Saline contrast echocardiography can detect the unclosed hole, known as a patent foramen ovale (PFO). It is most often performed with the patient at rest. Cardiologist Brett Fenster, MD, and his colleagues evaluated saline contrast echocardiography for PFO done immediately after vigorous exercise, when blood flow and pressure are higher. They reported in the International Journal of Cardiovascular Imaging that they detected PFOs in 22 of 33 patients evaluated at rest. They found an additional four PFOs when the echocardiography was done following vigorous exercise. Staph Bacteria Associated with Food Allergy Atopic dermatitis patients are up to six times more likely to develop food allergy than those without the disease. Research at National Jewish Health suggests that colonization of patients’ skin with Staphylococcus aureus bacteria promotes the development of food allergy. About half of patients with atopic dermatitis have skin colonized by Staphylococcus aureus bacteria, which secrete numerous toxins that damage the skin and reduce its ability to serve as a protective barrier against external threats. Researchers led by Donald Leung, MD, PhD, reported in the Journal of Allergy and Clinical Immunology that blood tests of 718 pediatric atopic dermatitis patients indicated more frequent and more serious allergies to peanut and egg in patients with S. aureus on their skin than among patients without the bacteria. The findings support an emerging concept that food proteins entering the body through cracks in the skin can sensitize patients and lead to food allergy. Alternative Therapy for African Americans with Asthma For more than a decade, there have been safety concerns, especially for African Americans, about long-acting beta agonists (LABAs), a medication combined with corticosteroids in several asthma medications. Professor of Medicine Michael Wechsler, MD, MMSc, and his colleagues reported in JAMA that the anticholinergic medication tiotropium is an alternative to LABAs that is equally effective at preventing asthma exacerbations in African American patients when used with inhaled corticosteroids. Tiotropium and LABAs performed equivalently as measured by time-to-first-exacerbation, which is defined as a worsening of asthma requiring treatment with systemic corticosteroids. Dr. Wechsler is the principal investigator in the ongoing NIH National Heart, Lung, and Blood Institute-sponsored Best African American Response to Asthma Drugs (BARD) study, aimed at improving asthma therapy for black patients, who are disproportionately burdened by the disease.