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Tulane Eosinophilic Disorder Center


The Tulane Center for Eosinophilia Disorders under the leadership of Dr. Anil Mishra is the first comprehensive center of its kind in the southern US. The center will provide an opportunity for researchers, patients and their families to understand the disease and receive better treatment of their eosinophil associated disorders. The center will also provide an opportunity for basic research scientists to directly translate their exciting new findings to afflicted patients with the help of a diverse clinician team. The center will be involved in basic, clinical and translational studies to determine the mechanistic aspects of eosinophilic disorders in the lung, skin and gastrointestinal tract. The center’s aim is to develop diagnostic and therapeutic interventions for eosinophilic diseases.

.Eosinophilic disorders occur when eosinophils, white blood cells with a bilobed nucleus and multiple toxic granules, are found in increased numbers in various parts of the body. In the healthy state eosinophils reside in the gastrointestinal tract; however, during allergic (food or aeroallergen) responses, a large number of eosinophils are generated from their precursors in response to the stimulus and move into various organs of the body, where they release a variety of toxins that can cause chronic inflammation, which leads to organ damage.

Eosinophils have a critical role in promoting asthma, dermatitis, multiple gastrointestinal disorders and tissue remodeling (fibrosis).

We and other investigators have found that eosinophils play a major role in promoting asthma, dermatitis and a number of gastrointestinal diseases. We now have a better understanding of a number of allergic diseases because of our growing knowledge and better diagnostic technology. We are currently studying multiple novel compounds that block eosinophil production and their recruitment into various organs. Our research will lead to improved treatments for eosinophil-associated medical disorders such as asthma, eosinophilic dermatitis, eosinophil associated gastrointestinal disorders and tissue remodeling (fibrosis).

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Asthma                                                           Fibrosis                                                            Eosinophilic esophagitis

Focus area of our research

  • Asthma is a chronic inflammatory disease of the airways caused by a combination of genetic and environmental factors and characterized by airflow obstruction, and bronchospasm. Common symptoms include wheezing, coughing, chest tightness, and shortness of breath.

  • Fibrosis is the formation of excess size scar tissue in an organ in response to injury. Fibrosis can occur in many organs within the body, typically as a result of inflammation or damage, and examples include:
  • Eosinophilic dermatitis also known as “Wells syndrome” or eosinophilic cellulitis is an uncommon condition of unknown etiology. The presentation usually involves a mildly itchy or tender cellulitis-like eruption with typical histologic features characterized by edema, flame figures, and a marked infiltrate of eosinophils within the skin.

  • Eosinophilic gastrointestinal disorders such as:

Basic and Clinical Studies

Dr. Mishra’s general research is aimed at deciphering mechanisms of inflammation, and is primarily based on discoveries concerning innate immunity. In particular, gene-environment interactions in the elicitation of inflammatory states in the respiratory and gastrointestinal tracts are under investigation. Environmental triggers (such as aeroallergens and food allergens) are studied in the context of specific genetic variants (e.g. IL-15 and IL-18 signaling) using population studies (cross sectional and longitudinal prospective cohorts) and mechanism-driven studies. The biological properties of innate inflammatory cells (eosinophils, mast cells, NKT cells, epithelial cells) and the cytokines (especially chemokines) that mediate their function are under investigation. The contribution of these basic processes to diverse human inflammatory conditions (e.g. asthma, eosinophil associated gastrointestinal disorders) is pursued by translational studies often involving unique clinical resources (e.g. patient samples and databanks) and clinical intervention studies (e.g. anti-cytokine therapeutics).

Future clinical trials

  1. rIL-15 therapy for lung and esophageal fibrosis.
  2. rIL-15 therapy for airway restrictions (airway hyperactivity).
  3. Anti-CD1d and anti-Vα24Jα18 therapy to target iNKT cells for the treatment of eosinophilic esophagitis.

Our Team

Principal Investigator

Anil Mishra, PhD, Professor of Medicine and Edward G. Schlieder Educational Foundation Chair of Pulmonary Diseases, Director, Eosinophilic Disorder Center,
Tulane University School of Medicine, New Orleans, LA 70112
tel 504-988-3840
fax 504-988-2144
Email: amishra@tulane.edu

Members and Co-investigators:

  1. Dr. Joseph Lasky, MD Professor and Director, Pulmonary Diseases, Tulane University School of Medicine, New Orleans, LA
  2. Dr. Luis Balart, MD Professor and Director, Adult Gastroenterology and Hepatology Section, Tulane University School of Medicine, New Orleans, LA
  3. Dr. Ilana S. Fortgang, MD Pediatric Gastroenterology and Hepatology, Tulane University School of Medicine, New Orleans, LA
  4. Dr. Laurianne Wild, MD Professor and Director, Clinical Immunology, Tulane University School of Medicine, New Orleans, LA
  5. Dr. Erin Boh, MD Professor and Chair Dermatology, Tulane University School of Medicine, New Orleans, LA

Patients and Family

Patients and families are encouraged to contact our center for any information needed to understand the disease pathogenesis or treatment options for their eosinophil related disorders.

Contact

Tulane Eosinophilic Disorder Center
Phone: 504-988-3840
FAX: 504-988-2144
Clinical Coordinator: Jaya Mishra, PhD, CCRP
Email: jmishra@tulane.edu

Gift/Donation

Funds needed for diagnostic and therapeutic interventions
Currently we are supported in part by the NIH; however further support will accelerate our work. We are in need of funds to support our research program to find a permanent cure for eosinophil related lung, skin and gastrointestinal disorders. Some of our most important research highlights are as follows.

  1. Aeroallergens promote asthma associated eosinophilic esophagitis. J Clin. Invest. 2001, 107, 83-90
  2. II-15 has a critical role in EoE pathogenesis. Gastroenterology. 139, 182-92
  3. Peanut and corn allergen induce EoE pathogenesis is iNKT cell mediated. AJP-Gastroenterology and Liver Physiol. 2011, 302, G645-654
  4. mRNA levels of IL-15 responsive cell surface molecules and mediators are the novel noninvasive biomarkers for EoE that differentiate EoE from GERD (patent Filed).
  5. rIL-5 treatment protects allergen-induced airway hyperactivity and tissue remodeling (fibrosis) in the lung and esophagus (Patent Filed)
  6. iNKT cell neutralization using monoclonal antibody for the treatment of eosinophilic esophagitis. Clinical and Translational Immunology. 2013

Off Site Collaborative Partners and Consultants

  1. Paul E. Hyman, MD: Professor of Pediatrics, Division Head, Children’s Hospital, New Orleans, LA 70118. email: phyman@lsuhsc.edu, Ph 504-896-9334, FAX 504-894-5567
  2. Sandeep K. Gupta, MD: Professor of Clinical Pediatrics & Clinical Medicine Director, Pediatric Over Weight Education and Research Program, Riley Hospital for Children, Indianapolis, IN. email: guptas@iupui.edu
  3. Manoj R. Warrier, MD: Allergy, Asthma & Sinus Care Center 12818 Tesson Ferry Road, Suite #103, St. Louis, MO 63128; Phone: 314.849.8700; Fax: 314.849.8737; email. m_warrier@hotmail.com

 

 

1430 Tulane Ave, New Orleans, LA 70112 504-988-5187 medsch@tulane.edu