R. James White, M.D., Ph.D.

R. James White, M.D., Ph.D.

Contact Information

University of Rochester Medical Center
School of Medicine and Dentistry
601 Elmwood Ave, Box 692
Rochester, NY 14642

Fax: (585) 486-0947
Lab: (585) 276-9848
Office: (585) 486-0147 x123

Lab Information

The overall goal of my laboratory is to understand the vascular biology which causes severe pulmonary arterial hypertension.

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Professional Bio

The overall goal of my clinical research and bench laboratory is to provide better care to patients with a rare disease of the lung blood vessels, pulmonary arterial hypertension (PAH). We provide care for patients from all over New York and central PA, and we use the full complement of approved PAH therapies. We also contribute actively to clinical research in hopes of better therapies with drugs that are already available. In my laboratory, we do experiments in animals and cells in an attempt to discover entirely new ways to treat this deadly disease.

Research Bio

The University of Rochester is the regional referral center for patients with echo estimated pulmonary hypertension. We take care of ~170 patients with WHO Group 1 classified Pulmonary Arterial Hypertension. I was a lead enroller and study author in the Phase III pivotal trial for tadalafil, and we continue to make significant contributions to the development of oral treprostinil (Remodulin). We are actively participating in the Reveal registry. We use subcutaneous treprostinil (about 50 patients), inhaled iloprost, bosentan, ambrisentan, tadalafil and sildenafil in combinations best tailored to a particular patients needs. We provide a strong link to San Diego for our patients with chronic thromboembolic pulmonary hypertension.



The overall goal of my bench laboratory is to understand the vascular biology which causes severe pulmonary arterial hypertension. Our main approach is with a rat model that recapitulates the histopathology, severe hemodynamic alterations, and right ventricular heart failure seen in advanced human disease. This rat model employs pneumonectomy (promotes contralateral lung growth) and endothelial injury (monocrotaline) to cause lethal pulmonary hypertension in about 4 weeks. Our animals die earlier with a more severe phenotype, and we have presented the first report of plexiform lesions. We have developed a novel CT angiography to assess for vascular pruning during disease progression, and we are also utilizing invasive techniques to measure pressure and cardiac output in awake, behaving animals. We hypothesize that tissue factor (the membrane bound glycoprotein which initiates coagulation) is an important contributor to disease progression, and we are actively testing small molecule inhibitors of tissue factor and thrombin as novel therapies in this devastating disease.

A second line of investigation seeks to define the role of thrombin and the PAR1 receptor in PH. In endothelial cells isolated from the rat pulmonary microvasculature, PAR1 activation promotes migration, wound closure, and tube formation in in vitro angiogenesis assays. The migratory activity is dependent on the matrix (fibronectin or collagen) and the microvascular endothelial cells behave differently than those derived from the proximal pulmonary artery. We hypothesize that plexiform lesions result from exuberant proliferation after these cells migrate to sites of injury rich in a fibronectin matrix. This is the work of the recently graduated M.D. Ph.D. student in my laboratory, David Meoli.

Awards & Honors (Local)

Parker B. Francis Fellowship in Pulmonary Biology, Francis Family Foundation 2005 - 2007
Buswell Fellowship, Department of Medicine, University of Rochester SMD 2003 - 2005
NIH Training Grant Multi-Disciplinary Training & Pulmonary Research, University of Rochester SMD 2001 - 2004
Alpha Omega Alpha, University of Pittsburgh 1996
NIH Medical Scientist Training Program, University of Pittsburgh 1990 - 1997
Phi Beta Kappa, Ohio State University 1990

Patents

Tissue Factor Pathway Inhibition as a Treatment Strategy for Severe Pulmonary Arterial Hypertension

United States Serial NO.: 11/576,773
Filed Date: October 7, 2005
Title: Treatment of Pulmonary Hylertension uisng An Agent that Inhibits a Tissue Factor Pathway
Invented by: R. James White, Mark Taubman

Recent Journal Articles

Showing the 5 most recent journal articles. 13 available »

2014 Aug
White RJ, Lannan KL, Phipps RP. "Drug discovery in pulmonary arterial hypertension: attacking the enigmatic root of a deadly weed." Drug discovery today.. 2014 Aug; 19(8):1226-9. Epub 2014 Apr 21.
2013 Sep
White RJ, Levin Y, Wessman K, Heininger A, Frutiger K. "Subcutaneous treprostinil is well tolerated with infrequent site changes and analgesics." Pulmonary circulation.. 2013 Sep; 3(3):611-21. Epub 2013 Nov 18.
2012 Oct 9
White RJ, Morrell NW. "Understanding the low penetrance of bone morphogenetic protein receptor 2 gene mutations: another needle in the haystack." Circulation.. 2012 Oct 9; 126(15):1818-20.
2012 Sep
Friedman SM, White RJ, Finkelstein SM, Kellam J, Allen EF, Sip AK, Stanton R. "Hip fracture in a patient with severe pulmonary hypertension." Geriatric orthopaedic surgery & rehabilitation.. 2012 Sep; 3(3):135-40.
2011 Nov
Ferrantino M, White RJ. "Inhaled treprostinil sodium for the treatment of pulmonary arterial hypertension." Expert opinion on pharmacotherapy. 2011 Nov; 12(16):2583-93.

Current Appointments

Associate Professor - Department of Medicine, Pulmonary Diseases and Critical Care (SMD) - Primary
Associate Professor - Department of Pharmacology and Physiology (SMD)

Specialties

Internal Medicine - American Board of Internal Medicine
Pulmonary Disease - American Board of Internal Medicine
Critical Care Medicine - American Board of Internal Medicine

Education

MD | Medicine | Univ Pittsburgh Sch Medicine1997
PhD | Neuroscience | Univ Pittsburgh Sch Medicine1996
BS | Arts & Sciences | Ohio State University1990

Post-Doctoral Training & Residency

Fellowship in Pulmonary/Critical Care at University of Rochester, Dept. of Medicine07/01/2000 - 06/30/2003
Residency in Internal Medicine at University of Rochester, Dept. of Medicine06/24/1998 - 06/23/2000
Internship in Internal Medicine at University of Rochester, Dept. of Medicine06/24/1997 - 06/23/1998