URMC Researcher Honored With Guest Editor Post

Aug. 20, 2009
The normal rat lung on the left is dense with blood vessels. PAH disease mechanisms have greatly reduced the number and caliber of vessels in the lung to the right.

R. James White, M.D., Ph.D., assistant professor of Medicine, Pharmacology & Physiology within the Division of Pulmonary and Critical Care Medicine at the University of Rochester Medical Center, was tapped to serve as guest editor of the current edition of Advances in Pulmonary Hypertension, which published online today. White is recognized by the Pulmonary Hypertension Association as a leader in the treatment and study of pulmonary arterial hypertension (PAH), a rare, often fatal disorder affecting blood vessels in the lung and causing increased blood pressure in the pulmonary artery that leads from the heart to the lungs. He along with his staff, Karen Frutiger and Toni Heininger, offer patients from Albany to Erie the opportunity to participate in clinical trials and to join a growing support group.

PAH symptoms include shortness of breath with minimal exertion, fatigue, chest pain, dizziness and fainting. In many cases, the cause is unknown and those affected, young adult women. While many patients may receive a presumptive diagnosis of pulmonary hypertension (PH) based on the results of an echocardiogram, only a few will actually have the rare disorder, PAH.

During his fellowship at the University of Rochester, White became fascinated with the pulmonary circulatory system because the field was in its infancy. The University supported White’s desire to develop a pulmonary hypertension clinic, and he joined the Division of Pulmonary and Critical Care Medicine in 2003. White’s specialty clinic helps determine which patients might benefit from expensive and often complicated PAH therapies. A right heart catheterization and many additional tests are required to confirm a PAH diagnosis. His group has been sufficiently successful that he now devotes all of his clinical effort to patients who have pulmonary hypertension while conducting bench research into the precise molecular mechanisms of PAH. 

In this light, it is not surprising that White was chosen by the journal’s editorial board to guest edit the current issue titled New Therapeutic Approaches to PAH, which focuses on recent clinical trials and experimental treatments. While treatment options are still limited, 2009 has been an exciting year for PAH patients with the recent approval of two new drugs. Rochester was a key enrolling site for one of the trials, and White was an author on a related paper published in the journal Circulation in May 2009.

Articles in the new issue of Advances challenge readers to consider whether current therapies address fundamental disease mechanisms and the implications of how some current treatments work. Other pieces include useful summaries of recent clinical trials, including those looking at combinations of older and newer drugs. Still other analysis tracks patients’ progress over the last decade, showing the limitations of current treatments and teasing out related ethical implications. An article written by White highlights clinical research undertaken in Rochester toward making a drug now available only by pump-based infusion into a pill to be taken orally, which would make therapy easier for patients.

“With collaborative, international efforts, the pace of progress has quickened in the last five years, and indeed, a ‘New Day is Dawning’ on treatment options for our patients,” White said. “We wanted the issue to provide an authoritative update on recent clinical trials and to highlight therapies that have graduated from bench science to bedside investigation.”

Advances in Pulmonary Hypertension is a quarterly clinical publication of the Pulmonary Hypertension Association (PHA). Editor-in-chief Richard Channick, MD, is Professor of Clinical Medicine in the Pulmonary and Critical Care Division at the University of California, San Diego, Medical Center. The mission of PHA is to find ways to prevent and cure pulmonary hypertension, and to provide hope for the pulmonary hypertension community through support, education, advocacy and awareness. More information about pulmonary hypertension and the organization is available at