CONTACT INFORMATIONBIOGRAPHYCREDENTIALSAWARDSPATENTSPUBLICATIONSVIDEOSR James White III, M.D., Ph.D.Contact InformationPhone NumbersAppointment: (585) 486-0869Administrative: (585) 275-4861Fax: (585) 486-0947A member of the University of Rochester Medical Faculty GroupgroupAn Accountable Health PartnerassignmentAccepting New PatientsLocations400 Red Creek Dr, Ste 110Rochester, NY 14623-4273Pulmonology: (585) 486-0147Additional LinksPHA Accredited CentersVideo CME -- Respite StudyPH Aware PodcastFaculty AppointmentsProfessor - Department of Medicine , Pulmonary Diseases and Critical Care (SMD) Professor - Department of Pharmacology and Physiology (SMD) - JointProfessor - Department of Pediatrics (SMD) - JointPatient Care SettingsHospital Medicine, PulmonaryBiographyThe 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). Our nationally accredited PHA Comprehensive Care Center provides evaluation and therapy 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 and those yet to be approved. I serve as leadership on steering committees and DSMB for global clinical trials in this deadly disease. In my laboratory, we do experiments in animals and cells in an attempt to discover entirely new ways to treat this deadly disease. Because echocardiograms often estimate pulmonary hypertension in patients with obstructive sleep apnea and heart failure, much of my clinical practice and expertise is focused in these two common problems. The URMC Pulmonary Hypertension group also includes my partner Dan Lachant, MD; three full time RN's, Karen Frutiger, Ali Theuer and new comer Cyndi MacDonald; a full time administrator, Jocelyn Dixon; two research technicians, Deb Haight and Jackie Bruno; and a post-doctoral research associate, Allison Light.Professional BackgroundI am a scarlet and grey bleeding Ohio State Buckeye who still has a special drawer for OSU sweatshirts and the like. I earned my MD and PhD degrees while in an NIH funded Medical Scientist Training Program at the University of Pittsburgh under the expert mentorship of Ian Reynolds. My thesis studies demonstrated that mitochondria were critical buffers of glutamate stimulated calcium loads and further that mitochondrial depolarization was an important consequence after pathologic neuronal stimulation. I moved to Rochester in 1997 to begin residency training in internal medicine and stayed to complete training in pulmonary and critical care. Mark Taubman mentored my early scientific career in the lab studying rat models of pulmonary hypertension and a potential pathogenic role for tissue factor, the protease which initiates blood coagulation. I still have a strong interest in bench studies of the pulmonary vasculature, but more recently I have enjoyed leadership roles in phase 2 and 3 clinical trials for PAH drug development.ResearchThe University of Rochester is a nationally accredited PHA Comprehensive Care Center, and we provide evaluations for patients with echo estimated pulmonary hypertension. We take care of ~300 patients with WHO Group 1 classified Pulmonary Arterial Hypertension. I was a lead enroller and study author in the labeling trials for tadalafil (PHIRST), oral treprostinil (Freedom-M), and the initial combination Ambition study. I chair the Freedom-EV steering committee and am leading the ongoing global development efforts for oral treprostinil in WHO Group 1. We participated actively in the Reveal registry, and I am associate medical director for Bill Nichols' NIH funded PAH Biobank. We are the lead nationwide enrollers for the NIH funded study of rituxan in scleroderma PAH, and we are making active contributions to Reata's studies of bardoxolone. We use subcutaneous treprostinil (Remodulin, more than 150 patients over the years), inhaled Tyvaso, ambrisentan, tadalafil, macitentan, selexipag, and riociguat in combinations best tailored to a particular patient's needs. We provide a strong link to surgical centers at Massachusetts General and Allegheny General for our patients with chronic thromboembolic pulmonary hypertension. I am grateful for the opportunity to serve as steering committee leadership in drug development projects with United Therapeutics (oral treprostinil) and PhaseBio (VIP analogue PB1046). I also serve as a consultant providing development advice to Reata, Gilead, Bayer, and Celtaxsys. I chair the DSMB for the first randomized, placebo-controlled trial of genetically-modified, endothelial progenitor cells led by colleagues in Canada (sponsor, Northern Therapeutics). The overall goal of my bench laboratory is to do better preclinical testing of potential novel treatment options for pulmonary arterial hypertension. Our current 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 (low dose monocrotaline) to cause lethal pulmonary hypertension in about 4 weeks. Our animals die earlier with a more severe phenotype, and we presented the first report of proliferative, plexiform-like lesions in 2004. We have developed a novel CT angiography to assess for vascular pruning during disease progression, and we have become expert at evaluating RV size and function with echo. We have also utilized telemetry techniques to measure pressure in awake, behaving animals. Our main recent contribution has been to establish a model severe enough that we can test new therapy approaches in animals treated with today's FDA approved agents. We believe that this sort of preclinical testing will provide the best evidence to move compounds into the clinic. Deb Haight, LVT, leads the lab work. 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.CredentialsSpecialtiesCritical Care MedicineInternal MedicinePulmonary DiseaseEducation1997MD, PhD | University of Pittsburgh School of MedicinePost-doctoral Training & Residency07/01/2000 - 06/30/2003Fellowship in Pulmonary/Critical Care at University of Rochester Medical Center06/24/1998 - 06/23/2000Residency in Internal Medicine at University of Rochester Medical Center06/24/1997 - 06/23/1998Internship in Internal Medicine at University of Rochester Medical CenterVIEW ALL expand_moreAwards2005 - 2007Parker B. Francis Fellowship in Pulmonary Biology, Francis Family Foundation2003 - 2005Buswell Fellowship, Department of Medicine, University of Rochester SMD2001 - 2004NIH Training Grant Multi-Disciplinary Training & Pulmonary Research, University of Rochester SMD1996Alpha Omega Alpha, University of Pittsburgh1990 - 1997NIH Medical Scientist Training Program, University of Pittsburgh1990Phi Beta Kappa, Ohio State UniversityVIEW ALL expand_morePatentsPatent Title: Treatment of Pulmonary Hypertension Using an Agent that Inhibits a Tissue Factor Pathway Patent #: 1799243 Issue Date: Jul 15, 2015 Country: Europe Invented By: Mark B Taubman, R. James WhitePatent Title: Treatment of Pulmonary Hypertension Using An Agent that Inhibits a Tissue Factor Pathway Patent #: FR1799243 Issue Date: Jul 15, 2015 Country: France Invented By: Mark B Taubman, R. James WhitePatent Title: Treatment of Pulmonary Hypertension Using An Agent that Inhibits a Tissue Factor Pathway Patent #: DE1799243 Issue Date: Jul 15, 2015 Country: Germany Invented By: Mark B Taubman, R. James WhitePatent Title: Treatment of Pulmonary Hypertension Using An Agent that Inhibits a Tissue Factor Pathway Patent #: GB1799243 Issue Date: Jul 15, 2015 Country: United Kingdom Invented By: Mark B Taubman, R. James WhitePatent Title: Treatment of Pulmonary Hypertension Using An Agent that Inhibits a Tissue Factor Pathway Patent #: 8,563,511 Issue Date: Oct 22, 2013 Country: United States Invented By: Mark B Taubman, R. James WhiteVIEW ALL expand_morePublicationsJournal Articles11/4/2019Lachant DJ, Light AN, Mackin ML, Schwartz RG, White RJ. "Heart Rate Expenditure Correlates with Right Ventricular Function." Annals of the American Thoracic Society.. 2019 Nov 4; Epub 2019 Nov 04. 10/1/2019Lachant DJ, Meoli DF, Haight D, Staicu S, Akers S, Glickman S, Ambrosini R, Champion HC, White RJ. "Combination therapy improves vascular volume in female rats with pulmonary hypertension." American journal of physiology. Lung cellular and molecular physiology.. 2019 Oct 1; 317(4):L445-L455. Epub 2019 Jul 19. 9/12/2019White RJ, Vonk-Noordegraaf A, Rosenkranz S, Oudiz RJ, McLaughlin VV, Hoeper MM, Grünig E, Ghofrani HA, Chakinala MM, Barberà JA, Blair C, Langley J, Frost AE. "Clinical outcomes stratified by baseline functional class after initial combination therapy for pulmonary arterial hypertension." Respiratory research.. 2019 Sep 12; 20(1):208. Epub 2019 Sep 12. 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