I am a respirologist and my main research interest is finding innovative new therapeutic solutions to patients with COPD. The postings reflect personal views

Vancouver, British Columbia
Joined July 2016
Congratulations Adeera!
Congratulations to Dr. Adeera Levin for receiving this prestigious award bestowed by @ASNKidney! Dr. Levin is a true advocate for patient-oriented research. kidneynews.org/view/journals…
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The most dangerous airway in #COPD is one that has both t2 and nont2 inflammation. Drugs that target both will be the winners!
New data suggest that one-third of patients with chronic obstructive pulmonary disease (COPD) may have mixed granulocytic airway inflammation. Learn about the expression of immune response and lung tissue remodeling pathways in those with the phenotype. bit.ly/4B3sDSB
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Some warnings coming from Russia
Kevin co-chairs our scientific advisory board Kevin is at @MIT and one of the smartest people in the world on issues of engineered pathogens Kevin's tweets are worth your time
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For those wondering what "digital twinning" (point 4) looks like in lung research, see paper by Sage et al Digital twins of ex vivo human lungs enable accurate and personalized evaluation of therapeutic efficacy | Nature Biotechnology
This week in medicine 1. Optogenetics wins the Nobel Prize! It goes to Karl Deisseroth, Peter Hegemann and Georg Nagel. 2. Full phase 3 results published for Lilly’s triple-G, retatrutide: ~25% mean weight loss. 3. ARPA-H plans to cut drug development from 10+ years to <4 years: with phaseless trials, adaptive platforms, digital twins and AI agents. 4. Pfizer's trispecific antibody works (in a phase 2 trial) in atopic dermatitis - it blocks IL-4, IL-13 and TSLP. 5. Dana-Farber researchers develop a new way to drug undruggable GPCRs, with GTACs: bispecific antibodies that use the transferrin receptor to drag GPCRs into lysosomes. 6. FDA approves the Autus Size-Adjustable Valve, for patients with congenital pulmonary valve disease - the first heart valve that grows with a child. 7. The first treatment for the rare genetic disease, MCT8 deficiency, is FDA-approved - a thyroid-hormone analogue that reduces peripheral thyrotoxicosis. 8. Both of Kodiak’s next-gen antibodies work in phase 3 trials for wet age-related macular degeneration - the long-acting anti-VEGF antibody–biopolymer conjugate and the bispecific VEGF-trap/anti-IL6 therapy. 9. Roche's all-oral combo of giredestrant (SERD) + everolimus (mTOR inhibitor) targets both ER and PI3K–AKT–mTOR resistance, cutting progression in ESR1-mutant breast cancer. 10. Lilly’s EloraTZP, an amylin agonist-tirzepatide combination, beats tirzepatide alone in a phase 2 diabetes trial (with increased risk of adverse events).
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The pipeline for new #COPD therapeutics is robust
COPD trial wins spur broad respiratory hopes nature.com/articles/d41573-0… AstraZeneca’s tozorakimab reduced disease flare ups in patients with COPD, suggesting IL-33-targeted antibodies could offer broad potential in lung diseases. Read about the COPD pipeline in this news feature
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Don Sin retweeted
In the latest ERJ Podcast, Deputy Chief Editor Don Sin interviews Marlies van Dijk (University of Groningen, Groningen, Netherlands) about her multicentre randomised crossover trial of fentanyl & morphine for persistent dyspnoea in COPD: channel.ersnet.org/channel-8… @ERSpublications
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In clinic, I saw a 30 y.o. lady, who has been coughing nightly since May. Normal PFTs. 1 year ago, she took Advil and experienced nasal congestion. A month later, she took generic ibuprofen and couldn't breathe because of complete nasal blockage from mucus. What does she have?
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This is amazing new proposal for advancing therapeutics
How ARPA-H is planning to cut clinical trial times from 10+ years to <4 years: 1. 'Phaseless' clinical trials - move towards replacing phase 1 → 2 → 3 with adaptive trials that can cut failed drugs (or advance good ones) faster. 2. Simulate trial outcomes before starting, with digital twins - to reduce reliance on large control groups. 3. AI agents for trial operations. 4. Turn ordinary hospitals into reusable clinical trial sites, and gets AIs to flag eligible trials to doctors and patients.
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Overmedicalization is real problem leading to increased costs and morbidity
A growing body of evidence suggests millions of surgeries performed each year are unnecessary. They cause needless physical pain and financial stress—and are a terrible waste of resources

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Unbelievable that betting market is better than weather forecasters in predicting weather. We should get bettors to predict future risk of exacerbations!
Kalshi's edge over the most accurate public forecast (NBM), by City. Los Angeles: +14% Chicago: +12% Philadelphia: +11% New York: +10% Denver: +9% Austin: +5% Miami: −1%
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This is a great piece in @NEJM . It even includes data from #COPD. PRS may be the way of implementing genomics in our Resp clinics!
Twenty-five years after the draft of the human genome sequence, genomics has revolutionized many areas of biology, the diagnosis of familial and early-onset diseases, and the development of targeted therapies, particularly in oncology. Genomic knowledge has had little effect on the diagnosis and treatment of most common adult-onset conditions. Genome-wide association studies have revealed that for these conditions, thousands of genetic variants of small effect underpin the polygenic nature of risk. When incorporated into polygenic risk scores, these variants predict risk (seen in figure); however, polygenic risk scores have had little effect in the clinic. Read more about the reasons for the slow pace of the diffusion of these methods in clinical practice and the ways they may be useful for the prevention and treatment of common diseases: nej.md/4Amwv0F
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Blaming it on others including trainees is not right. This cannot be the get out of jail card for academic fraud
Replying to @FrancyPolverino
I do not know Dr Choi personally but if the allegations are true then he committed academic fraud and gained significant personal advantage including millions from NIH. If this isn’t true, there should be clear statements from the university and Dr Choi, exonerating the matter.
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This is an older story but I found the allegations disturbing for one of our elite pulmonologists (if true). What has happened since then?
Nine published research studies by Dr. Augustine M.K. Choi, a former dean and provost and a current professor at Weill Cornell Medicine, have been retracted due to falsified data allegations. cornellsun.com/2024/03/20/fo…
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Triple inhibition of t2 targets in #COPD. Very promising approach; likely a future blockbuster
This is a very cool molecule that moves us deeper into the era of multispecifics. It combines IL-4/IL-13 inhibition (like dupilumab - one of the biggest drugs in the world) with upstream TSLP blockade, for stronger suppression of inflammation. It's being tested in eczema, asthma, and COPD - and kudos to Pfizer for including dupilumab as an active comparator arm.
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This happens in almost all medical subspecialties: repeated follow-up of stable patients, which leaves very little room to see new, complex patients
👇🏽The reason we have a “shortage” of cardiologists.👇🏽
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What a remarkable figure, showing the therapeutic advances in multiple myeloma over the past few decades. We need something similar in #COPD. We have made remarkable progress, but are having a hard time demonstrating it.
Beautiful chart on the therapeutic revolutions that drove survival improvements in multiple myeloma, from a median of ~2 to ~11 years. (Source: nejm.org/doi/full/10.1056/NE…)
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Congratulations Jim. Well deserved
Congratulations to Dr. Jim Christenson on being appointed to the Order of BC, the province’s highest honour! 🏅 Dr. Christenson is an emergency physician at St. Paul’s Hospital and a scientist with the Centre for Advancing Health Outcomes. Read more: ow.ly/AsG250ZNZiR
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