Department of Medicine
David Christiani, MD, MPH
Explore This Research Lab
About the Lab
ARDS, acute lung injury (ALI) and septic shock are commonly encountered conditions in the intensive care unit, with relatively high mortality rates despite advances in treatment. Research into these conditions often focuses on the role of inflammatory cells. However, little is known about why some patients progress to ARDS or septic shock while others with the same risk factors do not.
Our primary study proposes that genes play a role in the development of these conditions. We investigate this hypothesis through a prospective cohort of patients admitted to Massachusetts General Hospital and Beth Israel Deaconess Medical Center intensive care units with known risk factors for development of ARDS. During this study, which began in 1998, we expect to enroll about 6,800 patients.
The major research interests of the Christiani Lab are to understand the interactions and impact of environmental exposures and genetics on health and disease. This research is part of a field known as molecular epidemiology. Dr. Christiani has been active in developing new methods for assessing health effects after exposure to pollutants, incorporating genetic studies in environmental health and introducing genetic studies into the critical-care setting. He has also led or co-led multiple international collaborative studies in Asia, Africa and Latin America.
A staff physician in the Mass General Division of Pulmonary and Critical Care Medicine, Dr. Christiani is also a professor of medicine at Harvard Medical School and the Elkan Blout Professor of Environmental Genetics at the Harvard School of Public Health. In addition, he directs the environmental and occupational medicine section of the Mass General Division of Pulmonary and Critical Care Medicine.
Boston Lung Cancer Survival (BLCS) Cohort Study
Lung cancer is the third most common cancer and the leading cause of cancer deaths in the United States. Lung cancer is a heterogenous disease, meaning it has multiple subtypes, which could require different treatment approaches. Understanding the underlying causes for this heterogeneity is one focus of current cancer research. The Boston Lung Cancer Survival study is a cancer epidemiology cohort of over 14,000 lung cancer cases enrolled at Massachusetts General Hospital and the Dana-Farber Cancer Institute from 1992 to the present, and it is continuing to recruit new patients. The study is funded by the National Cancer Institute, and collects detailed demographic, smoking, occupational, and dietary information, as well as data on treatments, oncogenic mutation status, biosamples, imaging, and pathology. The extensive questionnaire and biologic data provide unique opportunities for multidisciplinary collaborations and facilitates research into the predictors of overall survival and treatment outcomes.
Dr. Christiani is a member of the steering committee for the study and oversees the core activities of the study including questionnaires, electronic medical records and the bio-repository of DNA, serum, tumor tissue samples and radiologic images and overall data management.
Acute Respiratory Distress Syndrome (ARDS)
Acute respiratory distress syndrome (ARDS) is a disorder that occurs after a toxic insult to the lungs (e.g. sepsis, smoke inhalation). The syndrome has a high associated mortality despite advances in treatment, and little is known about why some patients progress to ARDS or how it can be prevented. In collaboration with other physicians and investigators at Mass General, Dr. Christiani examines the role of genetic susceptibility in the development of ARDS, as well as biomarkers of both risk and survival in this deadly syndrome. He has co-led a large consortium effort funded by NHLBI on the genetics of ARDS. His studies were among the first to demonstrate a role for genetic susceptibility to acute lung injury (ALI) and ARDS as well as identify genetic variants that may predispose individuals to different kinds of ALI.
Global Health Studies
Dr. Christiani has enjoyed conducting occupational-health research in Asia, Africa and North America. He has developed a wide network of collaboratives and contacts as his lab undertakes new studies examining the respiratory effects of exposure to vegetable dust and endotoxin (China), arsenic exposure and cancer (Taiwan and Bangladesh), petrochemical exposures, brain neoplasms and leukemia in Asia (Taiwan) and respiratory effects of paraquat exposure (Africa), as well as the role of rural agricultural and combustion air pollution studies on lung health (Africa). His studies in Bangladesh led to the first genome-wide association study (GWAS) of the interaction between genetics and metal exposures on birth outcomes and child development. An exciting aspect of the international work is in methodological work, specifically, the development and adaptation of epidemiologic and laboratory techniques to the conditions of the industrializing world. The potential for effective interventions for disease prevention make this work particularly rewarding.
Respiratory Disease in Cotton-Textile Workers, Shanghai, China
Dr. Christiani has led a 40-year longitudinal study of respiratory disease in cotton-textile workers in Shanghai, China. The objectives of this landmark study include determining the rate of loss in lung function among cotton dust-exposed workers at various levels of dust exposure and evaluating the relationship of exposure to gram-negative bacterial endotoxin and acute and chronic lung disease. The study has expanded to include an assessment of relevant genetic factors, and an examination of reproductive effects of shift work and ergonomic factors at work as well as the exposures noted above. Currently, they are also using high resolution chest CT scanning to assess the airway and parenchymal changes in the lung from dust and endotoxin exposures, as well as their interactions with smoking.
Co-Principal Investigator & Medical Director
- John Iafrate, MD, PhD (Pathology)
- Leo Cheng, PhD (Radiology and Pathology)
- Jason Gainor, MD (Oncology)
- B. Taylor Thompson, MD
Selected Recent Publications
Deep learning classification of lung cancer histology using CT images. Chaunzwa TL, Hosny A, Xu Y, Shafer A, Diao N, Lanuti M, Christiani DC, Mak RH, Aerts HJWL. Sci Rep. 2021 Mar 09. 11(1):5471. PMID: 33727623
Antagonistic effect of early stage zinc on arsenic toxicity induced preterm birth during pregnancy: evidence from a rural Bangladesh birth cohort. Wei YY, Huang H, Xia YK, Wei LM, Chen X, Zhang RY, Duan WW, Su L, Rahman ML, Rahman M, Mostofa MG, Qamruzzaman Q, Guo WH, Sun X, Yu H, Shen HB, Hu ZB, Christiani DC, Chen F. Chin Med J (Engl). 2021 Feb 01. 134(5):619-621. PMID: 33528218
Interstitial lung abnormalities in patients with stage I non-small cell lung cancer are associated with shorter overall survival: the Boston lung cancer study. Hida T, Hata A, Lu J, Valtchinov VI, Hino T, Nishino M, Honda H, Tomiyama N, Christiani DC, Hatabu H. Cancer Imaging. 2021 Jan 19. 21(1):14. PMID: 33468255
An Unrecognized Hazard in E-Cigarette Vapor: Preliminary Quantification of Methylglyoxal Formation from Propylene Glycol in E-Cigarettes. Azimi P, Keshavarz Z, Lahaie Luna M, Cedeno Laurent JG, Vallarino J, Christiani DC, Allen JG. Int J Environ Res Public Health. 2021 01 06. 18(2). PMID: 33419122
The oral microbiome and lung cancer risk. Christiani DC. Thorax. 2021 Mar. 76(3):216-217. PMID: 33318238
Plasma Insulin-like Growth Factor Binding Protein 7 Contributes Causally to ARDS 28-Day Mortality: Evidence From Multistage Mendelian Randomization. Dong X, Zhu Z, Wei Y, Ngo D, Zhang R, Du M, Huang H, Lin L, Tejera P, Su L, Chen F, Ahasic AM, Thompson BT, Meyer NJ, Christiani DC. Chest. 2021 Mar. 159(3):1007-1018. PMID: 33189655
Metabolomic profiling identifies plasma sphingosine 1-phosphate levels associated with welding exposures. Gao S, Zhuo Z, Hutchinson J, Su L, Christiani DC. Occup Environ Med. 2021 Apr. 78(4):255-261. PMID: 33106349
Tumor evolutionary trajectories during the acquisition of invasiveness in early stage lung adenocarcinoma. Wang S, Du M, Zhang J, Xu W, Yuan Q, Li M, Wang J, Zhu H, Wang Y, Wang C, Gong Y, Wang X, Hu Z, Christiani DC, Xu L, Shen H, Yin R. Nat Commun. 2020 Nov 27;11(1):6083. doi: 10.1038/s41467-020-19855-x. PMID: 33247113
Plasma Levels of Proresolving and Prophlogistic Lipid Mediators: Association With Severity of Respiratory Failure and Mortality in Acute Respiratory Distress Syndrome. Tejera P, Abdulnour RE, Zhu Z, Su L, Levy BD, Christiani DC. Crit Care Explor. 2020 Oct. 2(10):e0241. PMID: 33134939
Risk of Acute Respiratory Distress Syndrome Among Older Adults Living Near Construction and Manufacturing Sites. Rhee J, Dominici F, Zanobetti A, Schwartz J, Wang Y, Di Q, Christiani DC. Epidemiology. 2020 Jul;31(4):468-477. doi: 10.1097/EDE.0000000000001195. PMID: 32483064
Epigenomic analysis of 5-hydroxymethylcytosine (5hmC) reveals novel DNA methylation markers for lung cancers. Wang Z, Du M, Yuan Q, Guo Y, Hutchinson JN, Su L, Zheng Y, Wang J, Mucci LA, Lin X, Hou L, Christiani DC. Neoplasia. 2020 Mar;22(3):154-161. doi: 10.1016/j.neo.2020.01.001. Epub 2020 Feb 12. PMID: 32062069
SIPA1L3 methylation modifies the benefit of smoking cessation on lung adenocarcinoma survival: an epigenomic-smoking interaction analysis. Zhang R, Lai L, Dong X, He J, You D, Chen C, Lin L, Zhu Y, Huang H, Shen S, Wei L, Chen X, Guo Y, Liu L, Su L, Shafer A, Moran S, Fleischer T, Bjaanaes MM, Karlsson A, Planck M, Staaf J, Helland Å, Esteller M, Wei Y, Chen F, Christiani DC. Mol Oncol. 2019 May;13(5):1235-1248. doi: 10.1002/1878-0261.12482. Epub 2019 Apr 17. PMID: 30924596
Genetic overlap of chronic obstructive pulmonary disease and cardiovascular disease-related traits: a large-scale genome-wide cross-trait analysis. Zhu Z, Wang X, Li X, Lin Y, Shen S, Liu CL, Hobbs BD, Hasegawa K, Liang L; International COPD Genetics Consortium, Boezen HM, Camargo CA Jr, Cho MH, Christiani DC. Respir Res. 2019 Apr 2;20(1):64. doi: 10.1186/s12931-019-1036-8. PMID: 30940143
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