# Pneumonia Biology

> **NIH NIH R35** · BOSTON UNIVERSITY MEDICAL CAMPUS · 2021 · $838,786

## Abstract

Abstract
Pneumonia biology should be the focus of an R35 from the NHLBI. Pneumonia is a leading global burden of
disease in every analysis. It kills more children worldwide and hospitalizes more US children than does any
other disease. Older adults are even more affected. The incidence and risk of death from pneumonia increase
throughout adulthood until becoming orders of magnitude greater than for young children. But the idea that
adults have to be old and frail to get pneumonia is a counter-productive misconception. Pneumonia
susceptibility is pronounced in middle age, with the median age of non-immunocompromised US adults
hospitalized for pneumonia being 57 years. In addition to the directly attributable immediate morbidity and
mortality, pneumonia also accelerates unhealthy aging, including exacerbations and more rapid decline of
chronic pulmonary diseases, cardiovascular diseases, and more. A wide ranging assortment of viruses,
bacteria, and other microbes causes pneumonia, with no one organism responsible for as much as a tenth of
cases. It is not about the microbe. These are pathobionts, not pathogens. They circulate among us
repeatedly or live on us continuously, growing in the lung to cause pneumonia only under exceptional
circumstances. Whether pneumonia ensues depends on the quality and quantity of the host response.
Pneumonia results from failures of lung defense more than from microbial virulence. We need to understand
the lung defenses that normally prevent pneumonia in young healthy adults before we can identify, prevent, or
reverse what goes wrong to make individuals susceptible to pneumonia. Our ongoing research program is
addressing the question of lung defense against pneumonia with a long-standing and continuing focus on
pulmonary inflammation and innate immunity that is now coupled with a newer emphasis on naturally acquired
heterotypic adaptive immunity against respiratory pathobionts. This research program includes 2 ongoing
NHLBI R01s that are defining roles of lung epithelial cells and alveolar macrophages in mediating protection
against pneumonia. These 2 grants together total 26 R01-years of support from the NHLBI, and we propose
unifying these distinct components of our mature and productive research program into a more integrated R35
award. During the coming years, we envision our research program (i) advancing mechanistic understanding
of lung defense against pneumonia by functionally integrating the activities of lung constituents and adaptive
immunity, (ii) leveraging discoveries in lung defense to generate new approaches to preventing and curing
pneumonia, and (iii) forwarding the concept that pneumonia susceptibility is a chronic disease of aging, and
attacking the mechanisms of susceptibility rather than (or in addition to) the acute infection has the greatest
promise for diminishing the burden of this lung disease.

## Key facts

- **NIH application ID:** 10076845
- **Project number:** 5R35HL135756-05
- **Recipient organization:** BOSTON UNIVERSITY MEDICAL CAMPUS
- **Principal Investigator:** JOSEPH P MIZGERD
- **Activity code:** R35 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $838,786
- **Award type:** 5
- **Project period:** 2017-01-11 → 2023-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10076845

## Citation

> US National Institutes of Health, RePORTER application 10076845, Pneumonia Biology (5R35HL135756-05). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10076845. Licensed CC0.

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