# Airway Immune Response in Critically Ill Children-Precision Medicine in Children At Risk for Acute Respiratory Distress Syndrome

> **NIH NIH K23** · EMORY UNIVERSITY · 2021 · $191,743

## Abstract

PROJECT SUMMARY
The majority of pediatric acute respiratory distress syndrome (PARDS) is triggered by lower respiratory tract
infections, and more that 40% of children who die PARDS-related deaths are previously healthy, very young
children. The unique airway environment of each child contributes to the heterogeneity of PARDS, and this
lack of insight into how the airway environment influences immunity has resulted in no therapies that hasten
recovery from PARDS.
This proposal describes a five-year career development and research plan for Dr. Jocelyn Grunwell to gain
training and expertise in 1) advanced biostatistics and big data management, 2) sound design of clinical trials,
and 3) to generate new biological and mechanistic insights into PARDS triggered by acute lower respiratory
tract infections. The ultimate objective of this K23 proposal is to become an independently funded physician-
scientist focused on developing precision therapies for critically ill children with acute lung injury. With
additional training in clinical research methodology and advanced biostatistical methods, this K23 award will
investigate novel pathobiological mechanisms of importance to the onset and progression of PARDS and link
these biologic endotypes with clinical phenotypes to achieve the following aims: 1) determine the phenotype of
recruited airway neutrophils and response to secondary insult, 2) determine whether recruited airway
neutrophils suppress T cell function through an arginine depletion mechanism, and 3) determine whether
endotype-phenotype clusters predict clinical outcomes using latent class analysis.
Investigating heterogeneous biological mechanisms and linking them to clinical PARDS phenotypes will be
aided by a knowledgeable and experienced mentorship team led by Dr. Anne Fitzpatrick. Dr. Fitzpatrick is an
expert in biostatistical approaches to phenotype identification in heterogeneous pediatric disorders such as
asthma and in the analysis of high-dimensional patient data resulting from metabolomic and gene expression
studies. The mentorship team is complimented by Dr. Adrienne Randolph, a pediatric intensivist with an
interest in influenza induced lung injury, complex analyses of the airway cytokine environment, and functional
assays of the innate immune response to stimulus by viral and bacterial mimetics. The mentorship team and
institutional environment are ideal to foster career development and collaboration related to pediatric acute
lung injury and sequelae of critical illness.
Dr. Grunwell has had outstanding foundation in molecular methods, having earned a PhD and a Damon-
Runyon Postdoctoral fellowship in biochemistry from the University of California, Berkeley and San Francisco,
respectively. At the completion of this K23, Dr. Grunwell will be an expert in identifying endotype-phenotype
associations of complex critical illness syndromes using advanced biostatistical methods who will then use her
molecular training to hone in on novel ...

## Key facts

- **NIH application ID:** 10136710
- **Project number:** 5K23HL151897-02
- **Recipient organization:** EMORY UNIVERSITY
- **Principal Investigator:** Jocelyn Rebecca Grunwell
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $191,743
- **Award type:** 5
- **Project period:** 2020-04-01 → 2025-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10136710

## Citation

> US National Institutes of Health, RePORTER application 10136710, Airway Immune Response in Critically Ill Children-Precision Medicine in Children At Risk for Acute Respiratory Distress Syndrome (5K23HL151897-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10136710. Licensed CC0.

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