In Conversation: Dr. Mark Nicolls

February 2016

Dr. Mark Nicolls, Chief, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Stanford University 

Dr. Nicolls, Chief of the Division of Pulmonary and Critical Care Medicine (PCCM), oversees specialized clinical programs in lung disease and critical illnesses. He is committed to advancing our understanding and treatment of these diseases through basic research and innovative clinical approaches. In Summer 2015, he welcomed the Sean N. Parker Center for Allergy and Asthma Research, headed by Director Dr. Kari Nadeau, to PCCM. We recently sat down with Dr. Nicolls to discuss the incorporation of the Center into PCCM and to understand his vision, both for PCCM and for the Center.

Would you please tell us more about PCCM and its mission?

Dr. Nicolls: PCCM is committed to improving the lives of patients with serious lung diseases and those who are critically ill. We have specialized clinical programs in interstitial lung disease, lung transplantation, cystic fibrosis, pulmonary hypertension, interventional pulmonology, lung nodule surveillance and cancer detection, and lymphangioleiomyomatosis. Research and patient care for asthma and allergic diseases are now available through the Sean N. Parker Center for Allergy and Asthma Research. Stanford has been at the forefront of medical advances in lung disease and the first heart-lung transplant in the world was performed here in 1981 for a patient with pulmonary hypertension. Lung diseases are complex and a thorough understanding of these conditions requires expertise in multiple areas. We are focused on establishing key partnerships and programs in order to accelerate discovery and innovation. Our faculty is dedicated to basic research and innovative clinical approaches to provide the best possible care and most advanced treatment for our patients. 

Dr. Nicolls is excited to collaborate with Dr. Kari Nadeau and the Sean N. Parker Center for Allergy & Asthma Research. 

How does the incorporation of the Sean N. Parker Center for Allergy and Asthma Research fit into the mission of PCCM?

Dr. Nicolls: PCCM has one of the leading pulmonary hypertension research programs in the country. In patients with pulmonary hypertension, the arteries leading to the lungs become narrow, leading to high blood pressure. There is now evidence of inflammation and accumulation of immune cells in these areas and therapies for preventing and reversing these changes are being explored.

Allergic diseases, as well as allergic asthma, are also mediated by immune cells. Asthma results from chronic inflammation of the airways and are caused by poorly-regulated immunity. Dr. Nadeau’s lab has made great strides in immunotherapy for food allergies and is now focused on understanding the immune profile changes that occur in patients that respond positively to treatment. Understanding these changes may assist in the development of drugs to prevent or reverse disease progression in allergic disease, asthma, as well as pulmonary hypertension and further advance the mission of the Division.

Under the strong leadership of Director Dr. Nadeau, we are geared to become a center of excellence in asthma and allergic diseases and hope to attract patients, community, faculty, and trainees. There is an increased urgency to treat these diseases as the number of individuals affected by these diseases has significantly increased over the last few decades and continues to rise. There are needless deaths caused by asthma and food allergies. Through education and innovative treatments, we hope to prevent and treat these diseases. Dr. Nadeau has made immense advances in immunotherapy for the treatment of patients with multiple food allergens by pretreating patients with omalizumab, a treatment that has been approved for asthma. PCCM and the Center are also pioneering efforts to advance immunotherapies to treat a variety of lung diseases. Spearheaded by Dr. Arthur Sung, we now offer innovative and state-of-the-art treatments for severe asthma, such as bronchial thermoplasty. In this procedure, a thin, flexible, tube-like instrument is used to heat and destroy specific muscle tissues in the lungs, which leads to decreased narrowing of the airways and reduced number and severity of exacerbations.

Another area that we are focusing on is the creation of biobanks for the storage of blood, saliva, plasma, and purified DNA from individuals with asthma. These biobanks will be a tremendous aid to accelerate research and understand the biological mechanism underlying asthma.

We are incredibly excited to welcome the Center into PCCM. This is a landmark event for our Division and positions us and the Center to become the leaders in research and patient care for asthma and allergy.

Can you tell us a little more about your background and your path towards your current role as Chief of the Division?

Dr. Nicolls: I graduated from Stanford University School of Medicine where I spent considerable time performing basic research in transplant immunology. After completing my Internal Medicine residency at Stanford, I went on to complete a pulmonary and critical care fellowship at the University of Colorado. There, I was fortunate to continue basic science research in immunology. In 2007, after a few years in Colorado, I returned to Stanford to become the Director of Lung Immunology. In 2010, I became the Chief of the Division of PCCM. My research interests continue to be centered on pulmonary diseases that are negatively impacted by immune injury. I am primarily involved in understanding the role of innate and adaptive immunity in the development of pulmonary hypertension and the changes associated with airway microvessels after lung transplantation. In connection with these diseases, we have recently become immersed in understanding lymphedema, a chronic and debilitating condition (currently without medical treatment) associated with cancer therapy as well as with third-world parasitic infections.

What is your vision for PCCM?

Dr. Nicolls: My vision is to expand the four basic areas within PCCM beyond Stanford and the Bay Area. These are (1) Expanding general pulmonary services, including asthma and allergy, (2) Further developing the Center for Advanced Lung Disease (covering lung transplantation, interstitial lung disease, and cystic fibrosis), (3) Promoting the care and science of pulmonary vascular disease, and (4) Being a national leader in Intensive Care Medicine treatment and research. We are now providing comprehensive multidisciplinary services for the diagnosis and treatment for allergy and asthma at the California Pacific Medical Center at San Francisco. The Allergy Clinic at Stanford Health Care and the Center for Asthma and Allergic Diseases (a part of Stanford’s Children’s Health) have been launched to provide continuing care for patients with allergy or asthma. Stanford's Center for Advanced Lung Disease (CALD) now has three locations – Stanford, Monterey, and Fresno. And through the incredible support of the Vera Moulton Wall Center, we provide internationally-recognized comprehensive care for patients with pulmonary vascular disease.

We are continuing to establish key partnerships and programs in order to make our vision a reality.

Interview by Vanitha Sampath

Vanitha Sampath received her PhD in Nutrition from the University of California at Davis. At the Sean N. Parker Center for Allergy and Asthma Research, as a medical writer and content manager, she enjoys being in the midst of groundbreaking research in asthma and allergy and is committed to communicating the scientific advances of the Center and spreading awareness of its mission and vision. 

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