BREATHE Training Program
Breathing REsearch And THErapeutics (BREATHE) is focused on the respiratory neuromuscular system, emphasizing the discovery of new knowledge and its translation to severe clinical disorders that compromise breathing capacity, stability and/or airway defense.At its core, breathing is a neuromuscular act, initiated in the brain and translated through somatic motor neurons to engage the respiratory muscles that move the lung/chest wall system. Airway defense, a distinct yet related neuromuscular act, involves coordination of complex automatic behaviors (breathing and swallowing) or expulsive maneuvers to clear airways (cough). Breathing and airway defense are inextricably linked in function and are regulated by a complex, integrated neural control system.
Diminished breathing capacity, unstable breathing and/or aspiration pneumonia from inadequate airway defense are hallmarks of virtually all neuromuscular disorders, and respiratory failure is the most common cause of death in most clinical disorders that compromise movement. Despite its importance, relatively little attention has been paid to the neuromuscular system responsible for breathing and airway defense. Indeed, we know of no other training program with a similar focus on breathing and airway defense in traumatic, ischemic, genetic and neurodegenerative clinical disorders.
The University of Florida Center for Respiratory Research and Rehabilitation is the administrative home of the BREATHE Training Program, and provides a stimulating and rigorous intellectual environment to enable “cross-training.” We train individuals with diverse academic backgrounds, including neuroscience, engineering and clinical training (physicians, physical therapists, speech pathologists and veterinarians). A hallmark of our program is “cross-training,” where clinician scientists establish strong basic research foundations and basic scientists are exposed to meaningful clinical experiences that, although limited, change their appreciation for the complexities of translational research.
Why BREATHE and University of Florida?
Meet the BREATHE Directors:
Gordon S. Mitchell, PhD is a Preeminence Professor of Neuroscience in the Department of Physical Therapy. Dr. Mitchell was among the first to recognize the importance of neuroplasticity in respiratory motor control. Current research focuses on fundamental mechanisms of spinal respiratory motor plasticity induced by intermittent hypoxia, and attempts to harness that plasticity to treat clinical disorders that compromise breathing and non-respiratory limb movements, such as spinal injury and ALS. Dr. Mitchell has run an active research laboratory with continuous federal funding since 1983, has won institutional teaching awards and national research awards, has served as a departmental chair for 17 years, and has contributed extensively to the field through University, National and International service.
Program Co- Director:
David D. Fuller, PhD is a Professor in Physical Therapy and an authority on respiratory neuroplasticity in rodent models of spinal injury and Pompe Disease. He is Director of the UF Rehabilitation Science Doctoral Program (http://rehabsci.phhp.ufl.edu/) and has beem a primary instructor in graduate courses on neuroplasticity, fellowships. His work has focused on clinically relevant problems with high translational potential. He has published >90 peer-reviewed articles in leading journals, has served on NIH Study Sections, serves on the editorial board of the Journal of Applied Physiology and Frontiers in Respiratory Physiology.
Program Co- Director:
Barry J. Byrne, MD/Ph.D. is a clinician scientist specializing inherited neuromuscular disorders; his goal is to develop gene therapies to treat these catastrophic clinical disorders. His group has made significant contributions towards a treatment of Pompe Disease. His team developed new AAV-based gene therapy approaches to restore muscle function in Pompe and other inherited myopathies, including Duchenne Muscular Dystrophy. He has sustained NIH funding for >20 years and is currently PI of a Program Grant to develop new therapies for the cardiopulmonary disease. He has extensive experience with clinical trials focused on innovative treatment strategies, including the first trial of gene therapy to improve diaphragm function in humans He has mentored pre-doctoral, medical and postdoctoral fellows, with >20 basic science and clinically qualified trainees throughout his career. Dr. Byrne edits two journals and chaired the Skeletal Muscle and Exercise Physiology NIH study section. He has extensive administrative experience as Associate Chair of Pediatrics and as Director of the UF Powell Center for Gene Therapy (http://powellcenter.med.ufl.edu)
Curriculum and Program Requirements:
Predoctoral trainees are admitted by and receive a degree from established UF Ph.D. granting graduate programs. BREATHE graduate programs include:
Program admission is based on GPA, GRE scores, letters of reference, educational accomplishments and interviews with training faculty. You can read more about the exact requirements by clicking on your program of interest. Once admitted into the graduate program, trainees choose an area for advanced study. Graduate students will be considered for a BREATHE fellowship after one year of training.
Postdoctoral trainees focus on research, with few formal course requirements except for courses on research ethics and the neuromuscular control of breathing and airway defense.
The program consists of an Individualized training plan. Each trainee will create a plan based on their background, experiences and research focus.
These plans consist of six components:
• Didactic program
• Seminars and journal clubs
• Plan to acquire needed technical skills
• Clinical training experiences
• Participation in conferences and networking opportunities
• A mentored research project
Past Trainees and their Experience:
Mai ElMallah, MD:
She joined the Fuller laboratory in 2010 as an MD with no prior laboratory research experience. Her training and interactions with the broader UF respiratory community led her to reevaluate her goals as a physician and convinced her to pursue an academic career. Dr. ElMallah joined the Fuller laboratory during her pediatric pulmonary fellowship because of her clinical experiences in providing respiratory care to patients with Pompe disease, and conversations with Dr. Fuller concerning ongoing studies of gene therapy attempting to reverse respiratory dysfunction in a murine model of Pompe. She quickly learned how to conduct respiratory research, and published a series of papers describing novel gene therapy approaches targeting respiratory-dysfunction. After her fellowship, Dr. ElMallah received an NIH K08 award, followed shortly by her appointment as an Assistant Professor at the University of Massachusetts. She has already received an NIH R21 award as PI, and is an emerging leader in translational research in respiratory control. When asked about her experiences at UF, Dr. ElMallah said: “My time at UF provided me with the foundation for a successful research career. The UF respiratory
community is second to none, and I could not imagine a better
environment for an MD such as myself to learn the fundamentals
of respiratory research.”
Daryl Fields (MD/PhD candidate):
After working as an MD/PhD student in Dr. Mitchell’s laboratory at the University of Wisconsin, Dr. Fields chose to defer clinical training for one year to gain additional research experiences at UF, funded by an NRSA F30 and a fellowship from the United Negro College Fund. His PhD thesis concerned novel signaling pathways giving rise to respiratory motor plasticity. His decision to rejoin Dr. Mitchell at UF was fueled by his desire to refine his skills in project planning, manuscript preparation, laboratory management and translational research. During this year, he developed several novel projects related to cancer, sleep apnea and spinal injury, including conceptualization of a patent application recently filed with the USPTO. He defended his PhD in June, and resumed clinical training in July 2016. His collective experience will result in >12 publications in strong journals, and he was recognized with several national awards for research excellence. Although back in Wisconsin, he continues to maintain frequent contact with his UF collaborators and mentors. He plans to enter a residency that will allow him to advance novel therapeutics to patients with compromised breathing ability. He said about his UF experience: “the strong collaborative environment at UF exposed me to leading investigators in the respiratory neurobiology field. I know the multidisciplinary skill-set that I’ve developed has prepared me for future success as an independent physician scientist. I look forward to working with my UF colleagues on future projects!”
Lauren Tabor (CCC-SLP, MS):
Lauren is a speech pathologist with a specialization in dysphagia, and is currently in her third year of the UF Rehabilitation Science PhD program. She reports: “my experience has been incredibly fulfilling. As a clinician, my training consisted primarily of anatomy and physiology and behavioral manifestations of disease, and touched very little on the neural pathways and cellular adaptations that underlie these behavioral changes. Our classes, including Neuroplasticity and the Control of Breathing and Airway Defense: Implication for Rehabilitation, consist of basic, translational and clinical scientists, which provides a comprehensive understanding of rehabilitation from the cellular through patient levels. The interdisciplinary discussion and potential for translational collaboration is one of my favorite aspects of the RSD program. As a result, my own research questions and goals are more sound, with a solid understanding of mechanisms of change
supported by principles of neuroplasticity.”