We study the interplay between genes and the environment to determine the causes of asthma health disparities in children and adolescents in order to identify and develop targeted interventions that improve asthma health outcomes.
In the UC San Francisco lab of Esteban González Burchard, MD, MPH (UCSF Asthma Collaboratory), research focuses on the interplay between genes and their social and physical environments to determine the root causes of asthma health disparities among different populations locally and globally. Our work is based on the belief that if we can understand the root causes of asthma at the genetic, social, and physical environmental levels, we can develop novel therapies and targeted public health interventions to improve asthma outcomes and reduce the risk of developing asthma.
Genetics/Genomics: We use modern advances in genetics/genomics and we take a multi-omics approach to identify genetic risk factors and novel therapeutic targets for asthma.
Social risk factors: We examine the social determinants of health throughout the life course to better understand how they influence disease and to identify which of these determinants can be modified to improve health.
The environment: We use state-of-the-art geocoded measures of air pollution and other neighborhood characteristics as well as biomarkers of environmental exposures to identify populations at increased risk for asthma and potential targets for public health interventions.
There have been tremendous advances in modern genetics. Unfortunately, 96% of all modern genetic studies have been performed in populations of European origin. As a global community, we are missing out on the tremendous genetic diversity that exists throughout the world.
In the UCSF Asthma Collaboratory, we have created the largest and most ethnically diverse gene-environment study of asthma in the United States. The complexities of asthma and respiratory illness require the integration of multiple disciplines, including clinical medicine, genetics, genomics, statistics, and epidemiology. We have assembled a diverse team of physicians and scientists to address asthma health disparities. Our team has collaborated for over twenty years and brings together expertise in social, environmental, and clinical epidemiology, genetics, statistical methods, asthma outcomes, pediatric and adult pulmonology, virology, and immunology. By leveraging the convergence of rapid advances in genetics and a maturing understanding of the human body’s response to the social determinants of health and environmental risk factors for asthma, our team aims to bridge the gaps among genetic, social, and environmental determinants of asthma health disparities.
The use of racial or ethnic classification in medical practice and research has been the subject of tremendous international debate. Race and ethnicity are complex constructs incorporating social, cultural, and genetic factors. Currently, pulmonary function testing is one of the few clinical applications in which self-reported race or ethnic group is used to define a normal range for a test outcome. Our team has been at the forefront of this research area. Specifically, we have demonstrated that the incorporation of genetic ancestry into lung function prediction models improves the accuracy of the diagnosis of lung disease in African American and Latino populations even after accounting for socio-ecological factors, such as early life exposures, air pollution, and socioeconomic status. Our ancestry-informed respiratory equations account for an individual's genetic ancestry, thereby making genomic medicine a part of routine clinical care.
Productive asthma research requires collaboration across disciplines. The UCSF Asthma Collaboratory is innately collaborative and our research team spans the globe.
The UCSF Asthma Collaboratory bridges two departments from two separate schools: the Department of Bioengineering and Therapeutic Sciences (Schools of Pharmacy and Medicine) and the Department of Medicine (School of Medicine). This transdisciplinary position leverages the best of both schools—exploring biology and applying research discoveries to support the creation of new, more efficient and effective therapeutics. The spirit of collaboration that created this novel bridge typifies the entire UCSF research enterprise, which is a leader in engaging scientists across fields to explore research questions from out-of-the-box perspectives.
Effective asthma research must be translational. UCSF’s health sciences research agenda encompasses both basic science research and translational research.
Research in the UCSF Asthma Collaboratory is translational and aims to rapidly incorporate the latest discoveries from the lab bench into treatment at the bedside. The environment of UCSF facilitates our translational work. UCSF is home to the federally funded Clinical and Translational Science Institute, which provides infrastructure, services, and training to support clinical and translational science. As a graduate health sciences campus, UCSF focuses solely and intensely on health. It is home to the UCSF Medical Center and its hospitals and ambulatory care clinics, and it integrates its patient care mission with its research and education missions.
Under this umbrella, the Burchard team focuses on improving health by translating our discoveries into new therapeutics and diagnostics.
Esteban González Burchard, MD, MPH, directs the lab, which is located within the UCSF Lung Biology Center and affiliated with the UCSF Institute for Human Genetics. His research applies state-of-the-art advances in genetics toward large, racially/ethnically diverse populations of children to understand the root causes of asthma disparities, with the goal of creating novel therapies and identifying targets for public health interventions. Burchard is the author of more than 300 peer-reviewed articles, and his work has been featured at the American Museum of Natural History in New York City and the Smithsonian Institution National Museum of Natural History in Washington, D.C.
The members of the UCSF Asthma Collaboratory have a wide breadth of expertise in clinical medicine, genetics/genomics, epidemiology, and statistics. The lab is cross-functional at its core; statisticians, geneticists, epidemiologists, physicians, bioinformaticians, and biologists work together to foster cross-fertilization of ideas in approaching asthma research. The unique melding of backgrounds among the UCSF Asthma Collaboratory team members results in a place where research integrates expertise from all fields of science and medicine.
Our goal is to be among the best and most respected in understanding the effects of genetic, environmental, and social determinants of health and drug response. Specifically, we identify novel risk factors for asthma, then assess whether they may be generalized across all populations. We also identify risk factors associated with poor drug response to improve therapies for all populations. We collaborate with other researchers and share our results and strengths. We are recognized for being collaborative. We believe in hard work and conviction and in the know-how that runs deep in each of us. To achieve our goals, we embrace a THINK BIG approach.