J. Burns Amberson Lecture

The first step to success in scientific research is asking the right questions.

“I saw my very first patient with pulmonary fibrosis and didn’t know what I was seeing on the X-ray,” said this year’s J. Burns Amberson Award winner Moisés Selman, MD, director of research at the National Institute of Lung Diseases, Mexico City, Mexico, during the Respiratory Health Awards ceremony on Sunday, May 19. “I asked and no one else knew, either.”

The Amberson Lecture, named for James Burns Amberson, an international authority on chest disease and tuberculosis, recognizes major international lifetime contributions to clinical or basic research that have advanced the fundamental understanding of respiratory disease, critical illnesses, or sleep disorders.

Dr. Selman’s seemingly simple question, “What is lung fibrosis?” led to a series of key developments in the understanding and treatment of idiopathic pulmonary fibrosis (IPF). He identified excessive collagen in IPF tissues despite the contradicting literature and wisdom of the time.

“How do I reconcile these biochemical data with my own morphological observations?” he asked.

Annie Pardo, PhD, a biochemist working on the extracellular matrix (ECM) and matrix metalloproteinases (MMPs) in an experimental model, had another question.

“How come no one has explored the putative role of MMPs in pulmonary fibrosis?” she asked Dr. Selman.

The collaboration between the two led to new reports on epithelial and fibroblastic localization of MMPs and the upregulation of their activity in injured and reactive epithelial cells.

There are both pro- and anti-inflammatory MMP phenotypes. IPF is virtually the only interstitial lung disease (ILD) that does not improve with anti-inflammatory immunosuppressive drugs and inflammation is rarely a prominent finding in IPF pathology.

This led to yet another query: If IPF is not an inflammatory disorder, what is it?

IPF lungs feature aberrant alveolar re-epithelialization. The growth factors influencing migration, proliferation, and activation of fibroblasts are expressed primarily by airway epithelial cells.

Aging also drives IPF by progressively stiffening the ECM to amplify and perpetuate aberrant matrix remodeling. Dr. Selman dubbed interactions between epithelial cells, ECM, and fibroblasts the “Axis of Evil” for the havoc they can wreak on lung tissue.

More recently, Dr. Selman identified a perfect storm of susceptible genetic architecture: male sex, older age, smoking (or other exposures), host factors, and epigenetic reprogramming, leading to IPF and other ILDs.

Edward Livingston Trudeau Medal

The Trudeau Medal is the highest honor bestowed by the ATS. It recognizes leadership in research, education, or clinical care in lung disease, critical illness, or sleep disorders and acknowledges exemplary membership in the ATS community. The medal honors Edward Livingston Trudeau, a founder and first president of the American Lung Association

The 2024 honoree is David S. Wilkes, MD, dean emeritus of the University of Virginia School of Medicine.

“This is something that happens to other folks, not to me,” Dr. Wilkes said to a standing ovation. “So many marginalized groups feel they have no place to call home, which makes me particularly grateful to the ATS for being my home all these years.”

Dr. Wilkes has been a member of the ATS since 1989. He is a researcher, mentor, sponsor, educator, administrator, and executive. His lab was the first to define autoimmunity in the pathogenesis of lung transplant rejection. Dr. Wilkes holds six U.S. patents and founded ImmuneWorks, Inc., a biotech firm developing novel treatments for immune-mediated lung disease.

“I grew up in the ATS, and you can, too,” Dr. Wilkes said.

Distinguished Achievement Award Winners

ATS has two 2024 recipients for the Distinguished Achievement Award: Jeffrey L. Curtis, MD, ATSF, and Sonye K. Danoff, MD, PhD, ATSF. The award recognizes outstanding contributions to the ATS mission through leadership.

Dr. Curtis is a professor of pulmonary and critical care medicine at the University of Michigan Medicine and the VA Ann Arbor Healthcare System.

“The ATS has an incredible mission,” he said. “It is, in a word that is not used often enough, noble. Healthcare is a fundamental right. I am proud of the ATS for taking that view.”

Dr. Danoff is a professor of pulmonary and critical care medicine at the Johns Hopkins University School of Medicine, director of the Interstitial Lung Disease Program, and associate director of the Myositis Center.

“I am honored to call ATS home,” she said.

Read more about all ATS 2024 Respiratory Health Award winners on ATS Conference News.