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Dr. Eisner received his M.D. degree from University of Pennsylvania
School of Medicine in 1992. He completed clinical training in
Internal Medicine and Pulmonary / Critical Care Medicine at UCSF.
During his pulmonary fellowship, he completed clinical research
training and obtained his Masters of Public Health degree at University
of California, Berkeley. He joined the UCSF faculty in 2000. His
major academic interests include the epidemiologic research in
adult asthma and COPD, clinical trials in the Acute Respiratory Distress
Syndrome, and critical care medicine.
Obstructive lung diseases, including asthma
and COPD, are common chronic health conditions. National trends
indicate that the prevalence of asthma has doubled during the
past two decades; it has also become more severe. Disability and
death from COPD will markedly increase during the next 20 years.
My research program has two central aims: (1) to identify factors
that adversely affect adults with asthma, especially those with
severe disease and (2) to elucidate how disability develops in
COPD. These two parallel lines of investigation are distinct,
but mutually reinforcing. In conducting this work, I collaborate
with a multi-disciplinary investigator group, which includes faculty
with expertise in epidemiology, biostatistics, social science,
economics, and health services research. Using tools from these
disciplines, we conduct studies designed to elucidate factors
that influence asthma outcomes.
To elucidate the risk factors for adverse health outcomes in severe
asthma, I am conducting a prospective cohort study of adults with
severe asthma. To study severe asthma, I developed a novel recruitment
approach that enrolled 865 adults who were hospitalized for asthma
at any Northern California Kaiser Permanente hospital. The cohort
includes nearly 200 adults who had a life-threatening asthma exacerbation
that required ICU admission.
A major focus of my research program is cigarette smoking and
secondhand tobacco smoke (SHS) exposure among adults with asthma.
To study the effects of SHS exposure, I have been using an approach
that combines survey-based and direct personal exposure monitoring.
I designed a survey instrument that measures recent SHS exposure
in commonly encountered microenvironments. To validate this instrument,
I used passive badge monitors that measure actual exposure to
ambient nicotine in a cohort of 50 adults with asthma. Using this
survey instrument, I also showed that SHS exposure contributes
to poor asthma control. Moreover, I am also studying the impact
of directly measured SHS exposure on longitudinal health outcomes
in my Kaiser cohort of adults with severe asthma. In addition,
I have designed and performed a series of epidemiologic studies
that demonstrated the adverse impact of SHS exposure on asthma
health outcomes, pulmonary function, and other respiratory health
outcomes.7
Building on this work, I am examining the impact of SHS exposure
on longitudinal health outcomes in adults with COPD. As director
of the pulmonary disease component of the UCSF Environmental Tobacco
Smoke Center of Excellence, I am measuring SHS exposure in a national
cohort of adults with COPD using my validated survey instrument
and direct exposure assessment.
In the public health arena, I designed and conducted a study to
evaluate the impact of smoke-free workplace legislation on the
respiratory health of bartenders. The study has received extensive
media attention and has been directly used to support smoke-free
workplace legislation in New York City, the Republic of Ireland,
and other locations.
In addition to SHS exposure, I have evaluated the impact of other
environmental exposures, such as gas stove use and other indoor
combustion sources, on the risk of adverse asthma outcomes. I
am also examining the impact of health care process factors and
patient-level attributes on longitudinal outcomes in adults with
severe asthma. These process factors include pulmonary or allergy
specialist care and prescription of anti-inflammatory medications.
The patient-level attributes include psychological factors (e.g.,
depression), health-related quality of life, and disease severity.
A central goal of my research in obstructive lung disease is to
prevent deterioration of health status and the development of
disability. Using research tools developed during my work in asthma,
I designed a newly-funded 5-year NIH R01 project to elucidate
the disablement process in COPD. I have previously shown that
adults with COPD have a 10-fold higher risk of disability than
members of the general population. However, the current understanding
of how disability develops in COPD is limited. In particular,
pulmonary function impairment does not predict who will develop
disability. To elucidate the disablement process, the project
has established a population-based prospective cohort study of
1200 COPD patients to test a specific conceptual model of how
disability develops in COPD. The goal is to provide a scientific
basis for the screening and prevention of COPD-related disability.
Overall, our goal is to improve public health by understanding
the factors that exacerbate and ameliorate obstructive lung disease.
We aim to achieve this goal by conducting studies that focus on
the epidemiology and outcomes of asthma and COPD.
The National Heart, Lung, and Blood Institute ARDS Clinical Trials Network. Pulmonary-artery versus central venous catheter to guide treatment of acute lung injury. N Engl J Med 2006; 354:2213-2224. (Dr. Eisner was member of the ARDS Network Steering Committee and Publications Committee).
The National Heart, Lung, and Blood Institute ARDS Clinical Trials Network. Comparison of two fluid-management strategies in acute lung injury. N Engl J Med 2006; 354:2564-2575). (Dr. Eisner was member of the ARDS Network Steering Committee and Publications Committee).
Blanc PD, Yen IH, Chen H, Katz PP, Earnest G, Balmes JR, Trupin L, Friedling N, Yelin EH, Eisner MD. Area-level socioeconomic status and health status among adults with asthma and rhinitis. European Respiratory Journal 2006;27:85-94.
Eisner MD, Balmes J, Yelin EH, Katz PP, Hammond SK, Benowitz N, Blanc PD. Directly measured secondhand smoke exposure and COPD health outcomes. BMC pulmonary medicine 2006; 6:12.
Eisner MD, Yelin EH, Katz PP, Lactao G, Iribarren C, Blanc PD. Risk factors for work disability in severe asthma. Am J Med 2006; 119:884-91.
Calfee CS, Katz PP, Yelin EH, Iribarren C, Eisner MD. The influence of perceived control on asthma health outcomes. Chest 2006; 130:1312-1318.
Yen IH, Yelin EH, Katz P, Eisner MD, Blanc PD. Perceived neighborhood problems and quality of life, physical functioning, and depressive symptoms among adults with asthma. Am J Public Health 2006; 96:873-9.
McClintock D, Starcher B, Eisner MD, Thompson BT, Hayden DL, Church GD, Matthay MA. Higher urine desmosine levels are associated with mortality in patients with acute lung injury. Am J Physiol Lung Cell Mol Physiol 2006; 291: L566-71.
Archea C, Yen IH, Chen H, Eisner MD, Katz PP, Masharani U, Yelin EH, Earnest G, Blanc PD. Negative life events and quality of life in asthma. Thorax 2007; 62:139-146.
Eisner MD, Iribarren C. The influence of cigarette smoking on adult asthma outcomes. Nicotine and Tobacco Research 2007;9:53-56.
McClintock DE, Ware LB, Eisner MD, Wickersham N, Thompson BT, Matthay MA. Higher urine nitric oxide is associated with improved outcomes in patients with acute lung injury. American Journal of Respiratory and Critical Care Medicine 2007; 175:256-262.
Eisner MD, Blanc PD, Sidney S, Yelin EH, Lathon PV, Katz PP, Tolstykh I, Ackerson L, Iribarren C. Body composition and functional limitation in COPD. Respiratory Research 2007; 8:7.
Erickson SE, Iribarren C, Tolstykh I, Blanc PD, Eisner MD. The Effects of Race on Asthma Management and Outcomes. Archives of Internal Medicine 2007; in press.
Ware LB, Matthay MA, Parsons PE, Thompson BT, Jauuzzi JL, and Eisner MD. Pathogenetic and Prognostic Significance of Altered Coagulation and Fibrinolysis in ALI/ARDS. Critical Care Medicine 2007; 35:1821-8.
Eisner MD, Wang Y, Haight TJ, Balmes J, Hammond SK, Tager IB. Secondhand smoke exposure, pulmonary function, and cardiovascular mortality. Annals of Epidemiology 2007; in press.
Calfee CS, Eisner MD, Ware LB, Thompson T, Parsons PE, Wheeler AP, Korpak A,Matthay MA, and the NHLBI ARDS Network. Trauma-Associated Lung Injury Differs Clinically and Biologically From Acute Lung Injury Due to Other Clinical Disorders. Critical Care Medicine 2007; in press.
Yen IH, Yelin EH, Katz P, Eisner MD, Blanc PD. Prospective impact of perceived neighborhood problems on change in asthma-related health outcomes. Health and Place, 2007 in press.
Liu K, Glidden D, Eisner M, Parsons P, Ware L, Wheeler A, Korpak A, Thompson T, Chertow G, Matthay MA. Predictive and pathogenic values of plasma biomarkers for acute kidney injury in patients with acute lung injury. Critical Care Medicine 2007; in press.
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