User:David.chengyu
Dr. Chen’s career has developed from a pulmonologist and intensivist to his research interest in acute lung injury, inflammation and immunity. His research program has established in several aspects of translational research covering chronic obstructive pulmonary disease, lung cancer and acute respiratory distress syndrome (ARDS). The current theme of his Ph.D. program is focusing on the pathophysiological role of decoy receptor 3 in sepsis-related ARDS. The most significant findings in his research are summarized below:
1. The epidemic infectious disease of severe acute respiratory syndrome (SARS) in Taiwan from March to July 2003 had a great impact. Dr. Chen and his colleagues depicted the clinical characteristics and short-term outcomes of patients with SARS treated at Taipei Veterans General Hospital. The overall mortality rate was 31.3% (21/67). They found the potential predictive factors for ARDS development are elderly (odds ratio for patients over 65-year-old is 10.6), pre-existing diabetes mellitus (OR, 13.7), and elevated levels of LDH (OR, 8.4) at admission. This study has yielded a publication entitled “Association factors of Acute Respiratory Distress Syndrome in Patients with Severe Acute Respiratory Syndrome” ( J Chin Med Assoc. 2005; 68:4-10) and was recommended by editorial.
2. Dr. Chen, in his clinical practice, disclosed that the safety and drug concentration of aminophylline at a standard dose are not different in elderly patients. He proposed a 10-week prospective study recruited sixth to ninth decades of COPD patients. This study revealed that patients younger than 75 years have more improvement in PEFR than older patients; however, older COPD patients have more symptoms relief in chest tightness after aminophylline therapy. A publication entitled “Effect of oral aminophylline on pulmonary function improvement and tolerability in different age groups COPD patients” (Chest 2005;128:2088-2092) has been cited by several journals including, Hospital Physician in Oct. 2006, Expert Review of Respiratory Medicine in Jun. 2008, Drugs & Aging in Oct. 2009.
3. ARDS, a serious inflammatory reaction to acute lung injury, is associated with high mortality rates. Biomarkers that reliably predict outcomes in ARDS are not currently available. Decoy receptor 3 (DcR3) is a soluble protein with immunomodulatory effects. The role of DcR3 in ARDS is unknown. Comparing DcR3 with the APACHE II scores and three other plasma markers, we explored the association of DcR3 and the clinical outcome in ARDS. Eighty-eight ARDS patients were studied. Baseline APACHE II scores and clinical data were recorded. Plasma levels of DcR3, soluble triggering receptor expressed on myeloid cells-1 (sTREM-1), tumor necrosis factor α (TNFα), and interleukin-6 (IL-6) were measured on Day 1 and later time points, and correlated with the survival status on Day 28 after the onset of ARDS. Among the four biomarkers evaluated, only DcR3 discriminated the survivors and non-survivors at all time points in the first week of ARDS development. DcR3 was independently associated with and best predicted the 28-day mortality of ARDS patients. Plasma DcR3 levels most correlated to multiple-organ dysfunction and ventilator dependence. Regardless of either low or high APACHE II scores, Day 1 DcR3 levels were significantly higher in the non-survivor group of patients. Kaplan-Meier survival analysis showed higher mortality in ARDS patients with higher DcR3 levels. A high plasma DcR3 level independently predicts the 28-day mortality of patients with ARDS. This study has yielded a publication entitled “Decoy Receptor 3 Levels in Peripheral Blood Predict the Outcome of Patients with Acute Respiratory Distress Syndrome” (American Journal of Respiratory and Critical Care Medicine 180(8):751-760, 2009; 180:751-760).
