“I am surprised by how quickly COVID-19 afflicted the world and how rapidly some medical care structures became overwhelmed,” says Dr. John Repine, the James J. Waring Professor of Medicine, Pediatrics, and Surgery and the Director of the Webb-Waring Center (WW) at the University of Colorado (CU) Anschutz School of Medicine.
Bonfils-Stanton Foundation wanted to catch up with the 1995 Science and Medicine Award honoree (and our former long-serving Board Member) and hear his thoughts on the current COVID-19 pandemic. Dr. Repine’s ARDS (Acute Respiratory Distress Syndrome) research goes back many years – which, coincidentally is the fatal consequence of COVID-19.
While the research lab is closed on the Anschutz Campus, Dr. Repine has been writing and researching at home – we were pleased to hear about his continued work along with learning more about the success of his Webb-Waring-Colorado Undergraduate Summer Program.
Here’s what Dr. Repine has to say about ARDS, COVID-19, advice for the general public – and how he feels the pandemic will transpire in the years to come when it comes to properly preparing the medical world from another global health crisis.
Bonfils-Stanton Foundation: Dr. Repine, thank you so much for catching up with us. As the Foundation’s 1995 Science and Medicine Award Recipient, you were recognized for your work at the Webb-Waring Center which focuses on the causes and consequences of inflammation, antioxidant deficiency and oxidative stress. What has been the most rewarding part of your work there?
Dr. John Repine: As the Waring Professor of Medicine, Pediatrics, and Surgery, the Director of the Webb-Waring Center, and the Associate Dean for Student Advocacy at the University of Colorado School of Medicine, I wear many hats including physician, scientist, mentor, and administrator. Although there are many points during my career that are very rewarding and motivate me, my most memorable academic accomplishments relate to our ongoing research and education programs.
About a decade ago, I created the Webb-Waring-Colorado Undergraduate Summer Program (“CUSP”) to teach and inspire young individuals to choose careers in biomedical research and medicine. CUSP now receives more than 120 applications each year from a highly talented cadre of diverse undergraduates from the most prestigious colleges nationwide. CUSP trainees participate in a comprehensive, intense NIH supported summer training program in medicine and research. At the end of the summer, they present their research accomplishments in a formal scientific poster session. Increasingly, former CUSP trainees are returning to Colorado for medical school and residency training. I hope they will become physician-scientists and choose to live and work in Colorado.
Over the summers I get to know these students well. I hear stories about their families, upbringings, and career goals. I become invested in their futures and want them to succeed in any field that they choose. It brings me great joy when they let me know that they have achieved their dreams – just last week, I received a note from a former CUSP saying he was just accepted into the MD-PhD training program at Duke University. This was his dream and he thanked the CUSP program for helping him get there. Words can’t describe how proud I am of my CUSP students and how grateful I am to be part of their journey onto great things.
BSF: You and your team are recognized for making the first clinical recognition of the Acute Respiratory Distress Syndrome (ARDS) and developing a commonly used diagnostic test of lung function. Can you tell us a bit about your research in layman’s terms and how it possibly relates to the current COVID-19 crisis?
Dr. Repine: My research goes back many years to discovering the contributions of blood neutrophils (representative of inflammation) and oxygen free radicals (reflective of oxidative stress) to the development of the Acute Respiratory Distress Syndrome (ARDS) which is a major consequence of COVID-19 infection. ARDS develops in both extremely ill, hospitalized patients and previously healthy individuals who recently encountered infections, trauma, and other predisposing disorders. Unfortunately, the mortality of ARDS is approximately 40% and there are presently no specific treatments. It is a terrible disease and that is why I’ve dedicated my life’s work to uncovering better treatments for people who encounter it—and usually at no fault of their own.
Our present research goals are to identify which individuals are more susceptible to developing ARDS and find ways to treat and prevent it. A way to prospectively select ARDS susceptible individuals would help immensely with allocating professional (e.g., critical care physicians and nurses) and other resources (e.g., ventilators) for critical care and, more importantly, starting therapies for ARDS susceptible patients sooner. Some of our present research involves investigating the mechanisms responsible for the unique strain of rats that we developed that naturally resists ARDS and survives indefinitely breathing pure oxygen. The importance of this type of endeavor is more evident now as COVID-19 infection leads to ARDS and the need to breath pure oxygen often using mechanical ventilation.
BSF: As a follow-up to that, what is one result of your research that we, as the general public, might benefit from knowing about?
Dr. Repine: We must find a way to treat and prevent ARDS which is the highly fatal consequence of COVID-19 and other viral infections (including even the yearly “flu”). A treatment for ARDS would be available immediately and save lives immediately while it will take considerable time to develop a specific vaccine each time a new virus arises. After the crisis abates, discovering a treatment for ARDS will likely emerge as an increasingly important new target for medical research because it is not virus specific and will save lives.
BSF: How has your day to day work and life changed during the pandemic?
Dr. Repine: The biomedical research laboratories at the Anschutz Medical Center have understandably been closed. Accordingly, my daily routine has changed greatly. I currently spend my time writing and reading in my home office. I also review new information about COVID-19 and its respiratory consequences in ZOOM meetings with physician-scientists nationwide. In addition, we are planning our next research projects. The landscape of research in the coming months will clearly change, so we will need to continue to adapt.
BSF: Did you ever think you’d live through a pandemic in your lifetime?
Dr. Repine: Unfortunately, yes. Throughout my medical career, we witnessed a number of pandemics that clearly look different than COVID-19. AIDS, SARS, H1N1, and H5N1 all challenged the world albeit in different ways. It is hard to predict the scope and characteristics of future pandemics. I am surprised by how quickly COVID-19 afflicted the world and how rapidly some medical care structures became overwhelmed.
The COVID-19 pandemic will provide an opportunity for healthcare providers, political planners, and hospitals to develop improved contingency plans for handling future pandemics. The concepts of preserving PPE, managing resources and personnel, creating rapid response teams, and developing new diagnostic and treatment strategies will remain pertinent and valuable during future pandemics.
BSF: Outside of what we usually hear on the news, are there any words of advice to protect ourselves that you would offer?
Dr. Repine: Obviously, I would advocate for following Center for Disease Control as well as city and state regulations regarding social distancing. One positive consequence of the COVID-19 pandemic is our increased awareness regarding how social and healthcare decisions can influence our health and the health and livelihood of our community.
BSF: What are you doing personally to relieve some of the stress associated with self-distancing?
Dr. Repine: My wife, Karen M. Repine, MD, and I ride bicycles around our neighborhood and on the highline canal trail. Although it may not resemble any “Tour-de-France”, we enjoy covering a few miles each day as our own “peloton”. I also started revisiting an old hobby of watercolor painting. My most recent painting is an avocado.