Ongoing Observational Studies
in Critical Care
Across UCSF, investigators are conducting observational studies that use real-world patient data to understand patterns of critical illness, treatment responses, and recovery. This work helps identify new targets for intervention and informs best practices in critical care across diverse patient populations. Explore our actively recruiting studies below.
ARDS, Pneumonia, and Sepsis (APS) Consortium
CPR-CC Faculty Involved: Carolyn Calfee, Michael Matthay, Carolyn Hendrickson, Lucy Kornblith, Chaz Langelier, Narges Alipanah-Lechner, Aartik Sarma
Enrolling Sites: UCSF Parnassus, Zuckerberg San Francisco General
The overarching goal of the APS Consortium is to support the development of deeper mechanistic understanding of critical illness syndromes to facilitate precision-based therapies that will curtail the devastating morbidity and mortality caused by ARDS, pneumonia and sepsis. UCSF and ZSFG are two enrollment sites. The study recruits adults hospitalized in the United States with ARDS, pneumonia, and/or sepsis and collects data and specimens during hospitalization, with a subset followed for up to one year. Contact: [email protected] (UCSF) and [email protected] (ZSFG)
CFF LTC
(Cystic Fibrosis Foundation Lung Transplant Consortium)
CPR-CC Faculty Involved: Jonathan Singer, MD MS
Enrolling Sites: UCSF Parnassus
The purpose of the multicenter consortium is to provide researchers the tools to learn more about lung transplantation, Chronic Lung Allograft Dysfunction (chronic rejection) and other health problems by creating a biorepository. This study is sponsored by the Cystic Fibrosis Foundation. Contact: [email protected] and [email protected]
EARLI
(Early Assessment of Renal and Lung Injury)
CPR-CC Faculty Involved: Carolyn Calfee, Michael Matthay, Carolyn Hendrickson, Kathleen Liu, Chaz Langelier, Narges Alipanah-Lechner, Aartik Sarma
Enrolling Sites: UCSF Parnassus, Zuckerberg San Francisco General
The EARLI study is a long-standing observational cohort that enrolls patients at UCSF Medical Center at Parnassus Moffitt-Long Hospital and Zuckerberg San Francisco General Hospital. The EARLI study recruits patients who are admitted directly from the emergency department into the ICU to identify novel risk factors and biomarkers of early organ injury and to facilitate the development of both prevention and treatment strategies. Contact: [email protected] (UCSF) and [email protected] (ZSFG)
The UCSF Advanced Lung Disease and Transplant “Global” Research Program
CPR-CC Faculty Involved: Jonathan Singer, MD MS
Enrolling Sites: UCSF Parnassus
The purpose of this program is to collect clinical information and biologic specimens to learn about problems that can occur after lung transplantation. Contact: [email protected] and [email protected]
LTBC-2
CPR-CC Faculty Involved: Jonathan Singer, MD MS
Enrolling Sites: UCSF Parnassus
The purpose of this study is to understand how body composition before transplant impacts early outcomes after lung transplantation. This study is sponsored by the NIH. Contact: [email protected] and [email protected]
K24 Subphenotypes of Frailty
CPR-CC Faculty Involved: Jonathan Singer, MD MS
Enrolling Sites: UCSF Parnassus
The goal of this study is to understand the different biological factors that contribute to frailty before and after surgery, and to determine how these differences affect the risk of complications during and after surgery. Contact: [email protected] and [email protected]
PROMISE
(Prospective Multicenter Research on Donor and Recipient Management Strategies to Improve Lung Transplant Outcomes)
CPR-CC Faculty Involved: Jonathan Singer, MD MS
Enrolling Sites: UCSF Parnassus
The purpose of the PROMISE-Lung Study is to find out how to improve the results of lung transplant by creating a national biorepository. This study is sponsored by the NIH. Contact: [email protected] and [email protected]
Additional Studies of Critical Care by CPR-CC Faculty
Assessing the impact of empiric antibiotic exposure on the pulmonary microbiome and antimicrobial resistome
CPR-CC Faculty Involved: Chaz Langelier, MD PhD
California Shock Map
CPR-CC Faculty Involved: Connor O’Brien, MD
We have sent out surveys to every cardio-capable hospital in California and have collected hospital-level information on capacity and capabilities for cardiogenic shock care. We are planning to analyze these data in the context of California Census Data and OSHPD to understand how access to care maps to population density, demographics, and disease burden.
cfDNA
CPR-CC Faculty Involved: Connor O’Brien, MD
Leveraging cfDNA as an early detection tool for tissue hypoperfusion. We have plasma from patients admitted to the UCSF CICU. We collect samples on days 0, 2, and 8. Each patient is deeply clinically phenotyped with over 600 clinical variables in a REDCap database. We are actively studying day 0 samples with plans to study the prognostic value of serial sampling. As part of this project we are also performing MethylSeq to understand if tissue specific signatures offer further prognostic value.
Combining AI assessment of electronic medical records with host biomarkers to diagnose and risk stratify patients with pneumonia and sepsis
CPR-CC Faculty Involved: Chaz Langelier, MD PhD
Determining etiology of sepsis in the US and in Sub-Saharan Africa using host/microbe metagenomics
CPR-CC Faculty Involved: Chaz Langelier, MD PhD
Differential trajectory of shock in molecular subphenotypes of sepsis and ARDS
CPR-CC Faculty Involved: Pablo Sanchez, MD
Longitudinal EHR data, proteomics, recruiting from UCSF/ZSFG medical ICUs.
Differentiating infectious from auto-inflammatory critical illness syndromes using host/microbe metagenomics
CPR-CC Faculty Involved: Chaz Langelier, MD PhD
Endothelial inflammatory pathways and dysfunction in sepsis and injury
CPR-CC Faculty Involved: Judith Hellman, MD
The human body contains more than one trillion endothelial cells. Microvascular endothelial cells play substantial roles in the pathophysiology of sepsis, contributing to shock, vascular leak, coagulopathy, and organ injury. We described the broad endothelial effects of TLR2 activation in vitro and in vivo in mice. Our recent work points to substantial differences in TLR signaling between endothelial cells and leukocytes and to differences in the signaling pathways leading to TLR-dependent permeability versus cytokine production. We are currently using in vitro and in vivo methods to define the role of endothelial TLR2 in the pathogenesis of S. aureus pneumonia and sepsis. Contact: [email protected]
Identifying novel molecular phenotypes of sepsis and pneumonia using host/microbe respiratory metatranscriptomics
CPR-CC Faculty Involved: Chaz Langelier, MD PhD
Immunomodulation by cannabinoids and the endocannabinoid system
CPR-CC Faculty Involved: Judith Hellman, MD
Cannabis and cannabinoid products are increasingly being used to manage symptoms associated with inflammation, but the understanding of how the endocannabinoid system is involved in inflammation is limited. Emerging evidence suggests that cannabinoids can affect inflammation, and that CBRs play substantial immunomodulatory roles in sepsis and injury. We reported that Δ-9-tetrahydrocannbinol (THC) strongly induces the anti-inflammatory cytokine IL-10, while reducing multiple pro-inflammatory cytokines, and improves early functional outcomes in mice with endotoxemic shock. Currently we are further defining the immunomodulatory effects and mechanisms of action of cannabinoids in sepsis and inflammation, and in pain, and defining the effects of S. aureus pneumonia and sepsis on endocannabinoid levels in the circulation and in neuronal tissues. Contact: [email protected]
TRPV1
Immunomodulation by vanilloids and the transient receptor potential vanilloid 1
CPR-CC Faculty Involved: Judith Hellman, MD
We reported that two endogenous lipids, N-arachidonoyl dopamine (NADA) and N-oleoyl dopamine (OLDA), reduces pro-inflammatory cytokine production by human endothelial cells and leukocytes induced by bacterial lipopolysaccharide (LPS), and have strong TRPV1-dependent anti-inflammatory effects in mice with endotoxemia or bacterial sepsis. OLDA and NADA upregulate blood levels of IL-10, an anti-inflammatory cytokine, while decreasing multiple pro-inflammatory cytokines. We discovered that TRPV1 expressed by neurons mediates the ant-inflammatory effects of OLDA. Our current studies are focused on defining the immunomodulatory effects and mechanisms of action of NADA and OLDA, charactering the effects of OLDA and NADA on inflammatory and functional outcomes of bacterial sepsis and acute inflammation, and defining the effects of bacterial sepsis on levels of NADA and OLDA in the circulation and in neuronal tissues. Contact: [email protected]
LiLAC
(Living Life After Cardiogenic shock)
CPR-CC Faculty Involved: Connor O’Brien, MD
A Eureka based app study following patients admitted for cardiogenic shock after discharge. Using validated questionnaires we are quantifying quality of life, mood, and socio-economic impacts. We are also leveraging cell phone data using geofencing and step counter to quantify readmissions and mobility.
Mechanisms underlying trajectory of shock in molecular subphenotypes of sepsis and ARDS
CPR-CC Faculty Involved: Pablo Sanchez, MD
Longitudinal clinical data, transcriptomics, recruiting from UCSF/ZSFG medical ICUs.
Mechanisms underlying trajectory of myocardial injury, cardiac and pulmonary vascular dysfunction in molecular subphenotypes of sepsis and ARDS
CPR-CC Faculty Involved: Pablo Sanchez, MD
Longitudinal echocardiography & proteomics, recruiting from UCSF/ZSFG medical ICUs.
Molecular Mapping Human Lung
CPR-CC Faculty Involved: Michael Matthay, MD
Spatial transcriptomics and proteomics in the ex vivo human lung injured with elevated airway pressures and bacterial pneumonia.
Molecular profiling of broad cardiogenic shock populations for prediction of shock severity progression and mortality
CPR-CC Faculty Involved: Pablo Sanchez, MD
Longitudinal clinical data/proteomics/transcriptomics, recruiting from UCSF cardiac ICU.
O-link proteomics and bulk RNAseq
CPR-CC Faculty Involved: Connor O’Brien, MD
We have analyzed plasma for bulk proteomics and PBMCs for bulk RNAseq to investigate molecular pathways and triggers associated with progression and death in cardiogenic shock. These data will both independently describe patient factors leading to shock progression as well as help offer mechanistic insights into our other biomarkers studies.
Tracking pathogen transmission in the ICU using culture-independent metagenomics
CPR-CC Faculty Involved: Chaz Langelier, MD PhD
Understanding host, pathogen and microbiome differences between infection and incidental pathogen carriage in patients with acute respiratory illnesses
CPR-CC Faculty Involved: Chaz Langelier, MD PhD
We have analyzed plasma for bulk proteomics and PBMCs for bulk RNAseq to investigate molecular pathways and triggers associated with progression and death in cardiogenic shock. These data will both independently describe patient factors leading to shock progression as well as help offer mechanistic insights into our other biomarkers studies.
Understanding the impacts of aging on host, pathogen and microbiome in patients with pneumonia
CPR-CC Faculty Involved: Chaz Langelier, MD PhD
16s rRNA
CPR-CC Faculty Involved: Connor O’Brien, MD
In collaboration with Susan Lynch’s lab we are studying how bacterial translocation impacts shock outcomes and may contribute to molecular signatures observed in the aforementioned projects.
How Do Clinical Trials Work?
In a field where lives often hang in a delicate balance, UCSF recognized that time is of the essence – for patients in the hospital and for populations facing an epidemic. We harness the efficiency of multidisciplinary teams to accelerate scientific progress and speed the development of new therapies and cures. We are constantly pushing forward the policies and partnerships that ensure that people in need are getting access to the most cutting-edge care and treatment.
Our Researchers
UCSF is part of the 10-campus University of California, the world’s premier public research university system, and the only of its campuses dedicated to graduate and professional education. Driven by our public mission, we are a collection of dedicated scientists, clinicians, students and staff who strive to make the world a better place through our singular focus on health. Compassion is as critical as discovery in fulfilling our mission to make a difference for individual patients and whole populations.
What to Expect
By bringing together a variety of perspectives and backgrounds through UCSF’s cross-disciplinary research and industry partnerships, our teams are constantly renewing and advancing the fields of medicine, pharmacy, dentistry and nursing.