For many children, asthma begins long before their first breath. Virender S. Rehan, MD, a neonatologist and investigator at The Lundquist Institute, is dedicated to understanding the mechanisms in which this occurs and how to prevent it. Dr. Rehan’s work rests on a simple but powerful idea: the lungs we develop before birth shape how well we breathe for life.
With a recent $3.3 million R01 grant from the National Institutes of Health’s National Heart, Lung, and Blood Institute, Dr. Rehan launched a project called, “Mechanisms of Perinatal Nicotine Vaping-Induced Pulmonary ILC2 Dysregulation and Allergic Asthma Development.” It asks two questions: how does nicotine vaping during pregnancy set a baby up for asthma, and how can we prevent it?
“Once the lungs are affected during the developing period, that basically sets the trajectory of the lung function for our whole life,” he explains, adding that children who start with weaker lungs tend to stay behind.
That makes his message to expectant mothers especially urgent. E-cigarettes are often marketed as a safer alternative to smoking, but Dr. Rehan is clear. “There is no such thing as a safer option of nicotine. It’s not safe in any form,” he said.
The project focuses on ILC2s (group 2 innate lymphoid cells), a type of immune cell that lives in the lungs. In adults, these cells play a key role in asthma. But no one has studied what happens to them when a developing baby is exposed to nicotine vapor.
To fill that gap, he has joined forces with Omid Akbari, PhD, a collaborator at the University of Southern California who has studied these cells in adults, pairing that expertise with his own lab’s models of injury in the developing and adult lungs. This effort builds on nearly 20 years of research by Dr. Rehan’s team, investigating how smoke and nicotine harm the developing lung.
That work has shown something striking: the damage can carry forward across generations. A reality that drives Dr. Rehan’s dedication to his research and its impact to improve lives. His top priority for the first years of the grant is turning that finding into something that helps families.
“We have shown that in experimental models it may be possible to mitigate, treat, and perhaps even prevent chronic lung disease of prematurity,” Dr. Rehan said. “Treating lung disease is important but the opportunity to prevent it from ever happening is what really interests me and my team.”