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Richard N Pierson
M.D.
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| Academic Title:
Professor |
| Primary Appointment:
Surgery |
| Additional Title(s):
Director, Surgical Care Clinical Center, VA Maryland Health Care System |
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rpierson@smail.umaryland.edu |
| Location:
UMMC,
N4W94 |
| Phone:
(410) 328-5842 |
| Phone:
(410) 605-7233 |
| Fax:
(410) 328-2750 |
| Lab:
(410) 706-1896 or 1164 |
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Personal History
Dr. Richard Norris Pierson, III, received his BA from Princeton University in English and American Studies in 1978, and his MD from Columbia University College of Physicians and Surgeons in 1983. His postgraduate clinical training included General Surgery at the University of Michigan, Ann Arbor, MI (1983-1990), Cardiac and Thoracic Surgery at the Massachusetts General Hospital, Boston, MA (1990-1992), and clinical and research fellowship in Cardiothoracic Transplantation at Papworth Hospital, Cambridge University, Cambridge, England (1993-1994). He joined the faculty at Vanderbilt University as Director of Heart and Lung Transplantation in 1994, with appointments at Vanderbilt University Medical Center and the Nashville VAMC. He was promoted to Associate Professor with tenure in 1999. In 2002 he was recruited as Clinical Director of Heart and Lung Transplantation at University of Maryland Baltimore, with appointments in Cardiac Surgery at UMMC and Baltimore VAMC. In 2006 he was promoted to Professor of Surgery at University of Maryland, and appointed Director of the Surgical Service at the Baltimore VA Medical Center (VA Maryland Health Care System). Dr. Pierson is the President of the International Xenotransplant Association (2007-2009).
Research Interests
Basic and Translational research
Dr. Pierson's laboratory specializes in basic and translation research related to transplant immunology, with the following principle foci:
• Investigating the mechanisms by which costimulation pathways modulate the immune response to an allograft, a xenograft, or an infectious antigenic challenge in a primates, and particularly with regard to promoting induction of tolerance.
• Investigating the role of chemokine receptors in innate and adaptive immunity, using primate models.
• Defining the pathogenesis of hyperacute lung rejection, using an ex vivo model of pig lung perfused with human blood and orthotopic transplants in primate models.
• Development of strategies to regulate local coagulation pathway activation which may induce the long term acceptance of pig heart xenografts in primates.
Fruitful collaborations exist with investigators at many other academic institutions and in industry.
Clinical Research
Mechanical Circulatory Support Device Trials
Patients who are require "bridge-to-transplant" circulatory support as well as those who are not transplant candidates are enrolled in FDA-approved Phase 2 or prospective randomized Phase 3 clinical research trials. Survival, quality of life, and other outcomes are measured over time after device implant. Ongoing studies will examine nutrition, inflammation, and coagulation pathway control in device recipients relative to heart transplant and heart failure patients.
Clinical Heart and Lung Transplantation
Clinically approved immunosuppressive agents are being used in novel combinations at UMMC in clinical heart and lung transplantation, to explore their capacity to prevent chronic rejection, and to limit undesirable side effects of therapy. It is expected that retrospective analysis will show that this approach will be associated with improved patient outcomes, and will lead to novel approaches to immune system monitoring and modulation.
Clinical Speciality
Heart and Lung Transplantation , Mechanical Circulatory Support
Grants and Contracts:
VA Merit Award PI: Pierson, RN III 4/98-3/09
A Novel Strategy to Prolong Discordant Xenograft Survival
The objective of this project is to define the role of CD154 in delayed xenograft rejection, and evaluate genetic modifications to the pig to control this pathology.
NIH U01 AI 066719-01 PI: Pierson, RN III 7/05-6/10
Immunomodulation for Heart Allograft Tolerance
To study costimulation blockade as a tolerance induction strategy in a primate heart transplant model.
NIH UO1 AI 066335-01 PI: Pierson, RN III 9/05-2/10
Mechanisms of GalT KO Lung Xenograft Injury
To define the role of complement activation and coagulation pathway dysregulation in hyperacute lung rejection of GalT KO and GalTKO/hTFPI transgenic lung xenografts.
Publications
Selected Publications
Pierson RN III, Winn HJ, Russell PS, Auchincloss H Jr: Xenogeneic skin graft rejection is especially dependent on CD4+ T cells. Journal of Experimental Medicine 1989; 170: 991-6.
Moses RD, Pierson RN III, Winn HJ, Auchincloss H Jr: Xenogeneic proliferation and lymphokine production are dependent on CD4+ helper T cells and self antigen-presenting cells in the mouse. Journal of Experimental Medicine 1990; 172(2): 567-75.
Pierson RN III, Rosengard BR: The uses of molecular biology in transplantation. JAMA 1994; 272(21): 1706-7.
Pierson RN III, Tew DF, Konig WK, Dunning JJ, White DJG, Wallwork J: Pig lungs are susceptible to hyperacute rejection by human blood in a working ex-vivo heart-lung model. Transplant Proc 1994; 26(3): 1318.
Robson SC, Young VK, Cook NS, Metternich R, Kasper-Konig W, Lesnikoski BA, Pierson RN III, Hancock WW, White DJG, Bach FH: Thrombin inhibition in an ex vivo model of porcine heart xenograft hyperacute rejection. Transplantation 1996; 61(6): 862-8.
Pierson RN III, Pino-Chavez G, Young VK, Kasper-Konig W, White DJG, Wallwork J: Expression of human decay accelerating factor may protect pig lung from hyperacute rejection by human blood. J Heart and Lung Transplantation 1997; 16(2): 231-239.
Pierson RN III, Kasper-Konig W, Tew DN, Young VK, Dunning JJ, Horsley J, Carey NRB, Wallwork J, White DJG: Hyperacute lung rejection in a pig-to-human transplant model. 1) The role of anti-species antibody and complement. Transplantation 1997; 63(4): 594-603.
Miller GG, Davis SF, Aune TJ, Zhao SM, Pierson RN. Fibroblast growth factors and their receptors in allograft vascular disease. Graft 1998; 1(3): 96-100.
Skepper JN, Pierson RN, Tew DN, Boa Y-P, Williamson G, Wallwork J, White D, Davies MJ, Jones JG, Menon DK. Cytochemical demonstration of sites of hydrogen peroxide generation and increased vascular permeability in isolated pig hearts after ischemia and reperfusion. Microscopy Research and Techniques 1998; 42(5): 369-385.
Chang AC, Blum MG, Blair KSA, Zhang J, Scott MA, Brock JE, Thomas DW, Burkly LC, Miller GG, Pierson RN III. Modulation of interleukin-12 gene expression in primate cardiac allografts during anti-CD40 Ligand monoclonal antibody treatment, Surgical Forum 1998; Vol. XLIX: 363-364.
Miller GG, Davis SF, Atkinson JB, Chomsky DB, Pedroso P, Reddy VS, Drinkwater DC, Zhao XM, Pierson RN. Longitudinal analysis of fibroblast growth factor (aFGF) expression following transplantation and association with severity of cardiac allograft vasculopathy. Circulation, 1999; 100: 2396-99.
Pierson RN III, Chang AC, Blum MG, Blair KSA, Scott MA, Atkinson JB, Collins BJ, Zhang J-P, Thomas DW, Burkly LC, Miller GG. Prolongation of primate cardiac allograft survival by treatment with anti-CD 40L (CD154) antibody. Transplantation, 1999; 68(11): 1800-5.
Pierson RN III, Miller GG. Late graft failure: Lessons from clinical and experimental thoracic organ transplantation. Graft 2000; 3 (2): 88-93.
Shin H-G, Barnett JV, Chang P, Reddy S, Drinkwater DC, Pierson RN, Wiley RG, Murray KT. Molecular heterogeneity of protein kinase C expression in human ventricle. Cardiovasc Res 2000; 48: 285-299.
Pierson RN III, Crowe JE Jr., Pfeiffer S, Atkinson J, Azimzadeh A, Miller GG. CD40-Ligand in Primate Cardiac Allograft and Viral Immunity. Immunologic Research 2001; 23(2-3): 253-62.
Pierson III RN, Schraeder C, Wu GS, Kawka DW, Peterson L, Springer MS, Siciliano SJ, Lyons K, Mills, S, Illiff S, Miller GG, Azimzadeh AM, Singer II, DeMartino, JA. Synergism between CCR5 blockade and CSA in primate cardiac allotransplantation. Transplantation 2002 Suppl. 74; 4: 299.
Crowe JE Jr, Sannella EC, Pfeiffer S, Zorn GL III, Azimzadeh A, Newman R, Miller GG, Pierson RN III. CD154 regulates primate humoral immunity to influenza. Am J Transplantation 2003; 3: 680-88.
Schraeder C, Azimzadeh AM, Wu G, Price JO, Atkinson JB, Pierson RN III. Anti-CD20 treatment depletes B-cells in blood and lymphatic tissue of cynomolgus monkeys. Transplant Immunology 2003; 12(1): 19-28.
Pierson RN III, Barr ML, McCullough KP, Egan T, Garrity E, Jessup M, Murray S. SRTR Report on the State of Transplantation: Thoracic Organ Transplantation. Am J Transplant 2004; 4 (Suppl 9): 93-105.
Azimzadeh AM, Pfeiffer S, Wu GS, Schroeder C, Zorn GL III, Kehry M, Miller GG, Rose ML, Pierson RN III. Humoral immunity to vimentin is associated with cardiac allograft injury in nonhuman primates. Am J Transplantation, 2005; 5(10): 2349-59.
Pfeiffer S, Zorn G III, Blair K, Farley S, Wu G, Schuurmann HK, Azimzadeh A, Pierson RN III. Hyperacute lung rejection in the pig-to-human model. 4) Evidence for complement- and antibody independent mechanisms. Transplantation 2005; 79(6): 662-71.
Wu G, Pfeiffer S, Schroeder C, Zhang T, Nguyen BN, Kelishadi S, Atkinson JB, Schuurman H-J, White DJG, Azimzadeh AM, Pierson RN III. Co-stimulation blockade targeting CD154 and CD28/B7 modulates the induced antibody response after a pig-to-baboon cardiac xenograft. Xenotransplantation 2005; 12(3): 197-208.
Azimzadeh A, Pfeiffer S, Wu G, Schroeder C, Zorn G III, Ozkaynak E, Kehry M, Atkinson J, Miller G, Pierson RN III. Alloimmunity in primate heart recipients with CD154 blockade: evidence for alternative costimulation mechanisms. Transplantation 2006; 81(2): 255-64.
Barrows BR, Azimzadeh AM, Zhou H, Vives-Rodriguez G, McCulle SL, Stark WN, Ambulos N, Yin J, Pierson, RN III, Johnson FL, Balke CW, Gottlieb SS, and Bond M. Robust gene expression analysis using amplified RNA from biopsy-sized human heart tissue. J Mol Cell Cardiol 2007; 42: 260-264.
Wu G, Pfeiffer S, Schroder C, Zhang T, Nguyen BN, Kelishadi S, Atkinson JB, Schuurman HJ, White DJ, Azimzadeh AM, Pierson RN III. Coagulation cascade activation triggers early failure of pig hearts expressing human complement regulatory genes. Xenotransplantation 2007; 14:34-47.
Nguyen BN, Azimzadeh AM, Zhang T, Wu G, Shuurman H-J, Sachs DH, Ayares D, Allan JS, Pierson RN III. Life-Supporting Function of Genetically Modified Swine Lungs in Baboons. J Thorac CV Surg 2007; 133(5): 1354-63.
Schroeder C*, Pierson RN III*, Nguyen BN, Kawka DW, Peterson LB, Wu G, Zhang T, Springer MS, Siciliano SJ, Iliff S, Ayala JM, Lu M, Mudgett JS, Lyons K, Mills S, Miller GG, Singer II, Azimzadeh AM, DeMartino JA. CCR5 blockade modulates inflammation and alloimmunity in primates. J Immunol. 2007; 179(4): 2289-99.
Cooper DKC, Dorling A, Rees M, Seebach J, Yazer M, Ohdan H, Awwad M, Ayares D, Pierson RN III. aGalactosyltransferase gene-knockout pigs: where do we go from here? Transplantation 2007; 84(1): 1-7.
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