Division of Respiratory Medicine

Dr. Christopher Carlsten is director of the Centre for Lung Health, a professor and head of the Respiratory Medicine Division at the University of British Columbia (UBC). He is a Canada Research Chair in Occupational and Environmental Lung Disease and holds the Astra-Zeneca Chair in Occupational and Environmental Lung Disease at UBC. He is the director of both the Legacy for Airway Health and the Air Pollution Exposure Laboratory, and also holds adjunct positions at the Peter Wall Institute for Advanced Studies and the UBC School of Population and Public Health. He attended undergraduate and medical school at Stanford University before training in internal, occupational, pulmonary and critical care medicine at the University of Washington. 

Dr. Carlsten’s clinical and research interests center on occupational airways disease, including the effects of diesel exhaust and other inhaled exposures on asthma induction and exacerbation. His laboratory investigates the cardio-pulmonary-immunological health effects of inhaled environmental and occupational exposures, using diesel exhaust, western red cedar and phthalates as model inhalants. Across these domains, he focuses on community-partnered engagement, reducing disparities, and narrowing the gaps between the academic and applied realms of health care, prevention and related policy. As director of the Occupational Lung Disease Clinic at Vancouver General Hospital’s Lung Centre, he welcomes patients with concerns regarding occupational or environmental exposures contributing to respiratory disease including asthma, COPD, interstitial lung disease, cancer and pleural disease.

Dr. John Fleetham is a Professor and a clinician-scientist at the University of British Columbia He has an extensive publication record and his research has been acknowledged by a variety of international and national awards and in 2023 he was named to the Order of Canada. He has served in a variety of international, national and local leadership positions and is the former Associate Head of the UBC Department of Medicine, UBC/VGH Respiratory Divisions and Vancouver Coastal Health Sleep Disorder Program. He is currently on the advisory boards for BC Lung Association, Canadian Lung Association and CIHR Institute of Circulatory and Respiratory Health.

Areas of interest: Obstructive sleep apnea; Respiratory sleep and neuromuscular disorders; Obstructive lung disease; Mycobacterial infections including tuberculosis.

Professor Lam received his medical training at the University of Toronto. He joined the UBC Faculty of Medicine in 1979 and BC Cancer in 1984. He is an interventional pulmonologist and medical director of the BC Lung Screening Program at BC Cancer. He is an expert adviser of the Canadian Partnership Against Cancer and chairs the partnership’s Pan-Canadian Lung Cancer Screening Network. He was the recipient of the International Association for the Study of Lung Cancer’s (IASLC’s) Joseph Cullen Award for lifetime scientific achievements in lung cancer prevention research and the 2020 Doctors of BC Terry Fox Medal.

Areas of interest: Areas of interest: Artificial intelligence; Chemoprevention; Early detection; Lung cancer; Screening

Dr. Frank Ryan graduated from the National University of Ireland (Galway) in 1979. He completed his postgraduate training in Internal Medicine and Respiratory Medicine in Ireland and Vancouver and became a Fellow of the Royal College of Physicians and Surgeons of Canada in 1988, and of the Royal College of Physicians of Ireland in 1993. After completing a British Columbia Lung Association Research Fellowship in Respiratory Sleep Disorders at UBC, he joined the staff of the UBC Respiratory Division as Assistant Professor in 1991 and was promoted to Professor (Tenure) in 2006. He has been a consultant to the UBC Hospital Sleep Disorders Program since 1991. He received a British Columbia Health Research Foundation Scholar Award in 1992-96, a Vancouver Hospital Clinical Investigator Award in 1997-98, a UBC Departmental Scholar Award in 2001, and a British Columbia Lung Association/Vancouver General Hospital Clinical Scientist Award in 1998-2003. His research focussed mainly on the investigation and treatment of obstructive sleep apnea. More recently, he has been actively involved in medical education and was the UBC Respiratory Division Postgraduate Training Program Director from 2009-2016. He has been an Examiner in respiratory medicine for the Royal College of Physicians and Surgeons of Canada since 2016. He has a longstanding interest in pleural disease. In 2017, he developed a successful Pleural Disease Program at Vancouver General Hospital, currently staffed by a dedicated nurse practitioner and three interventional pulmonologists who provide ambulatory and inpatient management of pleural disease at VGH, as well as training in pleural disease for Fellows and Residents.

Areas of interest or specialty: Medical education; Pleural disease; Respiratory sleep and neuromuscular disease

Dr. Chris Ryerson completed his core clinical training at the University of British Columbia and an interstitial lung disease (ILD) fellowship and Masters degree in clinical research at the University of California San Francisco before joining UBC faculty in 2011. He is an Associate Professor at UBC, director of the St. Paul’s Hospital ILD clinical and research program, and Head of the Division of Respiratory Medicine at Providence Health Care. His research focuses on the diagnosis, management, and prognostication of ILD. He is also involved in several national and international clinical practice guidelines on the diagnosis and management of fibrotic ILD.

Dr. Ryerson’s research focuses on the diagnosis, management, and prognostication of pulmonary fibrosis. This includes recent work on frailty and body composition as well as several studies exploring the benefits of oxygen supplementation in patients with pulmonary fibrosis and optimal strategies for its use. Dr. Ryerson leads the Canadian Registry for Pulmonary Fibrosis (CARE-PF), an 8-centre prospective registry that is among the largest in the world, as well as the HOPE-IPF study, which is a randomized controlled trial evaluating the clinical and physiological impact of oxygen supplementation during exercise training in patients with idiopathic pulmonary fibrosis. Dr. Ryerson has also been involved in several national and international clinical practice guidelines on the diagnosis and management of pulmonary fibrosis.

Dr. Andy Sandford is a Professor in the Division of Respiratory Medicine, Department of Medicine at the University of British Columbia. He joined the UBC Pulmonary Research Laboratory at St. Paul’s Hospital (now part of the Centre for Heart Lung Innovation) in 1994 as a Postdoctoral Research Fellow. Dr. Sandford has held a Parker B. Francis Foundation Fellowship, a Tier 2 Canada Research Chair and a Michael Smith Foundation for Health Research Senior Scholar Award. Dr. Sandford has received research funding from the Canadian Institutes for Health Research (CIHR), the British Columbia Lung Association and Cystic Fibrosis Canada.

The focus of Dr. Sandford’s research is the genetic basis of obstructive lung disease. His current work includes identification of genetic risk factors for the development of asthma, peanut allergy and chronic obstructive pulmonary disease as well as genetic modifiers of disease severity in cystic fibrosis. He is investigating epigenetic markers that predict long-term adverse complications in patients with obstructive sleep apnea. The functional impact of genetic variants that have been associated with respiratory disease is another research interest.

These studies will extend current knowledge of inherited factors that affect susceptibility to respiratory disease as well as disease severity and progression. Variants in genes which modulate the severity and progression of disease may be identified and this knowledge could be used to structure therapy to better address given subsets of patients. Knowing which genes and variants are responsible for the marked heterogeneity in disease susceptibility and severity may suggest novel avenues for future therapies.

Don Sin is the Director of the Centre for Heart Lung Innovation (HLI), a Professor of Medicine at University of British Columbia (UBC) and respirologist at St. Paul’s Hospital (SPH). He holds a Tier 1 Canada Research Chair in COPD and the De Lazzari Family Chair at HLI. He has published 700 peer-reviewed papers and has an H-index of 110. He obtained his medical degree at University of Alberta in 1991. He currently serves on the Global initiative for chronic Obstructive Lung Disease (GOLD) scientific committee and CTS COPD guidelines committee and is the deputy chief editor for the European Respiratory Journal. His research focus is using “omics” data to discover novel biomarkers of disease activity and new therapeutic targets to reduce hospitalization and mortality in patients with COPD.

Because COPD is a heterogeneous disorder, large sample sizes are generally required for therapeutic and even mechanistic studies to enable sufficient statistical power. This problem is exacerbated by the fact that even within a given COPD lung, there is tremendous variability in the severity and extent of the disease.

With the advent of in vivo imaging techniques such as high-resolution CT scans and more recently functional magnetic resonance imaging (MRI), structural abnormalities and disease activity levels can be detected and mapped out regionally prior to sampling of small airways, which are the primary site of disease in COPD (e.g. sampling can be done using bronchoscopy). By knowing which regions of the lung are “hot” and which are “quiescent” a priori, bronchoscopists can take samples in a targeted way to ensure that the full spectrum of disease activity is represented in the sampling process and more importantly, that there is alignment of histologic, molecular and microbial changes in these samples with the disease activity readouts from in vivo imaging.

Over the next 7 years, we will optimize the use of hyperpolarized ¹²⁹Xe MRI imaging for COPD. In the same subjects, we will also perform research bronchoscopies and sample different small airways based on disease activity readouts from the in vivo imaging. We will then perform multi-omics evaluation of bronchoscopic brushes (which are >95% pure epithelial cells) and bronchoalveolar lavage fluid (BALF). The multi-omic evaluation will include:

1. 16S sequencing for the microbiome;
2. Bulk RNA-seq (and single cell seq for sub-projects);
3. DNA methylation and other epigenetic interrogations; and others.

The cellular components of BALF are >80% macrophages, which can be profiled, and the supernatant can be used to evaluate surfactants, cytokines/growth factors and other molecules that may play an important role in COPD pathogenesis.

Dr. Scott J. Tebbutt is Professor in the Department of Medicine (Respiratory Division), University of British Columbia, as well as Principal Investigator and Director of Education at the Centre for Heart Lung Innovation, St. Paul’s Hospital, Vancouver, Canada. He is also Chief Executive Office (since 2020) and Chief Scientific Officer (since 2009), of the Prevention of Organ Failure (PROOF) Centre of Excellence – a not-for-profit organization dedicated to moving research findings into health care, and focused on non-invasive biomarkers that can diagnose and/or predict organ failure and other clinically-important indications.

Dr. Tebbutt’s research program is focused on the molecular and cellular understanding of complex disease and other health-related conditions, including inflammatory disorders of the lung, allergic rhinitis, heart failure, and neonatal vaccinology. His research interests include the evaluation and deployment of new, high-performance technologies to improve biomarker discovery, development and implementation, as well as development of bioinformatic approaches to better deal with sample heterogeneity and integration of high-dimensional ‘omic datasets. Dr. Tebbutt serves on numerous local and international scientific advisory committees, including the BC Children’s Hospital Research Institute “Transplantation and Cell Therapy (TRACE) Program Biomarker and Cell Therapy Oversight Committee (BCTOC),” the United States National Institutes of Health Human Immunology Project Consortium (HIPC) “Biostatistics and Bioinformatics Subcommittee,” and the Coalition for Epidemic Preparedness Innovations (CEPI) “Systems Immunology Task Force.”