Avrum Spira

Professor of Medicine, Pathology & Laboratory Medicine, & Bioinformatics, School of Medicine

Dr. Spira is an Associate Professor in the Departments of Medicine, and Pathology and Bioinformatics and is Chief of the Division of Computational Biomedicine in the Department of Medicine at BUSM. He attends in the Medical Intensive Care Unit at Boston Medical Center. He directs the Bioinformatics Program in the Pulmonary Center and directs the Translational Bioinformatics Program in the Clinical and Translational Science Institute at Boston University.

Dr. Spira’s laboratory research interests focus on applying genomic and bioinformatics tools to the translational study of lung cancer and Chronic Obstructive Lung Disease (COPD), with the ultimate objective of developing novel diagnostics and therapeutics that can directly impact clinical care. He is funded as a Principal Investigator through three institutes at the NIH including the NCI, NHLBI, and NIEHS as well as the Department of Defense. His research program centers around the concept that inhaled toxins create a “field of injury” in all exposed airway epithelial cells, and that by measuring gene expression in a relatively pure population of these cells, one can develop a gene-expression profile that reflects the physiological response to and damage from the toxin. The importance of the “field-of-injury” concept is that it allows for the detection of lung disease in tissues that are more readily assayed than the diseased lung itself.

His lab has characterized the impact of cigarette smoking on intra-thoracic (lobar bronchi) and extra-thoracic (mouth and nasal) airway epithelial cell gene expression, and he has leveraged this approach to develop a bronchial airway gene-expression biomarker for the early detection of lung cancer that is currently being validated in a multicenter clinical trial. His lab has also extended this “field of injury” paradigm to the premalignant and lung cancer screening settings, potentially allowing personalized genomic approaches to lung cancer chemoprophylaxis and therapy. This disease-specific airway “field of injury” concept is also being applied to Chronic Obstructive Lung Disease (COPD), to better understand the molecular diversity of COPD, both for developing subtype-targeted therapies and for developing biomarkers that would allow identification of biologically distinct forms of COPD. Most significantly, his lab has identified airway gene-expression biomarkers that can be used to monitor disease activity and response to therapy in COPD, and they have connected gene expression signatures of disease in clinical samples to in vitro small molecule perturbations to move from bedside to bench and identify new uses for existing drugs as potential COPD therapeutics. Finally, we are exploring gene-expression profiles in nasal and buccal epithelium as biomarkers of the physiological response to inhaled toxins and their potential role as lung disease biomarkers in large-scale population studies.