Raul Villacreses, MD, clinical assistant professor in the Division of Pulmonary, Critical Care, and Occupational Medicine, has received a K12 award from the National Institutes of Health. The K-series clinical scientist development grants are aimed at nurturing newly trained clinicians building research programs. Under the grant and the guidance of mentor Joseph Zabner, MD, Villacreses will continue his research into small airway biology and its impact on human pulmonary diseases.

Specifically, Villacreses is investigating the connection between COVID-19 infections, small airway cells, and individuals who develop so-called long COVID. Villacreses has been treating patients in the UI Health Care Long COVID clinic since it was first established in 2020, one of the first to try and understand the lingering symptoms and sequelae post-infection. In addition to treating people with a variety of sometimes debilitating post-COVID symptoms, Villacreses and other clinician-investigators have sought a clearer understanding of its mechanisms.

Villacreses said that he and his colleagues found a group of patients in the clinic who had shortness of breath also showed “significant air trapping on their CT scans that was rarely detected with regular pulmonary function tests.” This hyperinflation, he said, is a hallmark feature of small airway disease. In his research under this grant, he and his team will track its persistence, stability, or growth in a patient population.They also found that “small airway cells express the receptors to which the COVID-19 virus attaches before entering the cells at higher levels than in large airway cells. So, we are interested to know if the small airways are more susceptible to infection.”

Villacreses’s growth as a physician-scientist will be aided by this grant, but this path was not always his goal. A graduate of our residency program and a former Chief Resident, Villacreses said he knew he wanted to be an educator, but it was in the second year of his pulmonary and critical care fellowship that he discovered how much was still left to be learned about small airway biology, physiology, and pathophysiology. That was when he developed a “compelling need” to also pursue a career in research. “It hasn’t been easy, as I moved away completely from my comfort zone, but it has certainly been worth it because it is for the best cause, which is helping our patients.”

Villacreses identified Zabner as his primary mentor, but he said that he is grateful to all the investigators in the Lung Biology and Cystic Fibrosis Research Center have been supportive of his learning. Zabner said that he is impressed by Villacreses’s “encyclopedic knowledge” and that “the secret” to growing physician-scientists among junior faculty is “protecting time,” whether through grants like the K12 or other means. Zabner notes the importance of “developing their potential,” because “their discoveries will change health care.”

[Related: Listen to Villacreses and host Gerard Clancy, MD, discuss long COVID on this January 2021 episode of the Carver College of Medicine podcast Rounding@Iowa.]