Debra A. Schwinn, M.D.

t was an honor to be asked by David S. Warner, M.D., to second the nomination of Debra A. Schwinn, M.D., for the ASA 2007 Excellence in Research Award. It was an even greater thrill to learn that she had won. For many years, Deb has been a valued mentor and an inspirational colleague for me and for many academic anesthesiologists across the country.

Dr. Warner’s upcoming article in the September 2007 issue of Anesthesiology will very nicely highlight Dr. Schwinn’s career as an innovator and educator in perioperative biomedical science. Her remarkable career of important discoveries and scientific leadership is recognized and applauded nationally and internationally. While marking her past accomplishments with this prestigious award, it is important to note that we are recognizing an individual with impact on anesthesiology, and academic medicine in general, that is ongoing and has tremendous momentum. From my vantage point, Deb has only just begun.

As program director of cardiovascular genomics in the Center for Genomic Medicine at Duke University’s Institute for Genome Sciences and Policy, Deb has recently played a huge role in shaping the landscape of science in anesthesiology to embrace perioperative disease. In many ways, she encourages the discipline of anesthesiology to view the operating room as the last human physiology laboratory and the perioperative period as a window into acute and chronic stress. She has challenged the field to consider whether biologic processes activated in the operating room can predict not only perioperative clinical outcomes but also whether these responses offer clues about an individual’s natural progression in aging and disease.

At a time when National Institutes of Health (NIH) funding is increasingly focusing on discoveries that can be directly translated to patients, Deb’s research is a success model for many young investigators seeking research careers in anesthesiology. Since the time of her graduate studies, her work has remained focused on understanding the mechanisms underlying an adrenergic receptor regulation, but at the same time, it has increasingly embraced the tools of genetics with a view to translation to patient care. Because adrenergic receptors are fundamental to the function of smooth muscle and the heart, her research has shed light on our understanding of how common pre-existing conditions such as hypertension and myocardial hypertrophy impact patients undergoing surgery.

For example, while defining the adrenergic receptor subtypes and their molecular and pharmacologic properties, she has led the field in innovative methods to define a_1a regulatory pathways at the mRNA and protein levels in animals and humans. Her studies clearly demonstrate that the distribution of a_1a in human tissues is distinct from that seen in animal models, and she has proven that a_1a receptors reside in the human resistance vessels critical for maintaining blood pressure in shock or conditions of rapid blood loss. More recently she has characterized the key features of a_1a modulation with aging. These findings have all greatly impacted studies in broad disciplines concerned with autonomic regulation, and their translation from the bench to clinical studies, while highly acclaimed in perioperative medicine, also has impacted a broad array of medical specialties from cardiovascular medicine to urology.

Dr. Schwinn’s laboratory also has been a prototype for drawing genetics into perioperative clinical trials. She established the interdisciplinary perioperative genomics group at Duke, which combines clinicians and genetics researchers dedicated to using genetic variability to predict patient response to surgery. Her leadership has led many of us to reference “perioperative genomics” alongside other contemporary fields, such as pharmacogenomics. As such, her efforts have played a major role in placing anesthesiology squarely in the midst of the most cutting-edge science impacting clinical research at a time when the NIH focus, through its new “Roadmap” and “Clinical and Translational Science Awards,” is rapidly shifting to the application of molecular medicine in human subjects.

Finally, it should be said that Dr. Schwinn takes her responsibility as a leader in our discipline very seriously. While impacting biomedical science at-large through her own research, she has been tireless in her efforts to catalyze changes in anesthesiology training to bolster the position of the specialty in biomedical science and health care. As a recently elected member of the Institute of Medicine of the National Academy of Sciences, she has become an articulate spokesperson for the role of discovery science in unlocking the pressing questions in perioperative disease while also advocating for the importance of expanded research training in our specialty. For this — and for the many new initiatives Deb Schwinn will continue to spearhead to enrich and advance academic anesthesiology — we owe her our sincere gratitude. The ASA Award for Excellence in Research is just one way for us all to say, “Thank You!”

Jeffrey R. Balser, M.D., Ph.D., is Associate Vice-Chancellor for Research and Gwathmey Professor of Anestheisology, Medicine and Pharmacology, Vanderbilt University Medical Center, Nashville, Tennessee.