Taking research to extremes, from intense fires to space
By Lisa Ashley Warshaw
Since its start 20 years ago, the Institute for Exercise and Environmental Medicine (IEEM) has helped Olympic athletes improve their exercise capacity, mountain climbers scale Mount Everest, and long-distance swimmers set world records.
The IEEM also has helped NASA understand how weightlessness affects the heart functions of astronauts after prolonged spaceflight by conducting experiments on four space shuttle missions and at the Mir and International Space Stations. It’s even sent one of its own researchers into space.
“The high-profile work we’ve done is gratifying, but our core mission is to improve the health and well-being of people in all walks of life,” said Dr. Benjamin Levine, Professor of Internal Medicine at UT Southwestern Medical Center and Medical Director of the IEEM, which celebrated its 20th anniversary in early October.
“Helping an Olympic runner improve his time, for example, helps us better understand the cardiovascular limitations of a patient with heart failure,” Dr. Levine said. “And understanding how weightlessness affects the heart tells us a tremendous amount about how sedentary lifestyles can lead to stiffening of the heart muscle, a looming health issue as rates of obesity and inactivity in the U.S. continue to increase and our population ages.”
The 40,000-square-foot Institute – created by leaders of UT Southwestern and Texas Health Presbyterian Hospital Dallas in 1992 – boasts 10 laboratories and is supported by eight faculty members, 16 postdoctoral researchers, and more than 40 technical staff. The Institute’s researchers have published more than 400 papers in peer-reviewed scientific and medical journals, as well as more than 100 books and chapters.
Their findings have changed how scientists view the effects of prolonged exercise on heart function, the impact of cardiovascular health on brain function, and the causes of complex, previously misunderstood blood pressure syndromes in women.
Today, the IEEM is one of the largest human physiology clinical research programs in the country, with hyperbaric chambers and other equipment engineered for cardiovascular, respiratory, and neuromuscular research on how altitude, heat, and stress affect the body.
At the time the IEEM was created, medicine and science were heading in divergent directions.
“Reductionists of molecular and cellular biology were reducing medical problems to their smallest component parts by assessing underlying genetic abnormalities, along with the proteins they produce,” said Dr. Levine. “In contrast, the concept of the large-scale clinical trial to establish evidence-based medicine was becoming predominant.”
By bridging these two trends, the IEEM advanced medical science into integrative physiology, which emphasizes how the complex, individual parts of the body are interwoven to create a functional whole.
“We’re striving to fill the void left by the two research trends in order to improve the quality of life for individual patients,” said Dr. Tony G. Babb, Professor of Internal Medicine and Director of the Institute’s Cardiopulmonary Exercise Laboratory. Dr. Babb’s research focuses on the breathing capacity of pulmonary patients and elderly and obese individuals, along with defining the physiological limits of breathing in healthy adults.
The “exercise” part of the Institute’s name derives from the fact that ultimately, every human activity, whether it’s walking the dog or running a marathon, requires some form of exercise. The “environmental” part of the name emphasizes that these activities do not take place in a vacuum, Petri dish, or lab, but rather in the context of how a person’s external environment influences normal physiological function.
Dr. Craig Crandall, Professor of Internal Medicine and Director of the Institute’s Thermoregulation and Vascular Physiology Laboratory, studies how the body responds to bleeding in extreme heat, findings that have the potential to determine how wounded soldiers are treated on the battlefield and how injured firefighters are attended to in burn centers.
The IEEM also features an Environmental Physiology/Hyperbaric Medicine Laboratory with a 1,110-cubic-foot chamber that uses compressed air to simulate depths of up to 165 feet below sea level to treat patients with chronic nonhealing wounds, diabetic foot wounds, bone infections, radiation soft-tissue injuries, and failing skin grafts.
The chamber also can mimic altitudes of 100,000 feet above sea level, helping train pilots to cope with low oxygen levels at high altitudes.
Dr. Levine holds the Distinguished Professorship in Exercise Sciences.