Long-time faculty member, former Department of Medicine chair, and nationally recognized leader in asthma and allergy research William Busse, MD, professor, Allergy, Pulmonary and Critical Care Medicine, will retire on July 2, 2021.

A Badger through and through, Busse joined the department in 1974 after completing his undergraduate degree, medical degree, internal medicine residency and research fellowship in allergy and clinical immunology all at the University of Wisconsin–Madison.

He held numerous leadership roles in the department, including head of what was then the Section of Allergy and Clinical Immunology, vice chair for research, and the George R. and Elaine Love Professor and Chair of Medicine.

Busse’s remarkable 47-year research career is exemplified by continuous National Institutes of Health (NIH)-funded grant support. From his early role as a co-investigator on the now 50-year Asthma and Allergic Disease Center, through multi-investigator programs as the Specialized Center of Research (SCORs), the Severe Asthma Research Program and the landmark Inner-City Asthma Consortium ICAC), he has always believed that collaboration has been the key to success.

“In most of our funded projects, we patterned our efforts towards team science before team science was in vogue,” he reflects. “This approach leveraged local expertise, expanded the scope of our efforts, and introduced asthma research to more investigators.”

Busse and his collaborators were also among the earliest in their field to focus on translational research. They conducted studies primarily in patients with asthma, which provided a more direct link to disease mechanisms and potentially to improved clinical understanding and care.

Reflecting the success of these collaborative efforts, Busse received numerous awards, including the 2004 UW School of Medicine and Public Health’s Folkert Belzer Life Achievement Award, the 2005 American Thoracic Society (ATS) Award for Scientific Accomplishments and the 2014 ATS Foundation Breathing for Life Award. He also received a UW Health Patient Experience Physician Champion Award in 2014.

What have been the most personally gratifying aspects of your work and why?

The greatest joy, and fulfillment, that I’ve had has been collaborations with other investigators, largely at Wisconsin and in the Department of Medicine. For me, collaboration brought in new ideas, expertise, approaches, and an expansion into novel avenues of research. The end result was a more comprehensive and innovative approach to our research. In addition, working together created an expanded mutual interest that was not only more effective and productive, but just more enjoyable. The social aspects of our collaborations were a very positive spin-off.

A second very positive aspect of collaboration was team building, not only of the research unit but as an opportunity to attract, mentor, and develop the next generation of investigators. Invariably, a junior investigator became part of the research team, developed their own skills and imparted their own expertise, and then went on to establish their own program. Team building became a multiplication and amplification aspect of our collective efforts. Participating in this collective process has been both a heartening and gratifying experience, which served to build our research core and, most importantly, the study of asthma.

What are the biggest highlights from your time in the Department of Medicine?

An obvious highlight, as well as honor and privilege, was being a faculty member of the Department of Medicine and the School of Medicine and Public Health. I’ve been fortunate to participate in, share and witness the growth of excellent programs in education, training, and patient care, all of which are critical to the success of a medical school and medical center. This collective growth has been a source of fulfillment and highlight throughout my career as a physician and physician-investigator. Our department established important and effective leadership roles in these essential spheres of medicine, and it has been gratifying to see our faculty guide us in these positive directions.

Participating in our many collaborative research programs has also been, and continues to be, a career highlight for me. Here are a few examples.

The Role of Rhinovirus in Asthma

When I joined our faculty, a major research focus was discovering and explaining how asthma attacks are caused. We found that the major cause was a respiratory infection with the common cold virus, rhinovirus. For some patients with asthma, these generally innocuous upper respiratory infections would lead to a severe asthma attack.

Working with Rob Lemanske, Jim Gern, Ron Sorkness and others, we identified how rhinovirus infections exacerbated asthma and gained insight into improved methods of treatment. Importantly, this work is ongoing under the direction of Jim Gern, Yury Bochkov, Ann Palmenberg, Chris Seroogy, and Dan Jackson, and includes a focus on a new strain of rhinoviruses, rhinovirus C, which this group discovered.

Importance of the Eosinophil

Airway inflammation is a driving factor in asthma severity. The eosinophil is a major contributor to these processes and has been another focus of our research, with Nizar Jarjour, Stephane Esnault, Deane Mosher, Mats Johansson, James Malter, Paul Bertics, Julie Sedgwick, and Mary Ellen Bates. Our interest in this cell’s importance to asthma led to the commissioned sculpture of this cell, pictured below.

Understanding and Treating Severe Asthma

Some patients with asthma have severe disease with a greater risk for attacks and morbidity and are the least responsive to current treatments. Because this subpopulation with severe asthma represented a major unmet need, the National Institutes of Health (NIH) established the Severe Asthma Research Program (SARP). We and other centers across the country have contributed major advances, including understanding the underlying immune molecular mechanisms that lead to inflammation and persistent disease severity.

This work is also ongoing with the innovative establishment of the NIH-supported PrecISE protocol, in which precision medicine approaches are being tested to gain disease control. Loren Denlinger and Nizar Jarjour are leading this effort in Madison.

Asthma in High-Risk Children in Large Cities

The NIH-funded Inner City Asthma Consortium (ICAC) has been a major opportunity to identify mechanisms of and new treatment approaches for asthma in high-risk children living in large cities. These children tend to have more severe disease, which is complicated by limited access to care.

Jim Gern, Dan Jackson and Chris Sorkness now have the leadership role in ICAC, and they collaborate with physician-investigators at urban clinical research centers across the country to test and evaluate the effectiveness of new approaches to improve asthma outcomes in these children. They have also conducted research to more fully understand the mechanisms of why their disease is severe. We have made a major positive influence in the lives of these children and their families.

The program was just renewed, is now called CAUSE (Childhood Asthma in Urban Settings Clinical Research Network), and Dan Jackson, Jim Gern and Chris Sorkness head the Leadership Center here in Madison.

Asthma and Psychology

Psychology disorders are common in asthma, but very poorly understood or appreciated. As part of a NIH-funded effort called the Body, Mind, and Health Initiative, I was able to collaborate with Richard Davidson and Melissa Rosenkranz to study asthma-brain interactions. Using brain imaging, we showed that provocation of asthma activated emotion-centered regions of the brain.

Asthma as a Risk Factor for Dementia

There is also now emerging evidence that asthma may affect brain health and function, a consequence of systemic inflammation in asthma. Through a Department of Medicine Collaborative grant, Nizar Jarjour, Melissa Rosenkranz, Stephane Esnault, Amy Kind, Christie Bartels, Cindy Carlsson, Barb Bendlin, Sanjay Asthana, and Tyler Ulland are exploring the possibilities that asthma may be a risk factor for dementia, including Alzheimer’s disease.

Amazing Collaborators

These collaborative efforts were built and made successful with an amazing and dedicated staff of clinical coordinators, nurses and laboratory researchers. In addition, and for me personally, Reitha Johnson has been an administrative assistant for over three decades; her commitment to our program has been invaluable especially with grant preparation.

There are many fond memories.

What are you looking forward to?

My next step will be a transition towards a traditional retirement with explorations of undiscovered areas of interest. For the next year, however, the Department of Medicine has provided an appointment as an Honorary Fellow, which will allow me opportunities to complete ongoing manuscripts. After that, I will largely enjoy seeing the progress arising from these many collaborations and the advances that will continue to follow.

This next chapter of asthma research in our program will be a testimony to, and reflection of, the collaborative spirit that is encouraged, supported and prevails at the University of Wisconsin School of Medicine and Public Health, and, especially, in the Department of Medicine.

Banner: Dr. William Busse in his lab in 2017. Photo credit: Clint Thayer/Department of Medicine