Dr. Voynow breathes life into the fight against cystic fibrosis

When Dr. Judith Voynow isn’t with patients and their parents in clinic, you’re likely to find her in the lab investigating new ways to improve their quality of life. With a fervor for defeating cystic fibrosis, Dr. Voynow explains how her career began, why she came to CHoR and what keeps her going strong.

This world-class CHoR researcher is funded by the National Institutes of Health, Department of Defense and Cystic Fibrosis Foundation and the work her lab does right here in Richmond impacts kids around the globe.  

What made you decide to become a physician?

When I was young, my grandfather – whose brother was a physician – said, “Why don’t you be a doctor?” I came from a family of teachers, but his suggestion got me thinking.

I’ve always liked working with kids. As an undergrad, I volunteered at Children’s Hospital of Philadelphia and was assigned to the cystic fibrosis clinic. Things were really different then. I was able to sit in on visits and help out with weighing and measuring patients. I could see the relationship between the kids and families and their physicians. The doctor was really part of the family, helping them through crises that no parents want to face. It was life-changing for me.

I knew this was exactly what I wanted to do – help kids reach their potential.

How did you get into the research side of things?

As part of my volunteer experience, I also had the chance to participate in a research project. I could have shied away from the opportunity, thinking I didn’t have the knowledge or experience, but instead I went for it! We studied how to make sure we could get enough sweat from patients for accurate CF sweat tests. Working with this group taught me how to properly conduct measurements, such as skin and air temperatures.

Another physician was working in a biochemistry lab studying the cause of CF and offered me the amazing opportunity to come into the lab. We compared healthy cells to CF cells and identified problems with sugars on proteins.

With this background, I entered college. I ended up transferring to University of Pennsylvania so I could continue working in the lab. It was a fun and dynamic experience. Even when things didn’t work, I was so excited about being part of groundbreaking research. I met some really great people who helped solidify my career path.

Then I went on to medical school at UPenn and completed my pediatric residency at CHOP. I wanted to continue studying CF, but they didn’t have a fellowship in pediatric pulmonology – so I asked to do a research fellowship prior to my clinical fellowship. I spent three years doing research, then completed my pediatric pulmonology fellowship.

My husband and I ended up moving to Washington, DC for his job as a child neurologist. At that point, in 1990, the CF gene had been discovered. I got a position at the National Institutes of Health as one of 40 international fellows studying all aspects of CF and the CF transmembrane conductance regulator (CFTR) – a protein that helps to maintain the balance of salt and water in the body, including on the surface of the lungs. I collaborated with scientists from around the world and learned more tools of molecular biology.

How did all this training prepare you for what was next?

After the fellowship at NIH, I felt ready to go out on my own. I was very interested in mucus. When you work with patients with CF, you’re struck with how they struggle with their mucus. I wanted to figure out what was different about it.

As it turns out, Children’s National Hospital – also in Washington, DC – was one of the first to clone respiratory mucin genes. I met the biochemist who ran the lab there, who was motivated by her late husband who lost his battle with CF, and she invited me to join her. This is where I got my first R01 grant from NIH to study mucin genes and their expression. We began really investigating neutrophil elastase and its role in stimulating mucus production and exacerbating inflammation in the lungs.

At this point, my husband had to begin paying back his military loans and we were called to relocate to North Carolina. I got a position at Duke University and took my R01 with me. While I had become an independent investigator, I found a village of colleagues at Duke who were kind and generous scientists. They were willing to read my grants, help me make edits, talk about rejection and celebrate successes – and I did the same for them. I stayed at Duke for 19 years.

What attracted you to CHoR as a physician-researcher?

I had known Dr. Bruce Rubin for many years and he asked me to join him in researching mucus and airway inflammation at CHoR. I promised him I’d come take a look. When I did, I was so impressed with the work happening here. What I heard when talking with Dr. Rubin and everyone else throughout my visit was that pediatrics was the jewel in the crown of VCU. Research is what makes the difference between providing excellent clinical care and being recognized as one of the best children’s hospitals. CHoR recruits physician-scientists to build this vision.

I was very fortunate to convince two colleagues to move with me from Duke University to VCU, Dr. Shuo Zheng and Dr. Apparao Kummarapurugu. They are outstanding scientists and long-time collaborators. When I got here in 2013, I had wonderful support from Children’s Hospital Foundation to set up my lab. I also had the honor of partnering with Dr. Karen Hendricks-Muñoz to expand my research into pulmonary function testing for pre-term babies in the NICU. I was also starting to work on a new drug, a glycosaminoglycan, to block neutrophil elastase. I met two leaders in the VCU School of Pharmacy, Dr. Umesh Desai, an expert in glycosaminoglycan biology, and Dr. Hiro Sakagami, an expert in aerosol delivery, and we received a grant to collaborate on developing this new drug.

At CHoR, I’ve been able to grow my research while helping to advance the future of pediatric care through the training of clinical and research fellows – another passion of mine.

Do you have any additional funding?

I currently have NIH funding to study how neutrophil elastase impacts inflammation in the airways of people with CF through something called extracellular traps.

CF affects about 30,000 people in our country, but this research can impact thousands more with other lung diseases, like chronic obstructive pulmonary disease (COPD). Patients with COPD also have excessive neutrophil elastase and extracellular traps that increase inflammation in the airways. There are very few effective drugs for COPD, so I submitted a grant and received funding from the Department of Defense to study COPD macrophages. Not only can we target neutrophil elastase, but there may be other aspects of the disease that overlap between CF and COPD that we can uncover.

The last grant is from the Cystic Fibrosis Foundation. The CF Foundation has been extremely supportive of our program here at CHoR. They are committed to helping build strong interdisciplinary clinical teams, but they understand that it’s research that will make the difference moving forward.

What do you want patients and families to know about the research your team is doing?

I love my clinical practice and taking care of patients, and one of my greatest joys is to be able to tell them that my team and I are working on research leading to a treatment that will improve their quality of life.

Why is it important for children’s hospitals to support research?

Physicians understand the present, pressing problems with chronic disease. Scientists understand cell biology, microbiology and how drugs function to improve disease. It’s important that there are people who stand with a leg in both worlds. That’s how we’re going to make the greatest progress in understanding chronic disease and developing new therapies. If we can find a way to target these diseases for kids, we can improve their quality of life for decades to come. I learn so much from my scientific and other clinical colleagues. We’re all working toward the same goal of helping people.

What advice would you give to junior researchers?

Whether they’re interested in clinical, quality improvement, translational or basic research, I have encouraged all my fellows to do more than one fellowship and gather all the training and tools they can. I think I got my first faculty position at age 37 – but the only way to do what I loved was to get that training.

As they’re exploring jobs, I urge them to look for new mentors but keep close contact with previous teachers and advisors. Just as the Girl Scouts say, make new friends but keep the old. Develop a network of people who will provide guidance, feedback and collaboration.

And, of course, go for it! Don’t be held back or intimidated.

Do you have any passions outside the lab and clinical setting?

I’m very proud of my trainees – it’s the mom in me. Fellows who have trained with me have gone on to work on clinical trials and lead tremendous research on their own. I’m proud to have been part of their learning journey.

Of course, I’m very proud of my own family too. I have three daughters who also happen to love science. The oldest is an environmental scientist in the U.S. Army Corps of Engineers. The middle is a marine biologist and a 6th-grade science teacher. And my youngest daughter is in college considering a career as a pediatrician. She’s very interested in working with kids with developmental disabilities and addressing disparities in health care. All of them want to help others and make the world a better place – which is all I could ask for as a mom.

In my free time, I love playing tennis and pickleball, reading novels and trying new restaurants with my husband – just takeout for now, though.

Discover more about CHoR’s commitment to pediatric research through the Children’s Health Research Institute.