Animesh RayProf. Dr

1. Key research focus areas and questions : My research has focussed on the various aspects of pulmonary infections viz. pulmonary aspergillosis, tuberculosis and its sequelae, hospital-acquired pneumonia. For the last ten years, I have been deeply fascinated by the varied and often devastating manifestations of pulmonary aspergillosis – mainly chronic (CPA) and invasive pulmonary aspergillus. Supported by the research ecosystem at AIIMS, I have tried to answer the following questions – How common is pulmonary aspergillosis in post-TB lung disease patients (PTLD) and what is its estimated burden in India? How commonly do patients of pulmonary aspergillosis die, in the Indian and global setting? What are the diagnostic performances of existing and novel diagnostic algorithm for pulmonary aspergillosis? Since pulmonary aspergillosis is associated with significant mortality, what are the optimum treatment strategies ? 2. Major findings and their scientific/clinical significance: I believe that the findings most relevant to my practice have been – estimating the significant burden of pulmonary aspergillosis in India (highest burden of chronic pulmonary aspergillosis in the world, published in IJID journal); a multi-centre individual-patient data metanalysis for estimating global mortality of chronic pulmonary aspergillosis was completed (likely the first IPD meta-analysis from India, published in Lancet Infectious Diseases); the role of point-of-care assays e.g., LDBio was estimated for the first time(published in Journal of Fungi); the role of Aspergillus PCR and broncho-alveolar lavage galactomannan was quantified (published in Mycopathologia), role of nebulized amphotericin-B in pulmonary aspergillosis was evaluated for the first time by a randomized controlled trial (published in Mycoses). I believe that my research has helped in streamlining diagnosis and management for patients affected with pulmonary aspergillosis. Besides the work on pulmonary aspergillosis I have also worked on developing an AI model of diagnosing ventilator-associated pneumonia (work presented in Tokyo, Japan;published). 3. Innovative methodologies or conceptual advances: The conceptual advances which I believe, I have been a part of , is demonstrating that CPA and treatment-naïve pulmonary tuberculosis can co-exist (previously thought to happen in PTLD patients, published in Mycoses), showing that allergic bronchopulmonary aspergillosis can happen in PTLD patients(published in Mycoses), showing that nebulized amphotericin-B can help in management of patients of CPA (published in Mycoses). These findings I believe has been appreciated by my peers and has sparked collaborations, national and international, to further research on these areas. 4. Role and leadership in research efforts: I have tried to build a network of clinicians/researchers in different parts of India (AIIMS Jodhpur, AIIIMS Bhubaneshwar, AIIMS Kalyani, CMC Vellore, IGIB, THSTI) who are now actively working in the field of pulmonary aspergillosis, as collaborators and have themselves streamlined the management of pulmonary aspergillosis in their respective centres. I have initiated and sustained several multinational collaborations that has helped in sharing expertise across borders and comparative analyses across diverse patient populations. These associations have led to a rich exchange of ideas, skills and strategies. 5. Translational or societal impact of the work: I feel that my research has had considerable impact, from both societal and translational aspects. From societal point-of-view the influence has been mainly on raising awareness among fellow doctors (internists, pulmonologists, infectious disease specialists and general physicians) about the entity of pulmonary aspergillosis. I have established by my research and have tried to disseminate, among other things, that diseases like chronic pulmonary aspergillosis is rampant in India and can be easily diagnosed and treated. From translational point-of-view I had reached out and collaborated with like-minded individuals, working on both basic and clinical sciences, nationally and internationally. The notable results include identification of several key fungal proteins which are now being used in an ELISA-based test for diagnosing chronic pulmonary aspergillosis (in collaboration with THSTI). Designing animal-experiments to prove clinical hypothesis (mouse experiment proving relationship between food intake and serum galactomannan levels) is another such satisfying example where I have tried to answer clinical problem with the help of lab-based experiments 6. Ongoing and future research directions: In the future I would like to work on the following aspects – 1) Developing indigenous diagnostic tools for pulmonary aspergillosis; which are affordable and reliable,2) Generating evidence to optimize management protocol for pulmonary aspergillosis in the Indian context. 3) Working on the interaction between mycobacterial and Aspergillus-related lung diseases, from both clinical and mechanistic point-of-view. DESIGNATION: Additional Professor DEPARTMENT: Department of Medicine, AIIMS New Delhi EDUCATIONAL QUALIFICATION: MD(Medicine) DNB FSM(ISDA) MRCP(UK) EDIC EDRM DM (Pulm & Crit) AREA OF INTEREST: Chronic pulmonary aspergillosis, Post Tubercular sequelae, Pulmonary tuberculosis, Invasive pulmonary aspergillosis, Ventilator-associated pneumonia, Sepsis, Chest radiology ACADEMIC ACHIEVEMENTS: Working at AIIMS for ~10 years. More than 270 publications in peer-reviewed journals. Leads numerous national/international projects on pulmonary fungal infections.