Urban — Global Public Health

Faculty Profile

  • Stephan Schwander, MD, PhD

  • Director, Global Public Health Concentration
    Associate Professor

  • Department of Urban-Global Public Health

  • CV

Keywords
Global public health; urban public health, tuberculosis; Mycobacterium tuberculosis (M.tb) immune responses; transmission of M.tb in communities; environmental health; air pollution particulate matter; particulate matter effects on human host immunity against M.tb.

Biography
Stephan Schwander MD, PhD received his MD from University of Frankfurt/Germany and his PhD from University of Hamburg/Germany. His clinical training included pediatrics, internal and tropical medicine. Dr. Schwander spent a total of 4 years working in clinical and translational research in low and middle income countries, including Peru, Uganda and Mexico. After a postdoctoral research fellowship in tuberculosis (TB) lung immunity in the Pulmonary and Infectious Disease Divisions at Case Western Reserve University in Cleveland, and subsequent faculty positions there and later at NJ Medical School in Newark, he is now an Associate Professor in Urban-Global Public Health & Environmental and Occupational Health and the Director for the Global Public Health concentration at Rutgers School of Public Health. His NIH-funded research focusses on human immunity in TB and during Mycobacterium tuberculosis (M.tb) infection and the confounding effects from exposures to particulate air pollution.

Research Interests
Dr. Schwander’s research is translational in nature, involves international and local sites and focuses on TB and environmental health effects in urban communities. Specifically his research aims at understanding how air pollution affects human immunity during the infection process with M.tb, the bacterium that causes TB. Both, air pollution and TB contribute significantly to the global burden of disease. TB is now the ninth leading cause of death worldwide and the leading cause of death from a single infectious agent. Air pollution, both indoors and outdoors (urban), is responsible for the deaths of millions of people worldwide every year. Deteriorating air quality from rapid industrial growth, vehicular traffic and garbage burning affects large populations in growing urban environments worldwide, many living in poverty and areas endemic for TB. As TB is a social disease, research on TB in the real world encompasses multiple aspects relevant to public health, the environment, nutrition, poverty, social justice, equity, and health systems. This research is in line with the global TB elimination goals put forth by the Word Health Organization and the United Nations (UN). Dr. Schwander’s lab in collaboration with others has spearheaded research on human lung immune responses to M.tb and helped to establish the concept of compartmentalization of immune responses to the lungs in human pulmonary TB. During the last decade Dr. Schwander’s research focus expanded to explore how air pollution affects TB as M.tb and air pollutants enter the human body through the breathing process. The lungs are therefore the first organ to interact with both M.tb and for example particulate matter (PM, tiny inhalable particles composed of many chemicals adsorbed on a carbon core) from polluted air. The main source of household air pollution in low and middle income countries (LMICs) is the combustion of fossil fuels from cooking processes, in the urban environment main sources are from industrialization and traffic growing globally, however, increasingly large populations, many in TB endemic LMICs, are also exposed to outdoor air pollution. While epidemiological studies have shown that household air pollution significantly increases the risk for TB development (accounting for nearly as many global TB cases as malnutrition, and many more than HIV coinfection), an important question is now whether urban (outdoor) air pollution particulate matter may result in similar effects. Does urban air pollution particulate matter adversely affecting protective immune responses against M.tb? In collaboration with institutions in Mexico City/Mexico findings form Dr. Schwander’s lab at RU School of Public Health point to a ‘Yes’. Earlier studies by Dr. Schwander’s team had already shown that exposures to diesel exhaust particles – a common component of urban air pollution –suppressed the responsiveness of human immune cells to M.tb, suggesting that air pollution exposed persons may be less able to fight off infections with M.tb. In a next step, Dr Schwander’s team is expanding its laboratory based research into the real world trying to answer the question if M.tb transmission may be affected by air pollution exposure. Studying this crucial question involves international, interinstitutional collaborations, combined efforts from multiple disciplines in public health, urban environmental, health systems and policies, behavioral, and biomedical sciences.  The team is currently developing large grant applications to do this research work in Kampala, the capital city of Uganda/East Africa by involving several academic institutions in Uganda, Canada, the UK and the US.

Research Highlights

Designed and performed the first randomized double-blind comparative treatment study of drug regimens for HIV associated tuberculosis in Sub-Saharan Africa (Uganda) in 1992/1993.

Several of my studies in Mexico City helped to shape and expand the concept of compartmentalized antimycobacterial immune responses in human lungs during TB.

Executed two of a couple of studies published in the world literature on lung immune responses in healthy household contacts of patients with TB. Studies in aerogenically exposed but healthy household contacts of untreated, actively M.tb-shedding, patients with lung TB, provide the best possible approach to understanding human local immune responses associated with protection against M.tb infection.

Showed that bad air quality, PM and nanoparticle exposures suppress protective human immune responses against M.tb thus probably increasing susceptibility to M.tb infection in a world with fast progressing urbanization in many TB endemic countries.

Select Publications
BJ Kirenga,Q Meng,F van Gemert,H Aanyu-Tukamuhebwa,N Chavannes,A Katamba,G Obai,T van der Molen,S Schwander,V Mohsenin (2015) "The State of Ambient Air Quality in Two Ugandan Cities: A Pilot Cross-Sectional Spatial Assessment.", International Journal of Environmental Research and Public Health 12(5) 8075-8091 http://www.ncbi.nlm.nih.gov/pubmed/?term=26184273&report=abstract

Y Son,ÁR Osornio-Vargas,MS O'Neill,P Hystad,JL Texcalac-Sangrador,P Ohman-Strickland,Q Meng,S Schwander (2018) "Land use regression models to assess air pollution exposure in Mexico City using finer spatial and temporal input parameters.", The Science of the Total Environment 639(5) 40-48 http://www.ncbi.nlm.nih.gov/pubmed/?term=29778680&report=abstract

S Schwander,K Dheda (2011) "Human lung immunity against Mycobacterium tuberculosis: insights into pathogenesis and protection.", American Journal of Respiratory and Critical Care Medicine 183(5) 696-707 http://www.ncbi.nlm.nih.gov/pubmed/?term=21075901&report=abstract

S Sarkar,Y Song,S Sarkar,HM Kipen,RJ Laumbach,J Zhang,PA Strickland,CR Gardner,S Schwander (2012) "Suppression of the NF-?B pathway by diesel exhaust particles impairs human antimycobacterial immunity.", Journal of Immunology 188(5) 2778-2793 http://www.ncbi.nlm.nih.gov/pubmed/?term=22345648&report=abstract

S Schwander,CD Okello,J Freers,JC Chow,JG Watson,M Corry,Q Meng (2014) "Ambient particulate matter air pollution in Mpererwe District, Kampala, Uganda: a pilot study.", Journal of environmental and public health 2014(5) - http://www.ncbi.nlm.nih.gov/pubmed/?term=24693293&report=abstract

S Sarkar,L Zhang,P Subramaniam,KB Lee,E Garfunkel,PA Strickland,G Mainelis,PJ Lioy,TD Tetley,KF Chung,J Zhang,M Ryan,A Porter,S Schwander (2014) "Variability in bioreactivity linked to changes in size and zeta potential of diesel exhaust particles in human immune cells.", PloS one 9(5) - http://www.ncbi.nlm.nih.gov/pubmed/?term=24825358&report=abstract

CE Rivas-Santiago,S Sarkar,P Cantarella,Á Osornio-Vargas,R Quintana-Belmares,Q Meng,TJ Kirn,P Ohman Strickland,JC Chow,JG Watson,M Torres,S Schwander (2015) "Air Pollution Particulate Matter Alters Antimycobacterial Respiratory Epithelium Innate Immunity", Infection and Immunity 83(5) 2507-2517 http://www.ncbi.nlm.nih.gov/pubmed/?term=25847963&report=abstract

S Sarkar,BF Leo,C Carranza,S Chen,C Rivas-Santiago,AE Porter,MP Ryan,A Gow,KF Chung,TD Tetley,JJ Zhang,PG Georgopoulos,PA Ohman-Strickland,S Schwander (2015) "Modulation of Human Macrophage Responses to Mycobacterium Tuberculosis by Silver Nanoparticles of Different Size and Surface Modification.", PloS One 10(5) - http://www.ncbi.nlm.nih.gov/pubmed/?term=26580078&report=abstract

S Schwander,J Keane (2018) "Cause or Effect? The Elusive Role of Regulatory T Cells in Tuberculosis", American Journal of Respiratory and Critical Care Medicine 198(5) 11-12 http://www.ncbi.nlm.nih.gov/pubmed/?term=29490145&report=abstract

Scholarly Activities
Co Guest Editor HIV-associated TB, Clin. Dev. Immunol

Adhoc Reviewer of Multiple Peer-Reviewed Journals

Adhoc Reviewer of NIH and MRC Grants

Awards
Rutgers Global Health Institute 2017 Global Health seed grant (2017-2019). Title: The effect of air pollution on M.tb transmission in Kampala, Uganda (PIs Stephan Schwander and Qingyu Meng)

NIEHS 1 R01ES020382-03 Schwander PI, 09/01/12-05/31/2017 (in No-cost extension May 2019). Title: Air Pollution Particle Effects on Human Antimycobacterial Immunity.

US EPA STAR fellowship for Funmi Ibironke PhD, graduate student in Schwander lab, start September 2016 – 2018.

NIEHS CEED Pilot Grant. S. Schwander (PI) and G. Mainelis (Co-PI). Title: Assessment of Microbial Communities in Real-world Urban Air pollution Particulate Matter. 07/01/2015- 12/31/2017.

New Jersey Health Foundation. Q. Meng and S. Schwander Co-PI 2015-2017. Title: E-Cigarettes Vapor and Immunotoxicity.

Rutgers Global Advancement and International Affairs (GAIA) Q. Meng and S. Schwander Co-PIs 2015-2017. Title: Air pollution campaign in Uganda. 03-04-15-12-31-2016.

Rutgers Global Advancement and International Affairs (GAIA) S. Schwander and Q. Meng Co-PIs 2015-2017. Title: “Air Quality Assessment and the Perception of Health Risk from Air Pollution in Tanzania – A Pilot Study”. 05/19/2015 – 09/01/2016.

NIEHS 3R01ES020382-04S2 Supplemental Award. S. Schwander Co-PI (with C. Weisel), 09/07/2014 - 09/01/2016. Title: Metabolomic Analysis: Air Particulate Effects on Human Antimycobacterial Immunity.

NIEHS 3R01ES020382-05S1 minority training supplemental grant for Funmi Ibironke PhD student in my lab. Title: Air Pollution Particle Effects on Human Antimycobacterial Immunity, 12/04/2015 – 08/31/2016.