It's six o'clock in the afternoon, 94 degrees, a code-orange smog alert. You're stuck in Clifton Road traffic. Do you know what the air is doing to your child's lungs?

W. Gerald Teague, Professor of Pediatrics in the School of Medicine and Professor of Environmental and Occupational Health in the School of Public Health, is working with atmospheric scientists to answer that question. Using a concentrated exposure system designed by Roby Greenwald, post-doctoral researcher in Emory's Department of Pediatrics, Teague is studying the effects of air pollution on children with asthma. He wants to know what happens when they are exposed to ultrafine atmospheric particles in the air on Clifton Road – what we all breathe in during a traffic jam.

Testing environmental exposure levels is just one part of Teague's work as a pediatrician specializing in severe and difficult-to-treat asthma. The Director of the Emory Pediatrics Asthma Clinical Research Center, Teague also serves as Section Chief of Pulmonary Medicine at Children's Healthcare of Atlanta at Egleston. "My lab is my clinic," he says. "My research questions come from my clinical observations."

One of the questions Teague is asking has to do with corticosteroid insensitivity. Up to one-quarter of all children diagnosed with asthma do not respond well to inhaled corticosteroids, a standard treatment endorsed by national asthma guidelines. Asthma is not a single disorder with one treatment that works for everyone, Teague explains. It is a highly complicated syndrome that demands a personalized approach. Every time he sees a new patient, Teague must take into account not only the environmental irritants that can aggravate existing asthma, but also the mysterious interplay among biological, social, cultural, and epigenetic factors that causes a child to fall ill in the first place. "We now know that the environment can actually alter your DNA," he says.

This wide-angle approach to the diagnosis and treatment of asthma leaves no stone unturned and no symptom unexamined. A baby who contracts a rhinovirus (which causes the common cold) and begins to wheeze, for example, should be watched closely; he or she is much more likely to develop asthma than a baby who contracts a rhinovirus but does not wheeze. Children whose asthma is triggered by seasonal allergies may respond as well to non-steroidal medications (such as montelukast) than to more conventional steroid treatments. Even psychological and familial factors play a role in shaping asthma, says Teague, including the pattern and severity of asthma attacks. And because children contract asthma amidst a constellation of factors, the road to successful management of the disease must take into account the whole person – not just immediate symptoms. Says Teague: "My vision is to treat individual children, not diseases or care paths."

In his latest research, Teague is examining the relation between gastro-esophageal reflux disease (GERD, or acid reflux) and asthma control. More than 42% of adults with poorly controlled asthma also have GERD. For years, doctors and clinicians have assumed a connection between the two diseases, suggesting that acid reflux worsens asthma symptoms, or at least makes them more difficult to control. Teague and his colleagues, however, are calling that assumption into question. In a recent trial funded by the National Institutes of Health and conducted in collaboration with the American Lung Association, they found no relation between acid reflux disease and asthma control, lung function, or quality of life. They also found that the use of a proton pump inhibitor (an anti-acid reflux medication such as esomeprazole) had absolutely no effect on asthma control. This finding directly counters current pharmacological outlooks, which encourage doctors to prescribe esomeprazole for both diseases. "This is going to change clinical practice," Teague says.

His work doesn't end when he leaves the clinic. For several years, Teague has taken on a leadership role with Not One More Life, an advocacy group whose mission is to improve asthma outcomes in communities of faith. The group has conducted asthma assessments and screenings in nearly 100 Atlanta-area churches so far, and that number is rising. Volunteering has changed Teague's outlook on his professional life. "Humility and relationships," he says. "That's what matters. The arrogance that sometimes creeps into academics can be very destructive." A native Atlantan, Teague worked his way through college and medical school and spent three years in private practice before Emory recruited him in 1992 to start a program in pediatric pulmonary medicine. During his time here, he has overseen more than two dozen clinical residents and post-doctoral fellows, including Anne Fitzpatrick, PhD, now a research colleague and Associate Director of the Pediatric Pulmonary Fellowship Program.

Through it all, Teague has kept his focus: helping children. He connects easily with his young patients and is grateful for the opportunity to make a real difference in their lives. He is glad to be working at Emory, where contributing to the greater good forms a cornerstone of the university's mission and strategic plan. "Emory's star is rising," Teague says. "I am very grateful to be able to work in such a dynamic and excellent environment."