Scholars@Duke
David Noble Howell

David Noble Howell

Professor of Pathology
Pathology
david.howell@duke.edu
Duke Box 3712, Durham, NC 27710
Room 3095, Duke South, Yellow Zone, DUMC, 40 Duke Medicine Dr., Durham, NC 27710

Overview

A major focus of both my clinical practice and investigative work is the diagnosis and treatment of disorders affecting solid-organ transplant recipients, particularly infectious complications. For the past 15 years, I have served as the primary pathologist for one of the largest lung transplant programs in the world; in the process contributing to over 20 peer-reviewed publications on complications of lung transplantation, including infections, gastroesophageal reflux, tumors, and antibody-mediated rejection; and writing a major book chapter on the subject (Howell DN and Palmer SM, Pathology of the Lung Transplant. 2006. In: Lynch JP, Ross D, eds. Lung and Heart-Lung Transplantation. Marcel Dekker, Inc., New York, pp. 683-722). I have also been the primary pathologist for Duke's renal and liver transplant programs, authoring or co-authoring a wide variety of journal articles and a book chapter in these areas (e.g., Plumb et al., Transplantation 2006;82:1224-1224; Snyder et al., Am. J. Respir. Crit. Care Med. 2010;181:1391-1396).

A second major area of interest is the pathogenesis of renal glomerular diseases. In collaboration with members of the Division of Nephrology at Duke, I have helped assemble and characterize a large registry of patients with familial focal segmental glomerulosclerosis (FFSGS)(Conlon et al., Kidney Int. 1999;56:1863-1871). Analysis of one of the families in this registry led to the discovery at Duke, in the laboratory of Dr. Michelle Winn, of mutations in the TRPC6 cation channel as a cause of FFSGS (Winn et al., Genomics 1999;58:113-120; Winn et al., Science 2005;308:1801-1804). We are continuing to collect data on additional families with focal segmental glomerulosclerosis. In addition, I have served as principle consultative pathologist for several investigators working in animal models of renal disease and transplantation (e.g., Crowley et al., Hypertension 2010;55:99-108).

Finally, I have devoted considerable time and energy to applications of correlative microscopy to diagnostic pathology, with particular emphasis electron microscopy. I am currently President of the Society for Ultrastructural Pathology, an international organization that promotes the use of ultrastructural examination in both diagnostic pathology and clinical and basic research. Much of my published work in this area involves the role of electron microscopy in the diagnosis of renal diseases (e.g., Howell et al., Ultrastruct. Pathol. 2003;17:295-312; Pavlisko and Howell, Ultrastruct. Pathol., in press), but I have also written extensively, with my colleague Dr. Sara Miller, on the ultrastructural diagnosis of infectious disorders, contributing, among other things, to the first description of a new polyomavirus-induced skin disorder, trichodysplasia spinulosa (Haycox et al., J. Investig. Dermatol. Symp. Proc. 1999;4:268-271).

Current Appointments & Affiliations

Professor of Pathology · 2006 - Present Pathology, Clinical Science Departments
Senior Vice Chair in Pathology · 2016 - Present Pathology, Clinical Science Departments

Recent Publications

Hidden in the Absence: Clinicopathologic Insights on Kidney Diseases Associated With Selective IgA Deficiency.

Journal Article Lab Invest · April 6, 2025 Selective IgA deficiency (sIgAD) is the most common type of primary immunodeficiency. The diagnosis of sIgAD has occasionally been suggested when a complete absence of background IgA immunofluorescent staining on renal biopsies was observed, but such findi ... Full text Link to item Cite

Targeting allograft inflammatory factor 1 reprograms kidney macrophages to enhance repair.

Journal Article J Clin Invest · January 21, 2025 The role of macrophages (MΦs) remains incompletely understood in kidney injury and repair. The plasticity of MΦs offers an opportunity to polarize them toward mediating injury resolution in both native and transplanted kidneys undergoing ischemia and/or re ... Full text Link to item Cite
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Recent Grants

Targeting the B Cell Response to Treat Antibody-Mediated Rejection

ResearchCo Investigator · Awarded by National Institutes of Health · 2021 - 2028

The Role of the IL-1 Receptor in the AKI to CKD transition

ResearchSignificant Contributor · Awarded by National Institutes of Health · 2019 - 2024

Alternative Endpoints for Plague Challenge Models

ResearchConsultant · Awarded by National Institutes of Health · 2004 - 2008

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Education, Training & Certifications

Duke University · 1984 M.D.
Duke University · 1982 Ph.D.
Duke University · 1976 B.A.