Alexandra Racanelli, MD, PhD, officially joined Montefiore Einstein as an assistant professor in the department of medicine, division of pulmonology, in September 2024, with a dual appointment in the department of cell biology. After beginning her scientific career studying cancer biology, she now focuses on how the vasculature in the lungs contributes to lung disease, including chronic obstructive pulmonary disease (COPD). 

We spoke with her about her path in research and her current interests, and what brought her to Montefiore Einstein. 

When did you know you wanted to become a scientist? 

I did not come from a family of scientists or doctors. While I always liked science growing up, I don't think I really understood what a career as a scientist was until I went to college. I went to a small liberal arts college, Mary Washington, and I had great mentors who noticed my curious nature and suggested that I apply for a summer research program to fund a basic science investigation. These early days of scientific exploration were incredibly exciting and informed my decision to obtain a job as a research technician at Memorial Sloan Kettering after graduating college. 

As a research technician at MSKCC, I worked in a translational laboratory and saw firsthand how observations we made at the bench were informing clinical trials that were taken to the bedside. This is where I realized that a career as a physician-scientist needed to be my path. I pursued training as an MD-PhD at Virginia Commonwealth University and had an amazing mentor, Richard Moran, who demanded scientific excellence and rigor, and helped me build the strong foundation required for a research career. 

How did you arrive at your current focus on lung disease? 

My dissertation research was focused on cancer biology and understanding mechanisms of transcriptional control and regulation in the context of cancer therapeutics. After medical school, I trained in internal medicine at Weill Cornell Medicine and during that time I became fascinated with the biology underpinning pulmonary and critical care disease states. There are many gaps in our understanding of pulmonary medicine, and therapies for patients suffering from lung disease are severely lacking. We currently have very little understanding of what makes one person have severe illness, while another person may fare much better. As one example, it’s not uncommon to see two patients with same stage of chronic obstructive pulmonary disease based on lung function studies, where one patient has daily symptoms, and the other patient has minimal complications.   

My current research program is focused on teasing apart the mechanisms by which pulmonary vasculature dysfunctions contribute to acute and chronic lung disease. This is an area that is often overlooked by investigations focused on the epithelium, which is the lining of the airways, and the alveolar sacs, which get oxygen to the blood. My hope is to build a research program that will address the crosstalk between the pulmonary vasculature and the surrounding cells within the alveolar niche to determine how complex interactions drive the disease process. 

What’s your methodology? 

We use murine models, human organoids, and are also engaged with several different national consortiums that provide access to patient samples and longitudinal data. The goal is to identify factors that may eventually help develop new therapeutics.

What is at stake?

COPD is the third leading cause of death worldwide. And within that diagnosis, there are a wide spectrum of patients. Teasing apart what causes more severe disease in some is critical to impacting negative outcomes. Therapies that improve mortality or reverse disease are lacking.  We hope by uncovering key steps in the pathogenesis of COPD we can identify early risk factors and markers of disease that will offer opportunities for intervention. At early stages of disease, reversibility and regenerative capabilities of the lung are much more promising than in advanced states. 

Will you be involved in patient care at Montefiore Einstein? 

I am excited to participate in the inpatient pulmonary and critical care medicine services at Montefiore Einstein, although the bulk of my effort will be spent establishing my laboratory and research program. I look forward to working with residents and fellows on the inpatient services and getting to know the Montefiore Einstein clinical and patient communities.   

What else drew you to Montefiore Einstein? 

When I interviewed at Einstein for a faculty position, I was immediately struck by the collaborative and cohesive scientific community here. I met junior and senior faculty and post-doctoral fellows, and the culture of respect and collegiality between individuals stood out. I also sensed that level of engagement in the pulmonary and critical care divisions and in the departments of medicine and cell biology. Throughout my career I have had the good fortune of learning from amazing mentors, and I look forward to giving back and helping others find their way. The dedication of the faculty members at Montefiore Einstein to the students and trainees was obvious from my initial meetings, and I knew this was an environment that would support my passion for mentorship. I look forward to working with the medical and graduate students as well as the residents and fellows here. Overall, I was drawn to Montefiore Einstein because of a great opportunity at a fantastic place!