About

Brooks Thomas Kuhn, M.D., M.A.S., is an Associate Professor of Medicine at UC Davis Health and serves as the Medical Director of the Pulmonary Faculty Practice. He specializes in pulmonology and critical care medicine, with a focus on managing patients with chronic obstructive pulmonary disease (COPD) and alpha-1 anti-trypsin deficiency. Dr. Kuhn is co-director of the UC Davis Comprehensive COPD Clinic and director of the Alpha-1 Foundation designated Clinical Resource Center. His research interests include the management of acute exacerbations of COPD, early identification of exacerbations using new technologies such as remote patient monitoring, and applying health informatics tools to improve COPD patient care. He emphasizes personalized care through precise phenotyping of disease, thorough review of patient medical records, and patient education to optimize diagnosis and treatment.

Research topics

• Medicine
• Intensive care medicine
• Internal medicine
• Immunology
• Computer science

Selected publications

• Correction: Letter to the Editor: An unspoken contributor to VILI in ARDS—asymmetry of lung injury

  Intensive Care Medicine · 2025-11-04

  erratumOpen accessSenior author
  PublisherOA PDFDOI

• Characterizing Adult Respiratory Phenotypes in Filamin a Deficiency

  American Journal of Respiratory and Critical Care Medicine · 2025-05-01

  articleSenior author

  Abstract INTRODUCTION: Pulmonary manifestations of filamin A deficiency can present with pediatric respiratory failure and severe bronchopulmonary dysplasia — often fatal or necessitating childhood lung transplant. To our knowledge, there have been only two publications with a total of three patients who had adult pulmonary manifestations of filamin A deficiency.1,3 Here, we present a case of filamin A deficiency-associated congenital emphysema, initially misdiagnosed as childhood asthma. CASE PRESENTATION: A 22-year-old woman presented to our pulmonology clinic for evaluation of emphysema incidentally appreciated on CT scan of the heart. She has a history of mild developmental delay, and patent ductus arteriosus that was incidentally identified at 1 year of age and since repaired, but her clinical course was complicated by vasodilator-responsive group 3 pulmonary hypertension. She was additionally diagnosed with childhood “asthma” and prescribed an albuterol inhaler. At presentation, she endorses mild dyspnea on exertion and decreased activity tolerance, and states that her prior inhaler helped alleviate her symptoms. Interestingly, her sister was also born with a patent ductus arteriosus and intracortical brain lesions, and their mother had multiple miscarriages prior to three successful female births. Genome sequencing analysis from a genetics referral recently had identified a filamin A mutation which she shares with her sister. The CT imaging demonstrated left upper lobe panlobular emphysema, diffuse centrilobular emphysema, and mosaic attenuation (figure 1). DISCUSSION: Filamin A deficiency is increasingly described in the pediatric literature. As screening, treatment, and overall childhood mortality improve, adult pulmonologists should be aware of this potential cause of cardiopulmonary disease, including emphysema. To date, there is a paucity of published experience on this topic in adults. In contrast to alpha-1-antitrypsin deficiency, the CT findings for Filamin A deficiency appear to suggest both panlobular and centrilobular emphysema. Testing for filamin A deficiency, similar to alpha-1-antitrypsin deficiency, should be considered when patients present with emphysema and associated childhood cardiovascular, neurological, and/or connective tissue disorders. Additionally, the mother may have a history of multiple miscarriages as male intrauterine fetal death is common. Childhood dyspnea is commonly labeled as asthma but patients with filamin A deficiency may need further work up with post-bronchodilator testing and high-resolution CT chest to exclude emphysema as a cause of their activity limitations, dyspnea or wheezing. More data is necessary to define the respiratory phenotype, and better characterize imaging and PFT findings.

  PublisherDOI

• 24 Mitigating wildfire health impacts through data-driven strategies and population health approach

  2025-12-01

  articleOpen access1st authorCorresponding
  PublisherDOI

• Low TET1 Expression Levels in COPD Are Associated with Airway and Blood Neutrophilia

  medRxiv · 2025-04-16

  preprintOpen access

  Epigenetic dysregulation, particularly DNA methylation variations, is implicated in the pathogenesis of chronic obstructive pulmonary disease (COPD). Ten-eleven translocation (TET) proteins (TET1, TET2, and TET3) regulate DNA methylation and gene transcription. Impaired TET1 expression was previously associated with airway inflammation and asthma. Here we investigated TET gene associations with COPD severity. We found that reduced TET1 expression in peripheral blood mononuclear cells was associated with higher sputum and blood neutrophil counts, decreased lung function and increased disease severity in patients. These findings support a potential protective role and warrant further mechanistic investigations into the actions of TET1 in COPD.

  PublisherOA PDFDOI

• Patient Burden and Insights in COPD: A Survey Analysis

  Chronic Obstructive Pulmonary Diseases Journal of the COPD Foundation · 2025-01-01 · 1 citations

  articleOpen accessSenior author

  Background: Chronic obstructive pulmonary disease (COPD) affects millions of people and is associated with significant morbidity and mortality. Patients experience a high symptom burden with impacts on quality of life, which have not been well quantified. Methods: Phreesia's PatientInsightsquantitative survey was offered in January 2025 to patients with COPD during their check-in process for health care provider (HCP) visits. The survey comprised 28 questions. Survey question categories included COPD symptom experience and impact, and the treatment journey of patients with COPD. The survey also sought to identify potential communication gaps between patients and HCPs that might hinder effective COPD management. Results: Of 1615 patients surveyed, most (59%) were female, and the majority identified as White (82%). A total of 39% of patients had experienced COPD for over 7 years at the time the survey was conducted, and 25% reported experiencing symptoms all 30 days in a typical month. A large proportion (64%) said that COPD had a moderate-to-great impact on their daily lives. Only 45% of patients had detailed discussions about their COPD with their HCPs. Among patients who had not tried/were currently not on any maintenance medications (n=339), the leading reasons included that their COPD was not severe enough, and that their HCP had not recommended it. Among patients who had tried maintenance medications, the majority (77%) indicated that they would be willing to try another therapy. Conclusions: Improvements in patient-HCP communication are needed to achieve more effective, timely COPD management.

  PublisherDOI

• Two‐Staged Bronchoscopic Lung Volume Reduction: A Single US Academic Center Retrospective Analysis Demonstrating Reduction in Pneumothorax

  Respirology Case Reports · 2025-09-01

  articleOpen access

  Staged Bronchoscopic lung volume reduction (BLVR) has been proposed to reduce the risk of pneumothorax in patients with emphysema, though evidence to date is limited. We present a retrospective series from a single US academic centre, evaluating pneumothorax and other complications following staged BLVR. Seventeen patients underwent staged BLVR at our centre. Two illustrative cases are presented: (1) a case of pneumothorax post-staged BLVR managed conservatively without chest tube insertion, and (2) a patient who initially developed pneumothorax after single-stage BLVR, subsequently completing staged BLVR without complications. Overall, the pneumothorax rate within 45 days was 11.8%, and none of the events required tube drainage or valve removal. This retrospective analysis suggests that staged BLVR may reduce the incidence of pneumothorax. Larger, randomised controlled trials are warranted to confirm these potential benefits.

  PublisherDOI

• The Effect of Respiratory Therapist Case Managers Integrated into COPD Clinical Care

  Respiratory Care · 2025-01-28 · 2 citations

  articleSenior author

  Background: Personalized education and treatment selection can improve health behaviors and outcomes in patients with COPD. However, many patients with COPD have incomplete knowledge of their disease, which leads to undertreated symptoms. We hypothesized that an interdisciplinary care approach to COPD with respiratory therapists (RTs) integrated in our dedicated clinic will significantly affect care as measured by COPD Assessment Test (CAT) scores, exacerbation rates, and COPD-related hospitalizations. Methods: This study was a retrospective analysis of patients enrolled in the UC Davis Comprehensive COPD Clinic registry. Between January 2018–January 2020, 241 patients were seen. Patients screened ( n = 101) had been followed 12 months post initial COPD clinic visit. Two subjects were excluded from analysis due to discrepancies in CAT assessments, leaving 99 subjects in total. The clinic RT provided assessment, education, and treatment recommendations. We collected CAT scores, exacerbation rates, and those that required hospitalization in the 12 months prior to and after the initial COPD clinic visit. Analysis for CAT is reported as median and interquartile range (IQR), with differences determined by Wilcoxon test. Summary data are reported as percentages, 95% CI, and chi-square test. Results: The initial median CAT score was 22 (IQR 7–34), and 2-month follow-up CAT median was 19 (IQR 11–24, P < .001). There were 115 exacerbations in the 12-month period prior to the initial clinic visit and 63 exacerbations in the 12 months post clinic visit ( P = .006). In the 12-month period prior to the clinic visit, there were 44 hospital admissions for COPD exacerbations compared to 20 hospital admissions for COPD exacerbations in the 12 months after initial clinic visit ( P = .06). Conclusions: Our retrospective study demonstrated significant improvements in symptoms and exacerbation rates and a non-significant reduction in hospitalizations for COPD. This suggests that an RT-facilitated program may improve meaningful clinical outcomes.

  PublisherDOI

• Letter to the Editor: An unspoken contributor to VILI in ARDS—asymmetry of lung injury

  Intensive Care Medicine · 2025-03-01 · 2 citations

  letterSenior author
  PublisherDOI

• Patient Preference Factors in Bronchoscopic Lung Volume Reduction

  American Journal of Respiratory and Critical Care Medicine · 2025-05-01 · 1 citations

  articleSenior author

  Abstract Rationale: While bronchoscopic lung volume reduction (BLVR) use has increased in the US focusing on health outcomes, there is a paucity of data on patient-experience and considerations. Early data suggests that two-staged BLVR may reduce pneumothorax, but patient acceptance due to increased socioeconomic burden and hospital stays remains uncertain. Methods: After IRB approval, we interviewed patients who previously received or were under consideration for BLVR from University of California, Davis, utilizing a questionnaire created and revised with our advanced COPD and interventional pulmonology physicians. The questionnaire included 12 different factors proposed as patient-relevant factors in considering BLVR (Figure 1). Patients also answered exploratory questions regarding staged valve placement. Result: Sixty patients were identified, which 33 consented to participate in the study with 27 total responses (9 under evaluation and 18 had BLVR) and 6 didn't complete the questionnaire. Median age was 74 (IQR 71.5-78) and 100% self-identified as white. Median self-reported yearly household income was 50,000-59,999 USD (IQR 30,000 – 79,999). Mean distance from responder address to academic center was 81.5 miles (95% CI 59-103). Baseline pulmonary function test metrics showed severe emphysema with hyperinflation: mean FEV1, TLC, RV, and DLCO percentile were 36.8%, 127%, 213%, 38% respectively. Responders who already underwent BLVR had median time from first clinic visit to procedure of 247 days (IQR 146-287) and median number of 3 clinic visits (IQR 3-3). Of the 12 different factors, trust in the providers recommending BLVR, trust in the providers performing BLVR, and the thoroughness of counseling as the most important factors. On a 0 to 100 score of importance these 3 factors scored mean of 87(95% CI 77-96), 85 (95% CI 76-95), and 77(95% CI 65-88) respectively. Traveling distances to hospital, cost of procedures, and days hospitalized post-procedure were the 3 least important factors with mean score of 48(95% CI 34-62), 42 (95% CI 28-57), and 35(95% CI 23-47) respectively. 87% of responders reported willingness to undergo staged valve placement if it reduces chance of pneumothorax. Conclusion: For a single-center study, patients considered rapport and counseling from providers to be the most important factors when making decisions regarding BLVR and less so for socioeconomic factors. Majority of patients would consider staged BLVR if it reduces pneumothorax, despite increased hospital time and two bronchoscopies. A subsequent retrospective case series of staged BLVR patients from our center is in process and preliminarily demonstrates a lower rate of pneumothorax than standard published rate.

  PublisherDOI

• Respiratory Therapist as a COPD/Asthma Care Manager to Improve Outcomes in the Primary Care Setting

  American Journal of Respiratory and Critical Care Medicine · 2025-05-01 · 1 citations

  articleSenior author

  Abstract RATIONALE: COPD and asthma are common diseases marked by exacerbations and emergent care utilization, which often can lead to fragmented and inadequate care. Treatment is complex, involving inhaled medications, pulmonary rehabilitation, reducing risk factors by providing education, vaccination, and training in self-assessment skills. Although disease control can be obtained, exacerbation rates, ED visits, and hospitalizations remain high. Treatments are introduced in the primary, emergency, and specialty care, but this often leads to inadequate education and uneven care. We hypothesize a dedicated Respiratory Therapist Care Manager (RT-CM) tasked with optimizing and personalizing the myriad interventions in high-risk asthma/COPD patients can reduce unnecessary emergency visits and hospitalizations.METHODS: As part of the Population Health effort at University of California Davis, an RT-CM targeted primary care patients with asthma and/or COPD who were at high risk for all-cause unplanned visits and hospitalizations. The definition for this high-risk registry a diagnosis within our validated Asthma/COPD Acute Decline grouper or have a prescribed controller respiratory medication within the broader Epic-derived Asthma/COPD Exacerbation grouper who had a hospital or ED visit within the previous year. The RT CM made optimal inhaled therapy recommendations (on cost, delivery, and drug), created self-management action plans, coordinated referrals and diagnostics, provided disease education, and assisted in management during acute decline. We analyzed the total number of all-cause ED visits and hospitalizations in the 12-month period before enrollment into the Asthma/COPD Care Management Program and compared it to the 12-month period following. Statistical analysis was performed with paired t-test. RESULTS: A total of 127 patients have been enrolled in the program with 49 enlisted between October 2021 to October 2023 who had graduated the program, securing the 12-month post enrollment data to analyze. 43% were male and a total average age of 73 years. Thirty-eight patients had COPD, 1 with asthma, and 9 had Asthma/COPD overlap. Total all-cause ED visits 12 months prior to enrollment were 35 with 17 in the 12 months following, reducing visits by 51%, p=.02. All-cause hospitalizations 12 months prior to enrollment were 23 with 18 in the 12 months following, reducing admissions by 22%, p=.51.CONCLUSIONS: This small, retrospective quasi-experimental research demonstrates feasibility and suggests benefit for RT-CM to optimize COPD/asthma care, bridge silos of care, and reduced unnecessary ED visits and hospitalizations.

  PublisherDOI

Frequent coauthors

• Jason Y. Adams

  University of California, Davis

  28 shared

• Michael Schivo

  University of California, Davis

  24 shared

• Nicholas J. Kenyon

  VA Northern California Health Care System

  15 shared

• Amir A. Zeki

  University of California, Davis

  13 shared

• Angela Haczku

  13 shared

• Timothy E. Albertson

  University of California Davis Medical Center

  11 shared

• A. Linderholm

  10 shared

• Gregory B. Rehm

  University of California, Davis

  10 shared

Labs

• Pulmonary, Critical Care and Sleep MedicinePI

Education

• M.A.S. Clinical Research, Clinical and Translational Science Center

  UC Davis Health System

  2017

• Fellow, Pulmonary, Sleep, and Critical Care

  UC Davis Health System

  2017

• Resident Physician, Internal Medicine

  UC Davis Health System

  2012

• M.D., School of Medicine

  Thomas Jefferson University Hospital

  2009

• B.S. Microbiology

  UCSB

  2005

Awards & honors

• PCCM Fellow's Faculty of the Year, 2021
• Sacramento Magazine’s Top Doctors 2020, Pulmonary and Critic…
• Alpha-1 Foundation Designated Expert in Alpha-1 Antitrypsin…
• Honored Scholar, Western Section of the American Federation…
• Outstanding Faculty of the Year Award at Sacramento VA Hospi…