For some Kentucky families, seeing a pediatric subspecialist once meant several hours on the road or leaving the state entirely. In rural parts of the state where rates of respiratory disease remain high, access to advanced care can shape the course of a child’s life.
At the University of Kentucky College of Medicine, physician–scientist Mark Wurth, M.D. ‘08, Ph.D. ‘07, is helping bring that specialized care closer to home.
Since joining the faculty in 2017, Wurth has helped build a rapidly expanding pediatric allergy and immunology program. His work helps connect Kentucky patients to national clinical trial networks, and his research focuses on some of the most complex immune diseases in children.
Wurth is a Henderson, Ky., native and first-generation college student who completed his undergraduate education, MD/PhD training and a combined pediatrics and internal medicine residency at UK. For him, the work carries a personal sense of responsibility.
“If we don’t serve the communities we came from,” he said, “we can’t assume someone else will.”
Building Specialty Care in Kentucky
Wurth completed his doctoral training in the lab of Rebecca Dutch, Ph.D., professor of molecular and cellular biochemistry and vice dean for research at the College of Medicine. She has watched him grow, from working in the lab to leading large clinical programs.
“Mark was an absolute joy as a graduate student, with a highly inquisitive mind, great problem-solving skills and a real passion for making a difference with his work,” shared Dutch. “He has pushed himself to learn as much as he can and now is using his knowledge and experience to transform our ability to help children with complex medical issues.”
When Wurth left Kentucky to complete fellowship training at Vanderbilt University Medical Center, pediatric allergy and immunology had a limited presence at UK. By the time he finished his fellowship, he was already thinking about what it would take to build the specialty back to Lexington, Ky.
Launching a modern allergy and immunology practice required more than opening clinic doors. It meant creating the systems needed to safely care for complex immune conditions. It included establishing compounding areas for immunotherapy, temperature-controlled storage for biologic medications and protocols for managing emergencies like anaphylaxis. It also meant training staff on procedures like supervised oral food challenges that include peanut ingestion for children previously considered allergic. These procedures require careful monitoring and strong trust between clinicians, patients and families.
In its first full year, they recorded roughly 800 visits. Last year, it surpassed 5,000. What began as a one-physician clinic now includes multiple allergists and advanced practice providers, with additional faculty expected to join.
Just as important, children who once would have been referred to out-of-state centers are increasingly being treated in Lexington instead. For families across Kentucky, particularly those in rural communities, staying in state can mean fewer missed workdays, lower travel costs and more consistent care.
Kentucky has high rates of respiratory disease, a large rural population and longstanding barriers to accessing specialty care that shape how and where patients receive treatment.
“We’re constantly thinking about how to push care into communities,” he said.
Telehealth, which rapidly expanded during the COVID-19 pandemic, has become part of that solution. Beyond video visits, they partner with regional sites equipped with remote examination tools that allow physicians to conduct more comprehensive assessments while patients remain closer to home.
For families who might otherwise postpone or miss specialty appointments because of travel, those connections can make advanced care more accessible.
Research That Reaches Patients
The connection between research and patient care is especially clear in Wurth’s work with cystic fibrosis, a genetic disease that affects the lungs and digestive system.
As site director of the Cystic Fibrosis Foundation’s Therapeutics Development Center at UK, which is part of a national research network, he oversees clinical trials that have helped transform treatment for the disease in recent years.
For Kentucky families, participating in these trials locally means access to promising therapies earlier without leaving the state.
Wurth’s second major research focus reflects what he calls a genomics and “omics” revolution in allergy and immunology.
Working with Ilhem Messaoudi, Ph.D. – who is a professor and chair of the Department of Microbiology, Immunology, and Molecular Genetics, and acting vice president for research at UK – Wurth studies children whose inflammatory or autoimmune diseases appear unusually severe.
Using advanced immune profiling and next-generation research tools, the team analyzes which pathways are activated and how immune signaling is altered. As biologic therapies targeting specific cytokines and inflammatory pathways expand, that information can guide more precise treatment decisions.
“If we can identify the pathway that’s dysregulated,” said Wurth, “we may be able to use a drug that specifically targets it.”
The work is early but promising. For Kentucky children with rare immune disorders, this approach could mean moving beyond trial-and-error treatment toward targeted intervention
“We hope this research lets us find off-the-shelf medications that may be effective for some of our children with severe disease where existing therapies come up short,” Wurth said. “With a better understanding of the inflammation driving disease, there may be drugs available that target that inflammation that we may not have otherwise thought about for a specific condition.”
The field of allergy and immunology is changing quickly, driven by advances in genomics and large-scale data analysis. Clinicians can now measure thousands of variables at once, revealing patterns that were invisible a decade ago. The challenge lies in translating that information into treatments that make a difference for patients. For children with rare or treatment-resistant conditions, that work could open new options where few existed before.
Preparing the Next Generation of Physicians
Wurth’s work also extends into the classroom. As clinical director for the foundations course required of all first-year medical students, he helps shape how they learn the scientific basis of medicine early in their training.
When he entered medical school in the early 2000s, basic science and clinical practice were often taught separately. Today’s curriculum integrates physicians into foundational courses and connects concepts like molecular biology to direct patient care much earlier.
“The volume of knowledge has exploded,” he said. “We have to be intentional about what prepares students for the realities of medicine.”
He also tries to connect the science to the daily realities patients face. When teaching about cystic fibrosis, as an example, he asks students to imagine removing two hours from every day. One hour in the morning, and another at night, for time devoted solely to treatments that keep patients healthy. It is a powerful reminder that advances in medicine are not only measured by lab results but also by the time and quality of life returned to patients.
He encourages students to listen closely to patients and approach difficult cases with humility. He also emphasizes that inflammation and immune biology influence nearly every specialty. That perspective is helping inspire some trainees to pursue careers in allergy and immunology. In a field with relatively few specialists, building that pipeline will be essential to expanding care in the years ahead.
As clinical care, research, and education continue to intersect, the growing program is expanding both access and possibilities for learners and patients alike.