University of Chicago, 1965
University of Chicago
Postgraduate Training
University of Chicago, Anatomic and Clinical Pathology
Board Certification
Anatomic and Clinical Pathology

Areas of Interest

Clinical Interests

Clinical pathology, Immunology, Autopsy Pathology

Research Interests

Pathogenesis of tuberculosis

Research Information

Pathogenesis of Tuberculosis.

Development of vaccines and host directed therapies for post-primary tuberculosis (TB) is impeded by a flawed paradigm that granulomas are the key lesion of both primary and post-primary TB. As a result, investigators have neither reliable targets nor biomarkers. This paradigm derives from animal studies in the late 20th century. We have rediscovered, confirmed and extended the paradigm that obstructive lobular pneumonia, not granulomas, is the precursor lesion of post-primary TB (1-7). This lesion is seldom seen because it is asymptomatic. It develops in people with sufficient immunity to heal all granulomas. Alveolar macrophages in the least active part of the lung become infected and small bronchioles become obstructed. The lesions spread for months via bronchi before rapidly undergoing necrosis to produce clinical disease. Our recognition of the precursor lesion of post-primary TB and development of an animal model provide both a target and biomarkers for development of host directed therapy. Such therapies involving immune checkpoints are being intensively studied for cancer. We use methods and results of studies with cancer in coordinated studies of human and mouse TB to define the microenvironment of developing post primary TB and evaluate agents for host directed therapy of TB.

1. Hunter, R. 2015. Tuberculosis as a three-act play: A new paradigm for the pathogenesis of pulmonary tuberculosis. . Submitted.

2. Hunter, R. L., J. K. Actor, S. Hwang, V. Karev, and C. Jagannath. 2014. Pathogenesis of Post Primary Tuberculosis: Immunity and Hypersensitivity in the Development of Cavities. Ann Clin Lab Sci 44: 365-387.

3. Hunter, R. L. 2011. On the pathogenesis of post primary tuberculosis: the role of bronchial obstruction in the pathogenesis of cavities. Tuberculosis (Edinb) 91 Suppl 1: S6-10.

4. Hunter, R. L. 2011. Pathology of post primary tuberculosis of the lung: an illustrated critical review. Tuberculosis (Edinb) 91: 497-509.

5. Hunter, R. L., C. Jagannath, and J. K. Actor. 2007. Pathology of postprimary tuberculosis in humans and mice: contradiction of long-held beliefs. Tuberculosis (Edinb) 87: 267-278.

6. Hunter, R. L., M. Olsen, C. Jagannath, and J. K. Actor. 2006. Trehalose 6,6′-dimycolate and lipid in the pathogenesis of caseating granulomas of tuberculosis in mice. Am J Pathol 168: 1249-1261.

7. Welsh, K. J., S. A. Risin, J. K. Actor, and R. L. Hunter. 2011. Immunopathology of Postprimary Tuberculosis: Increased T-Regulatory Cells and DEC-205-Positive Foamy Macrophages in Cavitary Lesions. Clinical and Developmental Immunology 2011: 1-9.

Additional Information


1967-1969 Staff Associate, L.I., NIAID, NIH, Bethesda, Maryland

1975-1980 Research Career Development Award, NIH CAOO032

1970-1980 Instructor, Asst. and Assoc. Professor of Pathology, University of Chicago

1973- Board Certification – Clinical and Anatomic Pathology

1980-1997 Emory University, Atlanta, GA

Professor of Pathology, School of Medicine

Director of Diagnostic Immunology Laboratories

Director of Ph.D. Program in Experimental Path., Graduate School of Arts and Sciences

1997- to present- University of Texas Medical School, Houston, TX

Distringuished Professor of Pathology and Laboratory Medicine

Chairman. Dept. of Pathology and Laboratory Medicine

Awards and Other Professional Activities:

2015 – Gold Headed Cane Award from the Association of Clinical Scientists

2015 – Harlan J Spujt Award for sustained and distinguished scholarly achievement in pathology

by the Houston Society of Clinical Pathologists

2014 – Presidents Award of The Texas Society of Pathologists

2010 – George T. Caldwell Distinguished Service Award, Texas Society of Pathologists

2003 – Philip Levine Award for outstanding research by the American Society for Clinical Pathology

1987 – Diploma of Honor in recognition of Outstanding Contributions to Clinical Science awarded by The Association of Clinical Scientists

1988 – Commissioners’ Medal awarded by the American Society of Clinical Pathologists for Outstanding Service as Chairman of the Council on Immunopathology

1989 – Sunderman Award to The Clinical Scientist of the Year awarded by The Association of Clinical Scientists, during the 40th anniversary meeting of the society.

1986 -1991 Member, Tuberculosis Panel, U.S.-Japan Cooperative Medical Science Program

1998 – 1998 Member of Special Study Section for Malaria, NIAID, NIH

1999 NIH Special Study Section Reviewer, “Bioengineering Partnerships”

1999 Chairman, Special Emphasis Panel, AIDS and related research NIAID-NIH

1999 – 2011, Member VACC Special Study Section on Vaccines, NIH