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Liu MY, Chen B, Borji M, Garcia de Alba Rivas C, Dost AFM, Moye AL, Movval Abdulla N, Paschini M, Rollins SD, Wang R, Schnapp LM, Khalil HA, Wu CJ, Sharma NS, Kim CF. Human Airway and Alveolar Organoids from Bronchoalveolar Lavage Fluid. Am J Respir Crit Care Med 2024. [PMID: 38652140 DOI: 10.1164/rccm.202310-1831le] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 03/28/2024] [Indexed: 04/25/2024] Open
Affiliation(s)
- Monica Yun Liu
- University of Wisconsin-Madison School of Medicine and Public Health, 5232, Medicine, Madison, Wisconsin, United States
| | - Belinda Chen
- Boston Children's Hospital, 1862, Boston, Massachusetts, United States
| | - Mehdi Borji
- Broad Institute, 33577, Cambridge, Massachusetts, United States
| | | | - Antonella F M Dost
- Hubrecht Institute for Developmental Biology and Stem Cell Research, 8120, Utrecht, Netherlands
| | - Aaron L Moye
- Boston Children's Hospital, 1862, Boston, Massachusetts, United States
| | | | - Margherita Paschini
- Children's Hospital, Stem Cell Program, Boston, Massachusetts, United States
| | - Stuart D Rollins
- Boston Children's Hospital, 1862, Boston, Massachusetts, United States
| | - Ruobing Wang
- Boston Children's Hospital, 1862, Pulmonary, Boston, Massachusetts, United States
| | - Lynn M Schnapp
- University of Wisconsin-Madison School of Medicine and Public Health, 5232, Medicine, Madison, Wisconsin, United States
| | - Hassan A Khalil
- Brigham and Women's Hospital, 1861, Boston, Massachusetts, United States
| | - Catherine J Wu
- Dana-Farber Cancer Institute, 1855, Boston, Massachusetts, United States
| | - Nirmal S Sharma
- Brigham and Women's Hospital, 1861, Boston, Massachusetts, United States
| | - Carla F Kim
- Boston Children's Hospital, 1862, Stem Cell Program, Boston, Massachusetts, United States;
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2
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Banday MM, Rao SB, Shankar S, Khanday MA, Finan J, O'Neill E, Coppolino A, Seyfang A, Kumar A, Rinewalt DE, Goldberg HJ, Woolley A, Mallidi HR, Visner G, Gaggar A, Patel KN, Sharma NS. Erratum to IL-33 mediates Pseudomonas induced airway fibrogenesis and is associated with CLAD. J Heart Lung Transplant 2024; 43:527. [PMID: 38043037 DOI: 10.1016/j.healun.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2023] Open
Affiliation(s)
- Mudassir M Banday
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | | | - Shruthi Shankar
- University of South Florida, Morsani College of Medicine/Tampa General Hospital
| | | | - Jon Finan
- University of South Florida, Morsani College of Medicine/Tampa General Hospital
| | - Edward O'Neill
- University of South Florida, Morsani College of Medicine/Tampa General Hospital
| | - Antonio Coppolino
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Andreas Seyfang
- University of South Florida, Morsani College of Medicine/Tampa General Hospital
| | - Archit Kumar
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Daniel E Rinewalt
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Hilary J Goldberg
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Ann Woolley
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Hari R Mallidi
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Gary Visner
- Boston Children's Hospital, Harvard Medical School
| | | | - Kapil N Patel
- University of South Florida, Morsani College of Medicine/Tampa General Hospital
| | - Nirmal S Sharma
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Boston VA Medical Center.
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3
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Leung R, Lo WK, Sharma NS, Goldberg HJ, Chan WW. Esophageal Function and Reflux Evaluations in Lung Transplantation: A Nationwide Survey of UNOS-Accredited Transplant Centers in the United States. Clin Transl Gastroenterol 2023; 14:e00641. [PMID: 37747103 PMCID: PMC10749699 DOI: 10.14309/ctg.0000000000000641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 09/15/2023] [Indexed: 09/26/2023] Open
Abstract
INTRODUCTION Gastroesophageal reflux disease has been associated with worse lung transplant outcomes. We aimed to assess local practices for esophageal function testing (EFT) across transplant centers. METHODS This was a survey study of all United Network for Organ Sharing-accredited adult lung transplant centers regarding local EFT practice. RESULTS Among 39/63 (60%) responded centers, 38.5% required any EFT (35.9% esophageal manometry, 15.4% pH monitoring, and 28.2% pH impedance), while another 28.2% may consider EFT based on symptoms. Five-year transplant volume was higher among centers requiring EFT (253 vs 159, P = 0.04). DISCUSSION Only a minority of lung transplant centers routinely obtained EFT, supporting the need for guidelines for standardized reflux/esophageal assessment.
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Affiliation(s)
- Ryan Leung
- Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Boston, Massachusetts, USA
- LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Wai-Kit Lo
- Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Nirmal S. Sharma
- Harvard Medical School, Boston, Massachusetts, USA
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Hilary J. Goldberg
- Harvard Medical School, Boston, Massachusetts, USA
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Walter W. Chan
- Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
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4
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Lee SF, Woolley A, Sharma NS. Impact of MyD88 Deficiency on Innate Immune Function in COVID-19 Infection and Allotransplantation. Transplantation 2023; 107:2084-2086. [PMID: 37749810 DOI: 10.1097/tp.0000000000004725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
Affiliation(s)
- Stefi F Lee
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA
- Division of Pulmonary and Critical Care Medicine, Veteran Affairs Boston Health Care System, Boston, MA
| | - Ann Woolley
- Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA
| | - Nirmal S Sharma
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA
- Division of Pulmonary and Critical Care Medicine, Veteran Affairs Boston Health Care System, Boston, MA
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5
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Sharma NS, Patel K, Sari E, Shankar S, Gastanadui MG, Moncada-Giraldo D, Soto-Vazquez Y, Stacks D, Hecker L, Dsouza K, Banday M, O’Neill E, Benson P, Payne G, Margaroli C, Gaggar A. Active transcription in the vascular bed characterizes rapid progression in idiopathic pulmonary fibrosis. J Clin Invest 2023; 133:e165976. [PMID: 37384419 PMCID: PMC10425209 DOI: 10.1172/jci165976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023] Open
Affiliation(s)
- Nirmal S. Sharma
- Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- West Roxbury VA Medical Center, Boston, Massachusetts, USA
| | - Kapil Patel
- Department of Medicine, University of South Florida, Tampa, Florida, USA
| | - Ezgi Sari
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Shruti Shankar
- Department of Medicine, University of South Florida, Tampa, Florida, USA
| | - Maria G. Gastanadui
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | | | - Yixel Soto-Vazquez
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Delores Stacks
- Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Louise Hecker
- Department of Medicine, Emory University, Atlanta, Georgia, USA
| | - Kevin Dsouza
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Mudassir Banday
- Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Edward O’Neill
- Department of Medicine, University of South Florida, Tampa, Florida, USA
| | - Paul Benson
- Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Gregory Payne
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Birmingham VA Medical Center, Birmingham, Alabama, USA
- Lung Health Center, Program in Protease and Matrix Biology, and Gregory Fleming James CF Center, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Camilla Margaroli
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Amit Gaggar
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Birmingham VA Medical Center, Birmingham, Alabama, USA
- Lung Health Center, Program in Protease and Matrix Biology, and Gregory Fleming James CF Center, University of Alabama at Birmingham, Birmingham, Alabama, USA
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6
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Granger EE, Silk AW, Sharma NS, Groover MK, Guenette JP, Emerick KS, Miller DM, Krause KA, Ruiz ES. Leptomeningeal carcinomatosis from a recurrent cutaneous squamous cell carcinoma with perineural invasion in a lung transplant patient. JAAD Case Rep 2023; 37:61-63. [PMID: 37492433 PMCID: PMC10363661 DOI: 10.1016/j.jdcr.2023.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023] Open
Affiliation(s)
- Emily E. Granger
- Department of Dermatology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Ann W. Silk
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Nirmal S. Sharma
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Morgan K. Groover
- Department of Dermatology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jeffrey P. Guenette
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Kevin S. Emerick
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - David M. Miller
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Katherine A. Krause
- Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Emily S. Ruiz
- Department of Dermatology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
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7
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Margaroli C, Fram T, Sharma NS, Patel SB, Tipper J, Robison SW, Russell DW, Fortmann SD, Banday MM, Soto-Vazquez Y, Abdalla T, Saitornuang S, Madison MC, Leal SM, Harrod KS, Erdmann NB, Gaggar A. Interferon-dependent signaling is critical for viral clearance in airway neutrophils. JCI Insight 2023; 8:e167042. [PMID: 37071484 PMCID: PMC10322684 DOI: 10.1172/jci.insight.167042] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 04/12/2023] [Indexed: 04/19/2023] Open
Abstract
Neutrophilic inflammation characterizes several respiratory viral infections, including COVID-19-related acute respiratory distress syndrome, although its contribution to disease pathogenesis remains poorly understood. Blood and airway immune cells from 52 patients with severe COVID-19 were phenotyped by flow cytometry. Samples and clinical data were collected at 2 separate time points to assess changes during ICU stay. Blockade of type I interferon and interferon-induced protein with tetratricopeptide repeats 3 (IFIT3) signaling was performed in vitro to determine their contribution to viral clearance in A2 neutrophils. We identified 2 neutrophil subpopulations (A1 and A2) in the airway compartment, where loss of the A2 subset correlated with increased viral burden and reduced 30-day survival. A2 neutrophils exhibited a discrete antiviral response with an increased interferon signature. Blockade of type I interferon attenuated viral clearance in A2 neutrophils and downregulated IFIT3 and key catabolic genes, demonstrating direct antiviral neutrophil function. Knockdown of IFIT3 in A2 neutrophils led to loss of IRF3 phosphorylation, with consequent reduced viral catabolism, providing the first discrete mechanism to our knowledge of type I interferon signaling in neutrophils. The identification of this neutrophil phenotype and its association with severe COVID-19 outcomes emphasizes its likely importance in other respiratory viral infections and potential for new therapeutic approaches in viral illness.
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Affiliation(s)
- Camilla Margaroli
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine
- Program in Protease and Matrix Biology
- Department of Pathology, Division of Molecular and Cellular Pathology, and
| | - Timothy Fram
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Nirmal S. Sharma
- Program in Protease and Matrix Biology
- Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Siddharth B. Patel
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine
| | | | - Sarah W. Robison
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine
- Program in Protease and Matrix Biology
| | - Derek W. Russell
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine
- Program in Protease and Matrix Biology
| | | | - Mudassir M. Banday
- Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Yixel Soto-Vazquez
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine
- Program in Protease and Matrix Biology
| | - Tarek Abdalla
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine
- Program in Protease and Matrix Biology
| | | | - Matthew C. Madison
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine
- Program in Protease and Matrix Biology
| | - Sixto M. Leal
- Department of Pathology, Division of Laboratory Medicine, and
| | | | - Nathaniel B. Erdmann
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Amit Gaggar
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine
- Program in Protease and Matrix Biology
- Lung Health Center and Gregory Fleming James Cystic Fibrosis Research Center, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Birmingham VA Medical Center, Birmingham, Alabama, USA
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8
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Alshimali H, Kuckelman J, Seethala R, Sharma NS, Coppolino A, Keshk M, Young JS, Mallidi HR. Adverse Outcomes Associated With Atrial Arrhythmias After Veno-Venous Extracorporeal Membrane Oxygenation. ASAIO J 2023; 69:e188-e191. [PMID: 37018766 DOI: 10.1097/mat.0000000000001929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023] Open
Abstract
Veno-venous extracorporeal membrane oxygenation (VV ECMO) is used as a treatment modality in those who fail to respond to conventional care. Hypoxia and medications used in the intensive care unit may increase risk for atrial arrhythmias (AA). This study aims to evaluate the impact of AA on post-VV ECMO outcome. A retrospective review of patients who were placed on VV ECMO between October 2016 and October 2021. One hundred forty-five patients were divided into two groups, AA and no AA. Baseline characteristic and potential risk factors were assessed. Uni- and multivariate analysis using logistic regression models were constructed to evaluate the predictors of mortality between groups. Survival between groups was estimated by the Kaplan-Meier method using the log-rank test. Advanced age with history of coronary artery disease and hypertension were associated with increased risk to develop AA post-VV ECMO placement ( p value < 0.05). Length on ECMO, time intubated, hospital length of stay, and sepsis were significantly increased in patients in the AA group ( p value < 0.05). There was no difference in the overall mortality between the two groups. AAs were associated with worse hospital course and complications but no difference in overall mortality rate. Age and cardiovascular disease seem to be predisposing risk factors for this. Further studies are needed to investigate potential strategies to prevent AAs development in this population.
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Affiliation(s)
- Hussain Alshimali
- From the Thoracic and Cardiac Surgery, Brigham and Women's Hospital, Boston, Massachusetts
| | - John Kuckelman
- From the Thoracic and Cardiac Surgery, Brigham and Women's Hospital, Boston, Massachusetts
| | - Raghu Seethala
- Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Nirmal S Sharma
- Pulmonary and Critical Care, Brigham and Women's Hospital, Boston, Massachusetts
| | - Antonio Coppolino
- From the Thoracic and Cardiac Surgery, Brigham and Women's Hospital, Boston, Massachusetts
| | - Mohamed Keshk
- From the Thoracic and Cardiac Surgery, Brigham and Women's Hospital, Boston, Massachusetts
| | - John S Young
- From the Thoracic and Cardiac Surgery, Brigham and Women's Hospital, Boston, Massachusetts
| | - Hari R Mallidi
- From the Thoracic and Cardiac Surgery, Brigham and Women's Hospital, Boston, Massachusetts
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9
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Maron BA, Kleiner DE, Arons E, Wertheim BM, Sharma NS, Haley KJ, Samokhin AO, Rowin EJ, Maron MS, Rosing DR, Maron BJ. Evidence of Advanced Pulmonary Vascular Remodeling in Obstructive Hypertrophic Cardiomyopathy With Pulmonary Hypertension. Chest 2023; 163:678-686. [PMID: 36243062 PMCID: PMC9993337 DOI: 10.1016/j.chest.2022.09.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Elevated mean pulmonary artery pressure (mPAP) is common in patients with hypertrophic cardiomyopathy (HCM) and heart failure symptoms. However, dynamic left ventricular (LV) outflow tract obstruction may confound interpretation of pulmonary hypertension (PH) pathophysiologic features in HCM when relying on resting invasive hemodynamic data alone. RESEARCH QUESTION Do structural changes to the lung vasculature clarify PH pathophysiologic features in patients with HCM with progressive heart failure? STUDY DESIGN AND METHODS Clinical data and ultrarare lung autopsy specimens were acquired retrospectively from the National Institutes of Health (1975-1992). Patients were included based on the availability of lung tissue and recorded mPAP. Discarded tissue from rejected lung donors served as control specimens. Histomorphology was performed on pulmonary arterioles and veins. Comparisons were calculated using the Student t test and Mann-Whitney U test; Pearson correlation was used to assess association between morphometric measurements and HCM cardiac and hemodynamic measurements. RESULTS The HCM cohort (n = 7; mean ± SD age, 43 ± 18 years; 71% men) showed maximum mean ± SD LV wall thickness of 25 ± 2.8 mm, mean ± SD outflow tract gradient of 90 ± 30 mm Hg, median mPAP of 25 mm Hg (interquartile range [IQR], 6 mm Hg), median pulmonary artery wedge pressure (PAWP) of 16 mm Hg (IQR, 4 mm Hg), and median pulmonary vascular resistance of 1.8 Wood units (WU; IQR, 2.4 WU). Compared with control samples (n = 5), patients with HCM showed greater indexed pulmonary arterial hypertrophy (20.7 ± 7.2% vs 49.7 ± 12%; P < .001) and arterial wall fibrosis (11.5 ± 3.4 mm vs 21.0 ± 4.7 mm; P < .0001), which correlated with mPAP (r = 0.84; P = .018), PAWP (r = 0.74; P = .05), and LV outflow tract gradient (r = 0.78; P = .035). Compared with control samples, pulmonary vein thickness was increased by 2.9-fold (P = .008) in the HCM group, which correlated with mPAP (r = 0.81; P = .03) and LV outflow tract gradient (r = 0.83; P = .02). INTERPRETATION To the best of our knowledge, these data demonstrate for the first time that in patients with obstructive HCM, heart failure is associated with pathogenic pulmonary vascular remodeling even when mPAP is elevated only mildly. These observations clarify PH pathophysiologic features in HCM, with future implications for clinical strategies that mitigate outflow tract obstruction.
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Affiliation(s)
- Bradley A Maron
- Division of Cardiovascular Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
| | - David E Kleiner
- Laboratory of Pathology, National Cancer Institute, Bethesda, MD
| | - Elena Arons
- Division of Cardiovascular Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Bradley M Wertheim
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Nirmal S Sharma
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Kathleen J Haley
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Andriy O Samokhin
- Division of Cardiovascular Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Ethan J Rowin
- HCM Center, Lahey Hospital and Medical Center, Burlington, MA
| | - Martin S Maron
- HCM Center, Lahey Hospital and Medical Center, Burlington, MA
| | - Douglas R Rosing
- Cardiovascular Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Barry J Maron
- HCM Center, Lahey Hospital and Medical Center, Burlington, MA
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10
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Holt HR, Walker M, Beauvais W, Kaur P, Bedi JS, Mangtani P, Sharma NS, Gill JPS, Godfroid J, McGiven J, Guitian J. Modelling the control of bovine brucellosis in India. J R Soc Interface 2023; 20:20220756. [PMID: 36882115 PMCID: PMC9991488 DOI: 10.1098/rsif.2022.0756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Brucellosis imposes substantial impacts on livestock production and public health worldwide. A stochastic, age-structured model incorporating herd demographics was developed describing within- and between-herd transmission of Brucella abortus in dairy cattle herds. The model was fitted to data from a cross-sectional study conducted in Punjab State of India and used to evaluate the effectiveness of control strategies under consideration. Based on model results, stakeholder acceptance and constraints regarding vaccine supply, vaccination of replacement calves in large farms should be prioritized. Test and removal applied at early stages of the control programme where seroprevalence is high would not constitute an effective or acceptable use of resources because significant numbers of animals would be 'removed' (culled or not used for breeding) based on false positive results. To achieve sustained reductions in brucellosis, policymakers must commit to maintaining vaccination in the long term, which may eventually reduce frequency of infection in the livestock reservoir to a low enough level for elimination to be a realistic objective. This work provides key strategic insights into the control of brucellosis in India, which has the largest cattle population globally, and a general modelling framework for evaluating control strategies in endemic settings.
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Affiliation(s)
- H R Holt
- Veterinary Epidemiology, Economics and Public Health Group, WOAH Collaborating Centre in Risk Analysis and Modelling, Department of Pathobiology and Population Sciences, Royal Veterinary College, University of London, Hatfield AL9 7TA, UK.,Communicable Diseases Policy Research Group, London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT, UK
| | - M Walker
- Veterinary Epidemiology, Economics and Public Health Group, WOAH Collaborating Centre in Risk Analysis and Modelling, Department of Pathobiology and Population Sciences, Royal Veterinary College, University of London, Hatfield AL9 7TA, UK.,London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Imperial College London, London W2 1PG, UK
| | - W Beauvais
- Comparative Pathobiology Department, College of Veterinary Medicine, Purdue University, West Lafayette, IN 47906, USA
| | - P Kaur
- Department of Veterinary Microbiology, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab, India
| | - J S Bedi
- School of Public Health and Zoonosis, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab, India
| | - P Mangtani
- Faculty of Epidemiology and Population Health, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - N S Sharma
- Department of Veterinary Microbiology, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab, India
| | - J P S Gill
- School of Public Health and Zoonosis, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab, India
| | - J Godfroid
- Faculty of Biosciences, Fisheries and Economics, Department of Arctic and Marine Biology, UiT - The Arctic University of Norway, Hansine Hansens veg 18, 9019 Tromsø, Norway
| | - J McGiven
- WOAH Brucellosis Reference Laboratory, FAO Collaborating Centre for Brucellosis, Department of Bacteriology, Animal & Plant Health Agency, Surrey, UK
| | - J Guitian
- Veterinary Epidemiology, Economics and Public Health Group, WOAH Collaborating Centre in Risk Analysis and Modelling, Department of Pathobiology and Population Sciences, Royal Veterinary College, University of London, Hatfield AL9 7TA, UK
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11
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Banday MM, Rao SB, Shankar S, Khanday MA, Finan J, O'Neill E, Coppolino A, Seyfang A, Kumar A, Rinewalt DE, Goldberg HJ, Woolley A, Mallidi HR, Visner G, Gaggar A, Patel KN, Sharma NS. IL-33 mediates Pseudomonas induced airway fibrogenesis and is associated with CLAD. J Heart Lung Transplant 2023; 42:53-63. [PMID: 37014805 PMCID: PMC10260236 DOI: 10.1016/j.healun.2022.09.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Long term outcomes of lung transplantation are impacted by the occurrence of chronic lung allograft dysfunction (CLAD). Recent evidence suggests a role for the lung microbiome in the occurrence of CLAD, but the exact mechanisms are not well defined. We hypothesize that the lung microbiome inhibits epithelial autophagic clearance of pro-fibrotic proteins in an IL-33 dependent manner, thereby augmenting fibrogenesis and risk for CLAD. METHODS Autopsy derived CLAD and non-CLAD lungs were collected. IL-33, P62 and LC3 immunofluorescence was performed and assessed using confocal microscopy. Pseudomonas aeruginosa (PsA), Streptococcus Pneumoniae (SP), Prevotella Melaninogenica (PM), recombinant IL-33 or PsA-lipopolysaccharide was co-cultured with primary human bronchial epithelial cells (PBEC) and lung fibroblasts in the presence or absence of IL-33 blockade. Western blot analysis and quantitative reverse transcription (qRT) PCR was performed to evaluate IL-33 expression, autophagy, cytokines and fibroblast differentiation markers. These experiments were repeated after siRNA silencing and upregulation (plasmid vector) of Beclin-1. RESULTS Human CLAD lungs demonstrated markedly increased expression of IL-33 and reduced basal autophagy compared to non-CLAD lungs. Exposure of co-cultured PBECs to PsA, SP induced IL-33, and inhibited PBEC autophagy, while PM elicited no significant response. Further, PsA exposure increased myofibroblast differentiation and collagen formation. IL-33 blockade in these co-cultures recovered Beclin-1, cellular autophagy and attenuated myofibroblast activation in a Beclin-1 dependent manner. CONCLUSION CLAD is associated with increased airway IL-33 expression and reduced basal autophagy. PsA induces a fibrogenic response by inhibiting airway epithelial autophagy in an IL-33 dependent manner.
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Affiliation(s)
- Mudassir M Banday
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | | | - Shruthi Shankar
- University of South Florida, Morsani College of Medicine/Tampa General Hospital
| | | | - Jon Finan
- University of South Florida, Morsani College of Medicine/Tampa General Hospital
| | - Edward O'Neill
- University of South Florida, Morsani College of Medicine/Tampa General Hospital
| | - Antonio Coppolino
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Andreas Seyfang
- University of South Florida, Morsani College of Medicine/Tampa General Hospital
| | - Archit Kumar
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Daniel E Rinewalt
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Hilary J Goldberg
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Ann Woolley
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Hari Reddy Mallidi
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Gary Visner
- Boston Children's Hospital. Harvard Medical School
| | | | - Kapil N Patel
- University of South Florida, Morsani College of Medicine/Tampa General Hospital
| | - Nirmal S Sharma
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Boston VA Medical Center.
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12
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Kim AJ, Goldberg HJ, Thaniyavarn T, Kennedy JC, Coppolino A, Mallidi HR, Mallidi HR, Lee SF, Joyce MRM, Kovac V, Issa NC, Harris CE, LaCasce AS, Sharma NS, Baden LR, Woolley AE. 209. Epstein-Barr Virus Surveillance in Lung Transplantation: Post-transplant Lymphoproliferative Disorder and Impact on Survival. Open Forum Infect Dis 2022. [DOI: 10.1093/ofid/ofac492.286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Abstract
Background
Epstein-Barr virus (EBV) donor seropositive/recipient seronegative (D+/R-) status is a risk factor for post-transplant lymphoproliferative disorder (PTLD) which is associated with increased mortality post-lung transplant. The optimal surveillance strategy for PTLD post-lung transplant stratified by EBV serostatus for early diagnosis is unknown. We assessed serial EBV viral loads (VL) for early diagnosis of PTLD and compared outcomes in EBV D+/R- and R+ lung transplant recipients at our center.
Methods
A single-center retrospective study of lung transplants between January 2017 and September 2021 was performed, with a 6-month minimum follow-up. Recipient characteristics, outcomes, and serial EBV VL (biweekly months 1-3, monthly 4-12; using the cobas quantitative PCR assay on serum) were assessed.
Results
Of the 242 lung transplant recipients, 14 (6%) were EBV D+/R- and 228 (94%) were EBV R+ [Figure 1]. Median age and lung allocation score were similar between the two cohorts [Table 1]. 7 (50%) EBV D+/R- recipients had 2 consecutive, detectable EBV VL in the first-year post-transplant compared to 30 (13%) R+ recipients (p=0.002). 5 (71%) EBV D+/R- recipients with 2 consecutive, detectable EBV VL developed PTLD compared with 2 (7%) R+ recipients (p=0.001). Median weeks post-transplant for two consecutive, detectable EBV VL were 14 (IQR 7, 15) and 10 (IQR 6, 24); and median weeks post-transplant for diagnosis of PTLD were 22 (IQR 17, 31) and 17 (IQR 16, 17) for EBV D+/R- and R+, respectively. Only recipients with at least 2 consecutive, detectable VL in the first-year post-transplant developed PTLD. EBV VL level was not associated with development of PTLD. 6-month outcomes were similar between EBV D+/R- and R+. Though there were no differences in mortality at 1 and 2-years stratified by EBV serostatus, all 5 EBV D+/R- recipients with PTLD were alive 2 years post-transplant, whereas both EBV R+ PTLD recipients died < 2 years post-transplant (p=0.048). Figure 1:Study cohort characteristics and PTLD outcomes based on serial EBV viral loads within the first-year post-lung transplant*7 recipients were excluded per study criteria due to having died less than 1-month post-transplant and therefore not having sufficient EBV VL testing post-transplant for this analysis.Table 1:Baseline characteristics, index hospitalization, and clinical outcomes of lung transplant recipients stratified by EBV serostatus*P-values are based on Fisher’s two-sided exact test (for categorial variables) or the Wilcoxon rank-sum test (for continuous variables).**Time to ≥2 consecutive, detectable EBV VL was calculated based on the date of the second consecutive, detectable result.
Conclusion
Two consecutive, detectable EBV VL within the first-year post-lung transplant should prompt additional work-up for the early diagnosis of PTLD in all recipients regardless of the EBV VL level or serostatus. Though the attack rate of PTLD was greater in EBV D+/R- recipients, survival outcomes were similar irrespective of serostatus.
Disclosures
Nicolas C. Issa, MD, AiCuris: Grant/Research Support|Merck: Grant/Research Support.
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Affiliation(s)
- Andy J Kim
- Brigham and Women's Hospital , Boston, Massachusetts
| | | | | | | | | | | | | | - Stefi F Lee
- Brigham and Women's Hospital , Boston, Massachusetts
| | | | - Victor Kovac
- Brigham & Women's Hospital , Boston, Massachusetts
| | | | | | - Ann S LaCasce
- Dana-Farber Cancer Institute , Boston, Massachusetts
| | | | | | - Ann E Woolley
- Brigham and Women's Hospital , Boston, Massachusetts
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13
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Harris CE, Mehta A, Kim AJ, Goldberg HJ, Mallidi HR, Mallidi HR, Townsend K, Coppolino A, Thaniyavarn T, Kennedy JC, Lee SF, Durney V, Marshall S, Fenty-Scotland J, Cosimi LA, Kovac V, Issa NC, Sharma NS, Baden LR, Woolley AE. 2123. The Impact of Staphylococcus aureus Peri-transplant Cultures on Six-Month Outcomes in Lung Transplantation. Open Forum Infect Dis 2022. [PMCID: PMC9752450 DOI: 10.1093/ofid/ofac492.1744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background Staphylococcus aureus (S. aureus) infections post-lung transplant lead to increased mortality. The impact of S. aureus peri-transplant respiratory cultures on post-transplant outcomes is unknown as is the optimal duration of peri-transplant antibiotics. We compared lung transplant recipients with and without S. aureus growth on peri-transplant cultures and the impact on 6-month outcomes including rejection, survival, and occurrence of S. aureus infections. Methods A single-center, retrospective study of lung transplant recipients between January 2017 and April 2021 was performed. Donor/recipient characteristics, microbiologic data, antibiotics, and 6-month outcomes were analyzed. Results In this 4.5-year study period, 229 patients underwent lung transplant. 121 (53%) had S. aureus growth on peri-transplant cultures, of which 84 (69%) were methicillin-susceptible (MSSA), 30 (25%) methicillin-resistant (MRSA), and 7 (6%) had MSSA and MRSA. Median duration of antibiotics post-transplant was 28-days in the S. aureus group. 67% of non-S. aureus recipients received S. aureus targeting antibiotics (p = < 0.001) for other indications for a median of 13-days. In the S. aureus cohort, donors were younger (median age 33 vs 38 years, p = 0.027) and more donors died from drug intoxication (50% vs 31%, p = 0.005) [Table 1]. Recipient baseline characteristics and median length of hospitalization were similar in both cohorts. There were no statistically significant differences in 6-month outcomes, including rates of rejection or survival [Figure 1]. Having grown S. aureus in peri-transplant cultures was not associated with a higher incidence of post-transplant S. aureus infections (10% vs 13%, p = 0.534). Patients who had a S. aureus infection post-transplant had lower 6-month survival that was not statistically significant (85% vs 93%, p = 0.131).
![]() ![]() Conclusion The growth of S. aureus on peri-transplant respiratory cultures with a median 4-week antibiotic course does not increase the risk of having a S. aureus infection post-transplant and is not associated with increased mortality or rejection at 6-months. The impact of a shorter duration of peri-transplant antibiotics on recurrence of infection and outcomes needs to be further studied. Disclosures Nicolas C. Issa, MD, AiCuris: Grant/Research Support|Merck: Grant/Research Support.
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Affiliation(s)
| | | | - Andy J Kim
- Brigham and Women's Hospital, Boston, Massachusetts
| | | | | | | | | | | | | | | | - Stefi F Lee
- Brigham and Women's Hospital, Boston, Massachusetts
| | | | | | | | | | - Victor Kovac
- Brigham & Women's Hospital, Boston, Massachusetts
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14
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Alshimali H, Coppolino A, Keshk MA, Young JS, Itoh A, Goldberg HJ, Sharma NS, Mallidi HR. Heart recovery and reverse remodeling following lung transplant in pulmonary artery hypertension. Cardiothorac Surg 2022. [DOI: 10.1186/s43057-022-00082-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Pulmonary artery hypertension (PAH) is a progressive disease that result in right heart dysfunction. Lung transplantation (LTx) improve survival in end-stage disease. The aim of this study is to assess heart recovery after LTx for patients with primary and secondary pulmonary hypertension.
Methods
We conducted a single center retrospective review for patients with primary and secondary PAH underwent LTx between the period of January 2015 and December 2020. Baseline characteristics and echocardiographic measures were assessed pre-operative and after 1 year follow-up. Survival comparison between primary and secondary PAH was estimated by Kaplan–Meier method.
Results
We identified 43 participants for the study. Among the participants, 11 case had primary PAH. Median age during transplant was 60 years (45.5, 65.5). Left atrium anterio-posterior dimensions, systolic right ventricle pressure tricuspid peal regurgitant velocity and severity of tricuspid regurgitation were found to be significantly improved post-operatively compared to pre-operative echocardiography (p value < 0.05). Overall mortality was not significant between primary and secondary PAH (p value = 0.66).
Conclusions
LTx can reverse heart remodeling and facilitate recovery in primary and secondary PAH. Our data confirm the importance of LTx as a viable option in PAH failing medical treatment.
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15
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Smirnova NF, Riemondy K, Bueno M, Collins S, Suresh P, Wang X, Patel KN, Cool C, Königshoff M, Sharma NS, Eickelberg O. Single-cell transcriptome mapping identifies a local, innate B cell population driving chronic rejection after lung transplantation. JCI Insight 2022; 7:156648. [PMID: 36134664 PMCID: PMC9675462 DOI: 10.1172/jci.insight.156648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Bronchiolitis obliterans syndrome (BOS) is the main reason for poor outcomes after lung transplantation (LTx). We and others have recently identified B cells as major contributors to BOS after LTx. The extent of B cell heterogeneity and the relative contributions of B cell subpopulations to BOS, however, remain unclear. Here, we provide a comprehensive analysis of cell population changes and their gene expression patterns during chronic rejection after orthotopic LTx in mice. Of 11 major cell types, Mzb1-expressing plasma cells (PCs) were the most prominently increased population in BOS lungs. These findings were validated in 2 different cohorts of human BOS after LTx. A Bhlhe41, Cxcr3, and Itgb1 triple-positive B cell subset, also expressing classical markers of the innate-like B-1 B cell population, served as the progenitor pool for Mzb1+ PCs. This subset accounted for the increase in IgG2c production within BOS lung grafts. A genetic lack of Igs decreased BOS severity after LTx. In summary, we provide a detailed analysis of cell population changes during BOS. IgG+ PCs and their progenitors — an innate B cell subpopulation — are the major source of local Ab production and a significant contributor to BOS after LTx.
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Affiliation(s)
- Natalia F Smirnova
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.,Institut des Maladies Métaboliques et Cardiovasculaires (I2MC) - INSERM U1297, University of Toulouse III, Toulouse, France
| | - Kent Riemondy
- RNA Bioscience Initiative, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Marta Bueno
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Susan Collins
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Pavan Suresh
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Xingan Wang
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Kapil N Patel
- Center for Advanced Lung Disease and Lung Transplantation, University of South Florida/Tampa General Hospital, Tampa, Florida, USA
| | - Carlyne Cool
- Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Melanie Königshoff
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Nirmal S Sharma
- Center for Advanced Lung Disease and Lung Transplantation, University of South Florida/Tampa General Hospital, Tampa, Florida, USA.,Division of Pulmonary & Critical Care, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Oliver Eickelberg
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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16
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Fukumoto J, Lin M, Banday MM, Patil SS, Krishnamurthy S, Breitzig M, Soundararajan R, Galam L, Narala VR, Johns C, Patel K, Dunning J, Lockey RF, Sharma NS, Kolliputi N. Aberrant Expression of ACO1 in Vasculatures Parallels Progression of Idiopathic Pulmonary Fibrosis. Front Pharmacol 2022; 13:890380. [PMID: 35910393 PMCID: PMC9335372 DOI: 10.3389/fphar.2022.890380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 05/04/2022] [Indexed: 11/15/2022] Open
Abstract
Rationale: Idiopathic pulmonary fibrosis (IPF) is characterized by mitochondrial dysfunction. However, details about the non-mitochondrial enzymes that sustain the proliferative nature of IPF are unclear. Aconitases are a family of enzymes that sustain metabolism inside and outside mitochondria. It is hypothesized that aconitase 1 (ACO1) plays an important role in the pathogenesis of IPF given that ACO1 represents an important metabolic hub in the cytoplasm. Objectives: To determine if ACO1 expression in IPF lungs shows specific patterns that may be important in the pathogenesis of IPF. To determine the similarities and differences in ACO1 expression in IPF, bleomycin-treated, and aging lungs. Methods: ACO1 expression in IPF lungs were characterized and compared to non-IPF controls by western blotting, immunostaining, and enzymatic activity assay. ACO1-expressing cell types were identified by multicolor immunostaining. Using similar methods, the expression profiles of ACO1 in IPF lungs versus bleomycin-treated and aged mice were investigated. Measurements and main results: Lower lobes of IPF lungs, unlike non-IPF controls, exhibit significantly high levels of ACO1. Most of the signals colocalize with von Willebrand factor (vWF), a lineage marker for vascular endothelial cells. Bleomycin-treated lungs also show high ACO1 expressions. However, most of the signals colocalize with E-cadherin and/or prosurfactant protein C, representative epithelial cell markers, in remodeled areas. Conclusions: A characteristic ACO1 expression profile observed in IPF vasculatures may be a promising diagnostic target. It also may give clues as to how de novo angiogenesis contributes to the irreversible nature of IPF.
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Affiliation(s)
- Jutaro Fukumoto
- Division of Allergy and Immunology, Department of Internal Medicine, University of South Florida, Tampa, FL, United States
| | - Muling Lin
- Division of Allergy and Immunology, Department of Internal Medicine, University of South Florida, Tampa, FL, United States
| | - Mudassir Meraj Banday
- Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Sahebgowda Sidramagowda Patil
- Division of Allergy and Immunology, Department of Internal Medicine, University of South Florida, Tampa, FL, United States
| | - Sudarshan Krishnamurthy
- Division of Allergy and Immunology, Department of Internal Medicine, University of South Florida, Tampa, FL, United States
| | - Mason Breitzig
- Division of Allergy and Immunology, Department of Internal Medicine, University of South Florida, Tampa, FL, United States
| | - Ramani Soundararajan
- Division of Allergy and Immunology, Department of Internal Medicine, University of South Florida, Tampa, FL, United States
| | - Lakshmi Galam
- Division of Allergy and Immunology, Department of Internal Medicine, University of South Florida, Tampa, FL, United States
| | - Venkata Ramireddy Narala
- Division of Allergy and Immunology, Department of Internal Medicine, University of South Florida, Tampa, FL, United States
- Department of Zoology, Yogi Vemana University, Kadapa, India
| | - Colleen Johns
- Division of Allergy and Immunology, Department of Internal Medicine, University of South Florida, Tampa, FL, United States
| | - Kapilkumar Patel
- Pulmonary, Critical Care & Sleep Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL, United States
- Advanced Lung Diseases & Lung Transplantation, Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL, United States
| | - John Dunning
- Division of Cardiothoracic Surgery, Department of Surgery, University of South Florida, Tampa, FL, United States
| | - Richard F. Lockey
- Division of Allergy and Immunology, Department of Internal Medicine, University of South Florida, Tampa, FL, United States
| | - Nirmal S. Sharma
- Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
- *Correspondence: Nirmal S. Sharma, ; Narasaiah Kolliputi,
| | - Narasaiah Kolliputi
- Division of Allergy and Immunology, Department of Internal Medicine, University of South Florida, Tampa, FL, United States
- Department of Molecular Medicine, University of South Florida, Tampa, FL, United States
- *Correspondence: Nirmal S. Sharma, ; Narasaiah Kolliputi,
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17
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Hayes D, Board A, Calfee CS, Ellington S, Pollack LA, Kathuria H, Eakin MN, Weissman DN, Callahan SJ, Esper AM, Crotty Alexander LE, Sharma NS, Meyer NJ, Smith LS, Novosad S, Evans ME, Goodman AB, Click ES, Robinson RT, Ewart G, Twentyman E. Pulmonary and Critical Care Considerations for e-Cigarette, or Vaping, Product Use-Associated Lung Injury. Chest 2022; 162:256-264. [DOI: 10.1016/j.chest.2022.02.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 11/17/2021] [Accepted: 02/18/2022] [Indexed: 12/15/2022] Open
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18
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Roesel MJ, Sharma NS, Schroeter A, Matsunaga T, Xiao Y, Zhou H, Tullius SG. Primary Graft Dysfunction: The Role of Aging in Lung Ischemia-Reperfusion Injury. Front Immunol 2022; 13:891564. [PMID: 35686120 PMCID: PMC9170999 DOI: 10.3389/fimmu.2022.891564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 04/21/2022] [Indexed: 01/14/2023] Open
Abstract
Transplant centers around the world have been using extended criteria donors to remedy the ongoing demand for lung transplantation. With a rapidly aging population, older donors are increasingly considered. Donor age, at the same time has been linked to higher rates of lung ischemia reperfusion injury (IRI). This process of acute, sterile inflammation occurring upon reperfusion is a key driver of primary graft dysfunction (PGD) leading to inferior short- and long-term survival. Understanding and improving the condition of older lungs is thus critical to optimize outcomes. Notably, ex vivo lung perfusion (EVLP) seems to have the potential of reconditioning ischemic lungs through ex-vivo perfusing and ventilation. Here, we aim to delineate mechanisms driving lung IRI and review both experimental and clinical data on the effects of aging in augmenting the consequences of IRI and PGD in lung transplantation.
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Affiliation(s)
- Maximilian J Roesel
- Division of Transplant Surgery and Transplant Surgery Research Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.,Institute of Medical Immunology, Charité Universitaetsmedizin Berlin, Berlin, Germany
| | - Nirmal S Sharma
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA, United States.,Department of Medicine, Harvard Medical School, Boston, MA, United States
| | - Andreas Schroeter
- Division of Transplant Surgery and Transplant Surgery Research Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.,Regenerative Medicine and Experimental Surgery, Department of General, Visceral and Transplant Surgery, Hannover Medical School, Hannover, Germany
| | - Tomohisa Matsunaga
- Division of Transplant Surgery and Transplant Surgery Research Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.,Department of Urology, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Yao Xiao
- Division of Transplant Surgery and Transplant Surgery Research Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Hao Zhou
- Division of Transplant Surgery and Transplant Surgery Research Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Stefan G Tullius
- Division of Transplant Surgery and Transplant Surgery Research Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
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19
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Margaroli C, Benson P, Sharma NS, Madison MC, Robison SW, Arora N, Ton K, Liang Y, Zhang L, Patel RP, Gaggar A. Spatial mapping of SARS-CoV-2 and H1N1 lung injury identifies differential transcriptional signatures. Cell Rep Med 2021; 2:100242. [PMID: 33778787 PMCID: PMC7985929 DOI: 10.1016/j.xcrm.2021.100242] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 11/16/2020] [Accepted: 03/16/2021] [Indexed: 12/17/2022]
Abstract
Severe SARS-CoV-2 infection often leads to the development of acute respiratory distress syndrome (ARDS), with profound pulmonary patho-histological changes post-mortem. It is not clear whether ARDS from SARS-CoV-2 is similar to that observed in influenza H1N1, another common viral cause of lung injury. Here, we analyze specific ARDS regions of interest utilizing a spatial transcriptomic platform on autopsy-derived lung tissue from patients with SARS-CoV-2 (n = 3), H1N1 (n = 3), and a dual infected individual (n = 1). Enhanced gene signatures in alveolar epithelium, vascular tissue, and lung macrophages identify not only increased regional coagulopathy but also increased extracellular remodeling, alternative macrophage activation, and squamous metaplasia of type II pneumocytes in SARS-CoV-2. Both the H1N1 and dual-infected transcriptome demonstrated an enhanced antiviral response compared to SARS-CoV-2. Our results uncover regional transcriptional changes related to tissue damage/remodeling, altered cellular phenotype, and vascular injury active in SARS-CoV-2 and present therapeutic targets for COVID-19-related ARDS.
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Affiliation(s)
- Camilla Margaroli
- Department of Medicine, Division of Pulmonary, Allergy & Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- Program in Protease/Matrix Biology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Paul Benson
- Department of Pathology, Division of Anatomic Pathology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Nirmal S. Sharma
- Program in Protease/Matrix Biology, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Matthew C. Madison
- Department of Medicine, Division of Pulmonary, Allergy & Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- Program in Protease/Matrix Biology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Sarah W. Robison
- Department of Medicine, Division of Pulmonary, Allergy & Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- Program in Protease/Matrix Biology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Nitin Arora
- Department of Pediatrics, Division of Neonatology University of Alabama at Birmingham and Children’s Hospital of Alabama, Birmingham, AL, USA
| | - Kathy Ton
- Nanostring Technologies Inc., Seattle, WA, USA
| | - Yan Liang
- Nanostring Technologies Inc., Seattle, WA, USA
| | - Liang Zhang
- Nanostring Technologies Inc., Seattle, WA, USA
| | - Rakesh P. Patel
- Program in Protease/Matrix Biology, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Pathology, Division of Molecular & Cellular Pathology, University of Alabama at Birmingham, Birmingham, AL, USA
- Center for Free Radical Biology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Amit Gaggar
- Department of Medicine, Division of Pulmonary, Allergy & Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- Program in Protease/Matrix Biology, University of Alabama at Birmingham, Birmingham, AL, USA
- Center for Free Radical Biology, University of Alabama at Birmingham, Birmingham, AL, USA
- Birmingham VA Medical Center, Birmingham, AL, USA
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20
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Banday MM, Kumar A, Vestal G, Sethi J, Patel KN, O'Neill EB, Finan J, Cheng F, Lin M, Davis NM, Goldberg H, Coppolino A, Mallidi HR, Dunning J, Visner G, Gaggar A, Seyfang A, Sharma NS. N-myc-interactor mediates microbiome induced epithelial to mesenchymal transition and is associated with chronic lung allograft dysfunction. J Heart Lung Transplant 2021; 40:447-457. [PMID: 33781665 DOI: 10.1016/j.healun.2021.02.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 02/09/2021] [Accepted: 02/18/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Recent evidence suggests a role for lung microbiome in occurrence of chronic lung allograft dysfunction (CLAD). However, the mechanisms linking the microbiome to CLAD are poorly delineated. We investigated a possible mechanism involved in microbial modulation of mucosal response leading to CLAD with the hypothesis that a Proteobacteria dominant lung microbiome would inhibit N-myc-interactor (NMI) expression and induce epithelial to mesenchymal transition (EMT). METHODS Explant CLAD, non-CLAD, and healthy nontransplant lung tissue were collected, as well as bronchoalveolar lavage from 14 CLAD and matched non-CLAD subjects, which were followed by 16S rRNA amplicon sequencing and quantitative polymerase chain reaction (PCR) analysis. Pseudomonas aeruginosa (PsA) or PsA-lipopolysaccharide was cocultured with primary human bronchial epithelial cells (PBEC). Western blot analysis and quantitative reverse transcription (qRT) PCR was performed to evaluate NMI expression and EMT in explants and in PsA-exposed PBECs. These experiments were repeated after siRNA silencing and upregulation (plasmid vector) of EMT regulator NMI. RESULTS 16S rRNA amplicon analyses revealed that CLAD patients have a higher abundance of phyla Proteobacteria and reduced abundance of the phyla Bacteroidetes. At the genera level, CLAD subjects had an increased abundance of genera Pseudomonas and reduced Prevotella. Human CLAD airway cells showed a downregulation of the N-myc-interactor gene and presence of EMT. Furthermore, exposure of human primary bronchial epithelial cells to PsA resulted in downregulation of NMI and induction of an EMT phenotype while NMI upregulation resulted in attenuation of this PsA-induced EMT response. CONCLUSIONS CLAD is associated with increased bacterial biomass and a Proteobacteria enriched airway microbiome and EMT. Proteobacteria such as PsA induces EMT in human bronchial epithelial cells via NMI, demonstrating a newly uncovered mechanism by which the microbiome induces cellular metaplasia.
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Affiliation(s)
- Mudassir M Banday
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Archit Kumar
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Grant Vestal
- University of South Florida/Tampa General Hospital,Tampa, Florida
| | - Jaskaran Sethi
- University of South Florida/Tampa General Hospital,Tampa, Florida
| | - Kapil N Patel
- University of South Florida/Tampa General Hospital,Tampa, Florida
| | - Edward B O'Neill
- University of South Florida/Tampa General Hospital,Tampa, Florida
| | - Jon Finan
- University of South Florida/Tampa General Hospital,Tampa, Florida
| | - Feng Cheng
- University of South Florida/Tampa General Hospital,Tampa, Florida
| | - Muling Lin
- University of South Florida/Tampa General Hospital,Tampa, Florida
| | - Nicole M Davis
- University of South Florida/Tampa General Hospital,Tampa, Florida
| | - Hilary Goldberg
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Antonio Coppolino
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Hari R Mallidi
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - John Dunning
- University of South Florida/Tampa General Hospital,Tampa, Florida
| | - Gary Visner
- Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Amit Gaggar
- University of Alabama at Birmingham, Birmingham, Alabama
| | - Andreas Seyfang
- University of South Florida Morsani College of Medicine/Molecular Medicine, Tampa, Florida
| | - Nirmal S Sharma
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
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21
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Payne GA, Sharma NS, Lal CV, Song C, Guo L, Margaroli C, Viera L, Kumar S, Li J, Xing D, Bosley M, Xu X, Wells JM, George JF, Tallaj J, Leesar M, Blalock JE, Gaggar A. Prolyl endopeptidase contributes to early neutrophilic inflammation in acute myocardial transplant rejection. JCI Insight 2021; 6:139687. [PMID: 33571164 PMCID: PMC8026194 DOI: 10.1172/jci.insight.139687] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 02/04/2021] [Indexed: 11/21/2022] Open
Abstract
Altered inflammation and tissue remodeling are cardinal features of cardiovascular disease and cardiac transplant rejection. Neutrophils have increasingly been understood to play a critical role in acute rejection and early allograft failure; however, discrete mechanisms that drive this damage remain poorly understood. Herein, we demonstrate that early acute cardiac rejection increases allograft prolyl endopeptidase (PE) in association with de novo production of the neutrophil proinflammatory matrikine proline-glycine-proline (PGP). In a heterotopic murine heart transplant model, PGP production and PE activity were associated with early neutrophil allograft invasion and allograft failure. Pharmacologic inhibition of PE with Z-Pro-prolinal reduced PGP, attenuated early neutrophil graft invasion, and reduced proinflammatory cytokine expression. Importantly, these changes helped preserve allograft rejection-free survival and function. Notably, within 2 independent patient cohorts, both PGP and PE activity were increased among patients with biopsy-proven rejection. The observed induction of PE and matrikine generation provide a link between neutrophilic inflammation and cardiovascular injury, represent a potential target to reduce allogenic immune responses, and uncover a mechanism of cardiovascular disease that has been previously unrecognized to our knowledge.
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Affiliation(s)
- Gregory A Payne
- Division of Cardiovascular Disease, Department of Medicine.,Vascular Biology and Hypertension Program.,Comprehensive Cardiovascular Center, and.,Program in Protease and Matrix Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Medical Service at Birmingham VA Medical Center, Birmingham, Alabama, USA
| | - Nirmal S Sharma
- Department of Internal Medicine, University of South Florida, Tampa, Florida, USA.,Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Charitharth V Lal
- Program in Protease and Matrix Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Division of Neonatology, Department of Pediatrics
| | - Chunyan Song
- Division of Cardiovascular Disease, Department of Medicine
| | - Lingling Guo
- Department of Surgery.,Nephrology Research & Training Center, Division of Nephrology, Department of Medicine
| | - Camilla Margaroli
- Program in Protease and Matrix Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, and
| | - Liliana Viera
- Program in Protease and Matrix Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, and.,Lung Health Center, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Siva Kumar
- Department of Internal Medicine, University of South Florida, Tampa, Florida, USA.,Tampa General Hospital, Tampa, Florida, USA
| | - Jindong Li
- Program in Protease and Matrix Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, and
| | - Dongqi Xing
- Vascular Biology and Hypertension Program.,Program in Protease and Matrix Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, and
| | | | - Xin Xu
- Program in Protease and Matrix Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, and
| | - J Michael Wells
- Program in Protease and Matrix Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Medical Service at Birmingham VA Medical Center, Birmingham, Alabama, USA.,Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, and.,Lung Health Center, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - James F George
- Department of Surgery.,Nephrology Research & Training Center, Division of Nephrology, Department of Medicine
| | - Jose Tallaj
- Division of Cardiovascular Disease, Department of Medicine.,Comprehensive Cardiovascular Center, and
| | - Massoud Leesar
- Division of Cardiovascular Disease, Department of Medicine.,Comprehensive Cardiovascular Center, and
| | - J Edwin Blalock
- Vascular Biology and Hypertension Program.,Program in Protease and Matrix Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, and.,Lung Health Center, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Amit Gaggar
- Vascular Biology and Hypertension Program.,Program in Protease and Matrix Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Medical Service at Birmingham VA Medical Center, Birmingham, Alabama, USA.,Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, and.,Lung Health Center, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA
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22
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Sharma NS, Vestal G, Wille K, Patel KN, Cheng F, Tipparaju S, Tousif S, Banday MM, Xu X, Wilson L, Nair VS, Morrow C, Hayes D, Seyfang A, Barnes S, Deshane JS, Gaggar A. Differences in airway microbiome and metabolome of single lung transplant recipients. Respir Res 2020; 21:104. [PMID: 32375889 PMCID: PMC7201609 DOI: 10.1186/s12931-020-01367-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 04/22/2020] [Indexed: 12/16/2022] Open
Abstract
Background Recent studies suggest that alterations in lung microbiome are associated with occurrence of chronic lung diseases and transplant rejection. To investigate the host-microbiome interactions, we characterized the airway microbiome and metabolome of the allograft (transplanted lung) and native lung of single lung transplant recipients. Methods BAL was collected from the allograft and native lungs of SLTs and healthy controls. 16S rRNA microbiome analysis was performed on BAL bacterial pellets and supernatant used for metabolome, cytokines and acetylated proline-glycine-proline (Ac-PGP) measurement by liquid chromatography-high-resolution mass spectrometry. Results In our cohort, the allograft airway microbiome was distinct with a significantly higher bacterial burden and relative abundance of genera Acinetobacter & Pseudomonas. Likewise, the expression of the pro-inflammatory cytokine VEGF and the neutrophil chemoattractant matrikine Ac-PGP in the allograft was significantly higher. Airway metabolome distinguished the native lung from the allografts and an increased concentration of sphingosine-like metabolites that negatively correlated with abundance of bacteria from phyla Proteobacteria. Conclusions Allograft lungs have a distinct microbiome signature, a higher bacterial biomass and an increased Ac-PGP compared to the native lungs in SLTs compared to the native lungs in SLTs. Airway metabolome distinguishes the allografts from native lungs and is associated with distinct microbial communities, suggesting a functional relationship between the local microbiome and metabolome.
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Affiliation(s)
- Nirmal S Sharma
- Center for Advanced Lung Disease and Lung Transplantation, University of South Florida, Tampa, FL, USA. .,Division of Pulmonary, Critical Care & Sleep Medicine, University of South Florida/Tampa General Hospital, University of South Florida, Tampa, FL, USA. .,Division of Cardiothoracic Surgery, University of South Florida, Tampa, FL, USA. .,Brigham and Women's Hospital, Harvard Medical School, Thorn-908 C, 20 Shattuck St, Boston, MA, USA.
| | - Grant Vestal
- Center for Advanced Lung Disease and Lung Transplantation, University of South Florida, Tampa, FL, USA
| | - Keith Wille
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Kapil N Patel
- Center for Advanced Lung Disease and Lung Transplantation, University of South Florida, Tampa, FL, USA.,Division of Pulmonary, Critical Care & Sleep Medicine, University of South Florida/Tampa General Hospital, University of South Florida, Tampa, FL, USA
| | - Feng Cheng
- Department of Pharmaceutical Sciences, University of South Florida, Tampa, FL, USA
| | - Srinivas Tipparaju
- Department of Pharmaceutical Sciences, University of South Florida, Tampa, FL, USA
| | - Sultan Tousif
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Mudassir M Banday
- Center for Advanced Lung Disease and Lung Transplantation, University of South Florida, Tampa, FL, USA.,Division of Pulmonary, Critical Care & Sleep Medicine, University of South Florida/Tampa General Hospital, University of South Florida, Tampa, FL, USA
| | - Xin Xu
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, 35294, USA.,Program in Protease and Matrix Biology, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Landon Wilson
- Metabolomics Core, Microbiome Core, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Viswam S Nair
- Center for Advanced Lung Disease and Lung Transplantation, University of South Florida, Tampa, FL, USA.,Division of Pulmonary, Critical Care & Sleep Medicine, University of Washington School of Medicine, Washington, USA
| | - Casey Morrow
- Metabolomics Core, Microbiome Core, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Don Hayes
- Department of Pediatrics, The Ohio State University, Nationwide Children's Hospital, Columbus, OH, USA
| | - Andreas Seyfang
- Department of Molecular Medicine, University of South Florida, Tampa, FL, USA
| | - Stephen Barnes
- Metabolomics Core, Microbiome Core, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Jessy S Deshane
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Amit Gaggar
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, 35294, USA.,Program in Protease and Matrix Biology, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
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23
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Sutariya V, Kelly SJ, Weigel RG, Tur J, Halasz K, Sharma NS, Tipparaju SM. Nanoparticle drug delivery characterization for fluticasone propionate and in vitro testing 1. Can J Physiol Pharmacol 2019; 97:675-684. [PMID: 31100204 DOI: 10.1139/cjpp-2018-0569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Glucocorticoids, such as fluticasone propionate (FP), are used for the treatment of inflammation and alleviation of nasal symptoms and allergies, and as an antipruritic. However, both short- and long-term therapeutic use of glucocorticoids can lead to muscle weakness and atrophy. In the present study, we evaluated the feasibility of the nanodelivery of FP with poly(dl-lactide-co-glycolide) (PLGA) and tested in vitro function. FP-loaded PLGA nanoparticles were prepared via nanoprecipitation and morphological characteristics were studied via scanning electron microscopy. FP-loaded nanoparticles demonstrated an encapsulation efficiency of 68.6% ± 0.5% with a drug loading capacity of 4.6% ± 0.04%, were 128.8 ± 0.6 nm in diameter with a polydispersity index of 0.07 ± 0.008, and displayed a zeta potential of -19.4 ± 0.7. A sustained in vitro drug release pattern was observed for up to 7 days. The use of fluticasone nanoparticle decreased lipopolysaccharide (LPS)-induced lactate dehydrogenase release compared with LPS alone in C2C12 treated cells. FP also decreased expression of LPS-induced inflammatory genes in C2C12 treated cells as compared with LPS alone. Taken together, the present study demonstrates in vitro feasibility of PLGA-FP nanoparticle delivery to the skeletal muscle cells, which may be beneficial for treating inflammation.
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Affiliation(s)
- Vijaykumar Sutariya
- a Department of Pharmaceutical Sciences, College of Pharmacy, University of South Florida, Tampa, FL 33612, USA
| | - Shannon J Kelly
- a Department of Pharmaceutical Sciences, College of Pharmacy, University of South Florida, Tampa, FL 33612, USA
| | - Robert G Weigel
- a Department of Pharmaceutical Sciences, College of Pharmacy, University of South Florida, Tampa, FL 33612, USA
| | - Jared Tur
- a Department of Pharmaceutical Sciences, College of Pharmacy, University of South Florida, Tampa, FL 33612, USA
| | - Kathleen Halasz
- a Department of Pharmaceutical Sciences, College of Pharmacy, University of South Florida, Tampa, FL 33612, USA
| | - Nirmal S Sharma
- b Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL 33612, USA
| | - Srinivas M Tipparaju
- a Department of Pharmaceutical Sciences, College of Pharmacy, University of South Florida, Tampa, FL 33612, USA
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24
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Singh K, Chandra M, Kaur G, Narang D, Gupta DK, Arora AK, Sharma NS. Development of a multiplex PCR for identification of mastitis causing organisms. IJDS 2019. [DOI: 10.33785/ijds.2019.v72i02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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25
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Sharma NS, Lal CV, Li JD, Lou XY, Viera L, Abdallah T, King RW, Sethi J, Kanagarajah P, Restrepo-Jaramillo R, Sales-Conniff A, Wei S, Jackson PL, Blalock JE, Gaggar A, Xu X. The neutrophil chemoattractant peptide proline-glycine-proline is associated with acute respiratory distress syndrome. Am J Physiol Lung Cell Mol Physiol 2018; 315:L653-L661. [PMID: 30091378 PMCID: PMC6295514 DOI: 10.1152/ajplung.00308.2017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 07/24/2018] [Accepted: 08/07/2018] [Indexed: 12/26/2022] Open
Abstract
Acute respiratory distress syndrome (ARDS) is characterized by unrelenting polymorphonuclear neutrophil (PMN) inflammation and vascular permeability. The matrikine proline-glycine-proline (PGP) and acetylated PGP (Ac-PGP) have been shown to induce PMN inflammation and endothelial permeability in vitro and in vivo. In this study, we investigated the presence and role of airway PGP peptides in acute lung injury (ALI)/ARDS. Pseudomonas aeruginosa-derived lipopolysaccharide (LPS) was instilled intratracheally in mice to induce ALI, and increased Ac-PGP with neutrophil inflammation was noted. The PGP inhibitory peptide, arginine-threonine-arginine (RTR), was administered (it) 30 min before or 6 h after LPS injection. Lung injury was evaluated by detecting neutrophil infiltration and permeability changes in the lung. Pre- and posttreatment with RTR significantly inhibited LPS-induced ALI by attenuating lung neutrophil infiltration, pulmonary permeability, and parenchymal inflammation. To evaluate the role of PGP levels in ARDS, minibronchoalveolar lavage was collected from nine ARDS, four cardiogenic edema, and five nonlung disease ventilated patients. PGP levels were measured and correlated with Acute Physiology and Chronic Health Evaluation (APACHE) score, P a O 2 to F I O 2 (P/F), and ventilator days. PGP levels in subjects with ARDS were significantly higher than cardiogenic edema and nonlung disease ventilated patients. Preliminary examination in both ARDS and non-ARDS populations demonstrated PGP levels significantly correlated with P/F ratio, APACHE score, and duration on ventilator. These results demonstrate an increased burden of PGP peptides in ARDS and suggest the need for future studies in ARDS cohorts to examine correlation with key clinical parameters.
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Affiliation(s)
- Nirmal S Sharma
- Center for Advanced Lung Disease and Lung Transplantation, University of South Florida/Tampa General Hospital , Tampa, Florida
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham , Birmingham, Alabama
- Program in Protease and Matrix Biology, Department of Medicine, University of Alabama at Birmingham , Birmingham, Alabama
- Division of Pulmonary and Critical Care, University of South Florida , Tampa, Florida
| | - Charitharth Vivek Lal
- Program in Protease and Matrix Biology, Department of Medicine, University of Alabama at Birmingham , Birmingham, Alabama
- Department of Pediatrics, University of Alabama at Birmingham , Birmingham, Alabama
| | - Jin-Dong Li
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham , Birmingham, Alabama
- Program in Protease and Matrix Biology, Department of Medicine, University of Alabama at Birmingham , Birmingham, Alabama
- Medical Service at Birmingham Veterans Affairs Medical Center , Birmingham, Alabama
| | - Xiang-Yang Lou
- Biostatistics Program, Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences , Little Rock, Arkansas
| | - Liliana Viera
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham , Birmingham, Alabama
- Program in Protease and Matrix Biology, Department of Medicine, University of Alabama at Birmingham , Birmingham, Alabama
| | - Tarek Abdallah
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham , Birmingham, Alabama
- Program in Protease and Matrix Biology, Department of Medicine, University of Alabama at Birmingham , Birmingham, Alabama
| | - Robert W King
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham , Birmingham, Alabama
- Program in Protease and Matrix Biology, Department of Medicine, University of Alabama at Birmingham , Birmingham, Alabama
| | - Jaskaran Sethi
- Division of Pulmonary and Critical Care, University of South Florida , Tampa, Florida
| | - Prashanth Kanagarajah
- Division of Pulmonary and Critical Care, University of South Florida , Tampa, Florida
| | | | - Amanda Sales-Conniff
- Division of Pulmonary and Critical Care, University of South Florida , Tampa, Florida
| | - Shi Wei
- Department of Pathology, University of Alabama at Birmingham , Birmingham, Alabama
| | - Patricia L Jackson
- Lung Health Center, University of Alabama at Birmingham , Birmingham, Alabama
| | - J Edwin Blalock
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham , Birmingham, Alabama
- Program in Protease and Matrix Biology, Department of Medicine, University of Alabama at Birmingham , Birmingham, Alabama
- Gregory Fleming James Cystic Fibrosis Research Center, University of Alabama at Birmingham , Birmingham, Alabama
- Lung Health Center, University of Alabama at Birmingham , Birmingham, Alabama
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham , Birmingham, Alabama
| | - Amit Gaggar
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham , Birmingham, Alabama
- Program in Protease and Matrix Biology, Department of Medicine, University of Alabama at Birmingham , Birmingham, Alabama
- Gregory Fleming James Cystic Fibrosis Research Center, University of Alabama at Birmingham , Birmingham, Alabama
- Lung Health Center, University of Alabama at Birmingham , Birmingham, Alabama
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham , Birmingham, Alabama
- Medical Service at Birmingham Veterans Affairs Medical Center , Birmingham, Alabama
| | - Xin Xu
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham , Birmingham, Alabama
- Program in Protease and Matrix Biology, Department of Medicine, University of Alabama at Birmingham , Birmingham, Alabama
- Gregory Fleming James Cystic Fibrosis Research Center, University of Alabama at Birmingham , Birmingham, Alabama
- Lung Health Center, University of Alabama at Birmingham , Birmingham, Alabama
- Medical Service at Birmingham Veterans Affairs Medical Center , Birmingham, Alabama
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26
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Hough KP, Wilson LS, Trevor JL, Strenkowski JG, Maina N, Kim YI, Spell ML, Wang Y, Chanda D, Dager JR, Sharma NS, Curtiss M, Antony VB, Dransfield MT, Chaplin DD, Steele C, Barnes S, Duncan SR, Prasain JK, Thannickal VJ, Deshane JS. Unique Lipid Signatures of Extracellular Vesicles from the Airways of Asthmatics. Sci Rep 2018; 8:10340. [PMID: 29985427 PMCID: PMC6037776 DOI: 10.1038/s41598-018-28655-9] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 06/27/2018] [Indexed: 12/30/2022] Open
Abstract
Asthma is a chronic inflammatory disease process involving the conductive airways of the human lung. The dysregulated inflammatory response in this disease process may involve multiple cell-cell interactions mediated by signaling molecules, including lipid mediators. Extracellular vesicles (EVs) are lipid membrane particles that are now recognized as critical mediators of cell-cell communication. Here, we compared the lipid composition and presence of specific lipid mediators in airway EVs purified from the bronchoalveolar lavage (BAL) fluid of healthy controls and asthmatic subjects with and without second-hand smoke (SHS) exposure. Airway exosome concentrations were increased in asthmatics, and correlated with blood eosinophilia and serum IgE levels. Frequencies of HLA-DR+ and CD54+ exosomes were also significantly higher in asthmatics. Lipidomics analysis revealed that phosphatidylglycerol, ceramide-phosphates, and ceramides were significantly reduced in exosomes from asthmatics compared to the non-exposed control groups. Sphingomyelin 34:1 was more abundant in exosomes of SHS-exposed asthmatics compared to healthy controls. Our results suggest that chronic airway inflammation may be driven by alterations in the composition of lipid mediators within airway EVs of human subjects with asthma.
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Affiliation(s)
- Kenneth P Hough
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Landon S Wilson
- Department of Pharmacology and Toxicology, University of Alabama at Birmingham, Birmingham, AL, USA.,Targeted Metabolomics and Proteomics Laboratory, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jennifer L Trevor
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - John G Strenkowski
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Njeri Maina
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Young-Il Kim
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Marion L Spell
- Center for AIDS Research, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Yong Wang
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Diptiman Chanda
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jose Rodriguez Dager
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Nirmal S Sharma
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Miranda Curtiss
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Veena B Antony
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mark T Dransfield
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - David D Chaplin
- Department of Microbiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Chad Steele
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Stephen Barnes
- Department of Pharmacology and Toxicology, University of Alabama at Birmingham, Birmingham, AL, USA.,Targeted Metabolomics and Proteomics Laboratory, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Steven R Duncan
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jeevan K Prasain
- Department of Pharmacology and Toxicology, University of Alabama at Birmingham, Birmingham, AL, USA.,Targeted Metabolomics and Proteomics Laboratory, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Victor J Thannickal
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jessy S Deshane
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
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27
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Gupta N, Mendiratta G, Singal R, Sharma NS. Plasma Prolactin and Total Lipid Levels and Subsequent Risk of Breast Cancer in Pre- and Postmenopausal Women: Experience from an Indian Rural Centre. Maedica (Bucur) 2017; 12:258-266. [PMID: 29610588 PMCID: PMC5879588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
AIMS AND OBJECTIVES 1) To analyze serum lipid and prolactin levels in breast cancer patients and normal subjects; 2) to correlate those levels with risk and prognostic factors. MATERIAL AND METHODS The present study was performed in the Department of Surgery, MMIMSR, Mullana, Ambala, from 2013 to 2014, at a rural centre. The study group comprised 40 patients with carcinoma of the breast who underwent surgery and the control group included 10 patients who underwent surgery for reasons other than carcinoma of the breast. Apart from routine tests, special investigations like estimation of serum lipids and prolactin levels were carried out in each patient to assess the general health status and detect any potential evidence of distance metastasis. RESULTS Most patients were in the fourth and fifth decade of life. The mean value of serum total cholesterol in the study group (190.77 mg/dL) was higher than that of the control group (166.22 mg/dL), which was statistically significant. The mean value of LDL in the study group was 153.8 mg/dL, as compared to 118.4 mg/dL in the control group; therefore, the difference in LDL cholesterol levels between the two groups was statistically significant. The VLDL level was also higher in breast cancer patients, with a mean value of 35.25 mg/dL, as compared to 22.6 mg/dL in the control group. Serum triglycerides showed higher trends in the study group than in controls. The correlation coefficient of total lipids and prolactin was 0.428, which was significant (p value 0.002), and pointed to a positive relation between prolactin and total lipids, meaning that an elevation in total lipids would lead to an increase in prolactin levels. CONCLUSIONS It was observed that significantly increased prolactin levels were found among patients with breast cancer. Serum lipids in carcinoma of the breast had higher levels of VLDL and LDL cholesterol and elevated triglyceride concentrations. Serum prolactin showed a statistically significant elevation in premenopausal patients as compared to postmenopausal subjects with breast cancer. Prolactin level may be also one of the risk factors for breast cancer, which points to its diagnostic significance.
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Affiliation(s)
- Nidhi Gupta
- Department of Surgery, M.M. Institute of Medical Sciences and Research, Mullana (Distt-Ambala), Haryana, India
| | - Gautam Mendiratta
- Department of Surgery, M.M. Institute of Medical Sciences and Research, Mullana (Distt-Ambala), Haryana, India
| | - Rikki Singal
- Department of Surgery, M.M. Institute of Medical Sciences and Research, Mullana (Distt-Ambala), Haryana, India
| | - N S Sharma
- Department of Surgery, M.M. Institute of Medical Sciences and Research, Mullana (Distt-Ambala), Haryana, India
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Abstract
The use of extracorporeal membrane oxygenation (ECMO) in adults has rapidly increased as the technology has evolved, although there is little definitive evidence that it is beneficial in this group. ECMO is now being used in acute respiratory distress syndrome (and was used extensively for this indication during the influenza H1N1 pandemic), as a bridge to lung or heart transplant, and in postcardiac arrest patients. We review the current evidence and indications for ECMO, focusing on its principles and practical aspects in adult patients with respiratory or cardiac failure.
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Affiliation(s)
- Tejaswini Kulkarni
- Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Nirmal S Sharma
- Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Enrique Diaz-Guzman
- Medical Director, ECMO Program, Cardiothoracic Transplantation, University of Alabama at Birmingham, Birmingham, AL, USA. E-mail: .,Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
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Sharma NS, Wille KM, Athira S, Zhi D, Hough KP, Diaz-Guzman E, Zhang K, Kumar R, Rangarajan S, Eipers P, Wang Y, Srivastava RK, Rodriguez Dager JV, Athar M, Morrow C, Hoopes CW, Chaplin DD, Thannickal VJ, Deshane JS. Distal airway microbiome is associated with immunoregulatory myeloid cell responses in lung transplant recipients. J Heart Lung Transplant 2017; 37:S1053-2498(17)31898-3. [PMID: 28756121 PMCID: PMC5893420 DOI: 10.1016/j.healun.2017.07.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 07/10/2017] [Accepted: 07/11/2017] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND Long-term survival of lung transplant recipients (LTRs) is limited by the occurrence of bronchiolitis obliterans syndrome (BOS). Recent evidence suggests a role for microbiome alterations in the occurrence of BOS, although the precise mechanisms are unclear. In this study we evaluated the relationship between the airway microbiome and distinct subsets of immunoregulatory myeloid-derived suppressor cells (MDSCs) in LTRs. METHODS Bronchoalveolar lavage (BAL) and simultaneous oral wash and nasal swab samples were collected from adult LTRs. Microbial genomic DNA was isolated, 16S rRNA genes amplified using V4 primers, and polymerase chain reaction (PCR) products sequenced and analyzed. BAL MDSC subsets were enumerated using flow cytometry. RESULTS The oral microbiome signature differs from that of the nasal, proximal and distal airway microbiomes, whereas the nasal microbiome is closer to the airway microbiome. Proximal and distal airway microbiome signatures of individual subjects are distinct. We identified phenotypic subsets of MDSCs in BAL, with a higher proportion of immunosuppressive MDSCs in the proximal airways, in contrast to a preponderance of pro-inflammatory MDSCs in distal airways. Relative abundance of distinct bacterial phyla in proximal and distal airways correlated with particular airway MDSCs. Expression of CCAAT/enhancer binding protein (C/EBP)-homologous protein (CHOP), an endoplasmic (ER) stress sensor, was increased in immunosuppressive MDSCs when compared with pro-inflammatory MDSCs. CONCLUSIONS The nasal microbiome closely resembles the microbiome of the proximal and distal airways in LTRs. The association of distinct microbial communities with airway MDSCs suggests a functional relationship between the local microbiome and MDSC phenotype, which may contribute to the pathogenesis of BOS.
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Affiliation(s)
- Nirmal S Sharma
- Division of Pulmonary Allergy & Critical Care Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Keith M Wille
- Division of Pulmonary Allergy & Critical Care Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - S Athira
- Cognub Decision Solutions, Kerala, India
| | - Degui Zhi
- Division of Biostatistics, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Kenneth P Hough
- Division of Pulmonary Allergy & Critical Care Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Enrique Diaz-Guzman
- Division of Pulmonary Allergy & Critical Care Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Kui Zhang
- Division of Biostatistics, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Ranjit Kumar
- Division of Biomedical Informatics, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Sunad Rangarajan
- Division of Pulmonary Allergy & Critical Care Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Peter Eipers
- Division of Cell Developmental and Integrative Biology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Yong Wang
- Division of Pulmonary Allergy & Critical Care Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Ritesh K Srivastava
- Division of Dermatology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Jose Vicente Rodriguez Dager
- Division of Pulmonary Allergy & Critical Care Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Mohammad Athar
- Division of Dermatology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Casey Morrow
- Division of Cell Developmental and Integrative Biology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Charles W Hoopes
- Division of Surgery, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - David D Chaplin
- Division of Dermatology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Victor J Thannickal
- Division of Pulmonary Allergy & Critical Care Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Jessy S Deshane
- Division of Pulmonary Allergy & Critical Care Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
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Abstract
Evolution in technology has resulted in rapid increase in utilization of extracorporeal membrane oxygenation (ECMO) as a bridge to recovery and/or transplantation. Although there is limited evidence for the use of ECMO, recent improvements in ECMO technology, personnel training, ambulatory practices on ECMO and lung protective strategies have resulted in improved outcomes in patients bridged to lung transplantation. This review provides an insight into the current outcomes and best practices for utilization of ECMO in the pre- and post-lung transplantation period.
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Affiliation(s)
- Nirmal S Sharma
- Division of Pulmonary, Allergy & Critical Care Medicine, University of Alabama at Birmingham, Birmingham AL, USA
| | - Mathew G Hartwig
- Division of Cardiovascular and Thoracic Surgery, Duke University, Durham, NC, USA
| | - Don Hayes
- Departments of Pediatrics, Internal Medicine, and Surgery, The Ohio State University, OH, USA
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Chanda D, Kurundkar A, Rangarajan S, Locy M, Bernard K, Sharma NS, Logsdon NJ, Liu H, Crossman DK, Horowitz JC, De Langhe S, Thannickal VJ. Developmental Reprogramming in Mesenchymal Stromal Cells of Human Subjects with Idiopathic Pulmonary Fibrosis. Sci Rep 2016; 6:37445. [PMID: 27869174 PMCID: PMC5116673 DOI: 10.1038/srep37445] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 10/24/2016] [Indexed: 12/31/2022] Open
Abstract
Cellular plasticity and de-differentiation are hallmarks of tissue/organ regenerative capacity in diverse species. Despite a more restricted capacity for regeneration, humans with age-related chronic diseases, such as cancer and fibrosis, show evidence of a recapitulation of developmental gene programs. We have previously identified a resident population of mesenchymal stromal cells (MSCs) in the terminal airways-alveoli by bronchoalveolar lavage (BAL) of human adult lungs. In this study, we characterized MSCs from BAL of patients with stable and progressive idiopathic pulmonary fibrosis (IPF), defined as <5% and ≥10% decline, respectively, in forced vital capacity over the preceding 6-month period. Gene expression profiles of MSCs from IPF subjects with progressive disease were enriched for genes regulating lung development. Most notably, genes regulating early tissue patterning and branching morphogenesis were differentially regulated. Network interactive modeling of a set of these genes indicated central roles for TGF-β and SHH signaling. Importantly, fibroblast growth factor-10 (FGF-10) was markedly suppressed in IPF subjects with progressive disease, and both TGF-β1 and SHH signaling were identified as critical mediators of this effect in MSCs. These findings support the concept of developmental gene re-activation in IPF, and FGF-10 deficiency as a potentially critical factor in disease progression.
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Affiliation(s)
- Diptiman Chanda
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Ashish Kurundkar
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Sunad Rangarajan
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Morgan Locy
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Karen Bernard
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Nirmal S Sharma
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Naomi J Logsdon
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Hui Liu
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - David K Crossman
- Heflin Center for Genomic Science, Department of Genetics, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Jeffrey C Horowitz
- Division of Pulmonary and Critical Care Medicine Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | - Stijn De Langhe
- Department of Pediatrics, Division of Cell Biology, National Jewish Health, Denver, CO 80206, USA
| | - Victor J Thannickal
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA
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Diaz-Guzman E, Sharma NS, Wille K, Hoopes CW. Use of a novel pulmonary artery cannula to provide extracorporeal membrane oxygenation as a bridge to lung transplantation. J Heart Lung Transplant 2016; 35:1051-3. [PMID: 27377218 DOI: 10.1016/j.healun.2016.05.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 05/10/2016] [Accepted: 05/18/2016] [Indexed: 10/21/2022] Open
Affiliation(s)
| | | | | | - Charles W Hoopes
- Division of Pulmonary, Allergy & Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Alabama
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Rasool S, Narang D, Chandra M, Sharma NS, Tejinder Singh S. Detection of Mycobacterium avium subsp. paratuberculosis in bovine faecal samples by Quantitative Real-Time Polymerase Chain Reaction (qRT-PCR) TaqMan Assay. Trop Biomed 2016; 33:327-334. [PMID: 33579100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Mycobacterium avium subsp. paratuberculosis, the causative agent of Johne's disease is a degenerative chronic granulomatous disease of bovines. In the present study, quantitative real time polymerase chain reaction (qRT-PCR) using TaqMan chemistry targeting the IS900 sequence of Mycobacterium avium subsp. paratuberculosis (MAP) was employed for the molecular diagnosis of the disease in bovine faecal samples. Out of 200 bovine faecal samples processed, 7 samples were tested as positive by IS900 qRT-PCR. The sensitivity limit of detection of MAP DNA in faecal samples by qRT-PCR TaqMan assay was found to be 0.05pg. No amplification was observed in other Mycobacterial spp. viz. M. phlei, M. smegmatis, M. intracellulare and M. kansasii.
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Affiliation(s)
- S Rasool
- Department of Veterinary Microbiology
| | - D Narang
- Department of Veterinary Microbiology
| | - M Chandra
- Department of Veterinary Microbiology
| | | | - S Tejinder Singh
- Department of Animal Genetics and Breeding, COVS, GADVASU, Ludhiana
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Sharma NS, Peters T, Kulkarni T, Hoopes CW, Bellot SC, Wille KM, Diaz-Guzman E. Flexible Bronchoscopy Is Safe and Effective in Adult Subjects Supported With Extracorporeal Membrane Oxygenation. Respir Care 2016; 61:646-51. [PMID: 26814220 DOI: 10.4187/respcare.04456] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Previous studies have demonstrated the safety of flexible bronchoscopy (FB) in mechanically ventilated subjects. However, the safety of FB in adult subjects receiving extracorporeal membrane oxygenation (ECMO) has not been described previously. METHODS A retrospective review was conducted of all adult subjects who underwent FB while receiving ECMO support at the University of Alabama at Birmingham Hospital from January 1, 2013, to December 31, 2014. Physiologic variables, pre- and post-FB ECMO, and ventilator settings were recorded. RESULTS 79 adult subjects underwent FB receiving ECMO with a total of 223 bronchoscopies. The most common indications for bronchoscopy included diagnostic evaluation of infection in subjects with pneumonia (29%) and clearance of excessive secretions (22%). In 70% of subjects, moderate or greater amounts of secretions were noted. FB yielded positive culture data in 37 subjects (47%), which resulted in a change to the antibiotic regimen in 14 subjects (38%) with positive culture data. No significant differences in mean PaO2 /FIO2 , mean ECMO flow, mean sweep gas, ventilator settings, or hemodynamic parameters (heart rate, oxygen saturation, and mean blood pressure) were noted before and after FB. Complications were mild and transient: blood-tinged secretions after FB in 21% cases, which resolved spontaneously, intraprocedural hypoxemia in 2.2% of cases, and dysrhythmia in <1% of cases. There were no episodes of ECMO cannula dislodgement or inadvertent extubation. CONCLUSIONS FB can be used safely in adult subjects supported with ECMO and is not associated with significant hemodynamics changes, bleeding, or mechanical complications during ECMO support.
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Affiliation(s)
| | | | | | - Charles W Hoopes
- Division of Cardiothoracic Surgery, University of Alabama at Birmingham, Birmingham, Alabama
| | - Scott C Bellot
- Division of Cardiothoracic Surgery, University of Alabama at Birmingham, Birmingham, Alabama
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Teerapuncharoen K, Sharma NS, Barker AB, Wille KM, Diaz-Guzman E. Successful Treatment of Severe Carbon Monoxide Poisoning and Refractory Shock Using Extracorporeal Membrane Oxygenation. Respir Care 2015; 60:e155-60. [PMID: 25922545 DOI: 10.4187/respcare.03990] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Carbon monoxide (CO) is the most common cause of poisoning and poisoning-related death in the United States. It is a tasteless and odorless poisonous gas produced from incomplete combustion of hydrocarbons, such as those produced by cars and heating systems. CO rapidly binds to hemoglobin to form carboxyhemoglobin, leading to tissue hypoxia, multiple-organ failure, and cardiovascular collapse. CO also binds to myocardial myoglobin, preventing oxidative phosphorylation in cardiac mitochondria and resulting in cardiac ischemia or stunning and cardiogenic pulmonary edema. Treatment of CO poisoning is mainly supportive, and supplemental oxygen remains the cornerstone of therapy, whereas hyperbaric oxygen therapy is considered for patients with evidence of neurological and myocardial injury. Extracorporeal membrane oxygenation (ECMO) has been utilized effectively in patients with respiratory failure and hemodynamic instability, but its use has rarely been reported in patients with CO poisoning. We report the successful use of venoarterial ECMO in a patient with severe CO poisoning and multiple-organ failure.
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Affiliation(s)
| | - Nirmal S Sharma
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine
| | - Andrew B Barker
- Division of Critical Care and Perioperative Medicine, Department of Anesthesiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Keith M Wille
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine
| | - Enrique Diaz-Guzman
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine
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Kaur G, Chandra M, Dwivedi PN, Sharma NS. Isolation of Canine parvovirus with a view to identify the prevalent serotype on the basis of partial sequence analysis. Vet World 2015; 8:52-6. [PMID: 27046996 PMCID: PMC4777811 DOI: 10.14202/vetworld.2015.52-56] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Revised: 12/09/2014] [Accepted: 12/14/2014] [Indexed: 11/16/2022] Open
Abstract
Aim: The aim of this study was to isolate Canine parvovirus (CPV) from suspected dogs on madin darby canine kidney (MDCK) cell line and its confirmation by polymerase chain reaction (PCR) and nested PCR (NPCR). Further, VP2 gene of the CPV isolates was amplified and sequenced to determine prevailing antigenic type. Materials and Methods: A total of 60 rectal swabs were collected from dogs showing signs of gastroenteritis, processed and subjected to isolation in MDCK cell line. The samples showing cytopathic effects (CPE) were confirmed by PCR and NPCR. These samples were subjected to PCR for amplification of VP2 gene of CPV, sequenced and analyzed to study the prevailing antigenic types of CPV. Results: Out of the 60 samples subjected to isolation in MDCK cell line five samples showed CPE in the form of rounding of cells, clumping of cells and finally detachment of the cells. When these samples and the two commercially available vaccines were subjected to PCR for amplification of VP2 gene, a 1710 bp product was amplified. The sequence analysis revealed that the vaccines belonged to the CPV-2 type and the samples were of CPV-2b type. Conclusion: It can be concluded from the present study that out of a total of 60 samples 5 samples exhibited CPE as observed in MDCK cell line. Sequence analysis of the VP2 gene among the samples and vaccine strains revealed that samples belonged to CPV-2b type and vaccines belonging to CPV-2.
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Affiliation(s)
- Gurpreet Kaur
- Department of Veterinary Microbiology, College of Veterinary Science, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab, India
| | - Mudit Chandra
- Department of Veterinary Microbiology, College of Veterinary Science, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab, India
| | - P N Dwivedi
- Department of Veterinary Microbiology, College of Veterinary Science, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab, India
| | - N S Sharma
- Department of Veterinary Microbiology, College of Veterinary Science, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab, India
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Kaur G, Chandra M, Dwivedi PN, Sharma NS. Antigenic typing of canine parvovirus using differential PCR. Virusdisease 2014; 25:481-7. [PMID: 25674626 DOI: 10.1007/s13337-014-0232-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Accepted: 10/08/2014] [Indexed: 10/24/2022] Open
Abstract
Canine parvovirus (CPV) is an enteric pathogen causing hemorrhagic enteritis in pups of 3-6 months of age and is mainly transmitted via feco-oral route. In the present study, a total of 85 animals rectal swabs suspected of CPV were tested using a PCR, nested PCR and a newly designed differential PCR. Using PCR 7 (8.23 %) animals were positive whereas 39 (45.88 %) were positive by using nested PCR and 40 (47.05 %) were positive for either one or more than one antigenic types of CPV using differential PCR. Using differential PCR it was found that CPV-2a and CPV-2b were the most prevailing antigenic types. Also it was found that dogs that were vaccinated too yielded positive CPV indicating a possible presence of additional CPV antigenic types. Thus, the primers used in differential PCR can be used in a single PCR reaction to detect various antigenic types of CPV.
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Affiliation(s)
- Gurpreet Kaur
- Department of Veterinary Microbiology, College of Veterinary Science, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, 141004 Punjab India
| | - Mudit Chandra
- Department of Veterinary Microbiology, College of Veterinary Science, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, 141004 Punjab India
| | - P N Dwivedi
- Department of Veterinary Microbiology, College of Veterinary Science, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, 141004 Punjab India
| | - N S Sharma
- Department of Veterinary Microbiology, College of Veterinary Science, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, 141004 Punjab India
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Sharma NS, Ooi JL, Figueira EC, Rosenberg ML, Masselos K, Papalkar DP, Paramanathan N, Francis IC, Alexander SL, Ferch NI. Patient perceptions of second eye clear corneal cataract surgery using assisted topical anaesthesia. Eye (Lond) 2007; 22:547-50. [PMID: 17259915 DOI: 10.1038/sj.eye.6702711] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
AIM To assess patient recall of intraoperative pain, anxiety, fear, and sensory (visual and auditory) perceptions during second eye clear corneal cataract surgery using assisted topical anaesthesia (ATA), in comparison with first eye cataract surgery using the same technique. METHODS This prospective, consecutive, observational study was conducted in a free-standing dedicated ophthalmic day surgery centre. A voluntary questionnaire was distributed to 129 consecutive patients who underwent clear corneal cataract surgery using ATA. Two patients had to be converted to block anaesthesia, and were excluded. Patients were asked to rate intraoperative pain, anxiety, and fear using a visual analogue scale (VAS), and recollection of intraoperative visual and auditory perceptions. Results were analysed using the Mann-Whitney U and Spearman correlation tests. RESULTS There were 70/127 (55%) patients undergoing first eye cataract surgery and 57/127 (45%) undergoing second eye surgery. There was no significant difference in mean pain, anxiety, and fear scores between those undergoing the second eye operation compared with those undergoing their first eye operation. Similarly, there was no significant difference in sensory perceptions between the two cohorts. Overall, there was a small but significant positive correlation between recall of visual and auditory perceptions and combined pain, fear, and anxiety scores (r=0.33, P=0.0002). CONCLUSION There was no significant difference in levels of intraoperative pain, anxiety, fear, and sensory perceptions experienced by patients between the first eye and second eye surgeries. We recommend that preoperative counselling for a patient's second eye be as comprehensive as for the first eye surgery.
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Affiliation(s)
- N S Sharma
- Department of Ophthalmology, Prince of Wales Hospital, Randwick, Sydney, Australia
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Sharma NS, Shikhanovich R, Schloss R, Yarmush ML. Sodium butyrate-treated embryonic stem cells yield hepatocyte-like cells expressing a glycolytic phenotype. Biotechnol Bioeng 2006; 94:1053-63. [PMID: 16604521 DOI: 10.1002/bit.20936] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Embryonic stem cells serve as a promising technology to obtain specific cell types for a number of biomedical applications. Because traditional techniques, such as embryoid body formation result in a wide array of differentiated cells such as hepatic, neuronal, and cardiac lineages, strategies have been utilized which favor cell-specific differentiation to generate more uniformity. In the present study, we have investigated the use of sodium butyrate in a monolayer culture configuration to mediate hepatocyte differentiation of murine embryonic stem cells. Several functional assays used to characterize hepatocyte function (viz. urea secretion, intracellular albumin content, cytokeratin 18, and glycogen staining) were used to analyze the differentiating cell population, suggesting the presence of an enriched population of hepatocyte-like cells. Since mature hepatocytes mediate energy metabolism predominantly through oxidative means as opposed to hepatocyte precursors, which are primarily glycolytic, we have performed a kinetic analysis of glycolytic and functional capacity to characterize the differentiated cells. In conjunction with mitochondrial mass and activity measurements, we show that Na-butyrate-mediated differentiated cells mediate energy metabolism predominantly through glycolysis. This metabolic and mitochondrial characterization can assist in evaluating stem cell differentiation and may prove useful in identifying key regulatory molecules in mediating further differentiation.
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Affiliation(s)
- N S Sharma
- Department of Chemical & Biochemical Engineering, Rutgers University, 98 Brett Road, Piscataway, New Jersey 08854, USA
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Sharma NS, Ierapetritou MG, Yarmush ML. Novel quantitative tools for engineering analysis of hepatocyte cultures in bioartificial liver systems. Biotechnol Bioeng 2005; 92:321-35. [PMID: 16180239 DOI: 10.1002/bit.20586] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Extracorporeal bioartificial liver devices (BAL) are perhaps among the most promising technologies for the treatment of liver failure, but significant technical challenges remain in order to develop systems with sufficient processing capacity and of manageable size. One key limitation is that during BAL operation, when the device is exposed to plasma from the patient, hepatocytes are prone to accumulate intracellular lipids and exhibit poor liver-specific functions. Based on hepatic intermediary metabolism, we have utilized mathematical programming techniques to optimize the biochemical environment of hepatocyte cultures towards the desired effect of increased albumin and urea synthesis. To investigate the feasible range of optimal hepatic function, we have obtained a Pareto optimal set of solutions corresponding to liver-specific functions of urea and albumin secretion in the metabolic framework using multiobjective optimization. The importance of amino acids in the supplementation and the criticality of the metabolic pathways have been investigated using logic-based programming techniques. Since the metabolite measurements are bound to be patient specific, and hence subject to variability, uncertainty has to be integrated with system analysis to improve the prediction of hepatic function. We have used the concept of two stage stochastic programming to obtain robust solutions by considering extracellular variability. The proposed analysis represents a new systematic approach to analyze behavior of hepatocyte cultures and optimize different operating parameters for an extracorporeal device based on real-time conditions.
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Affiliation(s)
- N S Sharma
- Department of Chemical & Biochemical Engineering, Rutgers University, 98 Brett Road, Piscataway, New Jersey 08854, USA
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