A5072351295- Transplantation: Methods and Outcomes
- Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis
- Renal Transplantation Outcomes and Treatments
- Mechanical Circulatory Support Devices
- Organ Transplantation Techniques and Outcomes
- Pneumocystis jirovecii pneumonia detection and treatment
- Polyomavirus and related diseases
- Respiratory viral infections research
- Nutrition and Health in Aging
- Tracheal and airway disorders
- Mycobacterium research and diagnosis
- Frailty in Older Adults
- Alcohol Consumption and Health Effects
- Family and Patient Care in Intensive Care Units
- Medical Imaging and Pathology Studies
- Organ and Tissue Transplantation Research
- Inflammatory Myopathies and Dermatomyositis
- Influenza Virus Research Studies
- Fungal Infections and Studies
- Cell Adhesion Molecules Research
- Neutrophil, Myeloperoxidase and Oxidative Mechanisms
- Intensive Care Unit Cognitive Disorders
- Chronic Obstructive Pulmonary Disease (COPD) Research
- Systemic Sclerosis and Related Diseases
- Heart Failure Treatment and Management
University of California, San Francisco
2016-2024
University of California System
2016-2022
University of California San Francisco Medical Center
2021
Advanced ENT and Allergy
2021
University of Alabama at Birmingham
2013-2016
Emory University
2011-2013
Universidad Nacional Autónoma de México
2009
Abstract Matrix stiffening is a prominent feature of pulmonary fibrosis. In this study, we demonstrate that matrix stiffness regulates the ability fibrotic lung myofibroblasts to invade basement membrane (BM). We identify α 6 -integrin as mechanosensing integrin subunit mediates stiffness-regulated myofibroblast invasion. Increasing -expression, specifically B isoform (α B), couples β 1 mediate MMP-2-dependent pericellular proteolysis BM collagen IV, leading Human idiopathic fibrosis express...
Frailty is associated with increased mortality among lung transplant candidates. We sought to determine the association between frailty, as measured by Short Physical Performance Battery (SPPB), and after transplantation. In a multicenter prospective cohort study of adults who underwent transplantation, preoperative frailty was assessed SPPB (n = 318) and, in secondary analysis, Fried Phenotype (FFP; n 299). tested following transplantation propensity score-adjusted Cox models. calculated...
The immune system is designed to robustly respond pathogenic stimuli but be tolerant endogenous ligands not trigger autoimmunity. Here, we studied an damage-associated molecular pattern, mitochondrial DNA (mtDNA), during primary graft dysfunction (PGD) after lung transplantation. We hypothesized that cell-free mtDNA released ischemia–reperfusion triggers neutrophil extracellular trap (NET) formation via TLR9 signaling. found increases in the BAL fluid of experimental PGD (prolonged cold...
The extracellular matrix (ECM) provides structural support and imparts a wide variety of environmental cues to cells. In the past decade, growing body work revealed that mechanical properties ECM, commonly known as stiffness, regulate fundamental cellular processes lung. There is appreciation interplays between cells associated ECM are essential maintain lung homeostasis. Dysregulation ECM-derived signaling via altered mechanosensing mechanotransduction pathways with many common diseases....
Acute lung allograft dysfunction (ALAD) is an imprecise syndrome denoting concern for the onset of chronic (CLAD). Mechanistic biomarkers are needed that stratify risk ALAD progression to CLAD. We hypothesized single cell investigation bronchoalveolar lavage (BAL) cells at time would identify immune linked progressive graft dysfunction.
Lung transplantation and related medications are associated with pathobiological changes that can induce frailty, a state of decreased physiological reserve. Causes persistent or emergent frailty after lung transplantation, whether such transplant-related is key outcomes, unknown.Frailty health-related quality life (HRQL) were prospectively measured repeatedly for up to 3 years transplantation. Frailty, quantified by the Short Physical Performance Battery (SPPB), was tested as time-dependent...
Preoperative Mycobacterium abscessus infection is often considered a contraindication to lung transplantation because of its association with poor outcomes after transplant. Detailed strategies for bridging transplant, post-operative management, and data regarding are lacking.We reviewed in subjects M who underwent between 2010 2018 at the University California San Francisco. was defined by American Thoracic Society (ATS) criteria. Data collected included age, FEV1 , BMI, LAS, antibiotic...
After lung transplantation, both frailty and chronic allograft dysfunction (CLAD) commonly develop, when they do, are associated with poorer outcomes. Given their potential shared mechanisms, we sought to explore the temporal relationship between CLAD onset.
Heterogeneous frailty pathobiology might explain the inconsistent associations observed between and lung transplant outcomes. A Subphenotype analysis could refine measurement. In a 3-center pilot cohort study, we measured by Short Physical Performance Battery, body composition, serum biomarkers reflecting causes of frailty. We applied latent class modeling for these baseline data. Next, tested construct validity with disability, waitlist delisting/death, early postoperative complications....
Rationale: Sarcopenia is associated with disability and death. The optimal definition clinical relevance of sarcopenia in lung transplantation remain unknown. Objectives: To assess the construct predictive validity definitions transplant candidates. Methods: In a multicenter prospective cohort 424 candidates, we evaluated limited (muscle mass only) expanded quality) from European Working Group on Older People 2 (EWGSOP2), Foundation for National Institutes Health (FNIH), cohort-specific...
Clinical outcomes after lung transplantation, a life-saving therapy for patients with end-stage diseases, are limited by primary graft dysfunction (PGD). PGD is an early form of acute injury no specific pharmacologic therapies. Here, we present large multicenter study plasma and bronchoalveolar lavage (BAL) samples collected on the first posttransplant day, critical time investigations immune pathways related to PGD. We demonstrated that ligands NKG2D receptors were increased in BAL from...
Abstract Background Chronic alcohol abuse causes oxidative stress and impairs alveolar epithelial barrier integrity, thereby rendering the lung susceptible to acute edematous injury. Experimentally, alcohol-induced increases expression of transforming growth factor β1 (TGFβ1) in lung; however, we do not know precise contribution various cells this process. In present study, focused on cell-cell interactions between macrophages potential mechanisms by which TGFβ1 may become activated space...
While lung transplantation (LTx) improves health-related quality of life (HRQL) in cystic fibrosis (CF), the determinants this improvement are unknown. In other populations, frailty-a syndrome vulnerability to physiologic stressors-is associated with disability and poor HRQL. We hypothesized that improvements frailty would be improved HRQL adults CF undergoing LTx.In a single-center prospective cohort study from 2010 2017, assessments frailty, disability, were performed before at 3- 6-months...
Objective Most studies observing an association between depressive symptoms following lung transplantation and mortality are limited to symptom measurement at a single time point, unrelated allograft function. We aimed test the of over multiple assessments with dysfunction mortality. Methods assessed before serially up 3 years after in transplant recipients. quantified Geriatric Depression Scale (GDS; range 0–15; minimally important difference (MID): 2). changes GDS using linear mixed...
Primary graft dysfunction (PGD) limits clinical benefit after lung transplantation, a life-prolonging therapy for patients with end-stage disease. PGD is the syndrome resulting from pulmonary ischemia-reperfusion injury (IRI), driven by innate immune inflammation. We recently demonstrated key role NK cells in airways of mouse models and human tissue samples IRI. Here we used 2 paired transplant to investigate mechanisms whereby migrate mediate injury. demonstrate that chemokine receptor...
Hemolysis is a common complication of extracorporeal membrane oxygenation (ECMO) support and associated with increased mortality. Frequent monitoring markers hemolysis performed at ECMO centers. We report two cases spurious caused by hypertriglyceridemia in patients undergoing support. Critically ill patients, including those receiving ECMO, may be risk developing medication-induced hypertriglyceridemia. The interference lipids the measurement plasma free hemoglobin, marker hemolysis, should...