A5010336957- Transplantation: Methods and Outcomes
- Immune Cell Function and Interaction
- Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis
- Renal Transplantation Outcomes and Treatments
- Mechanical Circulatory Support Devices
- Polyomavirus and related diseases
- Tracheal and airway disorders
- Respiratory viral infections research
- Organ Transplantation Techniques and Outcomes
- Nutrition and Health in Aging
- Cytomegalovirus and herpesvirus research
- Complement system in diseases
- Pneumocystis jirovecii pneumonia detection and treatment
- Medical Imaging and Pathology Studies
- Hematopoietic Stem Cell Transplantation
- T-cell and B-cell Immunology
- Intensive Care Unit Cognitive Disorders
- Bone health and treatments
- Systemic Sclerosis and Related Diseases
- Family and Patient Care in Intensive Care Units
- Eosinophilic Esophagitis
- Respiratory Support and Mechanisms
- Frailty in Older Adults
- Inhalation and Respiratory Drug Delivery
- Cystic Fibrosis Research Advances
University of California, San Francisco
2016-2025
San Francisco VA Health Care System
2021-2025
Mill Valley Public Library
2024
San Francisco VA Medical Center
2019-2024
City College of San Francisco
2024
Pulmonary Associates
2024
University of California System
2022-2023
International Society for Heart and Lung Transplantation
2023
Advanced Circulatory System (United States)
2023
Veterans Health Administration
2021-2022
(Abridged) We describe here the most ambitious survey currently planned in optical, Large Synoptic Survey Telescope (LSST). A vast array of science will be enabled by a single wide-deep-fast sky survey, and LSST have unique capability faint time domain. The design is driven four main themes: probing dark energy matter, taking an inventory Solar System, exploring transient optical sky, mapping Milky Way. wide-field ground-based system sited at Cerro Pach\'{o}n northern Chile. telescope 8.4 m...
Platelets have a wide range of functions including critical roles in hemostasis, thrombosis, and immunity. We hypothesized that during acute inflammation, such as life-threatening sepsis, there are fundamental changes the sites platelet production phenotypes resultant platelets. Here, we showed sepsis spleen was major site megakaryopoiesis production. Sepsis provoked an adrenergic-dependent mobilization megakaryocyte-erythrocyte progenitors (MEPs) from bone marrow to spleen, where IL-3...
Human adaptive-like natural killer (NK) cells express low levels of FcεRIγ (FcRγ−/low) and are reported to accumulate during COVID-19 infection; however, the mechanism underlying regulating FcRγ expression in NK has yet be fully defined. We observed lower protein cell subsets from lung transplant patients rapamycin treatment, suggesting a link with reduced mTOR activity. Further, FcRγ−/low healthy donors displayed discovered that upregulation is dependent on proliferation progression...
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.
Antibodies targeting human leukocyte antigen (HLA)/major histocompatibility complex (MHC) proteins limit successful transplantation and transfusion, their presence in blood products can cause lethal transfusion-related acute lung injury (TRALI). It is unclear which cell types are bound by these anti-leukocyte antibodies to initiate an immunologic cascade resulting injury. We therefore conditionally removed MHC class I (MHC I) from likely cellular targets antibody-mediated Only the removal of...
Pulmonary ischemia-reperfusion injury (IRI) is a clinical syndrome of acute lung that occurs after transplantation or remote organ ischemia. IRI causes early mortality and has no effective therapies. While NK cells are innate lymphocytes capable recognizing injured cells, their roles in incompletely understood. Here, we demonstrated were increased frequency cytotoxicity 2 different mouse models. We showed trafficked to the tissue from peripheral reservoirs more mature within tissue. Acute...
Coronary artery disease (CAD) is linked to atherosclerosis plaque formation. In pro-inflammatory conditions, human Natural Killer (NK) cell frequencies in blood or decrease; however, NK cells are underexplored CAD pathogenesis, inflammatory mechanisms, and comorbidities, such as cytomegalovirus (HCMV) infection diabetes. Analysis of PBMC CITE-seq data from sixty-one patients revealed higher SPON2 expression with stenosis severity. Conversely, was lower tissue an enriched adaptive gene...
Cytomegalovirus (CMV) infection threatens outcomes across solid organ transplantation, but organ-specific differences in CMV immunity are incompletely understood. We investigated whether lung and kidney drove similar immune profiles, hypothesizing that CMV-associated T cells would be associated with graft function. longitudinally examined 41 transplant (LTx) recipients 31 (KTx) viremia, alongside non-viremic controls. performed flow cytometry single-cell protein transcriptomic profiling...
Cytomegalovirus (CMV) infection is a risk factor for chronic lung allograft dysfunction (CLAD), which limits survival in recipients. Natural killer (NK) cells that express the NKG2C receptor mediate CMV-specific immune responses. We hypothesized NK responding to CMV would reduce CMV-related inflammation and improve CLAD-free survival.We prospectively followed 130 subjects who underwent transplantation from 2012 2016. Bronchoalveolar lavage (BAL) were immunophenotyped NKG2C, maturation,...
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...
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.
Rationale: The Lung Allocation Score (LAS) was revised in 2015 to improve waiting list mortality and rate of transplant for patients with pulmonary arterial hypertension (PAH). Objectives: We sought determine if the revision achieved its intended goals. Methods: Using Standard Transplant Analysis Research file, we assessed impact LAS by comparing pre- post-revision eras. Registrants were divided into diagnostic categories: Group A-Chronic Obstructive Pulmonary Disease; B-Pulmonary Arterial...
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...
Chronic lung allograft dysfunction (CLAD) is linked to rejection and limits survival following transplantation. HLA-Bw4 recipients of HLA-Bw6 grafts have enhanced host-versus-graft (HVG) natural killer (NK) cell activity mediated by immunoglobulin-like receptor (KIR)3DL1 ligand. Because NK cells may promote tolerance depleting antigen-presenting cells, we hypothesized improved outcomes for grafts. We evaluated differences in acute cellular CLAD-free across 252 KIR3DL1+ from University...
BACKGROUNDInnate immune activation impacts lung transplant outcomes. Dectin-1 is an innate receptor important for pathogen recognition. We hypothesized that genotypes reducing dectin-1 activity would be associated with infection, graft dysfunction, and death in recipients.METHODSWe assessed the rs16910526 CLEC7A gene polymorphism Y238X, which results truncation, 321 allograft recipients at a single institution 1,129 multicenter Lung Transplant Outcomes Group (LTOG) cohort. Differences mRNA,...
Most lung transplantation immunosuppression regimens include tacrolimus. Single nucleotide polymorphisms (SNPs) in genes important to tacrolimus bioavailability and clearance (ABCB1, CYP3A4, CYP3A5) are associated with differences pharmacokinetics. We hypothesized that these would impact immunosuppression-related outcomes. categorized ABCB1, CYP3A5 SNPs for 321 allograft recipients. Genotype effects on time therapeutic level, interactions antifungal medications, concentration dose (C0 /D),...