A5056837789- Renal Transplantation Outcomes and Treatments
- Organ Transplantation Techniques and Outcomes
- Polyomavirus and related diseases
- Cytomegalovirus and herpesvirus research
- HIV/AIDS drug development and treatment
- T-cell and B-cell Immunology
- Organ and Tissue Transplantation Research
- SARS-CoV-2 and COVID-19 Research
- COVID-19 Clinical Research Studies
- Organ Donation and Transplantation
- Renal Diseases and Glomerulopathies
- Immune Cell Function and Interaction
- Renal and Vascular Pathologies
- Long-Term Effects of COVID-19
- Hematopoietic Stem Cell Transplantation
- Multiple Myeloma Research and Treatments
- Pregnancy and Medication Impact
- COVID-19 Impact on Reproduction
- Systemic Lupus Erythematosus Research
- Complement system in diseases
- Full-Duplex Wireless Communications
- Chronic Myeloid Leukemia Treatments
- Protein Kinase Regulation and GTPase Signaling
- Dialysis and Renal Disease Management
- Neurological Complications and Syndromes
Cedars-Sinai Medical Center
2005-2025
University of California, San Francisco
2014-2024
Immune Tolerance Network
2021-2024
University of California San Francisco Medical Center
2015-2020
Amala Institute of Medical Sciences
2017
The Wright Center for Graduate Medical Education
2014
Development Fund
2013
Stanford University
2008-2011
Early subclinical inflammation in kidney transplants is associated with later graft fibrosis and dysfunction. Regulatory T cells (Tregs) can reverse established animal models. We conducted a pilot safety feasibility trial of autologous Treg cell therapy three transplant recipients noted on 6-month surveillance biopsies. Tregs were purified from peripheral blood polyclonally expanded ex vivo using medium containing deuterated glucose to label the cells. All patients received single infusion...
Human bone marrow (BM) plasma cells are heterogeneous, ranging from newly arrived antibody-secreting (ASCs) to long-lived (LLPCs). We provide single-cell transcriptional resolution of 17,347 BM ASCs five healthy adults. Fifteen clusters identified minted (cluster 1) expressing MKI67 and high major histocompatibility complex (MHC) class II that progress late 5–8 through intermediate 2–4. Additional ASC include the following: immunoglobulin (Ig) M predominant (likely extra-follicular origin),...
The coronavirus disease 2019 (COVID-19) pandemic caused by SARS 2 (SARS-CoV-2) has significant morbidity and mortality for patients stressed healthcare systems worldwide. clinical features, course, serologic response of COVID-19 among immunosuppressed such as solid organ transplant (SOT) recipients, who are at presumed risk more severe disease, not well characterized. We describe our institutional experience with 10 SOT patients, including the presentation, treatment modalities, outcomes 7...
Immunosuppressed patients such as solid organ transplant and hematologic malignancy appear to be at increased risk for morbidity mortality due coronavirus disease 2019 (COVID-19) caused by SARS 2 (SARS-CoV-2). Convalescent plasma, a method of passive immunization that has been applied prior viral pandemics, holds promise potential treatment COVID-19. Immunocompromised may experience more benefit from convalescent plasma given underlying deficits in B T cell immunity well contraindications...
Interleukin-6 (IL-6) is a proinflammatory cytokine and key regulator of Treg: T effector cell (Teff) balance. We hypothesized that IL-6 blockade with tocilizumab, monoclonal antibody to IL-6R, would increase Tregs, dampen Teff function, control graft inflammation. conducted randomized controlled clinical trial (2014-2018) clinically stable kidney transplant recipients on calcineurin inhibitor, mycophenolate mofetil, prednisone, subclinical inflammation noted surveillance biopsies during the...
BK polyomavirus (BKV) infection remains a significant cause of nephropathy and graft loss. Fluoroquinolones inhibit BKV replication in vitro, small studies suggest vivo benefit. A strategy fluoroquinolone prophylaxis directed specifically against has not been formally tested control group kidney transplant recipients.We retrospectively compared the impact change antibiotic practice from no (Group 1, n=106, July-December 2009) to with ciprofloxacin 250 mg twice daily for 30 days 2, n=130,...
In Brief Background BK virus (BKV)-associated nephropathy is the second leading cause of graft loss in kidney transplant recipients. Due to high prevalence persistent infection with BKV general population, it possible that either recipient or donor may act as source resulting viruria and viremia. Although several studies suggest a correlation between donor-recipient serostatus development viremia, specific risk factors for BKV-related complications setting remain be established. Methods We...
Abstract Background Coccidioidomycosis is a significant cause of morbidity and mortality in solid organ transplant (SOT) recipients. Although existing guidelines address some aspects pre- post-transplant testing, prophylaxis, monitoring, many cases best practices are unknown, particularly for regions with variable Coccidioides endemicity such as California. This study aims to understand coccidioidomycosis prevention strategies at California centers. Methods We designed web-based survey that...
Regulation of epithelial Na+ channel (ENaC)-mediated transport in the distal nephron is a critical determinant blood pressure humans. Aldosterone via serum and glucocorticoid kinase 1 (SGK1) stimulates ENaC by phosphorylation E3 ubiquitin ligase Nedd4-2, which induces interaction with 14-3-3 proteins. However, mechanisms SGK1- 14-3-3-mediated regulation Nedd4-2 are unclear. There three canonical SGK1 target sites on that overlap phosphorylation-dependent motifs. Two these termed "minor," one...
The International Workshop on Clinical Transplant Tolerance is a biennial meeting that aims to provide an update the progress of studies immunosuppression minimization or withdrawal in solid organ transplantation. Fourth was held Pittsburgh, Pennsylvania, September 5-6, 2019. This report summary presentations status clinical trials designed minimize withdraw immunosuppressive drugs kidney, liver, and lung transplantation without subsequent evidence rejection. All protocols had common use...
The E3 ubiquitin ligase Nedd4-2 regulates several ion transport proteins, including the epithelial Na+ channel (ENaC). decreases apical membrane expression and activity of ENaC. Although it is subject to tight hormonal control, mechanistic basis regulation remains poorly understood. To characterize regulatory inputs function, we screened for novel sites phosphorylation using tandem mass spectrometry. Three seven identified Xenopus Ser/Thr corresponded previously target SGK1, whereas four...
Prolonged delayed graft function (DGF) in kidney transplant recipients imparts a risk of poor allograft function; tacrolimus may be detrimental this setting. We conducted retrospective single center analysis the first 20 patients converted to belatacept for prolonged DGF as part clinical protocol novel treatment strategy treat DGF. Prior conversion, underwent an biopsy rule out rejection and confirm tubular injury. The primary outcome was estimated glomerular filtration rate (eGFR) at 12...
Significance Statement Peritransplant TNF blockade with infliximab should not be used in recipients of deceased-donor kidney transplants due to lack efficacy and an increased incidence BK virus infection, according results a randomized controlled clinical trial. Our underscore the need for properly powered trials avoid falsely accepting unproven therapeutics reporting incorrect low adverse event rates derived from small, uncontrolled experiments. Background Ischemia-reperfusion (IR)...
Urinary tract infections (UTIs) are common after kidney transplantation, with limited data to guide antibiotic prophylaxis.Retrospective single-center study comparing sulfamethoxazole-trimethoprim 800/160 mg (SMZ/TMP) daily for 30 days followed by Monday, Wednesday, Friday an additional 5 months (Group 1) versus SMZ/TMP 6 plus ciprofloxacin 250 twice 2) on UTI incidence transplantation.There were 106 and 130 patients in Groups 1 2, respectively. Demographics transplant characteristics well...
Background Potential living kidney donors with prediabetes are often excluded from donation because of concerns about the development type 2 diabetes mellitus (DM) and progression to end-stage renal disease (ESRD). This strategy may be unnecessarily restrictive. Previous studies have not specifically examined subsets prediabetes. Methods We ascertained vital status ESRD in 143 1994 2007 predonation impaired fasting glucose (IFG). then compared DM, estimated glomerular filtration rate, level...
INTRODUCTION Chronic graft rejectionand toxicities of long-term immunosuppressive therapies impede the advancement organ transplantation. Establishment a state tolerance, in which immune system remains functional and competent but treats donor as "self," would prevent chronic rejection obviate need for immunosuppression (IS). In past 2 decades, several clinical protocols have achieved allograft tolerance. Furthermore, new biological compounds cell aimed at tolerance induction begun to be...
Background . BK virus (BKV) infection is a common complication following kidney transplantation. Immunosuppression reduction the cornerstone of treatment while adjuvant drugs have been tried in small uncontrolled studies. We sought to examine our center’s experience with use ciprofloxacin patients persistent BKV infection. Methods Retrospective evaluation effect 30-day course (250 mg twice daily) on transplant recipients who had diagnosed viruria ≥106 copies/mL and viremia ≥500 whom did not...