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Pre-Lung transplant reflux testing demonstrates high prevalence of gastroesophageal reflux in cystic fibrosis and reduces chronic rejection risk

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World Journal of Transplantation 2023年第4期13卷 138-146页

作者： Wai-Kit lo ryan Flanagan Nirmal Sharma Hilary J Goldberg Walter W Chan Division of Gastroenterology Hepatology and EndoscopyBrigham and Women's HospitalHarvard Medical SchoolBostonMA Division of Pulmonary and Critical Care Medicine Brigham and Women's HospitalHarvard Medical SchoolBostonMA 02115United States

BACKGROUND Gastroesophageal reflux(GER)has been associated with poor outcomes after lung transplantation for chronic lung disease,including increased risk of chronic *** is common in cystic fibrosis(CF),but factors influencing the likelihood of pre-transplant pH testing,and the impact of testing on clinical management and transplant outcomes in patients with CF are *** To evaluate the role of pre-transplant reflux testing in the evaluation of lung transplant candidates with *** This was a retrospective study from 2007-2019 at a tertiary medical center that included all patients with CF undergoing lung *** with pretransplant anti-reflux surgery were *** characteristics(age at transplantation,gender,race,body mass index),self-reported GER symptoms prior to transplantation,and pre-transplant cardiopulmonary testing results,were *** testing consisted of either 24-h pH-or combined multichannel intraluminal impedance and pH ***-transplant care included a standard immunosuppressive regimen,and regular surveillance bronchoscopy and pulmonary spirometry in accordance with institutional practice as well as in symptomatic *** primary outcome of chronic lung allograft dysfunction(CLAD)was defined clinically and histologically per International Society of Heart and Lung Transplantation *** analysis was performed with Fisher’s exact test to assess differences between cohorts,and time-to-event Cox proportional hazards *** After applying inclusion and exclusion criteria,a total of 60 patients were included in the *** all CF patients,41(68.3%)completed reflux monitoring as part of pre-lung transplant *** evidence of pathologic reflux,defined as acid exposure time>4%,was found in 24 subjects,representing 58%of the tested *** patients with pre-transplant reflux testing were older(35.8 vs 30.1 years,P=0.01)and more commonly reported typical

关键词： Cystic fibrosis Gastroesophageal reflux Lung transplantation pH monitoring

Serum-circulating His-tRNA synthetase inhibits organ-targeted immune responses

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Cellular & Molecular Immunology 2021年第6期18卷 1463-1475页

作者： ryan AAdams Cátia Fernandes-Cerqueira Antonella Notarnicola Elisabeth Mertsching Zhiwen Xu Wing-Sze lo Kathleen Ogilvie Kyle PChiang Jeanette Ampudia Sanna Rosengren Andrea Cubitt David JKing John DMendlein Xiang-Lei Yang Leslie ANangle Ingrid ELundberg Per-Johan Jakobsson Paul Schimmel aTyr Pharma 3545 John Hopkins CourtSuite 250San DiegoCA92121USA Division of Rheumatology Department of MedicineSolnaKarolinska InstitutetKarolinska University HospitalSE-17176StockholmSweden IAS HKUST-Scripps R&D Laboratory Institute for Advanced StudyHong Kong University of Science and Technologyand Pangu BiopharmaHong KongChina The Scripps Laboratories for tRNA Synthetase Research 10650 North Torrey Pines RoadLa JollaCA92037USA The Scripps Laboratories for tRNA Synthetase Research Scripps Florida130 Scripps WayJupiterFL33458USA

His-tRNA synthetase (HARS) is targeted by autoantibodies in chronic and acute inflammatory anti-Jo-1-positive antisynthetase syndrome. The extensive activation and migration of immune cells into lung and muscle are associated with interstitial lung disease, myositis, and morbidity. It is unknown whether the sequestration of HARS is an epiphenomenon or plays a causal role in the disease. Here, we show that HARS circulates in healthy individuals, but it is largely undetectable in the serum of anti-Jo-1-positive antisynthetase syndrome patients. In cultured primary human skeletal muscle myoblasts (HSkMC), HARS is released in increasing amounts during their differentiation into myotubes. We further show that HARS regulates immune cell engagement and inhibits CD4+ and CD8+ T-cell activation. In mouse and rodent models of acute inflammatory diseases, HARS administration downregulates immune activation. In contrast, neutralization of extracellular HARS by high-titer antibody responses during tissue injury increases susceptibility to immune attack, similar to what is seen in humans with anti-Jo-1-positive disease. Collectively, these data suggest that extracellular HARS is homeostatic in normal subjects, and its sequestration contributes to the morbidity of the anti-Jo-1-positive antisynthetase syndrome.

关键词： Immunology Autoimmunity Synthetase tRNA HARS

Augmented reality assisted surgery： a urologic training tool

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Asian Journal of Andrology 2016年第5期18卷 732-734页

作者： ryan M Dickey Neel Srikishen Larry I Lipshultz Philippe E Spiess Rafael E Carrion Tariq S Hakky Scott Department of Urology Baylor College of Medicine Houston 77030 USA University of South Florida Department of Urology Tampa 33606 USA.

Augmented reality is widely used in aeronautics and is a developing concept within surgery. In this pilot study, we developed an application for use on Google Glass optical head-mounted display to train urology residents in how to place an inflatable penile prosthesis. We use the phrase Augmented Reality Assisted Surgery to describe this novel application of augmented reality in the setting of surgery. The application demonstrates the steps of the surgical procedure of inflatable penile prosthesis placement. It also contains software that allows for detection of interest points using a camera feed from the optical head-mounted display to enable faculty to interact with residents during placement of the penile prosthesis. Urology trainees and faculty who volunteered to take part in the study were given time to experience the technology in the operative or perioperative setting and asked to complete a feedback survey. From 30 total participants using a lo-point scale, educational usefulness was rated 8.6, ease of navigation was rated 7.6, likelihood to use was rated 7.4, and distraction in operating room was rated 4.9. When stratified between trainees and faculty, trainees found the technology more educationally useful, and less distracting. Overall, 81% of the participants want this technology in their residency program, and 93% see this technology in the operating room in the future. Further development of this technology is warranted before full release, and further studies are necessary to better characterize the effectiveness of Augmented Reality Assisted Surgery in urologic surgical training.

关键词： andrology augmented reality assisted surgery Google glass inflatable penile prosthesis optical head mounted display surgical education

Immunity:树突细胞指导T细胞发挥作用的新型分子机制

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现代生物医学进展 2017年第8期17卷 I0002-I0002页

作者： Andrew Jones Jessica Bourque Lindsey Kuehm Adeleye Opejin ryan M. Teague Cindy Gross Daniel Hawiger Department of Molecular Microbiology and Immunology Saint Louis University School of Medicine St. Louis MO 63104 USA

日前。刊登在国际杂志Immunity上的一项研究报告中，来自圣路易斯大学（Saint louis University）的研究人员通过研究揭示了机体免疫系统中的树突细胞如何指挥T淋巴细胞学习对机体自身细胞的耐受性。机体免疫系统往往会通过避免过度反... 详细信息

日前。刊登在国际杂志Immunity上的一项研究报告中，来自圣路易斯大学（Saint louis University）的研究人员通过研究揭示了机体免疫系统中的树突细胞如何指挥T淋巴细胞学习对机体自身细胞的耐受性。机体免疫系统往往会通过避免过度反应或反应不足所带来的危险来维持机体健康，

关键词：树突细胞 T细胞分子机制机体免疫系统 T淋巴细胞研究人员机体健康耐受性