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Biology subjects

Mestan, K. K.

Publications and source records attributed to Mestan, K. K..

3 recordsLinked to original sources

Macrophage Polarizations in the Placenta and Lung are Associated with Bronchopulmonary Dysplasia

The intricate interplay between macrophage polarization and placenta vascular dysfunction has garnered increasing attention in the context of placental inflammatory diseases. This study delves into the complex relationship between macrophage polarization within the placenta and its potential impact on the development of vascular dysfunction and inflammatory conditions. The placenta, a crucial organ in fetal development, relies on a finely tuned balance of immune responses for proper functioning. Disruptions in this delicate equilibrium can lead to pathological conditions, including inflammatory diseases affecting the fetus and newborn infant. We explored the interconnectedness between placental macrophage polarization and its relevance to lung macrophages, particularly in the context of early life lung development. Bronchopulmonary dysplasia (BPD), the most common chronic lung disease of prematurity, has been associated with abnormal immune responses, and understanding the role of macrophages in this context is pivotal. The investigation aims to shed light on how alterations in placental macrophage polarization may contribute to lung macrophage behavior and, consequently, influence the development of BPD. By unraveling the intricate mechanisms linking macrophage polarization, placental dysfunction and BPD, this research seeks to provide insights that could pave the way for targeted therapeutic interventions. The findings may offer novel perspectives on preventing and managing placental and lung-related pathologies, ultimately contributing to improved maternal and neonatal health outcomes.

systems biology↗

Vital Signs Analysis Algorithm Detects Inflammatory Response in Premature Infants with Late Onset Sepsis and Necrotizing Enterocolitis

BackgroundNonspecific clinical signs and suboptimal diagnostic tests limit accurate identification of late onset sepsis (LOS) and necrotizing enterocolitis (NEC) in premature infants, resulting in significant morbidity and antibiotic overuse. An infants systemic inflammatory response may be identified earlier than clinical suspicion through analysis of multiple vital signs by a computerized algorithm (RALIS).\n\nAimTo evaluate the revised RALIS algorithm for detection of LOS and NEC in preterm infants.\n\nMethodsIn this nested case-control study, VS data (heart rate, respiratory rate, temperature, desaturations, bradycardias) were extracted from medical records of infants 23-32 weeks gestation. RALIS generated an output, with score >5 triggering an alert. Patient episodes were classified based on culture, radiograph, and antibiotic data into categories: LOS, expanded LOS, NEC, and controls. Paired t-tests, linear regression and cross-validation analyses were used to evaluate the relationship between RALIS alert and LOS/NEC.\n\nResultsAmong 155 infants with 161 episodes, there were 41 expanded LOS (+ blood, CSF, urine, respiratory culture), 31 LOS (+ blood, CSF, urine), 9 NEC, and 93 controls. RALIS alert was 43.1+/-79 hours before culture in LOS (p=0.012). There was a significant association between RALIS alert and LOS/NEC ({beta}=0.72, p<0.0001). Sensitivity and specificity for LOS/NEC were 84% and 80%, (PPV=63%; NPV=93%). The regression model demonstrated an AUC of 89.9%.\n\nConclusionsFor infants <32 weeks, RALIS detects systemic inflammatory responses in LOS and NEC in the first month of life. The algorithm identifies infection earlier than clinical suspicion, even for NEC with negative cultures. RALIS has high NPV to rule-out LOS and NEC, and may, after prospective validation, aid in antibiotic treatment decisions.

bioinformatics↗

Umbilical Cord Blood Diagnostics for Early Onset Sepsis in Premature Infants: Detection of Bacterial DNA and Systemic Inflammatory Response

Statement of financial supportThis work has been supported by a Thrasher Research Fund Early Career Award (#12573), National Institutes of Health (K23 HL093302 [KKM], R01GM108494 [PCS])), the Gerber Foundation, the Hartwall Foundation, and the Northwestern Memorial Foundation (Friends of Prentice Grants Initiative).\n\nDisclosure statementThe authors of this manuscript have no conflicts of interest to disclose.\n\nCategory of StudyTranslational

microbiology↗