American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Feb 2015
Comparative StudyDeveloping a Clinically Feasible Personalized Medicine Approach to Pediatric Septic Shock.
Using microarray data, we previously identified gene expression-based subclasses of septic shock with important phenotypic differences. The subclass-defining genes correspond to adaptive immunity and glucocorticoid receptor signaling. Identifying the subclasses in real time has theranostic implications, given the potential for immune-enhancing therapies and controversies surrounding adjunctive corticosteroids for septic shock. ⋯ We developed and tested a gene expression-based classification method for pediatric septic shock that meets the time constraints of the critical care environment, and can potentially inform therapeutic decisions.
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Am. J. Respir. Crit. Care Med. · Feb 2015
ReviewBlue Journal Conference: Aging and the Susceptibility to Lung Disease.
The aging of the population in the United States and throughout the developed world has increased morbidity and mortality attributable to lung disease, while the morbidity and mortality from other prevalent diseases has declined or remained stable. Recognizing the importance of aging in the development of lung disease, the American Thoracic Society (ATS) highlighted this topic as a core theme for the 2014 annual meeting. The relationship between aging and lung disease was discussed in several oral symposiums and poster sessions at the annual ATS meeting. ⋯ A consistent theme that emerged from the conference was the need to apply novel, systems-based approaches to integrate a growing body of genomic, epigenomic, transcriptomic, and proteomic data and elucidate the relationship between biologic hallmarks of aging, altered lung function, and increased susceptibility to lung diseases in the older population. The challenge remains to causally link the molecular and cellular changes of aging with age-related changes in lung physiology and disease susceptibility. The purpose of this review is to stimulate further research to identify new strategies to prevent or treat age-related lung disease.
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Am. J. Respir. Crit. Care Med. · Feb 2015
Longevity and Determinants of Protective Humoral Immunity Following Pandemic Influenza Infection.
Antibodies to influenza hemagglutinin are the primary correlate of protection against infection. The strength and persistence of this immune response influences viral evolution and consequently the nature of influenza epidemics. However, the durability and immune determinants of induction of humoral immunity after primary influenza infection remain unclear. ⋯ The longevity of protective humoral immunity after influenza infection has important implications for influenza transmission dynamics and vaccination policy, and identification of its predictive cellular immune correlate could guide vaccine development and evaluation.
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Am. J. Respir. Crit. Care Med. · Feb 2015
Comparative StudyIncreased Resource Utilization in Lung Transplant Admissions in the Lung Allocation Score Era.
In 2005, the lung allocation score (LAS) was implemented to prioritize organ allocation to minimize waiting-list mortality and maximize 1-year survival. It resulted in transplantation of older and sicker patients without changing 1-year survival. Its effect on resource use is unknown. ⋯ LAS implementation is associated with a significant increase in resource use during index hospitalization for lung transplant.
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Am. J. Respir. Crit. Care Med. · Feb 2015
Letter Multicenter Study Comparative StudyRevised definitions of multidrug-resistant tuberculosis treatment outcomes: closer to the reality?