Publications by authors named "Agrawal Pankaj"

In the aim of designing and developing a novel saponin-based adjuvant system, we combined the QS21 saponin with low microgram amounts of the fully synthetic TLR4 agonist, E6020, in cholesterol-containing liposomes. The resulting adjuvant system, termed SPA14, appeared as a long-term stable and homogeneous suspension of mostly unilamellar and a few multilamellar vesicles, with an average hydrodynamic diameter of 93 nm, when formulated in citrate buffer at pH 6.0-6.

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Background And Objectives: Hypotonia is a relatively common finding among infants in the neonatal intensive care unit (NICU). Consideration of genetic testing is recommended early in the care of infants with unexplained hypotonia. We aimed to assess the diagnostic yield and overall impact of exome and genome sequencing (ES and GS).

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Objective: To characterize clinical, hemodynamic, imaging, and pathologic findings in children with pulmonary arterial hypertension (PAH) and variants in SRY-box transcription factor 17 (SOX17), a novel risk gene linked to heritable and congenital heart disease-associated PAH.

Study Design: We assembled a multi-institutional cohort of children with PAH and SOX17 variants enrolled in the Pediatric Pulmonary Hypertension Network (PPHNet) and other registries. Subjects were identified through exome and PAH gene panel sequencing.

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The rapid and accurate diagnosis of rare diseases is paramount in directing clinical management. In recent years, the integration of multi-omics approaches has emerged as a potential strategy to overcome diagnostic hurdles. This review examines the application of multi-omics technologies, including genomics, epigenomics, transcriptomics, proteomics, and metabolomics, in relation to the diagnostic journey of rare diseases.

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In this work, acrylonitrile butadiene styrene (ABS) copolymer from electronic waste (e-waste) was used to produce filaments for application in 3D printing. Recycled ABS (rABS) from e-waste was blended with virgin ABS (vABS) in different concentrations. By differential scanning calorimetry, it was observed that the values of the glass transition temperatures for vABS/rABS blends ranged between the values of vABS and rABS.

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Article Synopsis
  • - This study examines the link between rare variants in the cullin-3 ubiquitin ligase (CUL3) gene and neurodevelopmental disorders (NDDs), gathering data from multiple centers to explore genetic mutations and their clinical impacts.
  • - Researchers identified 37 individuals with CUL3 variants, most of which result in loss-of-function (LoF), leading to intellectual disabilities and possibly autistic traits; specific mechanisms affecting protein stability were also investigated.
  • - The findings enhance the understanding of NDDs associated with CUL3 mutations, suggesting that LoF variants are the main cause, which could help inform future diagnostics and treatment strategies.
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  • Publicly available genetic databases, like gnomAD, are essential for studying human population variation and identifying harmful genetic variants linked to diseases.
  • This study focused on genes with strict constraints regarding loss-of-function and missense variants, analyzing their unique characteristics and relationships with human health conditions.
  • The findings highlight novel gene candidates for potential disease associations, enhancing our understanding of genetic factors in rare diseases and their biological significance.
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  • Researchers identified bi-allelic disruptive variants as the cause of autosomal recessive intellectual developmental disorder type 65, while dominant variants are harder to link to specific traits due to their presence in unaffected individuals.
  • The study involved a retrospective analysis of 21 individuals with likely pathogenic variants, focusing on clinical information and molecular data from their families.
  • Key findings revealed that those with dominant disruptive variants exhibited more developmental and behavioral problems, while individuals with dominant missense variants had a higher occurrence of renal and skin anomalies, enhancing the understanding of the related neurodevelopmental disorder.
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Inherited retinal diseases encompass a genetically diverse group of conditions caused by variants in genes critical to retinal function, including handful of ribosome-associated genes. This study focuses on the HBS1L gene, which encodes for the HBS1-like translational GTPase that is crucial for ribosomal rescue. We have reported a female child carrying biallelic HBS1L variants, manifesting with poor growth and neurodevelopmental delay.

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We aimed to conduct a systematic review and meta-analysis to evaluate the fetoscopic tracheal occlusion in patients with isolated severe and left-sided diaphragmatic hernia. Cochrane Library, Embase, and PubMed (Medline) databases were searched from inception to February 2024 with no filters or language restrictions. We included studies evaluating the outcomes of fetoscopic intervention compared to expectant management among patients with severe congenital diaphragmatic hernia exclusively on the left side.

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Purpose: Critically ill infants from marginalized populations disproportionately receive care in neonatal intensive care units (NICUs) that lack access to state-of-the-art genomic care, leading to inequitable outcomes. We sought provider perspectives to inform our implementation study (VIGOR) providing rapid genomic sequencing within these settings.

Methods: We conducted semistructured focus groups with neonatal and genetics providers at 6 NICUs at safety-net hospitals, informed by the Promoting Action on Research Implementation in Health Services framework, which incorporates evidence, context, and facilitation domains.

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Background And Aims: Cystic fibrosis (CF) is an autosomal recessive disease caused by mutations to the CF transmembrane conductance regulator (CFTR). Symptoms and severity of the disease can be quite variable suggesting modifier genes play an important role.

Materials And Methods: Exome sequencing was performed on six individuals carrying homozygous deltaF508 for CFTR genotype but present with rapidly progressing CF (RPCF).

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  • Researchers sequenced the genomes of 822 families with suspected rare monogenic diseases that were previously undiagnosed through standard genetic tests, including exome sequencing.
  • They found that genome sequencing provided a molecular diagnosis for 29.3% of the initial families, with 8.2% requiring genome sequencing to identify variants that exome sequencing missed.
  • The study showed that both research and clinical approaches could benefit from genome sequencing, demonstrating its importance in uncovering previously undetected genetic variations.
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Background: Autosomal-recessive mutations in SPEG (striated muscle preferentially expressed protein kinase) have been linked to centronuclear myopathy with or without dilated cardiomyopathy (CNM5). Loss of SPEG is associated with defective triad formation, abnormal excitation-contraction coupling, calcium mishandling and disruption of the focal adhesion complex in skeletal muscles. To elucidate the underlying molecular pathways, we have utilized multi-omics tools and analysis to obtain a comprehensive view of the complex biological processes and molecular functions.

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Background & Aims: Humans with WNT2B deficiency have severe intestinal disease, including significant inflammatory injury, highlighting a critical role for WNT2B. We sought to understand how WNT2B contributes to intestinal homeostasis.

Methods: We investigated the intestinal health of Wnt2b knock out (KO) mice.

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Aims: The purpose of this study was to comparatively evaluate the cutting efficiency of Pedoflex rotary, Kedo SH manual file, and manual K file systems used in root canal instrumentation while performing pulp therapy of deciduous teeth with a stereomicroscope.

Materials And Methods: Forty-five extracted primary human root canals were chosen, and following the removal of pulp tissue, the canals were dyed with Indian ink and left to dry for 2 h. The samples were randomly divided into three groups, Group A: Kedo SH manual file system ( = 15), Group B: Pedoflex rotary file system ( = 15), and Group C: Manual K files ( = 15).

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Copy number variants (CNVs) are significant contributors to the pathogenicity of rare genetic diseases and, with new innovative methods, can now reliably be identified from exome sequencing. Challenges still remain in accurate classification of CNV pathogenicity. CNV calling using GATK-gCNV was performed on exomes from a cohort of 6,633 families (15,759 individuals) with heterogeneous phenotypes and variable prior genetic testing collected at the Broad Institute Center for Mendelian Genomics of the Genomics Research to Elucidate the Genetics of Rare Diseases consortium and analyzed using the seqr platform.

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Article Synopsis
  • The study aimed to analyze genetic testing patterns in infants with congenital heart disease (CHD) compared to those without CHD in a NICU setting.
  • A total of 1,075 out of 7,112 infants underwent genetic evaluation, with a notable focus on 329 infants with CHD.
  • Results showed similar diagnosis rates post-testing for both groups, but atrioventricular septal defects were highly predictive of a genetic diagnosis, suggesting the importance of genetic testing in these cases.
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A sizable percentage of the population in India still does not have easy access to dental facilities. Therefore, it is of interest to document the role of artificial intelligence (AI) in oral surveillance of underserved communities. Available data shows that AI makes it possible to screen, diagnose, track, prioritize, and monitor dental patients remotely via smart devices.

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Background: Causal variants underlying rare disorders may remain elusive even after expansive gene panels or exome sequencing (ES). Clinicians and researchers may then turn to genome sequencing (GS), though the added value of this technique and its optimal use remain poorly defined. We therefore investigated the advantages of GS within a phenotypically diverse cohort.

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Article Synopsis
  • - The Virtual GenOme CenteR is a study designed to improve access to rapid genomic sequencing (rGS) for critically ill infants from racial and ethnic minority and low-income populations who typically receive care in community settings lacking advanced genomic resources.
  • - The study involves developing a virtual support system for neonatal intensive care units (NICUs) where staff are trained in genomic medicine, and eligible infants (around 250) receive rGS along with follow-up for one year to assess outcomes and evaluate the implementation process.
  • - Ethics approval has been obtained, and the study ensures that participating families provide informed consent while collecting data through various methods, including surveys and interviews with both providers and families, to analyze the effectiveness of the program.
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A primary concern in vaccine development is safety, particularly avoiding an excessive immune reaction in an otherwise healthy individual. An accurate prediction of vaccine reactogenicity using in vitro assays and computational models would facilitate screening and prioritization of novel candidates early in the vaccine development process. Using the modular in vitro immune construct model of human innate immunity, PBMCs from 40 healthy donors were treated with 10 different vaccines of varying reactogenicity profiles and then cell culture supernatants were analyzed via flow cytometry and a multichemokine/cytokine assay.

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Advances in bioinformatic tools paired with the ongoing accumulation of genetic knowledge and periodic reanalysis of genomic sequencing data have led to an improvement in genetic diagnostic rates. Candidate gene variants (CGVs) identified during sequencing or on reanalysis but not yet implicated in human disease or associated with a phenotypically distinct condition are often not revisited, leading to missed diagnostic opportunities. Here, we revisited 33 such CGVs from our previously published study and determined that 16 of them are indeed disease-causing (novel or phenotype expansion) since their identification.

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A deficiency of striated preferentially expressed gene (Speg), a member of the myosin light chain kinase family, results in abnormal myofibril structure and function of immature cardiomyocytes (CMs), corresponding with a dilated cardiomyopathy, heart failure and perinatal death. Mitochondrial development plays a role in cardiomyocyte maturation. Therefore, this study investigated whether Speg deficiency ( - / - ) in CMs would result in mitochondrial abnormalities.

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