Publications by authors named "Darley D"

Article Synopsis
  • Ongoing research is essential for tracking and understanding the emergence of new SARS-CoV-2 variants, particularly as diagnostic testing declines in Australia during the COVID-19 pandemic.
  • In 2023, collaborations with pathology and genomics teams allowed for the monitoring of SARS-CoV-2 variants in New South Wales through various methods, including viral culture and analysis of immune responses from a large pool of blood donations.
  • Findings indicated that while existing antibodies generally neutralized many variants, specific mutations in emerging strains, particularly JN.1, suggested future challenges in controlling their spread due to enhanced transmissibility.
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Background: Descriptions of eosinophils in transbronchial biopsy (TBBx) pathology reports after lung transplantation (LTx) are associated with poor long-term outcomes. The absence of routine reporting and standardization precludes accurate assessment of this histologic predictor. A systematic reporting scheme for the presence of TBBx eosinophils after LTx was implemented.

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Objective: To investigate the association between blood-brain barrier permeability, brain metabolites, microstructural integrity of the white matter, and cognitive impairment (CI) in post-acute sequelae of SARS-COV-2 infection (PASC).

Methods: In this multimodal longitudinal MRI study 14 PASC participants with CI and 10 healthy controls were enrolled. All completed investigations at 3 months following acute infection (3 months ± 2 weeks SD), and 10 PASC participants completed at 12 months ± 2.

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This study investigates the humoral and cellular immune responses and health-related quality of life measures in individuals with mild to moderate long COVID (LC) compared to age and gender matched recovered COVID-19 controls (MC) over 24 months. LC participants show elevated nucleocapsid IgG levels at 3 months, and higher neutralizing capacity up to 8 months post-infection. Increased spike-specific and nucleocapsid-specific CD4 T cells, PD-1, and TIM-3 expression on CD4 and CD8 T cells were observed at 3 and 8 months, but these differences do not persist at 24 months.

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Peak spirometry after single lung transplantation (SLTx) for interstitial lung disease (ILD) is lower than after double lung transplantation (DLTx), however the pathophysiologic mechanisms are unclear. We aim to assess respiratory mechanics in SLTx and DLTx for ILD using oscillometry. Spirometry and oscillometry (tremoflo C-100) were performed in stable SLTx and DLTx recipients in a multi-center study.

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A relationship between SARS-CoV-2 infection and psychiatric symptoms has been identified but is still being fully investigated. Neuropsychiatric sequalae have been reported for several infectious agents and are not unexpected for SARS-CoV-2 infection. This study follows for 12 months a sample ( = 144) of people who have had a confirmed infection of SARS-CoV-2.

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Objective: To determine the prevalence and natural history of post-acute COVID-19 objective cognitive impairment and function, and their relationship to demographic, clinical factors, post-acute sequelae of COVID-19 (PASC), and biomarkers.

Methods: A total of 128 post-acute COVID-19 patients (age = 46 ± 15; 42% women, acute disease severity: not hospitalized: 38.6% mild: 0-1 symptoms, 52% 2+ symptoms; 9.

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A high-risk epitope mismatch (REM) (found in DQA1∗05 + DQB1∗02/DQB1∗03:01) is associated with de novo donor specific antibodies after lung transplantation (LTx). Chronic lung allograft dysfunction (CLAD) remains a barrier to LTx survival. This study aimed to measure the association between DQ REM and the risk of CLAD and death after LTx.

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Article Synopsis
  • The Omicron variant of COVID-19, which began in 2022, evolved from several lineages (BA.1, BA.2, BA.5) and developed mutations that help it evade neutralizing antibodies.
  • Researchers evaluated the effectiveness of antibody responses by tracking over 420,000 U.S. plasma donors and studying blood samples from vaccinated and recovered individuals, along with testing clinically approved therapies.
  • Findings indicated that antibody responses improved over time, but emerging variants like BQ.1.1 and XBF were increasingly resistant to treatments like Evusheld and Sotrovimab, suggesting that even dominant variants can evade antibodies while maintaining a persistent advantage in spreading.
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Background: Baseline lung allograft dysfunction (BLAD), the failure to achieve ≥80%-predicted spirometry after lung transplant (LTx), is associated with impaired survival. Physiologic abnormalities in BLAD are poorly understood. Airway oscillometry measures respiratory system mechanics and may provide insight into understanding the mechanisms of BLAD.

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Article Synopsis
  • Long-term immunity to SARS-CoV-2 relies heavily on neutralizing antibodies and T cell responses among the population to help decrease disease spread.
  • Research indicates a strong connection between higher levels of neutralizing antibodies and specific CD4 T cell responses in individuals who have recovered from COVID-19.
  • Findings suggest that vaccines should focus on enhancing CD4 T cell responses related to the receptor binding domain (RBD) of the virus to boost immunity and antibody production.*
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A multispecies outbreak of Nocardia occurred among heart transplant recipients (HTR), but not lung transplant recipients (LTR), in Sydney, New South Wales, Australia, during 2018-2019. We performed a retrospective review of 23 HTR and LTR who had Nocardia spp. infections during June 2015-March 2021, compared risk factors for Nocardia infection, and evaluated climate conditions before, during, and after the period of the 2018-2019 outbreak.

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Background: Genetically distinct viral variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been recorded since January 2020. The introduction of global vaccine programs has contributed to lower COVID-19 hospitalisation and mortality rates, particularly in developed countries. In late 2021, Omicron BA.

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Background: Dried blood spot (DBS) specimens are a useful serosurveillance tool particularly in hard-to-reach populations but their application for detecting SARS-CoV-2 infection is poorly characterised.

Objectives: To compare detection of naturally acquired SARS-CoV-2 antibodies in paired DBS and serum specimens using commercially available serological immunoassays.

Study Design: Specimens were collected through St Vincent's Hospital observational post COVID-19 cohort study (ADAPT).

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Genetically distinct variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have emerged since the start of the COVID-19 pandemic. Over this period, we developed a rapid platform (R-20) for viral isolation and characterization using primary remnant diagnostic swabs. This, combined with quarantine testing and genomics surveillance, enabled the rapid isolation and characterization of all major SARS-CoV-2 variants circulating in Australia in 2021.

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A proportion of patients surviving acute coronavirus disease 2019 (COVID-19) infection develop post-acute COVID syndrome (long COVID (LC)) lasting longer than 12 weeks. Here, we studied individuals with LC compared to age- and gender-matched recovered individuals without LC, unexposed donors and individuals infected with other coronaviruses. Patients with LC had highly activated innate immune cells, lacked naive T and B cells and showed elevated expression of type I IFN (IFN-β) and type III IFN (IFN-λ1) that remained persistently high at 8 months after infection.

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Rationale: The diffusing capacity of the lung for carbon monoxide corrected for haemoglobin ( ) measures gas movement across the alveolar-capillary interface. We hypothesised that is a sensitive measure of injurious allograft processes disrupting this interface.

Objectives: To determine the prognostic significance of the trajectory on chronic lung allograft dysfunction (CLAD) and survival.

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Background: End-stage Eisenmenger syndrome (ES) due to unrepaired atrial septal defect (ASD) or ventricular septal defect (VSD) is an indication for lung transplantation (LTx) or heart-lung transplantation (HLTx). Limited evidence exists as to the optimal transplant strategy for this unique population.

Aim: To describe waitlist characteristics and post-transplant outcomes in patients with ES-ASD or ES-VSD.

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Aims: Tacrolimus is the cornerstone of immunosuppression management in heart and lung transplant recipients, improving overall survival. However, tacrolimus-associated toxicities, including nephrotoxicity, neurotoxicity, new-onset diabetes mellitus after transplant (NODAT), and gastrointestinal toxicity, are known contributors to increased post-transplant morbidity outcomes and reduced graft and recipient survival rates. The aim of this systematic review was to identify correlations between pharmacokinetic measures of tacrolimus exposure in heart and lung recipients and tacrolimus toxicities.

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Long-term outcomes after lung transplantation remain inferior to those of other solid organ groups. The significance of eosinophils detected on transbronchial biopsies (TBBx) after lung transplantation and their relationship to long-term outcomes remain unknown. A retrospective single-center cohort study was performed of patients transplanted between January 01, 2001, and July 31, 2018, who had at least 1 TBBx with evaluable parenchymal tissue.

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Unlabelled: Eosinophils are increasingly being recognised as an important characteristic feature of COPD. Patients with COPD and eosinophilic inflammation tend to respond to steroid therapy; however, many questions remain regarding the optimum measurement. Eosinophilic inflammation may be defined based on various sampling techniques, including eosinophil levels in blood, sputum, bronchoalveolar lavage or biopsy, which leads to inconsistencies in its definition.

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