Publications by authors named "David A Hill"

Background And Objectives: Children with severe persistent asthma managed by subspecialists represent a unique patient population. The factors predisposing these children to hospital admission are poorly understood. This study aimed to identify factors associated with future emergency department (ED) visits and hospitalization in this group.

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Purpose Of Review: This review aims to provide an overview of the current understanding of eosinophilic gastrointestinal disorders (EGIDs) and the role of the epithelium in influencing disease pathogenesis to inform and devise future therapeutic strategies.

Recent Findings: Changes in epithelial cell structure, functions, and integrity are observed in EGIDs. In eosinophilic esophagitis (EoE), the esophageal epithelium has been shown to play key roles in perpetuating the inflammatory response in EoE through the expression of pro-inflammatory cytokines and immunological cell-surface proteins.

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The Consortium of Eosinophilic Gastrointestinal disease Researchers (CEGIR) and The International Gastrointestinal Eosinophil Researchers (TIGERs) organized a daylong symposium at the 2024 annual meeting of the American Academy of Allergy, Asthma & Immunology. The symposium featured new discoveries in basic and translational research as well as debates on the mechanisms and management of eosinophilic gastrointestinal diseases. Updates on recent clinical trials and consensus guidelines were also presented.

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Adipose tissue macrophages (ATMs) influence obesity-associated metabolic dysfunction, but the mechanisms by which they do so are not well understood. We show that miR-6236 is a bona fide miRNA that is secreted by ATMs during obesity. Global or myeloid cell-specific deletion of miR-6236 aggravates obesity-associated adipose tissue insulin resistance, hyperglycemia, hyperinsulinemia, and hyperlipidemia.

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Background And Objectives: Respiratory viral infections increase risk of asthma in infants and children. Infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus can cause severe lung inflammation and prolonged respiratory symptoms. We sought to determine whether SARS-CoV-2 infection modified pediatric incident asthma risk.

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The Consortium of Eosinophilic Gastrointestinal Diseases and The International Gastrointestinal Eosinophil Researchers organized a day-long symposium at the 2022 Annual Meeting of the American Academy of Allergy, Asthma & Immunology. The symposium featured a review of recent discoveries in the basic biology and pathogenesis of eosinophilic gastrointestinal diseases (EGIDs) in addition to advances in our understanding of the clinical features of EGIDs. Diagnostic and management approaches were reviewed and debated, and clinical trials of emerging therapies were highlighted.

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Extracellular vesicles (EVs) are nanometer size lipid particles that are released from virtually every cell type. Recent studies have shown that miRNAs carried by EVs play important roles in intercellular and interorgan communication. In the context of obesity and insulin resistance, EV-derived miRNAs functionally bridge major metabolic organs, including the adipose tissue, skeletal muscle, liver, and pancreas, to regulate insulin secretion and signaling.

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Article Synopsis
  • The study aims to analyze patterns of pediatric allergies using a large dataset from health records across multiple US states, focusing on children aged 0-18.
  • Researchers tracked a cohort of 218,485 children for at least five years, identifying conditions like atopic dermatitis, food allergies, asthma, and allergic rhinitis through diagnosis codes and prescriptions.
  • Results show significant incidence rates for various allergies at young ages, with many children experiencing multiple allergic conditions, indicating a common trend known as the "allergic march."
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Current therapeutic strategies for treating nonalcoholic steatohepatitis (NASH) have failed to alleviate liver fibrosis, which is a devastating feature leading to hepatic dysfunction. Here, we integrated single-nucleus transcriptomics and epigenomics to characterize all major liver cell types during NASH development in mice and humans. The bifurcation of hepatocyte trajectory with NASH progression was conserved between mice and humans.

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Objective: Antiretroviral therapy (ART) extends the life of people with HIV (PWH), but these individuals are at increased risk for obesity, dyslipidemia, diabetes, and cardiovascular disease. These comorbidities may be a consequence of HIV-related chronic inflammation and/or adverse effects of ART on tissue regulatory adipose tissue macrophages (ATMs). We sought to determine the effects of HIV/ART on metabolically beneficial ATM populations and functions.

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Age-related macular degeneration (AMD), the leading cause of irreversible blindness among Americans over 50, is characterized by dysfunction and death of retinal pigment epithelial (RPE) cells. The RPE accumulates iron in AMD, and iron overload triggers RPE cell death in vitro and in vivo. However, the mechanism of RPE iron accumulation in AMD is unknown.

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Background: Dupilumab has been approved to treat atopic dermatitis, asthma, and nasal polyps and is in active clinical trials for the treatment of eosinophilic esophagitis (EoE). Given its shared immunopathology, we hypothesized that EoE symptoms and inflammation would improve when dupilumab therapy was used for other allergic indications.

Objective: To measure the clinical and histologic response in EoE to dupilumab when treating other atopic diseases.

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Background: Respiratory viruses, air pollutants, and aeroallergens are all implicated in worsening pediatric asthma symptoms, but their relative contributions to asthma exacerbations are poorly understood. A significant decrease in asthma exacerbations has been observed during the coronavirus disease 2019 pandemic, providing a unique opportunity to study how major asthma triggers correlate with asthma activity.

Objective: To determine whether changes in respiratory viruses, air pollutants, and/or aeroallergens during the coronavirus disease 2019 pandemic were concomitant with decreased asthma exacerbations.

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  • The Plastic Surgery Political Action Committee (PAC) is underutilized, with lower advocacy and financial contributions from ASPS members compared to other surgical subspecialties; this study explores its impact on practicing plastic surgeons.* -
  • An analysis of ASPS procedural data from 1992-2018 and PAC contributions from 2012-2018 shows significant increases in breast reconstruction volumes linked to key legislative changes, although there were no notable trends for congenital anomaly reconstructions.* -
  • The findings suggest a correlation between PAC legislative efforts and increased surgical case volumes, particularly for breast reconstructions, highlighting the importance of political engagement in the field of plastic surgery.*
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Objective: The classical allergic march model posits that atopy begins in infancy with atopic dermatitis and progresses to asthma and allergic rhinitis in a subset of individuals. The growing prevalence and severity of allergic diseases have prompted renewed interest in refining this model. This review outlines epidemiologic evidence for the existence of allergic march trajectories (distinct paths of atopy development in individuals); reviews the roles that genetics, environment, and disease endotypes play in determining trajectory outcomes; and discusses the clinical utility of the trajectory model.

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  • Eosinophilic esophagitis (EoE) is a food-related allergic condition affecting the esophagus, with challenges in identifying causative foods, leading to food elimination trials and endoscopies.
  • The study compared immune response features from blood samples of individuals with EoE milk allergy, other food allergies, and healthy controls, focusing on IgG4 levels and T cell responses to milk proteins.
  • Findings revealed that T cell responses, especially IL-4 production, were significantly higher in EoE milk allergy patients, indicating that measuring these immune responses could help identify foods causing EoE.
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Several early-life environmental factors have been associated with altered risk for the development and/or severity of individual allergic conditions. These include exposures implicated in the modulation of the microbiome, such as infant delivery mode, diet, and exposure to antibiotics and antacids. The impact of these early-life factors on allergic multimorbidity remains unknown.

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Eosinophilic esophagitis (EoE) is an allergic inflammatory disease of the esophagus that occurs in both children and adults. Previous studies of affected tissue from pediatric cohorts have identified prominent signatures of eosinophilia and type 2 inflammation. However, the details of the immune response in adults with EoE are still being elucidated.

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Background: The coronavirus disease 2019 (COVID-19) pandemic caused dramatic changes in daily routines and health care utilization and delivery patterns in the United States. Understanding the influence of these changes and associated public health interventions on asthma care is important to determine effects on patient outcomes and identify measures that will ensure optimal future health care delivery.

Objective: We sought to identify changes in pediatric asthma-related health care utilization, respiratory viral testing, and air pollution during the COVID-19 pandemic.

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Background: The allergic march refers to the natural history of allergic conditions during infancy and childhood. However, population-level disease incidence patterns do not necessarily reflect the development of allergic disease in individuals. A better understanding of the factors that predispose to different allergic trajectories is needed.

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Article Synopsis
  • Infectious diseases pose a significant threat to African great apes, particularly bonobos, due to their social interactions and group dynamics.
  • A flu-like illness outbreak was reported in two neighboring bonobo groups in Wamba, DR Congo, with the first occurring in the PE group on July 28, 2013, after interactions with the BI and PW groups.
  • The second outbreak affected the E1 group starting October 14, 2013, following close contact with the PE group, suggesting potential disease transmission between the groups, possibly linked to immigrant females who showed prior symptoms.
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