Publications by authors named "Kalpaj Parekh"
Screening for carcinoid heart disease: Trends and future Perspectives.
Int J Cardiol Cardiovasc Risk Prev
September 2024
Article Synopsis
- A study evaluated trends in screening for carcinoid heart disease (CHD) over two decades at a tertiary care center, focusing on patients with neuroendocrine tumors (NETs).
- The research found that 85% of patients met expert-recommended screening criteria, but only 40% underwent echocardiogram screening, with a notable increase post-guideline release (from 32% to 70%).
- The findings suggest that using these recommended criteria can significantly enhance early detection of CHD in at-risk patients.
Article Synopsis
- CFTR modulator drugs improve lung function and body mass index in cystic fibrosis patients, but inflammation remains a challenge, indicating a need to target the underlying causes in the lungs of patients with established disease.* -
- The study explores the presence of unique, potentially pathogenic stem cell variants in cystic fibrosis lungs, similar to those found in COPD, and aims to identify which of these variants contribute to ongoing inflammation.* -
- Research utilized advanced stem cell cloning technology on end-stage CF lungs to identify five predominant stem cell variants, three of which are pro-inflammatory, highlighting the complexity of stem cell involvement in cystic fibrosis lung inflammation.*
Article Synopsis
- Tracheal grafts are important for repairing airway obstructions after surgery, and bioengineered options offer customizable solutions for better integration with the body.* -
- The study involved using a specialized bioreactor to prepare ferret tracheas with basal cells, assessing how well these grafts performed when implanted back in the body.* -
- Although immunosuppression hindered early tissue integration, adding a growth factor helped improve blood vessel formation; the grafts showed signs of survival and integration after one month, leading to further research potential in regenerative therapy.*
Article Synopsis
- - The demand for donor lungs for transplantation exceeds the available supply, despite attempts to increase donor options.
- - Lung xenotransplantation, or using animal lungs for human transplants, has potential but hasn't been tried in humans yet, facing both biological and ethical challenges.
- - Advances in genetic engineering are helping to tackle these biological issues, which could lead to future clinical trials in this area.
Article Synopsis
- The research explores the use of a novel ferret tracheal injury and cell engraftment model to study airway biology, highlighting a gap in the use of such models compared to traditional animal models.
- The study introduces a whole-mount staining protocol that reveals detailed structural anatomy of the airway epithelium and submucosal glands, offering advantages over traditional 2D tissue sections.
- A novel 3D-printed culture chamber facilitates live imaging and cell differentiation at an air-liquid interface, aiming to improve cell-based therapies for pulmonary diseases.
Article Synopsis
- Idiopathic pulmonary fibrosis (IPF) is a severe lung disease characterized by the replacement of healthy lung tissue with dense fibrotic tissue, leading to progressive respiratory failure.
- Research utilizing single-cell RNA sequencing has uncovered a specific type of stem cell in IPF patients that is capable of converting normal lung cells into harmful myofibroblasts, suggesting a critical role in disease progression.
- Drug testing revealed that this profibrotic stem cell variant may be targeted with specific inhibitors, indicating potential new therapeutic approaches for treating IPF.
Article Synopsis
- Keratin expression in airway basal cells changes after lung injury, affecting their behavior, but the specific impacts have not been fully understood.
- In a study related to bronchiolitis obliterans (an issue post-lung transplant), a shift from keratin15 (Krt15) to keratin14 (Krt14) was linked to reduced cell division ability (clonogenicity) in these cells.
- Using genetic techniques, the research found that Krt14 promotes more cell growth but hinders differentiation, while Krt15 supports differentiation but decreases growth, highlighting their distinct roles in cell behavior, especially in chronic diseases like bronchiolitis obliterans.
Article Synopsis
- Lung transplantation (LT) can be a life-saving option for patients with severe COVID-19-related lung issues, and this study aimed to assess the outcomes of these recipients compared to others with similar lung dysfunction.
- Researchers analyzed data from the Organ Procurement and Transplant Network, finding that COVID-19 recipients tended to be younger, primarily male, and had worse lung function at the time of transplantation.
- Ultimately, the study concluded that six-month survival rates for LT recipients due to COVID-19 were similar to those of other lung transplant patients, indicating that LT can be an effective treatment option in these cases.
Article Synopsis
- The study identifies three key stem cell compartments in the airways of larger mammals and mice, specifically highlighting the role of Sox9-expressing progenitors in airway repair that decrease with age.
- It finds that Lef1 is crucial for the contribution of these progenitors to surface airway epithelium (SAE) repair, while deleting Sox9 enhances progenitor proliferation after injury but not in lab settings.
- Additionally, Sox9’s expression is linked to the regulation of glandular progenitor behavior, with different cellular signals (Wnt/Lef1 and Sox9) influencing their growth and movement.
Article Synopsis
- Long-term survival for lung transplant patients is often complicated by chronic lung allograft dysfunction (CLAD), which has two histological types: obliterative bronchiolitis (OB) and restrictive alveolar fibroelastosis (AFE), each with different clinical implications.
- A study utilized a ferret model of lung transplantation to investigate CLAD by comparing histological features and immune response in allografts with OB and AFE, using morphometric analysis and RNA expression profiling.
- Results showed that ferret lung allografts exhibited clinical markers of both OB and AFE, with AFE being associated with larger tertiary lymphoid organs and a greater immune response, highlighting the model's potential for developing new treatments for lung transplant
Article Synopsis
- Tracheal grafts present a potential solution for airway issues requiring surgical removal, but progress on regenerating submucosal glands has been limited.
- A new, cost-effective bioreactor system was created to test the growth of airway epithelial cells and myoepithelial cells on decellularized ferret tracheas, aiming to produce a complete trachea replacement.
- The research showed that the decellularized tracheas maintained their structural integrity, supported cell growth, and indicated successful early differentiation and regeneration of submucosal glands, paving the way for future transplantation studies.
Article Synopsis
- - Cellular transplantation, though smaller than solid organ transplants, has significant potential for growth in science and clinical practices, focusing on areas like islets, hepatocytes, adopted regulatory therapy, and stem cells.
- - The field is advancing with promising technologies like three-dimensional bioprinting, which could enhance the development and success of cellular transplants.
- - To unlock the full benefits of cellular transplantation, there's a need for regulatory changes, increased funding, and a shift in how these procedures are overseen, aligning them with the standards for solid organ transplants to reduce risks and improve outcomes.
Article Synopsis
- Regional analgesic techniques, like paravertebral blocks (PVBs), are explored for their effectiveness on pain management after video-assisted thoracoscopic surgery (VATS) compared to general anesthesia (GA) alone in a study with 520 patients.
- Results showed that opioid consumption was significantly lower in the PVB group during the first 24 hours post-surgery, but average pain scores between the two groups did not differ significantly.
- Non-analgesic outcomes such as hospital stay length and complication rates were analyzed, but the findings primarily highlighted the benefits of reduced opioid use with PVBs without significantly impacting pain levels.
Article Synopsis
- * Findings revealed that median overall survival was 6.6 months for all patients, but improved to 30.2 months for those who received both radiation and surgery, highlighting the effectiveness of aggressive treatments in some cases.
- * Certain factors, such as undergoing esophagectomy and having low tumor grades, were linked to better survival rates, while having liver or bone metastases worsened outcomes.
Article Synopsis
- This study explored the use of stereotactic body radiation therapy (SBRT) as a potential treatment for patients with locally recurrent esophageal cancer after initial curative treatments, hypothesizing that SBRT would control tumors effectively with low side effects.
- Nine patients with locoregional recurrences received SBRT, with most being primarily diagnosed with advanced adenocarcinoma, and a follow-up period of about 10.5 months was recorded.
- Results showed limited toxicity, with only mild side effects reported, and median progression-free survival of 5.0 months and overall survival of 12.9 months, indicating SBRT's feasibility as a salvage option in this patient group.*
Article Synopsis
- * This review covers known stem/progenitor cell populations, their differences between humans and rodents, and their implications for chronic lung disease and potential treatments.
- * Recent advancements, like lineage-tracing models and single-cell RNA sequencing, have improved our knowledge of lung stem cells, helping us understand how they differentiate and maintain flexibility, paving the way for better therapies for lung diseases.
Iatrogenic tracheal injuries are rare but potentially serious complications of endotracheal intubation that frequently require lung isolation to repair. This is not tolerated in patients with severe respiratory failure. We describe a case in a patient with acute respiratory distress syndrome, repaired using veno-venous extracorporeal membrane oxygenation.
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- * This study utilized single-cell cloning technologies to analyze lung tissue from COPD patients and controls, revealing that COPD lungs have distinct progenitor cells that contribute to disease symptoms and inflammation.
- * The research suggests that while these variant progenitor cells exist in healthy lungs, their excessive proliferation may trigger the damaging processes seen in COPD, implicating them in both normal and pathological lung functions.
Derivation of induced pluripotent stem cells from ferret somatic cells.
Am J Physiol Lung Cell Mol Physiol
April 2020
Article Synopsis
- * Researchers have successfully generated induced pluripotent stem cells (iPSCs) from ferrets, which demonstrate traits similar to human iPSCs, such as self-renewal and the ability to differentiate into multiple cell types.
- * This breakthrough in creating ferret iPSCs opens up new opportunities to test patient-specific cell therapies for lung regeneration and potentially other tissue repairs.
Background/aims: Peroral endoscopic myotomy (POEM) is a novel procedure for the treatment of achalasia and spastic esophageal disorders. Experience with POEM is limited, but its reported outcomes are excellent. It is deemed safe even for patients with prior interventions.
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- Esophagectomy combined with preoperative chemoradiation is the most effective treatment for early stage esophageal cancer.
- The traditional method of transhiatal esophagectomy has limited access to the mediastinum area.
- This text introduces a new technique for better mediastinal dissection during transhiatal esophagectomy using an innovative retractor.