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Article: Low Diagnostic Utility of Frequent Serial Tracheal Aspirate Cultures in the PICU.

Feldman, Evin / Shah, Shivang S / Ahn, Danielle

Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

2023 Volume 24, Issue 8, Page(s) 681–689

Abstract: Objectives: To determine the diagnostic outcomes of serial tracheal aspirate cultures (TACs) in the PICU.: Design: A retrospective chart review of TAC utilization was performed. Items recorded for each TAC included the time and date of culture ... ...

Abstract	Objectives: To determine the diagnostic outcomes of serial tracheal aspirate cultures (TACs) in the PICU. Design: A retrospective chart review of TAC utilization was performed. Items recorded for each TAC included the time and date of culture acquisition, result, changes in microbial resistance patterns, antimicrobial therapy, and patient clinical course. Setting: A single urban tertiary care children's hospital in the United States. Subjects: Patients admitted to the PICU from January 1, to October 31, 2021, for whom a TAC was performed. Interventions: None. Measurements and main results: One hundred fifty unique subjects had 582 TACs performed during the study period, of which 145 (24.9%) were serially repeated within 72 hours. Of these serial TACs, 82 (56.6%) had no growth, 41 (28.3%) grew the same organism as the prior culture, with most (36/41) displaying no major change in antimicrobial susceptibilities, 11 (7.6%) grew a new organism previously grown during the admission, and 11 (7.6%) grew a new organism not previously grown during the admission. Overall, only 26 of these serial TACs (17.9%) provided new diagnostic information, whereas only five (3.4%) led to a change in management. Conclusions: Frequent serial TAC sampling in the PICU is common and infrequently yields new data that impact clinical decision-making. Considering worsening antimicrobial resistance and the role of diagnostic stewardship in mitigating it, these findings further support a 72-hour reassessment period before performing a repeat TAC in critically ill children.
MeSH term(s)	Child ; Humans ; Infant ; Retrospective Studies ; Anti-Infective Agents ; Hospitalization ; Intensive Care Units, Pediatric ; Critical Illness/therapy
Chemical Substances	Anti-Infective Agents
Language	English
Publishing date	2023-04-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	2052349-X
ISSN	1947-3893 ; 1529-7535
ISSN (online)	1947-3893
ISSN	1529-7535
DOI	10.1097/PCC.0000000000003259
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Article ; Online: Bats and Coronaviruses in the Context of COVID-19.

Wang, Linfa / Ahn, Matae / Anderson, Danielle E

China CDC weekly

2021 Volume 3, Issue 7, Page(s) 153–155

Language	English
Publishing date	2021-09-14
Publishing country	China
Document type	Journal Article
ISSN	2096-7071
ISSN (online)	2096-7071
DOI	10.46234/ccdcw2021.045
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Article ; Online: Participation of the IL-10RB Related Cytokines, IL-22 and IFN-λ in Defense of the Airway Mucosal Barrier.

Ahn, Danielle / Prince, Alice

Frontiers in cellular and infection microbiology

2020 Volume 10, Page(s) 300

Abstract: The airway epithelial barrier is a major barrier protecting against clinically significant infections of the lung. Its integrity is often compromised due to mechanical, chemical, or infectious causes. Opportunistic bacterial pathogens are poised to cause ...

Abstract	The airway epithelial barrier is a major barrier protecting against clinically significant infections of the lung. Its integrity is often compromised due to mechanical, chemical, or infectious causes. Opportunistic bacterial pathogens are poised to cause parenchymal infection and become difficult to eradicate due to adaptive metabolic changes, biofilm formation, and the acquisition of antimicrobial resistance and fitness genes. Enhancing mucosal defenses by modulating the cytokines that regulate barrier functions, such as interleukin-22 (IL-22) and interferon-λ (IFN-λ), members of the IL-10 family of cytokines, is an attractive approach to prevent these infections that are associated with high morbidity and mortality. These cytokines both signal through the cognate receptor IL-10RB, have related protein structures and common downstream signaling suggesting shared roles in host respiratory defense. They are typically co-expressed in multiple models of infections, but with differing kinetics. IL-22 has an important role in the producing antimicrobial peptides, upregulating expression of junctional proteins in the airway epithelium and working in concert with other inflammatory cytokines such as IL-17. Conversely, IFN-λ, a potent antiviral in influenza infection with pro-inflammatory properties, appears to decrease junctional integrity allowing for bacterial and immune cell translocation. The effects of these cytokines are pleotropic, with pathogen and tissue specific consequences. Understanding how these cytokines work in the mucosal defenses of the respiratory system may suggest potential targets to prevent invasive infections of the damaged lung.
MeSH term(s)	Coronavirus Infections/immunology ; Humans ; Influenza, Human/immunology ; Interferon-gamma/immunology ; Interleukin-10 Receptor beta Subunit/immunology ; Interleukins/immunology ; Klebsiella Infections/immunology ; Klebsiella pneumoniae/immunology ; Pseudomonas aeruginosa/immunology ; Respiratory Mucosa/immunology ; Respiratory Mucosa/microbiology ; Staphylococcal Infections/immunology ; Staphylococcus aureus/immunology ; Tight Junctions/immunology ; Interleukin-22
Chemical Substances	IFNG protein, human ; IL10RB protein, human ; Interleukin-10 Receptor beta Subunit ; Interleukins ; Interferon-gamma (82115-62-6)
Keywords	covid19
Language	English
Publishing date	2020-06-19
Publishing country	Switzerland
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Review
ZDB-ID	2619676-1
ISSN	2235-2988 ; 2235-2988
ISSN (online)	2235-2988
ISSN	2235-2988
DOI	10.3389/fcimb.2020.00300
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Article ; Online: Personalized Feedback for Personalized Trials: Construction of Summary Reports for Participants in a Series of Personalized Trials for Chronic Lower Back Pain.

D'Angelo, Stefani / Ahn, Heejoon / Miller, Danielle / Monane, Rachel / Butler, Mark

Harvard data science review

2022 Volume 4, Issue SI3

Abstract: Personalized (N-of-1) trials offer a patient-centered research approach that can provide important clinical information for patients when selecting which treatment options best manage their chronic health concern. Researchers utilizing this approach ... ...

Abstract	Personalized (N-of-1) trials offer a patient-centered research approach that can provide important clinical information for patients when selecting which treatment options best manage their chronic health concern. Researchers utilizing this approach should present trial results to patients in a clear and understandable manner in order for personalized research trials to be useful to participants. The current study provides participant feedback examples for personalized trial reports using lay summaries and multiple presentation styles from a series of 60 randomized personalized trials examining the effects of massage and yoga versus usual care on chronic lower back pain (CLBP). Researchers generated summary participant reports that describe individual participant results using multiple presentation modalities of data (e.g., visual, written, and auditory) to offer the most appealing style for various participants. The article discusses contents of the participant report as well as participant satisfaction with the personalized summary report, captured using a satisfaction survey administered after study completion. The results from the satisfaction survey in the current study show that participants were generally satisfied with their personalized summary report. Researchers will use feedback from the participants in the current study to refine personalized feedback reports for future studies.
Language	English
Publishing date	2022-09-08
Publishing country	United States
Document type	Journal Article
ISSN	2644-2353
ISSN (online)	2644-2353
DOI	10.1162/99608f92.d5b57784
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Article ; Online: The Social Contagion Potential of Pro-Vaccine Messages on Black Twitter.

Grabe, Maria Elizabeth / Brown, Danielle K / Ochieng, Jimmy / Bryden, John / Robinson, Ranada D / Ahn, Yong-Yeol / Moss, Alana / Wang, Wei

Health communication

2023 , Page(s) 1–12

Abstract: Black Americans in the US not only suffered from disproportionately high hospitalization and death rates throughout the pandemic but also from the consequences of low COVID-19 vaccination rates. This pattern of disparity is linked to distrust of public ... ...

Abstract	Black Americans in the US not only suffered from disproportionately high hospitalization and death rates throughout the pandemic but also from the consequences of low COVID-19 vaccination rates. This pattern of disparity is linked to distrust of public health systems that originates from a history of medical atrocities committed against Black people. For that reason, mitigation of race-based inequity in COVID-19 impacts might find more success in grassroots information contagion than official public health campaigns. While Black Twitter is well-positioned as a conduit for such information contagion, little is known about message characteristics that would afford it. Here, we tested the impact of four different message frames (personalization, interactive, fear appeal, neutral) on the social contagion potential of bi-modal social media messages promoting COVID-19 vaccinations and finding personalized messages to be the most shareable. Wary of recommending personalization as the blueprint for setting a social contagion health campaign in motion, we probed further to understand the influence of individual-level variables on the communicability of personalized messages. Subsequently, regression models and focus group data were consulted, revealing that thinking styles, vaccine confidence levels, and attitudes toward social media were significant factors of influence on the contagion potential of personalized messages. We discussed the implications of these results for health campaigns.
Language	English
Publishing date	2023-11-23
Publishing country	England
Document type	Journal Article
ZDB-ID	1038723-7
ISSN	1532-7027 ; 1041-0236
ISSN (online)	1532-7027
ISSN	1041-0236
DOI	10.1080/10410236.2023.2281075
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Article ; Online: The Dysregulated IL-23/TH17 Axis in Endometriosis Pathophysiology.

Sisnett, Danielle J / Zutautas, Katherine B / Miller, Jessica E / Lingegowda, Harshavardhan / Ahn, Soo Hyun / McCallion, Alison / Bougie, Olga / Lessey, Bruce A / Tayade, Chandrakant

Journal of immunology (Baltimore, Md. : 1950)

2024 Volume 212, Issue 9, Page(s) 1428–1441

Abstract: Endometriosis is a chronic inflammatory disease in which endometrial-like tissue grows ectopically, resulting in pelvic pain and infertility. IL-23 is a key contributor in the development and differentiation of TH17 cells, driving TH17 cells toward a ... ...

Abstract	Endometriosis is a chronic inflammatory disease in which endometrial-like tissue grows ectopically, resulting in pelvic pain and infertility. IL-23 is a key contributor in the development and differentiation of TH17 cells, driving TH17 cells toward a pathogenic profile. In a variety of inflammatory and autoimmune disorders, TH17 cells secrete proinflammatory cytokines, including IL-17, contributing to disease pathophysiology. Our studies and others have implicated IL-17 and TH17 cell dysregulation in endometriosis, which is associated with disease severity. In this article, we address whether IL-23-driven TH17 cells contribute to cardinal features of lesion proliferation, vascularization, and inflammation in endometriosis using patient samples, representative cell lines, and our established mouse model of endometriosis. The results indicated dysregulated expression of key genes in the IL-23/TH17 axis in patient ectopic and eutopic endometrial samples and increased IL-23 protein in patient plasma compared with controls. In vitro studies using primary human TH cells determined that rIL-23 mixture treatment increased pathogenic TH17 cell frequency. Similarly, rIL-23 treatment of cell lines (12Z cells, EECCs, HUVECs, and hESCs) representative of the endometriotic lesion microenvironment increased cytokines and growth factors, which play a role in lesion establishment and maintenance. In a syngeneic mouse model of endometriosis, rIL-23 treatment altered numbers of myeloid and T cell subsets in peritoneal fluid and increased giant cells within the lesion. Lesions from rIL-23-treated mice did not reveal significant alterations in proliferation/vascularization, although trends of increased proliferation and vascularization were observed. Collectively, these findings provide insights into the impact of the IL-23/TH17 axis on local immune dysfunction and broadly on endometriosis pathophysiology.
MeSH term(s)	Animals ; Female ; Humans ; Mice ; Cytokines/metabolism ; Endometriosis/metabolism ; Endometriosis/pathology ; Endometrium/metabolism ; Endometrium/pathology ; Interleukin-17/metabolism ; Interleukin-23/metabolism ; Th17 Cells/metabolism
Chemical Substances	Cytokines ; Interleukin-17 ; Interleukin-23
Language	English
Publishing date	2024-04-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	3056-9
ISSN	1550-6606 ; 0022-1767 ; 1048-3233 ; 1047-7381
ISSN (online)	1550-6606
ISSN	0022-1767 ; 1048-3233 ; 1047-7381
DOI	10.4049/jimmunol.2400018
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Article: Participation of the IL-10RB Related Cytokines, IL-22 and IFN-λ in Defense of the Airway Mucosal Barrier

Ahn, Danielle / Prince, Alice

Front Cell Infect Microbiol

Abstract	The airway epithelial barrier is a major barrier protecting against clinically significant infections of the lung. Its integrity is often compromised due to mechanical, chemical, or infectious causes. Opportunistic bacterial pathogens are poised to cause parenchymal infection and become difficult to eradicate due to adaptive metabolic changes, biofilm formation, and the acquisition of antimicrobial resistance and fitness genes. Enhancing mucosal defenses by modulating the cytokines that regulate barrier functions, such as interleukin-22 (IL-22) and interferon-λ (IFN-λ), members of the IL-10 family of cytokines, is an attractive approach to prevent these infections that are associated with high morbidity and mortality. These cytokines both signal through the cognate receptor IL-10RB, have related protein structures and common downstream signaling suggesting shared roles in host respiratory defense. They are typically co-expressed in multiple models of infections, but with differing kinetics. IL-22 has an important role in the producing antimicrobial peptides, upregulating expression of junctional proteins in the airway epithelium and working in concert with other inflammatory cytokines such as IL-17. Conversely, IFN-λ, a potent antiviral in influenza infection with pro-inflammatory properties, appears to decrease junctional integrity allowing for bacterial and immune cell translocation. The effects of these cytokines are pleotropic, with pathogen and tissue specific consequences. Understanding how these cytokines work in the mucosal defenses of the respiratory system may suggest potential targets to prevent invasive infections of the damaged lung.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #637469
Database	COVID19

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Article ; Online: Host-Pathogen Interface: Progress in Understanding the Pathogenesis of Infection Due to Multidrug-Resistant Bacteria in the Intensive Care Unit.

Ahn, Danielle / Prince, Alice

The Journal of infectious diseases

2017 Volume 215, Issue suppl_1, Page(s) S1–S8

Abstract: The diverse responses of critically ill patients to infection with multi-drug resistant (MDR) bacteria are determined by many complex factors. These include the nature of the immune response activated by specific organisms. Properties unique to each ... ...

Abstract	The diverse responses of critically ill patients to infection with multi-drug resistant (MDR) bacteria are determined by many complex factors. These include the nature of the immune response activated by specific organisms. Properties unique to each organism such as adherence proteins, microvesicle formation, toxin production and the propensity to form biofilms are important factors in pathogenesis. Equally important is the variability in the host immune response, whether due to genetic or iatrogenic factors, including the presence of major comorbidities, treatment with immunomodulatory therapy and disruption of the microbiome. Future approaches in treating infections caused by MDR bacteria will be heavily influenced by a precision medicine approach, with rapid diagnostic techniques of both bacterial and host factors and high throughput screening of novel therapeutics becoming the mainstay of treatment.
MeSH term(s)	Anti-Bacterial Agents/therapeutic use ; Bacterial Infections/drug therapy ; Bacterial Infections/immunology ; Bacterial Infections/pathology ; Critical Illness ; Cross Infection/diagnosis ; Cross Infection/drug therapy ; Cross Infection/microbiology ; Drug Resistance, Multiple, Bacterial ; Host-Pathogen Interactions/drug effects ; Humans ; Immunity ; Intensive Care Units
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2017-03-30
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	3019-3
ISSN	1537-6613 ; 0022-1899
ISSN (online)	1537-6613
ISSN	0022-1899
DOI	10.1093/infdis/jiw405
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Article ; Online: Participation of Necroptosis in the Host Response to Acute Bacterial Pneumonia.

Ahn, Danielle / Prince, Alice

Journal of innate immunity

2017 Volume 9, Issue 3, Page(s) 262–270

Abstract: Common pulmonary pathogens, such as Streptococcus pneumoniae and Staphylococcus aureus, as well as the host-adapted pathogens responsible for health care-associated pneumonias, such as the carbapenem-resistant Klebsiella pneumoniae and Serratia ... ...

Abstract	Common pulmonary pathogens, such as Streptococcus pneumoniae and Staphylococcus aureus, as well as the host-adapted pathogens responsible for health care-associated pneumonias, such as the carbapenem-resistant Klebsiella pneumoniae and Serratia marcecsens, are able to activate cell death through the RIPK1/RIPK3/MLKL cascade that causes necroptosis. Necroptosis can influence the pathogenesis of pneumonia through several mechanisms. Activation of this pathway can result in the loss of specific types of immune cells, especially macrophages, and, in so doing, contribute to host pathology through the loss of their critical immunoregulatory functions. However, in other settings of infection, necroptosis promotes pathogen removal and the eradication of infected cells to control excessive proinflammatory signaling. Bacterial production of pore-forming toxins provides a common mechanism to activate necroptosis by diverse bacterial species, with variable consequences depending upon the specific pathogen. Included in this brief review are data demonstrating the ability of the carbapenem-resistant ST258 K. pneumoniae to activate necroptosis in the setting of pneumonia, which is counterbalanced by their suppression of CYLD expression. Exactly how necroptosis and other mechanisms of cell death are coregulated in the response to specific pulmonary pathogens remains a topic of active investigation, and it may provide potential therapeutic targets in the future.
MeSH term(s)	Acute Disease ; Animals ; Apoptosis ; Deubiquitinating Enzyme CYLD/metabolism ; Humans ; Klebsiella pneumoniae/immunology ; Lung/microbiology ; Lung/pathology ; Macrophages/immunology ; Macrophages/microbiology ; Necrosis ; Pneumonia, Bacterial/immunology ; Staphylococcus aureus/immunology ; Streptococcus pneumoniae/immunology
Chemical Substances	CYLD protein, human (EC 3.4.19.12) ; Deubiquitinating Enzyme CYLD (EC 3.4.19.12)
Language	English
Publishing date	2017-01-27
Publishing country	Switzerland
Document type	Journal Article ; Review ; Research Support, N.I.H., Extramural
ZDB-ID	2454158-8
ISSN	1662-8128 ; 1662-811X
ISSN (online)	1662-8128
ISSN	1662-811X
DOI	10.1159/000455100
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Article ; Online: Activin A marks a novel progenitor cell population during fracture healing and reveals a therapeutic strategy.

Yao, Lutian / Lu, Jiawei / Zhong, Leilei / Wei, Yulong / Gui, Tao / Wang, Luqiang / Ahn, Jaimo / Boerckel, Joel D / Rux, Danielle / Mundy, Christina / Qin, Ling / Pacifici, Maurizio

eLife

2023 Volume 12

Abstract: Insufficient bone fracture repair represents a major clinical and societal burden and novel strategies are needed to address it. Our data reveal that the transforming growth factor-β superfamily member Activin A became very abundant during mouse and ... ...

Abstract	Insufficient bone fracture repair represents a major clinical and societal burden and novel strategies are needed to address it. Our data reveal that the transforming growth factor-β superfamily member Activin A became very abundant during mouse and human bone fracture healing but was minimally detectable in intact bones. Single-cell RNA-sequencing revealed that the Activin A-encoding gene
MeSH term(s)	Mice ; Humans ; Animals ; Fracture Healing/genetics ; Bony Callus ; Osteogenesis ; Stem Cells ; Cell Differentiation ; Activins
Chemical Substances	activin A ; Activins (104625-48-1)
Language	English
Publishing date	2023-12-11
Publishing country	England
Document type	Journal Article
ZDB-ID	2687154-3
ISSN	2050-084X ; 2050-084X
ISSN (online)	2050-084X
ISSN	2050-084X
DOI	10.7554/eLife.89822
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