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  1. Article ; Online: Evaluating barriers to and promotors of telehealth during the COVID-19 pandemic at U.S. cystic fibrosis programs (Commentary).

    Ranganathan, Sarath C

    Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society

    2021  Volume 20 Suppl 3, Page(s) 14–15

    MeSH term(s) COVID-19 ; Cystic Fibrosis/epidemiology ; Humans ; Pandemics ; SARS-CoV-2 ; Telemedicine
    Language English
    Publishing date 2021-09-02
    Publishing country Netherlands
    Document type Journal Article ; Comment
    ZDB-ID 2084724-5
    ISSN 1873-5010 ; 1569-1993
    ISSN (online) 1873-5010
    ISSN 1569-1993
    DOI 10.1016/j.jcf.2021.08.026
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  2. Article ; Online: Attenuation of exacerbation.

    Ranganathan, Sarath C

    Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society

    2018  Volume 17, Issue 6, Page(s) 692–693

    MeSH term(s) Anti-Bacterial Agents ; Child ; Cystic Fibrosis ; Disease Progression ; Humans ; Lung
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2018-10-09
    Publishing country Netherlands
    Document type Editorial ; Comment
    ZDB-ID 2091075-7
    ISSN 1873-5010 ; 1569-1993
    ISSN (online) 1873-5010
    ISSN 1569-1993
    DOI 10.1016/j.jcf.2018.09.006
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  3. Article ; Online: The longitudinal microbial and metabolic landscape of infant cystic fibrosis: the gut-lung axis.

    Frayman, Katherine B / Macowan, Matthew / Caparros-Martin, Jose / Ranganathan, Sarath C / Marsland, Benjamin J

    The European respiratory journal

    2024  Volume 63, Issue 5

    Abstract: Background and aim: In cystic fibrosis, gastrointestinal dysfunction and lower airway infection occur early and are independently associated with poorer outcomes in childhood. This study aimed to define the relationship between the microbiota at each ... ...

    Abstract Background and aim: In cystic fibrosis, gastrointestinal dysfunction and lower airway infection occur early and are independently associated with poorer outcomes in childhood. This study aimed to define the relationship between the microbiota at each niche during the first 2 years of life, its association with growth and airway inflammation, and explanatory features in the metabolome.
    Materials and methods: 67 bronchoalveolar lavage fluid (BALF), 62 plasma and 105 stool samples were collected from 39 infants with cystic fibrosis between 0 and 24 months who were treated with prophylactic antibiotics. 16S rRNA amplicon and shotgun metagenomic sequencing were performed on BALF and stool samples, respectively; metabolomic analyses were performed on all sample types. Sequencing data from healthy age-matched infants were used as controls.
    Results: Bacterial diversity increased over the first 2 years in both BALF and stool, and microbial maturation was delayed in comparison to healthy controls from the RESONANCE cohort. Correlations between their respective abundance in both sites suggest stool may serve as a noninvasive alternative for detecting BALF
    Conclusion: Exploration of the gut-lung microbiome and metabolome reveals diverse multisite interactions in cystic fibrosis that emerge in early life. Gut-lung metabolomic links with airway inflammation and
    MeSH term(s) Humans ; Cystic Fibrosis/microbiology ; Cystic Fibrosis/metabolism ; Infant ; Bronchoalveolar Lavage Fluid/microbiology ; Feces/microbiology ; Male ; Female ; RNA, Ribosomal, 16S/genetics ; Lung/microbiology ; Lung/metabolism ; Infant, Newborn ; Gastrointestinal Microbiome ; Longitudinal Studies ; Case-Control Studies ; Metabolome ; Metabolomics ; Anti-Bacterial Agents/therapeutic use ; Child, Preschool
    Chemical Substances RNA, Ribosomal, 16S ; Anti-Bacterial Agents
    Language English
    Publishing date 2024-05-09
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
    ZDB-ID 639359-7
    ISSN 1399-3003 ; 0903-1936
    ISSN (online) 1399-3003
    ISSN 0903-1936
    DOI 10.1183/13993003.02290-2023
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    Zs.MO 292: Show issues

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  4. Article ; Online: Pulmonary immune profiling reveals common inflammatory endotypes of childhood wheeze and suppurative lung disease.

    Neeland, Melanie R / Gubbels, Liam / Wong, Anson Tsz Chun / Walker, Hannah / Ranganathan, Sarath C / Shanthikumar, Shivanthan

    Mucosal immunology

    2024  

    Abstract: Suppurative lung disease and wheezing are common respiratory diseases of childhood, however, due to poor understanding of underlying pathobiology, there are limited treatment options and disease recurrence is common. We aimed to profile the pulmonary and ...

    Abstract Suppurative lung disease and wheezing are common respiratory diseases of childhood, however, due to poor understanding of underlying pathobiology, there are limited treatment options and disease recurrence is common. We aimed to profile the pulmonary and systemic immune response in children with wheeze and chronic suppurative lung disease for identification of endotypes that can inform improved clinical management. We used clinical microbiology data, highly multiplexed flow cytometry and immunoassays to compare pulmonary [bronchoalveolar lavage (BAL)] and systemic immunity in children with lung disease and controls. Unsupervised analytical approaches were applied to BAL immune data to explore biological endotypes. We identified two endotypes that were analogous in both frequency and immune signature across both respiratory diseases. The hyper-inflammatory endotype had a 12-fold increase in neutrophil infiltration and upregulation of 14 soluble signatures associated with type 2 inflammation and cell recruitment to tissue. The non-inflammatory endotype was not significantly different from controls. We showed these endotypes are measurable in a clinical setting and can be defined by measuring only three immune factors in BAL. We identified hyper-inflammatory and non-inflammatory endotypes common across pediatric wheeze and chronic suppurative lung disease that, if validated in future studies, have the potential to inform clinical management.
    Language English
    Publishing date 2024-03-16
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2411370-0
    ISSN 1935-3456 ; 1933-0219
    ISSN (online) 1935-3456
    ISSN 1933-0219
    DOI 10.1016/j.mucimm.2024.03.001
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  5. Article ; Online: Bronchoalveolar lavage in children: Still the gold standard.

    Shanthikumar, Shivanthan / Ranganathan, Sarath C

    Pediatric pulmonology

    2020  Volume 56, Issue 2, Page(s) 325–326

    MeSH term(s) Bronchitis ; Bronchoalveolar Lavage ; Child ; Humans ; Pseudomonas Infections
    Language English
    Publishing date 2020-11-03
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 632784-9
    ISSN 1099-0496 ; 8755-6863
    ISSN (online) 1099-0496
    ISSN 8755-6863
    DOI 10.1002/ppul.25136
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  6. Article ; Online: Minimal structural lung disease in early life represents significant pathology.

    Shanthikumar, Shivanthan / Stick, Stephen M / Ranganathan, Sarath C

    Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society

    2021  Volume 20, Issue 6, Page(s) e118–e120

    MeSH term(s) Cystic Fibrosis ; Humans ; Lung
    Language English
    Publishing date 2021-01-06
    Publishing country Netherlands
    Document type Letter ; Comment
    ZDB-ID 2084724-5
    ISSN 1873-5010 ; 1569-1993
    ISSN (online) 1873-5010
    ISSN 1569-1993
    DOI 10.1016/j.jcf.2020.12.010
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  7. Article ; Online: Virtual monitoring in CF - the importance of continuous monitoring in a multi-organ chronic condition.

    Vagg, Tamara / Deasy, Kevin F / Chapman, Wendy W / Ranganathan, Sarath C / Plant, Barry J / Shanthikumar, Shivanthan

    Frontiers in digital health

    2023  Volume 5, Page(s) 1196442

    Abstract: Cystic Fibrosis (CF) is a chronic life-limiting condition that affects multiple organs within the body. Patients must adhere to strict medication regimens, physiotherapy, diet, and attend regular clinic appointments to manage their condition effectively. ...

    Abstract Cystic Fibrosis (CF) is a chronic life-limiting condition that affects multiple organs within the body. Patients must adhere to strict medication regimens, physiotherapy, diet, and attend regular clinic appointments to manage their condition effectively. This necessary but burdensome requirement has prompted investigations into how different digital health technologies can enhance current care by providing the opportunity to virtually monitor patients. This review explores how virtual monitoring has been harnessed for assessment or performance of physiotherapy/exercise, diet/nutrition, symptom monitoring, medication adherence, and wellbeing/mental-health in people with CF. This review will also briefly discuss the potential future of CF virtual monitoring and some common barriers to its current adoption and implementation within CF. Due to the multifaceted nature of CF, it is anticipated that this review will be relevant to not only the CF community, but also those investigating and developing digital health solutions for the management of other chronic diseases.
    Language English
    Publishing date 2023-05-04
    Publishing country Switzerland
    Document type Journal Article ; Review
    ISSN 2673-253X
    ISSN (online) 2673-253X
    DOI 10.3389/fdgth.2023.1196442
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  8. Article ; Online: Mapping Pulmonary and Systemic Inflammation in Preschool Aged Children With Cystic Fibrosis.

    Shanthikumar, Shivanthan / Ranganathan, Sarath C / Saffery, Richard / Neeland, Melanie R

    Frontiers in immunology

    2021  Volume 12, Page(s) 733217

    Abstract: The immune landscape of the paediatric respiratory system remains largely uncharacterised and as a result, the mechanisms of globally important childhood respiratory diseases remain poorly understood. In this work, we used high parameter flow cytometry ... ...

    Abstract The immune landscape of the paediatric respiratory system remains largely uncharacterised and as a result, the mechanisms of globally important childhood respiratory diseases remain poorly understood. In this work, we used high parameter flow cytometry and inflammatory cytokine profiling to map the local [bronchoalveolar lavage (BAL)] and systemic (whole blood) immune response in preschool aged children with cystic fibrosis (CF) and aged-matched healthy controls. We demonstrate that children with CF show pulmonary infiltration of CD66b
    MeSH term(s) Biomarkers/blood ; Bronchoalveolar Lavage Fluid/immunology ; Case-Control Studies ; Cystic Fibrosis/diagnosis ; Cystic Fibrosis/immunology ; Cystic Fibrosis/metabolism ; Cytokines/blood ; Flow Cytometry ; Humans ; Immunophenotyping ; Inflammation/diagnosis ; Inflammation/immunology ; Inflammation/metabolism ; Inflammation Mediators/blood ; Leukocytes/immunology ; Leukocytes/metabolism ; Phenotype ; Pneumonia/diagnosis ; Pneumonia/immunology ; Pneumonia/metabolism
    Chemical Substances Biomarkers ; Cytokines ; Inflammation Mediators
    Language English
    Publishing date 2021-10-15
    Publishing country Switzerland
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2606827-8
    ISSN 1664-3224 ; 1664-3224
    ISSN (online) 1664-3224
    ISSN 1664-3224
    DOI 10.3389/fimmu.2021.733217
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  9. Article ; Online: Telehealth in Cystic Fibrosis. A systematic review incorporating a novel scoring system and expert weighting to identify a 'top 10 manuscripts' to inform future best practices implementation.

    Vagg, Tamara / Shanthikumar, Shivanthan / Ibrahim, Hisham / O'Regan, Paul / Chapman, Wendy W / Kirwan, Laura / Ranganathan, Sarath C / Plant, Barry J

    Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society

    2023  Volume 22, Issue 4, Page(s) 598–606

    Abstract: The ongoing development and integration of telehealth within CF care has been accelerated in response to the Covid-19 pandemic, with many centres publishing their experiences. Now, as the restrictions of the pandemic ease, the use of telehealth appears ... ...

    Abstract The ongoing development and integration of telehealth within CF care has been accelerated in response to the Covid-19 pandemic, with many centres publishing their experiences. Now, as the restrictions of the pandemic ease, the use of telehealth appears to be waning, with many centres returning to routine traditional face-to-face services. For most, telehealth is not integrated into clinical care models, and there is a lack of guidance on how to integrate such a service into clinical care. The aims of this systematic review were to first identify manuscripts which may inform best CF telehealth practices, and second, to analyse these finding to determine how the CF community may use telehealth to improve care for patients, families, and Multidisciplinary Teams into the future. To achieve this, the PRISMA review methodology was utilised, in combination with a modified novel scoring system that consolidates expert weighting from key CF stakeholders, allowing for the manuscripts to be placed in a hierarchy in accordance with their scientific robustness. From the 39 found manuscripts, the top ten are presented and further analysed. The top ten manuscripts are exemplars of where telehealth is used effectively within CF care at this time, and demonstrate specific use cases of its potential best practices. However, there is a lack of guidance for implementation and clinical decision making, which remains an area for improvement. Thus, it is suggested that further work explores and provides guidance for standardised implementation into CF clinical practice.
    MeSH term(s) Humans ; Cystic Fibrosis/diagnosis ; Cystic Fibrosis/epidemiology ; Cystic Fibrosis/therapy ; Pandemics ; COVID-19/epidemiology ; Telemedicine
    Language English
    Publishing date 2023-05-23
    Publishing country Netherlands
    Document type Systematic Review ; Journal Article ; Review
    ZDB-ID 2084724-5
    ISSN 1873-5010 ; 1569-1993
    ISSN (online) 1873-5010
    ISSN 1569-1993
    DOI 10.1016/j.jcf.2023.05.012
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  10. Article ; Online: Telehealth spirometry for children with cystic fibrosis.

    Logie, Karla / Welsh, Liam / Ranganathan, Sarath C

    Archives of disease in childhood

    2019  Volume 105, Issue 12, Page(s) 1203–1205

    Abstract: Aim: We assessed the feasibility of telehealth spirometry assessments for children with cystic fibrosis (CF) living in a regional setting.: Method: Patients with acceptable computer hardware at home were provided with a SpiroUSB (Vyaire) spirometer. ... ...

    Abstract Aim: We assessed the feasibility of telehealth spirometry assessments for children with cystic fibrosis (CF) living in a regional setting.
    Method: Patients with acceptable computer hardware at home were provided with a SpiroUSB (Vyaire) spirometer. Spirometry was performed during 'home admissions' or for ongoing home monitoring in children living outside metropolitan Melbourne. At the end of the session, the family forwarded the data to the Royal Children's Hospital, Melbourne.
    Results: Twenty-two patients aged 7 to 17 years participated, with spirometry successful in 55 of 59 (93%) attempted sessions according to American Thoracic Society/European Respiratory Society criteria. The median distance between the subject's home and the hospital was 238 km (range 62-537 km) which equated to a travel time saving of 5 hours and 34 min per hospital visit.
    Conclusion: Home-based telehealth spirometry is feasible in children with CF and can support the CF team during home-based admissions and for ongoing outpatient monitoring.
    MeSH term(s) Adolescent ; Child ; Cystic Fibrosis/physiopathology ; Feasibility Studies ; Female ; Forced Expiratory Volume ; Humans ; Internet ; Male ; Microcomputers ; Pilot Projects ; Spirometry/instrumentation ; Spirometry/methods ; Telemedicine
    Language English
    Publishing date 2019-11-06
    Publishing country England
    Document type Journal Article
    ZDB-ID 524-1
    ISSN 1468-2044 ; 0003-9888 ; 1359-2998
    ISSN (online) 1468-2044
    ISSN 0003-9888 ; 1359-2998
    DOI 10.1136/archdischild-2019-317147
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