Alcohol, Author Interviews, Stanford / 13.11.2023

MedicalResearch.com Interview with: [caption id="attachment_61049" align="alignleft" width="128"]Timothy C. Durazzo, PhDClinical Neuropsychologist and Research Scientist Mental Illness Research and Education Clinical Centers VA Palo Alto Health Care System Professor Department of Psychiatry and Behavioral Sciences Stanford University School of Medicine Prof. Durazzo[/caption] Timothy C. Durazzo, PhD Clinical Neuropsychologist and Research Scientist Mental Illness Research and Education Clinical Centers VA Palo Alto Health Care System Professor, Department of Psychiatry and Behavioral Sciences Stanford University School of Medicine MedicalResearch.com: What is the background for this study? -There are a limited number of studies investigating changes in human brain structure, in individuals with an alcohol use disorder, with longer term abstinence after treatment. -Our study was the first to assess for change in cortical thickness over approximately 7 months of abstinence in those seeking treatment of alcohol use disorder. -Cortical thickness in humans is genetically and phenotypically distinct from other brain structural measures such as cortical volume and surface area. -Therefore, assessment of changes in cortical thickness with longer-term abstinence provides additional information on how human brain structure recovers with sobriety.
Alzheimer's - Dementia, Author Interviews, Genetic Research, JAMA, Stanford / 07.11.2023

MedicalResearch.com Interview with: [caption id="attachment_61020" align="alignleft" width="125"]MedicalResearch.com Interview with:Michael E. Belloy, PhD Department of Neurology and Neurological Sciences Stanford University, Stanford, California Dr. Belloy[/caption] Michael E. Belloy, PhD Department of Neurology and Neurological Sciences Stanford University, Stanford, California MedicalResearch.com: What is the background for this study? Response: Apolipoprotein E (APOE)*2 and APOE*4 are, respectively, the strongest protective and risk-increasing, genetic variants for late-onset Alzheimer disease. As such, one’s APOE genotype is highly relevant towards clinical trial design and Alzheimer’s disease research. However, most insights so far are focused on the associations of these APOE genotypes with Alzheimer’s disease risk in non-Hispanic white individuals. One important aspect of our work is that we really increased sample sizes for non-Hispanic Black, Hispanic, and East Asian individuals, so that we now have better understanding of the associations of APOE genotypes with Alzheimer’s disease risk in these groups. In complement, we also did the largest investigation to date on the role of ancestry on the associations of APOE genotypes with Alzheimer’s disease risk. The scale of our study was thus a critical factor in generating novel insights.
ASCO, Author Interviews, Cancer Research, Genetic Research, JAMA, Race/Ethnic Diversity, Stanford / 06.06.2023

MedicalResearch.com Interview with: [caption id="attachment_60473" align="alignleft" width="200"]Allison W. Kurian, M.D., M.Sc.Professor of Medicine and of Epidemiology and Population Health Associate Chief, Division of Oncology Co-Leader, Population Sciences Program, Stanford Cancer Institute Director, Women’s Clinical Cancer Genetics Program Stanford University School of Medicine Stanford, CA 94305-5405 Dr. Kurian[/caption] Allison W. Kurian, M.D., M.Sc. Professor of Medicine and of Epidemiology and Population Health Associate Chief, Division of Oncology Co-Leader, Population Sciences Program, Stanford Cancer Institute Director, Women’s Clinical Cancer Genetics Program Stanford University School of Medicine Stanford, CA 94305-5405 MedicalResearch.com: What is the background for this study? What types of cancers were in the study? Response: Genetic testing for cancer risk is increasingly important after a cancer diagnosis, to inform use of targeted therapies, secondary cancer prevention approaches and cascade genetic testing of family members. However, very little is known about how genetic testing is used after a cancer diagnosis at the population level. We leveraged a very large population-based data resource, the Surveillance, Epidemiology and End Results (SEER) cancer registries of the states of California and Georgia, and linked data from these registries to clinical genetic testing results provided by the four major laboratories that provide such testing. We used this linked registry-genetic testing dataset to study adults (age >=20 years) diagnosed with all types of cancer in the states of Georgia and California from 2013-2019.
Alzheimer's - Dementia, Author Interviews, Genetic Research, Race/Ethnic Diversity, Stanford / 21.02.2023

MedicalResearch.com Interview with: [caption id="attachment_60059" align="alignleft" width="125"]Yann Le Guen, Ph.D.Assistant Director, Computational Biology Quantitative Sciences Unit Stanford Medicine Dr. Yann Le Guen[/caption] Yann Le Guen, Ph.D. Assistant Director, Computational Biology Quantitative Sciences Unit Stanford Medicine MedicalResearch.com: What is the background for this study? Response: Apart from aging, the strongest contributing factor for late-onset Alzheimer’s disease is a specific allele of the APOE gene, which has three common alleles E2, E3, and E4. While E3 is the most common and considered as the reference, E2 is associated with decreased Alzheimer’s disease risk and E4 is associated with increased Alzheimer’s disease risk. Notably the prevalence of E4 among Alzheimer’s patient is high with about 60% of these carrying at least one E4 allele, while solely about 30% Americans carry one E4 allele. It’s worth emphasizing that individuals with an E4/E4 genotype have an exponential increased in their risk to develop AD (10 times as likely than the reference E3/E3 genotype), and individuals with an E3/E4 genotype have an intermediate risk. Though, most studies of Alzheimer’s disease genetic have been focused on European ancestry, this is beginning to change thanks to NIH’s efforts to fund more studies in non-European ancestry individuals. Our study built on these recent efforts to assess the Alzheimer disease risk associated with an APOE variant (R145C) present in about ~4% African Americans, but extremely rare in Europeans.
Author Interviews, Cost of Health Care, JAMA, Lung Cancer, Stanford, USPSTF / 24.10.2021

MedicalResearch.com Interview with: [caption id="attachment_58273" align="alignleft" width="200"]Dr. Summer Han Dr. Han[/caption] Summer S Han, PhD Assistant Professor Quantitative Sciences Unit Stanford Center for Biomedical Informatics Research (BMIR) Neurosurgery and Medicine Stanford University School of Medicine Stanford, CA 94304  MedicalResearch.com: What is the background for this study? Response: The US Preventive Services Task Force (USPSTF) issued their 2021 recommendation on lung cancer screening lowering the start age from 55 to 50 years and the minimum pack-year criterion from 30 to 20, relative to the 2013 recommendations. Although costs are expected to increase with the expanded screening eligibility, it is unknown if the new guidelines for lung cancer screening are cost-effective.
Author Interviews, Gout, Orthopedics, Rheumatology / 09.06.2021

MedicalResearch.com Interview with: Dr. Prof. Dr.  Gurkirpal Singh, MD Adjunct Clinical Professor of Medicine Stanford University MedicalResearch.com: What is the background for this study? Response: Joint damage from gout has been linked to a possible increase in knee and hip joint replacements. The strong association between gout and osteoarthritis could also lead to an increased risk of joint replacements in patients with gout as the presence of gout may accelerate or worsen osteoarthritis.[i] This study aimed to evaluate total or partial hip and knee joint replacements in patients with gout in the U.S. and to estimate their economic impact. Data was analyzed on hospitalizations in patients with gout with hip and knee joint replacements in 2018, using the Nationwide Inpatient Sample  (NIS) which is the largest publicly available all-payer inpatient healthcare database.
AHA Journals, Author Interviews, COVID -19 Coronavirus, Race/Ethnic Diversity, Stanford / 19.11.2020

MedicalResearch.com Interview with: [caption id="attachment_55996" align="alignleft" width="200"]Fatima Rodriguez, MD, MPH, FACC, FAHA Assistant Professor, Cardiovascular Medicine Stanford University School of Medicine Palo Alto, CA 94304 Dr. Rodriguez[/caption] Fatima Rodriguez, MD, MPH, FACC, FAHA Assistant Professor, Cardiovascular Medicine Stanford University School of Medicine Palo Alto, CA 94304 MedicalResearch.com: What is the background for this study? Response: The COVID-19 pandemic has magnified existing racial/ethnic disparities in the United States. The goal of this study was to leverage new data collected from the American Heart Association’s COVID-19 Cardiovascular Disease Registry to understand racial/ethnic differences in presentation and outcomes for hospitalized patients.
Author Interviews, Cancer Research, JAMA, Prostate Cancer, Technology / 13.11.2020

MedicalResearch.com Interview with: [caption id="attachment_55940" align="alignleft" width="200"]Dave Steiner MD PhD Clinical Research Scientist Google Health, Palo Alto, California Dr. Steiner[/caption] Dave Steiner MD PhD Clinical Research Scientist Google Health, Palo Alto, California MedicalResearch.com: What is the background for this study? Response: For prostate cancer patients, the grading of cancer in prostate biopsies by pathologists is central to risk stratification and treatment decisions. However, the grading process can be subjective, often resulting in variability among pathologists. This variability can complicate diagnostic and treatment decisions. As an initial step towards addressing this problem, we and others in the field have recently developed artificial intelligence (AI) algorithms that perform on-par with expert pathologists for prostate cancer grading. Such algorithms have the potential to improve the quality and efficiency of prostate biopsy grading, but the impact of these algorithms when used by pathologists has not been well studied. In the current study, we developed and evaluated an AI-based assistant tool for use by pathologists while reviewing prostate biopsies.
Author Interviews, Depression, Mental Health Research, Nature, PTSD / 21.10.2020

MedicalResearch.com Interview with: [caption id="attachment_55709" align="alignleft" width="125"]Amit Etkin, MD, PhD Department of Psychiatry and Behavioral Sciences Wu Tsai Neurosciences Institute, Stanford Universitu Stanford, CA Dr. Etkin[/caption] Amit Etkin, MD, PhD Department of Psychiatry and Behavioral Sciences Wu Tsai Neurosciences Institute, Stanford Universitu Stanford, CA    MedicalResearch.com: What is the mission of Cohen Veterans Bioscience - CVB?  Cohen Veterans Bioscience Response: Cohen Veterans Bioscience (CVB) is a non-profit 501(c)(3) research biotech dedicated to fast-tracking the development of diagnostic tests and personalized therapeutics for the millions of Veterans and civilians who suffer the devastating effects of trauma-related and other brain disorders.     MedicalResearch.com: How can patients with PTSD or MDD benefit from this information? Response: With the discovery of this new brain imaging biomarker, patients who suffer from PTSD or MDD may be guided towards the most effective treatment without waiting months and months to find a treatment that may work for them.   MedicalResearch.com: What is the background for this study? Response: This study, which was supported with a grant from Cohen Veterans Bioscience, grants from the National Institute of Mental Health (NIMH and other supporters, derives from our work over the past few years which has pointed to the critical importance of understanding how patients with a variety of psychiatric disorders differ biologically. The shortcomings of our current diagnostic system have become very clear over the past 1-2 decades, but the availability of tools for transcending these limitations on the back of objective biological tests has not kept pace with the need for those tools. In prior work, we have used a variety of methods, including different types of brain imaging, to identify brain signals that underpin key biological differences within and across traditional psychiatric diagnoses. We have also developed specialized AI tools for decoding complex patterns of brain activity in order to understand and quantify biological heterogeneity in individual patients. These developments have then, in turn, converged with the completion of a number of large brain imaging-coupled clinical trials, which have provided a scale of these types of data not previously available in the field.
Author Interviews, COVID -19 Coronavirus, Kidney Stones, Lancet, Stanford / 26.09.2020

MedicalResearch.com Interview with: [caption id="attachment_55479" align="alignleft" width="150"]Shuchi Anand M.D. M.S. Director of the Center for Tubulointerstitial Kidney Disease Stanford University Dr. Anand[/caption] Shuchi Anand M.D. M.S. Director of the Center for Tubulointerstitial Kidney Disease Stanford University MedicalResearch.com: What is the background for this study? Response: Seroprevalence (or presence of antibodies in response to SARS CoV-2) is considered by many experts to be the most complete to track the spread of COVID19 in communities. However seroprevalence studies are hard to conduct, because they require going into communities and underdoing random blood draws. Many people—especially racial and ethnic minorities, or people with underlying health conditions, or people with language barriers—may be hard to reach for these types of surveys. Plus outreach into communities is very difficult in light of the COVID19 pandemic. To mitigate this problem we worked with a random sample of 28,503 patients on hemodialysis, the vast majority of whom are covered by Medicare. They get their blood drawn monthly, as part of their routine care. Furthermore even though we used a random sample, we know that patients on dialysis are more likely to be racial and ethnic minorities, and more likely to come from disadvantaged backgrounds. 
Author Interviews, JAMA, Metabolic Syndrome, Race/Ethnic Diversity, Weight Research / 26.06.2020

MedicalResearch.com Interview with: [caption id="attachment_54641" align="alignleft" width="200"]Robert Wong, MD, MS Division of Gastroenterology and Hepatology Veterans Affairs Palo Alto Healthcare System Stanford University School of Medicine Dr. Wong[/caption] Robert Wong, MD, MS Division of Gastroenterology and Hepatology Veterans Affairs Palo Alto Healthcare System Stanford University School of Medicine MedicalResearch.com: What is the background for this study? Response: Prior to this study, we already knew that obesity and metabolic syndrome were major public health issues in the U.S.  A previous analyses by our team which analyzed data through 2012 observed than one in three adults in the U.S. have metabolic syndrome.  The aim of our current study was to evaluate more recent trends in the prevalence of metabolic syndrome and to identify whether certain groups are at higher risk of having metabolic syndrome. 
Author Interviews, Heart Disease, NEJM, Stanford / 31.03.2020

MedicalResearch.com Interview with: [caption id="attachment_53694" align="alignleft" width="200"]MedicalResearch.com Interview with: David J. Maron, MD, FACC, FAHA Clinical Professor of Medicine  Chief, Stanford Prevention Research Center Director, Preventive Cardiology Stanford University School of Medicine Dr. Maron[/caption] David J. Maron, MD, FACC, FAHA Clinical Professor of Medicine Chief, Stanford Prevention Research Center Director, Preventive Cardiology Stanford University School of Medicine  MedicalResearch.com: What is the background for this study? Response: Among patients with stable coronary disease and moderate or severe ischemia, whether clinical outcomes are better in those who receive an invasive intervention plus medical therapy than in those who receive medical therapy alone is uncertain. The goals of treating patients with stable coronary disease are to reduce their risk of death and ischemic events and to improve their quality of life. All patients with coronary disease should be treated with guideline-based medical therapy (GBMT) to achieve these objectives. Before the widespread availability of drug-eluting stents, strategy trials that tested the incremental effect of revascularization added to medical therapy did not show a reduction in the incidence of death or myocardial infarction. In one trial, fractional flow reserve–guided percutaneous coronary intervention (PCI) with drug-eluting stents, added to medical therapy, decreased the incidence of urgent revascularization but not the incidence of death from any cause or myocardial infarction at a mean of 7 months, whereas the 5-year follow-up showed marginal evidence of a decrease in the incidence of myocardial infarction.
Author Interviews, Breast Cancer, Genetic Research, JAMA, Stanford / 12.03.2020

MedicalResearch.com Interview with: [caption id="attachment_41598" align="alignleft" width="200"]Dr-Allison W. Kurian Dr. Kurian[/caption] Allison W. Kurian, M.D., M.Sc. Associate Professor of Medicine (Oncology) and of Epidemiology and Population Health Director, Women’s Clinical Cancer Genetics Program Stanford University School of Medicine Stanford, CA 94305-5405 MedicalResearch.com: What is the background for this study? Response: Genetic testing is increasingly relevant for the care of cancer patients. However, little was known about the prevalence of inherited mutations in cancer susceptibility genes among the most common group of women with breast cancer: those diagnosed after menopause and without a strong family history of cancer. 
Author Interviews, Biomarkers, Lung Cancer, Stanford / 09.03.2020

MedicalResearch.com Interview with: [caption id="attachment_53410" align="alignleft" width="149"]Professor Dr. Andreas Keller Stanford University School of Medicine Office Department of Neurology and Neurological Sciences  Chair for Clinical Bioinformatics Saarbrücken, Germany Prof. Keller[/caption] Professor Dr. Andreas Keller Stanford University School of Medicine Office Department of Neurology and Neurological Sciences Chair for Clinical Bioinformatics Saarbrücken, Germany MedicalResearch.com: What is the background for this study? Response: Lung cancer is among the three most common cancers and the leading cause of cancer-related deaths worldwide. The overall low survival rate of patients with lung cancer calls for improved detection tools to enable better treatment options and improved patients’ outcomes. To detect lung tumors, liquid biopsy-based strategies are increasingly explored, that are biomarkers, which are identifiable in body fluids such as human blood. The clinical application of biomarkers is, however, largely hampered by the relatively small numbers of cases that have been analyzed in the majority of the preclinical studies including the studies on lung cancer. 
Author Interviews, Cancer Research, Gender Differences, JAMA / 02.11.2019

MedicalResearch.com Interview with: [caption id="attachment_51995" align="alignleft" width="191"]Nina Niu Sanford, M.D.  Assistant Professor Dedman Family Scholar in Clinical Care UT Southwestern Department of Radiation Oncology Dallas TX Dr. Nina Niu Sanford[/caption] Nina Niu Sanford, M.D. Assistant Professor Dedman Family Scholar in Clinical Care UT Southwestern Department of Radiation Oncology Dallas TX MedicalResearch.com: What is the background for this study? Response: Minority racial/ethnic groups present at later stages of cancer and have worse stage-specific survival rates.  Cultural competency represents a single element within the dynamic and trans-disciplinary field of health disparities, but is an important modifiable factor for both providers and health organizations that could be associated with disparities in cancer outcomes. There have been longstanding initiatives and training requirements in medical education specifically designed to improve provider cultural competency over the past couple of decades, and the American Society of Clinical Oncology (ASCO) has recently outlined goals for improving cultural competency within its policy statement on cancer disparities. Moreover, ASCO health disparity policies have recently highlighted the association between racial/ethnic disparities in cancer outcomes and a “lack of access to high-quality care that is understanding and respectful of diverse traditions and cultures plays a significant role.”  Given the above, we wished to assess access to culturally competent providers among patients with cancer by race/ethnicity.
Author Interviews, Dermatology, Nature, Stanford / 18.10.2019

MedicalResearch.com Interview with: Stephen J. Galli, MD Mary Hewitt Loveless, MD Professor Professor of Pathology and of Microbiology and Immunology Department of Pathology Stanford University School of Medicine Center for Clinical Sciences Research Stanford, CA and Nicolas Gaudenzio PhD Unité de Différenciation Epithéliale et Autoimmunité Rhumatoïde INSERM, Université de Toulouse Toulouse, France MedicalResearch.com: What is the background for this study? What are the main findings? Response: We took a lead from existing clinical data showing that patients with moderate to severe atopic dermatitis, an increasingly common disorder producing skin pathology, also have elevated levels of neuropeptides in their blood, particularly one neuropeptide, named “substance P”, whose level is correlated with disease severity. These patients also have high levels of mast cell-specific proteases in the blood, indicating that mast cells, which are innate immune cells present in the skin, and which can be activated when exposed to substance P, might play an essential role in modulating inflammatory and allergic processes. Based on these observations, our teams (Galli Lab at Stanford University, USA and Gaudenzio Lab at Inserm Toulouse, France) decided to focus on the possible interactions between sensory neurons, which are a source of substance P, and mast cells. The results of this work have now been published in the journal Nature Immunology.
Annals Internal Medicine, Author Interviews, Outcomes & Safety, Stanford / 08.10.2019

MedicalResearch.com Interview with: [caption id="attachment_51734" align="alignleft" width="200"]Daniel Tawfik, MD, MS Pediatric Critical Care Medicine Stanford University School of Medicine Dr. Tawfik[/caption] Daniel Tawfik, MD, MS Pediatric Critical Care Medicine Stanford University School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Professional burnout is very common among health care providers and is frequently associated with poor quality of care in the published literature. However, we know that reporting biases are common in many fields of literature, and these biases typically result in exaggerated effects being published relative to the true effect. Research on burnout and quality of care appears especially vulnerable, because many studies are not pre-specified or have several potential methods of analysis. If the studies or analyses with more impressive results are more likely to be published, this would result in a skewed picture of the relationship between burnout and quality of care.
Author Interviews, Dermatology, Environmental Risks, General Medicine, JAMA, Melanoma, Stanford / 07.10.2019

MedicalResearch.com Interview with: [caption id="attachment_18136" align="alignleft" width="150"]Eleni Linos, MD DrPH, MPH Assistant Professor UCSF School of Medicine Dr. Linos[/caption] Eleni Linos MD MPH DrPH Professor of Dermatology and Epidemiology Stanford University  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: We know that tanning beds are harmful: people who use tanning beds are more likely to get skin cancer. Sexual minority men are much more likely to use tanning beds and also more likely to get skin cancer. In a separate study we discovered that one reason sexual minority men use tanning beds is if it is convenient: e.g. if close to home, cheap, and easy. (https://onlinelibrary.wiley.com/doi/abs/10.1111/bjd.17684). Recent research showed that tobacco retailers cluster in LGB neighborhoods: https://sph.unc.edu/sph-news/more-tobacco-retailers-in-lgbt-neighborhoods-may-explain-smoking-disparities/. This made us wonder if tanning salons also cluster in neighborhoods with more gay men. 
Author Interviews, Colon Cancer / 22.05.2019

MedicalResearch.com Interview with: [caption id="attachment_49285" align="alignleft" width="200"]Dr. Reinier G. S. Meester, PhDPostdoctoral scholar in the Department of MedicineDivision of Gastroenterology and HepatologyStanford Dr. Meester[/caption] Dr. Reinier G. S. Meester, PhD Postdoctoral scholar in the Department of Medicine Division of Gastroenterology and Hepatology Stanford MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Incidence of colorectal cancer has increased for decades in adults under age 50 years in the United States. However, there is still uncertainty regarding the underlying causes of this increase. We studied the patterns in the stage at diagnosis from cancer registry data to assess whether the increases may be due more common use of colonoscopy in the ages 40-49 years, which account for nearly 3 out of 4 young-onset cases. If the increase in incidence were the result of earlier detection from increased colonoscopy use, earlier stage at diagnosis would be expected, whereas if the increased incidence were the result of true rises in risk, relatively later stage at diagnosis would be expected. Our results suggest that the incidence of late-stage (metastatic) colorectal cancer increased at almost twice the relative rate since 1995 (2.9% per year) compared to earlier stages (1.3-1.4% per year). Over 1 in 4 young-onset cases are now diagnosed at a late stage vs. approximately 1 in 5 cases in the 1990s.
Author Interviews, Inflammation, JAMA, Kidney Disease, Pain Research, Stanford / 16.02.2019

MedicalResearch.com Interview with: Alan Nelson, MPAS, PhD Division of Primary Care and Population Health, Department of Medicine Stanford University School of Medicine Stanford, California  MedicalResearch.com: What is the background for this study?   Response: The past research literature has provided relatively little information on the appropriate level of concern regarding non-steroidal anti-inflammatory drugs (NSAIDs) and kidney disease risk among younger, apparently healthy patients. Clinicians are generally most concerned about the effects of these medications on the kidneys among patients with existing renal impairment and persons at risk for it, especially older patients. Given that NSAID use appears to be high and rising in the US, we were interested in developing evidence on this topic in a population of working-age adults.
Author Interviews, JAMA, Smoking, Social Issues, Tobacco Research, UCSD / 11.01.2019

MedicalResearch.com Interview with: [caption id="attachment_46797" align="alignleft" width="128"]Eric Leas PhD, MPH Stanford Prevention Research Center University of California, San Diego Dr. Leas[/caption] Eric Leas PhD, MPH Stanford Prevention Research Center University of California, San Diego MedicalResearch.com: What is the background for this study? What are the main findings? Response: Recent research has demonstrated the importance that neighborhood context has on life opportunity, health and well-being that can perpetuate across generations. A strongly defining factor that leads to differences in health outcomes across neighborhoods, such as differences in chronic disease, is the concurrent-uneven distribution of modifiable risk factors for chronic disease. The main goal of our study was to characterize inequities in smoking, the leading risk factor for chronic disease, between neighborhoods in America's 500 largest cities. To accomplish this aim we used first-of-its-kind data generated from the 500 Cities Project—a collaboration between Robert Wood Johnson Foundation and the US Centers for Disease Control and Prevention—representing the largest effort to provide small-area estimates of modifiable risk factors for chronic disease. We found that inequities in smoking prevalence are greater within cities than between cities, are highest in the nation’s capital, and are linked to inequities in chronic disease outcomes. We also found that inequities in smoking were associated to inequities in neighborhood characteristics, including race, median household income and the number of tobacco retailers. 
Author Interviews, Biomarkers, Infections, JAMA, Stanford / 29.10.2018

MedicalResearch.com Interview with: "Mycobacterium tuberculosis Bacteria, the Cause of TB" by NIAID is licensed under CC BY 2.0Purvesh Khatri, Ph.D. Associate Professor Stanford Institute for Immunity, Transplantation and Infection (ITI) Stanford Center for Biomedical Informatics Research (BMIR) Department of Medicine Stanford University Stanford, CA 94305 MedicalResearch.com: What is the background for this study? What are the main findings? Response: We have previously described a 3-gene signature for distinguishing patients with active tuberculosis (ATB) from those with other diseases, latent mycobacterium tuberculosis (LTB) infection, and healthy controls (Sweeney et al. Lancet Respir Med 2016). The current study in JAMA Network Open is a follow up study to validate the 3-gene signature in 3 additional independent cohorts that were prospectively collected. Using these 3 cohorts we have now showed that the 3-gene signature (1) can identify patients with LTB that will progress to ATB about 6 months prior to diagnosis of active tuberculosis. (2) can identify patients with ATB in active screening, and (3) can identify patients with ATB at diagnosis that have higher likelihood of persistent lung inflammation due to subclinical ATB at the end of treatment. 
Author Interviews, Infections, Pulmonary Disease, Stanford / 15.09.2018

MedicalResearch.com Interview with: [caption id="attachment_44541" align="alignleft" width="200"]Stephen J Ruoss MD Professor, Stanford University, Medicine, Division of Pulmonary and Cfritical Care Medicine Stanford, California Dr. Ruoss[/caption] Stephen J Ruoss MD Professor, Stanford University, Medicine, Division of Pulmonary and Cfritical Care Medicine Stanford, California MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by an atypical mycobacterial infection?  Response: Our interest in undertaking this study stems from three important clinical observations and issues. First, the use of inhaled steroid medications for a broad variety of respiratory complaints and diseases is increasing, including in clinical circumstances where there isn’t much strong supportive evidence for benefit to patients from using inhaled steroids. The second observation is that steroids can and do alter immune system responses, and can increase the risk for some infections. There are already data from studying patients on inhaled steroids where the incidence of bacterial respiratory infections has increased, supporting the concerns for infection risk from inhaled steroids. And the third issue is that steroids can more specifically alter immune system function that helps combat mycobacterial infections, and this means that the risk for, and incidence of mycobacterial infections could be increased in patients treated with inhaled steroids. The best known mycobacterial infection is of course tuberculosis, but there are other mycobacteria, called nontuberculous mycobacterial (or atypical mycobacterial) that are broadly found in the environment, and some of those nontuberculous mycobacteria (NTM) can cause lung infections. So our hypothesis was that the use of inhaled steroids might be associated with an increased frequency of NTM infections, and we designed the study to explore that hypothesis.
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