Browsing by Author "Almaani, Salem"

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    Molecular profiling of kidney compartments from serial biopsies differentiate treatment responders from non-responders in lupus nephritis
    (Elsevier, 2022) Parikh, Samir V.; Malvar, Ana; Song, Huijuan; Shapiro, John; Mejia-Vilet, Juan Manuel; Ayoub, Isabelle; Almaani, Salem; Madhavan, Sethu; Alberton, Valeria; Besso, Celeste; Lococo, Bruno; Satoskar, Anjali; Zhang, Jianying; Yu, Lianbo; Fadda, Paolo; Eadon, Michael; Birmingham, Dan; Ganesan, Latha P.; Jarjour, Wael; Rovin, Brad H.; Medicine, School of Medicine
    The immune pathways that define treatment response and non-response in lupus nephritis (LN) are unknown. To characterize these intra-kidney pathways, transcriptomic analysis was done on protocol kidney biopsies obtained at flare (initial biopsy (Bx1)) and after treatment (second biopsy (Bx2)) in 58 patients with LN. Glomeruli and tubulointerstitial compartments were isolated using laser microdissection. RNA was extracted and analyzed by nanostring technology with transcript expression from clinically complete responders, partial responders and non-responders compared at Bx1 and Bx2 and to the healthy controls. Top transcripts that differentiate clinically complete responders from non-responders were validated at the protein level by confocal microscopy and urine ELISA. At Bx1, cluster analysis determined that glomerular integrin, neutrophil, chemokines/cytokines and tubulointerstitial chemokines, T cell and leukocyte adhesion genes were able to differentiate non-responders from clinically complete responders. At Bx2, glomerular monocyte, extracellular matrix, and interferon, and tubulointerstitial interferon, complement, and T cell transcripts differentiated non-responders from clinically complete responders. Protein analysis identified several protein products of overexpressed glomerular and tubulointerstitial transcripts at LN flare, recapitulating top transcript findings. Urine complement component 5a and fibronectin-1 protein levels reflected complement and fibronectin expression at flare and after treatment. Thus, transcript analysis of serial LN kidney biopsies demonstrated how gene expression in the kidney changes with clinically successful and unsuccessful therapy. Hence, these insights into the molecular landscape of response and non-response may help align LN management with the pathogenesis of kidney injury.
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    Racial and Ethnic Disparities in Acute Care Utilization Among Patients With Glomerular Disease
    (Elsevier, 2023) Krissberg, Jill R.; O’Shaughnessy, Michelle M.; Smith, Abigail R.; Helmuth, Margaret E.; Almaani, Salem; Aviles, Diego H.; Brathwaite, Kaye E.; Cai, Yi; Cattran, Daniel; Gbadegesin, Rasheed; Glenn, Dorey A.; Greenbaum, Larry A.; Iragorri, Sandra; Jain, Koyal; Khalid, Myda; Kidd, Jason; Kopp, Jeffrey; Lafayette, Richard; Lane, Jerome C.; Lugani, Francesca; Nestor, Jordan G.; Parekh, Rulan S.; Reidy, Kimberly; Selewski, David T.; Sethna, Christine B.; Sperati, C. John; Tuttle, Katherine; Twombley, Katherine; Vasylyeva, Tetyana L.; Weaver, Donald J., Jr.; Wenderfer, Scott E.; Gibson, Keisha; CureGN Consortium; Pediatrics, School of Medicine
    Rationale & objective: The effects of race, ethnicity, socioeconomic status (SES), and disease severity on acute care utilization in patients with glomerular disease are unknown. Study design: Prospective cohort study. Setting & participants: 1,456 adults and 768 children with biopsy-proven glomerular disease enrolled in the Cure Glomerulonephropathy (CureGN) cohort. Exposure: Race and ethnicity as a participant-reported social factor. Outcome: Acute care utilization defined as hospitalizations or emergency department visits. Analytical approach: Multivariable recurrent event proportional rate models were used to estimate associations between race and ethnicity and acute care utilization. Results: Black or Hispanic participants had lower SES and more severe glomerular disease than White or Asian participants. Acute care utilization rates were 45.6, 29.5, 25.8, and 19.2 per 100 person-years in Black, Hispanic, White, and Asian adults, respectively, and 55.8, 42.5, 40.8, and 13.0, respectively, for children. Compared with the White race (reference group), Black race was significantly associated with acute care utilization in adults (rate ratio [RR], 1.76 [95% CI, 1.37-2.27]), although this finding was attenuated after multivariable adjustment (RR, 1.31 [95% CI, 1.03-1.68]). Black race was not significantly associated with acute care utilization in children; Asian race was significantly associated with lower acute care utilization in children (RR, 0.32 [95% CI 0.14-0.70]); no significant associations between Hispanic ethnicity and acute care utilization were identified. Limitations: We used proxies for SES and lacked direct information on income, household unemployment, or disability. Conclusions: Significant differences in acute care utilization rates were observed across racial and ethnic groups in persons with prevalent glomerular disease, although many of these difference were explained by differences in SES and disease severity. Measures to combat socioeconomic disadvantage in Black patients and to more effectively prevent and treat glomerular disease are needed to reduce disparities in acute care utilization, improve patient wellbeing, and reduce health care costs.
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    Racial-Ethnic Differences in Health-Related Quality of Life among Adults and Children with Glomerular Disease
    (Karger, 2021) Krissberg, Jill R.; Helmuth, Margaret E.; Almaani, Salem; Cai, Yi; Cattran, Daniel; Chatterjee, Debanjana; Gbadegesin, Rasheed A.; Gibson, Keisha L.; Glenn, Dorey A.; Greenbaum, Laurence A.; Iragorri, Sandra; Jain, Koyal; Khalid, Myda; Kidd, Jason M.; Kopp, Jeffrey B.; Lafayette, Richard; Nestor, Jordan G.; Parekh, Rulan S.; Reidy, Kimberly J.; Selewski, David T.; Sperati, C. John; Tuttle, Katherine R.; Twombley, Katherine; Vasylyeva, Tetyana L.; Weaver, Donald Jack; Wenderfer, Scott E.; O’Shaughnessy, Michelle M.; Pediatrics, School of Medicine
    Introduction: Disparities in health-related quality of life (HRQOL) have been inadequately studied in patients with glomerular disease. The aim of this study was to identify relationships between race/ethnicity, socioeconomic status, disease severity, and HRQOL in an ethnically and racially diverse cohort of patients with glomerular disease. Methods: Cure Glomerulonephropathy (CureGN) is a multinational cohort study of patients with biopsy-proven glomerular disease. Associations between race/ethnicity and HRQOL were determined by the following: 1. Missed school or work due to kidney disease; 2. Responses to Patient Reported Outcomes Measurement Information System (PROMIS) questionnaires. We adjusted for demographics, socioeconomic status, and disease characteristics using multivariable logistic and linear regression. Results: Black and Hispanic participants had worse socioeconomic status and more severe glomerular disease than White or Asian participants. Black adults missed work or school most frequently due to kidney disease (30% versus 16-23% in the other three groups, p=0.04), and had the worst self-reported global physical health (median score 44.1 versus 48.0-48.2, p<0.001) and fatigue (53.8 versus 48.5-51.1, p=0.002), compared to other racial/ethnic groups. However, these findings were not statistically significant with adjustment for socioeconomic status and disease severity, both of which were strongly associated with HRQOL in adults. Among children, disease severity but not race/ethnicity or socioeconomic status were associated with HRQOL. Conclusions: Among patients with glomerular disease enrolled in CureGN, the worse HRQOL reported by Black adults was attributable to lower socioeconomic status and more severe glomerular disease. No racial/ethnic differences in HRQOL were observed in children.