188 results on '"Zuhair K. Ballas"'
Search Results
2. 2022: The year in review
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Zuhair K. Ballas
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Immunology ,Immunology and Allergy - Published
- 2023
3. The 2022 AAAAI Foundation Faculty Development awardees
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Zuhair K, Ballas
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Immunology ,Awards and Prizes ,Humans ,Immunology and Allergy ,Faculty - Published
- 2022
4. DNA Immunomodulation of Asthma
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Joel N. Kline and Zuhair K. Ballas
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- 2023
5. 'Where are they now?' Catching up with the 2017 AAAAI Faculty Development Awardees
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Zuhair K. Ballas
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Immunology ,Immunology and Allergy ,Humans ,Faculty - Published
- 2022
6. The Editors’ Choice
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Zuhair K. Ballas
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Immunology ,Immunology and Allergy - Published
- 2021
7. The Editors’ Choice
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Zuhair K. Ballas
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Immunology ,Immunology and Allergy - Published
- 2021
8. The Editors’ Choice
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Zuhair K. Ballas
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Immunology ,Immunology and Allergy - Published
- 2021
9. The Editors’ Choice
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Zuhair K. Ballas
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Immunology ,Immunology and Allergy - Published
- 2020
10. The Editors’ Choice
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Zuhair K. Ballas
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Immunology ,Immunology and Allergy - Published
- 2020
11. The Editors’ Choice
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Zuhair K. Ballas
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Immunology ,Immunology and Allergy - Published
- 2020
12. The Editors’ Choice
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Zuhair K. Ballas
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Immunology ,Immunology and Allergy - Published
- 2020
13. The Editors’ Choice
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Zuhair K. Ballas
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Immunology ,Immunology and Allergy - Published
- 2020
14. The Editors’ Choice
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Zuhair K. Ballas
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Immunology ,Immunology and Allergy - Published
- 2020
15. The Editors’ Choice
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Zuhair K. Ballas
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Immunology ,Immunology and Allergy - Published
- 2020
16. The Editors’ Choice
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Zuhair K. Ballas
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Immunology ,Immunology and Allergy - Published
- 2020
17. AAAAI Foundation Faculty Development awardees: 2020
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Zuhair K. Ballas
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Societies, Scientific ,Academic Success ,Allergy immunology ,business.industry ,Immunology ,Awards and Prizes ,Foundation (engineering) ,Library science ,Atherosclerosis ,Faculty ,United States ,Allergy and Immunology ,Hypersensitivity ,Humans ,Immunology and Allergy ,Medicine ,Vascular Diseases ,Faculty development ,business - Published
- 2020
18. The Editors’ Choice
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Zuhair K. Ballas
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Immunology ,Immunology and Allergy - Published
- 2020
19. The Editors’ Choice
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Zuhair K. Ballas
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Immunology ,Immunology and Allergy - Published
- 2020
20. Evaluation of staging criteria for disposition and airway intervention in emergency department angioedema patients
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Ronna L. Campbell, Elizabeth Dang, Conor Dass, Zuhair K. Ballas, Sangil Lee, and Maggie Mahaffa
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Larynx ,Pediatrics ,medicine.medical_specialty ,emergency department ,law.invention ,law ,Medicine ,Stage (cooking) ,Angioedema ,Soft palate ,RC86-88.9 ,business.industry ,angioedema ,General Engineering ,Medical emergencies. Critical care. Intensive care. First aid ,Emergency department ,Original Articles ,Airway obstruction ,medicine.disease ,Intensive care unit ,Airway ,medicine.anatomical_structure ,Original Article ,medicine.symptom ,business ,edema - Abstract
Aim Angioedema is a nonpitting edema that can lead to death secondary to airway obstruction. Previously, a staging system based on localization of the angioedema was proposed for risk stratification of likelihood of need for admission or airway intervention. This study aims to evaluate a staging system based on angioedema localization as a method of predicting need for admission or airway intervention. Methods This was a retrospective chart review of angioedema cases that presented to an academic emergency department (ED) from August 1, 2006, to January 31, 2018. Data were collected on location of swelling, treatment setting, and medical and procedural interventions. Cases were categorized by modified Ishoo criteria, defined as follows: 1, lips, face, periorbital, extremities, total body/diffuse swelling; 2, soft palate, posterior pharynx; 3, tongue; 4, larynx. Predictive probability of disposition by stage was then compared. Results A total of 320 patients were included in this study (median age, 44 years; 54.4% female). Stage 4 was more likely to require intensive care unit care without (probability 17%) and with (67%) airway intervention compared with stage 1 without (2.5%) and with (0.1%) airway intervention. Conversely, stage 1 was more likely to be treated in ED and discharged (85%) compared with stage 4 (0%). Stage 4 was also more likely to require airway intervention (67%) compared with other stages (1, 0.1%; 2, 8.6%; 3, 16%). Conclusion Higher‐stage patients were more likely to require higher levels of care and airway intervention. Thus, the staging system appears to be a valid method of predicting risk among ED angioedema patients., We have evaluated the Ishoo criteria for angioedema in the emergency department and reported that they are valid predictors of disposition and need for airway intervention. By this, higher‐stage patients were more likely to require higher levels of care and airway intervention, suggesting that these staging criteria could be of benefit to the triage and management of patients presenting with angioedema.
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- 2021
21. Human Antibody Responses Following Vaccinia Immunization Using Protein Microarrays and Correlation With Cell-Mediated Immunity and Antibody-Dependent Cellular Cytotoxicity Responses
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C. Buddy Creech, Paul Chaplin, Mark J. Mulligan, Wilbur H. Chen, Sharon E. Frey, Thomas M. Kaufman, Lisa A. Jackson, Anna Wald, Samer S. El-Kamary, Jack T. Stapleton, Nadine Rouphael, Travis L. Jensen, Shital M. Patel, Heather Hill, Christine Johnston, Patricia L. Winokur, Hana M. El Sahly, D. Huw Davies, Kathryn M. Edwards, Tammy P Blevins, Zuhair K. Ballas, Wendy L. Rasmussen, Robert B. Belshe, Johannes B. Goll, Srilatha Edupuganti, Robert L. Atmar, Magdalena Tary-Lehmann, and Wendy A. Keitel
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0301 basic medicine ,Modified vaccinia Ankara ,viruses ,Protein Array Analysis ,Vaccinia virus ,Vaccines, Attenuated ,complex mixtures ,03 medical and health sciences ,chemistry.chemical_compound ,Major Articles and Brief Reports ,0302 clinical medicine ,Antigen ,Vaccines, DNA ,Vaccinia ,Immunology and Allergy ,Humans ,030212 general & internal medicine ,Antigens, Viral ,Antibody-dependent cell-mediated cytotoxicity ,Immunity, Cellular ,biology ,ELISPOT ,Virion membrane ,Antibody-Dependent Cell Cytotoxicity ,hemic and immune systems ,Viral Vaccines ,Titer ,030104 developmental biology ,Infectious Diseases ,chemistry ,Immunology ,Antibody Formation ,biology.protein ,Immunization ,Antibody ,Smallpox Vaccine - Abstract
Background There are limited data regarding immunological correlates of protection for the modified vaccinia Ankara (MVA) smallpox vaccine. Methods A total of 523 vaccinia-naive subjects were randomized to receive 2 vaccine doses, as lyophilized MVA given subcutaneously, liquid MVA given subcutaneously (liquid-SC group), or liquid MVA given intradermally (liquid-ID group) 28 days apart. For a subset of subjects, antibody-dependent cellular cytotoxicity (ADCC), interferon-γ release enzyme-linked immunospot (ELISPOT), and protein microarray antibody-binding assays were conducted. Protein microarray responses were assessed for correlations with plaque reduction neutralization titer (PRNT), enzyme-linked immunosorbent assay, ADCC, and ELISPOT results. Results MVA elicited significant microarray antibody responses to 15 of 224 antigens, mostly virion membrane proteins, at day 28 or 42, particularly WR113/D8L and WR101H3L. In the liquid-SC group, responses to 9 antigens, including WR113/D8L and WR101/H3L, correlated with PRNT results. Three were correlated in the liquid-ID group. No significant correlations were observed with ELISPOT responses. In the liquid-ID group, WR052/F13L, a membrane glycoprotein, correlated with ADCC responses. Conclusions MVA elicited antibodies to 15 vaccinia strain antigens representing virion membrane. Antibody responses to 2 proteins strongly increased and significantly correlated with increases in PRNT. Responses to these proteins are potential correlates of protection and may serve as immunogens for future vaccine development. Clinical Trials Registration NCT00914732.
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- 2020
22. Prevalence and the impact of hypogammaglobulinemia in newly diagnosed chronic lymphocytic lymphoma patients
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Sarah L. Mott, Grerk Sutamtewagul, Brian K. Link, Ashley McCarthy, Zuhair K. Ballas, Namrata Singh, James R. Cerhan, and Susan L. Slager
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Hypogammaglobulinemia ,medicine.medical_specialty ,biology ,business.industry ,Internal medicine ,biology.protein ,Medicine ,Newly diagnosed ,business ,medicine.disease ,Immunoglobulin E ,Gastroenterology ,Lymphocytic lymphoma - Abstract
To examine the prevalence of hypogammaglobulinemia in chronic lymphocytic lymphoma (CLL) patients and to test the hypothesis that patients with hypogammaglobulinemia have a distinct clinical profile and outcome.Immunoglobulin levels (IgA, IgG, IgM, IgE) were measured in newly diagnosed, treatment naïve banked samples of 150 patients with CLL followed prospectively for outcomes. Cox regression models were used to assess the effects of clinical variables on overall survival (OS).The median age of the selected CLL cohort was 64 years with a male predominance; 96.2% of the patients were white. Fifty-nine deaths occurred during a median follow up of 6.8 years. Hypogammaglobulinemia in CLL was common in our cohort with 88 (58.7%, 95% CI: 50.4-66.6%) patients having a measurable isotype deficiency. The most common Ig deficiency was IgM (44.0%). IgA deficiency or low IgE was associated with higher Rai stages as well as with higher white blood cell counts at presentation. Any immunoglobulin deficiency was not associated with overall survival.A significant proportion of treatment-naïve CLL patients had underlying Ig deficiencies - both in isolation and in isotype combinations. Although a deficiency of IgA or IgE was associated with more severe disease at presentation, the impact of this association was mild.
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- 2020
23. 2019: The year in review
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Zuhair K. Ballas
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medicine.medical_specialty ,Allergy immunology ,Bibliometrics ,Political science ,Year in review ,Family medicine ,Allergy and Immunology ,Immunology ,medicine ,Immunology and Allergy ,Animals ,Humans - Published
- 2020
24. Alcohol Consumption and Risk of Coronary Artery Disease (from the Million Veteran Program)
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Rebecca J. Song, Xuan-Mai T. Nguyen, Rachel Quaden, Yuk-Lam Ho, Amy C. Justice, David R. Gagnon, Kelly Cho, Christopher J. O'Donnell, John Concato, J. Michael Gaziano, Luc Djoussé, Ildiko Halasz, Daniel Federman, Jean Beckham, Scott E. Sherman, Peruvemba Sriram, Philip S. Tsao, Edward J. Boyko, Junzhe Xu, Frank Lederle, Louis J. Dellitalia, Rachel McArdle, Laurence Kaminsky, Alan C. Swann, Mark B. Hamner, Hermes J. Florez, Prashant Pandya, Gerardo Villarreal, Peter Wilson, Timothy R. Morgan, Lori Davis, Robin A. Hurley, Laurence Meyer, Sunil K. Ahuja, Eric P. Konicki, David Cohen, Jack Lichy, Jeffrey Whittle, Kathlyn Sue Haddock, Karl D. Straub, John T. Callaghan, Samuel M. Aguayo, Samir Gupta, Ronald G. Washburn, Mary E. Oehlert, Adriana M. Hung, Agnes Wallbom, Robert Keith, Elif Sonel, Ronald B. Schifman, Richard D. Childress, Michael F. Godschalk, Alan R. Shuldiner, Padmashri Rastogi, Salvador Gutierrez, Ronald Fernando, Pran R. Iruvanti, Darshana Jhala, Carlos Rosado-Rodriguez, Stephen M. Mastorides, John B. Harley, Kristin Mattocks, Brooks Robey, Robert T. Striker, Michael Rauchman, John Wells, Zuhair K. Ballas, Susan S. Woods, Shing Shing Yeh, Nora R. Ratcliffe, Jon B. Klein, Adam G. Golden, Harold M. Ginzburg, Satish Sharma, Kris Ann K. Oursler, Mary A. Whooley, Gretchen Gibson, and null Heinz
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Male ,medicine.medical_specialty ,Alcohol Drinking ,Population ,Coronary Artery Disease ,Alcohol use disorder ,030204 cardiovascular system & hematology ,Lower risk ,Article ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,education ,Aged ,Proportional Hazards Models ,Veterans ,education.field_of_study ,Proportional hazards model ,business.industry ,Alcoholic Beverages ,Hazard ratio ,Middle Aged ,Protective Factors ,medicine.disease ,United States ,Confidence interval ,Alcoholism ,Cardiology ,Female ,Self Report ,Cardiology and Cardiovascular Medicine ,business ,Body mass index ,Demography - Abstract
Moderate alcohol consumption has been associated with a lower risk of coronary artery disease (CAD) in the general population but has not been well studied in US veterans. We obtained self-reported alcohol consumption from Million Veteran Program participants. Using electronic health records, CAD events were defined as 1 inpatient or 2 outpatient diagnosis codes for CAD, or 1 code for a coronary procedure. We excluded participants with prevalent CAD (n = 69,995) or incomplete alcohol information (n = 8,449). We used a Cox proportional hazards model to estimate hazard ratios and 95% confidence intervals for CAD, adjusting for age, gender, body mass index, race, smoking, education, and exercise. Among 156,728 participants, the mean age was 65.3 years (standard deviation = 12.1) and 91% were men. There were 6,153 CAD events during a mean follow-up of 2.9 years. Adjusted hazard ratios (95% confidence intervals) for CAD were 1.00 (reference), 1.02 (0.92 to 1.13), 0.83 (0.74 to 0.93), 0.77 (0.67 to 0.87), 0.71 (0.62 to 0.81), 0.62 (0.51 to 0.76), 0.58 (0.46 to 0.74), and 0.95 (0.85 to 1.06) for categories of never drinker; former drinker; current drinkers of ≤0.5 drink/day, >0.5 to 1 drink/day, >1 to 2 drinks/day, >2 to 3 drinks/day, and >3 to 4 drinks/day; and heavy drinkers (>4 drinks/day) or alcohol use disorder, respectively. For a fixed amount of ethanol, intake at ≥3 days/week was associated with lower CAD risk compared with ≤1 day/week. Beverage preference (beer, wine, or liquor) did not influence the alcohol-CAD relation. Our data show a lower risk of CAD with light-to-moderate alcohol consumption among US veterans, and drinking frequency may provide a further reduction in risk.
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- 2018
25. Cancer in primary immunodeficiency diseases: Cancer incidence in the United States Immune Deficiency Network Registry
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Charlotte Cunningham-Rundles, Kirsten B. Moysich, Scott I. Abrams, Zuhair K. Ballas, Elizabeth Garabedian, Rebecca H. Buckley, Kathleen E. Sullivan, Hans D. Ochs, Brahm H. Segal, P.C. Mayor, Francisco A. Bonilla, Patricia L. Lugar, Kelly L. Singel, Kunle Odunsi, Kevin H. Eng, and Ramsay Fuleihan
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Adult ,Male ,0301 basic medicine ,Oncology ,medicine.medical_specialty ,Immunology ,Population ,Article ,03 medical and health sciences ,Neoplasms ,Internal medicine ,Epidemiology ,medicine ,Humans ,Immunology and Allergy ,education ,Aged ,Retrospective Studies ,education.field_of_study ,business.industry ,Incidence ,Common variable immunodeficiency ,Incidence (epidemiology) ,Immunologic Deficiency Syndromes ,Cancer ,Middle Aged ,medicine.disease ,Institutional review board ,United States ,030104 developmental biology ,Relative risk ,Primary immunodeficiency ,Female ,business ,SEER Program - Abstract
BACKGROUND: We evaluated the overall and site-specific incidence of cancer in subjects with primary immunodeficiency diseases (PIDD) enrolled in the United States Immune Deficiency Network (USIDNET) registry compared with age-adjusted cancer incidence in the Surveillance, Epidemiology and End Results Program (SEER) database. We hypothesized that subjects with PIDD would have an increased incidence of cancer due to impaired immune function. METHODS: Overall and site-specific cancer incidence rates were evaluated in subjects with PIDD (n = 3,658) enrolled in the USIDNET registry from 2003–2015, and compared with age-adjusted incidence rates in the SEER database. RESULTS: We observed a 1.42-fold excess relative risk of cancer in subjects with PIDD compared to the age-adjusted SEER population (p
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- 2018
26. Increased mortality associated with frequent exacerbations in COPD patients with mild-to-moderate lung function impairment, and smokers with normal spirometry
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John E. Hokanson, Patrick Tel Eyck, Chris H. Wendt, James D. Crapo, Zuhair K. Ballas, Alejandro P. Comellas, Spyridon Fortis, Ken M. Kunisaki, Russell P. Bowler, Emily S. Wan, and Edwin K. Silverman
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Pulmonary and Respiratory Medicine ,Spirometry ,medicine.medical_specialty ,COPD ,Normal spirometry ,RC705-779 ,Exacerbation ,medicine.diagnostic_test ,Copd patients ,business.industry ,Chronic obstructive pulmonary disease ,Hazard ratio ,RC581-607 ,medicine.disease ,Exacerbations ,Diseases of the respiratory system ,Internal medicine ,Cox proportional hazards regression ,medicine ,Mortality ,Immunologic diseases. Allergy ,business ,Lung function - Abstract
Background The burden of frequent respiratory exacerbations in COPD patients with mild-to-moderate spirometric impairment and smokers with preserved lung function is unknown. Methods We categorized COPD participants in COPDGene with post-bronchodilator FEV1%predicted≥50% by the annual exacerbation frequency into three groups: i)frequent exacerbators (top 5%; n = 109), ii)exacerbators (>0 but less than frequent exacerbators; n = 1,009), and iii)No exacerbation (n = 981). Exacerbations were defined as respiratory episodes requiring antibiotics and/or systemic steroids. We performed a Cox proportional hazards regression analysis to examine the association with mortality. We repeated the same process in current/former smokers with preserved spirometry (FEV1≥80%predicted and FEV1/FVC≥0.7). Results Among 2,099 COPD participants, frequent exacerbators had ≥1.8 exacerbations/year and were responsible for 34.3% of the total exacerbations. There were 102 (10.4%) deaths in the group with no exacerbations, 119 (11.8%) in the exacerbator group, and 24 (22%) in the frequent exacerbators. Adjusted mortality in frequent exacerbators was higher relative to individuals with no exacerbations (hazard ratio (HR) = 1.98; 95%CI = 1.25–3.13). An increase in frequency of exacerbations by one exacerbation/year was associated with increased mortality (HR = 1.40,95%CI = 1.21–1.62). Among 3,143 participants with preserved spirometry, frequent exacerbators had ≥0.8 exacerbations/year and were responsible for more than half of the exacerbations. There were 93 (4.2%) deaths in the group with no exacerbations, 28 (3.8%) in the exacerbator group, and 14 (7.6%) in the frequent exacerbators. The adjusted mortality was increased in frequent exacerbators with preserved spirometry relative to those with no exacerbations (HR = 2.25; 95%CI = 1.26–4.01). Conclusions In COPD participants with mild-to-moderate spirometric impairment and smokers with preserved spirometry, the frequent exacerbator phenotype is responsible for a large proportion of total exacerbations and associated with high mortality.
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- 2021
27. A Personalized Diagnostic and Treatment Approach for Macrophage Activation Syndrome and Secondary Hemophagocytic Lymphohistiocytosis in Adults
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Jennifer Petts, Sohaib Aleem, Bharat Kumar, Zuhair K. Ballas, and Hana Saleh
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Adult ,Male ,0301 basic medicine ,Secondary Hemophagocytic Lymphohistiocytosis ,Pediatrics ,medicine.medical_specialty ,Palliative care ,Adolescent ,Immunology ,Immunoglobulins ,Lymphohistiocytosis, Hemophagocytic ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Immunologic Factors ,Immunology and Allergy ,Precision Medicine ,Survival rate ,Aged ,Aged, 80 and over ,Hemophagocytic lymphohistiocytosis ,Anakinra ,business.industry ,Macrophage Activation Syndrome ,Middle Aged ,medicine.disease ,Lymphoma ,Interleukin 1 Receptor Antagonist Protein ,Leukemia ,Treatment Outcome ,030104 developmental biology ,Antirheumatic Agents ,030220 oncology & carcinogenesis ,Macrophage activation syndrome ,Cyclosporine ,Cytokines ,Female ,Steroids ,business ,medicine.drug - Abstract
We assessed the clinical features and outcomes based on therapeutic options adopted during hospital stay for adult patients with macrophage activation syndrome and secondary hemophagocytic lymphohistiocytosis (MAS/sHLH). We conducted a retrospective chart review of all adult patients (age ≥ 18 years) diagnosed with MAS/sHLH at our center between 2010 and 2015. Inclusion criteria for patients were diagnosis of MAS/sHLH during admission and patients meeting at least 5 out of 8 of Henter’s criteria or at least 4 out of 6 of the criteria that were tested. Nineteen adult patients with MAS/sHLH met the inclusion criteria from January 2010 to October 2015 (median age 48 years; female 68.4%). Treatment had been personalized, depending on the clinical presentation and course of disease. Majority of the patients received anakinra, cyclosporine, intravenous immunoglobulins (IVIG), and steroids. Fourteen (74%) patients survived, with clinical improvement by the time of discharge. After excluding the three patients with underlying leukemia/lymphoma who opted for palliative care and subsequently died, the survival rate was 88%. A modified diagnostic and treatment protocol for adult patients with MAS/sHLH that incorporated graded introduction of medications based on clinical presentation and cytokine profile resulted in the best adult survival rate reported in literature.
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- 2017
28. Significance of Hyperferritinemia in Hospitalized Adults
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Meredith Schaffner, Zuhair K. Ballas, Lori Rosenstein, and Manish Suneja
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Adult ,Male ,Pediatrics ,medicine.medical_specialty ,Iron Overload ,Elevated serum ferritin ,Gastroenterology ,Lymphohistiocytosis, Hemophagocytic ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Serum ferritin ,Aged ,Retrospective Studies ,030203 arthritis & rheumatology ,Hemophagocytic lymphohistiocytosis ,biology ,Adult patients ,business.industry ,Macrophage Activation Syndrome ,fungi ,Serum ferritin level ,General Medicine ,Middle Aged ,medicine.disease ,Iowa ,Ferritin ,030220 oncology & carcinogenesis ,Macrophage activation syndrome ,Ferritins ,biology.protein ,Female ,Elevated ferritin ,business ,hormones, hormone substitutes, and hormone antagonists - Abstract
Background Although high ferritin levels are associated with iron overload, it is known that ferritin is also an acute-phase reactant that may be elevated in conditions associated with acute and chronic inflammation. In addition, an elevated ferritin level is a criterion for the diagnosis of hemophagocytic lymphohistiocytosis/macrophage activation syndrome (HLH/MAS). Therefore, the significance of elevated serum ferritin is often unclear. As HLH/MAS is a medical emergency, prompt diagnosis is important to guide appropriate treatment. Materials and Methods To study the spectrum of diagnoses associated with elevated serum ferritin, we did a retrospective review of adult patients admitted to our academic medical center from 2008-2012 with serum ferritin levels greater than 2,000ng/mL. The degree of hyperferritinemia was compared to different diagnoses and selected laboratory values. Results A total of 333 patients were identified with a serum ferritin level >2,000ng/mL. Hepatocellular injury was the most prevalent diagnosis with n = 126; infection was next with n = 96. Eleven patients were diagnosed with HLH/MAS. Conclusions Elevated ferritin, as an isolated finding, was not a specific marker for the diagnosis of HLH/MAS. However, as a group, HLH/MAS patients had the highest mean and median ferritin values.
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- 2017
29. Biologic response modifiers: Indications, implications, and insights
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Zuhair K. Ballas and Benjamin P. Davis
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Immunology ,Biology ,Bioinformatics ,Immune Dysfunction ,Arthritis, Rheumatoid ,03 medical and health sciences ,0302 clinical medicine ,Immune system ,Animals ,Humans ,Immunologic Factors ,Immunology and Allergy ,Spondylitis, Ankylosing ,030212 general & internal medicine ,Sinusitis ,Rhinitis ,Immune mechanisms ,Biological Products ,Biologic response ,Inflammatory Bowel Diseases ,Asthma ,Immune Modulators ,CTLA-4 ,030220 oncology & carcinogenesis ,Cytokines - Abstract
The field of biologic immune modulators is currently mushrooming at a dizzying pace. Although most of these biologics are tested and approved for one or a few indications, their unanticipated side effects and off-label use have contributed significantly to our understanding of basic immune mechanisms, the involvement of cytokines in several apparently nonimmunologic diseases, and the importance of compartmentalized immune responses. In this review we attempt to give a bird's-eye view of the major biologics and to highlight insights and implications derived from their secondary effects and adverse reactions.
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- 2017
30. The Journal of Allergy and Clinical Immunology: 90 years strong
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Zuhair K. Ballas
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Publishing ,medicine.medical_specialty ,Allergy ,Biomedical Research ,Clinical immunology ,Information Dissemination ,Allergy immunology ,business.industry ,Immunology ,Manuscripts, Medical as Topic ,History, 20th Century ,medicine.disease ,History, 21st Century ,Dermatology ,Allergy and Immunology ,Hypersensitivity ,medicine ,Animals ,Humans ,Immunology and Allergy ,business - Published
- 2019
31. The clinical significance of soluble PD-1 and PD-L1 in lung cancer
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Gerald H. Clamon, Zuhair K. Ballas, Taher Abu Hejleh, and Muhammad Furqan
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0301 basic medicine ,Oncology ,medicine.medical_specialty ,Lung Neoplasms ,medicine.medical_treatment ,Cancer relapse ,Programmed Cell Death 1 Receptor ,B7-H1 Antigen ,03 medical and health sciences ,0302 clinical medicine ,PD-L1 ,Internal medicine ,Carcinoma, Non-Small-Cell Lung ,medicine ,Humans ,Clinical significance ,Positive test ,Lung cancer ,Curative intent ,biology ,business.industry ,Hematology ,Immunotherapy ,medicine.disease ,Prognosis ,Small Cell Lung Carcinoma ,030104 developmental biology ,030220 oncology & carcinogenesis ,biology.protein ,Neoplasm Recurrence, Local ,business - Abstract
Soluble PD-1 and PD-L1 are detected in the serum and plasma of lung cancer patients. The significance of these soluble proteins as prognostic or predictive markers in lung cancer is uncertain. The testing methods used to detect soluble PD1/PD-L1 are variable with no agreement on a common definition of a positive test. The advantages of validating soluble PD1/PD-L1 relevance in lung cancer include easiness of obtaining blood samples for testing, serial measurements to assess response to treatments such as immunotherapy, and potentially early identification of cancer relapse in cases treated with curative intent. In this review, we present the available data published on soluble PD1 and PD-L1 in lung cancer.
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- 2019
32. The 2019 AAAAI Foundation Faculty Development awardees
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Zuhair K. Ballas
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business.industry ,Allergy immunology ,Allergy and Immunology ,Immunology ,Foundation (engineering) ,MEDLINE ,Awards and Prizes ,Immunology and Allergy ,Medicine ,Library science ,Humans ,Faculty development ,business - Published
- 2019
33. Preliminary findings from a concise emergency department model to predict anaphylaxis and develop a clinical decision support tool
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Zuhair K. Ballas, Azeemuddin Ahmed, Morgan B Swanson, Cassandra T. Hardy, Karisa K. Harland, and Sangil Lee
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Adult ,Male ,Adolescent ,Epinephrine ,business.industry ,Reproducibility of Results ,Emergency department ,Middle Aged ,medicine.disease ,Decision Support Systems, Clinical ,Prognosis ,Clinical decision support system ,Decision Support Techniques ,Young Adult ,medicine ,Immunology and Allergy ,Humans ,Female ,Medical emergency ,business ,Emergency Service, Hospital ,Anaphylaxis ,Software - Published
- 2019
34. Nicotine Mediates CD161a + Renal Macrophage Infiltration and Premature Hypertension in the Spontaneously Hypertensive Rat
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Mark W. Chapleau, Fayyaz S. Sutterwala, David K. Meyerholz, Zuhair K. Ballas, Jason A Ratcliff, Sailesh C. Harwani, and Francois M. Abboud
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Male ,0301 basic medicine ,Hypertension, Renal ,alpha7 Nicotinic Acetylcholine Receptor ,Physiology ,Integrin alpha4beta1 ,030204 cardiovascular system & hematology ,Kidney ,Rats, Inbred WKY ,Nicotine ,Norepinephrine ,Prehypertension ,0302 clinical medicine ,Cell Movement ,Lectins ,Rats, Inbred SHR ,Age of Onset ,Cells, Cultured ,Chemokine CCL2 ,Nephritis ,Angiotensin II ,Denervation ,medicine.anatomical_structure ,Nicotinic agonist ,Hypertension ,Cytokines ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,NK Cell Lectin-Like Receptor Subfamily B ,medicine.drug ,medicine.medical_specialty ,Antigens, Differentiation, Myelomonocytic ,Inflammation ,Biology ,Receptor, Angiotensin, Type 2 ,Receptor, Angiotensin, Type 1 ,Article ,Immunophenotyping ,Proinflammatory cytokine ,03 medical and health sciences ,Spontaneously hypertensive rat ,Antigens, CD ,Internal medicine ,medicine ,Animals ,Macrophages ,Rats ,030104 developmental biology ,Endocrinology ,Gene Expression Regulation ,Cholinergic - Abstract
Rationale: Renal inflammation contributes to the pathophysiology of hypertension. CD161a + immune cells are dominant in the (SHR) spontaneously hypertensive rat and expand in response to nicotinic cholinergic activation. Objective: We aimed to phenotype CD161a + immune cells in prehypertensive SHR after cholinergic activation with nicotine and determine if these cells are involved in renal inflammation and the development of hypertension. Methods and Results: Studies used young SHR and WKY (Wistar–Kyoto) rats. Splenocytes and bone marrow cells were exposed to nicotine ex vivo, and nicotine was infused in vivo. Blood pressures, kidney, serum, and urine were obtained. Flow cytometry, Luminex/ELISA, immunohistochemistry, confocal microscopy, and Western blot were used. Nicotinic cholinergic activation induced proliferation of CD161a + /CD68 + macrophages in SHR-derived splenocytes, their renal infiltration, and premature hypertension in SHR. These changes were associated with increased renal expression of MCP-1 (monocyte chemoattractant protein-1) and VLA-4 (very-late antigen-4). LLT1 (lectin-like transcript 1), the ligand for CD161a, was overexpressed in SHR kidney, whereas vascular cellular and intracellular adhesion molecules were similar to those in WKY. Inflammatory cytokines were elevated in SHR kidney and urine after nicotine infusion. Nicotine-mediated renal macrophage infiltration/inflammation was enhanced in denervated kidneys, not explained by angiotensin II levels or expression of angiotensin type-1/2 receptors. Moreover, expression of the anti-inflammatory α7-nAChR (α7-nicotinic acetylcholine receptor) was similar in young SHR and WKY rats. Conclusions: A novel, inherited nicotinic cholinergic inflammatory effect exists in young SHR, measured by expansion of CD161a + /CD68 + macrophages. This leads to renal inflammation and premature hypertension, which may be partially explained by increased renal expression of LLT-1, MCP-1, and VLA-4.
- Published
- 2016
35. Immunoglobulin replacement therapy reduces chronic rhinosinusitis in patients with antibody deficiency
- Author
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Sarah L. Mott, Jarrett E. Walsh, Jose Gurrola, Scott M. Graham, and Zuhair K. Ballas
- Subjects
medicine.medical_specialty ,biology ,business.industry ,medicine.drug_class ,Chronic rhinosinusitis ,Common variable immunodeficiency ,medicine.medical_treatment ,Antibiotics ,Immunotherapy ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,Immune system ,030228 respiratory system ,Otorhinolaryngology ,Internal medicine ,Immunology ,medicine ,biology.protein ,Immunology and Allergy ,Antibody ,030223 otorhinolaryngology ,business ,Sinusitis ,Immunodeficiency - Abstract
Background Patients with primary antibody deficiencies have an increased frequency of sinonasal and pulmonary infections. Immunoglobulin (Ig) replacement is a standard therapy for common variable immunodeficiency (CVID) and other antibody deficiency diseases. Although there is convincing evidence that Ig replacement reduces pulmonary infections, there is little evidence that it reduces sinus infections or abates chronic rhinosinusitis (CRS). This study aims to identify the impact of Ig replacement on CRS in antibody deficiencies. Methods A single-center, retrospective chart review of adult patients from 1995 to 2015 was performed. Inclusion criteria were diagnosis of CVID or specific antibody deficiency (SAD), history of CRS requiring medical and/or surgical management within the year prior to presentation, treatment with Ig replacement therapy, and follow-up interval of at least 1 year after initiating Ig replacement. Patients with secondary immune deficiencies were excluded. Thirty-one patients met criteria. Data collected included pretreatment and posttreatment Lund-Mackay scores, and frequency of sinusitis and pulmonary infections requiring rescue antibiotics. Statistical analysis was performed using Wilcoxon signed-rank tests. Results A significant decline in the Lund-Mackay score was evidenced from pretreatment to posttreatment (p < 0.01). Treatment also resulted in significantly lower rates of sinusitis (p < 0.01) and pulmonary infections (p < 0.01). Additionally, 56% of patients who were on prophylactic antibiotics prior to Ig replacement were able to discontinue their use. Conclusion We present objective evidence showing that Ig replacement therapy has a positive impact on the frequency of sinusitis and confirm its positive impact on pulmonary infections in adult patients with CVID and SAD.
- Published
- 2016
36. Combined immunodeficiency in the United States and Kuwait: Comparison of patients' characteristics and molecular diagnosis
- Author
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Laurence E. Cheng, Ali Sadek, Mark Ballow, Zuhair K. Ballas, Waleed Al-Herz, Niraj Patel, Kathleen E. Sullivan, Javeed Akhter, Luigi D. Notarangelo, Elie Haddad, Francisco A. Bonilla, Elizabeth Garabedian, Charlotte Cunningham-Rundles, Hans D. Ochs, Burcin Uygungil, Rebecca H. Buckley, Karin Chen, Gary Kleiner, Elizabeth Secord, and Christine M. Seroogy
- Subjects
medicine.medical_specialty ,Pediatrics ,Immunology ,Patient characteristics ,Article ,Annual incidence ,Neonatal Screening ,parasitic diseases ,Epidemiology ,medicine ,Humans ,Immunology and Allergy ,Registries ,Age of Onset ,Pathology, Molecular ,Family history ,Child ,Immunodeficiency ,Newborn screening ,business.industry ,Incidence (epidemiology) ,Immunologic Deficiency Syndromes ,Infant, Newborn ,medicine.disease ,United States ,Kuwait ,Age of onset ,business - Abstract
Aim To compare different variables among (S)CID patients diagnosed in the USA and Kuwait. Methods Review of patients registered in The US Immune Deficiency Network registry or Kuwait National PID Registry between 2004 and 2014. Results Totals of 98 and 69 (S)CID patients were registered during the study period in the USIDNET registry and the KNPIDR, respectively. The average annual incidence rate for the period 2004–2014 of (S)CID in children in Kuwait was 13.01/100,000 children, with an estimated occurrence of 1/7500 live births. There were differences between the two countries in the following variables: age at onset and diagnosis, family history of (S)CID, parental consanguinity, and outcome. More than 14% of (S)CID patients from USIDNET registry were diagnosed through newborn screening. Conclusions Patients' characteristics and molecular causes of S(CID) are different between USA and Kuwait. NBS for SCID should be started in countries where the incidence of (S)CID is high.
- Published
- 2015
37. The Journal of Allergy and Clinical Immunology : An update on style and substance
- Author
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Cezmi A. Akdis, Justin Byrne, Zuhair K. Ballas, University of Zurich, and Akdis, Cezmi A
- Subjects
2403 Immunology ,Allergy ,medicine.medical_specialty ,Clinical immunology ,business.industry ,Immunology ,MEDLINE ,610 Medicine & health ,medicine.disease ,Style (sociolinguistics) ,10183 Swiss Institute of Allergy and Asthma Research ,Allergy and Immunology ,Family medicine ,2723 Immunology and Allergy ,medicine ,Humans ,Immunology and Allergy ,Periodicals as Topic ,business - Published
- 2017
38. Recurrent Mycobacterium avium Complex Infection
- Author
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Amanda Grippen Goddard, Girish Bathla, Jennifer Petts, and Zuhair K. Ballas
- Subjects
0301 basic medicine ,Microbiology (medical) ,medicine.medical_specialty ,Productive Cough ,biology ,business.industry ,medicine.drug_class ,030106 microbiology ,Antibiotics ,White female ,biology.organism_classification ,respiratory tract diseases ,03 medical and health sciences ,0302 clinical medicine ,Infectious Diseases ,Weight loss ,Internal medicine ,medicine ,Sputum ,Chills ,Mycobacterium avium complex ,030212 general & internal medicine ,medicine.symptom ,business - Abstract
A 64-year-old white female presented with 4 years of episodic, productive cough, fevers, chills, night sweats, and weight loss. Over this period, she had documented recurrent Mycobacterium avium complex in the bronchiolar lavage and sputum despite taking antibiotics for 2 years. Result of ex
- Published
- 2017
39. Characterization of serum biomarkers during anaphylaxis in emergency department patients
- Author
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Sangil Lee, Patrick Ten Eyck, Conor Dass, and Zuhair K. Ballas
- Subjects
Emergency Medical Services ,medicine.medical_specialty ,Epinephrine ,business.industry ,MEDLINE ,Emergency department ,medicine.disease ,Article ,Serum biomarkers ,Emergency medicine ,Humans ,Immunology and Allergy ,Medicine ,Emergency Service, Hospital ,business ,Anaphylaxis ,Biomarkers ,Retrospective Studies - Published
- 2020
40. Update on JACI’s evolution
- Author
-
Zuhair K. Ballas
- Subjects
Allergy immunology ,business.industry ,Immunology ,Immunology and Allergy ,Medicine ,business - Published
- 2020
41. Prevalence and the Impact of Hypogammaglobulinemia in Newly Diagnosed, Untreated Diffuse Large B Cell Lymphoma
- Author
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Andrew L. Feldman, Namrata Singh, Sarah L. Mott, Grzegorz S. Nowakowski, Thomas M. Habermann, Ashley Noel McCarthy, Thomas E. Witzig, Susan L. Slager, Zuhair K. Ballas, Sergei Syrbu, James R. Cerhan, Brian K. Link, and Umar Farooq
- Subjects
medicine.medical_specialty ,biology ,business.industry ,Chronic lymphocytic leukemia ,Immunology ,Cell Biology ,Hematology ,Newly diagnosed ,medicine.disease ,Immunoglobulin E ,Biochemistry ,Gastroenterology ,Lymphoma ,Hypogammaglobulinemia ,Immunoglobulin M ,hemic and lymphatic diseases ,Internal medicine ,medicine ,biology.protein ,Antibody ,business ,Diffuse large B-cell lymphoma - Abstract
Background: While there is evidence in the literature of increased prevalence of hypogammaglobulinemia in chronic lymphocytic leukemia (CLL), there are no studies evaluating the prevalence of hypogammaglobulinemia in newly diagnosed diffuse large B cell lymphoma (DLBCL) or the relationship between hypogammaglobulinemia and presentation or outcomes. The objective of this study was to examine the prevalence of hypogammaglobulinemia in newly diagnosed DLBCL patients and to test the hypothesis that DLBCL patients with baseline hypogammaglobulinemia have a distinct clinical profile and outcome. Methods: We obtained banked frozen sera from 200 newly diagnosed, treatment-naïve, DLBCL patients from the Lymphoma SPORE Molecular Epidemiology Resource (MER), a prospective cohort study conducted at the Mayo Clinic and the University of Iowa. IgG/A/M levels were measured using immunoturbidimetric assay whereas IgE level was measured using electrochemiluminescence immunoassay; deficiency was defined using standard reference ranges. IgE levels were considered deficient if Results: The mean age (SD) of the cohort was 65.6 (13.4) years, 54% were males and 98% of the patients were white. Over a median follow-up of five years, there were 59 (29.5%) deaths. The prevalence of hypogammaglobulinemia, defined as any deficiency, in newly diagnosed, treatment-naïve DLBCL was 22.1% (44/199) in our cohort, and the most common Ig deficiency was for IgG ( Conclusions: To the best of our knowledge, this is the first study to report the prevalence of hypogammaglobulinemia in treatment naïve DLBCL. We found that any Ig deficiency was not uncommon in our cohort and it was associated with an inferior EFS and OS in DLBCL patients. The prevalence of hypogammaglobulinemia in DLBCL patients seems to be lower than has been described in CLL patients. While the underlying relationship between these two immunologic disorders deserves further study, our findings highlight the interaction between global immune dysfunction and emergence of a clonal B cell process. Disclosures Nowakowski: Genentech, Inc.: Research Funding; F. Hoffmann-La Roche Ltd: Research Funding; Curis: Research Funding; Bayer: Consultancy, Research Funding; Celgene: Consultancy, Research Funding; Selvita: Membership on an entity's Board of Directors or advisory committees; NanoString: Research Funding; MorphoSys: Consultancy, Research Funding. Farooq:Celgene: Honoraria; Kite Pharma: Research Funding. Cerhan:NanoString: Research Funding; Celgene: Research Funding; Janssen: Membership on an entity's Board of Directors or advisory committees.
- Published
- 2019
42. Asthma clinical practice guidelines: Time for an update
- Author
-
Zuhair K. Ballas
- Subjects
medicine.medical_specialty ,Allergy immunology ,business.industry ,Immunology ,Longevity ,MEDLINE ,medicine.disease ,030226 pharmacology & pharmacy ,Asthma ,Clinical Practice ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Immunology and Allergy ,Humans ,030212 general & internal medicine ,Intensive care medicine ,business - Published
- 2018
43. DASH Score and Subsequent Risk of Coronary Artery Disease: The Findings From Million Veteran Program
- Author
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Luc Djoussé, Yuk‐Lam Ho, Xuan‐Mai T. Nguyen, David R. Gagnon, Peter W.F. Wilson, Kelly Cho, J. Michael Gaziano, Ildiko Halasz, Daniel Federman, Jean Beckham, Scott E. Sherman, Peruvemba Sriram, Philip S. Tsao, Edward J. Boyko, Junzhe Xu, Frank Lederle, Louis J. Dellitalia, Rachel McArdle, Laurence Kaminsky, Alan C. Swann, Mark B. Hamner, Hermes J. Florez, Prashant Pandya, Gerardo Villarreal, Peter Wilson, Timothy R. Morgan, Lori Davis, Robin A. Hurley, Laurence Meyer, Sunil K. Ahuja, Eric P. Konicki, David Cohen, Jack Lichy, Jeffrey Whittle, Kathlyn Sue Haddock, Karl D. Straub, John T. Callaghan, Samuel M. Aguayo, Samir Gupta, Ronald G. Washburn, Mary E. Oehlert, Adriana M. Hung, Agnes Wallbom, Robert Keith, Elif Sonel, Ronald B. Schifman, Richard D. Childress, Michael F. Godschalk, Alan R. Shuldiner, Padmashri Rastogi, Salvador Gutierrez, Ronald Fernando, Pran R. Iruvanti, Darshana Jhala, Carlos Rosado‐Rodriguez, Stephen M. Mastorides, John B. Harley, Kristin Mattocks, Robert T. Striker, Michael Rauchman, John Wells, Zuhair K. Ballas, Susan S. Woods, Shing Yeh, Nora R. Ratcliffe, Jon B. Klein, Adam G. Golden, Harold M. Ginzburg, Satish Sharma, Kris Ann K. Oursler, Mary A. Whooley, and Gretchen Gibson
- Subjects
0301 basic medicine ,Male ,medicine.medical_specialty ,Time Factors ,Dietary Approaches To Stop Hypertension ,Epidemiology ,Population ,Veterans Health ,Coronary Artery Disease ,Lower risk ,Risk Assessment ,Coronary artery disease ,03 medical and health sciences ,Risk Factors ,Internal medicine ,Cardiovascular Disease ,Dash ,medicine ,Humans ,Prospective Studies ,education ,Aged ,Original Research ,education.field_of_study ,030109 nutrition & dietetics ,business.industry ,Incidence (epidemiology) ,Incidence ,Hazard ratio ,Middle Aged ,Protective Factors ,medicine.disease ,Prognosis ,Lifestyle ,Confidence interval ,United States ,nutrition ,Patient Compliance ,Female ,Diet, Healthy ,Cardiology and Cardiovascular Medicine ,business ,Body mass index ,Risk Reduction Behavior - Abstract
Background While adherence to healthful dietary patterns has been associated with a lower risk of coronary artery disease (CAD) in the general population, limited data are available among US veterans. We tested the hypothesis that adherence to Dietary Approach to Stop Hypertension (DASH) food pattern is associated with a lower risk of developing CAD among veterans. Methods and Results We analyzed data on 153 802 participants of the Million Veteran Program enrolled between 2011 and 2016. Information on dietary habits was obtained using a food frequency questionnaire at enrollment. We used electronic health records to assess the development of CAD during follow‐up. Of the 153 802 veterans who provided information on diet and were free of CAD at baseline, the mean age was 64.0 (SD=11.8) years and 90.4% were men. During a mean follow‐up of 2.8 years, 5451 CAD cases occurred. The crude incidence rate of CAD was 14.0, 13.1, 12.6, 12.3, and 11.1 cases per 1000 person‐years across consecutive quintiles of Dietary Approach to Stop Hypertension score. Hazard ratios (95% confidence interval) for CAD were 1.0 (ref), 0.91 (0.84–0.99), 0.87 (0.80–0.95), 0.86 (0.79–0.94), and 0.80 (0.73–0.87) from the lowest to highest quintile of Dietary Approach to Stop Hypertension score controlling for age, sex, body mass index, race, smoking, exercise, alcohol intake, and statin use ( P linear trend, Conclusions Our data are consistent with an inverse association between Dietary Approach to Stop Hypertension diet score and incidence of CAD among US veterans.
- Published
- 2018
44. In lasting tribute: Philip S. Norman, August 4, 1924–August 2, 2019
- Author
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Zuhair K. Ballas, Peter S. Creticos, and Bruce S. Bochner
- Subjects
media_common.quotation_subject ,Immunology ,Immunology and Allergy ,Tribute ,Art ,Ancient history ,media_common - Published
- 2019
45. The 2018 Nobel Prize in Physiology or Medicine: An exemplar of bench to bedside in immunology
- Author
-
Zuhair K. Ballas
- Subjects
0301 basic medicine ,business.industry ,medicine.medical_treatment ,Immunology ,Cancer ,CD28 ,Immunotherapy ,medicine.disease ,Immune checkpoint ,Bench to bedside ,Nobel Prize ,03 medical and health sciences ,Antineoplastic Agents, Immunological ,030104 developmental biology ,0302 clinical medicine ,Cytotoxic T-Lymphocyte-Associated Antigen 4 ,Allergy and Immunology ,Neoplasms ,030220 oncology & carcinogenesis ,Animals ,Humans ,Immunology and Allergy ,Medicine ,business - Published
- 2018
46. Antibody deficiency in patients with frequent exacerbations of Chronic Obstructive Pulmonary Disease (COPD)
- Author
-
Antoine Azar, John D. Newell, M. Bridget Zimmerman, Zuhair K. Ballas, Alejandro P. Comellas, and Brian N. McCullagh
- Subjects
Male ,Pulmonology ,Physiology ,lcsh:Medicine ,Antibody Response ,Biochemistry ,Pulmonary function testing ,Pulmonary Disease, Chronic Obstructive ,0302 clinical medicine ,Adrenal Cortex Hormones ,Antibiotics ,Immune Physiology ,Medicine and Health Sciences ,Public and Occupational Health ,030212 general & internal medicine ,Antibiotic prophylaxis ,Prospective cohort study ,lcsh:Science ,Immune Response ,Cause of death ,COPD ,Vaccines ,Multidisciplinary ,Immune System Proteins ,Antimicrobials ,Drugs ,Middle Aged ,Vaccination and Immunization ,Anti-Bacterial Agents ,Immunoglobulin Isotypes ,Female ,Research Article ,medicine.medical_specialty ,Chronic Obstructive Pulmonary Disease ,Immunology ,Selective IgA deficiency ,Microbiology ,Antibodies ,03 medical and health sciences ,Immune Deficiency ,Diagnostic Medicine ,Internal medicine ,Microbial Control ,medicine ,Humans ,Risk factor ,Aged ,Pharmacology ,business.industry ,Prophylaxis ,Common variable immunodeficiency ,lcsh:R ,Immunologic Deficiency Syndromes ,Biology and Life Sciences ,Proteins ,Antibiotic Prophylaxis ,medicine.disease ,respiratory tract diseases ,030228 respiratory system ,lcsh:Q ,Clinical Immunology ,Preventive Medicine ,Clinical Medicine ,business ,Tomography, X-Ray Computed - Abstract
Chronic Obstructive Pulmonary Disease is the third leading cause of death in the US, and is associated with periodic exacerbations, which account for the largest proportion of health care utilization, and lead to significant morbidity, mortality, and worsening lung function. A subset of patients with COPD have frequent exacerbations, occurring 2 or more times per year. Despite many interventions to reduce COPD exacerbations, there is a significant lack of knowledge in regards to their mechanisms and predisposing factors. We describe here an important observation that defines antibody deficiency as a potential risk factor for frequent COPD exacerbations. We report a case series of patients who have frequent COPD exacerbations, and who were found to have an underlying primary antibody deficiency syndrome. We also report on the outcome of COPD exacerbations following treatment in a subset with of these patients with antibody deficiency. We identified patients with COPD who had 2 or more moderate to severe exacerbations per year; immune evaluation including serum immunoglobulin levels and pneumococcal IgG titers was performed. Patients diagnosed with an antibody deficiency syndrome were treated with either immunoglobulin replacement therapy or prophylactic antibiotics, and their COPD exacerbations were monitored over time. A total of 42 patients were identified who had 2 or more moderate to severe COPD exacerbations per year. Twenty-nine patients had an underlying antibody deficiency syndrome: common variable immunodeficiency (8), specific antibody deficiency (20), and selective IgA deficiency (1). Twenty-two patients had a follow-up for at least 1 year after treatment of their antibody deficiency, which resulted in a significant reduction of COPD exacerbations, courses of oral corticosteroid use and cumulative annual dose of oral corticosteroid use, rescue antibiotic use, and hospitalizations for COPD exacerbations. This case series identifies antibody deficiency as a potentially treatable risk factor for frequent COPD exacerbations; testing for antibody deficiency should be considered in difficult to manage frequently exacerbating COPD patients. Further prospective studies are warranted to further test this hypothesis.
- Published
- 2016
47. The Editors' Choice
- Author
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Cezmi A. Akdis and Zuhair K. Ballas
- Subjects
Immunology ,Immunology and Allergy - Published
- 2018
48. The Editors' Choice
- Author
-
Cezmi A. Akdis and Zuhair K. Ballas
- Subjects
Immunology ,Immunology and Allergy - Published
- 2017
49. The Editors' Choice
- Author
-
Cezmi A. Akdis and Zuhair K. Ballas
- Subjects
Immunology ,Immunology and Allergy - Published
- 2017
50. Localized Increase of Chemokines in the Lumen of Human Cerebral Aneurysms
- Author
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Lauren J Points, David Hasan, Zuhair K. Ballas, Pascal Jabbour, Gary L. Pierce, and Nohra Chalouhi
- Subjects
Adult ,Male ,Eotaxin ,Pathology ,medicine.medical_specialty ,Chemokine ,T cell ,Lumen (anatomy) ,Inflammation ,Aneurysm, Ruptured ,Article ,Aneurysm ,medicine ,Humans ,Aged ,Advanced and Specialized Nursing ,biology ,business.industry ,Interleukin ,Intracranial Aneurysm ,Chemotaxis ,Cerebral Arteries ,Middle Aged ,medicine.disease ,Up-Regulation ,Femoral Artery ,medicine.anatomical_structure ,biology.protein ,Female ,Neurology (clinical) ,Chemokines ,Inflammation Mediators ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background and Purpose— Inflammation may play an important role in the formation and rupture of cerebral aneurysms. Chemokines act as chemoattractants for leukocytes directing them toward sites of tissue inflammation. The purpose of this study was to determine whether chemokines and chemoattractant cytokines were increased in the lumen of human cerebral aneurysms. Methods— The concentrations of chemokines and other inflammatory molecules in blood samples drawn from the lumen of human cerebral aneurysms of 16 consecutive patients (harboring 18 aneurysms) were compared with blood samples from the femoral arteries of the same patients. Three aneurysms had ruptured. Results— The mean plasma concentration of regulated on activation, normal T cell expressed and secreted (RANTES), monokine-induced-by-γ-interferon (MIG), interferon-γ-induced protein-10 (IP-10), eotaxin, interleukin (IL) 8, and IL17 was significantly higher in samples taken from cerebral aneurysms compared with femoral arteries. In contrast, plasma concentrations of all remaining inflammatory molecules (except IL6) that were tested did not differ between cerebral aneurysms and femoral arteries. For unruptured aneurysms, there was a significantly higher mean plasma concentration of monocyte chemoattractant protein-1 as well as RANTES, MIG, IP-10, eotaxin, IL8, and IL17 in samples obtained from cerebral aneurysms. Conclusions— High plasma concentrations of chemokines (monocyte chemoattractant protein-1, RANTES, MIG, IP-10, and eotaxin) and chemoattractant cytokines (IL8 and IL17) were found in the lumen of human cerebral aneurysms. These findings suggest that there may be an active recruitment of inflammatory cells into the aneurysm wall that may be exploited therapeutically.
- Published
- 2013
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