Evidence map›Paper›PMID 41282717›Full record

ArticlemedRxiv : the preprint server for health sciences2025

Upper and Lower Respiratory Tract Compartmentalization in Pediatric Stem Cell Transplantation.

Erica M Evans, Madeline Y Mayday, Emma M Pearce, K Iwanaga, N P Ly, G D Church, Gustavo Reyes, Miriam R Simon, Jacob Blum, Hanna Kim and 24 more

Abstract readPreprint
PubMed Full text at PMC Publisher
In one paragraph

Article in medRxiv : the preprint server for health sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

34 authors.

Erica M EvansDivision of Critical Care Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA.
Madeline Y MaydayDivision of Critical Care Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA.
Emma M PearceDivision of Critical Care Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA.
K IwanagaDivision of Pulmonary Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA.
N P LyDivision of Pulmonary Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA.
G D ChurchDivision of Pulmonary Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA.
Gustavo ReyesDivision of Critical Care Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA.
Miriam R SimonDivision of Critical Care Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA.
Jacob BlumDivision of Critical Care Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA.
Hanna KimDivision of Critical Care Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA.
Jessica MuDivision of Critical Care Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA.
Jazmin Baez-MaidanaDivision of Critical Care Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA.
Jeffrey J AulettaHematology/Oncology/BMT and Infectious Diseases, Nationwide Children's Hospital, Columbus, OH, USA.
Peter J ShawThe Children`s Hospital at Westmead, Westmead, NSW, Australia.
Erin M KremlDepartment of Child Health, Division of Critical Care Medicine, University of Arizona, Phoenix, AZ, USA.
Paul L MartinDivision of Pediatric and Cellular Therapy, Duke University Medical Center, Durham, NC, USA.
Christine N DuncanHarvard Medical School, Boston, Massachusetts; Division of Pediatric Oncology, Department of Pediatrics, Dana-Farber Cancer Institute and Boston Children's Hospital, Boston, MA, USA.
Courtney M RowanIndiana University, Department of Pediatrics, Division of Critical Care Medicine, Indianapolis, IN, USA.
Kamar GodderCancer and Blood Disorders Center, Nicklaus Children's Hospital, Miami, FL, USA.
Caitlin HurleyDivision of Critical Care, Department of Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA.
Geoffrey D E CuvelierCancerCare Manitoba, Manitoba Blood and Marrow Transplant Program, University of Manitoba, Winnipeg, Manitoba, Canada.
Muna QayedAflac Cancer & Blood Disorders Center, Children's Healthcare of Atlanta and Emory University, Atlanta, GA, USA.
Hisham Abdel-AzimDepartment of Pediatrics, Division of Hematology/Oncology and Transplant and Cell Therapy, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Amy K KeatingHarvard Medical School, Boston, Massachusetts; Division of Pediatric Oncology, Department of Pediatrics, Dana-Farber Cancer Institute and Boston Children's Hospital, Boston, MA, USA.
Julie C FitzgeraldDepartment of Anesthesiology and Critical Care, Perelman School of Medicine, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA.
Rabi HannaDepartment of Pediatric Hematology, Oncology and Blood and Marrow Transplantation, Pediatric Institute, Cleveland Clinic, Cleveland, OH, USA.
James S KillingerDivision of Pediatric Critical Care, Department of Pediatrics, Weill Cornell Medicine, New York, NY, USA.
Janet R HumeUniversity of Minnesota, Department of Pediatrics, Division of Critical Care Medicine, Minneapolis, MN, USA.
Troy C QuiggPediatric Blood and Marrow Transplantation Program, Texas Transplant Institute, Methodist Children's Hospital, San Antonio, TX, USA.
Paul CastilloUniversity of Florida, Gainesville, UF Health Shands Children's Hospital, Gainesville, FL, USA.
Prakash SatwaniDivision of Pediatric Hematology, Oncology and Stem Cell Transplantation, Department of Pediatrics, Columbia University, New York, NY, USA.
Theodore B MooreDepartment of Pediatric Hematology-Oncology, Mattel Children's Hospital, University of California, Los Angeles, CA, USA.
Christopher C DvorakDivision of Allergy, Immunology, and Bone Marrow Transplantation, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA.
Matt S ZinterDivision of Critical Care Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA.ORCID 0000-0003-3351-3278

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Nicholas D Socci · 1985 to 2026
$347.4M
Pediatric Scientist Development Program (PSDP) [K12]K12HD000850 · NICHD · YALE UNIVERSITY · PI Sallie R. Permar · 1987 to 2026
$44.1M
Pulmonary Immune Regulation of Lung Injury after Pediatric Hematopoietic Cell TransplantR01HL180864 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Matthew Scott Zinter · 2025 to 2026
$1.4M
Pathobiologic Transcriptional Signatures of Pulmonary Complications in Pediatric Hematopoietic Cellular TransplantationK23HL146936 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI ZINTER, MATTHEW SCOTT · 2020 to 2024
$980k
Investigation of pulmonary fibrosis biology in pediatric hematopoietic cell transplant patientsR03HL171423 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI ZINTER, MATTHEW SCOTT · 2024 to 2025
$253k
Elucidation of the molecular mechanisms of the RBM15-MKL1 fusion protein in acute megakaryoblastic leukemiaF31CA271571 · NCI · YALE UNIVERSITY · PI Madeline Young Mayday · 2023 to 2026
$155k
NCI NIH HHS F31 CA271571NCI NIH HHS P30 CA008748NHLBI NIH HHS K23 HL146936NHLBI NIH HHS R01 HL180864NHLBI NIH HHS R03 HL171423NICHD NIH HHS K12 HD000850
6 · The paper itself

Abstract

Rationale: Lung injury after hematopoietic stem cell transplantation (HCT) occurs due to infection, chemotherapy toxicity, and alloreactive inflammation. Analyses of bronchoalveolar lavage (BAL) fluid have revealed dominant pathobiologic signatures, but minimally-invasive diagnostics are needed. Objectives: To determine whether microbiome and gene expression perturbations are shared along the respiratory tract or isolated to the alveoli in pediatric HCT patients with lung injury. Methods: We performed bulk RNA sequencing on 189 paired nasal and BAL samples from 160 patients enrolled at 28 children's hospitals (2016-2021). Microbial and human transcripts were compared using multivariable models accounting for age, sex, and paired sampling. Measurements and Main Results: BAL and nasal transcriptomes differed across 13,698 genes, 48 cellular components, and network interactions linking inflammation, reactive oxygen species, and immunometabolism. Minimal BAL-nasal correlation was observed in gene expression levels (median p=0.03, IQR -0.03 to 0.08) or fractional abundance of key cells such as neutrophils and CD8+ T-cells. BAL microbiomes harbored fewer commensal bacteria and more fungi and DNA viruses. BAL bacterial RNA was associated with diminished immune signaling whereas nasal bacterial RNA aligned with inflammatory gene expression. Further, only BAL microbial RNA was linked to transcriptional shifts in epithelial injury response, keratinization, and collagen deposition. Finally, BAL commensal microbiome depletion, epithelial injury, and immune dysregulation signatures were associated with death or ≥7 days of mechanical ventilation in 30% of patients, whereas nasal samples provided minimal prognostic information. Conclusions: These data support alveolar compartmentalization in pediatric HCT and emphasize the ongoing need for minimally-invasive but informative diagnostics.

Indexed as

Bronchoalveolar LavageHematopoietic Stem Cell TransplantationImmunocompromised HostIntensive Care Units, PediatricTranscriptome

Identifiers

PMID41282717
PMCPMC12633101

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.