School of Medicine
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Clinical Assistant Professor, Pediatrics - Gastroenterology
BioI enjoy working with a multidisciplinary team to care for patients who have complex medical needs with the aim of giving children a better future. As a clinical researcher, my main focus is on finding improved therapies for autoimmune and cholestatic liver diseases, since an ideal therapy currently does not exist.
Cristina Maria Alvira
Associate Professor of Pediatrics (Critical Care)
Current Research and Scholarly InterestsThe overall objective of the Alvira Laboratory is to elucidate the mechanisms that promote postnatal lung development and repair, by focusing on three main scientific goals: (i) identification of the signaling pathways that direct the transition between the saccular and alveolar stages of lung development; (ii) exploration of the interplay between postnatal vascular and alveolar development; and (iii) determination of developmentally regulated pathways that mediate lung repair after injury.
Manuel R. Amieva
Professor of Pediatrics (Infectious Diseases) and of Microbiology and Immunology
Current Research and Scholarly InterestsMy laboratory studies how bacteria colonize our bodies for long periods of time, and how interactions between bacteria and the epithelial surfaces of the gastrointestinal tract and skin may lead to disease. Epithelial surfaces are the first barrier against infection, but they also where our bodies meet and co-evolve with the microbial world.. Several of our studies have focused on the epithelial junctions as a target for bacterial pathogens. The host epithelium uses its epithelial junctions to form a tight but dynamic barrier with an external surface that is inhospitable to microbial attachment, secretes anti-microbial compounds, and has a rapid rate of self-renewal. The balance in the microbe-epithelial relationship results in silent commensalism or symbiosis; an imbalance results in diseases ranging from acute bacterial invasive disease to chronic ulcers or carcinoma.
Our laboratory has developed novel microscopy applications such as quantitative 3D confocal microscopy, electron microscopy, time-lapse imaging, microinjection and micromanipulation to visualize the interaction of pathogens with epithelial cells in culture and in animal and human tissues. Many of out studies focus on the gastric pathogen Helicobacter pylori, but we have also expanded our investigations to include the intestinal pathogens Listeria monocytogenes and Salmonella enterica, and the skin pathogen and colonizer Staphylococcus aureus. I believe that elucidating how microbes communicate with and alter our epithelial cells at a molecular level will be important for finding novel therapeutic targets to control mucosal colonization and prevent invasive disease.
Using this perspective, we have uncovered several novel concepts of how bacteria colonize and breach our epithelial surfaces. For example, we discovered that Helicobacter pylori target the intercellular junctions, and in particular that the virulence factor CagA affects junction assembly and cell polarity. This confers H. pylori the ability to extract nutrients and grow directly on the epithelial surface. We also found that these properties of CagA have consequences for cellular transformation of the epithelium. For instance, we showed that H. pylori affect the activity and state of epithelial stem cells in the stomach by colonizing the epithelial surface deep in the gastric glands. This gland-associated population is essential for pathological inflammation and hyperplasia in animal models, and confers significant colonization advantages to the bacteria. Our Listeria research uncovered a new mechanism and site where bacteria can breach the gastrointestinal epithelial barrier to invade. We found that Listeria find their receptor for invasion at sites of epithelial senescence, where the epithelial junctions undergo dynamic turnover. To study Salmonella and H. pylori we have developed a human organoid model to study their interactions with human gut epithelium in vitro. To study Staphylococcus aureus pathogenesis, we have developed methods to visualize infection at the scale of a single bacterial microcolony using an organoid culture system of human keratinocytes and fibroblasts that grow into a 3D skin-equivalent. We recently identified several proteins at the eptithelial junctions as host factors involved in the pathogenesis of one of Staphylococcus aureus major toxins.
Professor of Pediatrics (Hematology/Oncology) at the Lucile Salter Packard Children's Hospital, Emeritus
Current Research and Scholarly InterestsBone marrow transplantation (BMT) is a treatment modality which is being broadly applied to a growing number of disorders. Increasing success with BMT is offering improved survival to pediatric and adult patients with acute leukemia, chronic leukemia, lymphomas, and a variety of solid tumors as well as severe aplastic anemia.
Kanwaljeet S. Anand
Professor of Pediatrics (Pediatric Critical Care) and of Anesthesiology, Perioperative and Pain Medicine
Current Research and Scholarly InterestsDr. Anand is a translational clinical researcher who pioneered research on the endocrine-metabolic stress responses of infants undergoing surgery and developed the first-ever scientific rationale for pain perception in early life. This provided a framework for newer methods of pain assessment, numerous clinical trials of analgesia/anesthesia in newborns, infants and older children. His research focus over the past 30+ years has contributed fundamental knowledge about pediatric pain/stress, long-term effects of pain in early life, management of pain, mechanisms for opioid tolerance and withdrawal. Current projects in his laboratory are focused on developing biomarkers for repetitive pain/stress in critically ill children and the mechanisms underlying sedative/anesthetic neurotoxicity in the immature brain. He designed and directed many randomized clinical trials (RCT), including the largest-ever pediatric analgesia trial studying morphine therapy in ventilated preterm neonates. He has extensive experience in clinical and translational research from participating in collaborative networks funded by NIMH, NINDS, or NICHD, a track-record of excellent collaboration across multiple disciplines, while achieving success with large research teams like the Collaborative Pediatric Critical Care Research Network (CPCCRN). He played a leadership roles in CANDLE (Condition Affecting Neuro-Development & Learning in Early infancy) and other activities of the Urban Child Institute and UT Neuroscience Institute. More recently, he led the NeoOpioid Consortium funded by the European Commission, which collected data from 243 NICUs in 18 European countries.
Clinical Associate Professor, Pediatrics - Adolescent Medicine
Current Research and Scholarly InterestsResearch interests include high-risk youth, adolescent health services, and the juvenile justice system.
Clinical Associate Professor, Pediatrics
BioI graduated from UCLA (now Geffen) School of Medicine, did my pediatrics residency at Columbia-Presbyterian in NYC, followed by a clinical fellowship in developmental (what was then called an “ambulatory”) pediatrics at Boston Children’s Hospital. The first 28 years of my career were spent in clinical practice combining both DBP and primary care (the latter focused on serving CSHCN). During those years I was involved in numerous divide-bridging efforts - including programs to coordinate inpatient & outpatient medicine, connect tertiary & primary care, and promote teamwork between pediatricians, psychologists, nurse practitioners, and other community partners. I founded my own solo practice in 1989 and managed its growth to an 8-provider group over the next 25 years. Our practice was a founding member of the PPOC and I served on its board of directors for 6 years. The PPOC is one of the largest pediatric IPA’s in the country, with >200 member providers affiliated with Boston Children's Hospital. Over the years we were involved in groundbreaking QI initiatives including those involving asthma, weight, and ADHD management; medical home; and behavioral health integration with primary care.
I’m now well into my career's “second act” on the clinician-educator track here at Stanford. I'm proud to have piloted our division's primary care initiative (DBPCI) and am now in the process of planning for a second phase thereof, hoping to make improved collaboration between DBP and primary care more available to more patients. I also pioneered the use of telehealth in our division, and then helped guide its sudden widespread adoption by my peers during the COVID-19 crises. Looking forward, I expect what we have learned during the pandemic will inform what we do for DBPCI 2.0.