NYU Non-‐Tuberculous Mycobacteria Program Research
Leopoldo N. Segal, MD, MS
Assistant Professor of Medicine
Division of Pulmonary and Cri>cal Care Medicine
NYU School of Medicine
Pa>ent Educa>on
November 9th, 2016
Faculty Disclosure
Leopoldo N. Segal, MD, MS
Relevant financial relationships with a commercial interest:
No relevant commercial interests.
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Structural Damage of the Lung
Cough and Sputum Production
0"10"20"30"40"50"60"70"80"90"
100"
FEV1%
Decline in Lung Function
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NYU LANGONE NTM/Bronchiectasis
Multidisciplinary Program
Diagnosis TreatmentF/U and Prognosis
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NYU LANGONE NTM/Bronchiectasis
Multidisciplinary Program
Diagnosis TreatmentF/U and Prognosis
Understanding the microbiome among us and within us
Culture Independent
Microbial Product Identification
Microbe Isolation
Culture Dependent
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Host Defense
HealthDisease
Evalua8on of the Airway Microbiome In NTM
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Host Defense
HealthDisease
Microbial environment: e.g. Biofilm
Microbial Dynamics: • GERD • Impaired clearance
Bronchoscopy
Questionnaires Pulmonary Function Clinical Induced Sputum Oral Wash
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Evalua8on of the Airway Microbiome In NTM
NYU Langone NTM/Bronchiectasis Program
Respiratory Symptoms + Imaging abnormalities
Biomarker Cohort (n=200)
NTM + NTM -
NTM + NTM -
Case Control Sub-Study (n=40)
0.0001 0.001 0.01 0.1 1 10 100
Scardovia
Lactobacillus
Sphingomonas
Streptococcus
SR1(Other Genus)
Neisseria
Relative Abundance
NTM+NTM-
0.0001 0.001 0.01 0.1 1 10 100
Scardovia
Lactobacillus
Sphingomonas
Streptococcus
SR1(Other Genus)
Neisseria
Relative Abundance
NTM+NTM-
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Oral Samples
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NTM +
NTM -
PC1 (37%)
PC1
(22%
)Sputum Samples
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� NTM +
NTM -
PC1 (42%)
PC1
(21%
)
Are there differences in airway microbiota between NTM+ and NTM-‐?
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Host Defense
HealthDisease
Host Defense
HealthDisease
Permissive Microbiota Supressive Microbiota
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NYU LANGONE NTM/Bronchiectasis
Multidisciplinary Program
F/U and Prognosis
Outcomes of Patients Treated and Not Treated for Nontuberculous Mycobacteria
Treatment A Treatment B
Questionnaire Clinical and PFT Imaging Upper Airway and Swallowing Evaluation
NYU NTM/Bronchiectasis Cohort
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NYU LANGONE NTM/Bronchiectasis
Multidisciplinary Program
Treatment
NYU NTM/Bronchiectasis Cohort
• Non-Pharmacologic• Pharmacologic = Clinical Trials
• Liposomal Amikacin for refractory MAC• Clofazamine for Recalcitrant NTM/M. Abscessus• Liposomal Ciprofloxacin for Pseudomonas
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NYU LANGONE NTM/Bronchiectasis
Multidisciplinary Program
Be involved!! Ask us about research opportunities
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NYU NTM/Bronchiectasis Program
Be involved!! Ask us about research opportunities
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NYU NTM/Bronchiectasis Program
Yonghua Li, MD (Research Assistant/Lab)
Kathryn Norris, MS (Research Coordinator/IRB)
Sara Chambers (Development)
Stephanie Lau, MD (Research Coordinator/Clinical Trials)
Adrienne Scott, MS Imran Sulaiman, MS Will Wassmer(Research Associates)
Be involved!! Ask us about research opportunities
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NYU Langone NTM/Bronchiectasis Program
Funding Support: NIH/NIAID K23 AI102970 (Career Development Award)
We would like to acknowledge the generous support of donors to the NYU Langone NTM/bronchiectasis program:
Barbara Goldstein Amster Helaine Lerner The Chelnik family in honor of Harriette and Martin Chelnik Beatrice Ifshin, NTM Info & Research Mona Wandler Karen Elliott House Leeam Lowin Sandra Pearl
For more information about the program or opportunities for involvement, please contact Sara Chambers at [email protected] or 212-404-3538.
e-mail: [email protected]
