Andrew A Colin

University of Miami, كورال غيبلز، فلوريدا, Florida, United States

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Publications (95)368.23 Total impact

  • Giovanni A. Rossi · Michela Silvestri · Andrew A. Colin
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    ABSTRACT: MicroRNAs (miRNAs) are small single-stranded RNA molecules involved in the regulation of gene expression at the post-transcriptional level. In the airways, miRNAs are implicated in the modulation of antiviral defense, through modulation of both innate and adaptive immune response in inflammatory and immune effector cells but also in parenchymal cells. The first target of respiratory viruses are airway epithelial cells. Following infection, an altered expression of distinct miRNAs occurs in airway cells aimed at inhibiting viral replication and preserving the airway epithelial barrier, while at the same time viruses induce or repress the expression of other miRNAs that favor viral replication. Understanding the changes in miRNA expression profile, identification of miRNAs target genes and their contribution to the pathogenesis of the disease may help the intricate mechanisms of virus-host interaction. Further understanding of these molecular mechanisms could lead to development of new antiviral treatments in common, high impact, respiratory disorders for which specific treatments are not available. Respiratory syncytial virus (RSV) airway infection is a common example of virus modifying miRNAs expression to favor immune evasion, and constitutes the salient feature of this review. Pediatr Pulmonol. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.
    No preview · Article · Apr 2015 · Pediatric Pulmonology
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    ABSTRACT: The underlying cause of cystic fibrosis (CF) is the loss of epithelial chloride and bicarbonate transport due to mutations in the CF transmembrane conductance regulator (CFTR) gene encoding the CFTR protein. Ivacaftor is a gene-specific CFTR potentiator that augments in vivo chloride transport in CFTR mutations affecting channel gating. Originally approved for the G511D CFTR mutation, ivacaftor is now approved for eight additional alleles exhibiting gating defects and has also been tested in R117H, a CFTR mutation with residual function that exhibits abnormal gating. P67L is a class 4 conductance (nongating) mutation exhibiting residual CFTR function. We report marked clinical improvement, normalization of spirometry, and dramatic reduction in radiographic structural airway changes after > 1 year of treatment with ivacaftor in a young adult with the compound heterozygous genotype P67L/F508del CFTR. The case suggests that ivacaftor may have a potential benefit for patients with CF with nongating mutations.
    No preview · Article · Mar 2015 · Chest
  • Andrew A Colin · Mitra Shafieian · Martin Andreansky
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    ABSTRACT: No abstract is available for this article.
    No preview · Article · Mar 2015 · Pediatric Pulmonology

  • No preview · Article · Mar 2015 · Pediatric Allergy, Immunology, and Pulmonology
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    Giovanni A Rossi · Andrew A Colin
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    ABSTRACT: There is evidence that respiratory viruses play a key role in the development and exacerbation of obstructive respiratory diseases in children. This review attempts to juxtapose the separate profiles and prototypes of pathogenenetic mechanisms represented by the two most common amongst such viruses: respiratory syncytial virus (RSV) and human rhinovirus (HRV). RSV represents the most common agent of severe airway disease in infants and young children, and is predominant in winter months. Large epidemiological studies have revealed an unequivocal relationship between RSV infection and subsequent wheezing into childhood, thought to be related to long-term changes in neuroimmune control of the airways rather than allergic sensitisation. HRV is a highly diverse group of viruses that affect subjects of all ages, is ubiquitous and occurs year-round. In contrast to RSV, infections with HRV cause minimal cytotoxicity but induce a rapid production of cytokines and chemokines with amplification of the inflammatory response. The susceptibility to HRV-induced bronchiolitis and subsequent wheezing appears to be linked to individual predisposition since it is often associated with a family or personal history of asthma/atopy. Thus, RSV probably serves as an "inducer" rather than a "trigger". Conversely, HRVs seem to serve as a "trigger" rather than an "inducer" in predisposed individuals.
    Full-text · Article · Oct 2014 · European Respiratory Journal
  • Andrew Colin · Elisa Basora · Shatha Yousef
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    ABSTRACT: Nontuberculous mycobacteria (NTM) have been increasingly recognized in recent years as contributors to clinically significant lung infection in cystic fibrosis (CF) patients. Reports of prevalence vary from 6 to 22% around the world. Prevalence estimates in childhood CF is challenging since sputum producers are rare, bronchoalveolar lavage is an invasive procedure and may not be feasible, and mounting evidence deeming throat cultures to be unsuccessful in detecting NTM. We report a case of an overall healthy 13 year old young adolescent female with CF, who presented with Mycobacterium avium complex (MAC) as her first documented lung infection, and while only presenting with minor cough proved to have severe purulent bronchial infection. Contrary to common paradigms, NTM can be the first infection in a non-previously infected airway, and, this first infection can be of a serious nature unlike the more subtle anticipated pattern. The causes of the high and probably increasing overall incidence of NTM and specifically in CF elude explanation and mandate further study. Continuing efforts should be invested into the study of all aspects of this ominous infection. Pediatr Pulmonol. © 2014 Wiley Periodicals, Inc.
    No preview · Article · Sep 2014 · Pediatric Pulmonology
  • Source
    Andrew A Colin · Shatha Yousef · Erick Forno · Matti Korppi

    Preview · Article · May 2014 · Pediatrics
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    ABSTRACT: Suppurative complications of pneumonia such as empyema, lung abscess, pyopneumothorax, and necrotizing pneumonia (NP) are uncommon in children. Over the last decade an increasing incidence of NP has been reported. Streptococcus pneumoniae continues to be the predominant causative organism of NP, and while sporadic cases were reported prior to routine administration of heptavalent pneumococcal vaccine, a marked increase in NP appears to relate to replacement pneumococcal strains. Pleural involvement is almost universal in NP, and the course of pleural disease often determines its duration and outcome, particularly as it relates to complication of bronchopleural fistula. Cavities are formed in NP within the lung parenchyma and in the pleural space as the fibrosing pleural process organizes. The similarity of the radiologic appearance of parenchymal and pleural space cavities often makes the differentiation of pneumatocele versus residua of loculated pneumothorax challenging. The prevailing perception from most reports on childhood NP is of a favorable outcome with conservative approach. We report two pediatric cases with pneumonia who presented with prolonged fever despite antibiotic treatment, eventually diagnosed with NP. After stabilization on prolonged IV antibiotics, and weeks after discharge, they presented with unexpected acute respiratory failure due to a life-threatening tension air collection. In this article we discuss the nature of NP, its typical presentation, benign course and outcome, albeit its potential to cause serious late complications in the light of our recent experiences. Increasing awareness of such complications will result in more careful follow-up and in providing appropriate recommendations to parents of patients recovering from NP. Pediatr Pulmonol. © 2013 Wiley Periodicals, Inc.
    No preview · Article · Mar 2014 · Pediatric Pulmonology
  • Andrew A. Colin · Dennis Rosen
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    ABSTRACT: In analyzing a chest radiograph, it is important to have an understanding of some of the basic principles of respiratory physiology, and to appreciate how certain pathophysiological processes can cause distinct disease states, each with its own specific clinical signs and symptoms. These can be divided into broad categories, which include obstructive lung disorders, restrictive lung disorders, disorders of gas diffusion, shunts, and ventilation-perfusion abnormalities. For the pediatric radiologist, lung mechanics and in particular those related to changes in lung volume are of crucial significance. The radiograph of the noncooperative young child is never obtained at the optimal full inflation typical for the older person who inhales to full lung capacity (thus, total lung capacity) and breath-holds. The lung volumes reflected in the pediatric radiograph (assuming quiet breathing) span a volume range from FRC (the volume at end expiration) to peak of tidal volume (the volume at end inspiration). Thus, by definition, the volume of the normal pediatric radiograph is always well below the lung volume of the cooperative patient, with all the implications that this has on the quality of the radiograph. Obviously, the lower the lung volume, the less reliable is the interpretation of pathology. © 2012 Springer Science+Business Media, LLC. All rights reserved.
    No preview · Article · Dec 2013
  • Amir Kugelman · Andrew A Colin
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    ABSTRACT: Late preterm (LP) infants are defined as those born at 34-0/7 to 36-6/7 weeks' gestational age. LP infants were previously referred to as near term infants. The change in terminology resulted from the understanding that these infants are not fully mature and that the last 6 weeks of gestation represent a critical period of growth and development of the fetal brain and lungs, and of other systems. There is accumulating evidence of higher risks for health complications in these infants, including serious morbidity and a threefold higher infant mortality rate compared with term infants. This information is of critical importance because of its scientific merits and practical implications. However, it warrants a critical and balanced review, given the apparent overall uncomplicated outcome for the majority of LP infants.Others reviewed the characteristics of LP infants that predispose them to a higher risk of morbidity at the neonatal period. This review focuses on the long-term neurodevelopmental and respiratory outcomes, with the main aim to suggest putative prenatal, neonatal, developmental, and environmental causes for these increased morbidities. It demonstrates parallelism in the trajectories of pulmonary and neurologic development and evolution as a model for fetal and neonatal maturation. These may suggest the critical developmental time period as the common pathway that leads to the outcomes. Disruption in this pathway with potential long-term consequences in both systems may occur if the intrauterine milieu is disturbed. Finally, the review addresses the practical implications on perinatal and neonatal care during infancy and childhood.
    No preview · Article · Sep 2013 · PEDIATRICS
  • J Reiter · N Demirel · A Mendy · J Gasana · E R Vieira · A A Colin · A Quizon · E Forno
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    ABSTRACT: Macrolide antibiotics, which have anti-inflammatory and immune modulatory effects, have been studied as adjuncts for the management of asthma. However, results have been contradictory and trials underpowered. We therefore sought to conduct a meta-analysis of randomized controlled trials (RCT). All RCT of prolonged macrolides (3+ weeks) for asthma treatment, published up to January 2013 in MEDLINE, Scopus, CINAHL, Highwire, and The Cochrane Collaboration Library, were included. Fixed- or random-effects models were used to calculate pooled weighted or standard mean differences (WMD or SMD, respectively). A total of 12 studies were included for analysis. The pooled effect of macrolides on FEV1 (eight trials, 381 subjects) was not significant (SMD 0.05, 95% CI -0.14-0.25), but there was a significant increase in peak expiratory flow (four trials, 419 subjects; WMD 6.7, 95% CI 1.35-12.06). Pooled analysis also showed significant improvements in symptom scores (eight studies, 478 subjects; WMD -0.46, 95% CI -0.60 to -0.32), quality of life (five trials, 346 subjects; WMD 0.18, 95% CI 0.001-0.37), and airway hyper-reactivity (two trials, 131 subjects; SMD 1.99, 95% CI 0.46-3.52). Post hoc evaluation showed limited statistical power to detect significant differences in FEV1. Macrolide administration for asthma for three or more weeks was not associated with improvement in FEV1, but produced significant improvements in peak expiratory flow, symptoms, quality of life, and airway hyper-reactivity. Macrolides may therefore be beneficial as adjunct asthma therapy. Future trials, focusing on long-term safety and effectiveness, should use standardized outcomes and procedures.
    No preview · Article · Jul 2013 · Allergy

  • No preview · Article · Jul 2013 · Paediatric respiratory reviews

  • No preview · Article · Jul 2013 · Paediatric respiratory reviews

  • No preview · Article · Jul 2013 · Paediatric respiratory reviews

  • No preview · Article · Jul 2013 · Paediatric respiratory reviews
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    ABSTRACT: The optimal strategy for monitoring cystic fibrosis (CF) lung disease in infancy remains unclear. Objective: To describe longitudinal associations between infant pulmonary function tests (iPFTs), chest radiograph (CXR) scores and other characteristics. Methods: CF patients ≤24 months old were enrolled in a 10-center study evaluating iPFTs 4 times over a year. CXRs ∼1 year apart were scored with the Wisconsin and Brasfield systems. Associations of iPFTs with clinical characteristics were evaluated with mixed effects models. Results: The 100 participants contributed 246 acceptable flow/volume (FEV0.5, FEF75), 303 functional residual capacity (FRC) measurements and 171 CXRs. Both Brasfield and Wisconsin CXR scores worsened significantly over the 1 year interval. Worse Wisconsin CXR scores and S. aureus were both associated with hyperinflation (significantly increased FRC) but not with diminished FEV0.5 or FEF75. Parent-reported cough was associated with significantly diminished FEF75 but not with hyperinflation. Conclusions: In this infant cohort in whom we previously reported worsening in average lung function, CXR scores also worsened over a year. The significant associations detected between both Wisconsin CXR score and S. aureus and hyperinflation, as well as between cough and diminished flows, reinforce the ability of iPFTs and CXRs to detect early CF lung disease.
    Full-text · Article · May 2013 · European Respiratory Journal
  • Dennis Rosen · Jason E. Lang · Andrew A. Colin
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    ABSTRACT: In medical practice, patients usually present without a known diagnosis. Physicians move from a set of signs and symptoms to the formation of a differential diagnosis to a final diagnosis. This introductory chapter provides seven clinical algorithms that encompass a large part of the spectrum of pediatric pulmonary practice. By navigating through the appropriate algorithm, reference to possible relevant diagnoses may be encountered which will provide direction to further reading in the textbook. The algorithms are (a) chest pain, (b) chronic cough, (c) cyanosis/hypoxia, (d) shortness of breath, (e) hemoptysis, (f) noisy breathing, and (g) tachypnea.
    No preview · Chapter · Dec 2012
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    ABSTRACT: Among the most common infections in children are those affecting the lower respiratory tract, lower respiratory tract infections. Most frequently, this involves viral or bacterial pneumonia. Worldwide, more than two million children die of pneumonia annually, predominately in developing countries. Mortality is extremely rare in the United States and other parts of the developed world. However, respiratory infections remain a major cause of morbidity in the United States. Children experience 6-8 acute respiratory illnesses per year. Even in the most optimal circumstances, however, pediatric pneumonia is often difficult to diagnose. Patient history, physical findings, and laboratory results can all be elusive. Children with pneumonia do not necessarily present with the signs and symptoms typically associated with adult LRTI such as fever, cough, wheezing, tachypnea, and retractions. Section 11.1 of this chapter concentrates on the plain film radiographic manifestations of community-acquired lower respiratory tract illnesses in immunocompetent children who have developed beyond the neonatal period (>30 days). In Sect. 11.2, pulmonary cysts seen on plain chest radiographs as completely or partially air-filled, round masses may be of congenital, infectious/inflammatory, traumatic, or neoplastic in origin. Many of these lesions are discussed in greater detail elsewhere in the text, but are briefly discussed here in an approach to the differential diagnosis of lucent pulmonary cysts. The differential diagnosis can be refined based on the age of the patient and distribution within the lungs (unilateral vs. bilateral), as well as the clinical presentation and the presence of other findings such as nodules or wedge-shaped opacities. Section 11.3, which incorporates a conglomerate of different entities based on the common radiographic appearance of solitary or multiple pulmonary nodules, is divided into anomalies that tend to cause solitary nodules, and those that cause multiple nodules. Because developmental, infectious, inflammatory, hemorrhagic, and neoplastic disorders can all give the appearance of pulmonary nodules, many different disease entities will be touched upon or discussed in this chapter, or discussed elsewhere in this textbook in greater detail. Each section will describe the radiological or clinical traits of the various diseases characterized by pulmonary nodules. Section 11.4 discussed bleeding from the airway (hemoptysis) in childhood, which is an infrequent occurrence that represents a large array of underlying pathologies. The source of the blood is frequently in the mouth or other upper airway structure, and because cough and vomiting are often contemporaneous, gastrointestinal bleeding may be mistaken as emanating from the airway. As discussed in Sect. 11.5, there are many causes of over inflation of the lungs and increased lucency. This may affect all of both lungs, all of one lung or scattered segments of one or both lungs. These observations may be easily recognized from chest X-ray (CXR) or require dynamic imaging such as chest fluoroscopy or inspiratory/expiratory CT. As discussed in Sect. 11.6, necrotizing pneumonia (NP) is becoming an increasingly recognized complication of community-acquired pneumonia in children. NP has been recognized as a complication of pneumonia in adults for several decades, when initially described NP was thought to be extremely rare in children. The incidence of NP appears to be increasing, similar to the observed rise in cases of complicated pneumonia overall. Possible explanations for the increased incidence of NP include the emergence of particularly virulent microorganisms or simply the increased awareness and detection of this complication due to improved imaging techniques. © 2012 Springer Science+Business Media, LLC. All rights reserved.
    No preview · Chapter · Dec 2012
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    ABSTRACT: Herein we describe three infants with the rare presentation of pneumonia with septic shock as their initial medical encounter leading to the diagnosis of cystic fibrosis (CF). At the time of their presentation all three children had significant nutritional deficiency. We initiated an aggressive treatment regimen including nutritional supplementation which resulted in improvement in their pulmonary status and no further recurrences. This series highlights the possible presentation of CF in infancy as a life-threatening invasive infection of Staphylococcus aureus or Pseudomonas aeruginosa. It also supports neonatal screening and emphasizes the role of early attention to nutritional status and vitamin supplementation. Pediatr Pulmonol. 2012; 47:722–726.
    No preview · Article · Jul 2012 · Pediatric Pulmonology

  • No preview · Article · Jun 2012 · Paediatric respiratory reviews

Publication Stats

2k Citations
368.23 Total Impact Points

Institutions

  • 2007-2015
    • University of Miami
      • • Miller School of Medicine
      • • Department of Pediatrics
      كورال غيبلز، فلوريدا, Florida, United States
  • 2013
    • Miami University
      Оксфорд, Ohio, United States
  • 2006-2013
    • University of Miami Miller School of Medicine
      • Division of Pediatric Pulmonology
      Miami, Florida, United States
  • 2009-2010
    • Harvard University
      Cambridge, Massachusetts, United States
  • 1996-2007
    • Boston Children's Hospital
      • Division of Adolescent Medicine
      Boston, Massachusetts, United States
  • 2005
    • Beth Israel Deaconess Medical Center
      Boston, Massachusetts, United States
  • 1996-2004
    • Harvard Medical School
      • • Department of Radiology
      • • Department of Medicine
      Boston, Massachusetts, United States
  • 2000-2001
    • Mount Sinai School of Medicine
      • Department of Pediatrics
      Manhattan, NY, United States