Dr. Yende conducts epidemiologic and translational studies to understand how demographic factors and chronic health affects susceptibility to and outcomes of infection and severe sepsis. Using community-acquired pneumonia as a model of infection, Dr. Yende conducts epidemiologic research using population-based cohorts and large cohorts of patients hospitalized with infection. Yende also conducts translational research using biomarkers and genetic markers, and collaborates with basic scientists on animal models of sepsis to understand mechanisms.
1. Risk factors for susceptibility to pneumonia
Grants: K23AG025931, Yende - PI.
This project will examine the role of clinical risk factors, biomarkers, and genetic markers to develop novel risk prediction tools for pneumonia hospitalization. We also seek to understand the heterogeneity in the immune response to infection due to demographic factors (age, sex, and race) and chronic diseases. Sub-projects are:
Epidemiologic studies to develop precise risk prediction tools to target preventive strategies for pneumonia using clinical risk factors and biomarkers. This project is using 3 population-based cohorts (ARIC, Health ABC, and CHS) with over 20,000 subjects enrolled from 7 US states and over 10 years of follow-up.
Genome-wide association studies and candidate gene studies using 3 population-based cohorts and a cohort of pneumonia patients to identify novel pathways that increase risk of pneumonia.
Racial disparities – we have used 7 State Discharge databases to understand whether racial differences in susceptibility to pneumonia and severe sepsis occur and its public health implications. Using gene-expression microarray and genetic and biomarker analyses, we are assessing why blacks and whites respond differently to an infection.
2. Long-term consequences of sepsis
CTSI - Basic to Clinical Collaborative Research Pilot Program awarded to study cardiovascular consequences of infection and sepsis, Yende – Co-PI.
Consequences of Sepsis (ConsequenceS, R01GM097471)- Yende – PI (2012-2017)
This project is an ancillary study to ProCESS and will conduct long-term follow-up in 600 subjects who are discharged from the hospital. We will conduct in-home visits at 3, 6, and 12 months and focus on long-term cardiovascular outcomes after severe sepsis. We will also determine the duration of resolution of immune response after severe sepsis and its relationship with acute cardiovascular events during recovery, and whether early interventions for severe sepsis alter long-term cardiovascular outcomes by affecting immune response resolution.
We have shown that survivors of pneumonia hospitalization have increased long-term mortality and the higher mortality cannot be solely explained by higher burden of chronic diseases prior to the occurrence of pneumonia. This project seeks to understand why survivors of infection have higher morbidity and mortality during recovery and underlying mechanisms. Sub-projects are:
Epidemiologic studies using population-based cohorts (CHS and GEM study) and Medicare data to understand cardiovascular and cognitive dysfunction before and after sepsis.
Translational studies in an ongoing clinical trial of patients with septic shock with in-person follow-up to understand resolution of immune response and long-term cardiovascular consequences during recovery.
Translational studies in collaboration with basic scientists to develop animal models to understand cardiovascular and cognitive function in mice and rats with sepsis.
See full biography