Division Chief
Department / Division:
Pediatrics
/
Medical Genetics
Address:
DUMC 3528
Durham, NC 27710
Appointment Telephone:
919-684-2036
Office Telephone:
919-684-2036
Fax Telephone:
919-684-8944
Clinical Interests:
Down syndrome -- long-term follow-up, management, and treatment interventions to improve cognition; glycogen storage diseases with focus on types I, II, III, and IX for natural history, long-term complications, and treatment interventions; lysosomal storage diseases (Gaucher, Pompe, Fabry, Mucopolysaccharidosis) -- long-term follow-up, natural history, and treatment interventions such as enzyme replacement therapy; management and treatment of metabolic disorders (fat acid oxidation defects, urea cycle disorders, mitochondrial disease)
Research Interests:
RESEARCH INTERESTS
A multidisciplinary approach to care of individuals with genetic disorders in conjunction with clinical and bench research that contributes to:
1) An understanding of the natural history and delineation of long term complications of genetic disorders
2) The development of new therapies for genetic disorders through translational research
3) The development and execution of large multicenter trials to confirm safety and efficacy of potential therapies
. Down syndrome: The Duke Comprehensive Down syndrome (DS) clinic is a multidisciplinary clinic for the clinical care of approximately 700 children and young adults with Down syndrome. Research interests include establishing best practices for screening of celiac disease, thyroid dysfunction, and iron deficiency anemia. The Duke DS Research Team is evaluating the effects of cholinesterase inhibitors on cognition and behavior in children and young adults with Down syndrome. Research issues focus on establishing a standard dosing regimen and developing a sensitive and specific test battery to detect changes in language and cognitive ability. These studies are being performed at the Duke Clinical Research Unit at Duke. We are currently involved in a multi-center Phase 2 pediatric trial using donepezil, a cholinesterase inhibitor. The Duke DS Research team is also exploring how a national Down Syndrome registry program could be built and utilized to expand understanding of the condition.
. Lysosomal Storage Disease: The Duke Lysosomal Storage Disease (LSD) treatment center follows and treats patients with Pompe, Gaucher, Fabry, Mucopolysaccharidosis and other LSD's. The Duke Metabolism Clinical Research Team is exploring many aspects of enzyme replacement therapy (ERT), including impact on different systems, differential response, and long term effects. Other symptomatic and treatment interventions for this category of diseases are also being explored in the context of clinical care. The care team has extensive experience in the care of infants and adults with Pompe disease and was instrumental in conducting clinical trials and the bench to bedside work that led to the 2006 FDA approval of alglucosidase alfa, the first treatment for this devastating disease.
. Glycogen Storage Disease: We are actively following subjects with all types of Glycogen Storage Disease, with particular emphasis on types I, II, III, IV, VI and IX. The goal of the treatment team is to better determine the clinical phenotype and long term complications of these diseases. Attention to disease manifestations observed in adulthood, such as adenomas and risk for HCC, is of paramount importance in monitoring and treating these chronic illnesses. We are establishing clinical algorithms for managing adenomas, and the overall management of these patients including cardiac, bone, muscle and liver issues.
. Neuromuscular disorders: We are collaborating with neurologists, cardiologists and neuromuscular physicians to serve as a treatment site for clinical trials in these diseases. We are currently involved in trials of DMD and are working closely on setting up collaborations for studies in SMA.
. Pharmacogenomics: We are exploring how genotype can play a role in adverse drug reactions such as Steven Johnson syndrome caused by sulfonamides. We are also exploring the role of genotype in antidepressant treatment and the risk of suicide.
Representative Publications:
Hardy O, Worley G, Lee MM, Chaing S, Mackey J, Crissman B, Kishnani PS. Hypothyroidism in Down syndrome: screening guidelines and testing methodology. Am J Med Genet. 2004 Feb 1;124A(4):436-7.
(2004)
Abstract
Snyder MJ, Bradford WD, Kishnani PS, Hale LP. Idiopathic hyperammonemia following an unrelated cord blood transplant for mucopolysaccharidosis I. Pediatr Dev Pathol. 2003 Jan-Feb;6(1):78-83.
(2003)
Abstract
Koeberl DD, Young SP, Gregersen NS, Vockley J, Smith WE, Benjamin DK Jr, An Y, Weavil SD, Chaing SH, Bali D, McDonald MT, Kishnani PS, Chen YT, Millington DS. Rare disorders of metabolism with elevated butyryl- and isobutyryl-carnitine detected by tandem mass spectrometry newborn screening. Pediatr Res. 2003 Aug;54(2):219-23.
(2003)
Abstract
Koeberl DD, Millington DS, Smith WE, Weavil SD, Muenzer J, McCandless SE, Kishnani PS, McDonald MT, Chaing S, Boney A, Moore E, Frazier DM. Evaluation of 3-methylcrotonyl-CoA carboxylase deficiency detected by tandem mass spectrometry newborn screening. J Inherit Metab Dis. 2003;26(1):25-35.
(2003)
Abstract
Heller JH, Spiridigliozzi GA, Sullivan JA, Doraiswamy PM, Krishnan RR, Kishnani PS. Donepezil for the treatment of language deficits in adults with Down syndrome: a preliminary 24-week open trial. Am J Med Genet. 2003 Jan 15;116A(2):111-6.
(2003)
Abstract
Mackey J, Treem WR, Worley G, Boney A, Hart P, Kishnani PS. Frequency of celiac disease in individuals with Down syndrome in the United States. Clin Pediatr (Phila). 2001 May;40(5):249-52.
(2001)
Abstract
Kishnani PS, Spiridigliozzi GA, Heller JH, Sullivan JA, Doraiswamy PM, Krishnan KR. Donepezil for Down's syndrome. Am J Psychiatry. 2001 Jan;158(1):143.
(2001)
Abstract
Kishnani PS, Faulkner E, VanCamp S, Jackson M, Brown T, Boney A, Koeberl D, Chen YT. Canine model and genomic structural organization of glycogen storage disease type Ia (GSD Ia). Vet Pathol. 2001 Jan;38(1):83-91.
(2001)
Abstract
Van Hove JL, Kishnani PS, Demaerel P, Kahler SG, Miller C, Jaeken J, Rutledge SL. Acute hydrocephalus in nonketotic hyperglycemia. Neurology. 2000 Feb 8;54(3):754-6.
(2000)
Abstract
Shaiu WL, Kishnani PS, Shen J, Liu HM, Chen YT. Genotype-phenotype correlation in two frequent mutations and mutation update in type III glycogen storage disease. Mol Genet Metab. 2000 Jan;69(1):16-23.
(2000)
Abstract
REFERRED JOURNAL:
(1999)
Kishnani PS, Sullivan JA, Walter BK, Spiridigliozzi GA, Doraiswamy PM, Krishnan KR. Cholinergic therapy for Down's syndrome. Lancet. 1999 Mar 27;353(9158):1064-5.
(1999)
Abstract
Kishnani PS, Boney A, Chen YT. Nutritional deficiencies in a patient with glycogen storage disease type Ib. J Inherit Metab Dis. 1999 Oct;22(7):795-801.
(1999)
Abstract
Ahmad A, Kahler SG, Kishnani PS, Artigas-Lopez M, Pappu AS, Steiner R, Millington DS, Van Hove JL. Treatment of pyruvate carboxylase deficiency with high doses of citrate and aspartate. Am J Med Genet. 1999 Dec 3;87(4):331-8.
(1999)
Abstract
Ahmad A, Amalfitano A, Chen YT, Kishnani PS, Miller C, Kelley R. Dubowitz syndrome: a defect in the cholesterol biosynthetic pathway? Am J Med Genet. 1999 Oct 29;86(5):503-4.
(1999)
Abstract
REFEERED JOURNALS:
(1998)
Ahmad A., Miller C., Goldstrum R., Scherer G., Kishnani P. Acampomelic campomelic dysplasia and campomelic dysplasia - A continuous spectrum. J Med. Genet., 1998
(1998)
REFEERED JOURNALS:
(1997)
Kishnani PS, Bao Y, Wu JY, Brix AE, Lin JL, Chen YT. Isolation and nucleotide sequence of canine glucose-6-phosphatase mRNA: identification of mutation in puppies with glycogen storage disease type Ia. Biochem Mol Med. 1997 Aug;61(2):168-77.
(1997)
Abstract
Wang M., Kishnani P., Decker-Phillips M., Kahler, S.G., Chen, Y.T., Godfrey, M. Double mutant fibrillin-1(FBN1) allele in a patient with neonatal marfan syndrome. J Med Genet. 33:760-763, 1996
(1996)
Rosell, A.M., Wilson, C., Picoli, D.A., Boyle, J., DeClue, T., Kishnani, P., Shen, J., Boney, A., Brown, B., Chen, Y.T. Clinical and laboratory findings in four patients with a variant nonprogressive form of type IV glycogen storage disease. J. Inher. Metab. Dis. 19:51-58, 1996
(1996)
REFEERED JOURNALS:
(1996)
Kishnani, P., Van Hove, J.L.K., Shoffner, J.S., Kauffman, A., Bossen, E.H., Kahler, S.G. Severe infantile lactic acidosis and pancreatitis in a boy heteroplasmic for mt3243 (tRNALeu) mutation. European Journal of Pediatrics. Eur J Pediatr. 155:898-903, 1996
(1996)
Kishnani, P., Bangur, A.R., Chen, Y.T., Pulmonary Hypertension in Glycogen Storage Disease Type I (GSD-I). J. Inher. Metab. Dis. 19:213-216, 1996
(1996)
Kishnani PS, Van Hove JL, Shoffner JS, Kaufman A, Bossen EH, Kahler SG. Acute pancreatitis in an infant with lactic acidosis and a mutation at nucleotide 3243 in the mitochondrial DNA tRNALeu(UUR) gene. Eur J Pediatr. 1996 Oct;155(10):898-903.
(1996)
Abstract
Bao Y, Kishnani P, and Chen YT. Hepatic and neuromuscular forms of glycogen storage disease type IV caused by mutations in the same glycogen branching enzyme gene. J Clin Invest. 97:941-948, 1996.
(1996)
Van Hove J.L.K., Kishnani P., Muenzer J., Wenstrup R.J., Summar M.L., Brummond M.R., Lachiewicz A.M., Millington D.S., Kahler S.G. Benzoate and carnitine deficiency in non-ketotic hyperglycinemia. Am. J. Med. Genet 59:444-453, 1995
(1995)
Kishnani P., Iafolla A.K, McConkie-Rosell A., Kanter R.J., Van Hove J.L.K., Kahler S.G. Hemangiomas, midline raphe, and coarctation of a right aortic arch. A continuous spectrum? Am. J. Med. Genet 59:44-48, 1995
(1995)
Bao Y., Kishnani P., Chen Y.-T. Hepatic and neuromuscular forms of glycogen storage disease type IV caused by mutations in the same glycogen branching enzyme gene. The Journal of Clinical Investigation, 1995 (In press)
(1995)