Stanford Center for Excellence in Pulmonary Biology

Interstitial Lung Disease

Interstitial Lung Disease: Program Overview

Pediatric “interstitial lung diseases ILDs” represent a heterogeneous group of diseases that generally affect the lung diffusely.  They comprise some of the most challenging pediatric lung conditions to diagnose and treat. We have established a multidisciplinary clinic that brings together experts in lung transplantation, lung development, and rheumatology  to bridge the clinical sciences with our evolving understanding of the basic biology of each of the cell types in the lung.

In order to develop targeted therapies for each disease, we need to understand the diversity of individual cell types within the normal lung and how perturbations during normal development or in response to a variety of injuries (toxins, drugs, infectious agents) give rise to each of the clinical conditions listed below. We are using the most advanced single cell whole genome measurements combined with high-resolution imaging of proteins and RNA to visualize individual cells in situ to understand individual diseases at the level of single cells.

 

Pediatric Conditions Treated:

  • Diffuse developmental disorders:
    • Acinar dysplasias
  • Growth abnormalities realted to impaired alveolarization:
    • Pulmonary hypoplasia
    • Related to chromosomal disorders
  • Disorders of surfactant homeostasis:
    • Surfactant protein B (SFTPB) mutations
    • Surfactant protein C (SFTPC) mutations
    • ABCA3 mutations
    • Other surfactant dysfunction disroders
  • Specific developmental conditions:
    • Neuroendocrine cell hyperplasia of infancy
    • Pulmonary interstitial glycogenosis
  • Disorders realted to systemic diseases:
    • Immune-mediated/collagen vascular disease
    • Storage diseases
    • Sarcoidosis
    • Langerhans cell histiocytosis
    • Malignant infiltrate
  • Disorders of the normal host:
    • Infectious/post-infectious porcesses
    • Hypersensitivity pneumonitis; toxic inhalations
    • Eosinophilic pneumonia
  • Disorders of the immunocompromised host:
    • Related to therapeutic intervention
    • Related to transplantation and rejection
    • Diffuse alveolar damage

Meet Our Care Team

The Multidisciplinary Program in Bronchopulmonary Dysplasia has a Care Team comprised of the following care providers:

  • Pediatric Pulmonologists
  • Pediatric Rheumatologists
  • Registered Nurses
  • Respiratory Therapists
  • Registered Dieticians

     

Our Services

The Multidisciplinary Program in Bronchopulmonary Dysplasia provides the following services:

  • Inpatient Consultations
  • Outpatient Visits

 


 

 

Contact Us to Make an Appointment

To Make an appointment:

770 Welch Road, Suite

Palo Alto, CA, 94304

Phone: (844) 724-4140



 

Physician Team Leaders

Assistant Professor of Pediatrics (Pulmonary Medicine)

Bio

Dr. Kuo is a physician-scientist with expertise in single-cell genomics and pulmonary medicine. She has made pioneering contributions to pulmonary neuroendocrine cell (PNEC) biology by developing innovative strategies that established the first comprehensive framework for understanding the molecular and cellular diversity of normal PNECs and their roles in health and disease. Her discoveries have laid the foundation for this emerging field and her contributions are recognized internationally. PNECs are exceedingly rare lung epithelial cells with specialized airway sensory, secretory, and stem cell functions. These neurosensory cells are thought to monitor airway oxygen, chemicals, mechanical deformation, infection, and injury, and serve as sentinels that signal this sensory information locally in the lung, to the brain through synapses with pulmonary sensory neurons and potentially globally throughout the body via secretion of myriad local signals and hormones. PNECs are also known to play critical roles in the control of breathing, cough, and respiratory physiology. Among their diverse physiologic functions, their response to injury has been most intensively studied in murine models and they are a cell of origin for high grade lung neuroendocrine tumors. Dr. Kuo performed the first comprehensive anatomical mapping and lineage tracing studies of PNECs in mice which generated a foundational understanding of PNEC development (Kuo and Krasnow, Cell 2015). She also led single cell transcriptomic profiling studies that revealed a surprising diversity in PNEC sensors and signals (Kuo et al, eLife 2022). PNECs express over 25 different sensory receptor genes ("sensors") and over 40 different neuropeptide and peptide hormone genes ("signals"). Her scRNA-seq analysis of PNECs revealed a remarkable number and diversity of PNEC neuropeptide signals and their predicted cellular targets both within the lung and to innervating sensory neurons (Kuo et al., 2022, eLife). In contrast to the advanced understanding of PNEC development, stem cell, and signaling function in mouse, little is known about human PNECs. To compare the findings of PNEC development, diversity, and function in mouse models to human diseases, her lab recently established a platform to systematically construct a human PNEC atlas. This foundational work created a molecular and anatomic framework for the entire human pulmonary neuroendocrine system and the diseases that are predicted to originate from distinct PNECs. Her lab has recently used this new PNEC atlas combined with single cell transcriptomic approaches to identify the molecular diversity of anatomically and functionally distinct human PNECs. Dr. Kuo's studies with human models extends her lab’s current research aims to define the diverse neuroendocrine sensory and signaling interactions and the molecules that mediate them to their roles in lung cancer, neuroendocrine proliferative disorders such as diffuse idiopathic neuroendocrine cell hyperplasia (DIPNECH), neuroendocrine cell hyperplasia of infancy (NEHI) and major inflammatory and obstructive pulmonary diseases. Dr. Kuo’s lab engages a network of collaborators to develop and implement clinical protocols and strategically apply cutting-edge technologies to studying minor, but physiologically diverse airway sentinels. Please visit the research website for additional information and current research areas (https://kuo.stanford.edu).

Dr. Christin Kuo

Dr. Kuo is a physician-scientist at the Stanford University School of Medicine and joined the faculty in 2016. Her research focuses on pulmonary neuroendocrine (NE) cell development and disease. While sparsely distributed under normal conditions, NE cells can form large, abnormal clusters in pediatric lung disorders or proliferate and rapidly metastasize in small cell lung cancer. Her lab uses single cell approaches to study this developmental program in vivo. She is also identifying secreted NE cell signals and their targets. These studies will reveal how abnormal NE cells contribute to physiologic dysfunction in a diverse group of pediatric and adult respiratory diseases, potentially offering new avenues for diagnosis and treatment. Dr. Kuo’s contributions have been recognized internationally and across disciplines from cancer biology to basic epithelial biology. She is also the recipient of the Klosterfrau Award for Outstanding Pediatric Pulmonary Research (presented at the Society for Pediatric Pneumonology Conference, Dresden, Germany).