Curriculum Vita

Kriston Ganguli, MD
Instructor Of Pediatrics

GENERAL INFORMATION

Name: Kriston Ganguli

Office Address:

Massachusetts General Hospital
175 Cambridge Street, CRP 575
Boston, MA  02114

E-mail: kganguli@partners.org

Phone: 617-726-1450
Fax: 617-724-2710

Education:

1996 B.Sc., University of Wisconsin, Eau Claire, WI

2002 M.D., University of Minnesota, Minneapolis, MN

Postdoctoral Training:

6/2002 - 6/2003 Internship in Psychiatry
Boston Medical Center/Boston University, Boston, MA

7/2003 - 6/2006 Internship/Residency in Pediatrics
Tufts Medical Center/Tufts University, Boston, MA

7/2006 - 6/2007 Chief Residency in Pediatrics
Tufts Medical Center/Tufts University, Boston, MA

7/2007 - 6/2010 Fellowship in Pediatric Gastroenterology & Nutrition
Massachusetts General Hospital, Boston, MA

Licensure and Certification:
2006 American Board of Pediatrics
2006 Massachusetts Board of Medicine

Academic Appointments:
6/2002 - 6/2003 Resident in Psychiatry, Boston University
7/2003 - 6/2006 Clinical Associate in Pediatrics, Tufts University
7/2006 - 6/2007 Instructor in Pediatrics, Tufts University
7/2007 - 6/2010 Clinical Fellow in Pediatric Gastroenterology & Nutrition, Harvard Medical School
7/2010 - present Instructor, Harvard Medical School

Hospital or Affiliated Institution Appointments:
6/2002 - 6/2003 Resident Physician in Psychiatry, Boston Medical Center
7/2003 - 6/2006 Resident Physician in Pediatrics, Tufts Medical Center
7/2006 - 6/2007 Chief Resident in Pediatrics, Tufts Medical Center
7/2006 - 6/2007 Staff Pediatrician, Dept of Neonatology, Brockton Hospital
7/2007 - 6/2010 Fellow in Pediatric Gastroenterology & Nutrition, Massachusetts General Hospital 7/2010-present Attending in Pediatric Gastroenterology & Nutrition, Massachusetts General Hospital

Hospital and Health Care Organization Service Responsibilities:
6/2002 - 6/2003 Resident Physician in Psychiatry, Boston Medical Center
7/2003 - 6/2006 Resident Physician in Pediatrics, Tufts Medical Center
7/2006 - 6/2007 Chief Resident in Pediatrics, Tufts Medical Center
7/2007 - 6/2010 Fellow in Pediatric Gastroenterology & Nutrition, Massachusetts General Hospital

Major Committee Assignments: (Member unless noted otherwise)
1999 - 2000 American Medical Women's Association National Student Government, Midwest Region Representative
2006 - 2007 Pediatric Residency PL-1 Selection Committee, Tufts Medical Center
2006 - 2007 Pediatric Emergency Medicine Department Planning Committee, Tufts Medical Center
2006 - 2007 Child Protection Team & Patient Care Committee, Tufts Medical Center
2006 - 2007 Medical Student Clerkship Orientation Committee, Tufts Medical Center, Pediatric Department Representative
2006 - 2007 Graduate Medical Education Committee, Tufts Medical Center, Pediatric Residency Representative
2010 - present Pediatric Gastroenterology Fellow Education Committee, MGH for Children

Professional Societies: (Member unless noted otherwise)
1996 - 2002 Phi Kappa Phi
1998 - 2002 American Medical Women's Association
1998 - present American Medical Association
2002 - present Massachusetts Medical Society
2003 - present American Academy of Pediatrics
2007 - present North American Society of Pediatric Gastroenterology, Hepatology & Nutrition
2011- present American Gastroenterological Association

Awards and Honors:
1992-1996 Mayo Clinic Academic Scholarship
Academic Achievement-Based Award
2002 Minnesota Medical Foundation Medical Student Achievement Award
Recognition of Academic Achievement, Leadership & Community Involvement
2005 Frontiers in Science Pediatric Scientist Development Conference
Chosen to attend with Department Chairman - Tufts Medical Center

Part II: Teaching, Research and Clinical Contributions

Local Invited Teaching Presentations

2009 Lecturer, Cholangiocarcinoma in Adolescent with Crohn's Disease and PSC, New England Regional IBD Conference, Massachusetts General Hospital, April 2004
2011 Presenter, Updates in use of Proton Pump Inhibitors in Children & Use of Probiotics in Gastrointestinal Disease, Massachusetts General Hospital for Children General Pediatric Conference, Boston Marriott, Boston MA, November 2011

Teaching Leadership Roles

2006-2008 Organizer and lecturer, Retreat on Changing Roles in Clinical Care & Education
Intern and Junior Resident Retreats, Pediatric Residency
Tufts Medical Center/Tufts University
2009 Guest Lecturer, Pursuing Fellowship Training
Intern Resident Retreat, Pediatric Residency
Tufts Medical Center/Tufts University

2010-2012 Director, Combined Pediatric Gastroenterology and Radiology Conference
Pediatric Gastroenterology Fellowship Program
Massachusetts General Hospital/MGH

Regional, National, International Presentations - Invited Presentations

National (*presented as the result of an abstract submission)

2009 Ganguli K, Deshpande V, Katz AJ. Nonocclusive left-sided ischemic colitis: An uncommon sequelae of a common pediatric presentation. Annual Meeting of North American Society of Pediatric Gastroenterology, Hepatology and Nutrition. Poster presentation. National Harbor, MD, November 12, 2009*
2009 Ganguli K, Walker WA, Nanthakumar N. Attenuation of inflammatory potential by probiotic conditioned media in immature human intestinal epithelial cells. Annual Meeting of North American Society of Pediatric Gastroenterology, Hepatology and Nutrition. Poster Presentation. National Harbor, MD, November 12, 2009*
2011 Rautava S, Ganguli K, Satokari R, et al. Lactobacillus rhamnosus GG pilus protein SpaC binds to intestinal epithelial cells and attenuates inflammatory responsiveness in the immature human gut. Annual Meeting of Pediatric Academic Society. Poster Presentation. Denver, CO, USA.?May, 2011.

2011 Ganguli K, Walker WA, Nanthakumar N. Secreted Bioactive Effectors of Lactobacillus acidophilus Attenuate The Exaggerated Inflammatory Response Responsible for Necrotizing Enterocolitis. Annual Digestive Diseases Week Conference. Poster of Distinction. Chicago, IL, May 10, 2011*

Research Publications

2011 Ganguli K, Walker WA. Probiotics in the Prevention of Necrotizing Enterocolitis. J Clin Gastroenterol 2011;45:S133-S138

Report of Current Research Activities

With clinical and in vitro data supporting the therapeutic potential of probiotics and their secreted products, the direction of my current and future research activities center around demonstrating the anti-inflammatory properties of the secreted products using in vitro models as well as characterizing these products with various laboratory techniques. Equally as important is the investigation of whether single or combination probiotics offer optimal anti-inflammatory effects. Since B.infantis and L.acidophilus were included in three clinical trials showing a statistically significant reduction in the incidence of NEC, these two probiotics had been chosen for the initial stages of my research. To date, we have studied the inflammatory response of mature and immature human intestinal epithelium, quantified by cellular IL-6 secretion with ELISA assays, and the attenuation of this response with concomitant exposure to probiotic-conditioned cell culture medium.

The initial data show that cellular IL-6 secretion by immature, human enterocyte cell lines after TNF-_ or IL1-_ stimulation is decreased after concomitant exposure to probiotic-conditioned media compared to the positive control. The decrease in cellular IL-6 secretion is greatest with B.infantis-conditioned media in fetal IEC and H4 cells and L.acidophilus-conditioned media in NEC-IEC cells; the data does not support the idea that a combined probiotic preparation of B.infantis and L.acidophilus provides an optimal anti-inflammatory effect. The observed changes in IL-6 secretion were similar when boiled fractions of the secreted products were used, suggesting that the bioactive effecters are heat-stable. For further characterization, the bioactive products responsible for IL-6 secretion attenuation were size-fractionated using a centrifugal filtering system. Data from our size-fractionated studies suggest that there may be more than one bioactive secreted effector responsible for the anti-inflammatory effect of these particular probiotic strains. They also suggest that the effector(s) secreted by B.infantis may be very different than that secreted by L.acidophilus. The nature of these differences is unclear, and therefore the mechanism by which inflammatory attenuation occurs is being investigated for both bacteria. As preliminary data show an exaggerated inflammatory response in immature enterocytes, micro RNA analysis will also be used to determine whether developmentally regulated gene expression contributes to this finding and will characterize the influence probiotic secreted products have on enterocyte gene expression. The intestinal inflammatory attenuation as well as the mechanism of action determined by our in vitro models will be confirmed using an in vivo NEC model.

Narrative Report

After completion of my fellowship training in pediatric gastroenterology, hepatology and nutrition at Massachusetts General Hospital for Children, a major teaching hospital of Harvard Medical School, I accepted a position in the division which has allowed dedication to clinical responsibilities as well as ongoing investigation. My current clinical and academic interest is in the area of inflammatory gastrointestinal conditions, particularly inflammatory bowel diseases and necrotizing enterocolitis (NEC). Through my patient interactions, I appreciate the relative lack of effective medications with acceptable side effect profiles available to patients with intestinal inflammatory conditions. It is this observation that fuels my interest in probiotics as a therapeutic option in clinical care. Although the use of probiotics is becoming more frequent in the patient care arena, the knowledge to appropriately guide clinicians in choosing specific formulations, strains and doses is lacking. As an investigator in our division's mucosal immunology laboratory, I am seeking to evaluate the role of probiotics in attenuating the exaggerated inflammatory response of immature enterocytes, using both in vitro and in vivo models.

Additionally, after taking a Clinical Effectiveness Course in 2008 at the Harvard School of Public Health, quality improvement in healthcare has become an area of personal interest. The course, hosted by the Institute for Healthcare Improvement, introduced an incredibly motivating international panel of speakers. As a result of this experience, I plan to eventually transition my research focus to the management of intestinal inflammation as it is relevant in the global health arena. After working as a visiting fellow at the Royal London Hospital in 2009, I've been collaborating with their pediatric gastroenterology division to develop a two year prospective study comparing growth parameters and disease activity in newly diagnosed, pre-pubertal Crohn's disease patients treated with either enteral nutrition or systemic steroids as first line therapy.

Most recently, I have been fortunate to work with our pediatric gastroenterology fellowship program director in critically evaluating the quality of our fellowship experience and curriculum. After identifying a need for a more formal education in gastrointestinal imaging, I was able to collaborate with the MGH for Children pediatric radiology division to create a radiology curriculum relevant to pediatric gastroenterologists and trainees. I look forward to a career in pediatric gastroenterology and nutrition; providing patient care in a busy clinical practice with the majority of my time protected for academic development. I plan to be involved in medical student, resident and fellow education/training, while also continuing to develop as a clinical scientist in the area of probiotic use for intestinal inflammatory conditions.