Diego Preciado

I am a board certified pediatric otolaryngologist, with a busy clinical practice focused on childhood hearing loss and airway reconstruction. I am lead surgeon and director of a busy pediatric cochlear implant team. An active basic science researcher, I have also long been keenly intrigued by how unregulated inflammation, specifically through intracellular pro-inflammatory transcription factor pathways, appears to be a central feature of multiple cancerous and non-cancerous diseases. Ever since medical school I have had an interest and career goal of becoming a physician-scientist with an independently funded translational laboratory.  I have been extremely fortunate to be able to expand on this interest with outstanding basic science and clinical mentors. In the lab, I have sought to learn how pathologically relevant agents, most often inflammatory, result in cellular events that contribute to chronic ear infections. The long-term goals of my research are to contribute to a greater understanding of human otitis media and provide data to guide future investigations into the development of medical treatments to prevent or help resolve middle ear effusion in humans, which treatments currently do not exist.

Additional Education

• Residency, U of MN Dept of Otolaryngology, Minneapolis, MN 1998-2002 Otolaryngology
• Pediatric Otolaryngology Fellowship, Cincinnati, OH 2002-2004 Ped. Otolaryngology

Research

Otitis Media (OM)

Since my transition to CNMC I really have focused on OM, as inflammation clearly is a central feature in the progression of this disease from acute to chronic. Mucus hypersecretion is one of the characteristic phenotypes and Dr. Mary C. Rose, a world re-known leader in the mucin glycoprotein field, is in the Center for Genetic Medicine Research at CNMC. Dr. Rose has provided mentorship to me since I relocated to CNMC.  I have set up my laboratory immediately adjacent to hers and function directly as part of her lab team. OM is a multifactorial disease with many environmental agents being pathologically relevant. Through mentored research awards, we have begun to analyze effects of cigarette smoke products, bacterial agents, and supraesophageal reflux on mucin genes in vitro. Ultimately we hope to contribute meaningfully to the development of novel treatments in this exceedingly common disease.    

Sensorineural Hearing Loss

As part of our cochlear implant (CI) program, we are attempting to develop strategies to measure outcomes after CI. This will be critical to better predict clinical success and will be extremely useful for parental expectation education, surgical candidacy decision making, and risk-stratified outcomes assessments. We also want to determine whether certain individual patient characteristics can predict worse neuropsychological or language outcomes. Also, we are under the impression that although language may not be improved significantly in our older prelingually hearing impaired recipients, the ability to have sound awareness conferred by the device does allow them some potential neuropsychological benefit. This supposition is being assessed empirically and methodically. Finally, we serve a large portion of minority (largely Hispanic) families, where the implanted children are receiving speech therapy in English, most often a second language to their parents.  Whether their ultimate language outcome is different than same language (rehabilitation-home) recipient families remains controversial and is being studied. 

Infantile Hemangiomas

Infantile hemangiomas represent the most common tumor of infancy, affecting up to 10% of children. These benign tumors can vary significantly in their localization and extent of soft tissue involvement, but their biological progression is remarkably unique and predictable. Recently, propranolol was reported to be effective in treating infantile hemangiomas in a small patient series. Propranolol is rapidly becoming a widespread form of medical treatment to the point it may surpass prednisone as a preferred treatment mode. The molecular mechanism by which propranolol works in patients with infantile hemangiomas is unknown. In conjunction with Dr. Nancy Bauman,  a prospective, randomized trial has been set up to compare the effectiveness of propanalol vs. corticosteroids for the treatment of infantile hemangiomas. As a translational basic science aim, we are hoping to characterize the transcriptome of these lesions. Notably, no studies have been performed that have utilized genome wide, large scale expression array technology to determine if there are any differences in infantile hemangiomas by clinical extensiveness and likelihood to respond to medical treatment. The hypothesis to be tested herein is that genome wide expression arrays will demonstrate a distinct profile of genes depending on the lesions’ clinical extensiveness and on their responsiveness to medical treatment.

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