Cynthia L Blanco, M.D.

Dr. Blanco is a Professor of Pediatrics with Tenure. Dr. Blanco completed her undergraduate studies and received her MD at the Universidad de Guadalajara in Guadalajara, Jalisco Mexico. She completed her residency in Pediatrics at Texas Tech University and her Post-Doctoral degree in Neonatal-Perinatal Medicine at the University of Texas Health Science Center San Antonio with a Masters in Clinical Investigation. Dr. Blanco serves as a member of the Committee on Nutrition for the American Academy of Pediatrics. She is heavily involved in clinical and translational research. Her research interests are in parenteral and enteral nutrition of the critically ill neonate. Her research focuses on the fetal and neonatal environmental exposures and the effect on glucose metabolism and insulin signaling pathways. Specifically, the ontogeny of gluconeogenesic pathways, pancreatic development and insulin resistance and the alterations when exposed to antenatal steroids and prematurity. She also investigates the effect of intravenous Amino Acid supplementation in ELBW infants and relationship to infants’ metabolism. Her clinical research focus includes enteral nutrition strategies to decrease the incidence of necrotizing enterocolitis with exclusive human nutrition and the biochemical markers involved in pasteurized human milk in relationship with gastrointestinal disease. Due to her passion a Neonatal Nutrition and Bone Institute was established under her leadership at University Hospital San Antonio. In this Institute, body composition analyses can be performed utilizing DXA, body air displacement plethysmography and ultrasound bone scans. In this Institute, we have implemented the utilization of novel therapies such as Intravenous Fish oil and novel markers of liver disease for infants with Parenteral Nutrition Associated Liver disease and short bowel syndrome as a resource to bridge neonates to liver transplant and/or survive them without transplant. Dr. Blanco believes we will continue to improve the health of neonates, children and adults by improving nutrition and metabolism at an early age

• Professional Background

  Education

  • 2006 - MS - Clinical Investigation - University of Texas Health Science Center San Antonio
  • 2005 - Postdoctoral Fellowship - Neonatal-Perinatal Medicine - University of Texas Health Science Center San Antonio
  • 2001 - Residency - Pediatrics - Texas Tech University
  • 1997 - MD - Medicine - Universidad de Guadalajara
  • 1991 - BS - Mathematics - Universidad de Guadalajara

  Highlights

  2022 Founders Award, Southern Society for Pediatric Research, for significant contributions to the health care of children

  2019 Health Cell State of the Industry Awardee for research in babies requiring IV Fish oil

  2018 Collette M. Kohler Women in Medicine Leadership Award, Leaders in Bexar County

  2018 Miracle Gala Physician from University Hospital 

  2014  Clinical Excellence Award, Awarded by UTHSCSA 

  1997 Medical School Valedictorian

  Appointments

  • 1/2019 - Division Chief, Neonatology - University of Texas Health Science Center San Antonio, Pediatrics, San Antonio
  • 1/2018 - Greehey Family Foundation Chair in Neonatology Research - University of Texas Health Science Center, Pediatrics, San Antonio
  • 9/2016 - Professor of Pediatrics with Tenure - University of Texas Health Science Center, Pediatrics, San Antonio
  • 1/2014 - Director, Neonatal Nutrition and Bone Institute - University Health SystemSan Antonio
  • 11/2009 - Neonatologist - Community Medicine Associates, Division of Neonatology, San Antonio

• Instruction & Training

  • 7/2016 - Present, Post-Doctoral Student Supervision, UTHSCSA
  • 7/2016 - Present, Post-Doctoral Student Supervision, UTHSCSA
  • 1/2015 - Present, Individual Instruction, UTHSCSA
  • 11/2014 - Present, Post-Doctoral Student Supervision, UTHSCSA
  • 7/2014 - Present, Individual Instruction, UTHSCSA
  • 7/2014 - Present, Post-Doctoral Student Supervision, UTHSCSA
  • 7/2014 - Present, Individual Instruction, UTHSCSA
  • 1/2014 - Present, Individual Instruction, University Health System
  • 1/2012 - Present, Individual Instruction, UTHSCSA
  • 1/2012 - Present, Individual Instruction, UTHSCSA
  • 6/2006 - Present, Neonatal Resuscitation Program, UTHSCSA
  • 7/2005 - Present, Journal Club, UTHSCSA
  • 7/2005 - Present, Journal Update, UTHSCSA
  • 7/2005 - Present, Educational Curriculum, Neonatal Transport Team, University Health System
  • 7/2005 - Present, Rotation Student Supervision, UTHSCSA
  • 7/2005 - Present, Pediatrics Clerkship, The University of Texas Health Science Center
  • 7/2005 - Present, PEDI4023 Neonatal ICU Externship (4th year elective)

• Research & Grants

  2021 Randomized controlled trial to decrease length of stay in infants with Neonatal abstinence syndrome with an exclusive human milk diet

  2021- Detecting atypical neonatal cries as a dimension of developmental neuropsychiatric disorders

  2021 A Randomized, Double-Blind, Controlled, Clinical Trial to Evaluate the Risk of Developing Essential Fatty Acid Deficiency in Pediatric Patients

  2021 Closing the gaps in neonatal nutrition through data science

  2021 A Multicenter, Prospective, Controlled, Longitudinal-Cohort Study Assessing the Safety of Omegaven in Pediatric Patients with PNAC 

  2015 A randomized controlled study to evaluate growth velocity in cardiac infant

  Grants

  Funding Agency San Antonio Medical Fondation Title San Antonio Medical Foundation Status Active Period 8/2016 - 7/2017 Role Principal Investigator Grant Detail The objective of this study is to determine the effects of maternal obesity and diabetes on infantile body composition, growth and epigenetic changes related to free fatty acid/glucose metabolism and diabetes. Body composition is measured serially utilizing the air displacement plethysmography and dual-enegry X-ray absorptiometry. Cord blood is collected for analyses of promoter methylation status of key genes in the insulin signaling, glucose metabolism and free fatty acid pathways.

  Funding Agency Bexar County Hospital District Title University Health System Status Active Period 12/2015 - 12/2017 Role Principal Investigator Grant Detail The primary goal of this project is to investigate the effect of hyperglycemia on pancreatic development and peripheral insulin signaling at critical periods of development. The central hypothesis is that prematurity has decreased pancreatic function and further impairments of insulin signaling in skeletal muscle when compared with prematurity not exposed to adverse postnatal environment (hyperglycemia). Pancreatic function is assessed by hyperglycemic clamps and compared to histological endocrine cell development utilizing the CAST system. Insulin signaling molecules and glucose transporters are measured at basal and insulin-stimulated state in skeletal muscle.

   

  Funding Agency   Title Clinical Investigator Kickstart Program.Short and long term effects of maternal obesity and diabetes on infantile body composition and epigenetics. Status Active Period 8/2017 - 7/2018 Role Principal Investigator Grant Detail The primary goal of this project is to determine if differentially methylated regions in cord blood of infants of mothers with gestational diabetes and obesity are associated with increased adiposity in offspring. Body composition is measured serially (birth, 3 months and 1 year) by utilizing the air displacement plethysmography and dual-energy x-ray absorptiometry. Methylation status of key genes in the insulin signaling, glucose metabolism, and free fatty acid pathways are measured at 1 year of age. Funding Agency  

  Title Subaward Agreement Utrecht Medisch Centrum (UMC) Status Active Period 6/2014 - 7/2022 Role Co-Investigator Grant Detail Human Mesenchymal Stem Cell Treatment.
  The goal of our experiment is to investigate whether human Mesenchymal Stem Cells when given intranasally are capable of migrating to a cerebral lesion. The main purpose is to offer additional treatment options to newborns born with a global brain injury.

• Service

  Service to the Profession

  02/2014-02/2015  President, Southern Society for Pediatric Research 

  01/2014-2015               NIH Committee for the Pre-B Project 

  10/2022     IIMS/CSTA Pilot projects      Internal Reviewer

    07/2019   LSOM Pilot Program            Internal Reviewer 

    03/2017    SNPRC pilot grant                Internal Reviewer 

    02/2016    CTSA UT System Pannel      External Reviewer

  09/2008-07/2016   Pediatric Scholarship Oversight Committee

  National Service

  7/2021 - present   Committee on Nutrition, American Academy of Pediatrics

  Community Service

  04/2018-2022               State Government Perinatal Advisory Council, Texas Health and Human Services Commission       Co-Chair

• Publications

   

   

  Book Chapter                                                                                                                                                                                     

                             1.        Blanco CL. Approach to an infant with congenital heart disease In: In: Toy EC, Toy AL, Eds. Case Files Teaching Case Collection. New YorK: McGraw-Hill Publishers; 2019.

                                                                                                                                                               

                             2.        Blanco CL. Amino Acid Nutritional Therapy in the low birth weight infant In: Diet and Nutrition in Critical care. 2014.

                                                                                                                                                                                                                    

                             3.        Blanco CL, Ferry RJ. IGF axis in the Fetus and the Neonate In: IGF axis in the Fetus and the Neonate. Humana Press; 2005. p. 133 - 143.

                                                                                                                                                                                                                     

                  Journal Article                                                                                                                                                                                

  1. Elsaie A, Menon R, Shrestha A, Gowda S, Varghese N, Barrios R, Blanco C, Konduri G, Shivanna B. Endothelial Adenosine Monophosphate-Activated Protein Kinasa-Alpha1 Deficiency Potentiates hyperoxia-induced experimental bronchopulmonary dysplasia and pulmonary hypertension. Antioxidans. 2021 Nov 29;10 (12): 1913
  2. Heather E. Rizzo, Elia N. Escaname, Nicholas B. Alana, Elizabeth Lavender, Jonathan Gelfond, Roman Fernandez, Matthew A. Hibbs, Jonathan M. King, Nicholas R. Carr & Cynthia L. Blanco. Maternal diabetes and obesity influence the fetal epigenome in a largely Hispanic population Clinical Epigenetics 2020 Feb;12(1):1-10.
  3. Keller LM, Eighmy S, Li C, Winter L, Kerecman J, Goodman Z, Mittal N, Blanco CL. Association of novel markers of liver disease in premature baboons, Papio sp. PLoS One. 2020 Mar 9;15(3):e0228985
  4. Heim-Hall JM, Shui, Valerie, Mittal, Naveen, Julia, Jacqueline, Blanco CL. Microvillus Inclusion Disease, a diagnosis to consider when abnormal stools and neurological impairments run together due to a rare syntaxin 3 gene mutation. Journal of Neonatal-Perinatal Medicine 2019 Mar
  5. Blanco CL, McGill-Vargas L, Li C, Winter L, Nathanielsz P. High Branched-Chain Amino Acid Concentrations are found in Preterm Baboons receiving Intravenous Amino Acid Solutions and Mimic Alterations Found in Preterm Infants. JPEN. 2019 Nov
  6. McGill-Vargas L, Gastaldelli A, Liang H, Anzueto Guerra D, Johnson-Pais T, Seidner S, McCurnin D, Muscogiuri G, DeFronzo R, Musi N, Blanco C. Prematurity disrupts glomeruli development, whereas prematurity and hyperglycemia lead to altered nephron maturation and increased oxidative stress in newborn baboons Pediatric Research 2018 Mar:702-711..
  7. Blanco CL, Gastaldelli A, Anzueto DG, Winter LA, Seidner SR, McCurnin DC, Liang H, Javors MA, DeFronzo RA, Musi N.. Effects of intravenous AICAR (5-aminoimidazole-4-carboximide riboside) administration on insulin signaling and resistance in premature baboons, Papio sp. PLoS One 2018 Jan;13(12)
  8. McGill-Vargas L, Gastaldelli A, Liang H, Anzueto Guerra D, Johnson-Pais T, Seidner S, McCurnin D, Muscogiuri G, DeFronzo R, Musi N, Blanco CL. Hepatic Insulin Resistance and Altered Gluconeogenic Pathway in Premature Baboons Endocrinology 2017 Jan;158(5):1140-1151.
  9. Sorrell M, Moreira A, Green K, Jacob R, Tragus R, Keller L, Quinn A, McCurnin D, Gong A, El Sakka A, Mittal N, Blanco C. Favorable Outcomes of Preterm Infants With Parenteral Nutrition–associated Liver Disease Treated With Intravenous Fish Oil–based Lipid Emulsion J Pediatr Gastroenterol Nutr 2017 May;64(5):783-788.
  10. Hair AB, Bergner EM, Lee ML, Moreira AG, Hawthorne KM, Rechtman DJ, Abrams SA, Blanco CL. Premature Infants 750-1250g Birth Weight Supplemented with a Novel Human Milk Derived Cream are Discharged Sooner Breastfeeding Medicine 2016 Apr;11:133-137.
  11. Raiten D, Steiber A, Carlson S, Griffin I, Anderson D, Hay H, Robin S, Neu J, Georgieff M, Groh-Wargo, Fenton T, and the Pre-B Consultative Working groups (Blanco CL). Working group reports: evaluation of the evidence to support practice guidelines for nutritional care Am J Clin Nutr 2016;103
  12. Blanco CL. Transforming Growth Factor- B2 is sequestered in Preterm Human Milk by Chondroitin Sulfate Proteoglycans American journal of Physiology and Gastrointest Liver Physiology 2015 Aug;309(3):171-180
  13. Namachivayam K, Blanco CL, Frost BL, Reeves AA, Jagadeeswaran R, MohanKumar K, Safarulla A, Mandal P, Garzon SA, Raj JU, Maheshwari A. Preterm human milk contains a large pool of latent TGF-β, which can be activated by exogenous neuraminidase. Am J Physiol Gastrointest Liver Physiol. 2013 Jun 15;304(12):G1055-65.
  14. Blanco CL, Mcgill-Vargas LL, Gastaldelli A, Seidner SR, McCurinin DC, Leland MM, Anzueto DG, Johnson MC, Liang H, DeFronzo RA, Musi N. Peripheral Insulin Resistance and Impaired Insulin Signaling Contribute To Abnormal Glucose Metabolism in Preterm Baboons. Endocrinology 2015 Mar;156(3):813-823.
  15. Hair AB, Blanco CL, Moreira AG, Hawthorne KM, Lee ML, Rechtman DJ, Abrams SA. Randomized Trial of Human Milk Cream as a Supplement to Standard Fortification of an Exclusive Human Milk-Based Diet in Infants 750-1250g Birth Weight J Pediatrics 2014 Nov;165(5):915-920.
  16. Moreira AG, Swischuk L, Malloy M, Mudd D, Blanco C, Geary C. Parathyroid hormone as a marker for metabolic bone disease of prematurity. J Perinatol 2014 Oct;34(10):787-791
  17. Moreira AG, Koele L., Leland M, Seidner SR, Blanco CL. Neonatal Intubation with Direct Laryngoscopy versus Videolaryngoscopy: An Extremely Premature Baboon Model Paediatric Anesthesia 2014 Aug;24(8):840-844
  18. McGill-Vargas LL, Johnson-Pais T, Johnson MC, Blanco CL. Developmental regulation of key gluconeogenic molecules in nonhuman primates. Physiol Rep. 2014 Dec;18(2):pii:-e12243.
  19. Kim SE, Lee SY, Blanco CL, Kim JH. Developmental Profiles of the Intrinsic Properties and Synaptic Function of Auditory Neurons in Preterm and Term Baboon Neonates Journal of Neuroscience 2014 Aug;34(34):11399-11404.
  20. Abrams SA, Schanter RJ, Lee ML, Rechtman DJ, H2MF Study Group Blanco, CL. Greater mortality and morbidity in extremely preterm infants fed a diet containing cow milk protein products. Breastfeed Medicine 2014 Jun;9(6):281-285.
  21. Blanco CL, Moreira AG, McGill-Vargas LL, Anzueto DG, Nathanielsz P, Musi N. Antenatal corticosteroids alter insulin signaling pathways in fetal baboon skeletal muscle. J Endocrinol 2014 Apr;221(2):253-260.
  22. Reeves AA, Johnson MC, Vasquez M, Marheshwari A, Blanco CL. TGF-β2, a Protective Intestinal Cytokine, Is Abundant in Maternal Human Milk and Human-Derived Fortifiers but Not in Donor Human Milk. Breastfeeding Medicine 2013 Dec;8(6):496-502.
  23. Cristofalo EA, Schanler RJ, Blanco CL, Sullivan S, Trawoeger R, Kiechl-Kohlendorfer U, Dudell G, Rechtman DJ, Lee ML, Lucas A, Abrams S. Randomized trial of exclusive human milk versus preterm formula diets in extremely premature infants Journal Pediatrics 2013 Dec;163(6):1592-1595.
  24. Namachivayam K, Blanco CL*, Frost BL, Reeves AA, Jagadeeswaran R, Mohankumar K, Safarulla A, Mandal P, Garzon SA, Raj JU, Maheshwari A.. Preterm Human Milk contains a Large Pool of Latent TGF-β, which can be Activated by Exogenous Neuraminidase Am J Physiol Gastointest Liver Physiol 2013 Apr;304(12):1055-1065.
  25. Blanco CL, McGill-Vargas L, McCurnin D, Quinn A.. Hyperglycemia Increases the Risk of Death in Extremely Preterm Baboons Pediatric Research 2013 Mar;73(3):337-343.
  26. Blanco CL, MohanKumar K, Jagadeeswaran R, Vasquez M, McGill-Vargas L, Garzon SA, Jain SK, Gill RK, Freitag NE, Weitkamp JH, Seidner S, Maheshwari A. Smad7 inhibits autocrine expression of TGF-B2 in intestinal epithelial cells in baboon necrotizing enterocolitis Am J Physiol Gastrointest 2013 Jan;15:167-180.
  27. Namachivayam K, Blanco CL, MohanKumar K, Jagadeeswaran R, Vasquez MM, McGill-Vargas L, Garzon SA, Jain SK, Gill RK, Freitag NE, Weikamp JH, Seidner SR, Maheshwari A. Smad7 inhibits autocrine expression of TGF-ß2 in intestinal epithelial cells in baboon necrotizing enterocolitis Am J Physiol Gastrointest Liver Physiol 2013 Jan;304(2):G167-180.
  28. Quinn AR, Blanco CL, Perego C, Finzi G, La Rossa S, Capella C, Guardado-Mendoza R, Casiraghi F, Gastaldelli A, Johnson M, Dick EJ, Folli F. The ontogeny of the endocrine pancreas in the fetal/newborn baboon J Endocrinology 2012 Sep;14(3):289-299.
  29. Ghandehari H, Lee ML, Rechtman DJ; H2MF Study Group. An exclusive human milk-based diet in extremely premature infants reduces the probability of remaining on total parenteral nutrition: a reanalysis of the data BMC Res Notes 2012 Apr;25(5):188-188.
  30. Blanco CL, Gong AK, Daniels, W, Liechty, E, Schoolfield, J, Ramamurthy RS, Green, BK. The Impact of Early High Amino Acid Supplementation on ELBW Infants at Two Years Journal of Pediatric Gastroenterology & Nutrition 2012;54:601-607.
  31. Blanco CL, Gong AK, Green BK, Falck A, Schoolfield J, Liechty EA. Early changes in plasma amino acid concentrations during aggressive nutritional therapy in extremely low birth weight infants. J Pediatr 2011 Apr;158(4):543-548.
  32. Bishop, Christine E, Vasquez MM, Petershack JA, Blanco CL. Pasteurized Donor Human Milk for VLBW Infants: The Effects on Necrotizing Enterocolitis and Related Factors Journal of Neonatal-Perinatal Medicine 2010 Jun;3(2):87-93.
  33. Blanco CL, Hanyu L, Joya-Galeana J, DeFronzo M, McCumin D, Musi N. The ontogeny of insulin signaling in the preterm baboon model. Endocrinology 2010 May;151(5):1990-1997.
  34. Sandra Sullivan MDa, Richard J. Schanler MD, a, , Jae H. Kim MD, PhDa, Aloka L. Patel MDa, Rudolf Trawöger MDa, Ursula Kiechl-Kohlendorfer MDa, Gary M. Chan MDa, Cynthia L. Blanco MDa, Steven Abrams MDa, C. Michael Cotten MD, MHSa, Nirupama Laroia MDa, Richard A. Ehrenkranz MDa, Golde Dudell MDa, Elizabeth A. Cristofalo MD, MPHa, Paula Meier PhDa, Martin L. Lee PhDa, David J. Rechtman MDa and Alan Lucas MDa . An Exclusively Human Milk-Based Diet Is Associated with a Lower Rate of Necrotizing Enterocolitis than a Diet of Human Milk and Bovine Milk-Based Products The Journal of Pediatrics 2010 Apr;156(4):562-567.e1.
  35. Vasquez MM, German VF, Scott AA, Foulds DM, Blanco CL. Neonatal Lead Intoxication Following Maternal Pica: A Case Report and Review of the Literature Journal of Neonatal-Perinatal Medicine 2009 Jul;2(2):123-126.
  36. Lin AE, O‘Brien B, Demmer LA, Almeda KK, Blanco CL, Glasow PF, Berul CI, Hamilton R, Micheil Innes A, Lauzon JL, Sol-Church K, Gripp KW. Prenatal features of Costello syndrome: ultrasonographic findings and atrial tachycardia. Prenat Diagn 2009 Jul;29(7):682-690.
  37. Blanco CL, Falck A, Green BK, Cornell JA, Gong AK. Metabolic Responses to Early and High Protein Supplementation in a Randomized Trial Evaluating the Prevention of Hyperkalemia in ELBW Infants The Journal of Pediatrics 2008 Oct;153(4):535-540.
  38. C L Blanco, J G Baillargeon, R L Morrison and A K Gong. Hyperglycemia in Extremely Low Birth Weight Infants in a Predominantly Hispanic Population and Related Morbidities J Perinatol 2006 Dec;26(12):737-741.
  39. Ipson MA.Blanco CL. Saccharomyces Cerevisiae Sepsis in a 35 week old Premature Infant. A Case Report. Journal of Perinatology 2001 Oct;21(7):459-60.
  40. Margarita M. Vasquez, MD, Victor F. German, MD PhD, Anthony A. Scott, PhD, Michael Foulds, MD, Cynthia L. Blanco, MD.. Neonatal Lead Intoxication Following Maternal Pica: A Case Report Journal of Neonatal-Perinatal Medicine 2001 Feb;2(# 2):123-126.
  41. Blanco C. Congenital Rubella: Case Report El Paso Physician 1999 Nov

• Clinical

  Dr. Blanco's expertise is in neonatal nutrition. Her clinical research focus includes enteral nutrition strategies to decrease the incidence of necrotizing enterocolitis with exclusive human nutrition and the biochemical markers involved in pasteurized human milk in relationship with gastrointestinal disease. Due to her passion a Neonatal Nutrition and Bone Institute was established under her leadership at University Hospital San Antonio.  In this Institute, we have implemented the utilization of novel therapies such as Intravenous Fish oil for infants with Parenteral Nutrition Associated Liver disease and short bowel syndrome  to bridge neonates to liver transplant and/or survive them without transplant. 

  Board Certifications

  • 2005 - American Board of Pediatrics/Neonatal-Perinatal
  • 2001 - American Board of Pediatrics