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Johnsson M, Stenberg YT, Farman HH, Blennow K, Zetterberg H, Malmeström C, Sandgren S, Rosenstein I, Lycke J, Axelsson M, Novakova L. Serum neurofilament light for detecting disease activity in individual patients in multiple sclerosis: A 48-week prospective single-center study. Mult Scler 2024; 30:664-673. [PMID: 38481083 PMCID: PMC11071597 DOI: 10.1177/13524585241237388] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/05/2024] [Accepted: 02/18/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND Serum neurofilament light (sNfL) reflects neuroaxonal damage and is now used as an outcome in treatment trials of relapsing-remitting multiple sclerosis (RRMS). However, the diagnostic properties of sNfL for monitoring disease activity in individual patients warrant further investigations. METHOD Patients with suspected relapse and/or contrast-enhancing lesions (CELs) were consecutively included and performed magnetic resonance imaging (MRI) of the brain at baseline and weeks 28 and 48. Serum was obtained at baseline and 2, 4, 8, 16, 24, and 48 weeks. Neurofilament light concentration was measured using Single molecule array technology. RESULTS We included 44 patients, 40 with RRMS and 4 with clinically isolated syndrome. The median sNfL level peaked at 2 weeks post-baseline (14.6 ng/L, interquartile range (IQR); 9.3-31.6) and reached nadir at 48 weeks (9.1 ng/L, IQR; 5.5-15.0), equivalent to the median sNfL of controls (9.1 ng/L, IQR; 7.4-12). A baseline Z-score of more than 1.1 (area under the curve; 0.78, p < 0.0001) had a sensitivity of 81% and specificity of 70% to detect disease activity. CONCLUSION One out of five patients with relapse and/or CELs did not change significantly in post-baseline sNfL levels. The utility of repeated sNfL measurements to monitor disease activity is complementary rather than a substitute for clinical and MRI measures.
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Rönnebjerg L, Axelsson M, Kankaanranta H, Ekerljung L. Health-related quality of life, anxiety, depression, beliefs of medication, and self-efficacy in individuals with severe asthma - a population-based study. J Asthma 2024; 61:148-159. [PMID: 37610189 DOI: 10.1080/02770903.2023.2248512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 08/08/2023] [Accepted: 08/11/2023] [Indexed: 08/24/2023]
Abstract
OBJECTIVE Individuals with severe asthma often report poor Health-related quality of life (HRQoL) and more research is essential to increase understanding of how they may be helped to improve HRQoL. The main aim of the current paper is to evaluate HRQoL, and possible factors influencing HRQoL, in individuals with severe asthma. The aim is also to explore associations among anxiety, depression, beliefs of medication, self-efficacy, and HRQoL among individuals with severe and other asthma as well as those with no asthma. METHODS Participants with severe asthma (n = 59), other asthma (n = 526), and no asthma (n = 902) were recruited from West Sweden Asthma Study, a population-based study, which includes both questionnaire surveys and clinical examinations. RESULTS Individuals with severe asthma had worse physical HRQoL (measured with SF-8) than those with other and no asthma (median 48.4, 51.9, and 54.3, respectively). They also had worse mental HRQoL (median 46.7) and reported higher anxiety and depression scores (measured using HADS, median 5.0 and 3.5, respectively) compared to no asthma (median 4.0 and 2.0, respectively). HRQoL was particularly affected among women with severe asthma. Individuals with severe asthma believed that their asthma medication was more necessary than those with other asthma, but they reported more concern for the medication. Asthma control and packyears predicted physical HRQoL and anxiety predicted mental HRQoL among individuals with severe asthma. CONCLUSIONS Efforts to improve asthma control and to reduce anxiety may improve HRQoL in individuals with severe asthma. Especially, women with severe asthma seem to need support to improve their HRQoL. Reducing concerns with asthma medication is most likely essential as high concerns may lead to poor adherence, which in turn may negatively affect asthma control and HRQoL.
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Brijs J, Føre M, Gräns A, Clark TD, Axelsson M, Johansen JL. Bio-sensing technologies in aquaculture: how remote monitoring can bring us closer to our farm animals. Philos Trans R Soc Lond B Biol Sci 2021; 376:20200218. [PMID: 34121461 DOI: 10.1098/rstb.2020.0218] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Farmed aquatic animals represent an increasingly important source of food for a growing human population. However, the aquaculture industry faces several challenges with regard to producing a profitable, ethical and environmentally sustainable product, which are exacerbated by the ongoing intensification of operations and increasingly extreme and unpredictable climate conditions. Fortunately, bio-sensors capable of measuring a range of environmental, behavioural and physiological variables (e.g. temperature, dissolved gases, depth, acceleration, ventilation, heart rate, blood flow, glucose and l-lactic acid) represent exciting and innovative tools for assessing the health and welfare of farmed animals in aquaculture. Here, we illustrate how these state-of-the-art technologies can provide unique insights into variables pertaining to the inner workings of the animal to elucidate animal-environment interactions throughout the production cycle, as well as to provide insights on how farmed animals perceive and respond to environmental and anthropogenic perturbations. Using examples based on current challenges (i.e. sub-optimal feeding strategies, sub-optimal animal welfare and environmental changes), we discuss how bio-sensors can contribute towards optimizing the growth, health and welfare of farmed animals under dynamically changing on-farm conditions. While bio-sensors currently represent tools that are primarily used for research, the continuing development and refinement of these technologies may eventually allow farmers to use real-time environmental and physiological data from their stock as 'early warning systems' and/or for refining day-to-day operations to ethically and sustainably optimize production. This article is part of the theme issue 'Measuring physiology in free-living animals (Part I)'.
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Novakova L, Axelsson M, Malmeström C, Zetterberg H, Blennow K, Svenningsson A, Lycke J. NFL and CXCL13 may reveal disease activity in clinically and radiologically stable MS. Mult Scler Relat Disord 2020; 46:102463. [PMID: 32862040 DOI: 10.1016/j.msard.2020.102463] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 08/20/2020] [Accepted: 08/22/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Cerebrospinal fluid (CSF) levels of neurofilament light (NFL), a biomarker of axonal damage, and CXCL13, a chemokine involved in B-cell regulation, are both associated with disease activity in multiple sclerosis (MS). OBJECTIVE To explore the potential of NFL and CXCL13 to detect residual disease activity in patients with no signs of clinical or ongoing radiological activity and to study the clinical relevance of such activity. METHODS NFL and CXCL13 concentrations were determined with ELISA in CSF obtained from 90 relapsing-remitting (RR) MS and 47 Progressive (Pr) MS (including primary and secondary PrMS) at baseline and after 12 months of follow-up. The patients were assessed at baseline, before initiating or switching disease modifying therapy (DMT) and again after 12 and 27 months of follow-up. RESULTS All patients with ongoing disease activity (relapse or contrast-enhancing lesions on MRI) had increased NFL or CXCL13. The proportion of RRMS and PrMS patients without ongoing disease activity with elevation of either NFL or CXCL13 (residual disease activity) was 39% and 50%, respectively, and both were increased in 11% and 16%, respectively. The treatment with DMTs decreased the proportion with residual disease activity in both RRMS and PrMS significantly. We could not show any significant association between residual disease activity and clinical or MRI measures at 12 or 27 months of follow-up. CONCLUSIONS Although most of this real-world study population had been treated with second-line DMTs and achieved clinical and radiological stability, a significant proportion of patients still displayed increased CSF levels of both NFL and CXCL13, indicating residual disease activity. Thus, these markers seemed considerably more sensitive to disease activity than clinical and MRI measures. However, the long-term clinical significance of such activity remains to be determined.
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Veres P, Bhat PN, Briggs MS, Cleveland WH, Hamburg R, Hui CM, Mailyan B, Preece RD, Roberts OJ, von Kienlin A, Wilson-Hodge CA, Kocevski D, Arimoto M, Tak D, Asano K, Axelsson M, Barbiellini G, Bissaldi E, Dirirsa FF, Gill R, Granot J, McEnery J, Omodei N, Razzaque S, Piron F, Racusin JL, Thompson DJ, Campana S, Bernardini MG, Kuin NPM, Siegel MH, Cenko SB, O’Brien P, Capalbi M, Daì A, De Pasquale M, Gropp J, Klingler N, Osborne JP, Perri M, Starling RLC, Tagliaferri G, Tohuvavohu A, Ursi A, Tavani M, Cardillo M, Casentini C, Piano G, Evangelista Y, Verrecchia F, Pittori C, Lucarelli F, Bulgarelli A, Parmiggiani N, Anderson GE, Anderson JP, Bernardi G, Bolmer J, Caballero-García MD, Carrasco IM, Castellón A, Segura NC, Castro-Tirado AJ, Cherukuri SV, Cockeram AM, D’Avanzo P, Di Dato A, Diretse R, Fender RP, Fernández-García E, Fynbo JPU, Fruchter AS, Greiner J, Gromadzki M, Heintz KE, Heywood I, van der Horst AJ, Hu YD, Inserra C, Izzo L, Jaiswal V, Jakobsson P, Japelj J, Kankare E, Kann DA, Kouveliotou C, Klose S, Levan AJ, Li XY, Lotti S, Maguire K, Malesani DB, Manulis I, Marongiu M, Martin S, Melandri A, Michałowski MJ, Miller-Jones JCA, Misra K, Moin A, Mooley KP, Nasri S, Nicholl M, Noschese A, Novara G, Pandey SB, Peretti E, del Pulgar CJP, Pérez-Torres MA, Perley DA, Piro L, Ragosta F, Resmi L, Ricci R, Rossi A, Sánchez-Ramírez R, Selsing J, Schulze S, Smartt SJ, Smith IA, Sokolov VV, Stevens J, Tanvir NR, Thöne CC, Tiengo A, Tremou E, Troja E, de Ugarte Postigo A, Valeev AF, Vergani SD, Wieringa M, Woudt PA, Xu D, Yaron O, Young DR. Observation of inverse Compton emission from a long γ-ray burst. Nature 2019; 575:459-463. [DOI: 10.1038/s41586-019-1754-6] [Citation(s) in RCA: 92] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Accepted: 10/18/2019] [Indexed: 11/09/2022]
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Boremalm M, Juto A, Axelsson M, Novakova L, Frisell T, Svenningsson A, Lycke J, Piehl F, Salzer J. Natalizumab, rituximab and fingolimod as escalation therapy in multiple sclerosis. Eur J Neurol 2019; 26:1060-1067. [PMID: 30762259 DOI: 10.1111/ene.13936] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Accepted: 02/12/2019] [Indexed: 01/17/2023]
Abstract
BACKGROUND AND PURPOSE Breakthrough disease on first-line injectables in relapsing-remitting multiple sclerosis (RRMS) is a common clinical situation where comparative studies between different escalation therapies are lacking. The aim of this study was to compare the efficacy, safety and medication persistence of natalizumab (NTZ), rituximab (RTX) and fingolimod (FGL) as escalation therapy in RRMS. METHODS Patients switching from interferon or glatiramer acetate to NTZ, RTX or FGL due to breakthrough disease were identified through the Swedish multiple sclerosis (MS) registry at four large MS centers in this retrospective observational study. Data were collected from the MS registry and medical charts. Hazard ratios (HRs) for relapses, adverse events and drug discontinuation with 95% confidence interval (CI) were calculated using multivariable confounder-adjusted Cox proportional hazard models. RESULTS A total of 241 patients were included. The annualized relapse rates were 0.02 for NTZ, 0.03 for RTX and 0.07 for FGL. Compared with NTZ, the adjusted HR for relapse was 1.0 (95% CI, 0.2-5.6) for RTX and 3.4 (95% CI, 1.3-9.2) for FGL. The annualized drug discontinuation rates were 0.15, 0.01 and 0.15 for NTZ, RTX and FGL, respectively. The adjusted HR for drug discontinuation was 0.05 (95% CI, 0.01-0.38) for RTX and 1.0 (95% CI, 0.6-1.7) for FGL vs. NTZ. CONCLUSIONS In patients with RRMS on interferon/glatiramer acetate with breakthrough disease, switching to NTZ or RTX was associated with less disease activity compared with FGL. RTX displayed superior medication persistence compared with both NTZ and FGL.
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Axelsson M, Sjögren M, Andersen O, Blennow K, Zetterberg H, Lycke J. Neurofilament light protein levels in cerebrospinal fluid predict long-term disability of Guillain-Barré syndrome: A pilot study. Acta Neurol Scand 2018; 138:143-150. [PMID: 29624650 DOI: 10.1111/ane.12927] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2018] [Indexed: 01/04/2023]
Abstract
OBJECTIVES Although the recovery from Guillain-Barré syndrome (GBS) is good in most patients, some develop permanent severe disability or even die. Early predictors would increase the likelihood to identify patients at risk for poor outcome at the acute stage, allowing them intensified therapeutic intervention. MATERIALS AND METHOD Eighteen patients with a history of GBS 9-17 years ago were reassessed with scoring of neurological disability and quality of life assessment (QoL). Their previous diagnostic work-up included clinical examination with scoring of disability, neurophysiological investigation, a battery of serology tests for infections, and cerebrospinal fluid (CSF) examination. Aliquots of CSF were frozen, stored for 20-28 years, and analyzed by ELISA for determination of neurofilament light protein (NFL) and glial fibrillary acidic protein (GFAP). RESULTS Patients with poor outcome (n = 3) had significantly higher NFL and GFAP levels at GBS nadir than those with good outcome (n = 15, P < .01 and P < .05, respectively). High NFL correlated with more prominent disability and worse QoL at long-term follow-up (r = .694, P < .001, and SF 36 dimension physical component summary (PCS) (r =-.65, P < .05), respectively, whereas GFAP did not correlate with clinical outcome or QoL. CONCLUSION High NFL in CSF at the acute stage of GBS seems to predict long-term outcome and might, together with neurophysiological and clinical measures, be useful in treatment decisions and clinical care of GBS.
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Aharonian F, Akamatsu H, Akimoto F, Allen SW, Angelini L, Audard M, Awaki H, Axelsson M, Bamba A, Bautz MW, Blandford R, Brenneman LW, Brown GV, Bulbul E, Cackett EM, Chernyakova M, Chiao MP, Coppi PS, Costantini E, De Plaa J, De Vries CP, Den Herder JW, Done C, Dotani T, Ebisawa K, Eckart ME, Enoto T, Ezoe Y, Fabian AC, Ferrigno C, Foster AR, Fujimoto R, Fukazawa Y, Furuzawa A, Galeazzi M, Gallo LC, Gandhi P, Giustini M, Goldwurm A, Gu L, Guainazzi M, Haba Y, Hagino K, Hamaguchi K, Harrus IM, Hatsukade I, Hayashi K, Hayashi T, Hayashida K, Hiraga JS, Hornschemeier A, Hoshino A, Hughes JP, Ichinohe Y, Iizuka R, Inoue H, Inoue Y, Ishida M, Ishikawa K, Ishisaki Y, Iwai M, Kaastra J, Kallman T, Kamae T, Kataoka J, Katsuda S, Kawai N, Kelley RL, Kilbourne CA, Kitaguchi T, Kitamoto S, Kitayama T, Kohmura T, Kokubun M, Koyama K, Koyama S, Kretschmar P, Krimm HA, Kubota A, Kunieda H, Laurent P, Lee SH, Leutenegger MA, Limousin OO, Loewenstein M, Long KS, Lumb D, Madejski G, Maeda Y, Maier D, Makishima K, Markevitch M, Matsumoto H, Matsushita K, Mccammon D, Mcnamara BR, Mehdipour M, Miller ED, Miller JM, Mineshige S, Mitsuda K, Mitsuishi I, Miyazawa T, Mizuno T, Mori H, Mori K, Mukai K, Murakami H, Mushotzky RF, Nakagawa T, Nakajima H, Nakamori T, Nakashima S, Nakazawa K, Nobukawa KK, Nobukawa M, Noda H, Odaka H, Ohashi T, Ohno M, Okajima T, Oshimizu K, Ota N, Ozaki M, Paerels F, Paltani S, Petre R, Pinto C, Porter FS, Pottschmidt K, Reynolds CS, Safi-Harb S, Saito S, Sakai K, Sasaki T, Sato G, Sato K, Sato R, Sawada M, Schartel N, Serlemtsos PJ, Seta H, Shidatsu M, Simionescu A, Smith RK, Soong Y, Stawarz Ł, Sugawara Y, Sugita S, Szymkowiak A, Tajima H, Takahashi H, Takahashi T, Takeda S, Takei Y, Tamagawa T, Tamura T, Tanaka T, Tanaka Y, Tanaka YT, Tashiro MS, Tawara Y, Terada Y, Terashima Y, Tombesi F, Tomida H, Tsuboi Y, Tsujimoto M, Tsunemi H, Tsuru TG, Uchida H, Uchiyama H, Uchiyama Y, Ueda S, Ueda Y, Uno S, Urry CM, Ursino E, Watanabe S, Werner N, Wilkins DR, Williams BJ, Yamada S, Yamaguchi H, Yamaoka K, Yamasaki NY, Yamauchi M, Yamauchi S, Yaqoob T, Yatsu Y, Yonetoku D, Zhuravleva I, Zoghbi A, Terasawa T, Sekido M, Takefuji K, Kawai E, Misawa H, Tsuchiya F, Yamazaki R, Kobayashi E, Kisaka S, Aoki T. Hitomi X-ray studies of Giant Radio Pulses from the Crab pulsar. PUBLICATIONS OF THE ASTRONOMICAL SOCIETY OF JAPAN. NIHON TENMON GAKKAI 2018; 70:10.1093/pasj/psx083. [PMID: 32020916 PMCID: PMC6999749 DOI: 10.1093/pasj/psx083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
To search for giant X-ray pulses correlated with the giant radio pulses (GRPs) from the Crab pulsar, we performed a simultaneous observation of the Crab pulsar with the X-ray satellite Hitomi in the 2 - 300 keV band and the Kashima NICT radio observatory in the 1.4 - 1.7 GHz band with a net exposure of about 2 ks on 25 March 2016, just before the loss of the Hitomi mission. The timing performance of the Hitomi instruments was confirmed to meet the timing requirement and about 1,000 and 100 GRPs were simultaneously observed at the main and inter-pulse phases, respectively, and we found no apparent correlation between the giant radio pulses and the X-ray emission in either the main or inter-pulse phases. All variations are within the 2 sigma fluctuations of the X-ray fluxes at the pulse peaks, and the 3 sigma upper limits of variations of main- or inter-pulse GRPs are 22% or 80% of the peak flux in a 0.20 phase width, respectively, in the 2 - 300 keV band. The values become 25% or 110% for main or inter-pulse GRPs, respectively, when the phase width is restricted into the 0.03 phase. Among the upper limits from the Hitomi satellite, those in the 4.5-10 keV and the 70-300 keV are obtained for the first time, and those in other bands are consistent with previous reports. Numerically, the upper limits of main- and inter-pulse GRPs in the 0.20 phase width are about (2.4 and 9.3) ×10-11 erg cm-2, respectively. No significant variability in pulse profiles implies that the GRPs originated from a local place within the magnetosphere and the number of photon-emitting particles temporally increases. However, the results do not statistically rule out variations correlated with the GRPs, because the possible X-ray enhancement may appear due to a > 0.02% brightening of the pulse-peak flux under such conditions.
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Vågberg M, Axelsson M, Birgander R, Burman J, Cananau C, Forslin Y, Granberg T, Gunnarsson M, von Heijne A, Jönsson L, Karrenbauer VD, Larsson EM, Lindqvist T, Lycke J, Lönn L, Mentesidou E, Müller S, Nilsson P, Piehl F, Svenningsson A, Vrethem M, Wikström J. Guidelines for the use of magnetic resonance imaging in diagnosing and monitoring the treatment of multiple sclerosis: recommendations of the Swedish Multiple Sclerosis Association and the Swedish Neuroradiological Society. Acta Neurol Scand 2017; 135:17-24. [PMID: 27558404 PMCID: PMC5157754 DOI: 10.1111/ane.12667] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2016] [Indexed: 01/28/2023]
Abstract
Multiple sclerosis (MS) is associated with inflammatory lesions in the brain and spinal cord. The detection of such inflammatory lesions using magnetic resonance imaging (MRI) is important in the consideration of the diagnosis and differential diagnoses of MS, as well as in the monitoring of disease activity and predicting treatment efficacy. Although there is strong evidence supporting the use of MRI for both the diagnosis and monitoring of disease activity, there is a lack of evidence regarding which MRI protocols to use, the frequency of examinations, and in what clinical situations to consider MRI examination. A national workshop to discuss these issues was held in Stockholm, Sweden, in August 2015, which resulted in a Swedish consensus statement regarding the use of MRI in the care of individuals with MS. The aim of this consensus statement is to provide practical advice for the use of MRI in this setting. The recommendations are based on a review of relevant literature and the clinical experience of workshop attendees. It is our hope that these recommendations will benefit individuals with MS and guide healthcare professionals responsible for their care.
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Berglund T, Axelsson M, Kühlmann-Berenzon S, Velicko I. Can we reach men who have sex with men with HIV testing at gay venues in Stockholm? Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw167.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Nordvik MK, Axelsson M, Berglund T, Karlsson N. Estimation of the number of individuals living with hepatitis C-infection in Sweden. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw174.206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Wolff E, Larsson S, Fues Wahl H, Roth A, Axelsson M, Berglund T. Cost-effectiveness analysis of hepatitis B vaccination to children in Sweden. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw165.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Gisslén M, Svedhem V, Lindborg L, Flamholc L, Norrgren H, Wendahl S, Axelsson M, Sönnerborg A. Sweden, the first country to achieve the Joint United Nations Programme on HIV/AIDS (UNAIDS)/World Health Organization (WHO) 90-90-90 continuum of HIV care targets. HIV Med 2016; 18:305-307. [PMID: 27535540 PMCID: PMC5347969 DOI: 10.1111/hiv.12431] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2016] [Indexed: 12/01/2022]
Abstract
Objectives The Joint United Nations Programme on HIV/AIDS (UNAIDS)/World Health Organization (WHO) 90‐90‐90 goals propose that 90% of all people living with HIV should know their HIV status, 90% of those diagnosed should receive antiretroviral therapy (ART), and 90% of those should have durable viral suppression. We have estimated the continuum of HIV care for the entire HIV‐1‐infected population in Sweden. Methods The Swedish InfCare HIV Cohort Study collects viral loads, CD4 counts, and viral sequences, along with demographic and clinical data, through an electronic clinical decision support system. Almost 100% of those diagnosed with HIV infection are included in the database, corresponding to 6946 diagnosed subjects living with HIV‐1 in Sweden by 31 December 2015. Results Using HIV surveillance data reported to the Public Health Agency of Sweden, it was estimated that 10% of all HIV‐infected subjects in Sweden remain undiagnosed. Among all diagnosed patients, 99.8% were linked to care and 97.1% of those remained in care. On 31 December 2015, 6605 of 6946 patients (95.1%) were on ART. A total of 6395 had been on treatment for at least 6 months and 6053 of those (94.7%) had a viral load < 50 HIV‐1 RNA copies/mL. Conclusions The 2014 UNAIDS/WHO 90‐90‐90 goals for HIV care means that > 73% of all patients living with HIV should be virologically suppressed by 2020. Sweden has already achieved this target, with 78% suppression, and is the first country reported to meet all the UNAIDS/WHO 90‐90‐90 goals.
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Constantinescu R, Krýsl D, Bergquist F, Andrén K, Malmeström C, Asztély F, Axelsson M, Menachem EB, Blennow K, Rosengren L, Zetterberg H. Cerebrospinal fluid markers of neuronal and glial cell damage to monitor disease activity and predict long-term outcome in patients with autoimmune encephalitis. Eur J Neurol 2016; 23:796-806. [PMID: 26822123 DOI: 10.1111/ene.12942] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 11/13/2015] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND PURPOSE Clinical symptoms and long-term outcome of autoimmune encephalitis are variable. Diagnosis requires multiple investigations, and treatment strategies must be individually tailored. Better biomarkers are needed for diagnosis, to monitor disease activity and to predict long-term outcome. The value of cerebrospinal fluid (CSF) markers of neuronal [neurofilament light chain protein (NFL), and total tau protein (T-tau)] and glial cell [glial fibrillary acidic protein (GFAP)] damage in patients with autoimmune encephalitis was investigated. METHODS Demographic, clinical, magnetic resonance imaging, CSF and antibody-related data of 25 patients hospitalized for autoimmune encephalitis and followed for 1 year were retrospectively collected. Correlations between these data and consecutive CSF levels of NFL, T-tau and GFAP were investigated. Disability, assessed by the modified Rankin scale, was used for evaluation of disease activity and long-term outcome. RESULTS The acute stage of autoimmune encephalitis was accompanied by high CSF levels of NFL and T-tau, whereas normal or significantly lower levels were observed after clinical improvement 1 year later. NFL and T-tau reacted in a similar way but at different speeds, with T-tau reacting faster. CSF levels of GFAP were initially moderately increased but did not change significantly later on. Final outcome (disability at 1 year) directly correlated with CSF-NFL and CSF-GFAP levels at all time-points and with CSF-T-tau at 3 ± 1 months. This correlation remained significant after age adjustment for CSF-NFL and T-tau but not for GFAP. CONCLUSION In autoimmune encephalitis, CSF levels of neuronal and glial cell damage markers appear to reflect disease activity and long-term disability.
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Hofstra LM, Sauvageot N, Albert J, Alexiev I, Garcia F, Struck D, Van de Vijver DAMC, Åsjö B, Beshkov D, Coughlan S, Descamps D, Griskevicius A, Hamouda O, Horban A, Van Kasteren M, Kolupajeva T, Kostrikis LG, Liitsola K, Linka M, Mor O, Nielsen C, Otelea D, Paraskevis D, Paredes R, Poljak M, Puchhammer-Stöckl E, Sönnerborg A, Staneková D, Stanojevic M, Van Laethem K, Zazzi M, Zidovec Lepej S, Boucher CAB, Schmit JC, Wensing AMJ, Puchhammer-Stockl E, Sarcletti M, Schmied B, Geit M, Balluch G, Vandamme AM, Vercauteren J, Derdelinckx I, Sasse A, Bogaert M, Ceunen H, De Roo A, De Wit S, Echahidi F, Fransen K, Goffard JC, Goubau P, Goudeseune E, Yombi JC, Lacor P, Liesnard C, Moutschen M, Pierard D, Rens R, Schrooten Y, Vaira D, Vandekerckhove LPR, Van den Heuvel A, Van Der Gucht B, Van Ranst M, Van Wijngaerden E, Vandercam B, Vekemans M, Verhofstede C, Clumeck N, Van Laethem K, Beshkov D, Alexiev I, Lepej SZ, Begovac J, Kostrikis L, Demetriades I, Kousiappa I, Demetriou V, Hezka J, Linka M, Maly M, Machala L, Nielsen C, Jørgensen LB, Gerstoft J, Mathiesen L, Pedersen C, Nielsen H, Laursen A, Kvinesdal B, Liitsola K, Ristola M, Suni J, Sutinen J, Descamps D, Assoumou L, Castor G, Grude M, Flandre P, Storto A, Hamouda O, Kücherer C, Berg T, Braun P, Poggensee G, Däumer M, Eberle J, Heiken H, Kaiser R, Knechten H, Korn K, Müller H, Neifer S, Schmidt B, Walter H, Gunsenheimer-Bartmeyer B, Harrer T, Paraskevis D, Hatzakis A, Zavitsanou A, Vassilakis A, Lazanas M, Chini M, Lioni A, Sakka V, Kourkounti S, Paparizos V, Antoniadou A, Papadopoulos A, Poulakou G, Katsarolis I, Protopapas K, Chryssos G, Drimis S, Gargalianos P, Xylomenos G, Lourida G, Psichogiou M, Daikos GL, Sipsas NV, Kontos A, Gamaletsou MN, Koratzanis G, Sambatakou H, Mariolis H, Skoutelis A, Papastamopoulos V, Georgiou O, Panagopoulos P, Maltezos E, Coughlan S, De Gascun C, Byrne C, Duffy M, Bergin C, Reidy D, Farrell G, Lambert J, O'Connor E, Rochford A, Low J, Coakely P, O'Dea S, Hall W, Mor O, Levi I, Chemtob D, Grossman Z, Zazzi M, de Luca A, Balotta C, Riva C, Mussini C, Caramma I, Capetti A, Colombo MC, Rossi C, Prati F, Tramuto F, Vitale F, Ciccozzi M, Angarano G, Rezza G, Kolupajeva T, Vasins O, Griskevicius A, Lipnickiene V, Schmit JC, Struck D, Sauvageot N, Hemmer R, Arendt V, Michaux C, Staub T, Sequin-Devaux C, Wensing AMJ, Boucher CAB, van de Vijver DAMC, van Kessel A, van Bentum PHM, Brinkman K, Connell BJ, van der Ende ME, Hoepelman IM, van Kasteren M, Kuipers M, Langebeek N, Richter C, Santegoets RMWJ, Schrijnders-Gudde L, Schuurman R, van de Ven BJM, Åsjö B, Kran AMB, Ormaasen V, Aavitsland P, Horban A, Stanczak JJ, Stanczak GP, Firlag-Burkacka E, Wiercinska-Drapalo A, Jablonowska E, Maolepsza E, Leszczyszyn-Pynka M, Szata W, Camacho R, Palma C, Borges F, Paixão T, Duque V, Araújo F, Otelea D, Paraschiv S, Tudor AM, Cernat R, Chiriac C, Dumitrescu F, Prisecariu LJ, Stanojevic M, Jevtovic D, Salemovic D, Stanekova D, Habekova M, Chabadová Z, Drobkova T, Bukovinova P, Shunnar A, Truska P, Poljak M, Lunar M, Babic D, Tomazic J, Vidmar L, Vovko T, Karner P, Garcia F, Paredes R, Monge S, Moreno S, Del Amo J, Asensi V, Sirvent JL, de Mendoza C, Delgado R, Gutiérrez F, Berenguer J, Garcia-Bujalance S, Stella N, de Los Santos I, Blanco JR, Dalmau D, Rivero M, Segura F, Elías MJP, Alvarez M, Chueca N, Rodríguez-Martín C, Vidal C, Palomares JC, Viciana I, Viciana P, Cordoba J, Aguilera A, Domingo P, Galindo MJ, Miralles C, Del Pozo MA, Ribera E, Iribarren JA, Ruiz L, de la Torre J, Vidal F, Clotet B, Albert J, Heidarian A, Aperia-Peipke K, Axelsson M, Mild M, Karlsson A, Sönnerborg A, Thalme A, Navér L, Bratt G, Karlsson A, Blaxhult A, Gisslén M, Svennerholm B, Bergbrant I, Björkman P, Säll C, Mellgren Å, Lindholm A, Kuylenstierna N, Montelius R, Azimi F, Johansson B, Carlsson M, Johansson E, Ljungberg B, Ekvall H, Strand A, Mäkitalo S, Öberg S, Holmblad P, Höfer M, Holmberg H, Josefson P, Ryding U. Transmission of HIV Drug Resistance and the Predicted Effect on Current First-line Regimens in Europe. Clin Infect Dis 2015; 62:655-663. [PMID: 26620652 PMCID: PMC4741360 DOI: 10.1093/cid/civ963] [Citation(s) in RCA: 118] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 11/06/2015] [Indexed: 11/13/2022] Open
Abstract
Transmitted human immunodeficiency virus drug resistance in Europe is stable at around 8%. The impact of baseline mutation patterns on susceptibility to antiretroviral drugs should be addressed using clinical guidelines. The impact on baseline susceptibility is largest for nonnucleoside reverse transcriptase inhibitors. Background. Numerous studies have shown that baseline drug resistance patterns may influence the outcome of antiretroviral therapy. Therefore, guidelines recommend drug resistance testing to guide the choice of initial regimen. In addition to optimizing individual patient management, these baseline resistance data enable transmitted drug resistance (TDR) to be surveyed for public health purposes. The SPREAD program systematically collects data to gain insight into TDR occurring in Europe since 2001. Methods. Demographic, clinical, and virological data from 4140 antiretroviral-naive human immunodeficiency virus (HIV)–infected individuals from 26 countries who were newly diagnosed between 2008 and 2010 were analyzed. Evidence of TDR was defined using the WHO list for surveillance of drug resistance mutations. Prevalence of TDR was assessed over time by comparing the results to SPREAD data from 2002 to 2007. Baseline susceptibility to antiretroviral drugs was predicted using the Stanford HIVdb program version 7.0. Results. The overall prevalence of TDR did not change significantly over time and was 8.3% (95% confidence interval, 7.2%–9.5%) in 2008–2010. The most frequent indicators of TDR were nucleoside reverse transcriptase inhibitor (NRTI) mutations (4.5%), followed by nonnucleoside reverse transcriptase inhibitor (NNRTI) mutations (2.9%) and protease inhibitor mutations (2.0%). Baseline mutations were most predictive of reduced susceptibility to initial NNRTI-based regimens: 4.5% and 6.5% of patient isolates were predicted to have resistance to regimens containing efavirenz or rilpivirine, respectively, independent of current NRTI backbones. Conclusions. Although TDR was highest for NRTIs, the impact of baseline drug resistance patterns on susceptibility was largest for NNRTIs. The prevalence of TDR assessed by epidemiological surveys does not clearly indicate to what degree susceptibility to different drug classes is affected.
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Acero F, Ackermann M, Ajello M, Albert A, Atwood WB, Axelsson M, Baldini L, Ballet J, Barbiellini G, Bastieri D, Belfiore A, Bellazzini R, Bissaldi E, Blandford RD, Bloom ED, Bogart JR, Bonino R, Bottacini E, Bregeon J, Britto RJ, Bruel P, Buehler R, Burnett TH, Buson S, Caliandro GA, Cameron RA, Caputo R, Caragiulo M, Caraveo PA, Casandjian JM, Cavazzuti E, Charles E, Chaves RCG, Chekhtman A, Cheung CC, Chiang J, Chiaro G, Ciprini S, Claus R, Tanugi JC, Cominsky LR, Conrad J, Cutini S, D’Ammando F, Angelis AD, DeKlotz M, Palma FD, Desiante R, Digel SW, Venere LD, Drell PS, Dubois R, Dumora D, Favuzzi C, Fegan SJ, Ferrara EC, Finke J, Franckowiak A, Fukazawa Y, Funk S, Fusco P, Gargano F, Gasparrini D, Giebels B, Giglietto N, Giommi P, Giordano F, Giroletti M, Glanzman T, Godfrey G, Grenier IA, Grondin MH, Grove JE, Guillemot L, Guiriec S, Hadasch D, Harding AK, Hays E, Hewitt JW, Hill AB, Horan D, Iafrate G, Jogler T, Jóhannesson G, Johnson RP, Johnson AS, Johnson TJ, Johnson WN, Kamae T, Kataoka J, Katsuta J, Kuss M, Mura GL, Landriu D, Larsson S, Latronico L, Goumard ML, Li J, Li L, Longo F, Loparco F, Lott B, Lovellette MN, Lubrano P, Madejski GM, Massaro F, Mayer M, Mazziotta MN, McEnery JE, Michelson PF, Mirabal N, Mizuno T, Moiseev AA, Mongelli M, Monzani ME, Morselli A, Moskalenko IV, Murgia S, Nuss E, Ohno M, Ohsugi T, Omodei N, Orienti M, Orlando E, Ormes JF, Paneque D, Panetta JH, Perkins JS, Rollins MP, Piron F, Pivato G, Porter TA, Racusin JL, Rando R, Razzano M, Razzaque S, Reimer A, Reimer O, Reposeur T, Rochester LS, Romani RW, Salvetti D, Conde MS, Parkinson PMS, Schulz A, Siskind EJ, Smith DA, Spada F, Spandre G, Spinelli P, Stephens TE, Strong AW, Suson DJ, Takahashi H, Takahashi T, Tanaka Y, Thayer JG, Thayer JB, Thompson DJ, Tibaldo L, Tibolla O, Torres DF, Torresi E, Tosti G, Troja E, Klaveren BV, Vianello G, Winer BL, Wood KS, Wood M, Zimmer S. FERMI
LARGE AREA TELESCOPE THIRD SOURCE CATALOG. ACTA ACUST UNITED AC 2015. [DOI: 10.1088/0067-0049/218/2/23] [Citation(s) in RCA: 1146] [Impact Index Per Article: 127.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Parodis I, Zickert A, Sundelin B, Axelsson M, Gerhardsson J, Svenungsson E, Malmström V, Gunnarsson I. Evaluation of B lymphocyte stimulator and a proliferation inducing ligand as candidate biomarkers in lupus nephritis based on clinical and histopathological outcome following induction therapy. Lupus Sci Med 2015; 2:e000061. [PMID: 25632350 PMCID: PMC4305068 DOI: 10.1136/lupus-2014-000061] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 11/28/2014] [Accepted: 12/29/2014] [Indexed: 01/20/2023]
Abstract
Objectives Lupus nephritis (LN) is a major cause of morbidity in patients with systemic lupus erythematosus (SLE). B cells have a central role in the pathogenesis of SLE. B lymphocyte stimulator (BLyS) and a proliferation inducing ligand (APRIL) are pivotal in B cell homeostasis. We aimed to investigate a potential role of serum BLyS and APRIL as biomarkers in LN, especially as predictors of treatment response. Methods Sixty-four patients with active LN (52 proliferative lupus nephritis (PLN); 12 membranous LN) were included. Renal biopsies were performed at baseline and after immunosuppressive treatment. Serum levels of BLyS, APRIL and autoantibodies were measured on both biopsy occasions and in 64 individually matched controls. Renal biopsies were evaluated using the International Society of Nephrology/Renal Pathology Society classification, and scored for Activity Index and Chronicity Index. Clinical responders (CR) were required to have ≥50% reduction in proteinuria, normal or improved renal function, and inactive urinary sediment. Histopathological responders (HR) were required to have ≥50% improvement in Activity Index. Results Baseline BLyS levels were significantly higher in LN patients compared with controls (p<0.001) and remained unchanged following induction treatment. APRIL levels were significantly higher in patients compared with controls at baseline (p=0.005) and decreased following treatment (p<0.001). Among PLN patients, APRIL levels decreased significantly only in responders (CR: p=0.009; HR: p=0.01). Baseline BLyS levels <1.5 ng/mL predicted treatment response, attaining a positive predictive value of 92% for CR with PLN at baseline. Conclusions BLyS and APRIL were affected differently by immunosuppression; BLyS levels remained unchanged following therapy while APRIL levels decreased. Despite unchanged BLyS levels following therapy, low baseline levels predicted both clinical and histopathological improvement. Our data support APRIL as a candidate biomarker of renal disease activity in lupus patients with proliferative glomerulonephritis and point to low baseline BLyS levels predicting treatment response in LN, especially in PLN.
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Hammenstig D, Sandblom E, Axelsson M, Johnsson JI. Effects of rearing density and dietary fat content on burst-swim performance and oxygen transport capacity in juvenile Atlantic salmon Salmo salar. JOURNAL OF FISH BIOLOGY 2014; 85:1177-1191. [PMID: 25200031 DOI: 10.1111/jfb.12511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 07/28/2014] [Indexed: 06/03/2023]
Abstract
The effects of hatchery rearing density (conventional or one third of conventional density) and feeding regime (high or reduced dietary fat levels) on burst-swim performance and oxygen transport capacity were studied in hatchery-reared Atlantic salmon Salmo salar, using wild fish as a reference group. There was no effect of rearing density or food regime on swimming performance in parr and smolts. The maximum swimming speed of wild parr was significantly higher than that of hatchery-reared conspecifics, while no such difference remained at the smolt stage. In smolts, relative ventricle mass was higher in wild S. salar compared with hatchery-reared fish. Moreover, wild S. salar had lower maximum oxygen consumption following a burst-swim challenge than hatchery fish. There were no effects of hatchery treatment on maximum oxygen consumption or relative ventricle mass. Haemoglobin and haematocrit levels, however, were lower in low-density fish than in fish reared at conventional density. Furthermore, dorsal-fin damage, an indicator of aggression, was similar in low-density reared and wild fish and lower than in S. salar reared at conventional density. Together, these results suggest that reduced rearing density is more important than reduced dietary fat levels in producing an S. salar smolt suitable for supplementary release.
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Parodis I, Svenungsson E, Axelsson M, Gunnarsson I. AB0487 Decreased SLE Disease Activity and Corticosteroid Usage and NO Renal Flares during Belimumab Treatment. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.3876] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Parodis I, Zickert A, Axelsson M, Svenungsson E, Malmström V, Gunnarsson I. THU0530 Blys and APRIL in Lupus Nephritis: Correlations with Serology - Blys as A Non-Invasive Predictor of Response. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.3863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Behrens JW, Seth H, Axelsson M, Buchmann K. The parasitic copepod Lernaeocera branchialis negatively affects cardiorespiratory function in Gadus morhua. JOURNAL OF FISH BIOLOGY 2014; 84:1599-1606. [PMID: 24661216 DOI: 10.1111/jfb.12362] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Accepted: 01/29/2014] [Indexed: 06/03/2023]
Abstract
The parasitic copepod Lernaeocera branchialis had a negative effect on cardiorespiratory function in Atlantic cod Gadus morhua such that it caused pronounced cardiac dysfunction with irregular rhythm and reduced stroke amplitude compared with uninfected fish. In addition, parasite infection depressed the postprandial cardiac output and oxygen consumption.
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Ackermann M, Ajello M, Asano K, Atwood WB, Axelsson M, Baldini L, Ballet J, Barbiellini G, Baring MG, Bastieri D, Bechtol K, Bellazzini R, Bissaldi E, Bonamente E, Bregeon J, Brigida M, Bruel P, Buehler R, Burgess JM, Buson S, Caliandro GA, Cameron RA, Caraveo PA, Cecchi C, Chaplin V, Charles E, Chekhtman A, Cheung CC, Chiang J, Chiaro G, Ciprini S, Claus R, Cleveland W, Cohen-Tanugi J, Collazzi A, Cominsky LR, Connaughton V, Conrad J, Cutini S, D’Ammando F, de Angelis A, DeKlotz M, de Palma F, Dermer CD, Desiante R, Diekmann A, Di Venere L, Drell PS, Drlica-Wagner A, Favuzzi C, Fegan SJ, Ferrara EC, Finke J, Fitzpatrick G, Focke WB, Franckowiak A, Fukazawa Y, Funk S, Fusco P, Gargano F, Gehrels N, Germani S, Gibby M, Giglietto N, Giles M, Giordano F, Giroletti M, Godfrey G, Granot J, Grenier IA, Grove JE, Gruber D, Guiriec S, Hadasch D, Hanabata Y, Harding AK, Hayashida M, Hays E, Horan D, Hughes RE, Inoue Y, Jogler T, Jóhannesson G, Johnson WN, Kawano T, Knödlseder J, Kocevski D, Kuss M, Lande J, Larsson S, Latronico L, Longo F, Loparco F, Lovellette MN, Lubrano P, Mayer M, Mazziotta MN, McEnery JE, Michelson PF, Mizuno T, Moiseev AA, Monzani ME, Moretti E, Morselli A, Moskalenko IV, Murgia S, Nemmen R, Nuss E, Ohno M, Ohsugi T, Okumura A, Omodei N, Orienti M, Paneque D, Pelassa V, Perkins JS, Pesce-Rollins M, Petrosian V, Piron F, Pivato G, Porter TA, Racusin JL, Rainò S, Rando R, Razzano M, Razzaque S, Reimer A, Reimer O, Ritz S, Roth M, Ryde F, Sartori A, Parkinson PMS, Scargle JD, Schulz A, Sgrò C, Siskind EJ, Sonbas E, Spandre G, Spinelli P, Tajima H, Takahashi H, Thayer JG, Thayer JB, Thompson DJ, Tibaldo L, Tinivella M, Torres DF, Tosti G, Troja E, Usher TL, Vandenbroucke J, Vasileiou V, Vianello G, Vitale V, Winer BL, Wood KS, Yamazaki R, Younes G, Yu HF, Zhu SJ, Bhat PN, Briggs MS, Byrne D, Foley S, Goldstein A, Jenke P, Kippen RM, Kouveliotou C, McBreen S, Meegan C, Paciesas WS, Preece R, Rau A, Tierney D, van der Horst AJ, von Kienlin A, Wilson-Hodge C, Xiong S, Cusumano G, La Parola V, Cummings JR. Fermi-LAT Observations of the Gamma-Ray Burst GRB 130427A. Science 2014; 343:42-7. [DOI: 10.1126/science.1242353] [Citation(s) in RCA: 176] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Preece R, Burgess JM, von Kienlin A, Bhat PN, Briggs MS, Byrne D, Chaplin V, Cleveland W, Collazzi AC, Connaughton V, Diekmann A, Fitzpatrick G, Foley S, Gibby M, Giles M, Goldstein A, Greiner J, Gruber D, Jenke P, Kippen RM, Kouveliotou C, McBreen S, Meegan C, Paciesas WS, Pelassa V, Tierney D, van der Horst AJ, Wilson-Hodge C, Xiong S, Younes G, Yu HF, Ackermann M, Ajello M, Axelsson M, Baldini L, Barbiellini G, Baring MG, Bastieri D, Bellazzini R, Bissaldi E, Bonamente E, Bregeon J, Brigida M, Bruel P, Buehler R, Buson S, Caliandro GA, Cameron RA, Caraveo PA, Cecchi C, Charles E, Chekhtman A, Chiang J, Chiaro G, Ciprini S, Claus R, Cohen-Tanugi J, Cominsky LR, Conrad J, D'Ammando F, de Angelis A, de Palma F, Dermer CD, Desiante R, Digel SW, Di Venere L, Drell PS, Drlica-Wagner A, Favuzzi C, Franckowiak A, Fukazawa Y, Fusco P, Gargano F, Gehrels N, Germani S, Giglietto N, Giordano F, Giroletti M, Godfrey G, Granot J, Grenier IA, Guiriec S, Hadasch D, Hanabata Y, Harding AK, Hayashida M, Iyyani S, Jogler T, Jóhannesson G, Kawano T, Knödlseder J, Kocevski D, Kuss M, Lande J, Larsson J, Larsson S, Latronico L, Longo F, Loparco F, Lovellette MN, Lubrano P, Mayer M, Mazziotta MN, Michelson PF, Mizuno T, Monzani ME, Moretti E, Morselli A, Murgia S, Nemmen R, Nuss E, Nymark T, Ohno M, Ohsugi T, Okumura A, Omodei N, Orienti M, Paneque D, Perkins JS, Pesce-Rollins M, Piron F, Pivato G, Porter TA, Racusin JL, Rainò S, Rando R, Razzano M, Razzaque S, Reimer A, Reimer O, Ritz S, Roth M, Ryde F, Sartori A, Scargle JD, Schulz A, Sgrò C, Siskind EJ, Spandre G, Spinelli P, Suson DJ, Tajima H, Takahashi H, Thayer JG, Thayer JB, Tibaldo L, Tinivella M, Torres DF, Tosti G, Troja E, Usher TL, Vandenbroucke J, Vasileiou V, Vianello G, Vitale V, Werner M, Winer BL, Wood KS, Zhu S. The First Pulse of the Extremely Bright GRB 130427A: A Test Lab for Synchrotron Shocks. Science 2014; 343:51-4. [DOI: 10.1126/science.1242302] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Kuhle J, Malmeström C, Axelsson M, Plattner K, Yaldizli Ö, Derfuss T, Giovannoni G, Kappos L, Lycke J. Neurofilament light and heavy subunits compared as therapeutic biomarkers in multiple sclerosis. Acta Neurol Scand 2013; 128:e33-6. [PMID: 23763388 DOI: 10.1111/ane.12151] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Neurofilaments are promising biomarkers in multiple sclerosis (MS) and increased levels in cerebrospinal fluid (CSF) indicate axonal damage or degeneration. In a previous study, neurofilament light chain (NfL) levels in CSF of relapsing remitting (RR) patients with MS were normalized by natalizumab treatment. AIMS OF THE STUDY We compared the coherence between NfL and neurofilament heavy chain (NfH(SMI) (35) ) levels in longitudinal CSF samples in a subset of these patients. METHODS In 30 patients with RRMS, CSF was obtained prior to and following 12 months of natalizumab treatment. NfH(SMI) (35) was measured by an electrochemiluminescence-based immunoassay. NfL levels were determined previously by the UmanDiagnostics NF-light(®) assay. RESULTS NfH(SMI) (35) decreased in 73.3% and NfL in 90% of the patients following natalizumab treatment (32.4 vs 27.4 pg/ml, P = 0.002 and 820 vs 375 pg/ml, P < 0.0001). Patients experiencing a relapse showed higher NfH(SMI) (35) levels compared with patients in remission (47.7 vs 27.6 pg/ml, n = 8, P = 0.001). This difference was less obvious for NfL (1055 vs 725 pg/ml, P = 0.256). In patients in remission, NfL levels were lower following natalizumab treatment (830 vs 365 pg/ml, n = 20, P = 0.0002), whereas the same comparison failed significance for NfH(SMI) (35) (28.3 vs 26.9 pg/ml, P = 0.086). CONCLUSIONS We confirm previous findings, indicating reduced axonal damage under natalizumab treatment by measuring NfH(SMI) (35) , using an assay with independent methodology. In comparison with NfH(SMI) (35) , NfL changes were more pronounced and the treatment effect also included patients in remission. Our results suggest that NfL is superior over NfH(SMI) (35) as therapeutic biomarker and is a promising candidate to measure neuroaxonal damage in MS treatment trials.
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Parodis I, Axelsson M, Gunnarsson I. Belimumab for systemic lupus erythematosus: a practice-based view. Lupus 2013; 22:372-80. [PMID: 23553780 DOI: 10.1177/0961203313476154] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder with multiple organ involvement. B-lymphocyte activity plays a pivotal role in the development and course of the disease. A newly developed agent called belimumab has recently been approved to treat active, autoantibody positive SLE as an add-on to standard therapy. Specifically binding to soluble B-lymphocyte stimulator protein, it reduces the formation of immunoglobulins and autoantibodies. Its effects have been studied in one phase II and two phase III clinical trials, showing sustained improvement across various clinical indicators and no evidence of increased risk of serious adverse events. Further post-hoc analyses indicate that treatment with belimumab lowers levels of autoimmune antibodies, normalizes low complement and improves SLE activity predominantly in musculoskeletal and mucocutaneous organ domains. Further studies are needed to determine the efficacy of belimumab for patients with severe lupus nephritis and with active involvement of the central nervous system. The introduction of belimumab as the first biological drug approved for the management of SLE likely heralds a surge in the development and use of selectively addressed agents for this heterogeneous and complex disease.
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