201
|
|
202
|
|
203
|
Davis JM. Book Review: The Comprehensive Test of Phonological Processing (CTOPP). Journal of Psychoeducational Assessment 2016. [DOI: 10.1177/073428290302100109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
204
|
Leucht S, Davis JM. Second-generation antipsychotics and quality of life in schizophrenia. Lancet Psychiatry 2016; 3:694-695. [PMID: 27265549 DOI: 10.1016/s2215-0366(16)30093-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 05/05/2016] [Accepted: 05/09/2016] [Indexed: 11/24/2022]
Affiliation(s)
- Stefan Leucht
- Department of Psychiatry and Psychotherapy, Technische Universität München, Klinikum rechts der Isar, 81675 München, Germany.
| | - John M Davis
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| |
Collapse
|
205
|
Abstract
BACKGROUND Dose equivalents of antipsychotics are an important but difficult to define concept, because all methods have weaknesses and strongholds. METHODS We calculated dose equivalents based on defined daily doses (DDDs) presented by the World Health Organisation's Collaborative Center for Drug Statistics Methodology. Doses equivalent to 1mg olanzapine, 1mg risperidone, 1mg haloperidol, and 100mg chlorpromazine were presented and compared with the results of 3 other methods to define dose equivalence (the "minimum effective dose method," the "classical mean dose method," and an international consensus statement). RESULTS We presented dose equivalents for 57 first-generation and second-generation antipsychotic drugs, available as oral, parenteral, or depot formulations. Overall, the identified equivalent doses were comparable with those of the other methods, but there were also outliers. CONCLUSIONS The major strength of this method to define dose response is that DDDs are available for most drugs, including old antipsychotics, that they are based on a variety of sources, and that DDDs are an internationally accepted measure. The major limitations are that the information used to estimate DDDS is likely to differ between the drugs. Moreover, this information is not publicly available, so that it cannot be reviewed. The WHO stresses that DDDs are mainly a standardized measure of drug consumption, and their use as a measure of dose equivalence can therefore be misleading. We, therefore, recommend that if alternative, more "scientific" dose equivalence methods are available for a drug they should be preferred to DDDs. Moreover, our summary can be a useful resource for pharmacovigilance studies.
Collapse
Affiliation(s)
| | - Myrto Samara
- Department of Psychiatry and Psychotherapy, Technische Universität München, Munich, Germany
| | - Stephan Heres
- Department of Psychiatry and Psychotherapy, Technische Universität München, Munich, Germany
| | - John M Davis
- Psychiatric Institute, University of Illinois at Chicago, Chicago, IL; Maryland Psychiatric Research Center, University of Maryland, Baltimore, MD
| |
Collapse
|
206
|
Zamora-Legoff JA, Achenbach SJ, Crowson CS, Krause ML, Davis JM, Matteson EL. Opioid use in patients with rheumatoid arthritis 2005-2014: a population-based comparative study. Clin Rheumatol 2016; 35:1137-44. [PMID: 27022929 PMCID: PMC4850553 DOI: 10.1007/s10067-016-3239-4] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 03/18/2016] [Accepted: 03/18/2016] [Indexed: 01/03/2023]
Abstract
Opioid prescriptions have seen an increase across the USA, Canada, Europe, and the UK. In the USA, they have quadrupled from 1999 to 2010. Opioid use among patients with rheumatoid arthritis (RA) over time is not well described. This study examined trends of opioid use in patients with RA. Retrospective prescription data was examined from 2005 to 2014 in a population-based incidence cohort of patients with RA by 1987 ACR criteria and comparable non-RA subjects. Differences in opioid use were examined with Poisson models. A total of 501 patients with RA (71 % female) and 532 non-RA subjects (70 % female) were included in the study. Total and chronic opioid use in 2014 was substantial in both cohorts 40 % RA vs 24 % non-RA and 12 % RA vs. 4 % non-RA, respectively. Opioid use increased by 19 % per year in both cohorts during the study period (95 % confidence interval [CI] 1.15, 1.25). Relative risk (RR) of chronic opiate use for RA patients compared to non-RA subjects was highest in adults aged 50-64 years (RR 2.82; 95 % CI 1.43-6.23). RA disease characteristics, biologic use at index, treated depression/fibromyalgia, education, and smoking status were not significantly associated with chronic opiate use. Over a third of patients with RA use opioids in some form, and in more than a tenth use is chronic. Use has increased in recent years. Patients aged 50-64 with RA use substantially more opioids than their non-RA counterparts.
Collapse
Affiliation(s)
| | - Sara J Achenbach
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Cynthia S Crowson
- Division of Rheumatology, Mayo Clinic College of Medicine, Rochester, MN, USA
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Megan L Krause
- Division of Rheumatology, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - John M Davis
- Division of Rheumatology, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Eric L Matteson
- Division of Rheumatology, Mayo Clinic College of Medicine, Rochester, MN, USA.
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, USA.
| |
Collapse
|
207
|
Affiliation(s)
- John M Davis
- Department of Psychiatry, University of Illinois at Chicago, 1601 W. Taylor St, Chicago, IL 60612
| |
Collapse
|
208
|
Chen J, Wright K, Davis JM, Jeraldo P, Marietta EV, Murray J, Nelson H, Matteson EL, Taneja V. An expansion of rare lineage intestinal microbes characterizes rheumatoid arthritis. Genome Med 2016; 8:43. [PMID: 27102666 PMCID: PMC4840970 DOI: 10.1186/s13073-016-0299-7] [Citation(s) in RCA: 496] [Impact Index Per Article: 62.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 04/08/2016] [Indexed: 12/30/2022] Open
Abstract
Background The adaptive immune response in rheumatoid arthritis (RA) is influenced by an interaction between host genetics and environment, particularly the host microbiome. Association of the gut microbiota with various diseases has been reported, though the specific components of the microbiota that affect the host response leading to disease remain unknown. However, there is limited information on the role of gut microbiota in RA. In this study we aimed to define a microbial and metabolite profile that could predict disease status. In addition, we aimed to generate a humanized model of arthritis to confirm the RA-associated microbe. Methods To identify an RA biomarker profile, the 16S ribosomal DNA of fecal samples from RA patients, first-degree relatives (to rule out environment/background as confounding factors), and random healthy non-RA controls were sequenced. Analysis of metabolites and their association with specific taxa was performed to investigate a potential mechanistic link. The role of an RA-associated microbe was confirmed using a human epithelial cell line and a humanized mouse model of arthritis. Results Patients with RA exhibited decreased gut microbial diversity compared with controls, which correlated with disease duration and autoantibody levels. A taxon-level analysis suggested an expansion of rare taxa, Actinobacteria, with a decrease in abundant taxa in patients with RA compared with controls. Prediction models based on the random forests algorithm suggested that three genera, Collinsella, Eggerthella, and Faecalibacterium, segregated with RA. The abundance of Collinsella correlated strongly with high levels of alpha-aminoadipic acid and asparagine as well as production of the proinflammatory cytokine IL-17A. A role for Collinsella in altering gut permeability and disease severity was confirmed in experimental arthritis. Conclusions These observations suggest dysbiosis in RA patients resulting from the abundance of certain rare bacterial lineages. A correlation between the intestinal microbiota and metabolic signatures could determine a predictive profile for disease causation and progression. Electronic supplementary material The online version of this article (doi:10.1186/s13073-016-0299-7) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Jun Chen
- Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Mayo Clinic, 200 First St. S.W., Rochester, MN, 55905, USA
| | - Kerry Wright
- Department of Medicine, Division of Rheumatology, Mayo Clinic, 200 First St. S.W., Rochester, MN, 55905, USA
| | - John M Davis
- Department of Medicine, Division of Rheumatology, Mayo Clinic, 200 First St. S.W., Rochester, MN, 55905, USA
| | - Patricio Jeraldo
- Department of Surgery, Mayo Clinic, 200 First St. S.W., Rochester, MN, 55905, USA
| | - Eric V Marietta
- Department of Gastroenterology, Mayo Clinic, 200 First St. S.W., Rochester, MN, 55905, USA
| | - Joseph Murray
- Department of Gastroenterology, Mayo Clinic, 200 First St. S.W., Rochester, MN, 55905, USA
| | - Heidi Nelson
- Department of Surgery, Mayo Clinic, 200 First St. S.W., Rochester, MN, 55905, USA
| | - Eric L Matteson
- Department of Medicine, Division of Rheumatology, Mayo Clinic, 200 First St. S.W., Rochester, MN, 55905, USA
| | - Veena Taneja
- Department of Immunology and Division of Rheumatology, Mayo Clinic, 200 First St. S.W., Rochester, MN, 55905, USA.
| |
Collapse
|
209
|
Abstract
BACKGROUND Risperidone is the first new generation antipsychotic drug made available in a long-acting injection formulation. OBJECTIVES To examine the effects of depot risperidone for treatment of schizophrenia or related psychoses in comparison with placebo, no treatment or other antipsychotic medication.To critically appraise and summarise current evidence on the resource use, cost and cost-effectiveness of risperidone (depot) for schizophrenia. SEARCH METHODS We searched the Cochrane Schizophrenia Group's Register (December 2002, 2012, and October 28, 2015). We also checked the references of all included studies, and contacted industry and authors of included studies. SELECTION CRITERIA Randomised clinical trials comparing depot risperidone with other treatments for people with schizophrenia and/or schizophrenia-like psychoses. DATA COLLECTION AND ANALYSIS Two review authors independently selected trials, assessed trial quality and extracted data. For dichotomous data, we calculated the risk ratio (RR), with 95% confidence interval (CI). For continuous data, we calculated mean differences (MD). We assessed risk of bias for included studies and created 'Summary of findings' tables using GRADE. MAIN RESULTS Twelve studies, with a total of 5723 participants were randomised to the following comparison treatments: Risperidone depot versus placebo Outcomes of relapse and improvement in mental state were neither measured or reported. In terms of other primary outcomes, more people receiving placebo left the study early by 12 weeks (1 RCT, n=400, RR 0.74 95% CI 0.63 to 0.88, very low quality evidence), experienced severe adverse events in short term (1 RCT, n=400, RR 0.59 95% CI 0.38 to 0.93, very low quality evidence). There was however, no difference in levels of weight gain between groups (1 RCT, n=400, RR 2.11 95% CI 0.48 to 9.18, very low quality evidence). Risperidone depot versus general oral antipsychotics The outcome of improvement in mental state was not presented due to high levels of attrition, nor were levels of severe adverse events explicitly reported. Most primary outcomes of interest showed no difference between treatment groups. However, more people receiving depot risperidone experienced nervous system disorders (long-term:1 RCT, n=369, RR 1.34 95% CI 1.13 to 1.58, very-low quality evidence). Risperidone depot versus oral risperidoneData for relapse and severe adverse events were not reported. All outcomes of interest were rated as moderate quality evidence. Main results showed no differences between treatment groups with equivocal data for change in mental state, numbers leaving the study early, any extrapyramidal symptoms, weight increase and prolactin-related adverse events. Risperidone depot versus oral quetiapine Relapse rates and improvement in mental state were not reported. Fewer people receiving risperidone depot left the study early (long-term: 1 RCT, n=666, RR 0.84 95% CI 0.74 to 0.95, moderate quality evidence). Experience of serious adverse events was similar between groups (low quality evidence), but more people receiving depot risperidone experienced EPS (1 RCT, n=666, RR 1.83 95% CI 1.07 to 3.15, low quality evidence), had greater weight gain (1 RCT, n=666, RR 1.25 95% CI 0.25 to 2.25, low quality evidence) and more prolactin-related adverse events (1 RCT, n=666, RR 3.07 95% CI 1.13 to 8.36, very low quality evidence). Risperidone depot versus oral aripiprazoleRelapse rates, mental state using PANSS, leaving the study early, serious adverse events and weight increase were similar between groups. However more people receiving depot risperidone experienced prolactin-related adverse events compared to those receiving oral aripiprazole (2 RCTs, n=729, RR 9.91 95% CI 2.78 to 35.29, very low quality of evidence). Risperidone depot versus oral olanzapineRelapse rates were not reported in any of the included studies for this comparison. Improvement in mental state using PANSS and instances of severe adverse events were similar between groups. More people receiving depot risperidone left the study early than those receiving oral olanzapine (1 RCT, n=618, RR 1.32 95% CI 1.10 to 1.58, low quality evidence) with those receiving risperidone depot also experiencing more extrapyramidal symptoms (1 RCT, n=547, RR 1.67 95% CI 1.19 to 2.36, low quality evidence). However, more people receiving oral olanzapine experienced weight increase (1 RCT, n=547, RR 0.56 95% CI 0.42 to 0.75, low quality evidence). Risperidone depot versus atypical depot antipsychotics (specifically paliperidone palmitate)Relapse rates were not reported and rates of response using PANSS, weight increase, prolactin-related adverse events and glucose-related adverse events were similar between groups. Fewer people left the study early due to lack of efficacy from the risperidone depot group (long term: 1 RCT, n=749, RR 0.60 95% CI 0.45 to 0.81, low quality evidence), but more people receiving depot risperidone required use of EPS-medication (2 RCTs, n=1666, RR 1.46 95% CI 1.18 to 1.8, moderate quality evidence). Risperidone depot versus typical depot antipsychoticsOutcomes of relapse, severe adverse events or movement disorders were not reported. Outcomes relating to improvement in mental state demonstrated no difference between groups (low quality evidence). However, more people receiving depot risperidone compared to other typical depots left the study early (long-term:1 RCT, n=62, RR 3.05 95% CI 1.12 to 8.31, low quality evidence). AUTHORS' CONCLUSIONS Depot risperidone may be more acceptable than placebo injection but it is hard to know if it is any more effective in controlling the symptoms of schizophrenia. The active drug, especially higher doses, may be associated with more movement disorders than placebo. People already stabilised on oral risperidone may continue to maintain benefit if treated with depot risperidone and avoid the need to take tablets, at least in the short term. In people who are happy to take oral medication the depot risperidone is approximately equal to oral risperidone. It is possible that the depot formulation, however, can bring a second-generation antipsychotic to people who do not reliably adhere to treatment. People with schizophrenia who have difficulty adhering to treatment, however, are unlikely to volunteer for a clinical trial. Such people may gain benefit from the depot risperidone with no increased risk of extrapyramidal side effects.
Collapse
Affiliation(s)
- Stephanie Sampson
- The University of NottinghamInstitute of Mental HealthUniversity of Nottingham Innovation Park, Jubilee CampusNottinghamUKNG7 2TU
| | - Prakash Hosalli
- Seacroft HospitalThe Newsam CentreYork RoadLeedsWest YorkshireUKLS14 6WB
| | - Vivek A Furtado
- University of WarwickDivision of Mental Health and Wellbeing, Warwick Medical SchoolGibbet Hill RoadCoventryWest MidlandsUKCV4 7AL
| | - John M Davis
- University of Illinois at Chicago1601 West Taylor StChicagoUSAIL 60612
| | | |
Collapse
|
210
|
Ramsden CE, Zamora D, Majchrzak-Hong S, Faurot KR, Broste SK, Frantz RP, Davis JM, Ringel A, Suchindran CM, Hibbeln JR. Re-evaluation of the traditional diet-heart hypothesis: analysis of recovered data from Minnesota Coronary Experiment (1968-73). BMJ 2016; 353:i1246. [PMID: 27071971 PMCID: PMC4836695 DOI: 10.1136/bmj.i1246] [Citation(s) in RCA: 219] [Impact Index Per Article: 27.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To examine the traditional diet-heart hypothesis through recovery and analysis of previously unpublished data from the Minnesota Coronary Experiment (MCE) and to put findings in the context of existing diet-heart randomized controlled trials through a systematic review and meta-analysis. DESIGN The MCE (1968-73) is a double blind randomized controlled trial designed to test whether replacement of saturated fat with vegetable oil rich in linoleic acid reduces coronary heart disease and death by lowering serum cholesterol. Recovered MCE unpublished documents and raw data were analyzed according to hypotheses prespecified by original investigators. Further, a systematic review and meta-analyses of randomized controlled trials that lowered serum cholesterol by providing vegetable oil rich in linoleic acid in place of saturated fat without confounding by concomitant interventions was conducted. SETTING One nursing home and six state mental hospitals in Minnesota, United States. PARTICIPANTS Unpublished documents with completed analyses for the randomized cohort of 9423 women and men aged 20-97; longitudinal data on serum cholesterol for the 2355 participants exposed to the study diets for a year or more; 149 completed autopsy files. INTERVENTIONS Serum cholesterol lowering diet that replaced saturated fat with linoleic acid (from corn oil and corn oil polyunsaturated margarine). Control diet was high in saturated fat from animal fats, common margarines, and shortenings. MAIN OUTCOME MEASURES Death from all causes; association between changes in serum cholesterol and death; and coronary atherosclerosis and myocardial infarcts detected at autopsy. RESULTS The intervention group had significant reduction in serum cholesterol compared with controls (mean change from baseline -13.8%v-1.0%; P<0.001). Kaplan Meier graphs showed no mortality benefit for the intervention group in the full randomized cohort or for any prespecified subgroup. There was a 22% higher risk of death for each 30 mg/dL (0.78 mmol/L) reduction in serum cholesterol in covariate adjusted Cox regression models (hazard ratio 1.22, 95% confidence interval 1.14 to 1.32; P<0.001). There was no evidence of benefit in the intervention group for coronary atherosclerosis or myocardial infarcts. Systematic review identified five randomized controlled trials for inclusion (n=10,808). In meta-analyses, these cholesterol lowering interventions showed no evidence of benefit on mortality from coronary heart disease (1.13, 0.83 to 1.54) or all cause mortality (1.07, 0.90 to 1.27). CONCLUSIONS Available evidence from randomized controlled trials shows that replacement of saturated fat in the diet with linoleic acid effectively lowers serum cholesterol but does not support the hypothesis that this translates to a lower risk of death from coronary heart disease or all causes. Findings from the Minnesota Coronary Experiment add to growing evidence that incomplete publication has contributed to overestimation of the benefits of replacing saturated fat with vegetable oils rich in linoleic acid.
Collapse
Affiliation(s)
- Christopher E Ramsden
- Section on Nutritional Neurosciences, Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA Department of Physical Medicine and Rehabilitation, Program on Integrative Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Daisy Zamora
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Sharon Majchrzak-Hong
- Section on Nutritional Neurosciences, Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Keturah R Faurot
- Department of Physical Medicine and Rehabilitation, Program on Integrative Medicine, University of North Carolina, Chapel Hill, NC, USA
| | | | - Robert P Frantz
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| | - John M Davis
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA Psychiatric Institute, University of Illinois at Chicago, Chicago, IL, USA
| | - Amit Ringel
- Section on Nutritional Neurosciences, Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Chirayath M Suchindran
- Department of Biostatistics, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Joseph R Hibbeln
- Section on Nutritional Neurosciences, Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| |
Collapse
|
211
|
Bell AF, Carter CS, Davis JM, Golding J, Adejumo O, Pyra M, Connelly JJ, Rubin LH. Childbirth and symptoms of postpartum depression and anxiety: a prospective birth cohort study. Arch Womens Ment Health 2016; 19:219-27. [PMID: 26202722 PMCID: PMC4938632 DOI: 10.1007/s00737-015-0555-7] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 07/08/2015] [Indexed: 01/06/2023]
Abstract
We investigated associations between aspects of childbirth and elevated postpartum symptoms of depression and anxiety. We employed secondary analysis of perinatal data (N = 4657-4946) from the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort. Multivariable logistic regression models (adjusted for covariates) examined predictors of elevated symptoms of postpartum depression and anxiety. Predictors included the following: type of delivery (normal physiological vs. interventive non-physiological), immediate postpartum complications, and maternal perception of the recent birth experience. The Edinburgh Postnatal Depression Scale assessed elevated symptoms of depression (score ≥ 13), and the Crown-Crisp Experiential Index assessed elevated symptoms of anxiety (score ≥ 9) at 2 and 8 months after delivery. A more negative perception of the recent birth experience was associated with elevated symptoms of anxiety at 2 months [odds ratio (OR) 1.52, 95 % confidence interval (CI) 1.25-1.85] and 8 months (OR 1.30, 95 % CI 1.06-1.60) postpartum but was not associated with elevated symptoms of depression at either time point. Type of delivery (physiological vs. non-physiological) and immediate postpartum complications were not associated with elevated symptoms of depression or anxiety. Our findings suggest that improving women's childbirth experience may decrease the likelihood of postpartum anxiety, but not postpartum depression.
Collapse
Affiliation(s)
- A F Bell
- Department of Women Children and Family Health Science, University of Illinois at Chicago, 845 S. Damen Ave, M/C 820, Chicago, IL, 60612, USA.
| | - C S Carter
- Kinsey Institute and Department of Biology, Morrison Hall 13, Indiana University, Bloomington, IN, 47405, USA
| | - J M Davis
- Department of Psychiatry, University of Illinois at Chicago, 1601 W. Taylor, Chicago, IL, 60612, USA
| | - J Golding
- Centre for Child and Adolescent Health, School of Social & Community Medicine, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
| | - O Adejumo
- Department of Women Children and Family Health Science, University of Illinois at Chicago, 845 S. Damen Ave, M/C 820, Chicago, IL, 60612, USA
| | - M Pyra
- Department of Psychiatry, University of Illinois at Chicago, 912 S. Wood St., M/C 913, Chicago, IL, 60612, USA
| | - J J Connelly
- Department of Psychology, University of Virginia, 102 Gilmer Hall, PO Box 400400, Charlottesville, VA, 22904, USA
| | - L H Rubin
- Department of Psychiatry, University of Illinois at Chicago, 912 S. Wood St., M/C 913, Chicago, IL, 60612, USA
| |
Collapse
|
212
|
Ramsden CE, Ringel A, Majchrzak-Hong SF, Yang J, Blanchard H, Zamora D, Loewke JD, Rapoport SI, Hibbeln JR, Davis JM, Hammock BD, Taha AY. Dietary linoleic acid-induced alterations in pro- and anti-nociceptive lipid autacoids: Implications for idiopathic pain syndromes? Mol Pain 2016; 12:1744806916636386. [PMID: 27030719 PMCID: PMC4955998 DOI: 10.1177/1744806916636386] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 01/06/2016] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Chronic idiopathic pain syndromes are major causes of personal suffering, disability, and societal expense. Dietary n-6 linoleic acid has increased markedly in modern industrialized populations over the past century. These high amounts of linoleic acid could hypothetically predispose to physical pain by increasing the production of pro-nociceptive linoleic acid-derived lipid autacoids and by interfering with the production of anti-nociceptive lipid autacoids derived from n-3 fatty acids. Here, we used a rat model to determine the effect of increasing dietary linoleic acid as a controlled variable for 15 weeks on nociceptive lipid autacoids and their precursor n-6 and n-3 fatty acids in tissues associated with idiopathic pain syndromes. RESULTS Increasing dietary linoleic acid markedly increased the abundance of linoleic acid and its pro-nociceptive derivatives and reduced the abundance of n-3 eicosapentaenoic acid and docosahexaenoic acid and their anti-nociceptive monoepoxide derivatives. Diet-induced changes occurred in a tissue-specific manner, with marked alterations of nociceptive lipid autacoids in both peripheral and central tissues, and the most pronounced changes in their fatty acid precursors in peripheral tissues. CONCLUSIONS The present findings provide biochemical support for the hypothesis that the high linoleic acid content of modern industrialized diets may create a biochemical susceptibility to develop chronic pain. Dietary linoleic acid lowering should be further investigated as part of an integrative strategy for the prevention and management of idiopathic pain syndromes.
Collapse
Affiliation(s)
- Christopher E Ramsden
- Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA Department of Physical Medicine and Rehabilitation, University of North Carolina-Chapel Hill, NC, USA
| | - Amit Ringel
- Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Sharon F Majchrzak-Hong
- Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Jun Yang
- Department of Entomology and Nematology, University of California-Davis, Davis, CA, USA UCD Comprehensive Cancer Center, University of California-Davis, Sacramento, CA, USA
| | | | - Daisy Zamora
- Department of Psychiatry, University of North Carolina-Chapel Hill, NC, USA
| | - James D Loewke
- Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Stanley I Rapoport
- UCD Comprehensive Cancer Center, University of California-Davis, Sacramento, CA, USA
| | - Joseph R Hibbeln
- Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - John M Davis
- Department of Psychiatry, University of North Carolina-Chapel Hill, NC, USA Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - Bruce D Hammock
- Department of Entomology and Nematology, University of California-Davis, Davis, CA, USA UCD Comprehensive Cancer Center, University of California-Davis, Sacramento, CA, USA
| | - Ameer Y Taha
- National Institute on Aging, Bethesda, MD, USA Department of Food Science and Technology, College of Agriculture and Environmental Sciences, University of California-Davis, Davis, CA, USA
| |
Collapse
|
213
|
Quick VBS, Davis JM, Olincy A, Sikela JM. DUF1220 copy number is associated with schizophrenia risk and severity: implications for understanding autism and schizophrenia as related diseases. Transl Psychiatry 2016; 6:e735. [PMID: 26859817 PMCID: PMC4872429 DOI: 10.1038/tp.2016.11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
|
214
|
Millis SZ, Davis JM, Ratliff SM, Ray ML, Schroeder WM, Townsend T, LoBello JR, Demeure MJ, Staren ED. Personalized medicine as a model of care to improve patient outcomes, communication, and reduce cost. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.3_suppl.e270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e270 Background: Cancer treatment based on an individual’s tumor profiling has been associated with increased time to progression. Despite this, adoption has been impeded by various technical, financial, legislative, and ethical issues. Implementation of a personalized medicine program into a healthcare system with a goal of improving patient outcomes includes clinician and patient education, increased tumor profiling of patients, data sharing/analysis, expanded research, and billing/reimbursement practices. Methods: A personalized medicine program was implemented at a hospital system. Measures of physician practice included attendance at genomic medicine education sessions, utilization of genetic/genomic tests, enrollment of patients into clinical trials, modifications in billing practices, and submission of data for analysis. Reimbursement of off-label pharmaceutical agents as well as use of aggregate data to inform treatment and enrollment in biomarker-based clinical trials was recorded. Frequency of genetic and/or genomic tests relative to physician and patient education and access to research opportunities was also assessed. Early patient outcomes, overall costs of care, access to clinical trials, and changes in knowledge and communication are also being monitored. Results: Although analysis is ongoing, the initial assessment indicates an increased utilization of genetic and genomic tests, clarity in billing practices, improved reimbursement for off label therapies, and consumption of educational opportunities from clinicians to patients/caregivers. Analysis of the first year implementation will be reported, including evaluation of preliminary results relative to quality of life and survivorship. Conclusions: Preliminary analysis of data from implementation of a personalized medicine program indicates that utilizing relevant education, research, aggressive billing and reimbursement processes, and IT infrastructure, can provide patients with the individual therapies which reduce cost and improve survivorship.
Collapse
Affiliation(s)
| | | | | | | | | | - Tim Townsend
- Ashion Advanced Individual Medicine, Phoenix, AZ
| | | | | | - Edgar Donald Staren
- Cancer Treatment Centers of America at Western Regional Medical Center, Goodyear, AZ
| |
Collapse
|
215
|
Collette TW, Skelton DM, Davis JM, Cavallin JE, Jensen KM, Kahl MD, Villeneuve DL, Ankley GT, Martinović-Weigelt D, Ekman DR. Metabolite profiles of repeatedly sampled urine from male fathead minnows (Pimephales promelas) contain unique lipid signatures following exposure to anti-androgens. Comp Biochem Physiol Part D Genomics Proteomics 2016; 19:190-198. [PMID: 26810197 DOI: 10.1016/j.cbd.2016.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 12/10/2015] [Accepted: 01/03/2016] [Indexed: 11/16/2022]
Abstract
The purpose of this study was twofold. First, we sought to identify candidate markers of exposure to anti-androgens by analyzing endogenous metabolite profiles in the urine of male fathead minnows (mFHM, Pimephales promelas). Based on earlier work, we hypothesized that unidentified lipids in the urine of mFHM were selectively responsive to exposure to androgen receptor antagonists, which is otherwise difficult to confirm using established fish toxicity assays. A second goal was to evaluate the feasibility of non-lethally and repeatedly sampling urine from individual mFHMs over the time course of response to a chemical exposure. Accordingly, we exposed mFHM to the model anti-androgens vinclozolin or flutamide. Urine was collected from each fish at 48hour intervals over the course of a 14day exposure. Parallel experiments were conducted with mFHM exposed to bisphenol A or control water. The frequent handling/sampling regime did not cause apparent adverse effects on the fish. Endogenous metabolite profiling was conducted with gas chromatography-mass spectrometry (GC-MS), which exhibited lower variation for the urinary metabolome than was found in earlier work with nuclear magnetic resonance (NMR) spectroscopy. Specifically, for inter- and intra-individual variations, the median spectrum-wide relative standard deviation (RSD) was 32.6% and 33.3%, respectively, for GC-MS analysis of urine from unexposed mFHM. These results compared favorably with similar measurements of urine from other model species, including the Sprague Dawley rat. In addition, GC-MS allowed us to identify several lipids (e.g., certain saturated fatty acids) in mFHM urine as candidate markers of exposure to androgen receptor antagonists.
Collapse
Affiliation(s)
| | - David M Skelton
- U.S. EPA, National Exposure Research Laboratory, Athens, GA 30605, USA
| | - John M Davis
- U.S. EPA, National Exposure Research Laboratory, Athens, GA 30605, USA
| | - Jenna E Cavallin
- U.S. EPA, National Health and Environmental Effects Research Laboratory, Duluth, MN 55804, USA
| | - Kathleen M Jensen
- U.S. EPA, National Health and Environmental Effects Research Laboratory, Duluth, MN 55804, USA
| | - Michael D Kahl
- U.S. EPA, National Health and Environmental Effects Research Laboratory, Duluth, MN 55804, USA
| | - Daniel L Villeneuve
- U.S. EPA, National Health and Environmental Effects Research Laboratory, Duluth, MN 55804, USA
| | - Gerald T Ankley
- U.S. EPA, National Health and Environmental Effects Research Laboratory, Duluth, MN 55804, USA
| | | | - Drew R Ekman
- U.S. EPA, National Exposure Research Laboratory, Athens, GA 30605, USA
| |
Collapse
|
216
|
Smith RC, Amiaz R, Si TM, Maayan L, Jin H, Boules S, Sershen H, Li C, Ren J, Liu Y, Youseff M, Lajtha A, Guidotti A, Weiser M, Davis JM. Varenicline Effects on Smoking, Cognition, and Psychiatric Symptoms in Schizophrenia: A Double-Blind Randomized Trial. PLoS One 2016; 11:e0143490. [PMID: 26730716 PMCID: PMC4701439 DOI: 10.1371/journal.pone.0143490] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 11/05/2015] [Indexed: 11/18/2022] Open
Abstract
UNLABELLED Schizophrenic patients have a high rate of smoking and cognitive deficits which may be related to a decreased number or responsiveness of nicotinic receptors in their brains. Varenicline is a partial nicotinic agonist which is effective as an antismoking drug in cigarette smokers, although concerns have been raised about potential psychiatric side-effects. We conducted a double-blind placebo controlled study in 87 schizophrenic smokers to evaluate the effects of varenicline (2 mg/day) on measures of smoking, cognition, psychiatric symptoms, and side-effects in schizophrenic patients who were cigarette smokers. Varenicline significantly decreased cotinine levels (P<0.001), and other objective and subjective measures of smoking (P < .01), and responses on a smoking urges scale (P = .02), more than placebo. Varenicline did not improve scores on a cognitive battery designed to test the effect of drugs on cognitive performance in schizophrenia (the MATRICS battery), either in overall MATRICS battery Composite or individual Domain scores, more than placebo. There were no significant differences between varenicline vs. placebo effects on total symptom scores on psychiatric rating scales, PANSS, SANS, or Calgary Depression scales, and there were no significant drug effects in any of these scales sub-scores when we used Benjamin-Hochberg corrected significance levels (α = .05). Varenicline patients did not show greater side-effects than placebo treated patients at any time point when controlled for baseline side-effect scores. Our study supports the use of varenicline as a safe drug for smoking reduction in schizophrenia but not as a cognitive enhancer. TRIAL REGISTRATION ClinicalTrials.gov 00802919.
Collapse
Affiliation(s)
- Robert C. Smith
- Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York, United States of America
- NYU Langone Medical Center, Department of Psychiatry, New York, New York, United States of America
| | - Revital Amiaz
- Chaim Sheba Medical Center, Ramat-Gan, Israel
- Sackler School of Medicine, Tel Aviv, Israel
| | - Tian-Mei Si
- Peking University Institute of Mental Health, The Key Laboratory for Mental Health, Ministry of Health, Beijing, China
| | - Lawrence Maayan
- Albany Medical Center, Albany, New York, United States of America
| | - Hua Jin
- University of California San Diego, Department of Psychiatry, San Diego, California, United States of America
- VA San Diego Healthcare System, San Diego, California, United States of America
| | - Sylvia Boules
- Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York, United States of America
| | - Henry Sershen
- Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York, United States of America
- NYU Langone Medical Center, Department of Psychiatry, New York, New York, United States of America
| | - Chunbo Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Juanjuan Ren
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yanhong Liu
- Peking University Institute of Mental Health, The Key Laboratory for Mental Health, Ministry of Health, Beijing, China
| | - Mary Youseff
- Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York, United States of America
| | - Abel Lajtha
- Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York, United States of America
- NYU Langone Medical Center, Department of Psychiatry, New York, New York, United States of America
| | - Alessandro Guidotti
- Psychiatric Institute University of Illinois, Chicago, Illinois, United States of America
| | - Mark Weiser
- Chaim Sheba Medical Center, Ramat-Gan, Israel
- Sackler School of Medicine, Tel Aviv, Israel
| | - John M. Davis
- Psychiatric Institute University of Illinois, Chicago, Illinois, United States of America
| |
Collapse
|
217
|
Cranford TL, Enos RT, Velázquez KT, McClellan JL, Davis JM, Singh UP, Nagarkatti M, Nagarkatti PS, Robinson CM, Murphy EA. Role of MCP-1 on inflammatory processes and metabolic dysfunction following high-fat feedings in the FVB/N strain. Int J Obes (Lond) 2015; 40:844-51. [PMID: 26620890 PMCID: PMC4854829 DOI: 10.1038/ijo.2015.244] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 09/22/2015] [Accepted: 10/10/2015] [Indexed: 12/20/2022]
Abstract
Background MCP-1 is known to be an important chemokine for macrophage recruitment. Thus, targeting MCP-1 may prevent the perturbations associated with macrophage-induced inflammation in adipose tissue. However, inconsistencies in the available animal literature have questioned the role of this chemokine in this process. The purpose of this study was to examine the role of MCP-1 on obesity-related pathologies. Methods Wild-type (WT) and MCP-1 deficient mice on an FVB/N background were assigned to either low-fat-diet (LFD) or high-fat-diet (HFD) treatment for a period of 16 weeks. Body weight and body composition were measured weekly and monthly, respectively. Fasting blood glucose and insulin, and glucose tolerance were measured at 16 weeks. Macrophages, T cell markers, inflammatory mediators, and markers of fibrosis were examined in the adipose tissue at sacrifice. Results As expected, HFD increased adiposity (body weight, fat mass, fat percent, and adipocyte size), metabolic dysfunction (impaired glucose metabolism and insulin resistance) macrophage number (CD11b+F480+ cells, and gene expression of EMR1 and CD11c), T cell markers (gene expression of CD4 and CD8), inflammatory mediators (pNFκB and pJNK, and mRNA expression of MCP-1, CCL5, CXCL14, TNF-α, and IL-6), and fibrosis (expression of IL-10, IL-13, TGF-β, and MMP2) (P<0.05). However, contrary to our hypothesis, MCP-1 deficiency exacerbated many of these responses resulting in a further increase in adiposity (body weight, fat mass, fat percent and adipocyte size), metabolic dysregulation, macrophage markers (EMR1), inflammatory cell infiltration, and fibrosis (formation of type I and III collagens, mRNA expression of IL-10 and MMP2) (P<0.05). Conclusions These data suggest that MCP-1 may be a necessary component of the inflammatory response required for adipose tissue protection, remodeling, and healthy expansion in the FVB/N strain in response to HFD feedings.
Collapse
Affiliation(s)
- T L Cranford
- Department of Pathology, Microbiology & Immunology, School of Medicine, University of South Carolina, Columbia, SC, USA
| | - R T Enos
- Department of Pathology, Microbiology & Immunology, School of Medicine, University of South Carolina, Columbia, SC, USA
| | - K T Velázquez
- Department of Pathology, Microbiology & Immunology, School of Medicine, University of South Carolina, Columbia, SC, USA
| | - J L McClellan
- Department of Pathology, Microbiology & Immunology, School of Medicine, University of South Carolina, Columbia, SC, USA
| | - J M Davis
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - U P Singh
- Department of Pathology, Microbiology & Immunology, School of Medicine, University of South Carolina, Columbia, SC, USA
| | - M Nagarkatti
- Department of Pathology, Microbiology & Immunology, School of Medicine, University of South Carolina, Columbia, SC, USA
| | - P S Nagarkatti
- Department of Pathology, Microbiology & Immunology, School of Medicine, University of South Carolina, Columbia, SC, USA
| | - C M Robinson
- Department of Biomedical Sciences, West Virginia School of Osteopathic Medicine, Lewisburg, WV, USA
| | - E A Murphy
- Department of Pathology, Microbiology & Immunology, School of Medicine, University of South Carolina, Columbia, SC, USA
| |
Collapse
|
218
|
Searles Quick VB, Davis JM, Olincy A, Sikela JM. DUF1220 copy number is associated with schizophrenia risk and severity: implications for understanding autism and schizophrenia as related diseases. Transl Psychiatry 2015; 5:e697. [PMID: 26670282 PMCID: PMC5068589 DOI: 10.1038/tp.2015.192] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 09/29/2015] [Accepted: 10/21/2015] [Indexed: 11/30/2022] Open
Abstract
The copy number of DUF1220, a protein domain implicated in human brain evolution, has been linearly associated with autism severity. Given the possibility that autism and schizophrenia are related disorders, the present study examined DUF1220 copy number variation in schizophrenia severity. There are notable similarities between autism symptoms and schizophrenia negative symptoms, and divergence between autism symptoms and schizophrenia positive symptoms. We therefore also examined DUF1220 copy number in schizophrenia subgroups defined by negative and positive symptom features, versus autistic individuals and controls. In the schizophrenic population (N=609), decreased DUF1220 copy number was linearly associated with increasing positive symptom severity (CON1 P=0.013, HLS1 P=0.0227), an association greatest in adult-onset schizophrenia (CON1 P=0.00155, HLS1 P=0.00361). In schizophrenic males, DUF1220 CON1 subtype copy number increase was associated with increased negative symptom severity (P=0.0327), a finding similar to that seen in autistic populations. Subgroup analyses demonstrated that schizophrenic individuals with predominantly positive symptoms exhibited reduced CON1 copy number compared with both controls (P=0.0237) and schizophrenic individuals with predominantly negative symptoms (P=0.0068). These findings support the view that (1) autism and schizophrenia exhibit both opposing and partially overlapping phenotypes and may represent a disease continuum, (2) variation in DUF1220 copy number contributes to schizophrenia disease risk and to the severity of both disorders, and (3) schizophrenia and autism may be, in part, a harmful by-product of the rapid and extreme evolutionary increase in DUF1220 copy number in the human species.
Collapse
Affiliation(s)
- V B Searles Quick
- Department of Biochemistry and Molecular Genetics, Human Medical Genetics and Genomics and Medical Scientist Training Programs, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - J M Davis
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - A Olincy
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - J M Sikela
- Department of Biochemistry and Molecular Genetics, Human Medical Genetics and Genomics and Medical Scientist Training Programs, University of Colorado Anschutz Medical Campus, Aurora, CO, USA,Department of Biochemistry and Molecular Genetics, Human Medical Genetics and Genomics and Medical Scientist Training Programs, University of Colorado Anschutz Medical Campus, 12801 E. 17th Avenue, Aurora, CO 80045, USA. E-mail:
| |
Collapse
|
219
|
Davis JM, Rosenbaum A, Shahinian V, Brosius FC. Prevention of lithium-associated renal failure: recent evidence. Lancet Psychiatry 2015; 2:1045-7. [PMID: 26613842 DOI: 10.1016/s2215-0366(15)00498-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 10/27/2015] [Indexed: 10/22/2022]
Affiliation(s)
- John M Davis
- Department of Psychiatry, University of Illinois at Chicago, 1601 West Taylor Street, Chicago, IL 60612, USA.
| | - Alan Rosenbaum
- University of Michigan, Ann Arbor, MI, USA; Wayne State University, Farmington Hills, MI, USA
| | | | | |
Collapse
|
220
|
Krause ML, Crowson CS, Bongartz T, Matteson EL, Michet CJ, Mason TG, Persellin ST, Gabriel SE, Davis JM. Determinants of Disability in Rheumatoid Arthritis: A Community-Based Cohort Study. Open Rheumatol J 2015; 9:88-93. [PMID: 26862353 PMCID: PMC4740964 DOI: 10.2174/1874312901409010088] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 08/04/2015] [Accepted: 08/28/2015] [Indexed: 11/22/2022] Open
Abstract
Longitudinal care of a community-based cohort of patients with rheumatoid arthritis (RA) was evaluated retrospectively. Candidate determinants of disability included visual analog scales (VAS) for patient global assessment and pain, comorbidities, and medications. The outcome was the 'patient-acceptable symptom state' for disability as defined by the Health Assessment Questionnaire (HAQ) disability index, using a cutoff of <1.04. Two-sample t tests and multivariable logistic regression were used to determine odds ratios (OR) for associations between predictor variables and disability. Out of a total of 99 patients, 28 (28%) patients had HAQ ≥1.04 at their last visit. The greatest odds of not attaining the patient-acceptable symptom state in a multivariable model was associated with corticosteroids (OR: 5.1; p=0.02), antidepressants (OR: 5.3; p=0.02), and female sex (OR: 6.5; p=0.05). In the era of biologic therapy, female sex, corticosteroids, and antidepressants remain profound determinants of disability highlighting the need to understand the underlying mechanisms.
Collapse
Affiliation(s)
| | - Cynthia S Crowson
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research
| | - Tim Bongartz
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Eric L Matteson
- Division of Rheumatology, Department of Medicine;; Division of Epidemiology, Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | | | | | | | - Sherine E Gabriel
- Division of Rheumatology, Department of Medicine;; Division of Epidemiology, Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - John M Davis
- Division of Rheumatology, Department of Medicine
| |
Collapse
|
221
|
Leucht S, Samara M, Heres S, Patel MX, Furukawa T, Cipriani A, Geddes J, Davis JM. Dose Equivalents for Second-Generation Antipsychotic Drugs: The Classical Mean Dose Method. Schizophr Bull 2015; 41:1397-402. [PMID: 25841041 PMCID: PMC4601707 DOI: 10.1093/schbul/sbv037] [Citation(s) in RCA: 163] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND The concept of dose equivalence is important for many purposes. The classical approach published by Davis in 1974 subsequently dominated textbooks for several decades. It was based on the assumption that the mean doses found in flexible-dose trials reflect the average optimum dose which can be used for the calculation of dose equivalence. We are the first to apply the method to second-generation antipsychotics. METHODS We searched for randomized, double-blind, flexible-dose trials in acutely ill patients with schizophrenia that examined 13 oral second-generation antipsychotics, haloperidol, and chlorpromazine (last search June 2014). We calculated the mean doses of each drug weighted by sample size and divided them by the weighted mean olanzapine dose to obtain olanzapine equivalents. RESULTS We included 75 studies with 16 555 participants. The doses equivalent to 1 mg/d olanzapine were: amisulpride 38.3 mg/d, aripiprazole 1.4 mg/d, asenapine 0.9 mg/d, chlorpromazine 38.9 mg/d, clozapine 30.6 mg/d, haloperidol 0.7 mg/d, quetiapine 32.3mg/d, risperidone 0.4 mg/d, sertindole 1.1 mg/d, ziprasidone 7.9 mg/d, zotepine 13.2 mg/d. For iloperidone, lurasidone, and paliperidone no data were available. CONCLUSIONS The classical mean dose method is not reliant on the limited availability of fixed-dose data at the lower end of the effective dose range, which is the major limitation of "minimum effective dose methods" and "dose-response curve methods." In contrast, the mean doses found by the current approach may have in part depended on the dose ranges chosen for the original trials. Ultimate conclusions on dose equivalence of antipsychotics will need to be based on a review of various methods.
Collapse
Affiliation(s)
- Stefan Leucht
- Department of Psychiatry and Psychotherapy, Technische Universität München Klinikum rechts der Isar, Ismaningerstr. 22, 81675 Munich, Germany; Institute of Psychiatry, Psychology and Neuroscience, King's College London, Department of Psychosis Studies, London, UK;
| | - Myrto Samara
- Department of Psychiatry and Psychotherapy, Technische Universität München Klinikum rechts der Isar, Ismaningerstr. 22, 81675 Munich, Germany
| | - Stephan Heres
- Department of Psychiatry and Psychotherapy, Technische Universität München Klinikum rechts der Isar, Ismaningerstr. 22, 81675 Munich, Germany
| | - Maxine X. Patel
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, Department of Psychosis Studies, London, UK
| | - Toshi Furukawa
- Departments of Health Promotion and Human Behavior and of Clinical Epidemiology, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | | | - John Geddes
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - John M. Davis
- Psychiatric Institute, University of Illinois at Chicago, Chicago, IL
| |
Collapse
|
222
|
Ungprasert P, Thongprayoon C, Davis JM. Indirect comparisons of the efficacy of biological agents in patients with psoriatic arthritis with an inadequate response to traditional disease-modifying anti-rheumatic drugs or to non-steroidal anti-inflammatory drugs: A meta-analysis. Semin Arthritis Rheum 2015; 45:428-38. [PMID: 26610638 DOI: 10.1016/j.semarthrit.2015.09.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 09/01/2015] [Accepted: 09/28/2015] [Indexed: 02/08/2023]
Abstract
BACKGROUND While the efficacy of biologic agents for the treatment of psoriatic arthritis (PsA) has been well demonstrated in randomized controlled trials (RCTs), the data on their relative efficacy is limited. This meta-analysis is aimed at assessing the comparative efficacy of these agents in patients who had persistently active disease despite traditional non-steroidal anti-inflammatory drugs (NSAIDs)/disease-modifying anti-rheumatic drugs (DMARDs), or who could not tolerate NSAIDs/DMARDs. METHODS RCTs examining the efficacy of biologic agents in patients with PsA who experienced inadequate response or intolerance of traditional DMARDs or NSAIDs were identified. If more than one RCT were available for a given biologic agent, the pooled risk ratio (RR) and 95% confidence interval (CI) of attaining a 20% improvement according to American College of Rheumatology criteria (ACR20) response across trials were calculated. The pooled risk ratios for each biologic agent were then compared using the indirect comparison technique. RESULTS A total of 12 RCTs were identified and included in the data analyses. We found that patients who received older TNF inhibitors (etanercept, infliximab, adalimumab, and golimumab) had a statistically significantly higher chance of achieving ACR20 response compared with apremilast, ustekinumab, and certolizumab. The likelihood of achieving ACR20 response among secukinumab users (at the dose of 150 mg and 300 mg weekly) was also higher compared with apremilast, ustekinumab, and certolizumab, though the relative risk did not always reach statistical significance. CONCLUSIONS Our study demonstrates that patients with PsA who experience inadequate response or intolerance of traditional DMARDs or NSAIDs have a higher probability of achieving the ACR20 response with older TNF inhibitors and secukinumab.
Collapse
Affiliation(s)
- Patompong Ungprasert
- Department of Internal Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905; Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
| | | | - John M Davis
- Department of Internal Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905
| |
Collapse
|
223
|
Leucht S, Helfer B, Gartlehner G, Davis JM. How effective are common medications: a perspective based on meta-analyses of major drugs. BMC Med 2015; 13:253. [PMID: 26431961 PMCID: PMC4592565 DOI: 10.1186/s12916-015-0494-1] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 09/18/2015] [Indexed: 12/15/2022] Open
Abstract
The vastness of clinical data and the progressing specialization of medical knowledge may lead to misinterpretation of medication efficacy. To show a realistic perspective on drug efficacy we present meta-analyses on some of the most commonly used pharmacological interventions. For each pharmacological intervention we present statistical indexes (absolute risk or response difference, percentage response ratio, mean difference, standardized mean difference) that are often used to represent efficacy. We found that some of the medications have relatively low effect sizes with only 11 out of 17 of them showing a minimal clinically important difference. Efficacy was often established based on surrogate outcomes and not the more relevant patient-oriented outcomes. As the interpretation of the efficacy of medication is complex, more training for physicians might be needed to get a more realistic view of drug efficacy. That could help prevent harmful overtreatment and reinforce an evidence-based, but personalized medicine.
Collapse
Affiliation(s)
- Stefan Leucht
- Department of Psychiatry and Psychotherapy, Technische Universität München, Klinikum rechts der Isar, Ismaninger Straße 22, 81675, Munich, Germany.
| | - Bartosz Helfer
- Department of Psychiatry and Psychotherapy, Technische Universität München, Klinikum rechts der Isar, Ismaninger Straße 22, 81675, Munich, Germany.
| | - Gerald Gartlehner
- Department for Evidence-based Medicine and Clinical Epidemiology, Danube University Krems, Krems an der Donau, Austria. .,RTI-International, Research Triangle Park, NC, USA.
| | - John M Davis
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA.
| |
Collapse
|
224
|
Smith RC, Boules S, Mattiuz S, Youssef M, Tobe RH, Sershen H, Lajtha A, Nolan K, Amiaz R, Davis JM. Effects of transcranial direct current stimulation (tDCS) on cognition, symptoms, and smoking in schizophrenia: A randomized controlled study. Schizophr Res 2015; 168:260-6. [PMID: 26190299 DOI: 10.1016/j.schres.2015.06.011] [Citation(s) in RCA: 130] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 06/10/2015] [Accepted: 06/12/2015] [Indexed: 12/11/2022]
Abstract
Schizophrenia is characterized by cognitive deficits which persist after acute symptoms have been treated or resolved. Transcranial direct current stimulation (tDCS) has been reported to improve cognition and reduce smoking craving in healthy subjects but has not been as carefully evaluated in a randomized controlled study for these effects in schizophrenia. We conducted a randomized double-blind, sham-controlled study of the effects of 5 sessions of tDCS (2 milliamps for 20minutes) on cognition, psychiatric symptoms, and smoking and cigarette craving in 37 outpatients with schizophrenia or schizoaffective disorder who were current smokers. Thirty subjects provided evaluable data on the MATRICS Consensus Cognitive Battery (MCCB), with the primary outcome measure, the MCCB Composite score. Active compared to sham tDCS subjects showed significant improvements after the fifth tDCS session in MCCB Composite score (p=0.008) and on the MCCB Working Memory (p=0.002) and Attention-Vigilance (p=0.027) domain scores, with large effect sizes. MCCB Composite and Working Memory domain scores remained significant at Benjamini-Hochberg corrected significance levels (α=0.05). There were no statistically significant effects on secondary outcome measures of psychiatric symptoms (PANSS scores), hallucinations, cigarette craving, or cigarettes smoked. The positive effects of tDCS on cognitive performance suggest a potential efficacious treatment for cognitive deficits in partially recovered chronic schizophrenia outpatients that should be further investigated.
Collapse
Affiliation(s)
- Robert C Smith
- Nathan S. Kline institute for Psychiatric Research, Orangeburg, New York, United states; Department of Psychiatry NYU Langone Medical Center, United States.
| | - Sylvia Boules
- Staten Island University Hospital, Staten Island, New York, United States.
| | - Sanela Mattiuz
- Nathan S. Kline institute for Psychiatric Research, Orangeburg, New York, United states.
| | - Mary Youssef
- Nathan S. Kline institute for Psychiatric Research, Orangeburg, New York, United states.
| | - Russell H Tobe
- Nathan S. Kline institute for Psychiatric Research, Orangeburg, New York, United states.
| | - Henry Sershen
- Nathan S. Kline institute for Psychiatric Research, Orangeburg, New York, United states.
| | - Abel Lajtha
- Nathan S. Kline institute for Psychiatric Research, Orangeburg, New York, United states.
| | - Karen Nolan
- Nathan S. Kline institute for Psychiatric Research, Orangeburg, New York, United states.
| | - Revital Amiaz
- Psychiatry Clinic, The Haim Sheba Medical Center, Affiliated to the Tel - Aviv University Sackler School of Medicine TEL-HASHOMER 52621, Israel.
| | - John M Davis
- University of Illinois College of Medicine Psychiatric Institute, Chicago, Illinois, United States.
| |
Collapse
|
225
|
Davis JM. Toward Quality of Cardiovascular Preventive Care for Patients with Rheumatic Diseases. J Rheumatol 2015; 42:1539-41. [PMID: 26330123 DOI: 10.3899/jrheum.150697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- John M Davis
- Consultant, Division of Rheumatology; Associate Professor of Medicine, College of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
| |
Collapse
|
226
|
Affiliation(s)
- John M. Davis
- Department of Psychiatry, University of Illinois at Chicago
| | - Christopher E. Ramsden
- National Institutes of Health, National Institute on Alcohol Abuse
and Alcoholism, Bethesda, Maryland
| |
Collapse
|
227
|
Bell AF, Carter CS, Steer CD, Golding J, Davis JM, Steffen AD, Rubin LH, Lillard TS, Gregory SP, Harris JC, Connelly JJ. Interaction between oxytocin receptor DNA methylation and genotype is associated with risk of postpartum depression in women without depression in pregnancy. Front Genet 2015; 6:243. [PMID: 26257770 PMCID: PMC4508577 DOI: 10.3389/fgene.2015.00243] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 07/02/2015] [Indexed: 01/23/2023] Open
Abstract
Postpartum depression (PPD) affects up to 19% of women, negatively impacting maternal and infant health. Reductions in plasma oxytocin levels have been associated with PPD and heritability studies have established a genetic contribution. Epigenetic regulation of the oxytocin receptor gene (OXTR) has been demonstrated and we hypothesized that individual epigenetic variability at OXTR may impact the development of PPD and that such variability may be central to predicting risk. This case-control study is nested within the Avon Longitudinal Study of Parents and Children and included 269 cases with PPD and 276 controls matched on age group, parity, and presence or absence of depressive symptoms in pregnancy as assessed by the Edinburgh Postnatal Depression Scale. OXTR DNA methylation (CpG site -934) and genotype (rs53576 and rs2254298) were assayed from DNA extracted from blood collected during pregnancy. Conditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association of elevated symptoms of PPD with genotype, methylation, and their interaction adjusted for psychosocial factors (n = 500). There was evidence of an interaction between rs53576 and methylation in the OXTR gene amongst women who did not have depression prenatally but developed PPD (p interaction = 0.026, adjusted for covariates, n = 257). Those women with GG genotype showed 2.63 greater odds of PPD for every 10% increase in methylation level (95% CI: 1.37, 5.03), whereas methylation was unrelated to PPD amongst "A" carriers (OR = 1.00, 95% CI: 0.58, 1.73). There was no such interaction among women with PPD and prenatal depression. These data indicate that epigenetic variation that decreases expression of OXTR in a susceptible genotype may play a contributory role in the etiology of PPD.
Collapse
Affiliation(s)
- Aleeca F. Bell
- Department of Women, Children and Family Health Science, College of Nursing, University of Illinois at Chicago, ChicagoIL, USA
| | - C. S. Carter
- Kinsey Institute and Department of Biology, Indiana University, BloomingtonIN, USA
| | - Colin D. Steer
- Centre for Child and Adolescent Health, School of Social and Community Medicine, University of BristolBristol, UK
| | - Jean Golding
- Centre for Child and Adolescent Health, School of Social and Community Medicine, University of BristolBristol, UK
| | - John M. Davis
- Department of Psychiatry, University of Illinois at Chicago, ChicagoIL, USA
| | - Alana D. Steffen
- Department of Women, Children and Family Health Science, College of Nursing, University of Illinois at Chicago, ChicagoIL, USA
| | - Leah H. Rubin
- Department of Psychiatry, University of Illinois at Chicago, ChicagoIL, USA
| | - Travis S. Lillard
- Department of Psychology, University of Virginia, CharlottesvilleVA, USA
| | - Steven P. Gregory
- Centre for Child and Adolescent Health, School of Social and Community Medicine, University of BristolBristol, UK
| | - James C. Harris
- Department of Psychiatry and Behavioral Sciences, Developmental Neuropsychiatry, Johns Hopkins University School of Medicine, BaltimoreMD, USA
| | | |
Collapse
|
228
|
Levine SZ, Goldberg Y, Samara M, Davis JM, Leucht S. Joint modeling of dropout and outcome in three pivotal clinical trials of schizophrenia. Schizophr Res 2015; 164:122-6. [PMID: 25790904 DOI: 10.1016/j.schres.2015.02.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2014] [Revised: 02/05/2015] [Accepted: 02/25/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Dropout is a serious challenge to clinical trials in psychiatry, yet standard outcome analyses with mixed models do not account for dropout, while joint modeling uses dropout from a survival model to adjust the outcome from a mixed model, but is untested in clinical trials of schizophrenia. AIMS To compare mixed and joint modeling in three acute phase pivotal placebo controlled trials of schizophrenia. METHOD Data were reanalyzed on 611 in-patients with acute schizophrenia who participated in three pivotal randomized controlled trials that compared placebo with olanzapine or risperidone (dropout rates placebo: 62.6% and medication: 37.4%). The outcome measures were BPRS or PANSS total change scores. Mixed-effects models for repeated measures and joint models were computed and compared to examine the time-treatment interaction. Effect size comparisons were made. RESULTS Antipsychotic treatment was superior to placebo across analyses. Time treatment interactions were significant (p<.05) for the mixed (beta=2.33) and joint models (beta=2.62). Compared with mixed modeling, joint modeling reduced the estimated change score for treatment (21.24 vs 19.74) and placebo (1.64 vs -1.11). The effect size differences between placebo and treatment groups were greater for joint (ES=.89) than mixed modeling (ES=0.83). Sensitivity analysis replicated this trend of results in each of the three trials. CONCLUSION Compared to mixed modeling, joint modeling results in a greater separation between treatment and placebo groups. This offers preliminary evidence that joint modeling may be useful in the analysis of antipsychotic placebo controlled RCTs.
Collapse
Affiliation(s)
| | | | - Myrto Samara
- Department of Psychiatry and Psychotherapy, Technische Universität München, Germany
| | - John M Davis
- Psychiatric Institute, University of Illinois at Chicago, USA
| | - Stefan Leucht
- Department of Psychiatry and Psychotherapy, Technische Universität München, Germany
| |
Collapse
|
229
|
|
230
|
Helfer B, Prosser A, Samara MT, Geddes JR, Cipriani A, Davis JM, Mavridis D, Salanti G, Leucht S. Recent meta-analyses neglect previous systematic reviews and meta-analyses about the same topic: a systematic examination. BMC Med 2015; 13:82. [PMID: 25889502 PMCID: PMC4411715 DOI: 10.1186/s12916-015-0317-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Accepted: 03/10/2015] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND As the number of systematic reviews is growing rapidly, we systematically investigate whether meta-analyses published in leading medical journals present an outline of available evidence by referring to previous meta-analyses and systematic reviews. METHODS We searched PubMed for recent meta-analyses of pharmacological treatments published in high impact factor journals. Previous systematic reviews and meta-analyses were identified with electronic searches of keywords and by searching reference sections. We analyzed the number of meta-analyses and systematic reviews that were cited, described and discussed in each recent meta-analysis. Moreover, we investigated publication characteristics that potentially influence the referencing practices. RESULTS We identified 52 recent meta-analyses and 242 previous meta-analyses on the same topics. Of these, 66% of identified previous meta-analyses were cited, 36% described, and only 20% discussed by recent meta-analyses. The probability of citing a previous meta-analysis was positively associated with its publication in a journal with a higher impact factor (odds ratio, 1.49; 95% confidence interval, 1.06 to 2.10) and more recent publication year (odds ratio, 1.19; 95% confidence interval 1.03 to 1.37). Additionally, the probability of a previous study being described by the recent meta-analysis was inversely associated with the concordance of results (odds ratio, 0.38; 95% confidence interval, 0.17 to 0.88), and the probability of being discussed was increased for previous studies that employed meta-analytic methods (odds ratio, 32.36; 95% confidence interval, 2.00 to 522.85). CONCLUSIONS Meta-analyses on pharmacological treatments do not consistently refer to and discuss findings of previous meta-analyses on the same topic. Such neglect can lead to research waste and be confusing for readers. Journals should make the discussion of related meta-analyses mandatory.
Collapse
Affiliation(s)
- Bartosz Helfer
- Department of Psychiatry and Psychotherapy, Technical University Munich, Klinikum rechts der Isar, Ismaningerstr 22, 81675, Munich, Germany.
| | - Aaron Prosser
- Complex Mental Illness Program, Centre for Addiction and Mental Health, Toronto, Canada.
| | - Myrto T Samara
- Department of Psychiatry and Psychotherapy, Technical University Munich, Klinikum rechts der Isar, Ismaningerstr 22, 81675, Munich, Germany.
| | - John R Geddes
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK.
| | - Andrea Cipriani
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK.
| | - John M Davis
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA.
| | - Dimitris Mavridis
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece. .,Department of Primary Education, University of Ioannina, Ioannina, Greece.
| | - Georgia Salanti
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece.
| | - Stefan Leucht
- Department of Psychiatry and Psychotherapy, Technical University Munich, Klinikum rechts der Isar, Ismaningerstr 22, 81675, Munich, Germany.
| |
Collapse
|
231
|
Lancaster K, Carter CS, Pournajafi-Nazarloo H, Karaoli T, Lillard TS, Jack A, Davis JM, Morris JP, Connelly JJ. Plasma oxytocin explains individual differences in neural substrates of social perception. Front Hum Neurosci 2015; 9:132. [PMID: 25852519 PMCID: PMC4362216 DOI: 10.3389/fnhum.2015.00132] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 02/26/2015] [Indexed: 01/10/2023] Open
Abstract
The neuropeptide oxytocin plays a critical role in social cognition and behavior. A number of studies using intranasal administration have demonstrated that oxytocin improves social perception. However, little is known about the relationship between individual differences in endogenous levels of oxytocin and social cognition. In the current study, we assessed the relationship between endogenous oxytocin and brain activity during an animacy perception paradigm. Thirty-seven male participants underwent scanning and provided a blood sample for oxytocin analysis. In line with previous research, perception of animacy was associated with activations in superior temporal sulcus, inferior frontal gyrus, and medial prefrontal cortex (mPFC). Notably, participants’ levels of plasma oxytocin robustly predicted activation in areas critical for social cognitive processes, such that higher oxytocin levels were related to increased activity in dorsal mPFC, ventral mPFC, dorsolateral PFC, superior temporal gyrus, and temporoparietal junction (TPJ), suggesting differential processing of social stimuli. Together these results show that stable variations in endogenous oxytocin levels explain individual differences in social perception.
Collapse
Affiliation(s)
- Katie Lancaster
- Department of Psychology, University of Virginia Charlottesville, VA, USA
| | - C Sue Carter
- Kinsey Institute and Department of Biology, Indiana University Bloomington, IN, USA
| | | | - Themistoclis Karaoli
- Robert M. Berne Cardiovascular Research Center, University of Virginia Charlottesville, VA, USA
| | - Travis S Lillard
- Department of Psychology, University of Virginia Charlottesville, VA, USA
| | - Allison Jack
- Yale Child Study Center, Yale University New Haven, CT, USA
| | - John M Davis
- Department of Psychiatry, University of Illinois at Chicago Chicago, IL, USA
| | - James P Morris
- Department of Psychology, University of Virginia Charlottesville, VA, USA
| | - Jessica J Connelly
- Department of Psychology, University of Virginia Charlottesville, VA, USA
| |
Collapse
|
232
|
Davis JM, Searles Quick VB, Sikela JM. Replicated linear association between DUF1220 copy number and severity of social impairment in autism. Hum Genet 2015; 134:569-75. [PMID: 25758905 DOI: 10.1007/s00439-015-1537-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Accepted: 02/27/2015] [Indexed: 11/25/2022]
Abstract
Sequences encoding DUF1220 protein domains exhibit an exceptional human-specific increase in copy number and have been associated with several phenotypes related to brain size. Autism is a highly heritable and heterogeneous condition characterized behaviorally by social and communicative impairments, and increased repetitive and stereotyped behavior. Given the accelerated brain growth pattern observed in many individuals with autism, and the association between DUF1220 subtype CON1 copy number and brain size, we previously investigated associations between CON1 copy number and autism-related symptoms. We determined that CON1 copy number increase is associated with increasing severity of all three behavioral features of autism. The present study sought to replicate these findings in an independent population (N = 166). Our results demonstrate a replication of the linear relationship between CON1 copy number and the severity of social impairment in individuals with autism as measured by Autism Diagnostic Interview-Revised Social Diagnostic Score, such that with each additional copy of CON1 Social Diagnostic Score increased 0.24 points (SE = 0.11, p = 0.036). We also identified an analogous trend between CON1 copy number and Communicative Diagnostic Score, but did not replicate the relationship between CON1 copy number and Repetitive Behavior Diagnostic Score. Interestingly, these associations appear to be most pronounced in multiplex children. These results, representing the first replication of a gene dosage relationship with the severity of a primary symptom of autism, lend further support to the possibility that the same protein domain family implicated in the evolutionary expansion of the human brain may also be involved in autism severity.
Collapse
Affiliation(s)
- J M Davis
- Department of Biochemistry and Molecular Genetics and Human Medical Genetics and Genomics, Medical Scientist Training and Neuroscience Programs, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, 80045, USA
| | | | | |
Collapse
|
233
|
Ekman DR, Skelton DM, Davis JM, Villeneuve DL, Cavallin JE, Schroeder A, Jensen KM, Ankley GT, Collette TW. Metabolite profiling of fish skin mucus: a novel approach for minimally-invasive environmental exposure monitoring and surveillance. Environ Sci Technol 2015; 49:3091-3100. [PMID: 25607249 DOI: 10.1021/es505054f] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The application of 'omics tools to biologically based monitoring and surveillance of aquatic environments shows considerable promise for complementing chemical monitoring in ecological risk assessments. However, few of the current approaches offer the ability to sample ecologically relevant species (e.g., fish) in a way that produces minimal impact on the health of the organism(s) under study. In the current study we employ liquid chromatography tandem mass spectrometry (LC-MS/MS) to assess the potential for skin mucus-based metabolomics for minimally invasive sampling of the fathead minnow (FHM; Pimephales promelas). Using this approach we were able to detect 204 distinct metabolites in the FHM skin mucus metabolome representing a large number of metabolite classes. An analysis of the sex specificity of the skin mucus metabolome showed it to be highly sexually dimorphic with 72 of the detected metabolites showing a statistically significant bias with regard to sex. Finally, in a proof-of-concept fashion we report on the use of skin mucus-based metabolomics to assess exposures in male and female fathead minnows to an environmentally relevant concentration of bisphenol A, a nearly ubiquitous environmental contaminant and an established endocrine active chemical.
Collapse
Affiliation(s)
- D R Ekman
- Ecosystems Research Division, U. S. EPA , 960 College Station Road, Athens, Georgia 30605, United States
| | | | | | | | | | | | | | | | | |
Collapse
|
234
|
Shao W, Adams CE, Cohen AM, Davis JM, McDonagh MS, Thakurta S, Yu PS, Smalheiser NR. Aggregator: a machine learning approach to identifying MEDLINE articles that derive from the same underlying clinical trial. Methods 2015; 74:65-70. [PMID: 25461812 PMCID: PMC4339517 DOI: 10.1016/j.ymeth.2014.11.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Revised: 10/27/2014] [Accepted: 11/05/2014] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE It is important to identify separate publications that report outcomes from the same underlying clinical trial, in order to avoid over-counting these as independent pieces of evidence. METHODS We created positive and negative training sets (comprised of pairs of articles reporting on the same condition and intervention) that were, or were not, linked to the same clinicaltrials.gov trial registry number. Features were extracted from MEDLINE and PubMed metadata; pairwise similarity scores were modeled using logistic regression. RESULTS Article pairs from the same trial were identified with high accuracy (F1 score=0.843). We also created a clustering tool, Aggregator, that takes as input a PubMed user query for RCTs on a given topic, and returns article clusters predicted to arise from the same clinical trial. DISCUSSION Although painstaking examination of full-text may be needed to be conclusive, metadata are surprisingly accurate in predicting when two articles derive from the same underlying clinical trial.
Collapse
Affiliation(s)
- Weixiang Shao
- Department of Computer Science, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Clive E Adams
- Division of Psychiatry, University of Nottingham, Nottingham, UK
| | - Aaron M Cohen
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA
| | - John M Davis
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Marian S McDonagh
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA
| | - Sujata Thakurta
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA
| | - Philip S Yu
- Department of Computer Science, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Neil R Smalheiser
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL 60612, USA.
| |
Collapse
|
235
|
Cohen AM, Smalheiser NR, McDonagh MS, Yu C, Adams CE, Davis JM, Yu PS. Automated confidence ranked classification of randomized controlled trial articles: an aid to evidence-based medicine. J Am Med Inform Assoc 2015; 22:707-17. [PMID: 25656516 PMCID: PMC4457112 DOI: 10.1093/jamia/ocu025] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 11/15/2014] [Indexed: 11/24/2022] Open
Abstract
Objective: For many literature review tasks, including systematic review (SR) and other aspects of evidence-based medicine, it is important to know whether an article describes a randomized controlled trial (RCT). Current manual annotation is not complete or flexible enough for the SR process. In this work, highly accurate machine learning predictive models were built that include confidence predictions of whether an article is an RCT. Materials and Methods: The LibSVM classifier was used with forward selection of potential feature sets on a large human-related subset of MEDLINE to create a classification model requiring only the citation, abstract, and MeSH terms for each article. Results: The model achieved an area under the receiver operating characteristic curve of 0.973 and mean squared error of 0.013 on the held out year 2011 data. Accurate confidence estimates were confirmed on a manually reviewed set of test articles. A second model not requiring MeSH terms was also created, and performs almost as well. Discussion: Both models accurately rank and predict article RCT confidence. Using the model and the manually reviewed samples, it is estimated that about 8000 (3%) additional RCTs can be identified in MEDLINE, and that 5% of articles tagged as RCTs in Medline may not be identified. Conclusion: Retagging human-related studies with a continuously valued RCT confidence is potentially more useful for article ranking and review than a simple yes/no prediction. The automated RCT tagging tool should offer significant savings of time and effort during the process of writing SRs, and is a key component of a multistep text mining pipeline that we are building to streamline SR workflow. In addition, the model may be useful for identifying errors in MEDLINE publication types. The RCT confidence predictions described here have been made available to users as a web service with a user query form front end at: http://arrowsmith.psych.uic.edu/cgi-bin/arrowsmith_uic/RCT_Tagger.cgi.
Collapse
Affiliation(s)
- Aaron M Cohen
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR 97239 USA
| | - Neil R Smalheiser
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL 60612 USA
| | - Marian S McDonagh
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR 97239 USA
| | - Clement Yu
- Department of Computer Science, University of Illinois at Chicago, Chicago, IL 60612 USA
| | - Clive E Adams
- Division of Psychiatry, University of Nottingham, Nottingham, UK
| | - John M Davis
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL 60612 USA
| | - Philip S Yu
- Department of Computer Science, University of Illinois at Chicago, Chicago, IL 60612 USA
| |
Collapse
|
236
|
Deng X, Crowson CS, Rajkumar SV, Dispenzieri A, Larson DR, Therneau TM, Matteson EL, Kyle RA, Katzmann JA, Gabriel SE, Davis JM. Elevation of serum immunoglobulin free light chains during the preclinical period of rheumatoid arthritis. J Rheumatol 2015; 42:181-7. [PMID: 25593227 DOI: 10.3899/jrheum.140543] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Immunoglobulin free light chains (FLC) represent biomarkers of B cell activity in rheumatoid arthritis (RA) and are associated with all-cause mortality in the general population. Our objective was to evaluate the relationships of serum FLC to preclinical disease, RA characteristics, and mortality in RA compared to non-RA subjects. METHODS A population-based study in Olmsted County, Minnesota, USA, was performed by crosslinking a large cohort in the general population having available serum FLC measurements with established RA incidence and prevalence cohorts. Serum κ, λ, and total FLC and their trends relative to RA incidence were compared between RA and non-RA subjects. Regression models were used to determine the associations between FLC, disease characteristics, and mortality, testing for differential effects of FLC on mortality in RA. RESULTS Among 16,609 subjects, 270 fulfilled the criteria for RA at the time of FLC measurement. Mean total FLC were significantly higher in RA compared to non-RA subjects (4.2 vs 3.3 mg/dl, p < 0.001). FLC became elevated 3-5 years before the clinical onset of RA and remained elevated during followup. Polyclonal FLC were found to predict higher mortality in persons with RA, though elevation to the highest decile had a relatively lower effect on mortality in RA compared to non-RA subjects. CONCLUSION Elevation of serum FLC precedes the development of RA and may be useful in monitoring B cell activity and disease progression. FLC are associated with mortality among patients with RA as well as the general population.
Collapse
Affiliation(s)
- Xiaoli Deng
- From the Department of Rheumatology and Immunology, Peking University Third Hospital, Beijing, China; Department of Health Sciences Research, Department of Medicine, and Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA.X. Deng, MD, Department of Rheumatology and Immunology, Peking University Third Hospital, and formerly Research Trainee, Division of Rheumatology, Departments of Medicine and Immunology, Mayo Clinic; C.S. Crowson, MS, Associate Professor of Medicine, Assistant Professor of Biostatistics; T.M. Therneau, PhD, Professor of Biostatistics, Division of Biomedical Statistics and Informatics, Department of Health Sciences Research; S.V. Rajkumar, MD, Professor of Medicine, Division of Hematology, Department of Medicine; A. Dispenzieri, MD, Professor of Medicine, Professor of Laboratory Medicine and Pathology; R.A. Kyle, MD, Professor of Medicine, Professor of Laboratory Medicine and Pathology, Division of Hematology, Department of Medicine; E.L. Matteson, MD, MPH, Professor of Medicine; S.E. Gabriel, MD, MSc, Professor of Epidemiology, Professor of Medicine, Division of Rheumatology, Department of Medicine, Division of Epidemiology, Department of Health Sciences Research; J.M. Davis III, MD, MS, Associate Professor of Medicine, Division of Rheumatology, Department of Medicine; J.A. Katzmann, PhD, Assistant Professor of Microbiology, Associate Professor of Laboratory Medicine and Pathology, Division of Clinical Biochemistry and Immunology, Department of Laboratory Medicine and Pathology, Mayo Clinic, and the Mayo Clinic College of Medicine; D.R. Larson, MS, Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic
| | - Cynthia S Crowson
- From the Department of Rheumatology and Immunology, Peking University Third Hospital, Beijing, China; Department of Health Sciences Research, Department of Medicine, and Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA.X. Deng, MD, Department of Rheumatology and Immunology, Peking University Third Hospital, and formerly Research Trainee, Division of Rheumatology, Departments of Medicine and Immunology, Mayo Clinic; C.S. Crowson, MS, Associate Professor of Medicine, Assistant Professor of Biostatistics; T.M. Therneau, PhD, Professor of Biostatistics, Division of Biomedical Statistics and Informatics, Department of Health Sciences Research; S.V. Rajkumar, MD, Professor of Medicine, Division of Hematology, Department of Medicine; A. Dispenzieri, MD, Professor of Medicine, Professor of Laboratory Medicine and Pathology; R.A. Kyle, MD, Professor of Medicine, Professor of Laboratory Medicine and Pathology, Division of Hematology, Department of Medicine; E.L. Matteson, MD, MPH, Professor of Medicine; S.E. Gabriel, MD, MSc, Professor of Epidemiology, Professor of Medicine, Division of Rheumatology, Department of Medicine, Division of Epidemiology, Department of Health Sciences Research; J.M. Davis III, MD, MS, Associate Professor of Medicine, Division of Rheumatology, Department of Medicine; J.A. Katzmann, PhD, Assistant Professor of Microbiology, Associate Professor of Laboratory Medicine and Pathology, Division of Clinical Biochemistry and Immunology, Department of Laboratory Medicine and Pathology, Mayo Clinic, and the Mayo Clinic College of Medicine; D.R. Larson, MS, Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic
| | - S Vincent Rajkumar
- From the Department of Rheumatology and Immunology, Peking University Third Hospital, Beijing, China; Department of Health Sciences Research, Department of Medicine, and Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA.X. Deng, MD, Department of Rheumatology and Immunology, Peking University Third Hospital, and formerly Research Trainee, Division of Rheumatology, Departments of Medicine and Immunology, Mayo Clinic; C.S. Crowson, MS, Associate Professor of Medicine, Assistant Professor of Biostatistics; T.M. Therneau, PhD, Professor of Biostatistics, Division of Biomedical Statistics and Informatics, Department of Health Sciences Research; S.V. Rajkumar, MD, Professor of Medicine, Division of Hematology, Department of Medicine; A. Dispenzieri, MD, Professor of Medicine, Professor of Laboratory Medicine and Pathology; R.A. Kyle, MD, Professor of Medicine, Professor of Laboratory Medicine and Pathology, Division of Hematology, Department of Medicine; E.L. Matteson, MD, MPH, Professor of Medicine; S.E. Gabriel, MD, MSc, Professor of Epidemiology, Professor of Medicine, Division of Rheumatology, Department of Medicine, Division of Epidemiology, Department of Health Sciences Research; J.M. Davis III, MD, MS, Associate Professor of Medicine, Division of Rheumatology, Department of Medicine; J.A. Katzmann, PhD, Assistant Professor of Microbiology, Associate Professor of Laboratory Medicine and Pathology, Division of Clinical Biochemistry and Immunology, Department of Laboratory Medicine and Pathology, Mayo Clinic, and the Mayo Clinic College of Medicine; D.R. Larson, MS, Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic
| | - Angela Dispenzieri
- From the Department of Rheumatology and Immunology, Peking University Third Hospital, Beijing, China; Department of Health Sciences Research, Department of Medicine, and Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA.X. Deng, MD, Department of Rheumatology and Immunology, Peking University Third Hospital, and formerly Research Trainee, Division of Rheumatology, Departments of Medicine and Immunology, Mayo Clinic; C.S. Crowson, MS, Associate Professor of Medicine, Assistant Professor of Biostatistics; T.M. Therneau, PhD, Professor of Biostatistics, Division of Biomedical Statistics and Informatics, Department of Health Sciences Research; S.V. Rajkumar, MD, Professor of Medicine, Division of Hematology, Department of Medicine; A. Dispenzieri, MD, Professor of Medicine, Professor of Laboratory Medicine and Pathology; R.A. Kyle, MD, Professor of Medicine, Professor of Laboratory Medicine and Pathology, Division of Hematology, Department of Medicine; E.L. Matteson, MD, MPH, Professor of Medicine; S.E. Gabriel, MD, MSc, Professor of Epidemiology, Professor of Medicine, Division of Rheumatology, Department of Medicine, Division of Epidemiology, Department of Health Sciences Research; J.M. Davis III, MD, MS, Associate Professor of Medicine, Division of Rheumatology, Department of Medicine; J.A. Katzmann, PhD, Assistant Professor of Microbiology, Associate Professor of Laboratory Medicine and Pathology, Division of Clinical Biochemistry and Immunology, Department of Laboratory Medicine and Pathology, Mayo Clinic, and the Mayo Clinic College of Medicine; D.R. Larson, MS, Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic
| | - Dirk R Larson
- From the Department of Rheumatology and Immunology, Peking University Third Hospital, Beijing, China; Department of Health Sciences Research, Department of Medicine, and Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA.X. Deng, MD, Department of Rheumatology and Immunology, Peking University Third Hospital, and formerly Research Trainee, Division of Rheumatology, Departments of Medicine and Immunology, Mayo Clinic; C.S. Crowson, MS, Associate Professor of Medicine, Assistant Professor of Biostatistics; T.M. Therneau, PhD, Professor of Biostatistics, Division of Biomedical Statistics and Informatics, Department of Health Sciences Research; S.V. Rajkumar, MD, Professor of Medicine, Division of Hematology, Department of Medicine; A. Dispenzieri, MD, Professor of Medicine, Professor of Laboratory Medicine and Pathology; R.A. Kyle, MD, Professor of Medicine, Professor of Laboratory Medicine and Pathology, Division of Hematology, Department of Medicine; E.L. Matteson, MD, MPH, Professor of Medicine; S.E. Gabriel, MD, MSc, Professor of Epidemiology, Professor of Medicine, Division of Rheumatology, Department of Medicine, Division of Epidemiology, Department of Health Sciences Research; J.M. Davis III, MD, MS, Associate Professor of Medicine, Division of Rheumatology, Department of Medicine; J.A. Katzmann, PhD, Assistant Professor of Microbiology, Associate Professor of Laboratory Medicine and Pathology, Division of Clinical Biochemistry and Immunology, Department of Laboratory Medicine and Pathology, Mayo Clinic, and the Mayo Clinic College of Medicine; D.R. Larson, MS, Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic
| | - Terry M Therneau
- From the Department of Rheumatology and Immunology, Peking University Third Hospital, Beijing, China; Department of Health Sciences Research, Department of Medicine, and Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA.X. Deng, MD, Department of Rheumatology and Immunology, Peking University Third Hospital, and formerly Research Trainee, Division of Rheumatology, Departments of Medicine and Immunology, Mayo Clinic; C.S. Crowson, MS, Associate Professor of Medicine, Assistant Professor of Biostatistics; T.M. Therneau, PhD, Professor of Biostatistics, Division of Biomedical Statistics and Informatics, Department of Health Sciences Research; S.V. Rajkumar, MD, Professor of Medicine, Division of Hematology, Department of Medicine; A. Dispenzieri, MD, Professor of Medicine, Professor of Laboratory Medicine and Pathology; R.A. Kyle, MD, Professor of Medicine, Professor of Laboratory Medicine and Pathology, Division of Hematology, Department of Medicine; E.L. Matteson, MD, MPH, Professor of Medicine; S.E. Gabriel, MD, MSc, Professor of Epidemiology, Professor of Medicine, Division of Rheumatology, Department of Medicine, Division of Epidemiology, Department of Health Sciences Research; J.M. Davis III, MD, MS, Associate Professor of Medicine, Division of Rheumatology, Department of Medicine; J.A. Katzmann, PhD, Assistant Professor of Microbiology, Associate Professor of Laboratory Medicine and Pathology, Division of Clinical Biochemistry and Immunology, Department of Laboratory Medicine and Pathology, Mayo Clinic, and the Mayo Clinic College of Medicine; D.R. Larson, MS, Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic
| | - Eric L Matteson
- From the Department of Rheumatology and Immunology, Peking University Third Hospital, Beijing, China; Department of Health Sciences Research, Department of Medicine, and Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA.X. Deng, MD, Department of Rheumatology and Immunology, Peking University Third Hospital, and formerly Research Trainee, Division of Rheumatology, Departments of Medicine and Immunology, Mayo Clinic; C.S. Crowson, MS, Associate Professor of Medicine, Assistant Professor of Biostatistics; T.M. Therneau, PhD, Professor of Biostatistics, Division of Biomedical Statistics and Informatics, Department of Health Sciences Research; S.V. Rajkumar, MD, Professor of Medicine, Division of Hematology, Department of Medicine; A. Dispenzieri, MD, Professor of Medicine, Professor of Laboratory Medicine and Pathology; R.A. Kyle, MD, Professor of Medicine, Professor of Laboratory Medicine and Pathology, Division of Hematology, Department of Medicine; E.L. Matteson, MD, MPH, Professor of Medicine; S.E. Gabriel, MD, MSc, Professor of Epidemiology, Professor of Medicine, Division of Rheumatology, Department of Medicine, Division of Epidemiology, Department of Health Sciences Research; J.M. Davis III, MD, MS, Associate Professor of Medicine, Division of Rheumatology, Department of Medicine; J.A. Katzmann, PhD, Assistant Professor of Microbiology, Associate Professor of Laboratory Medicine and Pathology, Division of Clinical Biochemistry and Immunology, Department of Laboratory Medicine and Pathology, Mayo Clinic, and the Mayo Clinic College of Medicine; D.R. Larson, MS, Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic
| | - Robert A Kyle
- From the Department of Rheumatology and Immunology, Peking University Third Hospital, Beijing, China; Department of Health Sciences Research, Department of Medicine, and Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA.X. Deng, MD, Department of Rheumatology and Immunology, Peking University Third Hospital, and formerly Research Trainee, Division of Rheumatology, Departments of Medicine and Immunology, Mayo Clinic; C.S. Crowson, MS, Associate Professor of Medicine, Assistant Professor of Biostatistics; T.M. Therneau, PhD, Professor of Biostatistics, Division of Biomedical Statistics and Informatics, Department of Health Sciences Research; S.V. Rajkumar, MD, Professor of Medicine, Division of Hematology, Department of Medicine; A. Dispenzieri, MD, Professor of Medicine, Professor of Laboratory Medicine and Pathology; R.A. Kyle, MD, Professor of Medicine, Professor of Laboratory Medicine and Pathology, Division of Hematology, Department of Medicine; E.L. Matteson, MD, MPH, Professor of Medicine; S.E. Gabriel, MD, MSc, Professor of Epidemiology, Professor of Medicine, Division of Rheumatology, Department of Medicine, Division of Epidemiology, Department of Health Sciences Research; J.M. Davis III, MD, MS, Associate Professor of Medicine, Division of Rheumatology, Department of Medicine; J.A. Katzmann, PhD, Assistant Professor of Microbiology, Associate Professor of Laboratory Medicine and Pathology, Division of Clinical Biochemistry and Immunology, Department of Laboratory Medicine and Pathology, Mayo Clinic, and the Mayo Clinic College of Medicine; D.R. Larson, MS, Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic
| | - Jerry A Katzmann
- From the Department of Rheumatology and Immunology, Peking University Third Hospital, Beijing, China; Department of Health Sciences Research, Department of Medicine, and Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA.X. Deng, MD, Department of Rheumatology and Immunology, Peking University Third Hospital, and formerly Research Trainee, Division of Rheumatology, Departments of Medicine and Immunology, Mayo Clinic; C.S. Crowson, MS, Associate Professor of Medicine, Assistant Professor of Biostatistics; T.M. Therneau, PhD, Professor of Biostatistics, Division of Biomedical Statistics and Informatics, Department of Health Sciences Research; S.V. Rajkumar, MD, Professor of Medicine, Division of Hematology, Department of Medicine; A. Dispenzieri, MD, Professor of Medicine, Professor of Laboratory Medicine and Pathology; R.A. Kyle, MD, Professor of Medicine, Professor of Laboratory Medicine and Pathology, Division of Hematology, Department of Medicine; E.L. Matteson, MD, MPH, Professor of Medicine; S.E. Gabriel, MD, MSc, Professor of Epidemiology, Professor of Medicine, Division of Rheumatology, Department of Medicine, Division of Epidemiology, Department of Health Sciences Research; J.M. Davis III, MD, MS, Associate Professor of Medicine, Division of Rheumatology, Department of Medicine; J.A. Katzmann, PhD, Assistant Professor of Microbiology, Associate Professor of Laboratory Medicine and Pathology, Division of Clinical Biochemistry and Immunology, Department of Laboratory Medicine and Pathology, Mayo Clinic, and the Mayo Clinic College of Medicine; D.R. Larson, MS, Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic
| | - Sherine E Gabriel
- From the Department of Rheumatology and Immunology, Peking University Third Hospital, Beijing, China; Department of Health Sciences Research, Department of Medicine, and Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA.X. Deng, MD, Department of Rheumatology and Immunology, Peking University Third Hospital, and formerly Research Trainee, Division of Rheumatology, Departments of Medicine and Immunology, Mayo Clinic; C.S. Crowson, MS, Associate Professor of Medicine, Assistant Professor of Biostatistics; T.M. Therneau, PhD, Professor of Biostatistics, Division of Biomedical Statistics and Informatics, Department of Health Sciences Research; S.V. Rajkumar, MD, Professor of Medicine, Division of Hematology, Department of Medicine; A. Dispenzieri, MD, Professor of Medicine, Professor of Laboratory Medicine and Pathology; R.A. Kyle, MD, Professor of Medicine, Professor of Laboratory Medicine and Pathology, Division of Hematology, Department of Medicine; E.L. Matteson, MD, MPH, Professor of Medicine; S.E. Gabriel, MD, MSc, Professor of Epidemiology, Professor of Medicine, Division of Rheumatology, Department of Medicine, Division of Epidemiology, Department of Health Sciences Research; J.M. Davis III, MD, MS, Associate Professor of Medicine, Division of Rheumatology, Department of Medicine; J.A. Katzmann, PhD, Assistant Professor of Microbiology, Associate Professor of Laboratory Medicine and Pathology, Division of Clinical Biochemistry and Immunology, Department of Laboratory Medicine and Pathology, Mayo Clinic, and the Mayo Clinic College of Medicine; D.R. Larson, MS, Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic
| | - John M Davis
- From the Department of Rheumatology and Immunology, Peking University Third Hospital, Beijing, China; Department of Health Sciences Research, Department of Medicine, and Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA.X. Deng, MD, Department of Rheumatology and Immunology, Peking University Third Hospital, and formerly Research Trainee, Division of Rheumatology, Departments of Medicine and Immunology, Mayo Clinic; C.S. Crowson, MS, Associate Professor of Medicine, Assistant Professor of Biostatistics; T.M. Therneau, PhD, Professor of Biostatistics, Division of Biomedical Statistics and Informatics, Department of Health Sciences Research; S.V. Rajkumar, MD, Professor of Medicine, Division of Hematology, Department of Medicine; A. Dispenzieri, MD, Professor of Medicine, Professor of Laboratory Medicine and Pathology; R.A. Kyle, MD, Professor of Medicine, Professor of Laboratory Medicine and Pathology, Division of Hematology, Department of Medicine; E.L. Matteson, MD, MPH, Professor of Medicine; S.E. Gabriel, MD, MSc, Professor of Epidemiology, Professor of Medicine, Division of Rheumatology, Department of Medicine, Division of Epidemiology, Department of Health Sciences Research; J.M. Davis III, MD, MS, Associate Professor of Medicine, Division of Rheumatology, Department of Medicine; J.A. Katzmann, PhD, Assistant Professor of Microbiology, Associate Professor of Laboratory Medicine and Pathology, Division of Clinical Biochemistry and Immunology, Department of Laboratory Medicine and Pathology, Mayo Clinic, and the Mayo Clinic College of Medicine; D.R. Larson, MS, Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic.
| |
Collapse
|
237
|
Furukawa TA, Levine SZ, Tanaka S, Goldberg Y, Samara M, Davis JM, Cipriani A, Leucht S. Initial severity of schizophrenia and efficacy of antipsychotics: participant-level meta-analysis of 6 placebo-controlled studies. JAMA Psychiatry 2015; 72:14-21. [PMID: 25372935 DOI: 10.1001/jamapsychiatry.2014.2127] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Antipsychotic drugs constitute the mainstay in the treatment of schizophrenia, and their efficacy is well established in hundreds of randomized clinical trials. However, it is not known whether they are effective or how effective they are across the wide range of baseline symptom severity. OBJECTIVE To examine the influence of baseline severity of schizophrenia on the efficacy of antipsychotic drugs. DESIGN, SETTING, AND PARTICIPANTS Meta-analysis of participant-level data from 3 pivotal randomized trials of acute schizophrenia (n = 611) and 3 pivotal trials in patients with predominantly negative symptoms of schizophrenia (n = 475). INTERVENTIONS Olanzapine or risperidone vs placebo, and amisulpride vs placebo. MAIN OUTCOMES AND MEASURES Change scores on the Positive and Negative Syndrome Scale (PANSS; score range, 30-210) and the Scale for the Assessment of Negative Symptoms (SANS; score range, 0-125) up to 6 weeks after baseline. The relationship between baseline and change scores for the drug and placebo groups was examined with 8 competing mixed-effects models for repeated measures. RESULTS The best-fitting models showed that, for both types of patients, the interactions between baseline symptom severity and treatment were statistically significant (P < .01). The greater the baseline severity was, the greater the magnitude of the differences was between active treatment and placebo. In acute treatment, the mean differences in PANSS change scores were 9.5 points for patients who were mildly ill at baseline (baseline PANSS score of 58), 13.7 for moderately ill patients (baseline PANSS score of 75), 18.8 for markedly ill patients (baseline PANSS score of 95), and 24.0 for severely ill patients (baseline PANSS score of 116). In treatment of predominantly negative symptoms, the mean differences in SANS change scores were 1.7 for those who were moderately ill (baseline SANS score of 55), 5.7 for markedly ill patients (baseline SANS score of 70), and 9.7 for severely ill patients (baseline SANS score of 85). CONCLUSIONS AND RELEVANCE We can expect benefits of antipsychotic drugs for the full spectrum of patients likely to be treated for acute schizophrenia and for highly symptomatic patients with predominantly negative symptoms. Toward the mildest end of the spectrum, clinicians need to be aware that patients benefit less in terms of symptom improvement but may experience full adverse effects of antipsychotics. Clinicians also need to be aware that in addition to the treatment of active symptoms, which was the focus of this study, antipsychotics have another important action, namely to prevent relapses among patients in remission.
Collapse
Affiliation(s)
- Toshi A Furukawa
- Department of Health Promotion and Human Behavior, School of Public Health, Kyoto University Graduate School of Medicine, Kyoto, Japan2Department of Clinical Epidemiology, School of Public Health, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Stephen Z Levine
- Department of Community Mental Health, University of Haifa, Haifa, Israel
| | - Shiro Tanaka
- Department of Pharmacoepidemiology, School of Public Health, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yair Goldberg
- Department of Statistics, University of Haifa, Haifa, Israel
| | - Myrto Samara
- Department of Psychiatry and Psychotherapy, Technische Universität München, München, Germany
| | - John M Davis
- Psychiatric Institute, Department of Psychiatry, University of Illinois at Chicago, Chicago
| | - Andrea Cipriani
- World Health Organization Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy9Department of Psychiatry, Univ
| | - Stefan Leucht
- Department of Psychiatry and Psychotherapy, Technische Universität München, München, Germany9Department of Psychiatry, University of Oxford, Oxford, United Kingdom10Institute of Psychiatry, King's College London, London, United Kingdom
| |
Collapse
|
238
|
Davis JM, Urriola PE, Shurson GC, Baidoo SK, Johnston LJ. Effects of adding supplemental tallow to diets containing 30% distillers dried grains with solubles on growth performance, carcass characteristics, and pork fat quality in growing-finishing pigs. J Anim Sci 2015; 93:266-77. [PMID: 25568375 DOI: 10.2527/jas.2014-7895] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Crossbred pigs (n = 315) were blocked by initial BW (6.8 ± 1.1 kg) and randomly assigned to 1 of 4 dietary treatments to evaluate the effects of dietary inclusion of tallow and corn distillers dried grains with solubles (DDGS) on pig growth, carcass traits, and pork fat quality. Diets consisted of a corn-soybean meal control diet (CON) and another 3 corn-soybean meal diets containing 5% tallow (T), 30% DDGS (D), or 5% tallow plus 30% DDGS (TD) in a 2 × 2 factorial arrangement of treatments. Diets were formulated to contain similar levels of available P and standardized ileal digestible Lys:ME among treatments. Pigs were housed in 40 pens, with 7 to 8 pigs per pen, to provide 10 replicates per treatment. Overall ADG did not differ among treatments. Compared with CON (2.76 kg/d) and T (2.59 kg/d), feeding 30% DDGS reduced the ADFI (interaction, P > 0.05) of pigs when fed with 5% tallow (2.45 kg/d for TD) but not when fed alone (2.76 kg/d for D). There was no effect of DDGS on overall G:F, but pigs fed diets with tallow had greater (P < 0.01) G:F (0.4) than pigs fed no tallow (0.37). Feeding tallow increased (P < 0.01) HCW, carcass yield, and backfat depth of pigs independent of DDGS. Feeding DDGS reduced (P < 0.01) belly firmness, as measured by belly flop angle, independent of tallow (D = 71.8° and TD = 57.7° vs. CON = 134.0° and T = 113.4°) and tallow also tended to reduce belly firmness (P < 0.10). Feeding DDGS and tallow reduced the concentration of SFA in belly fat, while the concentration of MUFA were increased (P < 0.01) by feeding tallow but not DDGS. Conversely, feeding DDGS increased (P < 0.01) the concentration of PUFA in belly fat but there was no effect of tallow. An interaction (P = 0.03) between DDGS and tallow for iodine value (IV) of belly fat was observed, in which addition of tallow or DDGS increased the IV of belly fat (64.22 for T and 71.22 for D vs. 59.01 for CON) but addition of both reduced IV (67.88 for TD). The IV of belly fat and backfat were correlated (P < 0.01) with the IV product of the diet fed in phase 3 (r = 0.49 and r = 0.81, respectively). In conclusion, adding 5% tallow to 30% DDGS diets improved G:F and carcass yield while reducing the IV of belly fat. However, pork fat firmness as measured by belly flop angle was not improved.
Collapse
Affiliation(s)
- J M Davis
- Department of Animal Science, University of Minnesota, St. Paul 55018
| | - P E Urriola
- Department of Animal Science, University of Minnesota, St. Paul 55018
| | - G C Shurson
- Department of Animal Science, University of Minnesota, St. Paul 55018
| | - S K Baidoo
- Southern Research and Outreach Center, University of Minnesota, Waseca 56093
| | - L J Johnston
- West Central Research and Outreach Center, University of Minnesota, Morris 56267
| |
Collapse
|
239
|
Davis JM, Urriola PE, Baidoo SK, Johnston LJ, Shurson GC. Effects of adding supplemental tallow to diets containing distillers dried grains with solubles on fatty acid digestibility in growing pigs. J Anim Sci 2015; 93:258-65. [PMID: 25568374 DOI: 10.2527/jas.2014-7894] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2023] Open
Abstract
An experiment was conducted to measure the apparent ileal digestibility (AID) and apparent total tract digestibility (ATTD) of fatty acids in diets containing 0 or 30% corn distillers dried grains with solubles (DDGS) and 0, 5, or 10% tallow. Barrows (n = 24; initial BW = 25 kg) were surgically fitted with a T-cannula at the distal ileum. Pigs (n = 4/diet) were randomly assigned to diets: corn-soybean meal control (CON), CON plus 5% tallow (5T0D), CON plus 10% tallow (10T0D), CON plus 30% DDGS (0T30D), CON plus 5% tallow and 30% DDGS (5T30D), and CON plus 10% tallow and 30% DDGS (10T30D). Eight replicates per treatment were achieved by randomizing diets among pigs for a second collection period. Each pig was fed their respective diet for a 5-d adaptation period followed by 3-d fecal collection and 2-d ileal digesta collection periods. The AID and ATTD of fatty acids was calculated using the index method and acid-insoluble ash as an indigestible marker. When tallow was added to diets with 0% DDGS, there was no effect on AID of palmitic acid (C16:0) or SFA, while AID of stearic acid (C18:0) was increased (66.87% for CON, 72.06% for 5T0D, and 76.81% for 10T0D; P < 0.01). However, when diets contained 30% DDGS, the AID of all SFA was reduced as levels of tallow increased C16:0 (77.62% for 0T30D, 69.66% for 5T30D, and 68.43% for 10T30D), C18:0 (85.87% for 0T30D, 64.08% for 5T30D, and 61.25% for 10T30D), and SFA (79.88% for 0T30D, 68.23% for 5T30D, and 66.29% for 10T30D). The AID of MUFA was not affected when tallow was added to diets with 30% DDGS but actually increased in 5T0D and 10T0D. The amount of apparent ileal digested fatty acids increased with the addition of DDGS and tallow regardless of their digestibility. Amounts of ileal digested MUFA and PUFA increased when both DDGS (P < 0.01) and tallow (P < 0.01) were included in the diet compared to when either ingredient was excluded. For ileal digestible SFA, an interaction (P < 0.01) between DDGS and tallow was observed. Interactions between DDGS and tallow were observed for ATTD of all fatty acids (P < 0.01), except for linoleic acid and PUFA, which were not affected by dietary treatment. The amount of ileal digestible PUFA increased with tallow addition independent from the inclusion level of DDGS and it was a function the dietary concentration of the fatty acid. Adding tallow to corn-soybean based diets increased the amount of digested SFA, but in diets with DDGS, the increment in amount of ileal digestible SFA was less prominent due to lesser digestibility of SFA.
Collapse
Affiliation(s)
- J M Davis
- Department of Animal Science, University of Minnesota, St. Paul 55018
| | - P E Urriola
- Department of Animal Science, University of Minnesota, St. Paul 55018
| | - S K Baidoo
- Southern Research and Outreach Center, University of Minnesota, Waseca 56093
| | - L J Johnston
- West Central Research and Outreach Center, University of Minnesota, Morris 56267
| | - G C Shurson
- Department of Animal Science, University of Minnesota, St. Paul 55018
| |
Collapse
|
240
|
Westbrook JW, Walker AR, Neves LG, Munoz P, Resende MFR, Neale DB, Wegrzyn JL, Huber DA, Kirst M, Davis JM, Peter GF. Discovering candidate genes that regulate resin canal number in Pinus taeda stems by integrating genetic analysis across environments, ages, and populations. New Phytol 2015; 205:627-641. [PMID: 25266813 DOI: 10.1111/nph.13074] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Accepted: 08/14/2014] [Indexed: 06/03/2023]
Abstract
Genetically improving constitutive resin canal development in Pinus stems may enhance the capacity to synthesize terpenes for bark beetle resistance, chemical feedstocks, and biofuels. To discover genes that potentially regulate axial resin canal number (RCN), single nucleotide polymorphisms (SNPs) in 4027 genes were tested for association with RCN in two growth rings and three environments in a complex pedigree of 520 Pinus taeda individuals (CCLONES). The map locations of associated genes were compared with RCN quantitative trait loci (QTLs) in a (P. taeda × Pinus elliottii) × P. elliottii pseudo-backcross of 345 full-sibs (BC1). Resin canal number was heritable (h(2) ˜ 0.12-0.21) and positively genetically correlated with xylem growth (rg ˜ 0.32-0.72) and oleoresin flow (rg ˜ 0.15-0.51). Sixteen well-supported candidate regulators of RCN were discovered in CCLONES, including genes associated across sites and ages, unidirectionally associated with oleoresin flow and xylem growth, and mapped to RCN QTLs in BC1. Breeding is predicted to increase RCN 11% in one generation and could be accelerated with genomic selection at accuracies of 0.45-0.52 across environments. There is significant genetic variation for RCN in loblolly pine, which can be exploited in breeding for elevated terpene content.
Collapse
Affiliation(s)
- Jared W Westbrook
- Forest Genomics Laboratory, Genetics Institute, University of Florida, 1376 Mowry Rd, Rm 320, Gainesville, FL, 32611, USA; Plant Molecular and Cellular Biology graduate program, University of Florida, Gainesville, PO Box 110410, FL 32611, USA
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
241
|
Blitzer DN, Davis JM, Ahmed N, Kuo YH, Kuo YL. Impact of Procedure on the Post-Operative Infection Risk of Patients after Elective Colon Surgery. Surg Infect (Larchmt) 2014; 15:721-5. [DOI: 10.1089/sur.2013.147] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Affiliation(s)
| | - John M. Davis
- Jersey Shore University Medical Center, Neptune, New Jersey
| | - Nasim Ahmed
- Jersey Shore University Medical Center, Neptune, New Jersey
| | - Yen-Hong Kuo
- Jersey Shore University Medical Center, Neptune, New Jersey
| | - Yen-Liang Kuo
- Pingtung Christian Hospital Department of Surgery, Pingtung, Taiwan
| |
Collapse
|
242
|
Davis JM, Knutson KL, Strausbauch MA, Green AB, Crowson CS, Therneau TM, Matteson EL, Gabriel SE. Immune response profiling in early rheumatoid arthritis: discovery of a novel interaction of treatment response with viral immunity. Arthritis Res Ther 2014; 15:R199. [PMID: 24267267 PMCID: PMC3978471 DOI: 10.1186/ar4389] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2013] [Accepted: 11/12/2013] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION It remains challenging to predict the outcomes of therapy in patients with rheumatoid arthritis (RA). The objective of this study was to identify immune response signatures that correlate with clinical treatment outcomes in patients with RA. METHODS A cohort of 71 consecutive patients with early RA starting treatment with disease-modifying antirheumatic drugs (DMARDs) was recruited. Disease activity at baseline and after 21 to 24 weeks of follow-up was measured using the Disease Activity Score in 28 joints (DAS28). Immune response profiling was performed by analyzing multi-cytokine production from peripheral blood cells following incubation with a panel of stimuli, including a mixture of human cytomegalovirus (CMV) and Epstein-Barr virus (EBV) lysates. Profiles identified via principal components analysis (PCA) for each stimulus were then correlated with the ΔDAS28 from baseline to follow-up. A clinically meaningful improvement in the DAS28 was defined as a decrease of ≥1.2. RESULTS A profile of T-cell cytokines (IL-13, IL-4, IL-5, IL-2, IL-12, and IFN-γ) produced in response to CMV/EBV was found to correlate with the ΔDAS28 from baseline to follow-up. At baseline, a higher magnitude of the CMV/EBV immune response profile predicted inadequate DAS28 improvement (mean PCA-1 scores: 65.6 versus 50.2; P = 0.029). The baseline CMV/EBV response was particularly driven by IFN-γ (P = 0.039) and IL-4 (P = 0.027). Among patients who attained clinically meaningful DAS28 improvement, the CMV/EBV PCA-1 score increased from baseline to follow-up (mean +11.6, SD 25.5), whereas among patients who responded inadequately to DMARD therapy, the CMV/EBV PCA-1 score decreased (mean -12.8, SD 25.4; P = 0.002). Irrespective of the ΔDAS28, methotrexate use was associated with up-regulation of the CMV/EBV response. The CMV/EBV profile was associated with positive CMV IgG (P <0.001), but not EBV IgG (P = 0.32), suggesting this response was related to CMV exposure. CONCLUSIONS A profile of T-cell immunity associated with CMV exposure influences the clinical response to DMARD therapy in patients with early RA. Because CMV latency is associated with greater joint destruction, our findings suggest that changes in T-cell immunity mediated by viral persistence may affect treatment response and possibly long-term outcomes of RA.
Collapse
|
243
|
Keeney JG, O'Bleness MS, Anderson N, Davis JM, Arevalo N, Busquet N, Chick W, Rozman J, Hölter SM, Garrett L, Horsch M, Beckers J, Wurst W, Klingenspor M, Restrepo D, de Angelis MH, Sikela JM. Generation of mice lacking DUF1220 protein domains: effects on fecundity and hyperactivity. Mamm Genome 2014; 26:33-42. [PMID: 25308000 DOI: 10.1007/s00335-014-9545-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Accepted: 09/01/2014] [Indexed: 12/30/2022]
Abstract
Sequences encoding DUF1220 protein domains show the most extreme human lineage-specific copy number increase of any coding region in the genome and have been linked to human brain evolution. In addition, DUF1220 copy number (dosage) has been implicated in influencing brain size within the human species, both in normal populations and in individuals associated with brain size pathologies (1q21-associated microcephaly and macrocephaly). More recently, increasing dosage of a subtype of DUF1220 has been linked with increasing severity of the primary symptoms of autism. Despite these intriguing associations, a function for these domains has not been described. As a first step in addressing this question, we have developed the first transgenic model of DUF1220 function by removing the single DUF1220 domain (the ancestral form) encoded in the mouse genome. In a hypothesis generating exercise, these mice were evaluated by 197 different phenotype measurements. While resulting DUF1220-minus (KO) mice show no obvious anatomical peculiarities, they exhibit a significantly reduced fecundity (χ(2) = 19.1, df = 2, p = 7.0 × 10(-5)). Further extensive phenotypic analyses suggest hyperactivity (p < 0.05) of DUF1220 mice and changes in gene expression levels of brain associated with distinct neurological functions and disease. Other changes that met statistical significance include an increase in plasma glucose concentration (as measured by area under the curve, AUC 0-30 and AUC 30-120) in male mutants, fasting glucose levels, reduce sodium levels in male mutants, increased levels of the liver functional indicator ALAT/GPT in males, levels of alkaline phosphatase (also an indicator of liver function), mean R and SR amplitude by electrocardiography, elevated IgG3 levels, a reduced ratio of CD4:CD8 cells, and a reduced frequency of T cells; though it should be noted that many of these differences are quite small and require further examination. The linking of DUF1220 loss to a hyperactive phenotype is consistent with separate findings in which DUF1220 over expression results in a down-regulation of mitochondrial function, and potentially suggests a role in developmental metabolism. Finally, the substantially reduced fecundity we observe associated with KO mice argues that the ancestral DUF1220 domain provides an important biological functionthat is critical to survivability and reproductive success.
Collapse
Affiliation(s)
- J G Keeney
- Department of Biochemistry and Molecular Genetics and Human Medical Genetics and Neuroscience Programs, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, 80045, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
244
|
Makol A, Davis JM, Crowson CS, Therneau TM, Gabriel SE, Matteson EL. Time trends in glucocorticoid use in rheumatoid arthritis: results from a population-based inception cohort, 1980-1994 versus 1995-2007. Arthritis Care Res (Hoboken) 2014; 66:1482-8. [PMID: 24821680 PMCID: PMC4177279 DOI: 10.1002/acr.22365] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Accepted: 04/29/2014] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To examine trends in glucocorticoid (GC) use and dosing among patients diagnosed with rheumatoid arthritis (RA) over time. METHODS A population-based inception cohort of RA patients diagnosed during 1980-2007 was followed longitudinally through their medical records until death, migration, or December 31, 2008. GC start and stop dates were collected, along with doses in prednisone equivalents. RESULTS The study population comprised 349 patients (68% women) diagnosed in 1980-1994 and 464 (69% women) diagnosed in 1995-2007, with a median followup of 15.3 and 5.7 years, respectively. A higher proportion of patients started GCs in their first year of disease in 1995-2007 (68% versus 36%; P < 0.001), but the starting dose (mean 8.7 versus 10.3 mg; P = 0.08) and cumulative dose in the first year of use (mean 1.8g [mean daily dose 4.9 mg] versus 2.1 gm [mean daily dose 5.8 mg]; P = 0.48) were not different. A higher proportion also discontinued GCs in their first year of disease in the 1995-2007 cohort (P < 0.001). These differences in GC initiation and discontinuation persisted throughout followup. Prevalence of GC use was higher in the 1995-2007 cohort for the first 3 years of disease. CONCLUSION More patients are starting GCs early in their disease course now compared to previously, which is consistent with established treatment guidelines. A higher proportion are also discontinuing GCs, but the proportion of patients taking GCs at any given point of disease during the first 4 years is higher now than previously. Despite early addition of a disease-modifying antirheumatic drug, some patients may not be able to discontinue GCs over the long term.
Collapse
Affiliation(s)
- Ashima Makol
- Division of Rheumatology, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - John M. Davis
- Division of Rheumatology, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Cynthia S. Crowson
- Division of Rheumatology, Mayo Clinic College of Medicine, Rochester, MN, USA
- Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Terry M. Therneau
- Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Sherine E. Gabriel
- Division of Rheumatology, Mayo Clinic College of Medicine, Rochester, MN, USA
- Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Eric L. Matteson
- Division of Rheumatology, Mayo Clinic College of Medicine, Rochester, MN, USA
- Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MN, USA
| |
Collapse
|
245
|
Golding J, Gregory S, Iles-Caven Y, Lingam R, Davis JM, Emmett P, Steer CD, Hibbeln JR. Parental, prenatal, and neonatal associations with ball skills at age 8 using an exposome approach. J Child Neurol 2014; 29:1390-8. [PMID: 24828115 PMCID: PMC4388909 DOI: 10.1177/0883073814530501] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 03/12/2014] [Indexed: 11/15/2022]
Abstract
There is little consistency in the literature concerning factors that influence motor coordination in children. A hypothesis-free "exposome" approach was used with 7359 children using longitudinal information covering 3 generations in regard to throwing a ball accurately at age 7 years. The analyses showed an independent robust negative association with mother's unhappiness in her midchildhood (6-11 years). No such association was present for study fathers. The offspring of parents who described themselves as having poor eyesight had poorer ability. This hypothesis-free approach has identified a strong negative association with an unhappy childhood. Future studies of this cohort will be used to determine whether the mechanism is manifest through differing parenting skills, or a biological mechanism reflecting epigenetic effects.
Collapse
Affiliation(s)
- Jean Golding
- Centre for Child and Adolescent Health, School of Social & Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Steven Gregory
- Centre for Child and Adolescent Health, School of Social & Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Yasmin Iles-Caven
- Centre for Child and Adolescent Health, School of Social & Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Raghu Lingam
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - John M Davis
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - Pauline Emmett
- Centre for Child and Adolescent Health, School of Social & Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Colin D Steer
- Centre for Child and Adolescent Health, School of Social & Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Joseph R Hibbeln
- Section on Nutritional Neurosciences, National Institute of Alcohol Abuse & Alcoholism, National Institutes of Health, Bethesda, MD, USA
| |
Collapse
|
246
|
Dreaden TJ, Davis JM, de Beer ZW, Ploetz RC, Soltis PS, Wingfield MJ, Smith JA. Phylogeny of ambrosia beetle symbionts in the genus Raffaelea. Fungal Biol 2014; 118:970-8. [PMID: 25457944 DOI: 10.1016/j.funbio.2014.09.001] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 09/11/2014] [Accepted: 09/15/2014] [Indexed: 11/28/2022]
Abstract
The genus Raffaelea was established in 1965 when the type species, Raffaelea ambrosia, a symbiont of Platypus ambrosia beetles was described. Since then, many additional ambrosia beetle symbionts have been added to the genus, including the important tree pathogens Raffaelea quercivora, Raffaelea quercus-mongolicae, and Raffaelea lauricola, causal agents of Japanese and Korean oak wilt and laurel wilt, respectively. The discovery of new and the dispersal of described species of Raffaelea to new areas, where they can become invasive, presents challenges for diagnosticians as well as plant protection and quarantine efforts. In this paper, we present the first comprehensive multigene phylogenetic analysis of Raffaelea. As it is currently defined, the genus was found to not be monophyletic. On the basis of this work, Raffaelea sensu stricto is defined and the affinities of undescribed isolates are considered.
Collapse
Affiliation(s)
- Tyler J Dreaden
- School of Forest Resources and Conservation, University of Florida, Gainesville 32611, USA
| | - John M Davis
- School of Forest Resources and Conservation, University of Florida, Gainesville 32611, USA
| | - Z Wilhelm de Beer
- Department of Microbiology and Plant Pathology, Forestry and Agricultural Biotechnology Institute (FABI), University of Pretoria, Pretoria 0002, South Africa
| | - Randy C Ploetz
- Tropical Research and Education Center, University of Florida, Homestead 33031, USA
| | - Pamela S Soltis
- Florida Museum of Natural History, University of Florida, Gainesville 32611, USA
| | - Michael J Wingfield
- Department of Microbiology and Plant Pathology, Forestry and Agricultural Biotechnology Institute (FABI), University of Pretoria, Pretoria 0002, South Africa
| | - Jason A Smith
- School of Forest Resources and Conservation, University of Florida, Gainesville 32611, USA.
| |
Collapse
|
247
|
Geraghty RJ, Capes-Davis A, Davis JM, Downward J, Freshney RI, Knezevic I, Lovell-Badge R, Masters JRW, Meredith J, Stacey GN, Thraves P, Vias M. Guidelines for the use of cell lines in biomedical research. Br J Cancer 2014; 111:1021-46. [PMID: 25117809 PMCID: PMC4453835 DOI: 10.1038/bjc.2014.166] [Citation(s) in RCA: 237] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Accepted: 03/05/2014] [Indexed: 01/13/2023] Open
Abstract
Cell-line misidentification and contamination with microorganisms, such as mycoplasma, together with instability, both genetic and phenotypic, are among the problems that continue to affect cell culture. Many of these problems are avoidable with the necessary foresight, and these Guidelines have been prepared to provide those new to the field and others engaged in teaching and instruction with the information necessary to increase their awareness of the problems and to enable them to deal with them effectively. The Guidelines cover areas such as development, acquisition, authentication, cryopreservation, transfer of cell lines between laboratories, microbial contamination, characterisation, instability and misidentification. Advice is also given on complying with current legal and ethical requirements when deriving cell lines from human and animal tissues, the selection and maintenance of equipment and how to deal with problems that may arise.
Collapse
Affiliation(s)
- R J Geraghty
- Cancer Research UK Cambridge
Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way,
Cambridge
CB2 0RE, UK
| | - A Capes-Davis
- CellBank Australia, Children's
Medical Research Institute, Locked Bag 23,
Wentworthville, New South Wales
2145, Australia
| | - J M Davis
- School of Life and Medical Sciences,
University of Hertfordshire, College Lane, Hatfield,
Hertfordshire
AL10 9AB, UK
| | - J Downward
- Cancer Research UK, London Research
Institute, 44 Lincoln's Inn Fields, London
WC2A 3LY, UK
| | - R I Freshney
- Institute for Cancer Sciences,
University of Glasgow, 24 Greenwood Drive, Bearsden,
Glasgow
G61 2HA, UK
| | - I Knezevic
- Department of Essential Medicines and
Health Products, Quality, Safety and Standards Team, World Health
Organization, 20 Avenue Appia, 1211
Geneva 27, Switzerland
| | - R Lovell-Badge
- MRC National Institute for Medical
Research, The Ridgeway, Mill Hill, London
NW7 1AA, UK
| | - J R W Masters
- University College London, 67 Riding
House Street, London
W1W 7EJ, UK
| | - J Meredith
- Cancer Research UK, Angel Building,
407 St John Street, London
EC1V 4AD, UK
| | - G N Stacey
- National Institute for Biological
Standards and Control, A Centre of the Medicines and Healthcare Products
Regulatory Agency, Blanche Lane, South Mimms, Herts
EN6 3QG, UK
| | - P Thraves
- Culture Collections, Public Health
England, Porton Down, Salisbury
SP4 0JG, UK
| | - M Vias
- Cancer Research UK Cambridge
Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way,
Cambridge
CB2 0RE, UK
| |
Collapse
|
248
|
Samara MT, Cao H, Helfer B, Davis JM, Leucht S. Chlorpromazine versus every other antipsychotic for schizophrenia: a systematic review and meta-analysis challenging the dogma of equal efficacy of antipsychotic drugs. Eur Neuropsychopharmacol 2014; 24:1046-55. [PMID: 24766970 DOI: 10.1016/j.euroneuro.2014.03.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Revised: 03/27/2014] [Accepted: 03/30/2014] [Indexed: 10/25/2022]
Abstract
It is one of the major psychiatric dogmas that the efficacy of all antipsychotic drugs is same. This statement originated from old, narrative reviews on first-generation antipsychotics, but this old literature has never been meta-analysed. We therefore conducted a meta-analysis of randomised controlled trials on the efficacy of chlorpromazine versus any other antipsychotic in the treatment of schizophrenia. If the benchmark drug chlorpromazine were significantly more or less effective than other antipsychotics, the notion of equal efficacy would have to be rejected. We searched the Cochrane Schizophrenia Group׳s specialized register, MEDLINE, EMBASE, PsychInfo and reference lists of relevant articles. The primary outcome was response to treatment. We also analyzed mean values of schizophrenia rating scales at endpoint and drop-out rates. 128, mostly small, RCTs with 10667 participants were included. Chlorpromazine was compared with 43 other antipsychotics and was more efficacious than four (butaperazine, mepazine, oxypertine and reserpine) and less efficacious than other four antipsychotics (clomacran, clozapine, olanzapine and zotepine) in the primary outcome. There were no statistically significant efficacy differences between chlorpromazine and the remaining 28 antipsychotics. The most important finding was that, due to low numbers of participants (median 50, range 8-692), most comparisons were underpowered. Thus we infer that the old antipsychotic drug literature was inconclusive and the claim for equal efficacy of antipsychotics was never evidence-based. Recent meta-analyses on second-generation antipsychotics were in a better position to address this question and small, but consistent differences between drugs were found.
Collapse
Affiliation(s)
- Myrto T Samara
- Department of Psychiatry and Psychotherapy, Technische Universität München, Klinikum Rechts der Isar, Ismaningerstr. 22, 81675 Munich, Germany
| | - Haoyin Cao
- Department of Psychology, Neuro-Cognitive Psychology, Ludwig-Maximilians-Universität München, Germany; Klinik und Poliklinik für Psychiatrie und Psychotherapie der Technischen Universität München, Klinikum rechts der Isar, München, Germany
| | - Bartosz Helfer
- Department of Psychology, Neuro-Cognitive Psychology, Ludwig-Maximilians-Universität München, Germany; Klinik und Poliklinik für Psychiatrie und Psychotherapie der Technischen Universität München, Klinikum rechts der Isar, München, Germany
| | - John M Davis
- Psychiatric Institute, University of Illinois at Chicago, 1601 W. Taylor St., Chicago, IL 60612, USA; Maryland Psychiatric Research Center, Baltimore, MD, USA
| | - Stefan Leucht
- Department of Psychiatry and Psychotherapy, Technische Universität München, Klinikum Rechts der Isar, Ismaningerstr. 22, 81675 Munich, Germany.
| |
Collapse
|
249
|
Huhn M, Tardy M, Spineli LM, Kissling W, Förstl H, Pitschel-Walz G, Leucht C, Samara M, Dold M, Davis JM, Leucht S. Efficacy of pharmacotherapy and psychotherapy for adult psychiatric disorders: a systematic overview of meta-analyses. JAMA Psychiatry 2014; 71:706-15. [PMID: 24789675 DOI: 10.1001/jamapsychiatry.2014.112] [Citation(s) in RCA: 165] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE There is debate about the effectiveness of psychiatric treatments and whether pharmacotherapy or psychotherapy should be primarily used. OBJECTIVES To perform a systematic overview on the efficacy of pharmacotherapies and psychotherapies for major psychiatric disorders and to compare the quality of pharmacotherapy and psychotherapy trials. EVIDENCE REVIEW We searched MEDLINE, EMBASE, PsycINFO, and the Cochrane Library (April 2012, with no time or language limit) for systematic reviews on pharmacotherapy or psychotherapy vs placebo, pharmacotherapy vs psychotherapy, and their combination vs either modality alone. Two reviewers independently selected the meta-analyses and extracted efficacy effect sizes. We assessed the quality of the individual trials included in the pharmacotherapy and psychotherapy meta-analyses with the Cochrane risk of bias tool. FINDINGS The search yielded 45,233 results. We included 61 meta-analyses on 21 psychiatric disorders, which contained 852 individual trials and 137,126 participants. The mean effect size of the meta-analyses was medium (mean, 0.50; 95% CI, 0.41-0.59). Effect sizes of psychotherapies vs placebo tended to be higher than those of medication, but direct comparisons, albeit usually based on few trials, did not reveal consistent differences. Individual pharmacotherapy trials were more likely to have large sample sizes, blinding, control groups, and intention-to-treat analyses. In contrast, psychotherapy trials had lower dropout rates and provided follow-up data. In psychotherapy studies, wait-list designs showed larger effects than did comparisons with placebo. CONCLUSIONS AND RELEVANCE Many pharmacotherapies and psychotherapies are effective, but there is a lot of room for improvement. Because of the multiple differences in the methods used in pharmacotherapy and psychotherapy trials, indirect comparisons of their effect sizes compared with placebo or no treatment are problematic. Well-designed direct comparisons, which are scarce, need public funding. Because patients often benefit from both forms of therapy, research should also focus on how both modalities can be best combined to maximize synergy rather than debate the use of one treatment over the other.
Collapse
Affiliation(s)
- Maximilian Huhn
- Department of Psychiatry and Psychotherapy, Technische Universität München, München, Germany
| | - Magdolna Tardy
- Department of Psychiatry and Psychotherapy, Technische Universität München, München, Germany
| | - Loukia Maria Spineli
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, University Campus, Ioannina, Greece
| | - Werner Kissling
- Department of Psychiatry and Psychotherapy, Technische Universität München, München, Germany
| | - Hans Förstl
- Department of Psychiatry and Psychotherapy, Technische Universität München, München, Germany
| | - Gabriele Pitschel-Walz
- Department of Psychiatry and Psychotherapy, Technische Universität München, München, Germany
| | - Claudia Leucht
- Department of Psychiatry and Psychotherapy, Technische Universität München, München, Germany2Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, England
| | - Myrto Samara
- Department of Psychiatry and Psychotherapy, Technische Universität München, München, Germany
| | - Markus Dold
- Department of Psychiatry and Psychotherapy, Technische Universität München, München, Germany
| | - John M Davis
- Psychiatric Institute, University of Illinois at Chicago
| | - Stefan Leucht
- Department of Psychiatry and Psychotherapy, Technische Universität München, München, Germany2Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, England5Institute of Psychiatry, King's College London, London, England
| |
Collapse
|
250
|
Weiser M, Burshtein S, Gershon AA, Marian G, Vlad N, Grecu IG, Tocari E, Tiugan A, Hotineanu M, Davis JM. Allopurinol for mania: a randomized trial of allopurinol versus placebo as add-on treatment to mood stabilizers and/or antipsychotic agents in manic patients with bipolar disorder. Bipolar Disord 2014; 16:441-7. [PMID: 24712840 DOI: 10.1111/bdi.12202] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Accepted: 10/16/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVE An emerging body of evidence supports a role for dysfunctional purinergic neurotransmission in mood disorders. Adenosine agonists have been shown to have properties similar to those of dopamine antagonists; there is a well-characterized interaction between adenosine and dopamine receptors in the ventral striatum, and increasing adenosinergic transmission has been demonstrated to reduce the affinity of dopamine agonists for dopamine receptors. Allopurinol increases adenosine levels in the brain, and hence is hypothesized to reduce the symptoms of mania. Two randomized, placebo-controlled trials administering add-on allopurinol to manic patients showed significantly greater improvements in Young Mania Rating Scale (YMRS) scores for drug compared to placebo, while a more recent, relatively small, add-on study showed negative results. Based on these data, our objective was to examine the efficacy of allopurinol as add-on treatment to mood stabilizers and/or antipsychotic agents in manic patients with bipolar disorder. METHODS We performed a large, well-powered, multicenter, six-week, randomized, placebo-controlled trial of allopurinol added to mood stabilizers and/or antipsychotic agents in 180 patients with bipolar disorder in an acute manic episode. RESULTS Both groups showed improvement on the YMRS (effect size of 1.5 for placebo and 1.6 for allopurinol), with no difference observed between groups on YMRS scores (t = 0.28, p = 0.78). There was no difference in the proportion of patients who responded to treatment (defined as showing at least 50% improvement in YMRS score) between the two groups (p = 0.92), or in dropout rates (p = 0.84). LIMITATIONS None of our patients received lithium. However, the side effects of lithium and its narrow therapeutic index made the use of lithium less common and, therefore, our study results reflect common current clinical practice. In the present study, we used a variety of antipsychotic and/or mood stabilizing treatments, to which we added allopurinol; one might hypothesize that add-on allopurinol has a different effect in combination with different antipsychotic agents or mood stabilizers. CONCLUSIONS The findings of this large, well-powered study do not support add-on allopurinol as a treatment for acute mania. This study did not test the efficacy of allopurinol as monotherapy.
Collapse
Affiliation(s)
- Mark Weiser
- Division of Psychiatry, Chaim Sheba Medical Center, Tel-Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Israel
| | | | | | | | | | | | | | | | | | | |
Collapse
|