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Dibbasey M, Dahaba M, Sarfo F, Begum R, Kanteh M, Sumareh N, Bakare M, Umukoro S, Amambua-Ngwa A. Seasonal variations in haematological and biochemical parameters of healthy Gambian adults: Retrospective study 2018-2022. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003715. [PMID: 39288124 PMCID: PMC11407651 DOI: 10.1371/journal.pgph.0003715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 08/23/2024] [Indexed: 09/19/2024]
Abstract
The objectives of this study were to determine the presence and effect of seasonal variations and provide insights into trend from 2018 to 2022 in a comprehensive set of routine haematological indices and biochemical measurements in Gambian adults with no known underlying health condition. We retrieved five years of data from an electronic database and analysed 493 full blood counts and 643 biochemical data from different individuals. In this study, we focused on data from individuals with no known underlying health condition who visited the clinical diagnostic laboratory for routine medical examinations or assessments.Our study found a positive association between seasonality (wet season as the reference) and Hb (HB: 0.014(0.015), P<0.05), White blood cells (WBC) (WBC: 0.243(0.163), p = 0.0014), and neutrophils (neutrophils: 0.271(0.131), P<0.05) with exception to red blood cells (RBC) (RBC: - 0.184(0.061), P< 0.003) that showed negative association. Despite the association, the seasonal effects on our derived reference intervals for haematological indices and biochemical measurements from wet season to dry season were not statistically significant (P>0.05). In addition, we observed in our heatmap result that some laboratory parameters, including HB, RBC, haematocrit (HCT), urea, liver enzymes, and potassium, showed seasonal variation patterns throughout the year, with median levels being normal to slightly low during the dry season and normal to high during the wet season. We also found no significant difference (P>0.05) among the median values for all parameters from 2018 to 2022. Additionally, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) parameters showed a consistent declining trend from 2018 to 2022. Our study found no seasonal effects on the derived reference intervals of haematological indices and biochemical measurements. However, we observed changes in patterns for certain parameters particularly HB, RBC, liver enzymes, and potassium based on seasonality.
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Affiliation(s)
- Mustapha Dibbasey
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia
- Department of Biochemistry, Cell and Molecular Biology, School of Biological Science, University of Ghana, Accra, Legon, Ghana
| | - Mamudou Dahaba
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Francess Sarfo
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Rosyna Begum
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Mustapha Kanteh
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Nyima Sumareh
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Mustapha Bakare
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Solomon Umukoro
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Alfred Amambua-Ngwa
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia
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2
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Li Y, Lu L, Androulakis IP. The Physiological and Pharmacological Significance of the Circadian Timing of the HPA Axis: A Mathematical Modeling Approach. J Pharm Sci 2024; 113:33-46. [PMID: 37597751 PMCID: PMC10840710 DOI: 10.1016/j.xphs.2023.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 08/02/2023] [Accepted: 08/02/2023] [Indexed: 08/21/2023]
Abstract
As a potent endogenous regulator of homeostasis, the circadian time-keeping system synchronizes internal physiology to periodic changes in the external environment to enhance survival. Adapting endogenous rhythms to the external time is accomplished hierarchically with the central pacemaker located in the suprachiasmatic nucleus (SCN) signaling the hypothalamus-pituitary-adrenal (HPA) axis to release hormones, notably cortisol, which help maintain the body's circadian rhythm. Given the essential role of HPA-releasing hormones in regulating physiological functions, including immune response, cell cycle, and energy metabolism, their daily variation is critical for the proper function of the circadian timing system. In this review, we focus on cortisol and key fundamental properties of the HPA axis and highlight their importance in controlling circadian dynamics. We demonstrate how systems-driven, mathematical modeling of the HPA axis complements experimental findings, enhances our understanding of complex physiological systems, helps predict potential mechanisms of action, and elucidates the consequences of circadian disruption. Finally, we outline the implications of circadian regulation in the context of personalized chronotherapy. Focusing on the chrono-pharmacology of synthetic glucocorticoids, we review the challenges and opportunities associated with moving toward personalized therapies that capitalize on circadian rhythms.
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Affiliation(s)
- Yannuo Li
- Chemical & Biochemical Engineering Department, Piscataway, NJ 08854, USA
| | - Lingjun Lu
- Chemical & Biochemical Engineering Department, Piscataway, NJ 08854, USA
| | - Ioannis P Androulakis
- Chemical & Biochemical Engineering Department, Piscataway, NJ 08854, USA; Biomedical Engineering Department, Rutgers University, Piscataway, NJ 08540, USA.
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3
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Horvath G, Nagy K, Tuboly G, Nagy E. Pain and Weather associations - Action Mechanisms; Personalized profiling. Brain Res Bull 2023; 200:110696. [PMID: 37391130 DOI: 10.1016/j.brainresbull.2023.110696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/21/2023] [Accepted: 06/27/2023] [Indexed: 07/02/2023]
Abstract
It is a well-known hypothesis that weather can influence human health, including pain sensation. The primary meteorological factors are atmospheric pressure, wind, humidity, precipitation, and temperature, which vary from the climate and seasons, but the parameters of space weather (e.g., geomagnetic and cosmic ray activities) also may affect our body condition. Despite a significant number of experimental studies, reviews, and meta-analyses concerning the potential role of weather in pain sensitivity, the findings are heterogeneous and lack consensus. Therefore, rather than attempting a comprehensive analysis of the entire literature on the effects of weather on different pain types, this study highlights the potential action mechanisms of the meteorological factors, and the possible causes of the controversial results. The few data available about the individual evaluations are discussed in detail to reveal the significance of the personalized analysis of the possible relationships between the most available weather parameters and the pain scores. The use of special algorithms may enable the individual integration of different data for a precise outcome concerning the link between pain sensitivity and weather parameters. It is presumed that despite the high level of interindividual differences in response to meteorological parameters, the patients can be clustered in different groups based on their sensitivity to the weather parameters with a possible disparate treatment design. This information may help patients to control their daily activities and aid physicians to plan more valuable management for patients with pain states when the weather conditions change.
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Affiliation(s)
- Gyöngyi Horvath
- Department of Physiology, Albert Szent-Györgyi Medical School, University of Szeged.
| | - Kamilla Nagy
- Department of Pediatrics and Pediatric Health Centre, Albert Szent-Györgyi Health Centre, University of Szeged.
| | - Gabor Tuboly
- Department of Neurology, Albert Szent-Györgyi Health Centre, University of Szeged.
| | - Edit Nagy
- Department of Physiotherapy, Faculty of Health Sciences and Social Studies, University of Szeged.
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4
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Walsh CP, Lindsay EK, Grosse P, Natale BN, Fairlie S, Bwint A, Schaffer L, McMahon K, Del Duke C, Forse J, Lamonja-Vicente N, Marsland AL. A systematic review and meta-analysis of the stability of peripheral immune markers in healthy adults. Brain Behav Immun 2023; 107:32-46. [PMID: 36152782 PMCID: PMC9729419 DOI: 10.1016/j.bbi.2022.09.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 09/09/2022] [Accepted: 09/16/2022] [Indexed: 01/03/2023] Open
Abstract
Peripheral immune markers are widely used to predict risk for inflammatory disease. However, whether single assessments of inflammatory biomarkers represent stable individual differences remains unclear. We reviewed 50 studies (N = 48,674; 57 % male; mean age 54 (range 13-79) years) that assessed markers of inflammation on >1 occasion, with time between measures ranging from 24 h to 7+ years. Separate random effects meta-analyses were conducted for each inflammatory marker and time interval. Markers that had broad coverage across most time intervals included C-reactive protein (CRP; k = 37), interleukin (IL)-6 (k = 22), TNF-α (k = 10), and fibrinogen (Fg; k = 9). For CRP, IL-6, and TNF-α, stability estimates generally decreased with time, with strong to moderate stability over intervals <6 months (r's = 0.80-0.61), modest to moderate stability over 6 months - 3 years (r's = 0.60-0.51), and low stability for >3 years (r's = 0.39-0.30). Estimates were less reliable for Fg for time intervals ≤ 3 years although they generally followed the same pattern; more reliable findings suggested greater stability for Fg than other markers for intervals >3 years (r = 0.53). These findings suggest that single measures of inflammatory biomarkers may be an adequate index of stable individual differences in the short term (<6 months), with repeated measures of inflammatory biomarkers recommended over intervals ≥ 6 months to 3 years, and absolutely necessary over intervals >3 years to reliably identify stable individual differences in health risk. These findings are consistent with stability estimates and clinical recommendations for repeated measurement of other cardiovascular measures of risk (e.g., blood lipids, blood pressure).
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Affiliation(s)
- Catherine P Walsh
- Department of Psychology, University of Pittsburgh, 210 Bouquet St., Pittsburgh, PA, USA.
| | - Emily K Lindsay
- Department of Psychology, University of Pittsburgh, 210 Bouquet St., Pittsburgh, PA, USA.
| | - Philip Grosse
- Clinical and Translational Science Institute, Forbes Tower, Suite 7057, Pittsburgh, PA 15213, USA.
| | - Brianna N Natale
- Department of Psychology, University of Pittsburgh, 210 Bouquet St., Pittsburgh, PA, USA.
| | - Samantha Fairlie
- Department of Psychology, University of Pittsburgh, 210 Bouquet St., Pittsburgh, PA, USA.
| | - Amanda Bwint
- Department of Psychology, University of Pittsburgh, 210 Bouquet St., Pittsburgh, PA, USA.
| | - Luke Schaffer
- Department of Psychology, University of Pittsburgh, 210 Bouquet St., Pittsburgh, PA, USA.
| | - Katie McMahon
- Department of Psychology, University of Pittsburgh, 210 Bouquet St., Pittsburgh, PA, USA.
| | - Colin Del Duke
- Department of Psychology, University of Pittsburgh, 210 Bouquet St., Pittsburgh, PA, USA.
| | - Jenny Forse
- Department of Psychology, University of Pittsburgh, 210 Bouquet St., Pittsburgh, PA, USA.
| | - Noemi Lamonja-Vicente
- Department of Psychology, University of Pittsburgh, 210 Bouquet St., Pittsburgh, PA, USA; Department of Clinical Psychology and Psychobiology, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
| | - Anna L Marsland
- Department of Psychology, University of Pittsburgh, 210 Bouquet St., Pittsburgh, PA, USA.
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Madsen T, Klaassen M, Raven N, Dujon AM, Jennings G, Thomas F, Hamede R, Ujvari B. Transmissible cancer and longitudinal telomere dynamics in Tasmanian devils (Sarcophilus harrisii). Mol Ecol 2022; 31:6531-6540. [PMID: 36205590 PMCID: PMC10091798 DOI: 10.1111/mec.16721] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 09/21/2022] [Indexed: 01/13/2023]
Abstract
A plethora of intrinsic and environmental factors have been shown to influence the length of telomeres, the protector of chromosome ends. Despite the growing interest in infection-telomere interactions, there is very limited knowledge on how transmissible cancers influence telomere maintenance. An emblematic example of transmissible cancer occurs in the Tasmanian devil (Sarcophilus harrisii), whose populations have been dramatically reduced by infectious cancer cells. To investigate associations between telomere dynamics and the transmissible cancer, we used longitudinal data from a Tasmanian devil population that has been exposed to the disease for over 15 years. We detected substantial temporal variation in individual telomere length (TL), and a positive significant association between TL and age, as well as a marginally significant trend for devils with devil facial tumour disease (DFTD) having longer telomeres. A proportional hazard analysis yielded no significant effect of TL on the development of DFTD. Like previous studies, we show the complexity that TL dynamics may exhibit across the lifetime of organisms. Our work highlights the importance of long-term longitudinal sampling for understanding the effects of wildlife diseases on TL.
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Affiliation(s)
- Thomas Madsen
- School of Life and Environmental Sciences, Centre for Integrative Ecology, Deakin University, Geelong, Victoria, Australia
| | - Marcel Klaassen
- School of Life and Environmental Sciences, Centre for Integrative Ecology, Deakin University, Geelong, Victoria, Australia
| | - Nynke Raven
- School of Life and Environmental Sciences, Centre for Integrative Ecology, Deakin University, Geelong, Victoria, Australia
| | - Antoine M Dujon
- School of Life and Environmental Sciences, Centre for Integrative Ecology, Deakin University, Geelong, Victoria, Australia.,CREEC, UMR IRD 224-CNRS 5290-Université de Montpellier, Montpellier, France
| | - Geordie Jennings
- School of Life and Environmental Sciences, Centre for Integrative Ecology, Deakin University, Geelong, Victoria, Australia
| | - Frédéric Thomas
- CREEC, UMR IRD 224-CNRS 5290-Université de Montpellier, Montpellier, France.,MIVEGEC, IRD, CNRS, Université Montpellier, Montpellier, France
| | - Rodrigo Hamede
- School of Natural Sciences, University of Tasmania, Hobart, Tasmania, Australia
| | - Beata Ujvari
- School of Life and Environmental Sciences, Centre for Integrative Ecology, Deakin University, Geelong, Victoria, Australia
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Huang LJ, Zha JJ, Cao NW, Zhou HY, Chu XJ, Wang H, Li XB, Li BZ. Temperature might increase the hospital admission risk for rheumatoid arthritis patients in Anqing, China: a time-series study. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2022; 66:201-211. [PMID: 34718869 PMCID: PMC8557265 DOI: 10.1007/s00484-021-02207-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 10/13/2021] [Accepted: 10/13/2021] [Indexed: 05/20/2023]
Abstract
Temperature has been studied in relation to many health outcomes. However, few studies have explored its effect on the risk of hospital admission for rheumatoid arthritis (RA). A distributed lag non-linear model (DLNM) was used to analyze associations between mean temperature, diurnal temperature range (DTR), temperature change between neighboring days (TCN), and daily admissions for RA from 2015 to 2019 in Anqing, China. Subgroup analyses based on age, gender, rheumatoid factors, and admission route were performed. In total, 1456 patients with RA were hospitalized. Regarding the cumulative-lag effects of extreme cold temperature (5th percentile = 3℃), the risks of admissions for RA were increased and highest at lag 0-11 (RR = 2.68, 95% CI: 1.23-5.86). Exposing to low (5th percentile = 1.9℃) and high (95th percentile = 14.2℃) DTRs both had increased risks of RA admission, with highest RRs of 1.40 (95% CI: 1.03-1.91) and 1.24 (95% CI: 1.0-1.53) at lag 0 day, respectively. As for TCN, the marginal risk of admission in RA patients was found when exposed to high TCN (95th percentile = 2.9℃) with the largest single-day effect at lag 10 (RR = 1.11, 95% CI: 1.01-1.23). In subgroup analyses, females were more susceptible to extreme cold temperature, low and high DTRs, and high TCN. In regard to extreme cold temperature, significant risk of hospital admission in females only appeared at lag 2 (RR = 1.48, 95% CI: 1.02-2.15) and lag 0-2 (RR = 2.35, 95% CI: 1.11-4.95). It is clear that RA patients exposed to changing temperature may increase risks of admission.
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Affiliation(s)
- Li-Juan Huang
- Medical Department, The Affiliated Anqing Hospital of Anhui Medical University, Anqing, Anhui, China
| | - Jun-Jing Zha
- Medical Department, The Affiliated Anqing Hospital of Anhui Medical University, Anqing, Anhui, China
| | - Nv-Wei Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Hao-Yue Zhou
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Xiu-Jie Chu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Hua Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Xian-Bao Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Bao-Zhu Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China.
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Guilhem A, Portalès P, Dupuis-Girod S, Rivière S, Vincent T. Altered expressions of CXCR4 and CD26 on T-helper lymphocytes in hereditary hemorrhagic telangiectasia. Orphanet J Rare Dis 2021; 16:511. [PMID: 34906163 PMCID: PMC8670161 DOI: 10.1186/s13023-021-02139-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 11/28/2021] [Indexed: 11/10/2022] Open
Abstract
Background Hereditary hemorrhagic telangiectasia (HHT) is a rare genetic disease characterized by a deregulated neo-angiogenesis. Besides a mainly vascular phenotype (muco-cutaneous telangiectases, arteriovenous malformations), a specific risk of infection is suggested by case series of severe and atypical infections as well as by reports of decreased T and natural killer (NK) lymphocyte counts. As some evidence supports a dysregulation of the CXCR4/CXCL12 chemotactic axis of HHT endothelial cells, we hypothesized that a similar phenomenon could occur on lymphocytes. Methods Eighteen HHT patients with history of severe infection (HSI) were matched in age and sex with 18 HHT without HSI and 18 healthy control subjects (HC). We assessed the cell count and the surface expression of CXCR4 and CD26 (CXCL12 inactivating peptidase) of circulating T-helper and T-cytotoxic lymphocytes (including naive, memory and activated subsets) and NK cells. Results The overall HHT group of 36 patients exhibited a reduction of circulating T-helper lymphocytes compared to HC (median: 517 vs. 1026 cells/mm3, p < 0.0001), correlated with age (r = − 0.46, p = 0.005), requirement of intravenous iron or blood transfusions (median: 291 vs. 627 cells/mm3, p = 0.03) and CXCR4 surface expression (r = 0.353, p = 0.0345). CXCR4 and CD26 membrane expression were both decreased on HHT T-helper lymphocytes (median MFI ratio: 4.49 vs. 5.74 for CXCR4 and 3.21 vs. 4.33 for CD26, p = 0.03 and 0.0018 respectively) with an unchanged CXCR4/CD26 ratio. The HHT group with HSI had a higher CXCR4/CD26 ratio on the total T-lymphocyte population, as well as on the T-helper population and its naive subset (median on naive T-helper cells: 2.34 vs. 1.32, p = 0.0002). Conclusions Our findings support a dysregulation of the CXCL12/CXCR4 chemotaxis of T-helper lymphocytes in HHT patients, potentially linked to their T-helper lymphopenia and susceptibility to infection. Supplementary Information The online version contains supplementary material available at 10.1186/s13023-021-02139-y.
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Affiliation(s)
- Alexandre Guilhem
- CHU de Montpellier, Médecine interne et maladies multi-organiques de l'adulte, Hôpital Saint Eloi, Montpellier, France.
| | - Pierre Portalès
- CHU de Montpellier, Laboratoire d'immunologie, Hôpital Saint Eloi, Montpellier, France
| | - Sophie Dupuis-Girod
- Centre National de référence Maladie de Rendu-Osler, Service de génétique Hôpital Mère-Enfant, Hospices Civils de Lyon, Bron, France
| | - Sophie Rivière
- CHU de Montpellier, Médecine interne et maladies multi-organiques de l'adulte, Hôpital Saint Eloi, Montpellier, France
| | - Thierry Vincent
- CHU de Montpellier, Laboratoire d'immunologie, Hôpital Saint Eloi, Montpellier, France
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8
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Lau LHW, Wong NS, Leung CC, Chan CK, Lau AKH, Tian L, Lee SS. Seasonality of tuberculosis in intermediate endemicity setting dominated by reactivation diseases in Hong Kong. Sci Rep 2021; 11:20259. [PMID: 34642391 PMCID: PMC8511215 DOI: 10.1038/s41598-021-99651-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 09/21/2021] [Indexed: 12/16/2022] Open
Abstract
Summer-spring predominance of tuberculosis (TB) has been widely reported. The relative contributions of exogenous recent infection versus endogenous reactivation to such seasonality remains poorly understood. Monthly TB notifications data between 2005 and 2017 in Hong Kong involving 64,386 cases (41% aged ≥ 65; male-to-female ratio 1.74:1) were examined for the timing, amplitude, and predictability of variation of seasonality. The observed seasonal variabilities were correlated with demographics and clinical presentations, using wavelet analysis coupled with dynamic generalised linear regression models. Overall, TB notifications peaked annually in June and July. No significant annual seasonality was demonstrated for children aged ≤ 14 irrespective of gender. The strongest seasonality was detected in the elderly (≥ 65) among males, while seasonal pattern was more prominent in the middle-aged (45–64) and adults (30–44) among females. The stronger TB seasonality among older adults in Hong Kong suggested that the pattern has been contributed largely by reactivation diseases precipitated by defective immunity whereas seasonal variation of recent infection was uncommon.
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Affiliation(s)
- Leonia Hiu Wan Lau
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong , China
| | - Ngai Sze Wong
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, China
| | - Chi Chiu Leung
- Hong Kong Tuberculosis, Chest and Heart Disease Association, Hong Kong, China
| | - Chi Kuen Chan
- Tuberculosis and Chest Service, Centre for Health Protection, Department of Health, Hong Kong, China
| | - Alexis K H Lau
- Department of Civil and Environmental Engineering, The Hong Kong University of Science and Technology, Hong Kong, China.,Division of Environment and Sustainability, The Hong Kong University of Science and Technology, Hong Kong, China
| | - Linwei Tian
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Shui Shan Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, China.
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9
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Uwamahoro D, Beeman A, Sharma VK, Henry MB, Garbern SC, Becker J, Harfouche FD, Rogers AP, Kendric K, Guptill M. Seasonal influence of tuberculosis diagnosis in Rwanda. Trop Med Health 2021; 49:36. [PMID: 33980306 PMCID: PMC8114710 DOI: 10.1186/s41182-021-00328-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 05/03/2021] [Indexed: 11/16/2022] Open
Abstract
Background Tuberculosis (TB) remains a major global health concern. Previous research reveals that TB may have a seasonal peak during the spring and summer seasons in temperate climates; however, few studies have been conducted in tropical climates. This study evaluates the influence of seasonality on laboratory-confirmed TB diagnosis in Rwanda, a tropical country with two rainy and two dry seasons. Methods A retrospective chart review was performed at the University Teaching Hospital-Kigali (CHUK). From January 2016 to December 2017, 2717 CHUK patients with TB laboratory data were included. Data abstracted included patient demographics, season, HIV status, and TB laboratory results (microscopy, GeneXpert, culture). Univariate and multivariable logistic regression (adjusted for age, gender, and HIV status) analyses were performed to assess the association between season and laboratory-confirmed TB diagnoses. Results Patients presenting during rainy season periods had a lower odds of laboratory-confirmed TB diagnosis compared to the dry season (aOR=0.78, 95% CI 0.63–0.97, p=0.026) when controlling for age group, gender, and HIV status. Males, adults, and people living with HIV were more likely to have laboratory-confirmed TB diagnosis. On average, more people were tested for TB during the rainy season per month compared to the dry season (120.3 vs. 103.3), although this difference was not statistically significant. Conclusion In Rwanda, laboratory-confirmed TB case detection shows a seasonal variation with patients having higher odds of TB diagnosis occurring in the dry season. Further research is required to further elucidate this relationship and to delineate the mechanism of season influence on TB diagnosis.
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Affiliation(s)
- Doris Uwamahoro
- Department of Anesthesia, Emergency Medicine and Critical Care, University of Rwanda College of Medicine and Health Sciences, Kigali, Rwanda
| | - Aly Beeman
- Department of Emergency Medicine, Warren Alpert School of Medicine, Brown University, Providence, RI, USA.
| | - Vinay K Sharma
- Family Medicine Residency Program, Froedtert Hospital Menomonee Falls, Menomonee Falls, WI, USA
| | - Michael B Henry
- Columbia University-Vagelos College of Physicians and Surgeons, New York, NY, 10032, USA.,Department of Emergency Medicine, Maricopa Medical Center-Creighton University Arizona Health Education Alliance, Phoenix, AZ, USA
| | - Stephanie Chow Garbern
- Department of Emergency Medicine, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
| | - Joseph Becker
- Department of Emergency Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Alexis Perez Rogers
- Department of Emergency Medicine, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Kayla Kendric
- Department of Emergency Medicine, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Mindi Guptill
- Department of Emergency Medicine, Loma Linda University School of Medicine, Loma Linda, CA, USA
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10
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Taghavi S, Jackson-Weaver O, Abdullah S, Goldberg A, Lawicki S, Killackey M, Duchesne J, Pociask D, Steele C, Kolls J. A Comparison of Growth Factors and Cytokines in Fresh Frozen Plasma and Never Frozen Plasma. J Surg Res 2021; 264:51-57. [PMID: 33773321 DOI: 10.1016/j.jss.2021.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 01/28/2021] [Accepted: 02/17/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND Fresh frozen plasma (FFP) contains proinflammatory mediators released from cellular debris during frozen storage. In addition, recent studies have shown that transfusion of never-frozen plasma (NFP), instead of FFP, may be superior in trauma patients. We hypothesized that FFP would have higher levels of inflammatory mediators when compared to NFP. MATERIALS AND METHODS FFP (n = 8) and NFP (n = 8) samples were obtained from an urban, level 1 trauma center blood bank. The cytokines in these samples were compared using a Milliplex (Milliplex Sigma) human cytokine magnetic bead panel multiplex assay for 41 different biomarkers. RESULTS Growth factors that were higher in NFP included platelet-derived growth factor-AA (PDGF-AA; 8.09 versus 108.00 pg/mL, P < 0.001) and PDGF-AB (0.00 versus 215.20, P= 0.004). Soluble CD40-ligand (sCD40L), a platelet activator and pro-coagulant, was higher in NFP (31.81 versus 80.45 pg/mL, P< 0.001). RANTES, a leukocyte chemotactic cytokine was higher in NFP (26.19 versus 1418.00 pg/mL, P< 0.001). Interleukin-4 (5.70 versus 0.00 pg/mL, P= 0.03) and IL-8 (2.20 versus 0.52 pg/ml, P= 0.03) levels were higher in were higher in FFP. CONCLUSIONS Frozen storage of plasma may result in decrease of several growth factors and/or pro-coagulants found in NFP. In addition, the freezing and thawing process may induce release of pro-inflammatory chemokines. Further studies are needed to determine if these cytokines result in improved outcomes with NFP over FFP in transfusion of trauma patients.
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Affiliation(s)
- Sharven Taghavi
- Tulane University School of Medicine, Department of Surgery, New Orleans, Louisiana.
| | - Olan Jackson-Weaver
- Tulane University School of Medicine, Department of Surgery, New Orleans, Louisiana
| | - Sarah Abdullah
- Tulane University School of Medicine, Department of Surgery, New Orleans, Louisiana
| | - Amy Goldberg
- Temple University School of Medicine, Department of Surgery, Philadelphia, Pennyslvania
| | - Shaun Lawicki
- Louisiana State University School of Medicine, Department of Pathology, New Orleans, Louisiana
| | - Mary Killackey
- Tulane University School of Medicine, Department of Surgery, New Orleans, Louisiana
| | - Juan Duchesne
- Tulane University School of Medicine, Department of Surgery, New Orleans, Louisiana
| | - Derek Pociask
- Tulane University School of Medicine, Center for Translational Research in Infection and Inflammation, New Orleans, Louisiana
| | - Chad Steele
- Tulane University School of Medicine, Department of Microbiology and Immunology, New Orleans, Louisiana
| | - Jay Kolls
- Tulane University School of Medicine, Center for Translational Research in Infection and Inflammation, New Orleans, Louisiana
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Wang H, Li P, Zhang Y, Zhang C, Li K, Song C. Cytokine changes in different types of depression: Specific or general? ACTA ACUST UNITED AC 2020. [DOI: 10.1016/j.npbr.2020.02.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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12
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Li CK, Xu Z, Ho J, Lakhani I, Liu YZ, Bazoukis G, Liu T, Wong WT, Cheng SH, Chan MT, Zhang L, Gin T, Wong MC, Wong ICK, Wu WKK, Zhang Q, Tse G. Association of NPAC score with survival after acute myocardial infarction. Atherosclerosis 2020; 301:30-36. [PMID: 32304975 DOI: 10.1016/j.atherosclerosis.2020.03.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 02/14/2020] [Accepted: 03/05/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND AIMS Risk stratification in acute myocardial infarction (AMI) is important for guiding clinical management. Current risk scores are mostly derived from clinical trials with stringent patient selection. We aimed to establish and evaluate a composite scoring system to improve short-term mortality classification after index episodes of AMI, independent of electrocardiography (ECG) pattern, in a large real-world cohort. METHODS Using electronic health records, patients admitted to our regional teaching hospital (derivation cohort, n = 1747) and an independent tertiary care center (validation cohort, n = 1276), with index acute myocardial infarction between January 2013 and December 2017, as confirmed by principal diagnosis and laboratory findings, were identified retrospectively. RESULTS Univariate logistic regression was used as the primary model to identify potential contributors to mortality. Stepwise forward likelihood ratio logistic regression revealed that neutrophil-to-lymphocyte ratio, peripheral vascular disease, age, and serum creatinine (NPAC) were significant for 90-day mortality (Hosmer- Lemeshow test, p = 0.21). Each component of the NPAC score was weighted by beta-coefficients in multivariate analysis. The C-statistic of the NPAC score was 0.75, which was higher than the conventional Charlson's score (C-statistic = 0.63). Judicious application of a deep learning model to our dataset improved the accuracy of classification with a C-statistic of 0.81. CONCLUSIONS The NPAC score comprises four items from routine laboratory parameters to basic clinical information and can facilitate early identification of cases at risk of short-term mortality following index myocardial infarction. Deep learning model can serve as a gatekeeper to facilitate clinical decision-making.
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Affiliation(s)
| | - Zhongzhi Xu
- School of Data Science, City University of Hong Kong, Hong Kong, PR China
| | - Jeffery Ho
- Department of Anesthesia and Intensive Care, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong, PR China
| | - Ishan Lakhani
- Laboratory of Cardiovascular Physiology, Li Ka Shing Institute of Health Sciences, Hong Kong, PR China
| | - Ying Zhi Liu
- Department of Anesthesia and Intensive Care, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong, PR China
| | - George Bazoukis
- Second Department of Cardiology, Laboratory of Cardiac Electrophysiology, Evangelismos General Hospital of Athens, Athens, Greece
| | - Tong Liu
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Tianjin Institute of Cardiology, Department of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, 300211, PR China
| | - Wing Tak Wong
- School of Life Sciences, The Chinese University of Hong Kong, Hong Kong, PR China
| | - Shuk Han Cheng
- Department of Biomedical Sciences, College of Veterinary Medicine and Life Science, City University of Hong Kong, Kowloon Tong, Kowloon, Hong Kong, PR China
| | - Matthew Tv Chan
- Department of Anesthesia and Intensive Care, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong, PR China
| | - Lin Zhang
- Department of Anesthesia and Intensive Care, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong, PR China; State Key Laboratory of Digestive Disease, Institute of Digestive Disease, Li Ka Shing Institute of Health Sciences, And Shenzhen Research Institute, The Chinese University of Hong Kong, Shatin, Hong Kong, PR China
| | - Tony Gin
- Department of Anesthesia and Intensive Care, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong, PR China
| | - Martin Cs Wong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, PR China
| | - Ian Chi Kei Wong
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, PR China; University College London, United Kingdom
| | - William Ka Kei Wu
- Department of Anesthesia and Intensive Care, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong, PR China; State Key Laboratory of Digestive Disease, Institute of Digestive Disease, Li Ka Shing Institute of Health Sciences, And Shenzhen Research Institute, The Chinese University of Hong Kong, Shatin, Hong Kong, PR China.
| | - Qingpeng Zhang
- School of Data Science, City University of Hong Kong, Hong Kong, PR China.
| | - Gary Tse
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Tianjin Institute of Cardiology, Department of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, 300211, PR China; School of Life Sciences, The Chinese University of Hong Kong, Hong Kong, PR China.
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He X, Ma Q, Fan Y, Zhao B, Wang W, Zhu F, Ma X, Zhou L. The Role of Cytokines in Predicting the Efficacy of Acute Stage Treatment in Patients with Schizophrenia. Neuropsychiatr Dis Treat 2020; 16:191-199. [PMID: 32021213 PMCID: PMC6982444 DOI: 10.2147/ndt.s218483] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 12/20/2019] [Indexed: 12/11/2022] Open
Abstract
PURPOSE Inflammatory response in schizophrenia (SCz) is related to its underlying pathological mechanism and might be significant in deciding a patient's prognosis. The current study aims to investigate the differences in the serum inflammation level between schizophrenic patients and healthy controls and identify inflammatory markers that can predict clinical therapeutic effects in early-stage SCz patients at the 6-month follow-up. PATIENTS AND METHODS In total, 71 subjects were recruited in this study, including 35 patients with Scz and 36 healthy controls. The 35 Scz patients, who were in the first-episode or acute relapse state at admission, had completed the 6-month follow-up. The Positive and Negative Syndrome Scale (PANSS) and the Clinical Global Impression (CGI) assessment results, demographic details, and blood samples were collected at the baseline and at follow-up. Data were analyzed using the Spearman correlation and multiple linear regression. RESULTS Serum interleukin (IL-1β, IL-4, IL-6, and IL-8) levels were significantly elevated in SCz patients at baseline compared with healthy controls, with a reduced IL-8 level at the follow-up. Furthermore, a higher IL-6 level and lower IL-8 level was found to predict better improvement in negative symptoms. The higher IL-6 level also predicted lesser improvement in depressive symptoms. Finally, a higher interferon (IFN)-γ level predicted a lower therapeutic effect for excitatory symptoms. CONCLUSION The serum levels of inflammatory markers were higher in patients with SCz than in healthy controls. These markers can be considered accurate predictors of therapeutic effects in patients with SCz.
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Affiliation(s)
- Xiaoyan He
- Department of Psychiatry, The First Affiliated Hospital of Medical College of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Qingyan Ma
- Department of Psychiatry, The First Affiliated Hospital of Medical College of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Yajuan Fan
- Department of Psychiatry, The First Affiliated Hospital of Medical College of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Binbin Zhao
- Department of Psychiatry, The First Affiliated Hospital of Medical College of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Wei Wang
- Department of Psychiatry, The First Affiliated Hospital of Medical College of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Feng Zhu
- Center for Translational Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Xiancang Ma
- Department of Psychiatry, The First Affiliated Hospital of Medical College of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Lina Zhou
- Department of Psychiatry, The First Affiliated Hospital of Medical College of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
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Mohammed A, Ali T, Alwan A. Seasonality in acute promyelocytic leukemia: Fact or myth? IRAQI JOURNAL OF HEMATOLOGY 2020. [DOI: 10.4103/ijh.ijh_27_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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15
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Increased Trimethylamine N-Oxide Is Not Associated with Oxidative Stress Markers in Healthy Aged Women. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2019; 2019:6247169. [PMID: 31636806 PMCID: PMC6766136 DOI: 10.1155/2019/6247169] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 08/02/2019] [Accepted: 08/16/2019] [Indexed: 12/16/2022]
Abstract
Increased plasma trimethylamine N-oxide (TMAO) levels have been associated with cardiovascular diseases (CVD). L-carnitine induces TMAO elevation in human blood, and thus, it has been suggested as developing atherosclerosis. The aim of this study was to determine the relation between selected markers of oxidative stress and plasma TMAO concentration induced by L-carnitine supplementation for 24 weeks in healthy aged women. Twenty aged women were supplemented during 24 weeks with either 1500 mg L-carnitine-L-tartrate (n = 11) or isonitrogenous placebo (n = 9) per day. Fasting blood samples were taken from antecubital vein. L-carnitine supplementation induced an increase in TMAO, but not in γ-butyrobetaine (GBB). Moreover, there were no significant changes in serum ox-LDL, myeloperoxidase, protein carbonyls, homocysteine, and uric acid concentrations due to supplementation. Significant reduction in white blood cell counts has been observed following 24-week supplementation, but not attributable to L-carnitine. Our results in healthy aged women indicated no relation between TMAO and any determined marker of oxidative stress over the period of 24 weeks. At the same time, plasma GBB levels were not affected by L-carnitine supplementation. Further clinical studies of plasma GBB level as a prognostic marker are needed.
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Postnikoff CK, Pucker AD, Laurent J, Huisingh C, McGwin G, Nichols JJ. Identification of Leukocytes Associated With Midday Fogging in the Post-Lens Tear Film of Scleral Contact Lens Wearers. Invest Ophthalmol Vis Sci 2019; 60:226-233. [PMID: 30646011 PMCID: PMC6340400 DOI: 10.1167/iovs.18-24664] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Purpose Midday fogging is a frequent complaint among scleral contact lens (ScCL) wearers, and the mechanism and cause of this is unknown. The purpose of this investigation was to understand the relation between midday fogging, ocular surface leukocytes, and ScCL fitting characteristics. Methods Subjects arrived at a clinical exam having worn ScCLs for at least 4 hours. ScCL were removed, and 150 μL of phosphate-buffered saline (PBS) was used to wash the bowl of the ScCL. Eyes were washed post-ScCL removal with 5 mL PBS per eye. Wash solutions were collected and leukocytes were then isolated and counted, followed by assessment with flow cytometry. Samples from the post-lens tear fluid were stained with fluorescently labeled antibodies to detect leukocyte distributions. Results Thirty-nine eyes from 19 adapted, full-time, ScCL wearers were included, and 46% presented with midday fogging. ScCL corneal clearance was 246 ± 61 μm for nonfoggers, while it was 308 ± 98 μm for those with fogging (P < 0.05). On average, the number of leukocytes collected from the ScCL bowl (9551 ± 18,926) was greater than the number of leukocytes recovered from the eye wash (2195 ± 4384, P < 0.02). ScCL corneal clearance was associated with the presence of fogging, with an odds ratio of 2.24 (95% confidence interval = 1.48–3.38, P < 0.001). Conclusions Leukocytes, predominated by neutrophils, are present in the post-lens tear film of ScCL wearers, and in particular wearers with greater ScCL corneal clearance have greater odds of having midday fogging.
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Affiliation(s)
- Cameron K Postnikoff
- School of Optometry, Department of Optometry and Vision Science, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Andrew D Pucker
- School of Optometry, Department of Optometry and Vision Science, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - John Laurent
- School of Optometry, Department of Optometry and Vision Science, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Carrie Huisingh
- School of Medicine, Department of Ophthalmology, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Gerald McGwin
- School of Medicine, Department of Ophthalmology, University of Alabama at Birmingham, Birmingham, Alabama, United States.,School of Public Health, Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Jason J Nichols
- School of Optometry, Department of Optometry and Vision Science, University of Alabama at Birmingham, Birmingham, Alabama, United States
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17
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Manabe T, Takasaki J, Kudo K. Seasonality of newly notified pulmonary tuberculosis in Japan, 2007-2015. BMC Infect Dis 2019; 19:497. [PMID: 31170932 PMCID: PMC6555020 DOI: 10.1186/s12879-019-3957-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 04/08/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The seasonality of pulmonary tuberculosis (TB) incidence may indicate season-specific risk factors that could be controlled if they were better understood. The aims of this study were to elucidate how the incidence of TB changes seasonally and to determine the factors influencing TB incidence, to reduce the TB burden in Japan. METHODS We assessed the seasonality of newly notified TB cases in Japan using national surveillance data collected between 2007 and 2015. To investigate age and sex differences, seasonal variation was analyzed according to sex for all cases and then by stratified age groups (0-4, 5-14, 15-24, 25-44, 45-64, 65-74, and ≥ 75 years). We used Roger's test to analyze the cyclic monthly trends in seasonal variation of TB incidence. RESULTS A total of 199,856 newly notified TB cases (male, 62.2%) were reported over the past 9-year period. Among them, 60.6% involved patients aged ≥65 years. Overall, the peak months of TB incidence occurred from April to October, excluding September. In the analysis stratified by age group, a significant seasonal variation in TB cases was observed for age groups ≥15 years, whereas no seasonal variation was observed for age groups ≤14 years. For female patients aged ≥25 years, the peak TB epidemic period was seen from June to December, excluding November. Male patients in the same age groups exhibited declining TB incidence from September to March. CONCLUSIONS TB incidence exhibits seasonality in Japan for people aged > 15 years and peaks in summer to fall. Monthly trends differ according to age and sex. For age groups ≥25 years, cases in women showed longer peaks from June to December whereas cases in men declined from September to December. These results suggest that the seasonality of TB incidence in Japan might be influenced by health checkups in young adults, reactivation of latent TB infection with aging, and lifestyle habits in older adults. These findings can contribute to establishing the potential determinants of TB seasonality in Japan.
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Affiliation(s)
- Toshie Manabe
- Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, 333-1 Yakushiji, Shimotsuke, Tochigi, Japan. .,Waseda University Organization of Regional and Inter-Regional Studies, Tokyo, Japan. .,Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan.
| | - Jin Takasaki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Koichiro Kudo
- Waseda University Organization of Regional and Inter-Regional Studies, Tokyo, Japan
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Özçürümez MK, Haeckel R. Biological variables influencing the estimation of reference limits. Scandinavian Journal of Clinical and Laboratory Investigation 2018; 78:337-345. [PMID: 29764232 DOI: 10.1080/00365513.2018.1471617] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Reference limits (RLs) are required to evaluate laboratory results for medical decisions. The establishment of RL depends on the pre-analytical and the analytical conditions. Furthermore, biological characteristics of the sub-population chosen to provide the reference samples may influence the RL. The most important biological preconditions are gender, age, chronobiological influences, posture, regional and ethnic effects. The influence of these components varies and is often neglected. Therefore, a list of biological variables is collected from the literature and their influence on the estimation of RL is discussed. Biological preconditions must be specified if RL are reported as well for directly as for indirectly estimated RL. The influence of biological variables is especially important if RL established by direct methods are compared with those derived from indirect techniques. Even if these factors are not incorporated into the estimation of RL, their understanding can assist the interpretation of laboratory results of an individual.
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Affiliation(s)
- Mustafa K Özçürümez
- a IMD-Oderland GmbH , Frankfurt (Oder) , Germany.,b Institut für Klinische Chemie Medizinische Fakultät Mannheim der Universität Heidelberg , Mannheim , Germany
| | - Rainer Haeckel
- c Bremer Zentrum für Laboratoriumsmedizin Klinikum Bremen Mitte , Bremen , Germany
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Pierre K, Rao RT, Hartmanshenn C, Androulakis IP. Modeling the Influence of Seasonal Differences in the HPA Axis on Synchronization of the Circadian Clock and Cell Cycle. Endocrinology 2018; 159:1808-1826. [PMID: 29444258 PMCID: PMC6044315 DOI: 10.1210/en.2017-03226] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 02/06/2018] [Indexed: 12/22/2022]
Abstract
Synchronization of biological functions to environmental signals enables organisms to anticipate and appropriately respond to daily external fluctuations and is critical to the maintenance of homeostasis. Misalignment of circadian rhythms with environmental cues is associated with adverse health outcomes. Cortisol, the downstream effector of hypothalamic-pituitary-adrenal (HPA) activity, facilitates synchronization of peripheral biological processes to the environment. Cortisol levels exhibit substantial seasonal rhythmicity, with peak levels occurring during the short-photoperiod winter months and reduced levels occurring in the long-photoperiod summer season. Seasonal changes in cortisol secretion could therefore alter its entraining capabilities, resulting in a season-dependent modification in the alignment of biological activities with the environment. We develop a mathematical model to investigate the influence of photoperiod-induced seasonal differences in the circadian rhythmicity of the HPA axis on the synchronization of the peripheral circadian clock and cell cycle in a heterogeneous cell population. Model simulations predict that the high-amplitude cortisol rhythms in winter result in the greatest entrainment of peripheral oscillators. Furthermore, simulations predict a circadian gating of the cell cycle with respect to the expression of peripheral clock genes. Seasonal differences in cortisol rhythmicity are also predicted to influence mitotic synchrony, with a high-amplitude winter rhythm resulting in the greatest synchrony and a shift in timing of the cell cycle phases, relative to summer. Our results highlight the primary interactions among the HPA axis, the peripheral circadian clock, and the cell cycle and thereby provide an improved understanding of the implications of circadian misalignment on the synchronization of peripheral regulatory processes.
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Affiliation(s)
- Kamau Pierre
- Department of Biomedical Engineering, Rutgers, The State University of New Jersey, Piscataway, New Jersey
| | - Rohit T Rao
- Department of Chemical and Biochemical Engineering, Rutgers, The State University of New Jersey, Piscataway, New Jersey
| | - Clara Hartmanshenn
- Department of Chemical and Biochemical Engineering, Rutgers, The State University of New Jersey, Piscataway, New Jersey
| | - Ioannis P Androulakis
- Department of Biomedical Engineering, Rutgers, The State University of New Jersey, Piscataway, New Jersey
- Department of Chemical and Biochemical Engineering, Rutgers, The State University of New Jersey, Piscataway, New Jersey
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20
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Postnikoff CK, Nichols KK. Neutrophil and T-Cell Homeostasis in the Closed Eye. Invest Ophthalmol Vis Sci 2017; 58:6212-6220. [PMID: 29222551 PMCID: PMC6110127 DOI: 10.1167/iovs.17-22449] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Purpose This study sought to examine the changes and phenotype of the tear neutrophil and T-cell populations between early eyelid closure and after a full night of sleep. Methods Fourteen healthy participants were recruited and trained to wash the ocular surface with PBS for at-home self-collection of ocular surface and tear leukocytes following up to 1 hour of sleep and a full night of sleep (average 7 hours), on separate days. Cells were isolated, counted, and incubated with fluorescently labeled antibodies to identify neutrophils, monocytes, and T cells. For neutrophil analysis, samples were stimulated with lipopolysaccharide (LPS) or calcium ionophore (CaI) before antibody incubation. Flow cytometry was performed. Results Following up to 1 hour of sleep, numerous leukocytes were collected (2.6 × 105 ± 3.0 × 105 cells), although significantly (P < 0.005) more accumulated with 7 hours of sleep (9.9 × 105 ± 1.2× 106 cells). Neutrophils (65%), T cells (3%), and monocytes (1%) were identified as part of the closed eye leukocyte infiltration following 7 hours of sleep. Th17 cells represented 22% of the total CD4+ population at the 7-hour time point. Neutrophil phenotype changed with increasing sleep, with a downregulation of membrane receptors CD16, CD11b, CD14, and CD15, indicating a loss in the phagocytic capability of neutrophils. Conclusions Neutrophils begin accumulating in the closed eye conjunctival sac much earlier than previously demonstrated. The closed eye tears are also populated with T cells, including a subset of Th17 cells. The closed eye environment is more inflammatory than previously thought and is relevant to understanding ocular homeostasis.
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Affiliation(s)
- Cameron K Postnikoff
- School of Optometry, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Kelly K Nichols
- School of Optometry, University of Alabama at Birmingham, Birmingham, Alabama, United States
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Rao RT, Scherholz ML, Hartmanshenn C, Bae SA, Androulakis IP. On the analysis of complex biological supply chains: From Process Systems Engineering to Quantitative Systems Pharmacology. Comput Chem Eng 2017; 107:100-110. [PMID: 29353945 DOI: 10.1016/j.compchemeng.2017.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The use of models in biology has become particularly relevant as it enables investigators to develop a mechanistic framework for understanding the operating principles of living systems as well as in quantitatively predicting their response to both pathological perturbations and pharmacological interventions. This application has resulted in a synergistic convergence of systems biology and pharmacokinetic-pharmacodynamic modeling techniques that has led to the emergence of quantitative systems pharmacology (QSP). In this review, we discuss how the foundational principles of chemical process systems engineering inform the progressive development of more physiologically-based systems biology models.
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Affiliation(s)
- Rohit T Rao
- Department of Chemical and Biochemical Engineering, Rutgers, The State University of New Jersey, 98 Brett Road, Piscataway, NJ 08854
| | - Megerle L Scherholz
- Department of Chemical and Biochemical Engineering, Rutgers, The State University of New Jersey, 98 Brett Road, Piscataway, NJ 08854
| | - Clara Hartmanshenn
- Department of Chemical and Biochemical Engineering, Rutgers, The State University of New Jersey, 98 Brett Road, Piscataway, NJ 08854
| | - Seul-A Bae
- Department of Chemical and Biochemical Engineering, Rutgers, The State University of New Jersey, 98 Brett Road, Piscataway, NJ 08854
| | - Ioannis P Androulakis
- Department of Chemical and Biochemical Engineering, Rutgers, The State University of New Jersey, 98 Brett Road, Piscataway, NJ 08854.,Department of Biomedical Engineering, Rutgers The State University of New Jersey, 599 Taylor Road, Piscataway, NJ 08854
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Pierre K, Schlesinger N, Androulakis IP. The Hepato-Hypothalamic-Pituitary-Adrenal-Renal Axis: Mathematical Modeling of Cortisol’s Production, Metabolism, and Seasonal Variation. J Biol Rhythms 2017; 32:469-484. [DOI: 10.1177/0748730417729929] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Cortisol dynamics are governed by the integration of influences from the suprachiasmatic nucleus (SCN), the hypothalamic-pituitary-adrenal (HPA) axis, and metabolic enzymes, such as the 11β–hydroxysteroid dehydrogenase (HSD) family, which are highly expressed in hepatic and renal tissue. The coordinated regulation of cortisol dynamics is essential for the maintenance of a healthy state, and aberrant cortisol circadian rhythms are associated with various pathophysiological conditions. The duration of the light-dark cycle, or photoperiod, which regulates SCN activity, varies seasonally, and the shorter photoperiod winter season is associated with elevated cortisol levels, peak inflammatory disease incidence, and symptom exacerbation. Elevated expression and activity of 11β-HSD1 protein, assumed to also occur during the winter, have been allied with numerous inflammatory conditions. A comprehensive understanding of the communication between the underlying regulatory mechanisms of cortisol as well as how changes in their activity could lead to the development of disease is yet to be elucidated. In this work, we propose the use of a semimechanistic mathematical model to explore the impact of the hepato-hypothalamic-pituitary-adrenal-renal axis in modulating neuroendocrine-immune system dynamics. Our model predicts the predominance of a winter proinflammatory state and that genetic variations could alter 11β-HSD enzyme functionality, rendering certain subpopulations more susceptible to disease as a consequence of HPA axis dysregulation.
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Affiliation(s)
- Kamau Pierre
- Biomedical Engineering Department, Rutgers University, Piscataway, New Jersey
| | - Naomi Schlesinger
- Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Ioannis P. Androulakis
- Biomedical Engineering Department, Rutgers University, Piscataway, New Jersey
- Chemical & Biochemical Engineering Department, Rutgers University, Piscataway, New Jersey
- Department of Surgery, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey
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Wubuli A, Li Y, Xue F, Yao X, Upur H, Wushouer Q. Seasonality of active tuberculosis notification from 2005 to 2014 in Xinjiang, China. PLoS One 2017; 12:e0180226. [PMID: 28678873 PMCID: PMC5497978 DOI: 10.1371/journal.pone.0180226] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Accepted: 06/12/2017] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES Xinjiang is one of the highest TB-burdened provinces of China. A time-series analysis was conducted to evaluate the trend, seasonality of active TB in Xinjiang, and explore the underlying mechanism of TB seasonality by comparing the seasonal variations of different subgroups. METHODS Monthly active TB cases from 2005 to 2014 in Xinjiang were analyzed by the X-12-ARIMA seasonal adjustment program. Seasonal amplitude (SA) was calculated and compared within the subgroups. RESULTS A total of 277,300 confirmed active TB cases were notified from 2005 to 2014 in Xinjiang, China, with a monthly average of 2311±577. The seasonality of active TB notification was peaked in March and troughed in October, with a decreasing SA trend. The annual 77.31% SA indicated an annual mean of additional TB cases diagnosed in March as compared to October. The 0-14-year-old group had significantly higher SA than 15-44-year-old group (P<0.05). Students had the highest SA, followed by herder and migrant workers (P<0.05). The pleural TB cases had significantly higher SA than the pulmonary cases (P <0.05). Significant associations were not observed between SA and sex, ethnic group, regions, the result of sputum smear microcopy, and treatment history (P>0.05). CONCLUSION TB notification in Xinjiang shows an apparent seasonal variation with a peak in March and trough in October. For the underlying mechanism of TB seasonality, our results hypothesize that winter indoor crowding increases the risk of TB transmission, and seasonality was mainly influenced by the recent exogenous infection rather than the endogenous reactivation.
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Affiliation(s)
- Atikaimu Wubuli
- Department of Epidemiology and Biostatistics, School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Yuehua Li
- Center for Tuberculosis Control and Prevention, Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, Urumqi, Xinjiang, China
| | - Feng Xue
- Center for Tuberculosis Control and Prevention, Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, Urumqi, Xinjiang, China
| | - Xuemei Yao
- Department of Epidemiology and Biostatistics, School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Halmurat Upur
- Department of Traditional Uygur Medicine, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Qimanguli Wushouer
- Department of Respiratory Medicine, The First Teaching Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
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Winter to summer change in vitamin D status reduces systemic inflammation and bioenergetic activity of human peripheral blood mononuclear cells. Redox Biol 2017; 12:814-820. [PMID: 28441630 PMCID: PMC5406546 DOI: 10.1016/j.redox.2017.04.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 04/05/2017] [Accepted: 04/05/2017] [Indexed: 01/01/2023] Open
Abstract
Background Vitamin D status [25(OH)D] has recently been reported to be associated with altered cellular bioenergetic profiles of peripheral blood mononuclear cells (PBMCs). No study has tracked the seasonal variation of 25(OH)D and its putative influence on whole body energy metabolism, cellular bioenergetic profiles, inflammatory markers and clinical chemistry. Material and methods Whole body energy metabolism and substrate utilisation were measured by indirect calorimetry. PBMCs obtained from the same subjects were isolated from whole blood, counted and freshly seeded. Bioenergetic analysis (mitochondrial stress test and glycolysis stress test) was performed using the Seahorse XFe96 flux analyser. 25(OH)D was assessed using the Architect immunoassay method. Results 25(OH)D increased by a median (IQR) of 14.40 (20.13) nmol/L (p<0.001) from winter to summer and was accompanied by significant improvements in indices of insulin sensitivity, McAuley's index (p=0.019) and quantitative insulin sensitivity check index (p=0.028). PBMC mitochondrial parameters basal respiration, non-mitochondrial respiration, ATP production, proton leak, and maximal respiration decreased in summer compared to winter. Similarly, PBMC glycolytic parameters glycolytic activity, glucose response, and glycolytic capacity were all reduced in summer compared to winter. There was also a trend for absolute resting metabolic rate (RMR) to decrease (p=0.066). Markers of systemic inflammation MCP-1, IL-6, IL-8, IL-10, and IL-12p70 decreased significantly in summer compared to winter. Participants who entered winter with a low 25(OH)D (<50 nmol/L), had the greatest alteration in bioenergetic parameters in summer, relative to those with winter 25(OH)D concentrations of 50–75 nmol/L or >75 nmol/L. The absolute change in 25(OH)D was not associated with altered bioenergetics. Conclusion Seasonal improvements in 25(OH)D was associated with reduced systemic inflammation, PBMC bioenergetic profiles and whole body energy metabolism. These observational changes in PBMC bioenergetics were most pronounced in those who had insufficient 25(OH)D in winter. The data warrants confirmation through cause and effect study designs. Inflammation and clinical biochemistry improved in summer versus winter. Seasonal improvements in 25(OH)D modulated the bioenergetic profile of PBMCs. Maintaining 25(OH)D >50 nmol/L may be important for bioenergetic function.
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Maher IE, Higgins DP. Altered Immune Cytokine Expression Associated with KoRV B Infection and Season in Captive Koalas. PLoS One 2016; 11:e0163780. [PMID: 27706211 PMCID: PMC5051944 DOI: 10.1371/journal.pone.0163780] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 09/14/2016] [Indexed: 12/22/2022] Open
Abstract
Koala (Phascolarctos cinereus) populations are increasingly vulnerable and one of the main threats is chlamydial infection. Koala retrovirus (KoRV) has been proposed as an underlying cause of the koala’s susceptibility to infection with Chlamydia and high rates of lymphoid neoplasia; however, the regionally ubiquitous, endogenous nature of this virus suggests that KoRV A infection is not sufficient for immune suppression to occur. A recently discovered exogenous variant of KoRV, KoRV B, has several structural elements that cause increased pathogenicity in related retroviruses and was associated with lymphoid neoplasia in one study. The present study assesses whether KoRV B infection is associated with alterations in immune function. Cytokine gene expression by mitogen stimulated lymphocytes of KoRV B positive (n = 5–6) and negative (n = 6–7) captive koalas was evaluated by qPCR four times (April 2014-February 2015) to control for seasonal variation. Key immune genes in the Th1 pathway (IFNγ, TNFα), Th2 pathway (IL 10, IL4, IL6) and Th17 pathway (IL17A), along with CD4:CD8 ratio, were assessed. KoRV B positive koalas showed significantly increased up-regulation of IL17A and IL10 in three out of four sampling periods and IFNγ, IL6, IL4 and TNFα in two out of four. IL17A is an immune marker for chlamydial pathogenesis in the koala; increased expression of IL17A in KoRV B positive koalas, and concurrent immune dysregulation, may explain the differences in susceptibility to chlamydial infection and severity of disease seen between individuals and populations. There was also marked seasonal variation in up-regulation for most of the cytokines and the CD4:CD8 ratio. The up-regulation in both Th1 and Th2 cytokines mirrors changes associated with immune dysregulation in humans and felids as a result of retroviral infections. This is the first report of altered immune expression in koalas infected by an exogenous variant of KoRV and also the first report of seasonal variation in cytokine up-regulation and CD4:CD8 ratio in marsupials.
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Affiliation(s)
- Iona E. Maher
- School of Life and Environmental Sciences, Faculty of Veterinary Science, the University of Sydney, NSW, Australia
| | - Damien P. Higgins
- School of Life and Environmental Sciences, Faculty of Veterinary Science, the University of Sydney, NSW, Australia
- * E-mail:
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Lin BD, Hottenga JJ, Abdellaoui A, Dolan CV, de Geus EJC, Kluft C, Boomsma DI, Willemsen G. Causes of variation in the neutrophil-lymphocyte and platelet-lymphocyte ratios: a twin-family study. Biomark Med 2016; 10:1061-1072. [PMID: 27690543 DOI: 10.2217/bmm-2016-0147] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
AIM Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are biomarkers for disease development, for whom little is known about causes of variation in the general population. MATERIALS & METHODS We estimated the heritability of PLR and NLR and examined their association with gender, demographic, lifestyle and environmental factors in a Dutch nonpatient twin family population (n = 8108). RESULTS Heritability was estimated at 64% for PLR and 36% for NLR. Men had on average higher NLR, but lower PLR levels than women. PLR and NLR increased significantly with age, decreased in colder months and showed small but significant sex- and age-specific associations with body composition and smoking. CONCLUSION NLR and PLR levels are heritable and influenced by age, sex and environmental factors, such as seasonal conditions and lifestyle.
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Affiliation(s)
- Bochao D Lin
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jouke-Jan Hottenga
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,EMGO+ Institute for Health & Care Research, VU Medical Center, Amsterdam, The Netherlands
| | - Abdel Abdellaoui
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Conor V Dolan
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Eco J C de Geus
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,EMGO+ Institute for Health & Care Research, VU Medical Center, Amsterdam, The Netherlands
| | | | - Dorret I Boomsma
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,EMGO+ Institute for Health & Care Research, VU Medical Center, Amsterdam, The Netherlands
| | - Gonneke Willemsen
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,EMGO+ Institute for Health & Care Research, VU Medical Center, Amsterdam, The Netherlands
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Pierre K, Schlesinger N, Androulakis IP. The role of the hypothalamic-pituitary-adrenal axis in modulating seasonal changes in immunity. Physiol Genomics 2016; 48:719-738. [PMID: 27341833 DOI: 10.1152/physiolgenomics.00006.2016] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 06/23/2016] [Indexed: 12/21/2022] Open
Abstract
Seasonal changes in environmental conditions are accompanied by significant adjustment of multiple biological processes. In temperate regions, the day fraction, or photoperiod, is a robust environmental cue that synchronizes seasonal variations in neuroendocrine and metabolic function. In this work, we propose a semimechanistic mathematical model that considers the influence of seasonal photoperiod changes as well as cellular and molecular adaptations to investigate the seasonality of immune function. Our model predicts that the circadian rhythms of cortisol, our proinflammatory mediator, and its receptor exhibit seasonal differences in amplitude and phase, oscillating at higher amplitudes in the winter season with peak times occurring later in the day. Furthermore, the reduced photoperiod of winter coupled with seasonal alterations in physiological activity induces a more exacerbated immune response to acute stress, simulated in our studies as the administration of an acute dose of endotoxin. Our findings are therefore in accordance with experimental data that reflect the predominance of a proinflammatory state during the winter months. These changes in circadian rhythm dynamics may play a significant role in the seasonality of disease incidence and regulate the diurnal and seasonal variation of disease symptom severity.
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Affiliation(s)
- Kamau Pierre
- Biomedical Engineering Department, Rutgers University, Piscataway, New Jersey
| | - Naomi Schlesinger
- Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Ioannis P Androulakis
- Biomedical Engineering Department, Rutgers University, Piscataway, New Jersey; Chemical and Biochemical Engineering Department, Rutgers University, Piscataway, New Jersey; and Department of Surgery, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey
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Dharmaraj R, Jaber A, Arora R, Hagglund K, Lyons H. Seasonal variations in onset and exacerbation of inflammatory bowel diseases in children. BMC Res Notes 2015; 8:696. [PMID: 26588900 PMCID: PMC4654892 DOI: 10.1186/s13104-015-1702-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 11/17/2015] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Studies have suggested that inflammatory bowel diseases (IBD) follow a seasonal pattern with regard to their onset and exacerbations. The aim of this study is to determine if there is any seasonal pattern to the onset and exacerbation of IBD in the pediatric population and if the birth of children diagnosed with IBD follows a seasonal pattern. METHODS Patients between the ages of 1 and 21 years and with a diagnosis of IBD established between July 1992 and July 2012 were included. Their onset and exacerbations of IBD (year and season) were recorded. The birth dates of the patients were aggregated to determine whether a seasonal birth pattern existed amongst them. RESULTS A total of 170 children were included in this study; 34% of patients had their onset in the fall and 19% of them had their onset in the summer. The total number of documented exacerbations was 358 and the median number of exacerbations was two, with a range of 1-11. IBD exacerbations were generally uniformly distributed throughout the year. We did not observe any specific season where children with IBD tended to be born. CONCLUSIONS Our data suggests that the onset of symptoms of IBD tends to have a seasonal trend with the highest incidence in the fall. However, we did not observe any association between seasonality and exacerbations in the pediatric population. Moreover, there was no specific season in which children with IBD tended to be born in greater numbers.
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Affiliation(s)
- Rajmohan Dharmaraj
- Department of Pediatrics, St. John Providence Children's Hospital, Detroit, MI, 48236, USA.
| | - Anas Jaber
- Department of Pediatrics, St. John Providence Children's Hospital, Detroit, MI, 48236, USA.
| | - Rajan Arora
- Department of Pediatrics, St. John Providence Children's Hospital, Detroit, MI, 48236, USA.
| | - Karen Hagglund
- Department of Biostatistics, St. John Providence Children's Hospital, Detroit, MI, 48236, USA.
| | - Hernando Lyons
- Department of Pediatric Gastroenterology, St. John Providence Children's Hospital, Wayne State University School of Medicine, Detroit, MI, 48236, USA.
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Enhanced inflammatory and T-helper-1 type responses but suppressed lymphocyte proliferation in patients with seasonal affective disorder and treated by light therapy. J Affect Disord 2015; 185:90-6. [PMID: 26148465 DOI: 10.1016/j.jad.2015.06.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 06/05/2015] [Accepted: 06/05/2015] [Indexed: 01/28/2023]
Abstract
BACKGROUND Animals show seasonal changes in the endocrine and immune system in response to winter stressors. Even though increased inflammation has been implicated in the pathophysiology of depression, whether immune disorder is a key mediator in seasonal affective depression (SAD) is unknown. Here, we hypothesized that short photoperiods in winter may induce inflammatory response, which contributes to SAD, and that light treatments should normalize immune function and improve depressive symptoms. METHODS Twenty patients with a diagnosis of SAD, and a score on the HAM-29 of 20 or higher were recruited for this study. Twenty-one healthy subjects with no personal and family history of psychiatric disorder were matched to patients according to age and sex. Patients and controls were sampled during winter between November and January, inclusive. A subset of SAD patients (N=13) was re-sampled after 4 weeks of light therapy. Blood samples were assayed for macrophage activity, lymphocyte proliferation and cytokine release. RESULTS SAD patients showed significantly higher macrophage activity and lower lymphocyte proliferation in winter compared to healthy subjects. The concentrations of macrophage-produced proinflammatory cytokines interleukin-1β and tumour necrosis factor-α, and T-helper (Th)-1 produced cytokine, interferon-γ were all significantly increased. In contrast, no significant changes in Th2-produced cytokines were observed. Light therapy significantly improved depressive scores, which was associated with attenuation of decreased lymphocyte functions, increased macrophage activity and level of proinflammatory cytokines. CONCLUSION SAD patients have increased macrophage and Th1 type responses in winter, and light therapy normalized immune functions and depressive symptoms. These results support an inflammatory hypothesis for SAD and an immunomodulatory role of light therapy.
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30
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Parnell GP, Booth DR. Whole blood transcriptomic analysis to identify clinical biomarkers of drug response. Methods Mol Biol 2015; 1175:35-43. [PMID: 25150865 DOI: 10.1007/978-1-4939-0956-8_3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Since most immunological and hematological conditions might be expected to alter whole blood gene expression, its examination can lead to insights into disease processes, and biomarkers to assess molecular phenotypes, disease states, progression and response to therapy. In this chapter we describe collection and storage of RNA from whole blood, techniques to measure gene expression, and analytical approaches to identify the dysregulated gene expression using pathway and clustering analysis, gene set enrichment, heat map approaches, and cell subset deconvolution.
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Affiliation(s)
- Grant P Parnell
- Westmead Millennium Institute, University of Sydney, Hawkesbury Road, Sydney, NSW, 2145, Australia
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31
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An HM, Tan YL, Shi J, Wang ZR, Soars JC, Wu JQ, Yang FD, Huang XF, Zhang XY. Altered IL-2, IL-6 and IL-8 serum levels in schizophrenia patients with tardive dyskinesia. Schizophr Res 2015; 162:261-8. [PMID: 25600548 DOI: 10.1016/j.schres.2014.12.037] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Revised: 11/29/2014] [Accepted: 12/29/2014] [Indexed: 11/27/2022]
Abstract
Immune deregulation has been postulated to be one of the mechanisms underlying the pathogenesis of tardive dyskinesia (TD). We hypothesized that interleukins would have a link with TD in schizophrenia patients. In this study, the serum IL-2, IL-6 and IL-8 levels were examined by enzyme-linked immunosorbent assay (ELISA) in schizophrenia patients with TD (n=48) and without TD (n=45), and healthy controls (n=44). The psychopathological symptoms of schizophrenia were assessed by the Positive and Negative Syndrome Scale (PANSS). The severity of TD was evaluated using Abnormal Involuntary Movement Scale (AIMS). The results showed that serum IL-2, IL-6 and IL-8 levels were significantly different among schizophrenia patients with TD and without TD and normal controls. Moreover, IL-2 level was significantly correlated with PANSS positive subscale and general subscale in patients with TD and without TD. In addition, IL-2 level was positively correlated with AIMS score in TD patients. The results supported that immune disturbance is related to the schizophrenia patients, especially to the patients with TD and ILs might play an important role in the pathophysiology of schizophrenia patients with TD.
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Affiliation(s)
- Hui-Mei An
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Yun-Long Tan
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Jing Shi
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Zhi-Ren Wang
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Jair C Soars
- Department of Psychiatry and Behavioral Sciences, Harris County Psychiatric Center, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Jing Qin Wu
- School of Biomedical Sciences and Pharmacy, Faculty of Health, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Fu-De Yang
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Xu-Feng Huang
- Centre for Translational Neuroscience, School of Medicine, Illawarra Health and Medical Research Institute, University of Wollongong, NSW, Australia
| | - Xiang Yang Zhang
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China; Department of Psychiatry and Behavioral Sciences, Harris County Psychiatric Center, The University of Texas Health Science Center at Houston, Houston, TX, USA.
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Parnell GP, Gatt PN, Krupa M, Nickles D, McKay FC, Schibeci SD, Batten M, Baranzini S, Henderson A, Barnett M, Slee M, Vucic S, Stewart GJ, Booth DR. The autoimmune disease-associated transcription factors EOMES and TBX21 are dysregulated in multiple sclerosis and define a molecular subtype of disease. Clin Immunol 2014; 151:16-24. [PMID: 24495857 DOI: 10.1016/j.clim.2014.01.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Revised: 01/07/2014] [Accepted: 01/07/2014] [Indexed: 12/22/2022]
Abstract
We have identified a marked over-representation of transcription factors controlling differentiation of T, B, myeloid and NK cells among the 110 MS genes now known to be associated with multiple sclerosis (MS). To test if the expression of these genes might define molecular subtypes of MS, we interrogated their expression in blood in three independent cohorts of untreated MS (from Sydney and Adelaide) or clinically isolated syndrome (CIS, from San Francisco) patients. Expression of the transcription factors (TF) controlling T and NK cell differentiation, EOMES, TBX21 and other TFs was significantly lower in MS/CIS compared to healthy controls in all three cohorts. Expression was tightly correlated between these TFs, with other T/NK cell TFs, and to another downregulated gene, CCL5. Expression was stable over time, but did not predict disease phenotype. Optimal response to therapy might be indicated by normalization of expression of these genes in blood.
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Affiliation(s)
- Grant P Parnell
- Institute for Immunology and Allergy Research, Westmead Millennium Institute University of Sydney, Sydney, New South Wales 2145, Australia
| | - Prudence N Gatt
- Institute for Immunology and Allergy Research, Westmead Millennium Institute University of Sydney, Sydney, New South Wales 2145, Australia
| | - Malgorzata Krupa
- School of Medicine, Flinders University of South Australia, South Australia 5042, Australia
| | - Dorothee Nickles
- Department of Neurology, University of California at San Francisco, CA 94158, USA
| | - Fiona C McKay
- Institute for Immunology and Allergy Research, Westmead Millennium Institute University of Sydney, Sydney, New South Wales 2145, Australia
| | - Stephen D Schibeci
- Institute for Immunology and Allergy Research, Westmead Millennium Institute University of Sydney, Sydney, New South Wales 2145, Australia
| | - Marcel Batten
- Garvan Institute of Medical Research, Darlinghurst, Sydney, NSW 2010, Australia
| | - Sergio Baranzini
- Department of Neurology, University of California at San Francisco, CA 94158, USA
| | - Andrew Henderson
- Institute for Immunology and Allergy Research, Westmead Millennium Institute University of Sydney, Sydney, New South Wales 2145, Australia
| | - Michael Barnett
- Brain and Mind Research Institute, University of Sydney, Sydney, NSW 2050 Australia
| | - Mark Slee
- School of Medicine, Flinders University of South Australia, South Australia 5042, Australia
| | - Steve Vucic
- Westmead Clinical School, University of Sydney, Westmead Hospital, Sydney, New South Wales 2145, Australia
| | - Graeme J Stewart
- Institute for Immunology and Allergy Research, Westmead Millennium Institute University of Sydney, Sydney, New South Wales 2145, Australia
| | - David R Booth
- Institute for Immunology and Allergy Research, Westmead Millennium Institute University of Sydney, Sydney, New South Wales 2145, Australia.
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De Boever P, Wens B, Forcheh AC, Reynders H, Nelen V, Kleinjans J, Van Larebeke N, Verbeke G, Valkenborg D, Schoeters G. Characterization of the peripheral blood transcriptome in a repeated measures design using a panel of healthy individuals. Genomics 2013; 103:31-9. [PMID: 24321174 DOI: 10.1016/j.ygeno.2013.11.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Revised: 06/14/2013] [Accepted: 11/29/2013] [Indexed: 01/01/2023]
Abstract
A repeated measures microarray design with 22 healthy, non-smoking volunteers (aging 32±5years) was set up to study transcriptome profiles in whole blood samples. The results indicate that repeatable data can be obtained with high within-subject correlation. Probes that could discriminate between individuals are associated with immune and inflammatory functions. When investigating possible time trends in the microarray data, we have found no differential expression within a sampling period (within-season effect). Differential expression was observed between sampling seasons and the data suggest a weak response of genes related to immune system functioning. Finally, a high number of probes showed significant season-specific expression variability within subjects. Expression variability increased in springtime and there was an association of the probe list with immune system functioning. Our study suggests that the blood transcriptome of healthy individuals is reproducible over a time period of several months.
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Affiliation(s)
- Patrick De Boever
- Flemish Institute for Technological Research, Unit Environmental Risk and Health, Belgium; Hasselt University, Centre for Environmental Sciences, Belgium.
| | - Britt Wens
- Flemish Institute for Technological Research, Unit Environmental Risk and Health, Belgium
| | - Anyiawung Chiara Forcheh
- Catholic University of Leuven, Interuniversity Institute for Biostatistics and Statistical Bioinformatics, Belgium
| | - Hans Reynders
- Flemish Government, Environment, Nature and Energy Department, Belgium
| | - Vera Nelen
- Provincial Institute for Hygiene, Belgium
| | - Jos Kleinjans
- Maastricht University, Department of Toxicogenomics, The Netherlands
| | - Nicolas Van Larebeke
- Ghent University, Study Centre for Carcinogenesis and Primary Prevention of Cancer, Belgium
| | - Geert Verbeke
- Catholic University of Leuven, Interuniversity Institute for Biostatistics and Statistical Bioinformatics, Belgium
| | - Dirk Valkenborg
- Flemish Institute for Technological Research, Unit Environmental Risk and Health, Belgium; Hasselt University, Interuniversity Institute for Biostatistics and Statistical Bioinformatics, Belgium
| | - Greet Schoeters
- Flemish Institute for Technological Research, Unit Environmental Risk and Health, Belgium; University of Antwerp, Department of Biomedical Sciences, Belgium; University of Southern Denmark, Department of Environmental Medicine, Denmark
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34
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Seasonal trend of acute pelvic inflammatory disease. Arch Gynecol Obstet 2013; 289:1017-22. [DOI: 10.1007/s00404-013-3094-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2013] [Accepted: 11/11/2013] [Indexed: 10/26/2022]
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Parnell GP, Gatt PN, McKay FC, Schibeci S, Krupa M, Powell JE, Visscher PM, Montgomery GW, Lechner-Scott J, Broadley S, Liddle C, Slee M, Vucic S, Stewart GJ, Booth DR. Ribosomal protein S6 mRNA is a biomarker upregulated in multiple sclerosis, downregulated by interferon treatment, and affected by season. Mult Scler 2013; 20:675-85. [DOI: 10.1177/1352458513507819] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background: Multiple Sclerosis (MS) is an immune-mediated disease of the central nervous system which responds to therapies targeting circulating immune cells. Objective: Our aim was to test if the T-cell activation gene expression pattern (TCAGE) we had previously described from whole blood was replicated in an independent cohort. Methods: We used RNA-seq to interrogate the whole blood transcriptomes of 72 individuals (40 healthy controls, 32 untreated MS). A cohort of 862 control individuals from the Brisbane Systems Genetics Study (BSGS) was used to assess heritability and seasonal expression. The effect of interferon beta (IFNB) therapy on expression was evaluated. Results: The MS/TCAGE association was replicated and rationalized to a single marker, ribosomal protein S6 (RPS6). Expression of RPS6 was higher in MS than controls ( p<0.0004), and lower in winter than summer ( p<4.6E-06). The seasonal pattern correlated with monthly UV light index ( R=0.82, p<0.002), and was also identified in the BSGS cohort ( p<0.0016). Variation in expression of RPS6 was not strongly heritable. RPS6 expression was reduced by IFNB therapy. Conclusions: These data support investigation of RPS6 as a potential therapeutic target and candidate biomarker for measuring clinical response to IFNB and other MS therapies, and of MS disease heterogeneity.
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Affiliation(s)
- Grant P Parnell
- Westmead Millennium Institute, University of Sydney, Sydney, New South Wales, Australia
| | - Prudence N Gatt
- Westmead Millennium Institute, University of Sydney, Sydney, New South Wales, Australia
| | - Fiona C McKay
- Westmead Millennium Institute, University of Sydney, Sydney, New South Wales, Australia
| | - Stephen Schibeci
- Westmead Millennium Institute, University of Sydney, Sydney, New South Wales, Australia
| | - Malgorzata Krupa
- School of Medicine, Flinders University of South Australia, South Australia, Australia
| | - Joseph E Powell
- University of Queensland Diamantina Institute, Translational Research Institute, Brisbane, Queensland, Australia
- The Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Peter M Visscher
- University of Queensland Diamantina Institute, Translational Research Institute, Brisbane, Queensland, Australia
- The Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Grant W Montgomery
- The Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
| | | | | | - Christopher Liddle
- Westmead Millennium Institute, University of Sydney, Sydney, New South Wales, Australia
| | - Mark Slee
- School of Medicine, Flinders University of South Australia, South Australia, Australia
| | - Steve Vucic
- Westmead Clinical School, University of Sydney, Westmead Hospital, Sydney, New South Wales, Australia
| | - Graeme J Stewart
- Westmead Millennium Institute, University of Sydney, Sydney, New South Wales, Australia
| | - David R Booth
- Westmead Millennium Institute, University of Sydney, Sydney, New South Wales, Australia
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Iuliano AD, Weidle PJ, Brooks JT, Masaba R, Girde S, Ndivo R, Ogindo P, Omolo P, Zeh C, Thomas TK. Neutropenia in HIV-Infected Kenyan Women Receiving Triple Antiretroviral Prophylaxis to Prevent Mother-to-Child HIV Transmission Is Not Associated with Serious Clinical Sequelae. J Int Assoc Provid AIDS Care 2013; 14:261-8. [PMID: 24080477 DOI: 10.1177/2325957413502543] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Absolute neutrophil counts (ANCs) are lower in East African adults. To assess the impact of lower ANCs, we reviewed data from HIV-infected Kenyan women receiving antiretroviral therapy antepartum and postpartum. METHODS The Kisumu Breastfeeding Study (KiBS) participants received an antiretroviral regimen from 34 weeks' gestation through 6 months postpartum. Measured ANCs and subsequent illnesses were reviewed. Adverse events (AEs) potentially attributable to neutropenia were identified, and ANCs were graded using the 2004 Division of AIDS table for Grading the Severity of AEs. RESULTS Among 478 women with ≥1 postpartum ANC measured, 298 (62.1%) women met criteria for an AE (<1.3 × 10(9) cells/L). Of those, 38 (12.5%) women experienced a nonlife-threatening illness potentially attributable to neutropenia. CONCLUSION More than half of KiBS women met criteria for neutropenia. The mild clinical experience of most participants with low ANCs supports that these values might be typical for this population and may not result in adverse clinical sequelae.
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Affiliation(s)
- A Danielle Iuliano
- Division of HIV/AIDS Prevention, National Center for HIV, Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Paul J Weidle
- Division of HIV/AIDS Prevention, National Center for HIV, Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - John T Brooks
- Division of HIV/AIDS Prevention, National Center for HIV, Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Rose Masaba
- Kenya Medical Research Institute, Kisumu, Kenya
| | - Sonali Girde
- Division of HIV/AIDS Prevention, National Center for HIV, Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA ICF International, Atlanta, GA, USA
| | | | - Paul Ogindo
- Kenya Medical Research Institute, Kisumu, Kenya
| | - Paul Omolo
- Kenya Medical Research Institute, Kisumu, Kenya
| | - Clement Zeh
- Division of HIV/AIDS Prevention, National Center for HIV, Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA Kenya Medical Research Institute (KEMRI)/CDC, Kisumu, Kenya
| | - Timothy K Thomas
- Division of HIV/AIDS Prevention, National Center for HIV, Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA Kenya Medical Research Institute (KEMRI)/CDC, Kisumu, Kenya
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Jung YS, Song CS, Kim ER, Park DI, Kim YH, Cha JM, Kim JH, Lee SH, Eun CS, Han DS. Seasonal variation in months of birth and symptom flares in Korean patients with inflammatory bowel disease. Gut Liver 2013; 7:661-7. [PMID: 24312706 PMCID: PMC3848533 DOI: 10.5009/gnl.2013.7.6.661] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2013] [Revised: 02/07/2013] [Accepted: 02/07/2013] [Indexed: 12/20/2022] Open
Abstract
Background/Aims Seasonal variation may influence the development and exacerbation of inflammatory bowel disease (IBD). However, most epidemiologic studies on this topic have been conducted in Western countries. The purpose of this study was to determine whether birth dates and symptom flares follow a seasonal pattern in Korean patients with IBD. Methods Patients with a diagnosis of IBD established between January 2003 and December 2010 were investigated at six university hospitals in Korea. The expected births and flares, with a uniform distribution during the year and considering differences in the number of days in the months of 1 year, were calculated. Results A total of 411 patients with ulcerative colitis (UC) and 316 patients with Crohn disease (CD) were included in the study. Birth during the winter period, and especially in January and February, was associated with an increased risk of IBD, especially in UC patients. The symptom flares of CD patients occurred most frequently in the spring, with a nadir in the autumn. However, no disease flare seasonality was noted for UC patients. Conclusions Our data suggest that seasonally varying environmental factors during pregnancy and the postpartum period are associated with a susceptibility to IBD later in life and that exacerbations of CD are influenced by seasonal factors.
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Affiliation(s)
- Yoon Suk Jung
- Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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Variation in hematologic and serum biochemical values of belugas (Delphinapterus leucas) under managed care. J Zoo Wildl Med 2013; 44:376-88. [PMID: 23805556 DOI: 10.1638/2012-0172r] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Blood analytes are critical for evaluating the general health of cetacean populations, so it is important to understand the intrinsic variability of hematology and serum chemistry values. Previous studies have reported data for follow-up periods of several years in managed and wild populations, but studies over long periods of time (> 20 yr) have not been reported. The study objective was to identify the influences of partitioning characteristics on hematology and serum chemistry analytes of apparently healthy managed beluga (Delphinapterus leucas). Blood values from 31 managed belugas, at three facilities, collected over 22 yr, were assessed for seasonal variation and aging trends, and evaluated for biologic variation among and within individuals. Linear mixed effects models assessed the relationship between the analytes and sex, age, season, facility location, ambient air temperature, and photoperiod. Sex differences in analytes and associations with increasing age were observed. Seasonal variation was observed for hemoglobin, hematocrit, mean corpuscular volume, monocytes, alkaline phosphatase, total bilirubin, cholesterol, and triglycerides. Facilities were associated with larger effects on analyte values compared to other covariates, whereas age, sex, and ambient temperature had smaller effects compared to facility and season. Present findings provide important baseline information for future health monitoring efforts. Interpretation of blood analytes and animal health in managed and wild populations over time is aided by having available typical levels for the species and reference intervals for the degree to which individual animals vary from the species average and from their own baseline levels during long-term monitoring.
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Golan D, Halhal B, Glass-Marmor L, Staun-Ram E, Rozenberg O, Lavi I, Dishon S, Barak M, Ish-Shalom S, Miller A. Vitamin D supplementation for patients with multiple sclerosis treated with interferon-beta: a randomized controlled trial assessing the effect on flu-like symptoms and immunomodulatory properties. BMC Neurol 2013; 13:60. [PMID: 23767916 PMCID: PMC3691658 DOI: 10.1186/1471-2377-13-60] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2013] [Accepted: 05/31/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Flu-like symptoms (FLS) are common side effects of interferon beta (IFN-β) treatment in patients with Multiple Sclerosis (PwMS) and are associated with post-injection cytokine surge. We hypothesized that vitamin D3 supplementation would ameliorate FLS by decreasing related serum cytokines' levels. METHODS In a randomized, double blind study of 45 IFNβ-treated PwMS, 21 patients were assigned to 800 IU of vitamin D3 per day (low dose), while 24 patients received 4,370 IU per day (high dose) for one year. FLS were assessed monthly by telephonic interviews. Serum levels of 25-hydroxy-D (25-OH-D), calcium, PTH, IL-17, IL-10 and IFN-γ were measured periodically. EDSS, relapses, adverse events and quality of life (QoL) were documented. RESULTS 25-OH-D levels increased to a significantly higher levels and PTH levels decreased in the high dose group. There was no significant change in FLS. IL-17 levels were significantly increased in the low dose group, while patients receiving high dose vitamin D had a heterogeneous IL-17 response. No significant differences in relapse rate, EDSS, QoL, serum IL-10 and IFNγ were found. Hypercalcemia or other potential major adverse events were not observed. CONCLUSION Vitamin D supplementation to IFN-β treated PwMS, at the doses used, seems safe and associated with dose-dependent changes in IL-17 serum levels, while not affecting IFN-β related FLS. TRIAL REGISTRATION ClinicalTrials.gov ID: NCT01005095.
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Affiliation(s)
- Daniel Golan
- Division of Neuroimmunology & Multiple Sclerosis Center, Carmel Medical Center, 7 Michal Street, Haifa, 34362, Israel
- Department of Neurology, Carmel Medical Center, Haifa, Israel
| | - Basheer Halhal
- Division of Neuroimmunology & Multiple Sclerosis Center, Carmel Medical Center, 7 Michal Street, Haifa, 34362, Israel
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Lea Glass-Marmor
- Division of Neuroimmunology & Multiple Sclerosis Center, Carmel Medical Center, 7 Michal Street, Haifa, 34362, Israel
| | - Elsebeth Staun-Ram
- Division of Neuroimmunology & Multiple Sclerosis Center, Carmel Medical Center, 7 Michal Street, Haifa, 34362, Israel
| | - Orit Rozenberg
- Central Laboratory of Haifa and Western Galilee, Clalit Health Services, Haifa, Israel
| | - Idit Lavi
- Department of Community Medicine & Epidemiology, Carmel Medical Center, Haifa, Israel
| | - Sara Dishon
- Division of Neuroimmunology & Multiple Sclerosis Center, Carmel Medical Center, 7 Michal Street, Haifa, 34362, Israel
| | - Mira Barak
- Central Laboratory of Haifa and Western Galilee, Clalit Health Services, Haifa, Israel
| | - Sophia Ish-Shalom
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Ariel Miller
- Division of Neuroimmunology & Multiple Sclerosis Center, Carmel Medical Center, 7 Michal Street, Haifa, 34362, Israel
- Department of Neurology, Carmel Medical Center, Haifa, Israel
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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Calip GS, McDougall JA, Wheldon MC, Li CI, De Roos AJ. Evaluation of seasonality in the diagnosis of acute myeloid leukaemia among adults in the United States, 1992-2008. Br J Haematol 2012. [PMID: 23189956 DOI: 10.1111/bjh.12137] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Recent studies have suggested seasonal variation in the diagnosis of acute myeloid leukaemia (AML), and the aetiological role seasonal factors may play in this group of haematological neoplasms remains unclear. We evaluated potential seasonality of AML diagnosis among adults. Cases included were ascertained from the Surveillance, Epidemiology, and End Results (SEER) 13 registries from 1992-2008. Chi-square analysis for heterogeneity and multiple Poisson regression using parametric harmonic modelling and bootstrap testing were used to detect possible monthly variation. Months of peak diagnoses were December and January, although some variation was present by sex and age. Heterogeneity across months was statistically significant (P < 0·001). In stratified analyses, monthly variation was detected only among males (P = 0·009) and in cases aged 65 years and older (P = 0·031). Poisson regression found no seasonal effect among all cases when fit to the sinusoidal model (P = 0·110). However, similar variation among males (P = 0·009) and cases aged 65 years and older (P = 0·018) was present. There is growing evidence of seasonality in AML diagnosis, particularly among older persons and men. Investigation of specific seasonal risk factors would be informative in explaining the aetiology behind the observed variation.
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Affiliation(s)
- Gregory S Calip
- Department of Epidemiology, University of Washington, Seattle, WA 98109, USA.
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Seasonal changes in activities of human neutrophils in vitro. Inflamm Res 2011; 61:11-6. [PMID: 21960458 PMCID: PMC3249202 DOI: 10.1007/s00011-011-0382-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2011] [Revised: 08/04/2011] [Accepted: 09/05/2011] [Indexed: 12/24/2022] Open
Abstract
Objective and design We present a retrospective analysis of previously collected blood samples to determine whether the immune response of neutrophils depends on the season i.e., short versus long days, in which blood samples were collected. Methods The bactericidal activity and adhesive capacity of neutrophils, the production of reactive oxygen species (ROS), and CD11b/CD18 molecule expression level were investigated. The investigated neutrophils were divided into two groups based on the time of blood collection: the winter season with short days and the summer season with long days. Results We found seasonal variation in measurements of all the analyzed functional responses of neutrophils to stimuli. The strongest adhesion, as well as maximum values of ROS production, was presented by neutrophils isolated from the summer group. The highest bactericidal activity of neutrophils was also observed in blood donors from summer group. Conclusions The magnitude of the immune functional activity of neutrophils varies with the season of the year and is decreased in winter.
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Abstract
OBJECTIVES This study was designed to review previous studies and analyse the current knowledge and controversies related to seasonal variability of tuberculosis (TB) to examine whether TB has an annual seasonal pattern. STUDY DESIGN AND METHODS Systematic review of peer reviewed studies identified through literature searches using online databases belonging to PubMed and the Cochrane library with key words "Tuberculosis, Seasonal influence" and "Tuberculosis, Seasonal variation". The search was restricted to articles published in English. The references of the identified papers for further relevant publications were also reviewed. RESULTS Twelve studies conducted between the period 1971 and 2006 from 11 countries/regions around the world (South Western Cameroon, South Africa, India, Hong Kong, Japan, Kuwait, Spain, UK, Ireland, Russia, and Mongolia) were reviewed. A seasonal pattern of tuberculosis with a mostly predominant peak is seen during the spring and summer seasons in all of the countries (except South Western Cameroon and Russia). CONCLUSIONS The observation of seasonality leads to assume that the risk of transmission of M. tuberculosis does appear to be the greatest during winter months. Vitamin D level variability, indoor activities, seasonal change in immune function, and delays in the diagnosis and treatment of tuberculosis are potential stimuli of seasonal tuberculosis disease. Additionally, seasonal variation in food availability and food intake, age, and sex are important factors which can play a role in the tuberculosis notification variability. Prospective studies regarding this topic and other related subjects are highly recommended.
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Affiliation(s)
- Auda Fares
- Department of Internal Medicine, St. Johannes-Hospital, Troisdorf, Germany
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Klode J, Stoffels I, Körber A, Weindorf M, Dissemond J. Relationship between the seasonal onset of chronic venous leg ulcers and climatic factors. J Eur Acad Dermatol Venereol 2011; 25:1415-9. [DOI: 10.1111/j.1468-3083.2011.03988.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Broadbent S. Seasonal changes in haematology, lymphocyte transferrin receptors and intracellular iron in Ironman triathletes and untrained men. Eur J Appl Physiol 2010; 111:93-100. [PMID: 20821024 DOI: 10.1007/s00421-010-1635-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2010] [Indexed: 11/30/2022]
Abstract
We investigated whether 12 months of chronic endurance training would affect haematology, CD4(+) lymphocyte transferrin receptor (CD71) expression, CD4(+) intracellular iron and the incidence of upper respiratory tract illnesses (URTI) in Ironman triathletes compared with untrained men. Resting venous blood samples were taken from 15 Ironman triathletes (TR 30 ± 5 year) and 12 untrained men (UT 30 ± 6 year) every 4 weeks for 12 months. Erythrocyte, leukocyte and platelet concentration, haematocrit, haemoglobin (Hb) and mean corpuscular haemoglobin (MCHC) were measured with a full blood count. CD4(+) lymphocytes were analysed for changes in transferrin receptor (CD71) expression (CD4(+)CD71(+)), and intracellular iron (Fe(3+)), by flow cytometry. The TR group had significantly lower Hb, MCHC, and platelets for 10, 9 and 11 months, respectively; lower CD4(+)CD71(+) (3 months) and Fe(3+) (1 month), respectively; higher CD4(+)CD71(+) (1 month); a higher lymphocyte count for 4 months. There were no between-group differences in other variables. In both groups haematology and lymphocytes increased during spring, early summer and winter and decreased during late summer/late winter, with an inverse relationship between CD4(+)CD71(+) and Fe(3+). The TR group reported significantly fewer URTI than the UT. Low Hb and MCHC suggest an iron deficiency which may affect triathlete performance. Monthly changes in lymphocytes, CD4(+)CD71(+) and Fe(3+) suggested that spring, summer and late autumn are associated with CD4(+) proliferation. There may be seasonal relationships between haematology and lymphocyte function, independent of endurance training, possibly affecting performance but not the incidence of URTI.
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Affiliation(s)
- Suzanne Broadbent
- School of Sport and Exercise Science, Institute of Sport, Exercise and Active Living, Victoria University, PO Box 14428, Melbourne, VIC, 8001, Australia.
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Abstract
Objectives As many vascular pathologies exhibit circannual fluctuation, the aim of this study was to assess the chronobiological features of venous ulcers. Methods Based on a retrospective survey of the case histories of 391 venous ulcer patients, the rates of ulcer onset and healing in each month were analysed statistically; a time series was constructed to evaluate the seasonality. Results There was a significantly higher frequency of ulcer onset during the warmer part of the year (April–October), and onset showed strong seasonality. Healing rates were also unequally and statistically significantly distributed throughout the year: ulcers that appeared or that were treated with specialized treatment in the winter or summer healed slower in comparison to ulcers that began in the spring or autumn. Conclusions Venous ulcers exhibit circannual fluctuations in their onset and healing rates. Hypothetically, in addition to exacerbation of chronic venous insufficiency, seasonal variations in immune system activity might potentially be responsible for this phenomenon.
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Affiliation(s)
- M Simka
- Department of Angiology, Private Healthcare Institution SANA, Pszczyna, Poland
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Bai A, Guo Y, Shen Y, Xie Y, Zhu X, Lu N. Seasonality in flares and months of births of patients with ulcerative colitis in a Chinese population. Dig Dis Sci 2009; 54:1094-8. [PMID: 19051033 DOI: 10.1007/s10620-008-0453-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2008] [Accepted: 07/16/2008] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIMS Reports on seasonality in flares or months of births of inflammatory bowel disease patients have been inconsistent, but little data are available in a Chinese population. The aim of this study was to determine whether symptom flares and births of ulcerative colitis (UC) patients follow a seasonal pattern. METHODS Patients with a diagnosis of UC established between January 1990 and December 2007 were investigated according to the occurrence of flares of symptoms and months of births. The expected flares or births were calculated on a monthly basis over the study period, taking into consideration the difference in the number of days in the month in each year. RESULTS A total of 409 UC patients were included in the study, and 1030 flares of symptoms were determined. The peak number of flares occurred during the spring and summer, especially in June, while the nadir occurred in the winter, especially in January (chi(2) ((11 df))=32.74304, P<0.005). The symptom flares also occurred more frequently in the spring-summer period than in the autumn-winter period (chi(2) ((3 df))=22.1269, P<0.001). There was no statistical difference in birth distribution on a monthly or seasonal (spring, summer, autumn, winter) basis. However, the births of UC patients occurred more frequently in the autumn-winter period than in the spring-summer period when the data were merged into these two seasonal components (chi(2) ((1 df))=5.255607, P<0.025). CONCLUSIONS The data indicate that the symptom flares of UC occurred more frequently in the spring and summer, while the births of UC patients occurred more often in the autumn and winter. Environmental recurring factors may be associated with the symptom flares of UC, and these factors during pregnancy or postpartum may be associated with susceptibility to UC later in life.
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Affiliation(s)
- Aiping Bai
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China.
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Dahl ME, Berson A, Lora J, Fuentes M. A Novel CCR5-Specific Pharmacodynamic Assay in Whole Blood Using Phosphoflow Cytometry Highlights Different Ligand-Dependent Responses but Similar Properties of Antagonists in CD8+ and CD4+ T Lymphocytes. J Pharmacol Exp Ther 2008; 327:926-33. [DOI: 10.1124/jpet.108.142695] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Broadbent S, Gass G. Aerobic training increases the stimulated percentage of CD4+CD25+ in older men but not older women. Eur J Appl Physiol 2008; 103:79-87. [PMID: 18204854 DOI: 10.1007/s00421-007-0664-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2007] [Indexed: 11/25/2022]
Abstract
The purpose of the present study was to determine whether 12 months of moderate intensity cycling would increase the expression of IL-2 (CD25+) receptors in T helper (CD4+) lymphocytes in men and women aged 65-75 years. Fourteen men and 10 women completed 52 weeks of moderate intensity cycling (60% VO2peak). Subjects trained (TR) three times per week for 45 min per session. Eight age-matched untrained (UT) male and eight UT female subjects acted as controls. Resting blood samples were taken from TR and UT subjects every 4 weeks. Leukocyte concentration was measured using a full blood count. PHA-stimulated CD4+ lymphocytes were analysed for changes in the expression of CD25+, by flow cytometry. Training significantly increased VO2peak (l min(-1), ml kg(-1) min(-1)) in male (+14.3, +16%) and female (+16.7, +27.8%) groups. The TR male group showed a significantly lower percentage of CD4+CD25+ than the male UT in January but the TR male percentage was significantly higher than the UT male group during February, March, April, May, June, September B and December. The female TR group showed a significantly higher percentage CD4+CD25+ than the female UT only during July. There were also significant sequential monthly changes in the percentage of CD4+CD25+ for male and female UT and TR groups. Significant increases in the percentage of CD4+CD25+ in the male TR group suggest training-enhanced lymphocyte mitogenic responsiveness. Moderate intensity long-term training may increase the recruitment of active memory CD4+CD25+ in men rather than women.
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Affiliation(s)
- Suzanne Broadbent
- Institute of Food, Nutrition and Human Health, Massey University, Private Bag 756, Wellington, New Zealand.
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Widlansky ME, Vita JA, Keyes MJ, Larson MG, Hamburg NM, Levy D, Mitchell GF, Osypiuk EW, Vasan RS, Benjamin EJ. Relation of season and temperature to endothelium-dependent flow-mediated vasodilation in subjects without clinical evidence of cardiovascular disease (from the Framingham Heart Study). Am J Cardiol 2007; 100:518-23. [PMID: 17659939 PMCID: PMC1994775 DOI: 10.1016/j.amjcard.2007.03.055] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2006] [Revised: 03/06/2007] [Accepted: 03/06/2007] [Indexed: 01/03/2023]
Abstract
Multiple studies have documented an increased incidence of cardiovascular events in the winter, but the pathophysiologic mechanisms remain incompletely understood. It was hypothesized that brachial flow and flow-mediated dilation (FMD) would vary by season and temperature. Season and temperature were related to ultrasonic brachial artery endothelium-dependent FMD% (n = 2,587), baseline flow velocity, and maximal reactive hyperemia (n = 1,973) in the Framingham Offspring Cohort (mean age 61 +/- 10 years, 53% women). Outdoor temperatures were obtained from National Climate Data Center records for Bedford, Massachusetts (about 14 miles from the testing site), and the examination room temperature was measured. In multivariate models, FMD% was highest in summer and lowest in winter (3.01 +/- 0.09% vs 2.56 +/- 0.10%, respectively, p = 0.02 for differences across all 4 seasons). FMD% was highest in the warmest and lowest in the coldest outdoor-temperature quartiles. In stepwise models adjusting for risk factors and selecting among season, outdoor temperature, and room temperature, FMD% was associated with season (p = 0.02); temperature did not enter the model. In contrast, hyperemic flow velocity was significantly lower for cooler and higher for warmer room temperatures (p = 0.02 overall); season did not enter the model. Season and outdoor and room temperature were each retained in a stepwise model of baseline flow velocity (p <0.0001, p = 0.02, and p <0.0001, respectively). In conclusion, a significant association was observed between season and FMD%. Microvascular vasodilator function, as reflected by hyperemic flow velocity, was more strongly related to temperature than season. Endothelial dysfunction may be 1 of the mechanisms influencing seasonal variation in cardiovascular events.
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Affiliation(s)
- Michael E. Widlansky
- Cardiology Department, Boston University School of Medicine, Boston, MA
- Evans Department of Medicine, Boston University School of Medicine, Boston, MA
| | - Joseph A. Vita
- Cardiology Department, Boston University School of Medicine, Boston, MA
- Evans Department of Medicine, Boston University School of Medicine, Boston, MA
- Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA
| | - Michelle J. Keyes
- Department of Mathematics and Statistics, Boston University School of Public Health, Boston, MA
- NHLBI’s Framingham Study, Framingham, MA
| | - Martin G. Larson
- Department of Mathematics and Statistics, Boston University School of Public Health, Boston, MA
- NHLBI’s Framingham Study, Framingham, MA
| | - Naomi M. Hamburg
- Cardiology Department, Boston University School of Medicine, Boston, MA
- Evans Department of Medicine, Boston University School of Medicine, Boston, MA
| | | | | | | | - Ramachandran S. Vasan
- Cardiology Department, Boston University School of Medicine, Boston, MA
- Evans Department of Medicine, Boston University School of Medicine, Boston, MA
- Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA
- NHLBI’s Framingham Study, Framingham, MA
| | - Emelia J. Benjamin
- Cardiology Department, Boston University School of Medicine, Boston, MA
- Evans Department of Medicine, Boston University School of Medicine, Boston, MA
- Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA
- NHLBI’s Framingham Study, Framingham, MA
- *Corresponding author: Emelia J. Benjamin, MD, ScM, Professor of Medicine, Boston University, Framingham Heart Study, 73 Mt. Wayte Avenue, #2, Framingham, MA 01702-5827, E-mail: , Fax: (508)-626-1262, Phone: (617)-638-8968
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Zhang SJ, Chen ZX, Jiang KP, Wu WK, Zhang CY, Gu YL. Effect of seasonal variation on the clinical course of chronic hepatitis B. J Gastroenterol 2006; 41:1107-15. [PMID: 17160522 DOI: 10.1007/s00535-006-1903-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2005] [Accepted: 08/24/2006] [Indexed: 02/04/2023]
Abstract
BACKGROUND Seasonal variation in immunity has been found in healthy individuals and in association with some diseases. It is still unknown whether seasonal variation affects the clinical course of chronic hepatitis B. Our aim in this study was to explore the effect of seasonal variation on the clinical course of chronic hepatitis B. METHODS The flare and remission time of chronic hepatitis B were observed in patients with hepatitis B virus (HBV) infection. All patients enrolled were followed up at least every 3 months for a mean follow-up time of 24.0 (range, 12-60) months. Seasonal decomposition was employed to analyze the relationship between seasonal variation and flares, remission, and hepatitis B e antigen (HBeAg) seroconversion in chronic hepatitis B patients during follow-up. RESULTS A total of 2238 patients were observed in our study. Flare and HBeAg seroconversion were seldom seen in 1076 patients (48.08%) with alanine aminotransferase (ALT) levels of less than 2.0 x upper limit of normal (ULN) during follow-up (mean, 36 months). The remaining 1162 patients (51.92%) (766, HBeAg positive; 387 anti-HBeAg positive; 9 negative for both HBeAg and anti-HBeAg) with ALT levels >or=2.0 x ULN were followed longitudinally for 12 months to judge flare, remission, and HBeAg seroconversion. Flare, remission, and HBeAg seroconversion in patients with ALT levels >or=2.0 x ULN showed clear seasonal patterns (P < 0.001), with high peaks during spring, summer, and summer, respectively. An autocorrelation correlogram showed that flares, remission, and HBeAg seroconversion occurred with distinct periodicity in winter, spring, summer, and autumn. CONCLUSIONS Seasonal variation might affect the clinical course of chronic hepatitis B. The role of seasonal triggering factors should be further investigated.
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Affiliation(s)
- Shi-Jun Zhang
- Department of Gastroenterology of Traditional Chinese Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080 Guangdong, China
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