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Moti Wala S, AlEdani EM, Samuel EA, Ahmad K, Manongi NJ, Rajapandian R, Khan S. Exploring the Nexus: A Systematic Review on the Interplay of the Methylenetetrahydrofolate Reductase (MTHFR) Gene C677T Genotype, Hyperhomocysteinemia, and Spontaneous Cervical/Vertebral Artery Dissection in Young Adults. Cureus 2024; 16:e60878. [PMID: 38910639 PMCID: PMC11192624 DOI: 10.7759/cureus.60878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Accepted: 05/22/2024] [Indexed: 06/25/2024] Open
Abstract
Ischemic strokes (IS) in young adults often evade early detection, resulting in delayed diagnosis until complications arise. Cervical/vertebral artery dissection, a significant contributor to these strokes, presents with symptoms such as migraine with aura, severe headache, and neck pain, commonly overlooked due to their nonspecific nature. This review investigates early indicators of artery dissections, emphasizing their importance in diagnosis and exploring the correlation between methylenetetrahydrofolate reductase (MTHFR) gene C677T genotype polymorphism, hyperhomocysteinemia (HHCY), and IS in young adults. This systematic review encompasses a thorough analysis of 11 papers, including four observational studies, three case reports, three narrative reviews, and one experimental study, involving 4,840 patients aged 18-45 years. Findings reveal HHCY as a significant contributor to vascular damage and tissue ischemia leading to IS. The MTHFR gene C677T genotype polymorphism is closely associated with HHCY, often contributing to underdiagnosed strokes in young adults. Cervical/vertebral artery dissection may manifest as initial symptoms of neck pain or headache, remaining undiagnosed until imaging is conducted. Importantly, the review suggests that MTHFR gene polymorphism can be mitigated through simple supplementation with vitamin B12 and folates, serving as a valuable tool for primary prevention. Additionally, betaine, a methyl donor, was explored in severe MTHFR gene polymorphism cases resistant to conventional supplementation. In conclusion, recognizing the significance of early signs and symptoms, along with a high clinical suspicion, is crucial for preventing catastrophic outcomes, mortality, and morbidity associated with IS in young adults lacking traditional risk factors. The MTHFR gene C677T genotype polymorphism, a potential genetic cause, can be easily managed with simple measures but is often overlooked or underdiagnosed.
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Affiliation(s)
- Sajida Moti Wala
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Esraa M AlEdani
- Dermatology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Essa A Samuel
- Physical Medicine and Rehabilitation, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Khoula Ahmad
- internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Naelijwa J Manongi
- Family Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Ramkumar Rajapandian
- Trauma and Orthopaedics, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Safeera Khan
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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2
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Nwazor E, Chukwuocha I, Ajuonuma B, Obi P, Madueke O. A 2-year review of stroke admissions and short term out-come predictors in a teaching hospital, Southeast, Nigeria. Niger Med J 2024; 65:185-194. [PMID: 39005552 PMCID: PMC11240201 DOI: 10.60787/nmj-v65i2-442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/16/2024] Open
Abstract
Background Stroke is a common neurological disorder with a huge global burden in terms of mortality and morbidity. Epidemiological evidence has shown that modifiable risk factors are responsible for more than 90% of all strokes. Stroke outcome in hospitalized patients is influenced by several variables, such as socio-demographic factors, stroke subtype, and admission severity. The interaction between stroke outcomes and these parameters is often complex. The study is aimed to profile hospitalized stroke patients and determine outcome predictors. Methodology A descriptive retrospective study of 100 patients hospitalized for acute stroke. Their medical records were reviewed for demographic and clinical variables and relevant data were retrieved and analysed using appropriate statistical methods. Results Of the 100 acute stroke patients studied, 36% were men and 64% were women. The mean age was 65.16±15.72. About 78%had ischemic stroke while 21% had haemorrhagic strokes. The commonest risk factor was hypertension (71.2%). On multivariate analysis, stroke subtype and admission duration were significantly linked to stroke outcome. Conclusion Ischemic stroke comprises more than two-thirds of stroke admissions, with hypertension being the most common risk factor and stroke case fatality of 23%. Stroke subtype and admission duration significantly predicted stroke outcomes. The need to step up measures aimed at improving acute stroke care in hospitalized patients is imperative as this will hopefully improve overall outcomes in resource constraint settings such as Nigeria.
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Affiliation(s)
- Ernest Nwazor
- Department of Internal Medicine Federal University Teaching Hospital Owerri, Nigeria
- Department of Internal Medicine, Rivers State University Teaching Hospital, Port Harcourt, Nigeria
| | - Ikechukwu Chukwuocha
- Department of Internal Medicine Federal University Teaching Hospital Owerri, Nigeria
| | - Benneth Ajuonuma
- Department of Internal Medicine Federal University Teaching Hospital Owerri, Nigeria
- Department of Internal Medicine, Rivers State University Teaching Hospital, Port Harcourt, Nigeria
| | - Patrick Obi
- Department of Internal Medicine Federal University Teaching Hospital Owerri, Nigeria
- Department of Internal Medicine, Rivers State University Teaching Hospital, Port Harcourt, Nigeria
| | - Onyedika Madueke
- Department of Internal Medicine Federal University Teaching Hospital Owerri, Nigeria
- Department of Internal Medicine, Rivers State University Teaching Hospital, Port Harcourt, Nigeria
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3
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Huang H, Oo TT, Apaijai N, Chattipakorn N, Chattipakorn SC. An Updated Review of Mitochondrial Transplantation as a Potential Therapeutic Strategy Against Cerebral Ischemia and Cerebral Ischemia/Reperfusion Injury. Mol Neurobiol 2023; 60:1865-1883. [PMID: 36595193 DOI: 10.1007/s12035-022-03200-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 12/23/2022] [Indexed: 01/04/2023]
Abstract
Regardless of the progress made in the pathogenesis of ischemic stroke, it remains a leading cause of adult disability and death. To date, the most effective treatment for ischemic stroke is the timely recanalization of the occluded artery. However, the short time window and reperfusion injury have greatly limited its application and efficacy. Mitochondrial dysfunction and ATP depletion have become regarded as being hallmarks of neuropathophysiology following ischemic stroke. Mitochondrial transplantation is a novel potential therapeutic intervention for ischemic stroke that has sparked widespread concern during the past few years. This review summarizes and discusses the effects of mitochondrial transplantation in in vitro and in vivo ischemic stroke models. In addition, pharmacological interventions promoting mitochondrial transplantation are reviewed and discussed. We also discuss the potential challenges to the clinical application of mitochondrial transplantation in the treatment of ischemic stroke.
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Affiliation(s)
- Huatuo Huang
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, 50200, Chiang Mai, Thailand.,Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, 50200, Chiang Mai, Thailand.,Center of Excellence in Cardiac Electrophysiology, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Thura Tun Oo
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, 50200, Chiang Mai, Thailand.,Center of Excellence in Cardiac Electrophysiology, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Nattayaporn Apaijai
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, 50200, Chiang Mai, Thailand.,Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, 50200, Chiang Mai, Thailand.,Center of Excellence in Cardiac Electrophysiology, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Nipon Chattipakorn
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, 50200, Chiang Mai, Thailand.,Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, 50200, Chiang Mai, Thailand.,Center of Excellence in Cardiac Electrophysiology, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Siriporn C Chattipakorn
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, 50200, Chiang Mai, Thailand. .,Center of Excellence in Cardiac Electrophysiology, Chiang Mai University, Chiang Mai, 50200, Thailand. .,Department of Oral Biology and Diagnostic Sciences, Faculty of Dentistry, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
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4
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Wang Y, Yang S, Zhang S, Lu X, Ma W. Apolipoprotein E Gene Polymorphism Effects on Lipid Metabolism and Risk of Cerebral Infarction in Northwest Han Chinese Population. Pharmgenomics Pers Med 2023; 16:303-312. [PMID: 37051559 PMCID: PMC10083142 DOI: 10.2147/pgpm.s404663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 03/31/2023] [Indexed: 04/07/2023] Open
Abstract
Background The apolipoprotein E (ApoE) genetic variation may contribute to the development of Cerebral Infarction (CI). Serum lipid levels are known risk factors for CI, but the effect of the ApoE gene polymorphism on lipid metabolism remains unclear. This retrospective cohort study was designed to determine the role of ApoE genotypes in CI risk and the relationships between ApoE gene polymorphism and serum lipid levels among the population of northwest China. Patients and Methods 517 CI patients and 517 non-CI controls were enrolled in the study. Polymerase chain reaction and hybridization were utilized to determine the ApoE gene polymorphisms. Results The ε3/ε4 genotype and ε4 allele frequency were significantly higher in CI patients than in controls. When stratified by age and sex, statistically significant differences in the distribution and frequency of the ε3/ε4 genotype and ε4 allele were found between patients and controls. Compared to ε2 carriers, ε4 carriers had significantly lower ApoE levels and higher low-density lipoprotein cholesterol (LDL-C), ApoB and ApoB/ApoA-I levels in both two groups. Additionally, control participants with ε4 carriers had significantly higher levels of lipoprotein and total cholesterol (TC) levels than ε2 carriers, while CI patients with ε4 carriers had a significantly lower level of ApoA-I. After adjusting for other established risk factors, drinking, hypertension, lipoprotein, triglycerides (TG) and ε4 allele were significant independent risk factors for CI, which was shown to be associated with a nearly two-fold CI risk. Conclusion This study demonstrated that ε4 allele is independent risk factors for CI among patients in Northwest China. ApoE polymorphism was associated with CI, which was partly mediated through blood lipids and may also be mediated through non-lipid pathways. These data might be of great clinical significance in individualized preventive and therapeutic strategies.
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Affiliation(s)
- Yaqi Wang
- Department of Pharmacology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, 710061, People’s Republic of China
| | - Shuang Yang
- Department of Pharmacology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, 710061, People’s Republic of China
| | - Suya Zhang
- Department of Pharmacology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, 710061, People’s Republic of China
| | - Xiaoyu Lu
- Department of Biological Science and Bioengineering, Key Laboratory of Biomedical Information Engineering of the Ministry of Education, School of Life Science and Technology, Xi’an Jiaotong University, Xi’an, Shaanxi, 710049, People’s Republic of China
| | - Wenbing Ma
- Department of Pharmacology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, 710061, People’s Republic of China
- Department of Biological Science and Bioengineering, Key Laboratory of Biomedical Information Engineering of the Ministry of Education, School of Life Science and Technology, Xi’an Jiaotong University, Xi’an, Shaanxi, 710049, People’s Republic of China
- Correspondence: Wenbing Ma, Department of Pharmacology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, 710061, People’s Republic of China, Tel/Fax +86-29-85323240, Email
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5
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Revythis A, Boussios S, Ganesh V, Sarkar R. Case of cerebral venous thrombosis on a patient with background of nephrotic syndrome. BMJ Case Rep 2022; 15:e248329. [PMID: 35236700 PMCID: PMC8895991 DOI: 10.1136/bcr-2021-248329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2022] [Indexed: 11/04/2022] Open
Abstract
Hypercoagulability is a well-described feature of nephrotic syndrome. The risk of developing a venous thrombus is higher at the time of diagnosis or shortly after. The resulting deep vein thrombosis involves the pulmonary, the deep veins of the lower limbs and renal veins, as described in the literature. We present a case of a man in his 20s with background of nephrotic syndrome, diagnosed at an age of 3 years old, with multiple relapses and on maintenance immunosuppression which is unusual, in two respects: First, the site of thrombosis was in the cerebral venous sinus and second, the onset of the thrombotic episode was years after the initial diagnosis. This case report also focuses on the perspective of the patient, who experienced a rare complication after more than two decades of living with the condition. In a literature search with the search words of 'nephrotic syndrome' AND 'cerebral venous thrombosis in adults', written in English and published from 1970 to 2/2021, we could only find a review article including 5 cases and 10 individual case reports, of which there were only 16 number of cerebral sinus venous thrombosis reported.
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Affiliation(s)
- Antonios Revythis
- Department of Respiratory Medicine, Medway Maritime Hospital, Gillingham, UK
| | - Stergios Boussios
- Department of Medical Oncology, Medway Maritime Hospital, Gillingham, UK
- School of Cancer & Pharmaceutical Sciences, King's College London Faculty of Life Sciences and Medicine, London, UK
| | | | - Rahuldeb Sarkar
- Intensive Care Unit, Medway Maritime Hospital, Gillingham, UK
- Faculty of Life Sciences, King's College London, London, UK
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6
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Dey S, Bose A, Saha S, Chakraborty P, Ghalwash M, Guzm X E N-Sáenz A, Utro F, Ng K, Hu J, Parida L, Sow D. Impact of Clinical and Genomic Factors on COVID-19 Disease Severity. AMIA ... ANNUAL SYMPOSIUM PROCEEDINGS. AMIA SYMPOSIUM 2022; 2021:378-387. [PMID: 35308982 PMCID: PMC8861728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
To date, there have been 180 million confirmed cases of COVID-19, with more than 3.8 million deaths, reported to WHO worldwide. In this paper we address the problem of understanding the host genome's influence, in concert with clinical variables, on the severity of COVID-19 manifestation in the patient. Leveraging positive-unlabeled machine learning algorithms coupled with RubricOE, a state-of-the-art genomic analysis framework, on UK BioBank data we extract novel insights on the complex interplay. The algorithm is also sensitive enough to detect the changing influence of the emergent B.1.1.7 SARS-CoV-2 (alpha) variant on disease severity, and, changing treatment protocols. The genomic component also implicates biological pathways that can help in understanding the disease etiology. Our work demonstrates that it is possible to build a robust and sensitive model despite significant bias, noise and incompleteness in both clinical and genomic data by a careful interleaving of clinical and genomic methodologies.
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Affiliation(s)
- Sanjoy Dey
- Center for Computational Health, IBM Research, Yorktown Heights, NY, USA
| | - Aritra Bose
- Computational Genomics, IBM Research, Yorktown Heights, NY, USA
| | - Subrata Saha
- Columbia University Irving Medical Center, Columbia University, NY, USA
| | | | - Mohamed Ghalwash
- Center for Computational Health, IBM Research, Yorktown Heights, NY, USA
| | | | - Filippo Utro
- Computational Genomics, IBM Research, Yorktown Heights, NY, USA
| | - Kenney Ng
- Center for Computational Health, IBM Research, Yorktown Heights, NY, USA
| | - Jianying Hu
- Center for Computational Health, IBM Research, Yorktown Heights, NY, USA
| | - Laxmi Parida
- Computational Genomics, IBM Research, Yorktown Heights, NY, USA
| | - Daby Sow
- Center for Computational Health, IBM Research, Yorktown Heights, NY, USA
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7
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Luo Y, Yu F, Feng X, Liao D, Ying Y, Li X, Huang Q, Liu Z, Wei M, Zhao T, Zhang L, Tu R, Xia J. Molecular Biomarkers Associated with Early-Onset Symptomatic Intracranial Atherosclerosis. Clin Interv Aging 2021; 16:1013-1022. [PMID: 34103904 PMCID: PMC8179742 DOI: 10.2147/cia.s309945] [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: 03/07/2021] [Accepted: 05/13/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose Previous studies have shown a rising incidence of early-onset symptomatic intracranial atherosclerosis (sICAS), which has brought a severe economic burden to social development. This study aimed to evaluate the molecular biomarkers associated with early-onset sICAS and to seek possible intervention strategies for early prevention. Patients and Methods We consecutively recruited patients with sICAS and divided them into two groups based on age: early-onset sICAS group as age ≤60 years old and late-onset sICAS group as age >60 years old. We collected and compared the demographic data and laboratory results of each group. A bivariate logistic regression model was applied to evaluate the independent molecular biomarkers of early-onset sICAS. Results A total of 1007 subjects with sICAS were enrolled in this study, comprising 519 patients in the early-onset sICAS group and 488 patients in the late-onset sICAS group. Bivariate logistic regression analysis demonstrated an increased level of white blood cell, platelet, albumin globulin ratio, free triiodothyronine, and a decreased level of total bile acid, urea nitrogen, high-density lipoprotein, homocysteine, and fibrinogen in the early-onset sICAS group when compared to the late-onset group. Conclusion Our study showed the relevance between early sICAS and circulating levels of different molecular biomarkers. Detection of these related molecular biomarkers may provide a simple way for early sICAS preventions in the future.
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Affiliation(s)
- Yunfang Luo
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
| | - Fang Yu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
| | - Xianjing Feng
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
| | - Di Liao
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
| | - Yuanlin Ying
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
| | - Xi Li
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
| | - Qin Huang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
| | - Zeyu Liu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
| | - Minping Wei
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
| | - Tingting Zhao
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
| | - Lin Zhang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
| | - Ruxin Tu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
| | - Jian Xia
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.,Clinical Research Center for Cerebrovascular Disease of Hunan Province, Central South University, Changsha, Hunan, People's Republic of China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
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8
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Affiliation(s)
- Mary G. George
- Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
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9
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Dunn PJ, Maksemous N, Smith RA, Sutherland HG, Haupt LM, Griffiths LR. Investigating diagnostic sequencing techniques for CADASIL diagnosis. Hum Genomics 2020; 14:2. [PMID: 31915071 PMCID: PMC6950909 DOI: 10.1186/s40246-019-0255-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 12/30/2019] [Indexed: 11/18/2022] Open
Abstract
Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a cerebral small vessel disease caused by mutations in the NOTCH3 gene. Our laboratory has been undertaking genetic diagnostic testing for CADASIL since 1997. Work originally utilised Sanger sequencing methods targeting specific NOTCH3 exons. More recently, next-generation sequencing (NGS)-based technologies such as a targeted gene panel and whole exome sequencing (WES) have been used for improved genetic diagnostic testing. In this study, data from 680 patient samples was analysed for 764 tests utilising 3 different sequencing technologies. Sanger sequencing was performed for 407 tests, a targeted NGS gene panel which includes NOTCH3 exonic regions accounted for 354 tests, and WES with targeted analysis was performed for 3 tests. In total, 14.7% of patient samples (n = 100/680) were determined to have a mutation. Testing efficacy varied by method, with 10.8% (n = 44/407) of tests using Sanger sequencing able to identify mutations, with 15.8% (n = 56/354) of tests performed using the NGS custom panel successfully identifying mutations and a likely non-NOTCH3 pathogenic variant (n = 1/3) identified through WES. Further analysis was then performed through stratification of the number of mutations detected at our facility based on the number of exons, level of pathogenicity and the classification of mutations as known or novel. A systematic review of NOTCH3 mutation testing data from 1997 to 2017 determined the diagnostic rate of pathogenic findings and found the NGS-customised panel increases our ability to identify disease-causing mutations in NOTCH3.
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Affiliation(s)
- P J Dunn
- Genomics Research Centre, Institute of Health and Biomedical Innovation, School of Biomedical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - N Maksemous
- Genomics Research Centre, Institute of Health and Biomedical Innovation, School of Biomedical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - R A Smith
- Genomics Research Centre, Institute of Health and Biomedical Innovation, School of Biomedical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - H G Sutherland
- Genomics Research Centre, Institute of Health and Biomedical Innovation, School of Biomedical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - L M Haupt
- Genomics Research Centre, Institute of Health and Biomedical Innovation, School of Biomedical Sciences, Queensland University of Technology, Brisbane, QLD, Australia.
| | - L R Griffiths
- Genomics Research Centre, Institute of Health and Biomedical Innovation, School of Biomedical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
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Rinde LB, Morelli VM, Småbrekke B, Mathiesen EB, Løchen ML, Njølstad I, Wilsgaard T, Smith E, Rosendaal FR, Frazer KA, Braekkan SK, Hansen JB. Effect of prothrombotic genotypes on the risk of venous thromboembolism in patients with and without ischemic stroke. The Tromsø Study. J Thromb Haemost 2019; 17:749-758. [PMID: 30773804 DOI: 10.1111/jth.14410] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 02/09/2019] [Indexed: 11/27/2022]
Abstract
Essentials Prothrombotic genotypes may agument the risk of venous thromboembolism (VTE) after ischemic stroke. We studied this effect in a case-cohort study using a genetic risk score. In stroke patients, a one-category increase in the genetic risk score was associated with a 50% higher relative risk of VTE. The risk of VTE in stroke patients increased with an increasing number of risk alleles. SUMMARY: Background Patients with ischemic stroke have a transiently increased risk of subsequent venous thromboembolism (VTE). Prothrombotic genotypes may augment VTE risk under conditions of high thrombosis risk related to stroke. Aims To investigate the effect of prothrombotic genotypes in patients with ischemic stroke on the risk of VTE in a population-based case-cohort study. Methods Cases with incident VTE (n = 664) and a randomly selected age-weighted subcohort (n = 1817) were sampled from three surveys of the Tromsø Study (1994-2008). Participants were genotyped for ABO (rs8176719), F5 (rs6025), F2 (rs1799963), FGG (rs2066865) and F11 (rs2036914) single-nucleotide polymorphisms (SNPs). Cox regression models were used to calculate hazard ratios (HRs) for incident VTE according to individual SNPs and categories of risk alleles (5-SNP score; 0-1, 2, 3-4 and ≥ 5) in participants with and without ischemic stroke. Results There were 192 patients with incident stroke, of whom 43 developed VTE during a median of 15.2 years of follow-up. The risk alleles of individual SNPs augmented the elevated VTE risk brought about by ischemic stroke. In stroke patients, a one-category increase in the genetic risk score was associated with a 50% higher relative risk of overall VTE (HR 1.5, 95% confidence interval [CI] 1.3-1.8) and an 80% higher relative risk of provoked VTE (HR 1.8, 95% CI 1.5-2.1). Stroke patients with ≥ 5 risk alleles had a 12-fold (HR 11.7, 95% CI 4.1-33.3) higher relative risk of VTE than stroke-free participants with 0-1 risk alleles. Conclusions Prothrombotic genotypes increased the risk of VTE in stroke patients, and the risk increased with an increasing number of risk alleles.
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Affiliation(s)
- Ludvig B Rinde
- K. G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Vania M Morelli
- K. G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Birgit Småbrekke
- K. G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ellisiv B Mathiesen
- K. G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Brain and Circulation Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Maja-Lisa Løchen
- Epidemiology of Chronic Diseases Research Group, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Inger Njølstad
- K. G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Epidemiology of Chronic Diseases Research Group, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Tom Wilsgaard
- Epidemiology of Chronic Diseases Research Group, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Erin Smith
- K. G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Pediatrics and Rady's Children's Hospital, University of California, San Diego, La Jolla, CA, USA
| | - Frits R Rosendaal
- K. G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Kelly A Frazer
- K. G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Pediatrics and Rady's Children's Hospital, University of California, San Diego, La Jolla, CA, USA
| | - Sigrid K Braekkan
- K. G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
| | - John-Bjarne Hansen
- K. G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
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Lee J, Kim Y. Association between Green Tea Consumption and Risk of Stroke in Middle-Aged and Older Korean Men: The Health Examinees (HEXA) Study. Prev Nutr Food Sci 2019; 24:24-31. [PMID: 31008093 PMCID: PMC6456242 DOI: 10.3746/pnf.2019.24.1.24] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 02/11/2019] [Indexed: 11/11/2022] Open
Abstract
Green tea consumption is known to have varying effects on health and disease. The aim of this study was to investigate the association between green tea consumption and risk of stroke in Korean adult men. Data were obtained from the Health Examinees (HEXA) Study, which included 50,439 subjects aged 40 years and older. Information regarding dietary intake was collected from semi-quantified food frequency questionnaires consisting of 106 items. Green tea consumption was categorized as none, <1 cup/d, 1 to <3 cups/d, and ≥3 cups/d. Binary logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CIs) to examine a possible association between green tea consumption and risk of stroke by controlling for potential confounders. Subgroup analyses by age, body mass index, hypertension, diabetes mellitus, smoking status, and alcohol consumption were also performed. Compared with green tea non-drinkers, individuals that consumed 1 to <3 cups/d or ≥3 cups/d of green tea had multivariable adjusted OR (CI) of stroke of 0.75 (0.59~0.97) and 0.62 (0.39~0.98), respectively, after adjusting for age and various confounders. In the subgroup analyses, an inverse association between green tea consumption and risk of stroke was identified among younger, non-hypertensive, and non-diabetic men. Higher consumption of green tea was inversely associated with stroke risk in middle-aged and older Korean men.
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Affiliation(s)
- Jeeyoo Lee
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 03760, Korea
| | - Yuri Kim
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 03760, Korea
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12
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Polivka J, Polivka J, Pesta M, Rohan V, Celedova L, Mahajani S, Topolcan O, Golubnitschaja O. Risks associated with the stroke predisposition at young age: facts and hypotheses in light of individualized predictive and preventive approach. EPMA J 2019; 10:81-99. [PMID: 30984317 DOI: 10.1007/s13167-019-00162-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 02/06/2019] [Indexed: 12/25/2022]
Abstract
Stroke is one of the most devastating pathologies of the early twenty-first century demonstrating 1-month case-fatality rates ranging from 13 to 35% worldwide. Though the majority of cases do occur in individuals at an advanced age, a persistently increasing portion of the patient cohorts is affected early in life. Current studies provide alarming statistics for the incidence of "young" strokes including adolescents. Young stroke is a multifactorial disease involving genetic predisposition but also a number of modifiable factors, the synergic combination of which potentiates the risks. The article analyzes the prevalence and impacts of "traditional" risk factors such as sedentary lifestyle, smoking, abnormal alcohol consumption, drug abuse, overweight, hypertension, abnormal sleep patterns, and usage of hormonal contraceptives, among others. Further, less explored risks such as primary vascular dysregulation and associated symptoms characteristic for Flammer syndrome (FS) are considered, and the relevance of the FS phenotype for the stroke predisposition at young age is hypothesized. Considering the high prevalence of known genetic and modifiable risk factors in the overall predisposition to the young stroke, the risk mitigating measures are recommended including innovative screening programs by application of specialized questionnaires and biomarker panels as well as educational programs adapted to the target audiences such as children, adolescents, and young adults.
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Affiliation(s)
- Jiri Polivka
- 1Department of Histology and Embryology, Faculty of Medicine in Pilsen, Charles University, Staré Město, Czech Republic
- 2Biomedical Centre, Faculty of Medicine in Pilsen, Charles University, Staré Město, Czech Republic
- 3Department of Neurology, University Hospital Pilsen, and Faculty of Medicine in Pilsen, Charles University, Staré Město, Czech Republic
| | - Jiri Polivka
- 3Department of Neurology, University Hospital Pilsen, and Faculty of Medicine in Pilsen, Charles University, Staré Město, Czech Republic
| | - Martin Pesta
- 2Biomedical Centre, Faculty of Medicine in Pilsen, Charles University, Staré Město, Czech Republic
- 4Department of Biology, Faculty of Medicine in Pilsen, Charles University, Staré Město, Czech Republic
| | - Vladimir Rohan
- 3Department of Neurology, University Hospital Pilsen, and Faculty of Medicine in Pilsen, Charles University, Staré Město, Czech Republic
| | - Libuse Celedova
- 5Department of Social and Assessment Medicine, Faculty of Medicine in Pilsen, Charles University, Staré Město, Czech Republic
| | | | - Ondrej Topolcan
- 7Department of Immunochemistry, University Hospital Pilsen, Pilsen, Czech Republic
| | - Olga Golubnitschaja
- 8Radiological Clinic, UKB, Rheinische Friedrich-Wilhelms-Universität Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
- 9Breast Cancer Research Centre, UKB, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
- 10Centre for Integrated Oncology, Cologne-Bonn, UKB, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
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13
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Edwards DN, Bix GJ. Roles of blood-brain barrier integrins and extracellular matrix in stroke. Am J Physiol Cell Physiol 2018; 316:C252-C263. [PMID: 30462535 DOI: 10.1152/ajpcell.00151.2018] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Ischemicstroke is a leading cause of death and disability in the United States, but recent advances in treatments [i.e., endovascular thrombectomy and tissue plasminogen activator (t-PA)] that target the stroke-causing blood clot, while improving overall stroke mortality rates, have had much less of an impact on overall stroke morbidity. This may in part be attributed to the lack of therapeutics targeting reperfusion-induced injury after the blood clot has been removed, which, if left unchecked, can expand injury from its core into the surrounding at risk tissue (penumbra). This occurs in two phases of increased permeability of the blood-brain barrier, a physical barrier that under physiologic conditions regulates brain influx and efflux of substances and consists of tight junction forming endothelial cells (and transporter proteins), astrocytes, pericytes, extracellular matrix, and their integrin cellular receptors. During, embryonic development, maturity, and following stroke reperfusion, cerebral vasculature undergoes significant changes including changes in expression of integrins and degradation of surrounding extracellular matrix. Integrins, heterodimers with α and β subunits, and their extracellular matrix ligands, a collection of proteoglycans, glycoproteins, and collagens, have been modestly studied in the context of stroke compared with other diseases (e.g., cancer). In this review, we describe the effect that various integrins and extracellular matrix components have in embryonic brain development, and how this changes in both maturity and in the poststroke environment. Particular focus will be on how these changes in integrins and the extracellular matrix affect blood-brain barrier components and their potential as diagnostic and therapeutic targets for ischemic stroke.
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Affiliation(s)
- Danielle N Edwards
- Sanders-Brown Center on Aging, University of Kentucky , Lexington, Kentucky.,Department of Neuroscience, University of Kentucky , Lexington, Kentucky
| | - Gregory J Bix
- Sanders-Brown Center on Aging, University of Kentucky , Lexington, Kentucky.,Department of Neuroscience, University of Kentucky , Lexington, Kentucky.,Department of Neurology, University of Kentucky , Lexington, Kentucky.,Department of Neurosurgery, University of Kentucky , Lexington, Kentucky
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14
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Gupta S, Gupta N, Tiwari P, Menon S, Mathur P, Kothari SL, Nallapeta S, Medicherla KM, Suravajhala P. Lnc-EPB41-Protein Interactions Associated with Congenital Pouch Colon. Biomolecules 2018; 8:biom8030095. [PMID: 30227690 PMCID: PMC6163732 DOI: 10.3390/biom8030095] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 09/10/2018] [Accepted: 09/13/2018] [Indexed: 12/12/2022] Open
Abstract
Congenital Pouch Colon (CPC) is a rare anorectal anomaly common to northwestern India, specifically Rajasthan. Despite efforts to understand the clinical genetic makeup of CPC, no attempt on identifying non-coding RNAs was done. We have earlier reported CPC’s rare variants from whole exome sequencing (WES) across 18 affected samples in a total of 64 subjects. A Smith–Waterman algorithm was used to infer a couple of lncRNAs from WES samples of CPC with predictions from the Noncode database. Further screening and quantification using polymerase chain reaction (PCR), we ascertained interactions using Micro Scale Thermophoresis (MST). We report the role of lnc-EPB41-1-1 shown to be promiscuously interacting with KIF13A substantiating their role in regulation.
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Affiliation(s)
- Sonal Gupta
- Department of Biotechnology and Bioinformatics, Birla Institute of Scientific Research (BISR), Statue Circle, Jaipur 302021, India.
- Department of Biotechnology, Amity University Rajasthan, Kant Kalwar, Jaipur 303002, India.
| | - Nidhi Gupta
- Department of Biotechnology, IIS University, Mansarovar, Jaipur 302020, India.
| | - Pradeep Tiwari
- Department of Biotechnology and Bioinformatics, Birla Institute of Scientific Research (BISR), Statue Circle, Jaipur 302021, India.
- Department of Chemistry, School of Basic Science, Manipal University, Jaipur 303007, India.
| | - Saji Menon
- NanoTemper Technologies, World Trade Centre, Bengaluru 302017, India.
| | - Praveen Mathur
- Department of Paediatric Surgery, SMS Medical College, JLN Marg, Jaipur 302004, India.
| | - Shanker Lal Kothari
- Department of Biotechnology, Amity University Rajasthan, Kant Kalwar, Jaipur 303002, India.
| | | | - Krishna Mohan Medicherla
- Department of Biotechnology and Bioinformatics, Birla Institute of Scientific Research (BISR), Statue Circle, Jaipur 302021, India.
| | - Prashanth Suravajhala
- Department of Biotechnology and Bioinformatics, Birla Institute of Scientific Research (BISR), Statue Circle, Jaipur 302021, India.
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15
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Bodenant M, Leys D. Infarti cerebrali del soggetto giovane. Neurologia 2018. [DOI: 10.1016/s1634-7072(18)41288-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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16
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Alharbi KK, Ali Khan I, Alotaibi MA, Saud Aloyaid A, Al-Basheer HA, Alghamdi NA, Al-Baradie RS, Al-Sulaiman A. Molecular genetic studies in Saudi population; identified variants from GWAS and meta-analysis in stroke. Saudi J Biol Sci 2018; 25:83-89. [PMID: 29379361 PMCID: PMC5775098 DOI: 10.1016/j.sjbs.2017.08.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2017] [Revised: 08/09/2017] [Accepted: 08/22/2017] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Stroke is a multifactorial and heterogeneous disorder, correlates with heritability and considered as one of the major diseases. The prior reports performed the variable models such as genome-wide association studies (GWAS), replication, case-control, cross-sectional and meta-analysis studies and still, we lack diagnostic marker in the global world. There are limited studies were carried out in Saudi population, and we aim to investigate the molecular association of single nucleotide polymorphisms (SNPs) identified through GWAS and meta-analysis studies in stroke patients in the Saudi population. METHODS In this case-control study, we have opted gender equality of 207 cases and 207 controls from the capital city of Saudi Arabia in King Saud University Hospital. The peripheral blood (5 ml) sample will be collected in two different vacutainers, and three mL of the coagulated blood will be used for lipid analysis (biochemical tests) and two mL will be used for DNA analysis (molecular tests). Genomic DNA will be extracted with the collected blood samples, and specific primers will be designed for the opted SNPs (SORT1-rs646218 and OLR1-rs11053646 polymorphisms) and PCR-RFLP will be performed and randomly DNA sequencing will be carried out to cross check the results. RESULTS The rs646218 and rs11053646 polymorphisms were significantly associated with allele, genotype and dominant models with and without crude odds ratios (OR's) and Multiple logistic regression analysis (p < 0.05). Correlation between lipid profile and genotypes has confirmed the significant relation between triglycerides and rs646218 and rs1105364 6polymorphisms. However, rs11053646 polymorphism was correlated with HDLC (p = 0.04). Genotypes were examined in both males' vs. males and females' vs. females in cases and control and we concluded that in rs11053646 polymorphisms with male subjects compared between cases and controls found to be associated with dominant model heterozygote genotypes (p < 0.05). CONCLUSION The results of the current study confirmed the SORT1 and OLR1 SNPs were associated in the Saudi population. The current results were in the association with the prior study results documented through GWAS and meta-analysis association. However, other ethnic population studies should be performed to rule out in the human hereditary diseases.
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Affiliation(s)
- Khalid Khalaf Alharbi
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh 11433, Saudi Arabia
| | - Imran Ali Khan
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh 11433, Saudi Arabia
| | | | | | | | - Naelah Abdullah Alghamdi
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh 11433, Saudi Arabia
| | | | - A.M. Al-Sulaiman
- Department of Medical and Molecular Virology, PSMMC, Riyadh, Saudi Arabia
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17
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Malueka RG, Dwianingsih EK, Sutarni S, Bawono RG, Bayuangga HF, Gofir A, Setyopranoto I. The D allele of the angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism is associated with worse functional outcome of ischaemic stroke. Int J Neurosci 2017; 128:697-704. [PMID: 29199539 DOI: 10.1080/00207454.2017.1412962] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE Insertion/deletion polymorphism in ACE gene (ACE I/D) is known to be associated with the occurrence of ischaemic stroke through its effect on pathogenesis of atherosclerosis and hypertension. This study was aimed to examine the association between this polymorphism with functional outcome of ischaemic stroke. METHOD This was a cross-sectional study. The subjects were patients with ischaemic stroke in a reference hospital in Yogyakarta, Indonesia. Data on demographic characteristics, stroke risk factors, comorbidities and stroke severity were assessed on admission. The functional outcome, Barthel index (BI), was assessed when the patients were discharged from the hospital. ACE I/D genotypes of the patients were identified by polymerase chain reaction (PCR). RESULT In total, 61 patients were included. Of these, 38 patients (62.3%) had II polymorphism, 22 patients (36.1%) had ID polymorphism and 1 patient (1.6%) had DD polymorphism in the ACE gene. There were significant differences in the functional outcomes between patients without D allele (II polymorphisms) and patients with D allele (ID and DD polymorphism) (mean BI on discharge: 75 ± 23.57 and 60.65 ± 27.15, respectively; p = 0.034). Multiple linear regression model showed that the availability of D allele is an independent variable negatively associated with functional outcome as assessed by BI (β = -0.232, p = 0.024). CONCLUSION This study showed that the D allele in ACE I/D polymorphism is associated with worse functional outcomes. This highlights the possibility of further research to improve functional outcomes of ischaemic stroke by inhibiting the ACE system.
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Affiliation(s)
- Rusdy Ghazali Malueka
- a Neurology Department, Medical Faculty , Universitas Gadjah Mada , Yogyakarta , Indonesia
| | - Ery Kus Dwianingsih
- b Department of Anatomical Pathology, Faculty of Medicine , Universitas Gadjah Mada , Yogyakarta , Indonesia
| | - Sri Sutarni
- a Neurology Department, Medical Faculty , Universitas Gadjah Mada , Yogyakarta , Indonesia
| | - Rheza Gandi Bawono
- a Neurology Department, Medical Faculty , Universitas Gadjah Mada , Yogyakarta , Indonesia
| | - Halwan Fuad Bayuangga
- a Neurology Department, Medical Faculty , Universitas Gadjah Mada , Yogyakarta , Indonesia
| | - Abdul Gofir
- a Neurology Department, Medical Faculty , Universitas Gadjah Mada , Yogyakarta , Indonesia
| | - Ismail Setyopranoto
- a Neurology Department, Medical Faculty , Universitas Gadjah Mada , Yogyakarta , Indonesia
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18
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Arora P, Agarwal Z, Venkatraman A, Callas P, Kissela BM, Jenny NS, Judd SE, Zakai NA, Cushman M. Galectin-3 and risk of ischaemic stroke: Reasons for Geographic and Racial Differences in Stroke cohort. Eur J Neurol 2017; 24:1464-1470. [PMID: 28872212 DOI: 10.1111/ene.13440] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 08/31/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE Galectin-3 is a biomarker of atherosclerotic and cardiovascular disease, and may be a useful marker for ischaemic stroke risk. METHODS The Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort enrolled and examined 30 239 US participants between 2003 and 2007 (41% black, 59% white and 55% in the southeastern stroke belt). Baseline galectin-3 was measured in 526 subjects with incident ischaemic stroke over 5.4 years and in a cohort random sample (CRS) of 947 participants. Cox proportional hazards models were used to calculate hazard ratios (HRs) of ischaemic stroke by quartiles of galectin-3. RESULTS In the CRS, galectin-3 was significantly higher with older age, black race, female sex, body mass index, hypertension, diabetes mellitus and kidney disease, and also in those who developed incident stroke. Participants with galectin-3 levels in the fourth versus first quartile had a 2.3-fold increased stroke risk [95% confidence interval (CI) 1.6, 3.4] in an unadjusted model. An interaction with age was found (P = 0.06), and therefore age-stratified analyses were performed. Amongst those younger than age 64, baseline galectin-3 in the second-fourth quartiles was associated with increased stroke risk (HR 3.0, 95% CI 1.6, 5.5) compared to the first quartile in an age-, race- and sex-adjusted model. The HR was 2.0 (95% CI 1.0, 4.0) with multivariable adjustment. There was no association amongst older participants. CONCLUSIONS Galectin-3 was associated with incident ischaemic stroke in younger but not older individuals. Confirmation of this finding, and elucidation of its implications for stroke pathophysiology and prevention, is needed.
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Affiliation(s)
- P Arora
- Division of Cardiology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.,Section of Cardiology, Birmingham Veterans Affairs Medical Center, Birmingham, AL, USA
| | - Z Agarwal
- Department of Medicine, Larner College of Medicine at the University of Vermont, Burlington, VT, USA
| | - A Venkatraman
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - P Callas
- Department of Mathematics and Statistics, University of Vermont, Burlington, VT, USA
| | - B M Kissela
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - N S Jenny
- Department of Pathology and Laboratory Medicine, Larner College of Medicine at the University of Vermont, Burlington, VT, USA
| | - S E Judd
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - N A Zakai
- Department of Medicine, Larner College of Medicine at the University of Vermont, Burlington, VT, USA.,Department of Pathology and Laboratory Medicine, Larner College of Medicine at the University of Vermont, Burlington, VT, USA
| | - M Cushman
- Department of Medicine, Larner College of Medicine at the University of Vermont, Burlington, VT, USA.,Department of Pathology and Laboratory Medicine, Larner College of Medicine at the University of Vermont, Burlington, VT, USA
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19
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Yu DD, Ren QQ, Dong B, Zhao DD, Sun YH. Effect of Cholesteryl Ester Transfer Protein Gene TaqIB Polymorphism on the Risk of Ischemic Stroke: A Meta-Analysis. J Stroke Cerebrovasc Dis 2017. [DOI: 10.1016/j.jstrokecerebrovasdis.2017.05.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
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20
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Abstract
Ischemic stroke is a heterogeneous multifactorial disorder recognized by the sudden onset of neurologic signs related directly to the sites of injury in the brain where the morbid process occurs. The evaluation of complex neurologic disorders, such as stroke, in which multiple genetic and epigenetic factors interact with environmental risk factors to increase the risk has been revolutionized by the genome-wide association studies (GWAS) approach. This article reviews salient aspects of ischemic stroke emphasizing the impact of neuroepidemiology and GWAS.
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Affiliation(s)
- Albert S Favate
- Division of Neuroepidemiology, Department of Neurology, New York University School of Medicine, New York, NY, USA
| | - David S Younger
- Division of Neuroepidemiology, Department of Neurology, New York University School of Medicine, New York, NY, USA; College of Global Public Health, New York University, New York, NY, USA.
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21
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Li S, Zhang J, Li S, Liu C, Liu S, Liu Z. Extraction and separation of lactate dehydrogenase inhibitors from Poria cocos (Schw.) Wolf based on a hyphenated technique and in vitro methods. J Sep Sci 2017; 40:1773-1783. [PMID: 28217983 DOI: 10.1002/jssc.201700054] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 02/05/2017] [Accepted: 02/09/2017] [Indexed: 12/20/2022]
Abstract
Stroke is one of the most common diseases worldwide. Lactate dehydrogenase inhibitors are widely used in the treatment of ischemic stroke, with natural products considered a promising source of lactate dehydrogenase inhibitors. In this study, ultrafiltration liquid chromatography coupled with mass spectrometry was used for the screening and identification of lactate dehydrogenase inhibitors from Poria cocos. Five lactate dehydrogenase inhibitors were selected: dehydropachymic acid, pachymic acid, dehydrotrametenolic acid, trametenolic acid, and eburicoic acid. The inhibitors were extracted and isolated with purities of 96.75, 98.15, 97.25, 95.46, and 94.88%, respectively, by using a new "hyphenated" strategy of microwave-assisted extraction coupled with counter-current chromatography and centrifugal partition chromatography by a two-phase solvent system of n-hexane/ethyl acetate/ethanol/water at the volume ratio 0.965:1.000:0.936:0.826 v/v/v/v. The bioactivity of the isolated compounds was assessed using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay in PC12 cells. The results also showed that the hyphenated technique of microwave-assisted extraction coupled with counter-current chromatography and centrifugal partition chromatography was an efficient method for the continuous extraction and online isolation of chemical constituents from medicinal herbs. Furthermore, the research route based on the activity screening, extraction, separation, and activity verification of the compounds offered advantages of efficiency, orientation, and objectivity.
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Affiliation(s)
- Sainan Li
- Central Laboratory, Changchun Normal University, Changchun, China.,Changchun Center of Mass Spectrometry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun, China
| | - Jianxu Zhang
- Department of Rehabilitation, Second Branch of the First Hospital of Jilin University, Changchun, China
| | - Senlin Li
- Central Laboratory, Changchun Normal University, Changchun, China
| | - Chunming Liu
- Central Laboratory, Changchun Normal University, Changchun, China
| | - Shu Liu
- Changchun Center of Mass Spectrometry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun, China
| | - Zhiqiang Liu
- Changchun Center of Mass Spectrometry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun, China
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22
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Extraction and isolation of potential anti-stroke compounds from flowers of Pueraria lobata guided by in vitro PC12 cell model. J Chromatogr B Analyt Technol Biomed Life Sci 2017; 1048:111-120. [DOI: 10.1016/j.jchromb.2017.02.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 02/05/2017] [Accepted: 02/09/2017] [Indexed: 11/20/2022]
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23
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Li S, Liu S, Liu Z, Liu C, Song F, Pi Z. Bioactivity screening, extraction, and separation of lactate dehydrogenase inhibitors fromPolygala tenuifoliaWilld. based on a hyphenated strategy. J Sep Sci 2017; 40:1385-1395. [DOI: 10.1002/jssc.201601216] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 01/08/2017] [Accepted: 01/10/2017] [Indexed: 12/15/2022]
Affiliation(s)
- Sainan Li
- Changchun Center of Mass Spectrometry, Changchun Institute of Applied Chemistry; Chinese Academy of Sciences; Changchun China
- Central Laboratory; Changchun Normal University; Changchun China
| | - Shu Liu
- Changchun Center of Mass Spectrometry, Changchun Institute of Applied Chemistry; Chinese Academy of Sciences; Changchun China
| | - Zhiqiang Liu
- Changchun Center of Mass Spectrometry, Changchun Institute of Applied Chemistry; Chinese Academy of Sciences; Changchun China
| | - Chunming Liu
- Central Laboratory; Changchun Normal University; Changchun China
| | - Fengrui Song
- Changchun Center of Mass Spectrometry, Changchun Institute of Applied Chemistry; Chinese Academy of Sciences; Changchun China
| | - Zifeng Pi
- Changchun Center of Mass Spectrometry, Changchun Institute of Applied Chemistry; Chinese Academy of Sciences; Changchun China
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24
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Tang Y, Li S, Li S, Yang X, Qin Y, Zhang Y, Liu C. Screening and isolation of potential lactate dehydrogenase inhibitors from five Chinese medicinal herbs: Soybean, Radix pueraria, Flos pueraria, Rhizoma belamcandae, and Radix astragali. J Sep Sci 2016; 39:2043-9. [PMID: 27059876 DOI: 10.1002/jssc.201600050] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 03/18/2016] [Accepted: 03/18/2016] [Indexed: 12/21/2022]
Abstract
Stroke is among the leading causes of death and severe disability worldwide. Flavonoids have been extensively used in the treatment of ischemic stroke by reducing lactate dehydrogenase levels and thereby enhancing blood perfusion to the ischemic region. Here, we used ultrafiltration high-performance liquid chromatography coupled with diode array detection and mass spectrometry for the rapid screening and identification of flavonoids from five Chinese medicinal herbs: soybean, Radix pueraria, Flos pueraria, Rhizoma belamcandae, and Radix astragali. Using PC12 cells as a suitable in vitro model of toxicity, cell viability was quantitated using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. The results showed that the extracts of soybean and the six major components, namely, acetyldaidzin, malonylgenistin, daidiain, glycitin, genistin, and acetylcitin; the extract of R. pueraria and its main component daidzein; the extract of F. pueraria and its three major components, tectorigenin, tectoridin, and tectorigenin-7-O-xylosylglucosid; and the extract of R. belamcandae and its main component, tectoridin, were strong lactate dehydrogenase inhibitors. Also, the components of R. astragali showed no bioactivity. These findings indicate that the ultrafltration high-performance liquid chromatography coupled with diode array detection and mass spectrometry method could be utilized in rapid screening and separation of bioactive compounds from a complex matrix.
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Affiliation(s)
- Ying Tang
- Central Laboratory, Changchun Normal University, Erdao District, Changchun, Jilin, China
| | - Senlin Li
- Central Laboratory, Changchun Normal University, Erdao District, Changchun, Jilin, China
| | - Sainan Li
- Central Laboratory, Changchun Normal University, Erdao District, Changchun, Jilin, China
| | - Xiaojing Yang
- Central Laboratory, Changchun Normal University, Erdao District, Changchun, Jilin, China
| | - Yao Qin
- Central Laboratory, Changchun Normal University, Erdao District, Changchun, Jilin, China
| | - Yuchi Zhang
- Central Laboratory, Changchun Normal University, Erdao District, Changchun, Jilin, China
| | - Chunming Liu
- Central Laboratory, Changchun Normal University, Erdao District, Changchun, Jilin, China
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