1
|
Penman SL, Roeder NM, Wang J, Richardson BJ, Pareek O, Freeman-Striegel L, Mohr P, Khan A, Eiden RD, Chakraborty S, Thanos PK. Vaporized nicotine in utero results in reduced birthweight, increased locomotion, and decreased voluntary exercise, dependent on sex and diet in offspring. Psychopharmacology (Berl) 2024; 241:1857-1882. [PMID: 38733527 DOI: 10.1007/s00213-024-06602-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 04/27/2024] [Indexed: 05/13/2024]
Abstract
Rationale Clinical research has shown that prenatal exposure to nicotine may result in increased obesity risk later in life. Preclinical research has corroborated this finding, but few studies have investigated inhaled nicotine or the interaction with diet on obesity risk. Objective The aim of this study was to investigate the effects of prenatal nicotine exposure on both direct and indirect obesity measures, with both sex and diet as factors. Methods Pregnant rats were exposed to either vehicle or nicotine vapor (24 mg/mL or 59 mg/mL) throughout the entire gestational period. Offspring from each treatment group were given either a normal diet or a high fat diet starting at postnatal day 22. Caloric intake, body weight, spontaneous locomotion, sleep/wake activity, and voluntary exercise were measured throughout adolescence. Pregnancy weight gain and pup birthweights were collected to further measure developmental effects of prenatal nicotine exposure. Results Both maternal weight gain during pregnancy and pup weight at birth were decreased with prenatal nicotine exposure. Early adolescent males showed increased spontaneous activity in the open field following prenatal nicotine exposure compared to vehicle counterparts, particularly those given high-fat diet. Additionally, high dose nicotine prenatal treated males ran significantly less distance on the running wheel in late adolescence compared to vehicle counterparts, in the normal diet group only. Conclusion The results presented here show decreased birthweight, hyperactivity, and decreased voluntary exercise in adolescence following prenatal nicotine exposure in dose, sex, and diet dependent manners, which could lead to increased obesity risk in adulthood.
Collapse
Affiliation(s)
- Samantha L Penman
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions (BNNLA), Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, Clinical Research Institute on Addictions, University at Buffalo, 1021 Main Street, Buffalo, NY, 14203-1016, USA
| | - Nicole M Roeder
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions (BNNLA), Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, Clinical Research Institute on Addictions, University at Buffalo, 1021 Main Street, Buffalo, NY, 14203-1016, USA
- Department of Psychology, University at Buffalo, Buffalo, NY, USA
| | - Jia Wang
- Department of Biostatistics, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
| | - Brittany J Richardson
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions (BNNLA), Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, Clinical Research Institute on Addictions, University at Buffalo, 1021 Main Street, Buffalo, NY, 14203-1016, USA
| | - Ojas Pareek
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions (BNNLA), Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, Clinical Research Institute on Addictions, University at Buffalo, 1021 Main Street, Buffalo, NY, 14203-1016, USA
| | - Lily Freeman-Striegel
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions (BNNLA), Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, Clinical Research Institute on Addictions, University at Buffalo, 1021 Main Street, Buffalo, NY, 14203-1016, USA
| | - Patrick Mohr
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions (BNNLA), Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, Clinical Research Institute on Addictions, University at Buffalo, 1021 Main Street, Buffalo, NY, 14203-1016, USA
| | - Anas Khan
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions (BNNLA), Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, Clinical Research Institute on Addictions, University at Buffalo, 1021 Main Street, Buffalo, NY, 14203-1016, USA
| | - Rina D Eiden
- Department of Psychology, Social Science Research Institute, The Pennsylvania State University, University Park, PA, 16801, USA
| | - Saptarshi Chakraborty
- Department of Biostatistics, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
| | - Panayotis K Thanos
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions (BNNLA), Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, Clinical Research Institute on Addictions, University at Buffalo, 1021 Main Street, Buffalo, NY, 14203-1016, USA.
- Department of Psychology, University at Buffalo, Buffalo, NY, USA.
| |
Collapse
|
2
|
Jensen SK, Pedersen CET, Fischer-Rasmussen K, Melgaard ME, Brustad N, Kyvsgaard JN, Vahman N, Schoos AMM, Stokholm J, Chawes B, Eliasen A, Bønnelykke K. Genetic predisposition to high BMI increases risk of early life respiratory infections and episodes of severe wheeze and asthma. Eur Respir J 2024; 64:2400169. [PMID: 38811044 DOI: 10.1183/13993003.00169-2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 05/20/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND High body mass index (BMI) is an established risk factor for asthma, but the underlying mechanisms remain unclear. OBJECTIVE To increase understanding of the BMI-asthma relationship by studying the association between genetic predisposition to higher BMI and asthma, infections and other asthma traits during childhood. METHODS Data were obtained from the two ongoing Copenhagen Prospective Studies on Asthma in Childhood (COPSAC) mother-child cohorts. Polygenic risk scores for adult BMI were calculated for each child. Replication was done in the large-scale register-based Integrative Psychiatric Research (iPSYCH) cohort using data on hospitalisation for asthma and infections. RESULTS In the COPSAC cohorts (n=974), the adult BMI polygenic risk score was significantly associated with lower respiratory tract infections (incidence rate ratio (IRR) 1.20, 95% CI 1.08-1.33, false discovery rate p-value (pFDR)=0.005) at age 0-3 years and episodes of severe wheeze (IRR 1.30, 95% CI 1.06-1.60, pFDR=0.04) at age 0-6 years. Lower respiratory tract infections partly mediated the association between the adult BMI polygenic risk score and severe wheeze (proportion mediated: 0.59, 95% CI 0.28-2.24, p-value associated with the average causal mediation effect (pACME)=2e-16). In contrast, these associations were not mediated through the child's current BMI and the polygenic risk score was not associated with an asthma diagnosis or reduced lung function up to age 18 years. The associations were replicated in iPSYCH (n=114 283), where the adult BMI polygenic risk score significantly increased the risk of hospitalisations for lower respiratory tract infections and wheeze or asthma throughout childhood to age 18 years. CONCLUSION Children with genetic predisposition to higher BMI had increased risk of lower respiratory tract infections and severe wheeze, independent of the child's current BMI. These results shed further light on the complex relationship between body mass BMI and asthma.
Collapse
Affiliation(s)
- Signe Kjeldgaard Jensen
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Department of Pediatrics, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Casper-Emil Tingskov Pedersen
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Department of Pediatrics, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Kasper Fischer-Rasmussen
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Department of Pediatrics, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Mathias Elsner Melgaard
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Department of Pediatrics, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Nicklas Brustad
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Department of Pediatrics, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Julie Nyholm Kyvsgaard
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Department of Pediatrics, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
- Department of Pediatrics, Slagelse Hospital, Slagelse, Denmark
| | - Nilo Vahman
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Department of Pediatrics, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Ann-Marie Malby Schoos
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Department of Pediatrics, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
- Department of Pediatrics, Slagelse Hospital, Slagelse, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jakob Stokholm
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Department of Pediatrics, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
- Department of Pediatrics, Slagelse Hospital, Slagelse, Denmark
- Section of Microbiology and Fermentation, Department of Food Science, University of Copenhagen, Copenhagen, Denmark
| | - Bo Chawes
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Department of Pediatrics, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anders Eliasen
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Department of Pediatrics, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
- Department of Pediatrics, Division of Endocrinology, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
- Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Shared senior author
| | - Klaus Bønnelykke
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Department of Pediatrics, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Shared senior author
| |
Collapse
|
3
|
Layte R, Cronin FM, Nivakoski S, McEvoy O, Brannigan R, Stanistreet D. The relative roles of early life, physical activity, sedentarism and diet in social and economic inequalities in body mass index and obesity risk between 9 and 18. SSM Popul Health 2023; 24:101499. [PMID: 37731532 PMCID: PMC10507434 DOI: 10.1016/j.ssmph.2023.101499] [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: 04/10/2023] [Revised: 08/17/2023] [Accepted: 08/25/2023] [Indexed: 09/22/2023] Open
Abstract
Background Studies in many middle and high-income countries describe an increasing prevalence of adiposity and obesity among children and adolescents. Prevalence is higher among families of low socioeconomic position (SEP) and systematic reviews have identified relevant factors, but have not quantified their relative importance to SEP differentials. This paper examines the relative importance of different factors to Body Mass Index (BMI) and obesity trajectories from age 9 to age 17/18. Methods Multi-level models of child BMI/obesity risk trajectory by maternal education were conducted using a nationally representative cohort of children born in Ireland in 1998 and aged 9 at baseline (N = 8568), with follow-up at 13 and 17/18 years (88% and 73% response rate respectively). Models were stratified by sex and both time-varying (e.g. child physical activity, diet, sedentary activity) and time-invariant (e.g. early life) factors were tested. Results Significant inverse gradients in BMI and obesity risk by level of maternal education were present across both sexes and at each age; unadjusted absolute differentials in obesity risk between highest/lowest education groups increased by 56% for males and 42% for females between age 9 and 17/18. Early life factors accounted for 22% of the differential in obesity risk between the lowest and highest education groups among males at age 9, falling to 13% at 17/18. Among females the proportion fell from 33 to 23%. Unadjusted absolute high/low maternal education group differentials in BMI were 7.5 times higher among males and 11 times higher among females at 17/18 than at age 9. Conclusions Given the importance of early life exposures to subsequent differentials in BMI and obesity risk our findings suggest that policy makers should focus resources on primary prevention during the prenatal and early life period if they wish to reduce the prevalence of child and adolescent obesity.
Collapse
Affiliation(s)
- Richard Layte
- Department of Sociology, Trinity College Dublin, Dublin, Ireland
| | - Frances M. Cronin
- School of Population Health, Royal College of Surgeons University of Medicine and Health Sciences in Ireland, Dublin 2, Ireland
| | - Sanna Nivakoski
- European Foundation for Living and Working Conditions, Dublin, Ireland
| | - Olivia McEvoy
- Department of Sociology, Trinity College Dublin, Dublin, Ireland
| | - Ross Brannigan
- School of Population Health, Royal College of Surgeons University of Medicine and Health Sciences in Ireland, Dublin 2, Ireland
| | - Debbi Stanistreet
- School of Population Health, Royal College of Surgeons University of Medicine and Health Sciences in Ireland, Dublin 2, Ireland
| |
Collapse
|
4
|
Ratsch A, Bogossian F, Burmeister EA, Steadman K. Central Australian Aboriginal women's placental and neonatal outcomes following maternal smokeless tobacco, cigarette or no tobacco use. Aust N Z J Public Health 2021; 46:186-195. [PMID: 34821425 DOI: 10.1111/1753-6405.13186] [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: 05/01/2021] [Revised: 09/01/2021] [Accepted: 10/01/2021] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE To describe the placental characteristics and neonatal outcomes of Central Australian Aboriginal women based on maternal self-report of tobacco use. METHODS Placental and neonatal variables were collected from a prospective maternal cohort of 19 smokeless tobacco chewers, 23 smokers and 31 no-tobacco users. RESULTS Chewers had the lowest placental weight (460 g) while the no-tobacco group had the heaviest placental weight (565 g). Chewers and the no-tobacco group had placental areas of similar size (285 cm2 and 288 cm2 , respectively) while the placentas of smokers were at least 13 cm2 smaller (272 cm2 ). There were two stillbirths in the study and more than one-third (36%) of neonates (newborns) were admitted to the Special Care Nursery, with the chewers' neonates having a higher admission rate compared with smokers' neonates (44% vs. 23%). The cohort mean birthweight (3348 g) was not significantly different between the groups. When stratified for elevated maternal glucose, the chewers' neonates had the lowest mean birthweight (2906 g) compared to the neonates of the no-tobacco group (3242 g) and smokers (3398 g). CONCLUSIONS This research is the first to demonstrate that the maternal use of Australian Nicotiana spp. (pituri) as smokeless tobacco may negatively impact placental and neonatal outcomes. Implications for public health: Maternal smokeless tobacco use is a potential source of placental and foetal nicotine exposure. Maternal antenatal screening should be expanded to capture a broader range of tobacco and nicotine products, and appropriate cessation support is required.
Collapse
Affiliation(s)
- Angela Ratsch
- Wide Bay Hospital and Health Services, Queensland.,Rural Clinical School, The University of Queensland, Queensland
| | - Fiona Bogossian
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Queensland.,School of Nursing, Midwifery and Social Work, The University of Queensland, Queensland
| | - Elizabeth A Burmeister
- Wide Bay Hospital and Health Services, Queensland.,School of Nursing, Midwifery and Social Work, The University of Queensland, Queensland
| | | |
Collapse
|
5
|
Song Q, Sun D, Zhou T, Li X, Ma H, Liang Z, Wang H, Cardoso MA, Heianza Y, Qi L. Perinatal exposure to maternal smoking and adulthood smoking behaviors in predicting cardiovascular diseases: A prospective cohort study. Atherosclerosis 2021; 328:52-59. [PMID: 34091070 DOI: 10.1016/j.atherosclerosis.2021.05.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 05/06/2021] [Accepted: 05/12/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND AIMS Little is known about the associations between perinatal exposure to maternal smoking and cardiovascular disease (CVD) incidence in offspring, and whether such associations are modified by adulthood and genetically determined smoking behaviors. METHODS A total of 414,588 participants without CVD at baseline were included from the UK Biobank in 2006-2010 and followed up through 2018. Cox-proportional hazard models were used to examine the association of perinatal maternal smoking with CVD, and both multiplicative and additive interaction analyses were performed to investigate the modification effects of own smoking behaviors. RESULTS During a median follow-up of 8.93 years, we observed 10,860 incident CVD events, including 7006 myocardial infarction (MI) and 4147 stroke. We found that perinatal exposure to maternal smoking was associated with increased risks of CVD (HR: 1.10; 95% CI: 1.05-1.14), MI (1.10; 1.05-1.16) and stroke (1.10; 1.03-1.18). In addition, we observed significant interactions between perinatal exposure to maternal smoking and adulthood exposure to own smoking on CVD and MI on both the multiplicative and additive scales (all p < 0.05). The attributable proportions due to additive interaction between perinatal and adulthood exposure to smoking were 14% (9%-19%) for CVD and 16% (10%-22%) for MI, respectively. Perinatal exposure to maternal smoking also showed an interaction with genetically determined smoking on MI (p < 0.05), but no interactions were found on the total CVD and stroke. CONCLUSIONS Our results indicate that perinatal exposure to maternal smoking is associated with increased risks of CVD events, and such relations are modified by adulthood smoking behaviors.
Collapse
Affiliation(s)
- Qiying Song
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA; Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China; Maternal-Fetal Medicine Institute, Shenzhen Baoan Women's and Children's Hospital, Jinan University, Shenzhen, China
| | - Dianjianyi Sun
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Tao Zhou
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Xiang Li
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Hao Ma
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Zhaoxia Liang
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA; Department of Obstetrical, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Haijun Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Marly Augusto Cardoso
- Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
| | - Yoriko Heianza
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Lu Qi
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
| |
Collapse
|
6
|
Luetic GG, Menichini ML, Deri N, Steinberg J, Carrá A, Cristiano E, Patrucco L, Curbelo MC, Rojas JI. High birth weight and risk of multiple sclerosis: A multicentre study in Argentina. Mult Scler Relat Disord 2020; 47:102628. [PMID: 33220566 DOI: 10.1016/j.msard.2020.102628] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 10/11/2020] [Accepted: 11/10/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Multiple sclerosis (MS) is now recognized as a multifactorial disease in which genetic and environmental factors intervene. Considerable efforts have been made to identify external risk factors present in childhood, adolescence and youth, though only a few perinatal risk factors have been positively associated with MS. Previously, we found an association between high birth weight and MS in male patients in a small study in Argentina. The present research was designed to further assess the association between high birth weight and MS in a larger sample of patients, using an extensive and validated general population database as control. METHODS We present an analytical observational, multicentre, population-based, and case-control study. A total of 637 patients (cases) with confirmed MS diagnosis attending five MS specialized centres in Argentina were included. Birth weight (BW) data was recalled by the patient's mother, which is a validated approach. A two-way comparison was performed. First, we used the standard categories of high, adequate and low BW in grams. Then, we applied the weight percentile distribution to provide reproducible results for further research. For a proper assessment and comparison of variables, we adopted the guidelines of the American Academy of Pediatrics for neonate classification according to gestational weeks and to BW in grams. The neonate's BW distribution of the general population was used as control. For the purposes of the study, we adapted Urquía's et al. curves, which are based on an extensive database of all the live births registered in the country from 2003 to 2007. To measure the magnitude of the proportional differences between low, adequate and high BW, the odds ratio (OR) and their 95% confidence interval (CI) were estimated. The mean BW and percentile values for each sex were compared using a z-Normal test. The respective MS patients and general population BW distribution curves by sex were compared between each other. RESULTS Cases and controls were comparable in their demographic, geographic and environmental characteristics. Males showed higher BW than females both in the MS patients and the general population groups. When we applied the sex stratified analysis separately, we found that males in the MS group showed an almost seven times higher risk of high birth weight than males from the general population (OR 6.58 [95% CI 4.81-8.99]). Female patients showed an almost five times higher risk of high BW than their respective controls (OR 4.5 [95% CI 3.06-6.58]). The comparison based on the BW percentile distribution confirmed that MS patients showed higher BW than the general population. This result reached statistical significance from the 75th percentile onwards for both sexes. CONCLUSION In summary, our findings suggested that high BW could be one of the earliest risk factors for MS in life. If this results were reproduced in other centres, high birth weight would emerge as a novel and very early risk factor, potentially modifiable in utero or immediately postpartum, representing a unique opportunity to prevent the disease in future generations.
Collapse
Affiliation(s)
- Geraldine G Luetic
- Instituto de Neurociencias de Rosario, San Lorenzo 3598, Rosario, Santa Fe, 2000, Argentina.
| | - Maria L Menichini
- Instituto de Neurociencias de Rosario, San Lorenzo 3598, Rosario, Santa Fe, 2000, Argentina
| | - Norma Deri
- Centro de Investigaciones Diabaid, CABA, Argentina
| | - Judith Steinberg
- Sección de enfermedades desmielinizantes, Hospital Británico; CABA, Argentina
| | - Adriana Carrá
- Sección de enfermedades desmielinizantes, Hospital Británico; CABA, Argentina
| | | | | | - Maria C Curbelo
- Sección de enfermedades desmielinizantes, Hospital Británico; CABA, Argentina; Hospital Municipal Sofía Santamarina, Buenos Aires, Argentina
| | - Juan I Rojas
- Centro de Esclerosis Múltiple de Buenos Aires, CABA, Argentina
| |
Collapse
|