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Mlambo ZP, Sebitloane M, Naicker T. Association of angiogenic factors (placental growth factor and soluble FMS-like tyrosine kinase-1) in preeclamptic women of African ancestry comorbid with HIV infection. Arch Gynecol Obstet 2024:10.1007/s00404-024-07590-3. [PMID: 38910142 DOI: 10.1007/s00404-024-07590-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 06/04/2024] [Indexed: 06/25/2024]
Abstract
BACKGROUND Preeclampsia is a significant cause of maternal and fetal morbidity and mortality, particularly in low- and middle-income countries like South Africa. AIM The aim of our study was to investigate the association between placental growth factor (PlGF) and soluble FMS-like tyrosine kinase-1 (sFlt-1) in South African preeclamptic women of African ancestry, comorbid with HIV infection. METHODS The study population consisted of women attending a regional hospital in Durban, South Africa, stratified by pregnancy type (normotensive pregnant and preeclampsia) and HIV status. Preeclampsia was defined as new-onset hypertension and proteinuria. DNA was obtained from whole blood. The SNPs of interest were rs722503 in sFlt-1 and rs4903273 in PlGF. RESULTS Our findings suggest that single nucleotide polymorphisms of rs722503 analysis show no significant associations between the genotypic frequencies of rs722503 variants and preeclampsia risk in either HIV-negative or HIV-positive groups of women of African ancestry. Similarly, the rs493273 polymorphism showed no significant association with preeclampsia risk in either HIV-negative or HIV-positive pregnant women. Additionally, comparisons of dominant, recessive, and over-dominant allele models did not reveal significant associations. These findings suggest that these genetic variants may not significantly contribute to preeclampsia development in this African ancestry population. However, significant differences were observed in the rs4903273 genotype frequencies between normotensive and preeclamptic women, regardless of HIV status, over dominant alleles AA + GG vs AG showed a significant difference [OR = 2.706; 95% Cl (1.199-5.979); adjusted p = 0.0234*], also in normotensive compared to EOPE (OR = 2.804; 95% Cl (1.151-6.89) p = 0.0326* and LOPE (OR = 2.601; 95% Cl (1.0310-6.539) p = 0.0492*), suggesting that they may be the potential role of this variant in preeclampsia susceptibility. CONCLUSION The findings suggest that the rs722503 and rs493273 polymorphisms do not significantly contribute to preeclampsia susceptibility in HIV-negative or HIV-positive pregnant women. However, the rs4903273 genotype frequencies showed notable differences between normotensive and preeclamptic women, indicating a potential association with preeclampsia development in the African ancestry population irrespective of HIV status.
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Affiliation(s)
- Zinhle P Mlambo
- Optics and Imaging Centre, Doris Duke Medical Research Institute, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
| | - Motshedisi Sebitloane
- Department of Obstetrics and Gynaecology, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Thajasvarie Naicker
- Optics and Imaging Centre, Doris Duke Medical Research Institute, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
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HIV Associated Preeclampsia: A Multifactorial Appraisal. Int J Mol Sci 2021; 22:ijms22179157. [PMID: 34502066 PMCID: PMC8431090 DOI: 10.3390/ijms22179157] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/16/2021] [Accepted: 08/18/2021] [Indexed: 12/13/2022] Open
Abstract
Introduction: This review explores angiogenesis, vascular dysfunction, the complement system, RAAS, apoptosis and NETosis as potential pathways that are dysregulated during preeclampsia, HIV infection and ART usage. Results: HIV-1 accessory and matrix proteins are protagonists for the elevation of oxidative stress, apoptosis, angiogenesis, and elevation of adhesion markers. Despite the immunodeficiency during HIV-1 infection, HIV-1 exploits our cellular defence arsenal by escaping cell-mediated lysis, yet HIV-1 infectivity is enhanced via C5a release of TNF-α and IL-6. This review demonstrates that PE is an oxidatively stressed microenvironment associated with increased apoptosis and NETosis, but with a decline in angiogenesis. Immune reconstitution in the duality of HIV-1 and PE by protease inhibitors, HAART and nucleoside reverse transcriptase, affect similar cellular pathways that eventuate in loss of endothelial cell integrity and, hence, its dysfunction. Conclusions: HIV-1 infection, preeclampsia and ARTs differentially affect endothelial cell function. In the synergy of both conditions, endothelial dysfunction predominates. This knowledge will help us to understand the effect of HIV infection and ART on immune reconstitution in preeclampsia.
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Yeates AJ, McSorley EM, Mulhern MS, Spence T, Crowe W, Grzesik K, Thurston SW, Watson GE, Myers GJ, Davidson PW, Shamlaye CF, van Wijngaarden E, Strain JJ. Associations between maternal inflammation during pregnancy and infant birth outcomes in the Seychelles Child Development Study. J Reprod Immunol 2019; 137:102623. [PMID: 31710980 DOI: 10.1016/j.jri.2019.102623] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 10/11/2019] [Indexed: 01/18/2023]
Abstract
PROBLEM Markers of maternal inflammation may determine infant birth outcomes. METHOD OF STUDY Maternal serum samples were collected at 28 weeks gestation (n = 1418) in the Seychelles Child Development Study Nutrition Cohort 2 and analyzed for immune markers by MSD multiplex assay, including cytokines from the Th1 (IFN-γ, IL-1β, IL-2 and TNF-α) and Th2 (IL-4, IL-5, IL-10) subsets, with IL-6, MCP-1, TARC, sFlt-1 and VEGF-D. Associations of log-transformed immune markers with birthweight, length, head circumference and gestational age were assessed by multiple linear regression models, which were adjusted for maternal age, BMI, parity, child sex, gestational age and socioeconomic status. RESULTS Neither total Th1, Th2 nor Th1:Th2 were significantly associated with any birth outcome. However, the angiogenesis marker VEGF-D was predictive of a lower birthweight, (β = -0.058, P = 0.017) and birth length (β = -0.088, P = 0.001) after adjusting for covariates. Higher concentrations of CRP were predictive of a lower birthweight (β = -0.057, P = 0.023) and IL-2 (β = 0.073, P = 0.009) and the chemokine MCP-1 (β = 0.067, P = 0.016) were predictive of a longer gestational age. CONCLUSIONS In our cohort of healthy pregnant women, we found no evidence for associations between the Th1 or Th2 inflammatory markers with birth outcomes. However, VEGF-D and CRP appear to predict lower birthweight and IL-2 and MCP-1 a longer gestation. Greater understanding is required of the variation in these immune markers at different gestational stages, as well as the factors which may regulate their balance in healthy pregnancy. n = 233.
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Affiliation(s)
- A J Yeates
- Nutrition Innovation Centre for Food and Health (NICHE), Ulster University, Coleraine, County Londonderry, BT52 1SA, UK.
| | - E M McSorley
- Nutrition Innovation Centre for Food and Health (NICHE), Ulster University, Coleraine, County Londonderry, BT52 1SA, UK
| | - M S Mulhern
- Nutrition Innovation Centre for Food and Health (NICHE), Ulster University, Coleraine, County Londonderry, BT52 1SA, UK
| | - T Spence
- Nutrition Innovation Centre for Food and Health (NICHE), Ulster University, Coleraine, County Londonderry, BT52 1SA, UK
| | - W Crowe
- Nutrition Innovation Centre for Food and Health (NICHE), Ulster University, Coleraine, County Londonderry, BT52 1SA, UK
| | - K Grzesik
- School of Medicine and Dentistry, University of Rochester, 601 Elmwood Avenue, Rochester, NY, 14642, United States
| | - S W Thurston
- School of Medicine and Dentistry, University of Rochester, 601 Elmwood Avenue, Rochester, NY, 14642, United States
| | - G E Watson
- School of Medicine and Dentistry, University of Rochester, 601 Elmwood Avenue, Rochester, NY, 14642, United States
| | - G J Myers
- School of Medicine and Dentistry, University of Rochester, 601 Elmwood Avenue, Rochester, NY, 14642, United States
| | - P W Davidson
- School of Medicine and Dentistry, University of Rochester, 601 Elmwood Avenue, Rochester, NY, 14642, United States
| | - C F Shamlaye
- Child Development Centre, Ministry of Health, Box 52, Victoria, MahÉ, Republic of Seychelles
| | - E van Wijngaarden
- School of Medicine and Dentistry, University of Rochester, 601 Elmwood Avenue, Rochester, NY, 14642, United States
| | - J J Strain
- Nutrition Innovation Centre for Food and Health (NICHE), Ulster University, Coleraine, County Londonderry, BT52 1SA, UK
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Nourollahpour Shiadeh M, Riahi SM, Khani S, Alizadeh S, Hosseinzadeh R, Hasanpour AH, Shahbazi M, Ebrahimpour S, Javanian M, Fakhri Y, Vasigala V, Rostami A. Human Immunodeficiency Virus and risk of pre-eclampsia and eclampsia in pregnant women: A meta-analysis on cohort studies. Pregnancy Hypertens 2019; 17:269-275. [PMID: 31487651 DOI: 10.1016/j.preghy.2019.07.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 07/22/2019] [Accepted: 07/30/2019] [Indexed: 12/13/2022]
Abstract
Maternal HIV infection is related to several perinatal adverse outcomes. This study is aimed at establishing whether maternal HIV infection is associated with the development of pre-eclampsia (PE) and eclampsia. We comprehensively searched MEDLINE/PubMed, Web of Science, SCOPUS and Embase databases for relevant studies published up to 20 November 2018, without time and language restrictions. We have limited our literature searches to observational studies in humans. We applied a random-effects model to calculate the relative risks (RR) and 95% confidence intervals (CI) for the meta-analyses. We also systematically reviewed eligible studies to determine the effects of HIV infection on imbalance of angiogenic and anti-angiogenic factors, which are effective in increased risk of PE or eclampsia. We identified a total of 11,186 publications, out of which 22 eligible studies (11 prospective and 11 retrospective cohort studies) comprising 90,514 HIV-positive and 66,085,278 HIV-negative pregnant women were included in meta-analysis. Results of the meta-analyses suggested that maternal HIV infection is not significantly associated with the development of PE (RR, 1.04; 95%CI, 0.89-1.21) and eclampsia (RR, 1.05; 95%CI, 0.63-1.75). Six studies were included to understand the effects of HIV infection on imbalance of angiogenic and anti-angiogenic factors. All six studies demonstrated that HIV infection had no significant effect on expression levels of these factors in pre-eclamptic and normotensive pregnant women. Our study showed that maternal HIV infection was not significantly associated with increased or reduced risks of pre-eclampsia and eclampsia. More well-designed studies with large sample size and well defined outcomes are recommended to confirm or refute the present findings.
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Affiliation(s)
| | - Seyed Mohammad Riahi
- Cardiovascular Diseases Research Center, Department of Epidemiology and Biostatistics, Faculty of Health, Birjand University of Medical Sciences, Birjand, Iran.
| | - Soghra Khani
- Sexual and Reproductive Health Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Solmaz Alizadeh
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Rezvan Hosseinzadeh
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Amir Hossein Hasanpour
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mehdi Shahbazi
- Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran; Immunoregulation Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Soheil Ebrahimpour
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mostafa Javanian
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Yadollah Fakhri
- Department of Environmental Health Engineering, Student Research Committee, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Ali Rostami
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran; Immunoregulation Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
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Naicker T, Phoswa WN, Onyangunga OA, Gathiram P, Moodley J. Angiogenesis, Lymphangiogenesis, and the Immune Response in South African Preeclamptic Women Receiving HAART. Int J Mol Sci 2019; 20:ijms20153728. [PMID: 31366152 PMCID: PMC6696390 DOI: 10.3390/ijms20153728] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 05/15/2019] [Accepted: 05/22/2019] [Indexed: 02/06/2023] Open
Abstract
Purpose of the review: This review highlights the role of angiogenesis, lymphangiogenesis, and immune markers in human immunodeficiency virus (HIV)-associated preeclamptic (PE) pregnancies in an attempt to unravel the mysteries underlying the duality of both conditions in South Africa. Recent findings: Studies demonstrate that HIV-infected pregnant women develop PE at a lower frequency than uninfected women. In contrast, women receiving highly active anti-retroviral therapy (HAART) are more inclined to develop PE, stemming from an imbalance of angiogenesis, lymphangiogenesis, and immune response. Summary: In view of the paradoxical effect of HIV infection on PE development, this study examines angiogenesis, lymphangiogenesis, and immune markers in the highly HIV endemic area of KwaZulu-Natal. We believe that HAART re-constitutes the immune response in PE, thereby predisposing women to PE development. This susceptibility is due to an imbalance in the angiogenic/lymphangiogenic/immune response as compared to normotensive pregnant women. Further large-scale studies are urgently required to investigate the effect of the duration of HAART on PE development.
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Affiliation(s)
- Thajasvarie Naicker
- Optics and Imaging Centre, Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban 4013, South Africa.
| | - Wendy N Phoswa
- Discipline of Obstetrics and Gynecology, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban 4013, South Africa.
| | - Onankoy A Onyangunga
- Optics and Imaging Centre, Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban 4013, South Africa
| | - Premjith Gathiram
- Women's Health and HIV Research Group. Department of Obstetrics and Gynecology, School of Clinical Medicine, University of KwaZulu-Natal, Durban 4013, South Africa
| | - Jagidesa Moodley
- Women's Health and HIV Research Group. Department of Obstetrics and Gynecology, School of Clinical Medicine, University of KwaZulu-Natal, Durban 4013, South Africa
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Padayachee S, Moodley J, Naicker T. A Review of Angiogenic Imbalance in HIV-Infected Hypertensive Disorders of Pregnancy. Curr Hypertens Rep 2019; 21:69. [PMID: 31342170 DOI: 10.1007/s11906-019-0970-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW This review provides a comprehensive insight into the angiogenic profile of hypertensive and normotensive pregnancies compromised by HIV infection. Furthermore, we evaluate the economic implementation of the sFlt-1/PlGF ratio and review the reports on therapeutic apheresis in limiting sFlt-1 production. RECENT FINDINGS In preeclampsia, an increased expression of sFlt-1 triggers angiogenic imbalance. Women of African ancestry have high levels of angiogenic factors than other racial groups. The sFlt-1/PlGF ratio shows promise in the early assessment of preeclampsia, while sFlt-1 apheresis restores angiogenic imbalance. Studies suggest antiretroviral therapy does not impact the angiogenic shift in preeclampsia development. The angiogenic profile in pregnant women of different races influences preeclampsia development. Despite the opposing immune response in HIV infection and preeclampsia, the HIV tat protein strongly mimics vascular endothelial growth factor (VEGF); hence, it is plausible to assume that HIV infection may ameliorate the angiogenic imbalance in preeclampsia.
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MESH Headings
- Angiogenic Proteins/blood
- Angiogenic Proteins/physiology
- Biomarkers/blood
- Biomarkers/metabolism
- Blood Component Removal
- Female
- HIV Infections/blood
- HIV Infections/complications
- HIV Infections/physiopathology
- Humans
- Hypertension, Pregnancy-Induced/blood
- Hypertension, Pregnancy-Induced/physiopathology
- Hypertension, Pregnancy-Induced/therapy
- Membrane Proteins/blood
- Membrane Proteins/physiology
- Neovascularization, Pathologic/blood
- Neovascularization, Pathologic/physiopathology
- Neovascularization, Physiologic/physiology
- Pre-Eclampsia/blood
- Pre-Eclampsia/physiopathology
- Pre-Eclampsia/therapy
- Pregnancy
- Pregnancy Complications, Infectious/blood
- Pregnancy Complications, Infectious/physiopathology
- Vascular Endothelial Growth Factor A/blood
- Vascular Endothelial Growth Factor A/physiology
- Vascular Endothelial Growth Factor Receptor-1/blood
- Vascular Endothelial Growth Factor Receptor-1/physiology
- tat Gene Products, Human Immunodeficiency Virus/blood
- tat Gene Products, Human Immunodeficiency Virus/physiology
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Affiliation(s)
- Sayuri Padayachee
- Optics and Imaging Centre, Doris Duke Medical Research Institute, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Private Bag 7, Congella, Durban, KwaZulu-Natal, 4013, South Africa.
| | - Jagidesa Moodley
- Women's Health and HIV Research Group, Department of Obstetrics and Gynecology, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Thajasvarie Naicker
- Optics and Imaging Centre, Doris Duke Medical Research Institute, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Private Bag 7, Congella, Durban, KwaZulu-Natal, 4013, South Africa
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McSorley EM, Yeates AJ, Mulhern MS, van Wijngaarden E, Grzesik K, Thurston SW, Spence T, Crowe W, Davidson PW, Zareba G, Myers GJ, Watson GE, Shamlaye CF, Strain JJ. Associations of maternal immune response with MeHg exposure at 28 weeks' gestation in the Seychelles Child Development Study. Am J Reprod Immunol 2018; 80:e13046. [PMID: 30295973 PMCID: PMC6202202 DOI: 10.1111/aji.13046] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 08/07/2018] [Accepted: 08/09/2018] [Indexed: 12/30/2022] Open
Abstract
PROBLEM Maternal methylmercury (MeHg) exposure may be associated with immune response during pregnancy. METHOD OF STUDY In the high fish-eating Seychelles Child Development Study Nutrition Cohort 2, we examined the association between maternal MeHg, polyunsaturated fatty acids (PUFA), and immune markers (Th1:Th2; TNF-α, IL-1β, IFN-γ, IL-2, IL-4, IL-5, IL-10, MCP-1, TARC, sFlt-1, VEGF-D, CRP and IL-6) at 28 weeks' gestation. Linear regression examined associations between MeHg exposure and immune markers with and without adjustment for PUFA. RESULTS In all models, as MeHg concentrations increased, the Th1:Th2 ratio, total Th1 and individual Th1 (IL-1β, IL-2, TNF-α) concentrations decreased. MeHg was not associated with total Th2 cytokines but was associated with a decrease in IL-4 and IL-10. MeHg was positively associated with TARC and VEGF-D and negatively associated with CRP. There was a significant interaction between MeHg and the n-6:n-3 ratio, with MeHg associated with a larger decrease in Th1:Th2 at higher n-6:n-3 PUFA ratios. The n-3 PUFA were associated with lower CRP, IL-4 and higher IFN-γ. The n-6 PUFA were associated with higher IL-1β, IL-2, TNF-α, IL-4, IL-10, CRP and IL-6. CONCLUSION Maternal MeHg was associated with markers of immune function at 28 weeks' gestation. A significant interaction between MeHg and the n-6:n-3 ratio on the Th1:Th2 ratio suggests that the n-3 PUFA may mitigate any immunosuppressive associations of MeHg. The n-3 and n-6 PUFA were associated with suppressive and stimulatory immune responses, respectively. Overall, the associations were of small magnitude, and further research is required to determine the clinical significance.
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Affiliation(s)
- Emeir M. McSorley
- Nutrition Innovation Centre for Food and Health (NICHE)School of Biomedical SciencesUniversity of UlsterColeraineNorthern Ireland
| | - Alison J. Yeates
- Nutrition Innovation Centre for Food and Health (NICHE)School of Biomedical SciencesUniversity of UlsterColeraineNorthern Ireland
| | - Maria S. Mulhern
- Nutrition Innovation Centre for Food and Health (NICHE)School of Biomedical SciencesUniversity of UlsterColeraineNorthern Ireland
| | | | - Katherine Grzesik
- School of Medicine and DentistryUniversity of RochesterRochesterNew York
| | - Sally W. Thurston
- School of Medicine and DentistryUniversity of RochesterRochesterNew York
| | - Toni Spence
- Nutrition Innovation Centre for Food and Health (NICHE)School of Biomedical SciencesUniversity of UlsterColeraineNorthern Ireland
| | - William Crowe
- Nutrition Innovation Centre for Food and Health (NICHE)School of Biomedical SciencesUniversity of UlsterColeraineNorthern Ireland
| | - Philip W. Davidson
- School of Medicine and DentistryUniversity of RochesterRochesterNew York
| | - Grazyna Zareba
- School of Medicine and DentistryUniversity of RochesterRochesterNew York
| | - Gary J. Myers
- School of Medicine and DentistryUniversity of RochesterRochesterNew York
| | - Gene E. Watson
- School of Medicine and DentistryUniversity of RochesterRochesterNew York
| | | | - J. J. Strain
- Nutrition Innovation Centre for Food and Health (NICHE)School of Biomedical SciencesUniversity of UlsterColeraineNorthern Ireland
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