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Ren F, Yang C, Feng K, Shang Q, Liu J, Kang X, Wang X, Wang X. An exploration of causal relationships between nine neurological diseases and the risk of breast cancer: a Mendelian randomization study. Aging (Albany NY) 2024; 16:7101-7118. [PMID: 38663930 PMCID: PMC11087125 DOI: 10.18632/aging.205745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 03/18/2024] [Indexed: 05/08/2024]
Abstract
BACKGROUND Some preceding researches have observed that certain neurological disorders, such as Alzheimer's disease and multiple sclerosis, may affect breast cancer risk. However, whether there are causal relationships between these neurological conditions and breast cancer is inconclusive. This study was designed to explore whether neurological disorders affected the risks of breast cancer overall and of the two subtypes (ER+ and ER-). METHODS In the course of this study, genome-wide association study (GWAS) data for nine neurological diseases (Alzheimer's disease, multiple sclerosis, Parkinson's disease, myasthenia gravis, generalized epilepsy, intracerebral haemorrhage, cerebral atherosclerosis, brain glioblastoma, and benign meningeal tumour) were collected from the Complex Trait Genetics lab and the MRC Integrative Epidemiology Unit, and single-nucleotide polymorphisms (SNPs) extensively associated with these neurological ailments had been recognized as instrumental variables (IVs). GWAS data on breast cancer were collected from the Breast Cancer Association Consortium (BCAC). Two-sample Mendelian randomization (MR) analyses as well as multivariable MR analyses were performed to determine whether these SNPs contributed to breast cancer risk. Additionally, the accuracy of the results was evaluated using the false discovery rate (FDR) multiple correction method. Both heterogeneity and pleiotropy were evaluated by analyzing sensitivities. RESULTS According to the results of two-sample MR analyses, Alzheimer's disease significantly reduced the risks of overall (OR 0.925, 95% CI [0.871-0.982], P = 0.011) and ER+ (OR 0.912, 95% CI [0.853-0.975], P = 0.007) breast cancer, but there was a negative result in ER- breast cancer. However, after multiple FDR corrections, the effect of Alzheimer's disease on overall breast cancer was not statistically significant. In contrast, multiple sclerosis significantly increased ER+ breast cancer risk (OR 1.007, 95% CI [1.003-1.011], P = 0.001). In addition, the multivariable MR analyses showed that Alzheimer's disease significantly reduced the risk of ER+ breast cancer (IVW: OR 0.929, 95% CI [0.864-0.999], P=0.047; MR-Egger: OR 0.916, 95% CI [0.846-0.992], P=0.031); however, multiple sclerosis significantly increased the risk of ER+ breast cancer (IVW: OR 1.008, 95% CI [1.003-1.012], P=4.35×10-4; MR-Egger: OR 1.008, 95% CI [1.003-1.012], P=5.96×10-4). There were no significant associations between the remainder of the neurological diseases and breast cancer. CONCLUSIONS This study found the trends towards a decreased risk of ER+ breast cancer in patients with Alzheimer's disease and an increased risk in patients with multiple sclerosis. However, due to the limitations of Mendelian randomization, we cannot determine whether there are definite causal relationships between neurological diseases and breast cancer risk. For conclusive evidences, more prospective randomized controlled trials will be needed in the future.
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Affiliation(s)
- Fei Ren
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Chenxuan Yang
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Kexin Feng
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Qingyao Shang
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Jiaxiang Liu
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Xiyu Kang
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Xin Wang
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Xiang Wang
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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Wennberg A, Ding M, Feychting M, Modig K. Risk of All-Cause Dementia, Alzheimer Disease, and Vascular Dementia in Breast Cancer Survivors: A Longitudinal Register-Based Study. Neurol Clin Pract 2023; 13:e200173. [PMID: 37188244 PMCID: PMC10176959 DOI: 10.1212/cpj.0000000000200173] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 04/03/2023] [Indexed: 05/17/2023]
Abstract
Background and Objectives Now more than two-thirds of cancer survivors are aged 65 years or older, but evidence about their long-term health is thin. Cancer and its treatments have been linked to accelerated aging, so there is a concern that aging cancer survivors have an increased risk of age-related diseases, including dementia. Methods We examined the risk of dementia among 5-year breast cancer survivors using a matched cohort study design. We included breast cancer survivors aged 50 years and older at diagnosis (n = 26,741) and cancer-free comparison participants (n = 249,540). Women eligible for inclusion in the study were those born 1935-1975 and registered in the Swedish Total Population Register between January 1, 1991, and December 31, 2015. We defined breast cancer survivors as women with an initial breast cancer diagnosis between 1991 and 2005 who survived 5 or more years after their first diagnosis. We assessed all-cause dementia, Alzheimer disease (AD), and vascular dementia (VaD) using International Classification of Diseases codes. Survival analyses were conducted using age-adjusted subdistribution hazard models accounting for competing risk of death. Results We did not observe an association between breast cancer survivorship and risk of all-cause dementia, AD, or VaD. However, in models stratified by age at cancer diagnosis, women diagnosed with cancer after age 65 years had a higher risk of all-cause dementia (subdistribution hazard ratio [SHR] = 1.30, 95% CI 1.07-1.58), AD (SHR = 1.35, 95% CI 1.05-1.75), and VaD (SHR = 1.64, 95% CI 1.11-2.43) in models adjusted for age, education, and country of origin. Discussion Older breast cancer survivors who survive cancer have a higher risk for dementia than their peers without a cancer diagnosis, in contrast to earlier studies showing that prevalent or incident cancer is associated with a lower risk of dementia. With the older adult population growing rapidly and because cancer and dementia are 2 of the most common and debilitating diseases among older adults, it is critical that we understand the link between the 2.
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Affiliation(s)
- Alexandra Wennberg
- Unit of Epidemiology (AW, MD, MF, KM), Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Mozhu Ding
- Unit of Epidemiology (AW, MD, MF, KM), Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Maria Feychting
- Unit of Epidemiology (AW, MD, MF, KM), Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Karin Modig
- Unit of Epidemiology (AW, MD, MF, KM), Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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Valentine D, Teerlink CC, Farnham JM, Rowe K, Kaddas H, Tschanz J, Kauwe JSK, Cannon-Albright LA. Comorbidity and Cancer Disease Rates among Those at High-Risk for Alzheimer's Disease: A Population Database Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192416419. [PMID: 36554301 PMCID: PMC9778263 DOI: 10.3390/ijerph192416419] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/13/2022] [Accepted: 11/16/2022] [Indexed: 06/10/2023]
Abstract
(1) Importance: Alzheimer's disease (AD) is complex and only partially understood. Analyzing the relationship between other more treatable or preventable diseases and AD may help in the prevention and the eventual development of treatments for AD. Risk estimation in a high-risk population, rather than a population already affected with AD, may reduce some bias in risk estimates. (2) Objective: To examine the rates of various comorbidities and cancers in individuals at high-risk for AD, but without a clinical diagnosis, relative to individuals from the same population with normal AD risk. (3) Design, Setting, and Participants: We conducted a study using data from the Utah Population Database (UPDB). The UPDB contains linked data from the Utah Cancer Registry, Utah death certificates, the Intermountain Health patient population, and the University of Utah Health patient population. Subjects were selected based on the availability of ancestral data, linked health information, and self-reported biometrics. (4) Results: In total, 75,877 participants who were estimated to be at high risk for AD based on family history, but who did not have an active AD diagnosis, were analyzed. A lower incidence of diabetes (RR = 0.95, 95% CI [0.92,0.97], p < 0.001), hypertension (RR = 0.97, 95% CI [0.95,0.99], p < 0.001), and heart disease (RR = 0.95, 95% CI [0.93,0.98], p < 0.001) was found. There was no difference in rates of cerebrovascular disease or other forms of dementia. Of the 15 types of cancer analyzed: breast (RR = 1.23, 95% CI [1.16, 1.30], p < 0.001); colorectal (RR = 1.30, 95% CI [1.21, 1.39], p < 0.001); kidney (RR = 1.49, 95% CI (1.29, 1.72), p < 0.001); lung (RR = 1.25, 95% CI [1.13, 1.37], p < 0.001); non-Hodgkin's Lymphoma (RR = 1.29, 95% CI [1.15, 1.44], p < 0.001); pancreas (RR = 1.34, 95% CI [1.16, 1.55], p < 0.001); stomach (RR = 1.59, 95% CI [1.36, 1.86], p < 0.001); and bladder (RR = 1.40, 95% CI [1.25, 1.56], p < 0.001), cancers were observed in significant excess among individuals at high-risk for AD after correction for multiple testing. (5) Conclusions and Relevance: Since age is the greatest risk factor for the development of AD, individuals who reach more advanced ages are at increased risk of developing AD. Consistent with this, people with fewer comorbidities earlier in life are more likely to reach an age where AD becomes a larger risk. Our findings show that individuals at high risk for AD have a decreased incidence of various other diseases. This is further supported by our finding that our high-risk group was also found to have an increased incidence of various cancers, which also increase in risk with age. There is the possibility that a more meaningful or etiological relationship exists among these various comorbidities. Further research into the etiological relationship between AD and these comorbidities may elucidate these possible interactions.
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Affiliation(s)
- David Valentine
- Department of Biology, Brigham Young University, Provo, UT 84602, USA
| | - Craig C. Teerlink
- Genetic Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT 84132, USA
| | - James M. Farnham
- Genetic Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT 84132, USA
| | - Kerry Rowe
- National Oncology Program, Veterans Administration, Durham, NC 27705, USA
| | - Heydon Kaddas
- Genetic Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT 84132, USA
| | - JoAnn Tschanz
- Department of Psychology, Utah State University, Logan, UT 84322, USA
| | - John S. K. Kauwe
- Department of Biology, Brigham Young University, Provo, UT 84602, USA
| | - Lisa A. Cannon-Albright
- Genetic Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT 84132, USA
- George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UT 84148, USA
- Huntsman Cancer Institute, Salt Lake City, UT 84112, USA
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Autoencoder Networks Decipher the Association between Lung Cancer and Alzheimer’s Disease. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:2009545. [DOI: 10.1155/2022/2009545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 11/16/2022] [Accepted: 11/25/2022] [Indexed: 12/12/2022]
Abstract
Lung cancer is the most common malignancy and is responsible for the largest cancer-related mortality worldwide. Alzheimer’s disease is a degenerative neurological disease that burdens healthcare worldwide. While the two diseases are distinct, several transcriptomic studies have demonstrated they are linked. However, no concordant conclusion on how they are associated has been drawn. Since these studies utilized conventional bioinformatics methods, such as the differentially expressed gene (DEG) analysis, it is naturally expected that the proportion of DEGs having either the same or inverse directions in lung cancer and Alzheimer’s disease is substantial. This raises the inconsistency. Therefore, a novel bioinformatics method capable of determining the direction of association is desirable. In this study, the moderated t-tests were first used to identify DEGs that are shared by the two diseases. For the shared DEGs, separate autoencoder (AE) networks were trained to extract a one-dimensional representation (pseudogene) for each disease. Based on these pseudogenes, the association direction between lung cancer and Alzheimer’s disease was inferred. AE networks based on 266 shared DEGs revealed a comorbidity relationship between Alzheimer’s disease and lung cancer. Specifically, Spearman’s correlation coefficient between the predicted values using the two AE networks for the Alzheimer’s disease test set was 0.825 and for the lung cancer test set was 0.316. Novel bioinformatics methods such as an AE network may help decipher how distinct diseases are associated by providing the refined representations of dysregulated genes.
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Zhang DD, Ou YN, Yang L, Ma YH, Tan L, Feng JF, Cheng W, Yu JT. Investigating the association between cancer and dementia risk: a longitudinal cohort study. Alzheimers Res Ther 2022; 14:146. [PMID: 36199128 PMCID: PMC9533604 DOI: 10.1186/s13195-022-01090-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 09/16/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Previous studies found that cancer survivors had a reduced risk of dementia compared with the general population. However, these findings were uncertain because of survivor bias and a lack of stratification by cancer types. This current cohort study used data from the UK Biobank to explore these associations. METHODS Multivariable Cox regression analyses were used to examine the association of cancer status and the risk of dementia with its subtypes after adjusting for age and sex. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated as a measure of relative risk by comparing observed dementia incidence among cancer patients. RESULTS We included 263,151 participants in the observational analysis. During a median follow-up of 9.18 years, dementia was diagnosed in 472 individuals with cancer and 3685 individuals without cancer, respectively. Cancer patients had lower risks of dementia (hazard ratio: 0.89, confidence interval: 0.81-0.98) and its subtypes (Alzheimer's disease [AD]: 0.85 [0.74-0.98]; vascular dementia [VD]: 0.81 [0.66-0.99]) in the Cox regression adjusted for age and sex. Individuals with cancers in the male genital system had substantially reduced risks of dementia (0.66 [0.46-0.93]) and AD (0.53 [0.29-0.97]) than those with cancers in other systems. Moreover, non-melanoma skin cancer and prostate cancer were associated with a reduced risk of dementia (0.79 [0.62-0.99]; 0.69 [0.49-0.97]), but not with AD or VD (P>0.05). CONCLUSIONS The current study supported a negative association between cancer and dementia risk, and encourages further exploration of the mechanistic basis of this inverse relationship to improve understanding.
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Affiliation(s)
- Dan-Dan Zhang
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Ya-Nan Ou
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Liu Yang
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, 12th WulumuqiZhong Road, Shanghai, 200040, China
| | - Ya-Hui Ma
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Lan Tan
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Jian-Feng Feng
- Institute of Science and Technology for Brain-inspired Intelligence, Fudan University, Shanghai, China
| | - Wei Cheng
- Institute of Science and Technology for Brain-inspired Intelligence, Fudan University, Shanghai, China
| | - Jin-Tai Yu
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, 12th WulumuqiZhong Road, Shanghai, 200040, China.
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Zabłocka A, Kazana W, Sochocka M, Stańczykiewicz B, Janusz M, Leszek J, Orzechowska B. Inverse Correlation Between Alzheimer's Disease and Cancer: Short Overview. Mol Neurobiol 2021; 58:6335-6349. [PMID: 34523079 PMCID: PMC8639554 DOI: 10.1007/s12035-021-02544-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 08/21/2021] [Indexed: 12/20/2022]
Abstract
The negative association between Alzheimer's disease (AD) and cancer suggests that susceptibility to one disease may protect against the other. When biological mechanisms of AD and cancer and relationship between them are understood, the unsolved problem of both diseases which still touches the growing human population could be overcome. Actual information about biological mechanisms and common risk factors such as chronic inflammation, age-related metabolic deregulation, and family history is presented here. Common signaling pathways, e.g., p53, Wnt, role of Pin1, and microRNA, are discussed as well. Much attention is also paid to the potential impact of chronic viral, bacterial, and fungal infections that are responsible for the inflammatory pathway in AD and also play a key role to cancer development. New data about common mechanisms in etiopathology of cancer and neurological diseases suggests new therapeutic strategies. Among them, the use of nilotinib, tyrosine kinase inhibitor, protein kinase C, and bexarotene is the most promising.
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Affiliation(s)
- Agnieszka Zabłocka
- Laboratory of Microbiome Immunobiology, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, R. Weigla 12, 53-114, Wroclaw, Poland.
| | - Wioletta Kazana
- Laboratory of Microbiome Immunobiology, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, R. Weigla 12, 53-114, Wroclaw, Poland
| | - Marta Sochocka
- Laboratory of Virology, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, R. Weigla 12, 53-114, Wroclaw, Poland
| | - Bartłomiej Stańczykiewicz
- Department of Nervous System Diseases, Wroclaw Medical University, K. Bartla 5, 51-618, Wroclaw, Poland
| | - Maria Janusz
- Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, R. Weigla 12, 53-114, Wroclaw, Poland
| | - Jerzy Leszek
- Department of Psychiatry, Wroclaw Medical University, L. Pasteura 10, 50-367, Wroclaw, Poland
| | - Beata Orzechowska
- Laboratory of Virology, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, R. Weigla 12, 53-114, Wroclaw, Poland
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Klinger D, Hill BL, Barda N, Halperin E, Gofrit ON, Greenblatt CL, Rappoport N, Linial M, Bercovier H. Bladder Cancer Immunotherapy by BCG Is Associated with a Significantly Reduced Risk of Alzheimer's Disease and Parkinson's Disease. Vaccines (Basel) 2021; 9:vaccines9050491. [PMID: 34064775 PMCID: PMC8151667 DOI: 10.3390/vaccines9050491] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 05/06/2021] [Accepted: 05/07/2021] [Indexed: 12/16/2022] Open
Abstract
Bacillus Calmette–Guerin (BCG) is a live attenuated form of Mycobacterium bovis that was developed 100 years ago as a vaccine against tuberculosis (TB) and has been used ever since to vaccinate children globally. It has also been used as the first-line treatment in patients with nonmuscle invasive bladder cancer (NMIBC), through repeated intravesical applications. Numerous studies have shown that BCG induces off-target immune effects in various pathologies. Accumulating data argue for the critical role of the immune system in the course of neurodegenerative diseases such as Alzheimer’s disease (AD) and Parkinson’s disease (PD). In this study, we tested whether repeated exposure to BCG during the treatment of NMIBC is associated with the risk of developing AD and PD. We presented a multi-center retrospective cohort study with patient data collected between 2000 and 2019 that included 12,185 bladder cancer (BC) patients, of which 2301 BCG-treated patients met all inclusion criteria, with a follow-up of 3.5 to 7 years. We considered the diagnosis date of AD and nonvascular dementia cases for BC patients. The BC patients were partitioned into those who underwent a transurethral resection of the bladder tumor followed by BCG therapy, and a disjoint group that had not received such treatment. By applying Cox proportional hazards (PH) regression and competing for risk analyses, we found that BCG treatment was associated with a significantly reduced risk of developing AD, especially in the population aged 75 years or older. The older population (≥75 years, 1578 BCG treated, and 5147 controls) showed a hazard ratio (HR) of 0.726 (95% CI: 0.529–0.996; p-value = 0.0473). While in a hospital-based cohort, BCG treatment resulted in an HR of 0.416 (95% CI: 0.203–0.853; p-value = 0.017), indicating a 58% lower risk of developing AD. The risk of developing PD showed the same trend with a 28% reduction in BCG-treated patients, while no BCG beneficial effect was observed for other age-related events such as Type 2 diabetes (T2D) and stroke. We attributed BCG’s beneficial effect on neurodegenerative diseases to a possible activation of long-term nonspecific immune effects. We proposed a prospective study in elderly people for testing intradermic BCG inoculation as a potential protective agent against AD and PD.
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Affiliation(s)
- Danielle Klinger
- Department of Biological Chemistry, Institute of Life Sciences, The Hebrew University of Jerusalem, Jerusalem 91904, Israel;
| | - Brian L. Hill
- Department of Computer Science, University of California Los Angeles, Los Angeles, CA 90095-1596, USA; (B.L.H.); (E.H.)
| | - Noam Barda
- Clalit Research Institute, Innovation Division, Clalit Health Services, Ramat-Gan 6578898, Israel;
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA 02115, USA
| | - Eran Halperin
- Department of Computer Science, University of California Los Angeles, Los Angeles, CA 90095-1596, USA; (B.L.H.); (E.H.)
| | - Ofer N. Gofrit
- Department of Urology, Hadassah University Hospital, Jerusalem 91904, Israel;
| | - Charles L. Greenblatt
- Department of Microbiology and Molecular Genetics, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 91904, Israel; (C.L.G.); (H.B.)
| | - Nadav Rappoport
- Department of Software and Information Systems Engineering, Faculty of Engineering Sciences, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel;
| | - Michal Linial
- Department of Biological Chemistry, Institute of Life Sciences, The Hebrew University of Jerusalem, Jerusalem 91904, Israel;
- Correspondence: ; Tel.: +972-54-882-0035
| | - Hervé Bercovier
- Department of Microbiology and Molecular Genetics, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 91904, Israel; (C.L.G.); (H.B.)
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Chamberlain JD, Rouanet A, Dubois B, Pasquier F, Hanon O, Gabelle A, Ceccaldi M, Krolak-Salmon P, Béjot Y, Godefroy O, Wallon D, Gentric A, Chêne G, Dufouil C. Investigating the association between cancer and the risk of dementia: Results from the Memento cohort. Alzheimers Dement 2021; 17:1415-1421. [PMID: 33656287 PMCID: PMC8518910 DOI: 10.1002/alz.12308] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 01/07/2021] [Accepted: 01/18/2021] [Indexed: 12/21/2022]
Abstract
Introduction Studies on the association of cancer and risk of dementia are inconclusive due to result heterogeneity and concerns of survivor bias and unmeasured confounding. Methods This study uses data from the Memento cohort, a French multicenter cohort following persons with either mild or isolated cognitive complaints for a median of 5 years. Illness‐death models (IDMs) were used to estimate transition‐specific hazard ratios (HRs) and 95% confidence intervals (CIs) for incident cancer in relation to dementia from time since study entry. Results The analytical sample (N = 2258) excluded 65 individuals without follow‐up information. At the end of follow‐up, 286 individuals were diagnosed with dementia, 166 with incident cancer, and 95 died. Incident cancer was associated with a reduced risk of dementia (HR = 0.58, 95% CI = 0.35‐0.97), with a corresponding E‐value of 2.84 (lower CI = 1.21). Discussion This study supports a protective relationship between incident cancer and dementia, encouraging further investigations to understand potential underlying mechanisms.
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Affiliation(s)
- Jonviea D Chamberlain
- Bordeaux Population Health Research Center, UMR 1219, University of Bordeaux, Inserm, Bordeaux, France.,CIC1401-EC, Inserm, Bordeaux, France
| | - Anaïs Rouanet
- Bordeaux Population Health Research Center, UMR 1219, University of Bordeaux, Inserm, Bordeaux, France
| | - Bruno Dubois
- Sorbonne Université, AP-HP, Hôpital de la Pitié-Salpêtrière, Boulevard de l'hôpital, Paris, France
| | | | - Olivier Hanon
- EA 4468, Université de Paris, Geriatric department Broca hospital, APHP, Paris, France
| | - Audrey Gabelle
- Centre Mémoire Ressources Recherche Département de Neurologie CHU Gui de Chauliac, Montpellier, France
| | - Mathieu Ceccaldi
- Ouest CHU Timone APHM & Aix Marseille Univ INSERM INS Inst Neurosci Syst, CMMR PACA, Marseille, France
| | | | - Yannick Béjot
- Department of Neurology and Memory Resource and Research Center of Dijon, EA7460, University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Olivier Godefroy
- Neurology Department, Amiens University Hospital, Amiens, France
| | - David Wallon
- Functional Neurosciences Lab (UR UPJV4559), Centre Universitaire de Recherche en Santé, Normandie Univ, UNIROUEN, Department of Neurology and CNR-MAJ, Inserm U1245 and Rouen University Hospital, Rouen, France
| | | | - Geneviève Chêne
- CIC1401-EC, Inserm, Bordeaux, France.,Pole de sante publique Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France
| | - Carole Dufouil
- CIC1401-EC, Inserm, Bordeaux, France.,Pole de sante publique Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France
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Ospina-Romero M, Glymour MM, Hayes-Larson E, Mayeda ER, Graff RE, Brenowitz WD, Ackley SF, Witte JS, Kobayashi LC. Association Between Alzheimer Disease and Cancer With Evaluation of Study Biases: A Systematic Review and Meta-analysis. JAMA Netw Open 2020; 3:e2025515. [PMID: 33185677 PMCID: PMC7666424 DOI: 10.1001/jamanetworkopen.2020.25515] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
IMPORTANCE Observational studies consistently report inverse associations between cancer and Alzheimer disease (AD). Shared inverse etiological mechanisms might explain this phenomenon, but a systematic evaluation of methodological biases in existing studies is needed. OBJECTIVES To systematically review and meta-analyze evidence on the association between cancer and subsequent AD, systematically identify potential methodological biases in studies, and estimate the influence of these biases on the estimated pooled association between cancer and AD. DATA SOURCES All-language publications were identified from PubMed, Embase, and PsycINFO databases through September 2, 2020. STUDY SELECTION Longitudinal cohort studies and case-control studies on the risk of AD in older adults with a history of any cancer type, prostate cancer, breast cancer, colorectal cancer, or nonmelanoma skin cancer, relative to those with no cancer history. DATA EXTRACTION AND SYNTHESIS Two reviewers independently abstracted the data and evaluated study biases related to confounding, diagnostic bias, competing risks, or survival bias. Random-effects meta-analysis was used to provide pooled estimates of the association between cancer and AD. Metaregressions were used to evaluate whether the observed pooled estimate could be attributable to each bias. The study was designed and conducted according to the Preferring Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. MAIN OUTCOMES AND MEASURES Incidence, hazard, or odds ratios for AD comparing older adults with vs without a previous cancer diagnosis. RESULTS In total, 19 cohort studies and 3 case-control studies of the associations between any cancer type (n = 13), prostate cancer (n = 5), breast cancer (n = 1), and nonmelanoma skin cancer (n = 3) with AD were identified, representing 9 630 435 individuals. In all studies combined, cancer was associated with decreased AD incidence (cohort studies: random-effects hazard ratio, 0.89; 95% CI, 0.79-1.00; case-control studies: random-effects odds ratio, 0.75; 95% CI, 0.61-0.93). Studies with insufficient or inappropriate confounder control or greater likelihood of AD diagnostic bias had mean hazard ratios closer to the null value, indicating that these biases could not explain the observed inverse association. Competing risks bias was rare. Studies with greater likelihood of survival bias had mean hazard ratios farther from the null value. CONCLUSIONS AND RELEVANCE The weak inverse association between cancer and AD may reflect shared inverse etiological mechanisms or survival bias but is not likely attributable to diagnostic bias, competing risks bias, or insufficient or inappropriate control for potential confounding factors.
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Affiliation(s)
- Monica Ospina-Romero
- Department of Epidemiology and Biostatistics, University of California, San Francisco
- now at Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Madison
| | - M. Maria Glymour
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Eleanor Hayes-Larson
- Department of Epidemiology, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles
| | - Elizabeth Rose Mayeda
- Department of Epidemiology, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles
| | - Rebecca E. Graff
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | | | - Sarah F. Ackley
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - John S. Witte
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Lindsay C. Kobayashi
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor
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Ording AG, Horváth-Puhó E, Veres K, Glymour MM, Rørth M, Sørensen HT, Henderson VW. Cancer and risk of Alzheimer's disease: Small association in a nationwide cohort study. Alzheimers Dement 2020; 16:953-964. [PMID: 32432415 DOI: 10.1002/alz.12090] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 01/03/2020] [Accepted: 01/30/2020] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Small observational studies with short-term follow-up suggest that cancer patients are at reduced risk of Alzheimer's disease (AD) compared to the general population. METHODS A nationwide cohort study using Danish population-based health registries (1980-2013) with cancer patients (n = 949,309) to identify incident diagnoses of AD. We computed absolute reductions in risk attributed to cancer and standardized incidence rate ratios (SIRs) accounting for survival time, comparing the observed to expected number of AD cases. RESULTS During up to 34 years of follow-up of cancer survivors, the attributable risk reduction was 1.3 per 10,000 person-years, SIR = 0.94 (95% confidence interval 0.92-0.96). SIRs were similar after stratification by sex, age, and cancer stage, and approached that of the general population for those surviving >10 years. DISCUSSION Inverse associations between cancer and AD were small and diminished over time. Incidence rates in cancer survivors approached those of the general population, suggesting limited association between cancer and AD risk.
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Affiliation(s)
- Anne G Ording
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Katalin Veres
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - M Maria Glymour
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Mikael Rørth
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Henrik T Sørensen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Victor W Henderson
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.,Department of Epidemiology & Population Health, Stanford University, Stanford, California.,Department of Neurology & Neurological Sciences, Stanford University, Stanford, California
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11
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Hanson HA, Leiser CL, Madsen MJ, Gardner J, Knight S, Cessna M, Sweeney C, Doherty JA, Smith KR, Bernard PS, Camp NJ. Family Study Designs Informed by Tumor Heterogeneity and Multi-Cancer Pleiotropies: The Power of the Utah Population Database. Cancer Epidemiol Biomarkers Prev 2020; 29:807-815. [PMID: 32098891 PMCID: PMC7168701 DOI: 10.1158/1055-9965.epi-19-0912] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 01/15/2020] [Accepted: 02/18/2020] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Previously, family-based designs and high-risk pedigrees have illustrated value for the discovery of high- and intermediate-risk germline breast cancer susceptibility genes. However, genetic heterogeneity is a major obstacle hindering progress. New strategies and analytic approaches will be necessary to make further advances. One opportunity with the potential to address heterogeneity via improved characterization of disease is the growing availability of multisource databases. Specific to advances involving family-based designs are resources that include family structure, such as the Utah Population Database (UPDB). To illustrate the broad utility and potential power of multisource databases, we describe two different novel family-based approaches to reduce heterogeneity in the UPDB. METHODS Our first approach focuses on using pedigree-informed breast tumor phenotypes in gene mapping. Our second approach focuses on the identification of families with similar pleiotropies. We use a novel network-inspired clustering technique to explore multi-cancer signatures for high-risk breast cancer families. RESULTS Our first approach identifies a genome-wide significant breast cancer locus at 2q13 [P = 1.6 × 10-8, logarithm of the odds (LOD) equivalent 6.64]. In the region, IL1A and IL1B are of particular interest, key cytokine genes involved in inflammation. Our second approach identifies five multi-cancer risk patterns. These clusters include expected coaggregations (such as breast cancer with prostate cancer, ovarian cancer, and melanoma), and also identify novel patterns, including coaggregation with uterine, thyroid, and bladder cancers. CONCLUSIONS Our results suggest pedigree-informed tumor phenotypes can map genes for breast cancer, and that various different cancer pleiotropies exist for high-risk breast cancer pedigrees. IMPACT Both methods illustrate the potential for decreasing etiologic heterogeneity that large, population-based multisource databases can provide.See all articles in this CEBP Focus section, "Modernizing Population Science."
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Affiliation(s)
- Heidi A Hanson
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah.
- Utah Population Database, University of Utah, Salt Lake City, Utah
- Department of Surgery, University of Utah, Salt Lake City, Utah
| | - Claire L Leiser
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
- Department of Epidemiology, University of Washington, Seattle, Washington
| | - Michael J Madsen
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - John Gardner
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | | | - Melissa Cessna
- Intermountain Biorepository, Intermountain Healthcare, Salt Lake City, Utah
- Department of Pathology, Intermountain Medical Center, Intermountain Healthcare, Salt Lake City, Utah
| | - Carol Sweeney
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
- Utah Cancer Registry, University of Utah, Salt Lake City, Utah
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - Jennifer A Doherty
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
- Utah Cancer Registry, University of Utah, Salt Lake City, Utah
- Department of Population Sciences, University of Utah School of Medicine, Salt Lake City, Utah
| | - Ken R Smith
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
- Utah Population Database, University of Utah, Salt Lake City, Utah
- Department of Family and Consumer Studies, University of Utah, Salt Lake City, Utah
| | - Philip S Bernard
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
- Department of Pathology, University of Utah, Salt Lake City, Utah
| | - Nicola J Camp
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
- Utah Population Database, University of Utah, Salt Lake City, Utah
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah
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12
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Monserud MA. Later-Life Trajectories of Cognitive Functioning among Married and Widowed Older Men and Women of Mexican Origin. J Cross Cult Gerontol 2020; 34:307-324. [PMID: 31377984 DOI: 10.1007/s10823-019-09380-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Research on marital status-gender differences in later-life trajectories of cognitive functioning is scarce. Drawing on seven waves of data from the Hispanic Established Population for the Epidemiologic Study of the Elderly, this research uses growth curve models to examine later-life dynamics of cognitive functioning among married and widowed older men and women of Mexican descent (aged 65+; N = 3329). The findings demonstrate that the widowed, regardless of gender, had lower initial levels of cognition but a less steep cognitive decline across waves, compared to married men. Age and socioeconomic resources accounted for these marital status differences in levels and rates of change in cognitive functioning completely among widowed men and partially among widowed women. Moreover, net of all the factors, married women had a slower cognitive decline than married men. This study also shows that health and social integration might shape cognitive functioning among older adults of Mexican descent.
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Affiliation(s)
- Maria A Monserud
- Department of Sociology, University of Houston, 489 Philip G. Hoffman Hall, Houston, TX, 77204-3012, USA.
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13
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Battaglia C, Venturin M, Sojic A, Jesuthasan N, Orro A, Spinelli R, Musicco M, De Bellis G, Adorni F. Candidate Genes and MiRNAs Linked to the Inverse Relationship Between Cancer and Alzheimer's Disease: Insights From Data Mining and Enrichment Analysis. Front Genet 2019; 10:846. [PMID: 31608105 PMCID: PMC6771301 DOI: 10.3389/fgene.2019.00846] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 08/14/2019] [Indexed: 12/22/2022] Open
Abstract
The incidence of cancer and Alzheimer’s disease (AD) increases exponentially with age. A growing body of epidemiological evidence and molecular investigations inspired the hypothesis of an inverse relationship between these two pathologies. It has been proposed that the two diseases might utilize the same proteins and pathways that are, however, modulated differently and sometimes in opposite directions. Investigation of the common processes underlying these diseases may enhance the understanding of their pathogenesis and may also guide novel therapeutic strategies. Starting from a text-mining approach, our in silico study integrated the dispersed biological evidence by combining data mining, gene set enrichment, and protein-protein interaction (PPI) analyses while searching for common biological hallmarks linked to AD and cancer. We retrieved 138 genes (ALZCAN gene set), computed a significant number of enriched gene ontology clusters, and identified four PPI modules. The investigation confirmed the relevance of autophagy, ubiquitin proteasome system, and cell death as common biological hallmarks shared by cancer and AD. Then, from a closer investigation of the PPI modules and of the miRNAs enrichment data, several genes (SQSTM1, UCHL1, STUB1, BECN1, CDKN2A, TP53, EGFR, GSK3B, and HSPA9) and miRNAs (miR-146a-5p, MiR-34a-5p, miR-21-5p, miR-9-5p, and miR-16-5p) emerged as promising candidates. The integrative approach uncovered novel miRNA-gene networks (e.g., miR-146 and miR-34 regulating p62 and Beclin1 in autophagy) that might give new insights into the complex regulatory mechanisms of gene expression in AD and cancer.
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Affiliation(s)
- Cristina Battaglia
- Department of Medical Biotechnology and Translational Medicine (BIOMETRA), University of Milan, Segrate, Italy.,Department of Biomedical Sciences, Institute of Biomedical Technologies-National Research Council (ITB-CNR), Segrate, Italy
| | - Marco Venturin
- Department of Medical Biotechnology and Translational Medicine (BIOMETRA), University of Milan, Segrate, Italy
| | - Aleksandra Sojic
- Department of Biomedical Sciences, Institute of Biomedical Technologies-National Research Council (ITB-CNR), Segrate, Italy
| | - Nithiya Jesuthasan
- Department of Biomedical Sciences, Institute of Biomedical Technologies-National Research Council (ITB-CNR), Segrate, Italy
| | - Alessandro Orro
- Department of Biomedical Sciences, Institute of Biomedical Technologies-National Research Council (ITB-CNR), Segrate, Italy
| | - Roberta Spinelli
- Istituto Istruzione Superiore Statale IRIS Versari, Cesano Maderno, Italy
| | - Massimo Musicco
- Department of Biomedical Sciences, Institute of Biomedical Technologies-National Research Council (ITB-CNR), Segrate, Italy
| | - Gianluca De Bellis
- Department of Biomedical Sciences, Institute of Biomedical Technologies-National Research Council (ITB-CNR), Segrate, Italy
| | - Fulvio Adorni
- Department of Biomedical Sciences, Institute of Biomedical Technologies-National Research Council (ITB-CNR), Segrate, Italy
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14
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Seddighi S, Houck AL, Rowe JB, Pharoah PDP. Evidence of a Causal Association Between Cancer and Alzheimer's Disease: a Mendelian Randomization Analysis. Sci Rep 2019; 9:13548. [PMID: 31537833 PMCID: PMC6753207 DOI: 10.1038/s41598-019-49795-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 08/29/2019] [Indexed: 01/08/2023] Open
Abstract
While limited observational evidence suggests that cancer survivors have a decreased risk of developing Alzheimer's disease (AD), and vice versa, it is not clear whether this relationship is causal. Using a Mendelian randomization approach that provides evidence of causality, we found that genetically predicted lung cancer (OR 0.91, 95% CI 0.84-0.99, p = 0.019), leukemia (OR 0.98, 95% CI 0.96-0.995, p = 0.012), and breast cancer (OR 0.94, 95% CI 0.89-0.99, p = 0.028) were associated with 9.0%, 2.4%, and 5.9% lower odds of AD, respectively, per 1-unit higher log odds of cancer. When genetic predictors of all cancers were pooled, cancer was associated with 2.5% lower odds of AD (OR 0.98, 95% CI 0.96-0.988, p = 0.00027) per 1-unit higher log odds of cancer. Finally, genetically predicted smoking-related cancers showed a more robust inverse association with AD than non-smoking related cancers (OR 0.95, 95% CI 0.92-0.98, p = 0.0026, vs. OR 0.98, 95% CI 0.97-0.995, p = 0.0091).
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Affiliation(s)
- Sahba Seddighi
- University of Cambridge Institute of Public Health, University of Cambridge, Cambridge, UK
- Johns Hopkins University School of Medicine, Baltimore, USA
| | - Alexander L Houck
- University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - James B Rowe
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Paul D P Pharoah
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
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15
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Relationship of Cancer to Brain Aging Markers of Alzheimer's Disease: The Framingham Heart Study. ADVANCES IN GERIATRIC MEDICINE AND RESEARCH 2019; 1. [PMID: 31355371 DOI: 10.20900/agmr20190006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background Previous studies have demonstrated a strong inverse association between cancer and risk of Alzheimer's disease (AD). This study aimed to further investigate this association by examining measures of cognitive performance and neuroimaging. Methods Neuropsychological (NP) test batteries consisting of quantitative measures of memory and executive function and volumetric brain magnetic resonance imaging (MRI) scans measuring brain and white-matter hyperintensity volumes were administered to 2,043 dementia-free participants (54% women) in the Framingham Heart Study (FHS) Offspring cohort from 1999-2005. History of cancer was assessed at examination visits and through hospital records. Linear regression was used to examine the association between cancer history and NP/MRI variables. Results There were 252 and 1,791 participants with and without a previous history of cancer, respectively. Cancer survivors had an average time between diagnosis and NP/MRI exam of 9.8 years. History of any invasive cancer was associated with better executive function (Beta=0.16, p=0.04) but not memory function. Non-invasive cancer was not associated with any change in cognitive performance. Patients with prostate cancer had larger frontal brain volumes (Beta=4.13, p=0.03). Cancer history was not associated with any other MRI measure. Conclusions We did not find any strong evidence linking cancer to cognitive or neuroimaging biomarkers that would explain a lower risk of subsequent AD, although a previous FHS study demonstrated a strong inverse association between cancer and risk of AD. Future work should examine the association between cancer and other biomarkers of AD as well as more sensitive metrics of AD-related brain aging markers.
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16
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Yashin AI, Fang F, Kovtun M, Wu D, Duan M, Arbeev K, Akushevich I, Kulminski A, Culminskaya I, Zhbannikov I, Yashkin A, Stallard E, Ukraintseva S. Hidden heterogeneity in Alzheimer's disease: Insights from genetic association studies and other analyses. Exp Gerontol 2018; 107:148-160. [PMID: 29107063 PMCID: PMC5920782 DOI: 10.1016/j.exger.2017.10.020] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 10/20/2017] [Accepted: 10/22/2017] [Indexed: 02/08/2023]
Abstract
Despite evident success in clarifying many important features of Alzheimer's disease (AD) the efficient methods of its prevention and treatment are not yet available. The reasons are likely to be the fact that AD is a multifactorial and heterogeneous health disorder with multiple alternative pathways of disease development and progression. The availability of genetic data on individuals participated in longitudinal studies of aging health and longevity, as well as on participants of cross-sectional case-control studies allow for investigating genetic and non-genetic connections with AD and to link the results of these analyses with research findings obtained in clinical, experimental, and molecular biological studies of this health disorder. The objective of this paper is to perform GWAS of AD in several study populations and investigate possible roles of detected genetic factors in developing AD hallmarks and in other health disorders. The data collected in the Framingham Heart Study (FHS), Cardiovascular Health Study (CHS), Health and Retirement Study (HRS) and Late Onset Alzheimer's Disease Family Study (LOADFS) were used in these analyses. The logistic regression and Cox's regression were used as statistical models in GWAS. The results of analyses confirmed strong associations of genetic variants from well-known genes APOE, TOMM40, PVRL2 (NECTIN2), and APOC1 with AD. Possible roles of these genes in pathological mechanisms resulting in development of hallmarks of AD are described. Many genes whose connection with AD was detected in other studies showed nominally significant associations with this health disorder in our study. The evidence on genetic connections between AD and vulnerability to infection, as well as between AD and other health disorders, such as cancer and type 2 diabetes, were investigated. The progress in uncovering hidden heterogeneity in AD would be substantially facilitated if common mechanisms involved in development of AD, its hallmarks, and AD related chronic conditions were investigated in their mutual connection.
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Affiliation(s)
- Anatoliy I Yashin
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, 2024 W. Main Street, Durham, NC 27705, USA.
| | - Fang Fang
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, 2024 W. Main Street, Durham, NC 27705, USA
| | - Mikhail Kovtun
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, 2024 W. Main Street, Durham, NC 27705, USA
| | - Deqing Wu
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, 2024 W. Main Street, Durham, NC 27705, USA
| | - Matt Duan
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, 2024 W. Main Street, Durham, NC 27705, USA
| | - Konstantin Arbeev
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, 2024 W. Main Street, Durham, NC 27705, USA
| | - Igor Akushevich
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, 2024 W. Main Street, Durham, NC 27705, USA
| | - Alexander Kulminski
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, 2024 W. Main Street, Durham, NC 27705, USA
| | - Irina Culminskaya
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, 2024 W. Main Street, Durham, NC 27705, USA
| | - Ilya Zhbannikov
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, 2024 W. Main Street, Durham, NC 27705, USA
| | - Arseniy Yashkin
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, 2024 W. Main Street, Durham, NC 27705, USA
| | - Eric Stallard
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, 2024 W. Main Street, Durham, NC 27705, USA
| | - Svetlana Ukraintseva
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, 2024 W. Main Street, Durham, NC 27705, USA.
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Brothers HM, Gosztyla ML, Robinson SR. The Physiological Roles of Amyloid-β Peptide Hint at New Ways to Treat Alzheimer's Disease. Front Aging Neurosci 2018; 10:118. [PMID: 29922148 PMCID: PMC5996906 DOI: 10.3389/fnagi.2018.00118] [Citation(s) in RCA: 210] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 04/06/2018] [Indexed: 12/11/2022] Open
Abstract
Amyloid-ß (Aß) is best known as the misfolded peptide that is involved in the pathogenesis of Alzheimer's disease (AD), and it is currently the primary therapeutic target in attempts to arrest the course of this disease. This notoriety has overshadowed evidence that Aß serves several important physiological functions. Aß is present throughout the lifespan, it has been found in all vertebrates examined thus far, and its molecular sequence shows a high degree of conservation. These features are typical of a factor that contributes significantly to biological fitness, and this suggestion has been supported by evidence of functions that are beneficial for the brain. The putative roles of Aß include protecting the body from infections, repairing leaks in the blood-brain barrier, promoting recovery from injury, and regulating synaptic function. Evidence for these beneficial roles comes from in vitro and in vivo studies, which have shown that the cellular production of Aß rapidly increases in response to a physiological challenge and often diminishes upon recovery. These roles are further supported by the adverse outcomes of clinical trials that have attempted to deplete Aß in order to treat AD. We suggest that anti-Aß therapies will produce fewer adverse effects if the known triggers of Aß deposition (e.g., pathogens, hypertension, and diabetes) are addressed first.
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Affiliation(s)
- Holly M Brothers
- Department of Psychology, The Ohio State University Columbus, Columbus, OH, United States
| | - Maya L Gosztyla
- Department of Neuroscience, The Ohio State University Columbus, Columbus, OH, United States
| | - Stephen R Robinson
- Discipline of Psychology, School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
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18
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Frain L, Swanson D, Cho K, Gagnon D, Lu KP, Betensky RA, Driver J. Association of cancer and Alzheimer's disease risk in a national cohort of veterans. Alzheimers Dement 2017; 13:1364-1370. [PMID: 28711346 DOI: 10.1016/j.jalz.2017.04.012] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Revised: 04/04/2017] [Accepted: 04/29/2017] [Indexed: 12/20/2022]
Abstract
INTRODUCTION To examine the risk of Alzheimer's disease (AD) among cancer survivors in a national database. METHODS Retrospective cohort of 3,499,378 mostly male US veterans aged ≥65 years were followed between 1996 and 2011. We used Cox models to estimate risk of AD and alternative outcomes (non-AD dementia, osteoarthritis, stroke, and macular degeneration) in veterans with and without a history of cancer. RESULTS Survivors of a wide variety of cancers had modestly lower AD risk, but increased risk of the alternative outcomes. Survivors of screened cancers, including prostate cancer, had a slightly increased AD risk. Cancer treatment was independently associated with decreased AD risk; those who received chemotherapy had a lower risk than those who did not. DISCUSSION Survivors of some cancers have a lower risk of AD but not other age-related conditions, arguing that lower AD diagnosis is not simply due to bias. Cancer treatment may be associated with decreased risk of AD.
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Affiliation(s)
- Laura Frain
- Division of Aging, Brigham and Women's Hospital, Boston, MA, USA
| | - David Swanson
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Kelly Cho
- Division of Aging, Brigham and Women's Hospital, Boston, MA, USA; Massachusetts Veterans Epidemiology and Resource Information Center (MAVERIC), VA Boston Healthcare System (VABHS), Jamaica Plain, MA, USA
| | - David Gagnon
- Massachusetts Veterans Epidemiology and Resource Information Center (MAVERIC), VA Boston Healthcare System (VABHS), Jamaica Plain, MA, USA; Boston University School of Public Health, Boston, MA, USA
| | - Kun Ping Lu
- Division of Hematology-Oncology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Rebecca A Betensky
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jane Driver
- Division of Aging, Brigham and Women's Hospital, Boston, MA, USA; Massachusetts Veterans Epidemiology and Resource Information Center (MAVERIC), VA Boston Healthcare System (VABHS), Jamaica Plain, MA, USA; Geriatric Research Education and Clinical Center, VABHS, Jamaica Plain, MA, USA.
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