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Obeagu EI, Obeagu GU. Managing gastrointestinal challenges: Diarrhea in sickle cell anemia. Medicine (Baltimore) 2024; 103:e38075. [PMID: 38701274 PMCID: PMC11062666 DOI: 10.1097/md.0000000000038075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 04/10/2024] [Indexed: 05/05/2024] Open
Abstract
Sickle cell anemia (SCA), a hereditary hemoglobinopathy, is characterized by the presence of abnormal hemoglobin and has long been associated with a wide range of complications. While much attention has been given to the condition hematological aspects, gastrointestinal complications, particularly diarrhea, have been relatively understudied and often overlooked. This publication delves into the management of gastrointestinal challenges, with a focus on diarrhea, in individuals living with SCA. The pathophysiology of SCA is intrinsically linked to gastrointestinal complications, and diarrhea is a common manifestation of this condition. This abstract publication outlines the key elements discussed in the full-length work, which includes the clinical presentation of diarrhea in these patients, the diagnostic tools used to evaluate the condition, and various management strategies to alleviate symptoms and enhance the overall quality of life for affected individuals. The paper emphasizes the importance of patient education, offering healthcare professionals valuable insights into how to inform and support patients in managing their conditions effectively. It also highlights the need for continued research to further our understanding of gastrointestinal challenges in SCA and to identify potential areas for future therapeutic interventions. Ultimately, the comprehensive management of diarrhea in individuals with SCA is vital for their overall well-being. This publication serves as a valuable resource for healthcare providers, researchers, and caregivers in addressing the gastrointestinal challenges that accompany SCA, ultimately working toward a better quality of life for those affected by this condition.
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Agbalalah T, Bur D, Nwonu EJ, Rowaiye AB. Gut Microbiota: Potential Therapeutic Target for Sickle Cell Disease Pain and Complications. Anemia 2024; 2024:5431000. [PMID: 38533265 PMCID: PMC10965282 DOI: 10.1155/2024/5431000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 02/26/2024] [Accepted: 03/04/2024] [Indexed: 03/28/2024] Open
Abstract
Aim Sickle cell disease has witnessed a 41.4% surge from 2000 to 2021, significantly affecting morbidity and mortality rates, particularly in children from regions with elevated under-5 mortality rates. Gut microbiota dysbiosis is increasingly recognised in SCD, exacerbating complications, particularly chronic pain, marked by significant alterations of proinflammatory bacteria abundance. This review explores the therapeutic potential of Akkermansia muciniphila and Roseburia spp. in alleviating SCD-related complications, emphasising their roles in maintaining gut barrier integrity, reducing inflammation, and modulating immune responses. Method A literature search up to November 2023 using PubMed, MEDLINE, and Google Scholar databases explored SCD pathophysiology, gut microbiota composition, Akkermansia muciniphila and Roseburia spp. abundance, pain and gut dysbiosis in SCD, and butyrate therapy. Result A. muciniphila and Roseburia spp. supplementation shows promise in alleviating chronic pain by addressing gut dysbiosis, offering new avenues for sustainable SCD management. This approach holds the potential for reducing reliance on reactive treatments and improving overall quality of life. This research underscores the pivotal role of the gut microbiome in SCD, advocating for personalised treatment approaches. Conclusion Further exploration and clinical trials are needed to harness the full potential of these gut bacteria for individuals affected by this challenging condition.
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Affiliation(s)
- Tarimoboere Agbalalah
- Department of Anatomy, Faculty of Basic Medical Sciences, Baze University, Abuja, Nigeria
- Department of Medical Biotechnology, National Biotechnology Development Agency, Abuja, Nigeria
| | - Doofan Bur
- Department of Medical Biotechnology, National Biotechnology Development Agency, Abuja, Nigeria
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Kashyap Y, Wang ZJ. Gut microbiota dysbiosis alters chronic pain behaviors in a humanized transgenic mouse model of sickle cell disease. Pain 2024; 165:423-439. [PMID: 37733476 PMCID: PMC10843763 DOI: 10.1097/j.pain.0000000000003034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 05/31/2023] [Indexed: 09/23/2023]
Abstract
ABSTRACT Pain is the most common symptom experienced by patients with sickle cell disease (SCD) throughout their lives and is the main cause of hospitalization. Despite the progress that has been made towards understanding the disease pathophysiology, major gaps remain in the knowledge of SCD pain, the transition to chronic pain, and effective pain management. Recent evidence has demonstrated a vital role of gut microbiota in pathophysiological features of SCD. However, the role of gut microbiota in SCD pain is yet to be explored. We sought to evaluate the compositional differences in the gut microbiota of transgenic mice with SCD and nonsickle control mice and investigate the role of gut microbiota in SCD pain by using antibiotic-mediated gut microbiota depletion and fecal material transplantation (FMT). The antibiotic-mediated gut microbiota depletion did not affect evoked pain but significantly attenuated ongoing spontaneous pain in mice with SCD. Fecal material transplantation from mice with SCD to wild-type mice resulted in tactile allodynia (0.95 ± 0.17 g vs 0.08 ± 0.02 g, von Frey test, P < 0.001), heat hyperalgesia (15.10 ± 0.79 seconds vs 8.68 ± 1.17 seconds, radiant heat, P < 0.01), cold allodynia (2.75 ± 0.26 seconds vs 1.68 ± 0.08 seconds, dry ice test, P < 0.01), and anxiety-like behaviors (Elevated Plus Maze Test, Open Field Test). On the contrary, reshaping gut microbiota of mice with SCD with FMT from WT mice resulted in reduced tactile allodynia (0.05 ± 0.01 g vs 0.25 ± 0.03 g, P < 0.001), heat hyperalgesia (5.89 ± 0.67 seconds vs 12.25 ± 0.76 seconds, P < 0.001), and anxiety-like behaviors. These findings provide insights into the relationship between gut microbiota dysbiosis and pain in SCD, highlighting the importance of gut microbial communities that may serve as potential targets for novel pain interventions.
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Affiliation(s)
- Yavnika Kashyap
- Departments of Pharmaceutical Sciences and Center for Biomolecular Science, University of Illinois, Chicago, IL, United States
| | - Zaijie Jim Wang
- Departments of Pharmaceutical Sciences and Center for Biomolecular Science, University of Illinois, Chicago, IL, United States
- Department of Neurology & Rehabilitation, and Sickle Cell Center, University of Illinois College of Medicine, Chicago, IL, United States
- Department of Biomedical Engineering, University of Illinois, Chicago, IL 60607, United States
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4
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Delgadinho M, Veiga L, Ginete C, Santos B, Miranda A, de Vasconcelos JN, Brito M. Differential expression of adhesion molecules in sickle cell anemia and gut microbiome effect. Ann Hematol 2024; 103:409-419. [PMID: 38153527 PMCID: PMC10799142 DOI: 10.1007/s00277-023-05589-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 12/12/2023] [Indexed: 12/29/2023]
Abstract
Sickle cell anemia (SCA) causes a long-standing vascular inflammation state, leading to endothelial dysfunction and chronic overexpression of several adhesion molecules, which contributes to acute and constant vaso-occlusive (VOC) episodes. It has been demonstrated that hydroxyurea (HU) can reduce VOC events, organ damage, blood transfusions, and even the adhesion properties to endothelial cells of SCA subjects. Due to VOC episodes, these patients are also more susceptible to recurrent bacterial translocation and dysbiosis. Given this, our study aimed to uncover the interplay between adhesion molecules, gut microbiome, and hydroxyurea in a population of Angolan SCA children. Serum and fecal samples were obtained before and after HU treatment in 35 children. After HU, four of these adhesion molecules were significantly reduced: sE-selectin (p = 0.002), ADAMTS13 (p = 0.023), sICAM-1 (p = 0.003), and sVCAM-1 (p = 0.018). A positive correlation was observed between the number of neutrophils and sICAM-1, platelets, and sP-selectin, and also between leukocytes, sICAM-1, and sVCAM-1. Most taxa showing a significant correlation mainly belonged to the Clostridiales order. Specifically, from the Clostridium genera, the groups g19, g21, and g34 were all negatively correlated with HbF levels; g19, g21, and g24 positively correlated with leukocytes; g19 positively with neutrophils and sVCAM-1; and g34 positively with E- and P-selectin. Serratia, an opportunistic pathogen, was positively correlated with sE-selectin and sICAM-1 levels. Additionally, a negative correlation was observed between sP-selectin and Bifidobacterium. Research studies in this area could improve our understanding and contribute to finding new prognostic biomarkers to guarantee precise SCA patient stratification and predict severe complications.
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Affiliation(s)
- Mariana Delgadinho
- H&TRC - Health & Technology Research Center, ESTeSL - Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Lisbon, Portugal
| | - Luísa Veiga
- H&TRC - Health & Technology Research Center, ESTeSL - Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Lisbon, Portugal
| | - Catarina Ginete
- H&TRC - Health & Technology Research Center, ESTeSL - Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Lisbon, Portugal
| | - Brígida Santos
- Centro de Investigação em Saúde de Angola (CISA), Caxito, Bengo, Angola
- Hospital Pediátrico David Bernardino (HPDB), Luanda, Angola
| | - Armandina Miranda
- Instituto Nacional de Saúde Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | | | - Miguel Brito
- H&TRC - Health & Technology Research Center, ESTeSL - Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Lisbon, Portugal.
- Centro de Investigação em Saúde de Angola (CISA), Caxito, Bengo, Angola.
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5
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Bell V, Varzakas T, Psaltopoulou T, Fernandes T. Sickle Cell Disease Update: New Treatments and Challenging Nutritional Interventions. Nutrients 2024; 16:258. [PMID: 38257151 PMCID: PMC10820494 DOI: 10.3390/nu16020258] [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: 12/19/2023] [Revised: 01/11/2024] [Accepted: 01/12/2024] [Indexed: 01/24/2024] Open
Abstract
Sickle cell disease (SCD), a distinctive and often overlooked illness in the 21st century, is a congenital blood disorder characterized by considerable phenotypic diversity. It comprises a group of disorders, with sickle cell anemia (SCA) being the most prevalent and serious genotype. Although there have been some systematic reviews of global data, worldwide statistics regarding SCD prevalence, morbidity, and mortality remain scarce. In developed countries with a lower number of sickle cell patients, cutting-edge technologies have led to the development of new treatments. However, in developing settings where sickle cell disease (SCD) is more prevalent, medical management, rather than a cure, still relies on the use of hydroxyurea, blood transfusions, and analgesics. This is a disease that affects red blood cells, consequently affecting most organs in diverse manners. We discuss its etiology and the advent of new technologies, but the aim of this study is to understand the various types of nutrition-related studies involving individuals suffering from SCD, particularly in Africa. The interplay of the environment, food, gut microbiota, along with their respective genomes collectively known as the gut microbiome, and host metabolism is responsible for mediating host metabolic phenotypes and modulating gut microbiota. In addition, it serves the purpose of providing essential nutrients. Moreover, it engages in direct interactions with host homeostasis and the immune system, as well as indirect interactions via metabolites. Nutrition interventions and nutritional care are mechanisms for addressing increased nutrient expenditures and are important aspects of supportive management for patients with SCD. Underprivileged areas in Sub-Saharan Africa should be accompanied by efforts to define and promote of the nutritional aspects of SCD. Their importance is key to maintaining well-being and quality of life, especially because new technologies and products remain limited, while the use of native medicinal plant resources is acknowledged.
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Affiliation(s)
- Victoria Bell
- Faculty of Pharmacy, University of Coimbra, Pólo das Ciências da Saúde, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal;
| | - Theodoros Varzakas
- Department of Food Science and Technology, University of the Peloponnese, 24100 Kalamata, Greece
| | - Theodora Psaltopoulou
- Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Tito Fernandes
- CIISA, Faculty of Veterinary Medicine, University of Lisbon, 1649-004 Lisbon, Portugal
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6
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Delgadinho M, Ginete C, Santos B, Mendes J, Miranda A, Vasconcelos J, Brito M. Microbial gut evaluation in an angolan paediatric population with sickle cell disease. J Cell Mol Med 2022; 26:5360-5368. [PMID: 36168945 DOI: 10.1111/jcmm.17402] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/21/2022] [Accepted: 04/06/2022] [Indexed: 11/29/2022] Open
Abstract
Sickle cell disease (SCD) is one of the most common genetic conditions worldwide. It can contribute up to 90% of under-5 mortality in sub-Saharan Africa. Clinical manifestations are very heterogeneous, and the intestinal microbiome appears to be crucial in the modulation of inflammation, cell adhesion and induction of aged neutrophils, the main interveners of recurrent vaso-occlusive crisis. Enterocyte injury, increased permeability, altered microbial composition and bacterial overgrowth have all been documented as microbial and pathophysiologic changes in the gut microbiome of SCD patients in recent studies. Our aim was to sequence the bacterial 16S rRNA gene in order to characterize the gut microbiome of Angolan children with SCA and healthy siblings as a control. A total of 72 stool samples were obtained from children between 3 and 14 years old. Our data showed that the two groups exhibit some notable differences in microbiota relative abundance at different classification levels. Children with SCA have a higher number of the phylum Actinobacteria. As for the genus level, Clostridium cluster XI bacteria was more prevalent in the SCA children, whereas the siblings had a higher abundance of Blautia, Aestuariispira, Campylobacter, Helicobacter, Polaribacter and Anaerorhabdus. In this study, we have presented the first microbiota analysis in an Angolan paediatric population with SCD and provided a detailed view of the microbial differences between patients and healthy controls. There is still much to learn before fully relying on the therapeutic approaches for gut modulation, which is why more research in this field is crucial to making this a reality.
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Affiliation(s)
- Mariana Delgadinho
- H&TRC- Health & Technology Research Center, ESTeSL- Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Lisbon, Portugal
| | - Catarina Ginete
- H&TRC- Health & Technology Research Center, ESTeSL- Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Lisbon, Portugal
| | - Brígida Santos
- Centro de Investigação em Saúde de Angola (CISA), Bengo, Angola.,Hospital Pediátrico David Bernardino (HPDB), Luanda, Angola
| | - Joana Mendes
- H&TRC- Health & Technology Research Center, ESTeSL- Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Lisbon, Portugal
| | - Armandina Miranda
- Instituto Nacional de Saúde Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | | | - Miguel Brito
- H&TRC- Health & Technology Research Center, ESTeSL- Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Lisbon, Portugal.,Centro de Investigação em Saúde de Angola (CISA), Bengo, Angola
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7
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Delgadinho M, Ginete C, Santos B, Fernandes C, Silva C, Miranda A, de Vasconcelos JN, Brito M. How Hydroxyurea Alters the Gut Microbiome: A Longitudinal Study Involving Angolan Children with Sickle Cell Anemia. Int J Mol Sci 2022; 23:ijms23169061. [PMID: 36012325 PMCID: PMC9409137 DOI: 10.3390/ijms23169061] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/08/2022] [Accepted: 08/11/2022] [Indexed: 11/16/2022] Open
Abstract
Sickle cell anemia (SCA) is an inherited hematological disorder and a serious global health problem, especially in Sub-Saharan Africa. Although hydroxyurea (HU) is the leading treatment for patients with SCA, its effects on the gut microbiome have not yet been explored. In this context, the aim of this study was to investigate this association by characterizing the gut microbiome of an Angolan SCA pediatric population before and after 6 months of HU treatment. A total of 66 stool samples were obtained and sequenced for the 16S rRNA gene (V3-V4 regions). Significant associations were observed in alpha and beta-diversity, with higher values of species richness for the children naïve for HU. We also noticed that children after HU had higher proportions of several beneficial bacteria, mostly short-chain fatty acids (SCFAs) producing species, such as Blautia luti, Roseburia inulinivorans, Eubacterium halli, Faecalibacterium, Ruminococcus, Lactobacillus rogosae, among others. In addition, before HU there was a higher abundance of Clostridium_g24, which includes C. bolteae and C. clostridioforme, both considered pathogenic. This study provides the first evidence of the HU effect on the gut microbiome and unravels several microorganisms that could be considered candidate biomarkers for disease severity and HU efficacy.
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Affiliation(s)
- Mariana Delgadinho
- H&TRC-Health & Technology Research Center, ESTeSL-Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, 1990-096 Lisbon, Portugal
| | - Catarina Ginete
- H&TRC-Health & Technology Research Center, ESTeSL-Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, 1990-096 Lisbon, Portugal
| | - Brígida Santos
- Centro de Investigação em Saúde de Angola (CISA), Hospital Geral do Bengo, Bengo 9999, Angola
- Hospital Pediátrico David Bernardino (HPDB), Luanda 3067, Angola
| | - Carolina Fernandes
- H&TRC-Health & Technology Research Center, ESTeSL-Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, 1990-096 Lisbon, Portugal
| | - Carina Silva
- H&TRC-Health & Technology Research Center, ESTeSL-Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, 1990-096 Lisbon, Portugal
- Centro de Estatística e Aplicações, Universidade de Lisboa, 1749-016 Lisbon, Portugal
| | - Armandina Miranda
- Instituto Nacional de Saúde Doutor Ricardo Jorge (INSA), 1649-016 Lisbon, Portugal
| | | | - Miguel Brito
- H&TRC-Health & Technology Research Center, ESTeSL-Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, 1990-096 Lisbon, Portugal
- Centro de Investigação em Saúde de Angola (CISA), Hospital Geral do Bengo, Bengo 9999, Angola
- Correspondence: ; Tel.: +351-218980400
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8
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Lin X, Zhang W, He L, Xie H, Feng B, Zhu H, Zhao J, Cui L, Li B, Li YF. Understanding the hepatoxicity of inorganic mercury through guts: Perturbance to gut microbiota, alteration of gut-liver axis related metabolites and damage to gut integrity. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 225:112791. [PMID: 34555721 DOI: 10.1016/j.ecoenv.2021.112791] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 09/13/2021] [Accepted: 09/14/2021] [Indexed: 06/13/2023]
Abstract
Mercury (Hg) brings adverse effects to the environment and human beings and inorganic mercury (IHg) is a typical hepatic toxin. This work studied the impacts of IHg on gut microbes and metabolome together with its damage to liver and gut in rats through gut microbiome, metabolomics and metallomics. Sprague Dawley (SD) rats were orally exposed to 0.4 μg/mL IHg and sacrificed after 24 h. It was found that IHg perturbed greatly on the gut microbiota, such as increased pathogenic bacteria like G. bacillus. In addition, IHg also changed gut-liver axis related metabolites, which was confirmed by the secretion of a large number of inflammatory factors in both the gut and the liver. The changed gut-liver axis related metabolites correlated well to the changes of gut microbiome. In all, besides the direct deposition in liver of Hg, the perturbance to gut microbiome and alteration of gut-liver axis related metabolites by IHg also contributed to its hepatoxicity, which provides new insights about the hepatoxicity of chemicals. The strategy applied in this work may also be used to understand the hepatoxicity of other chemicals.
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Affiliation(s)
- Xiaoying Lin
- Jilin Medical University, Jilin 132013, Jilin, China; CAS-HKU Joint Laboratory of Metallomics on Health and Environment, & CAS Key Laboratory for Biological Effects of Nanomaterials and Nanosafety, & Beijing Metallomics Facility, & National Consortium for Excellence in Metallomics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - Wei Zhang
- CAS-HKU Joint Laboratory of Metallomics on Health and Environment, & CAS Key Laboratory for Biological Effects of Nanomaterials and Nanosafety, & Beijing Metallomics Facility, & National Consortium for Excellence in Metallomics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China; State Key Laboratory of Environmental Geochemistry, Institute of Geochemistry, Chinese Academy of Sciences, Guiyang 550081, Guizhou, China
| | - Lina He
- CAS-HKU Joint Laboratory of Metallomics on Health and Environment, & CAS Key Laboratory for Biological Effects of Nanomaterials and Nanosafety, & Beijing Metallomics Facility, & National Consortium for Excellence in Metallomics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - Hongxin Xie
- CAS-HKU Joint Laboratory of Metallomics on Health and Environment, & CAS Key Laboratory for Biological Effects of Nanomaterials and Nanosafety, & Beijing Metallomics Facility, & National Consortium for Excellence in Metallomics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - Bo Feng
- Jilin Medical University, Jilin 132013, Jilin, China
| | - Heyun Zhu
- Jilin Medical University, Jilin 132013, Jilin, China
| | - Jiating Zhao
- CAS-HKU Joint Laboratory of Metallomics on Health and Environment, & CAS Key Laboratory for Biological Effects of Nanomaterials and Nanosafety, & Beijing Metallomics Facility, & National Consortium for Excellence in Metallomics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Liwei Cui
- CAS-HKU Joint Laboratory of Metallomics on Health and Environment, & CAS Key Laboratory for Biological Effects of Nanomaterials and Nanosafety, & Beijing Metallomics Facility, & National Consortium for Excellence in Metallomics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Bai Li
- CAS-HKU Joint Laboratory of Metallomics on Health and Environment, & CAS Key Laboratory for Biological Effects of Nanomaterials and Nanosafety, & Beijing Metallomics Facility, & National Consortium for Excellence in Metallomics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - Yu-Feng Li
- CAS-HKU Joint Laboratory of Metallomics on Health and Environment, & CAS Key Laboratory for Biological Effects of Nanomaterials and Nanosafety, & Beijing Metallomics Facility, & National Consortium for Excellence in Metallomics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China; University of Chinese Academy of Sciences, Beijing 100049, China.
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9
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Poplawska M, Dutta D, Jayaram M, Salifu M, Chong NS, Lim SH. Intestinal pathophysiological abnormalities in steady state and after vaso-occlusive crisis in murine sickle cell disease. Br J Haematol 2021; 196:777-780. [PMID: 34632582 DOI: 10.1111/bjh.17889] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/15/2021] [Accepted: 09/27/2021] [Indexed: 11/30/2022]
Abstract
We showed in the present study that, not unlike in adult patients with sickle cell disease (SCD), Townes mice exhibit increases in serum intestinal fatty acid binding proteins and lipopolysaccharides (LPS), together with a breach in the intestinal barrier. These abnormalities increased rapidly after the induction of vaso-occlusive crisis (VOC). We also confirmed higher intestinal microbial density in SCD. These findings support the concept that SCD and/or its complications, and not hospitalisation or medications, are responsible for the intestinal pathophysiological changes. The present results provide the basis for use of Townes mice to further elucidate the mechanistic relationship between intestinal pathophysiology and VOC.
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Affiliation(s)
- Maria Poplawska
- Division of Hematology and Oncology, State University of New York Downstate Health Sciences University, Brooklyn, NY, USA
| | - Dibyendu Dutta
- Division of Hematology and Oncology, State University of New York Downstate Health Sciences University, Brooklyn, NY, USA
| | - Manjunath Jayaram
- Department of Chemistry, Middle Tennessee State University, Murfreesboro, TN, USA
| | - Moro Salifu
- Division of Hematology and Oncology, State University of New York Downstate Health Sciences University, Brooklyn, NY, USA
| | - Ngee S Chong
- Department of Chemistry, Middle Tennessee State University, Murfreesboro, TN, USA
| | - Seah H Lim
- Division of Hematology and Oncology, State University of New York Downstate Health Sciences University, Brooklyn, NY, USA
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10
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Jang T, Poplawska M, Cimpeanu E, Mo G, Dutta D, Lim SH. Vaso-occlusive crisis in sickle cell disease: a vicious cycle of secondary events. J Transl Med 2021; 19:397. [PMID: 34544432 PMCID: PMC8454100 DOI: 10.1186/s12967-021-03074-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 09/08/2021] [Indexed: 12/18/2022] Open
Abstract
Painful vaso-occlusive crisis (VOC) remains the most common reason for presenting to the Emergency Department and hospitalization in patients with sickle cell disease (SCD). Although two new agents have been approved by the Food and Drug Administration for treating SCD, they both target to reduce the frequency of VOC. Results from studies investigating various approaches to treat and shorten VOC have so far been generally disappointing. In this paper, we will summarize the complex pathophysiology and downstream events of VOC and discuss the likely reasons for the disappointing results using monotherapy. We will put forward the rationale for exploring some of the currently available agents to either protect erythrocytes un-involved in the hemoglobin polymerization process from sickling induced by the secondary events, or a multipronged combination approach that targets the complex downstream pathways of VOC.
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Affiliation(s)
- Tim Jang
- Division of Hematology and Oncology, Department of Medicine, SUNY Downstate Medical Center, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, MSC #20, Brooklyn, NY, 11203, USA
| | - Maria Poplawska
- Division of Hematology and Oncology, Department of Medicine, SUNY Downstate Medical Center, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, MSC #20, Brooklyn, NY, 11203, USA
| | - Emanuela Cimpeanu
- Division of Hematology and Oncology, Department of Medicine, SUNY Downstate Medical Center, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, MSC #20, Brooklyn, NY, 11203, USA
| | - George Mo
- Division of Hematology and Oncology, Department of Medicine, SUNY Downstate Medical Center, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, MSC #20, Brooklyn, NY, 11203, USA
| | - Dibyendu Dutta
- Division of Hematology and Oncology, Department of Medicine, SUNY Downstate Medical Center, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, MSC #20, Brooklyn, NY, 11203, USA
| | - Seah H Lim
- Division of Hematology and Oncology, Department of Medicine, SUNY Downstate Medical Center, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, MSC #20, Brooklyn, NY, 11203, USA.
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11
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Brim H, Taylor J, Abbas M, Vilmenay K, Daremipouran M, Varma S, Lee E, Pace B, Song-Naba WL, Gupta K, Nekhai S, O’Neil P, Ashktorab H. The gut microbiome in sickle cell disease: Characterization and potential implications. PLoS One 2021; 16:e0255956. [PMID: 34432825 PMCID: PMC8386827 DOI: 10.1371/journal.pone.0255956] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 07/27/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Sickle Cell Disease (SCD) is an inherited blood disorder that leads to hemolytic anemia, pain, organ damage and early mortality. It is characterized by polymerized deoxygenated hemoglobin, rigid sickle red blood cells and vaso-occlusive crises (VOC). Recurrent hypoxia-reperfusion injury in the gut of SCD patients could increase tissue injury, permeability, and bacterial translocation. In this context, the gut microbiome, a major player in health and disease, might have significant impact. This study sought to characterize the gut microbiome in SCD. METHODS Stool and saliva samples were collected from healthy controls (n = 14) and SCD subjects (n = 14). Stool samples were also collected from humanized SCD murine models including Berk, Townes and corresponding control mice. Amplified 16S rDNA was used for bacterial composition analysis using Next Generation Sequencing (NGS). Pairwise group analyses established differential bacterial groups at many taxonomy levels. Bacterial group abundance and differentials were established using DeSeq software. RESULTS A major dysbiosis was observed in SCD patients. The Firmicutes/Bacteroidetes ratio was lower in these patients. The following bacterial families were more abundant in SCD patients: Acetobacteraceae, Acidaminococcaceae, Candidatus Saccharibacteria, Peptostreptococcaceae, Bifidobacteriaceae, Veillonellaceae, Actinomycetaceae, Clostridiales, Bacteroidacbactereae and Fusobacteriaceae. This dysbiosis translated into 420 different operational taxonomic units (OTUs). Townes SCD mice also displayed gut microbiome dysbiosis as seen in human SCD. CONCLUSION A major dysbiosis was observed in SCD patients for bacteria that are known strong pro-inflammatory triggers. The Townes mouse showed dysbiosis as well and might serve as a good model to study gut microbiome modulation and its impact on SCD pathophysiology.
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Affiliation(s)
- Hassan Brim
- Department of Pathology, Department of Medicine, Cancer Center, Microbiology and Center for Sickle Cell Disease, Howard University College of Medicine, Washington, DC, United States of America
| | - James Taylor
- Department of Pathology, Department of Medicine, Cancer Center, Microbiology and Center for Sickle Cell Disease, Howard University College of Medicine, Washington, DC, United States of America
| | - Muneer Abbas
- Department of Pathology, Department of Medicine, Cancer Center, Microbiology and Center for Sickle Cell Disease, Howard University College of Medicine, Washington, DC, United States of America
| | - Kimberly Vilmenay
- Department of Pathology, Department of Medicine, Cancer Center, Microbiology and Center for Sickle Cell Disease, Howard University College of Medicine, Washington, DC, United States of America
| | - Mohammad Daremipouran
- Department of Pathology, Department of Medicine, Cancer Center, Microbiology and Center for Sickle Cell Disease, Howard University College of Medicine, Washington, DC, United States of America
| | - Sudhir Varma
- Hithru Analytics, Laurel, MD, United States of America
| | - Edward Lee
- Department of Pathology, Department of Medicine, Cancer Center, Microbiology and Center for Sickle Cell Disease, Howard University College of Medicine, Washington, DC, United States of America
| | - Betty Pace
- University of Augusta, Augusta, GA, United States of America
| | - Waogwende L. Song-Naba
- Division of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, MN, United States of America
| | - Kalpna Gupta
- Division of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, MN, United States of America
- Hematology/Oncology, Department of Medicine, University of California Irvine, Irvine, CA, United States of America
- Southern California Institute for Research and Education, Long Beach VA Healthcare System, Long Beach, CA, United States of America
| | - Sergei Nekhai
- Department of Pathology, Department of Medicine, Cancer Center, Microbiology and Center for Sickle Cell Disease, Howard University College of Medicine, Washington, DC, United States of America
| | - Patricia O’Neil
- Food and Drug Administration, Silver Spring, MD, United States of America
| | - Hassan Ashktorab
- Department of Pathology, Department of Medicine, Cancer Center, Microbiology and Center for Sickle Cell Disease, Howard University College of Medicine, Washington, DC, United States of America
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12
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Stewart C, Jang T, Mo G, Mohamed N, Poplawska M, Egini O, Dutta D, Lim SH. Antibiotics to modify sickle cell disease vaso-occlusive crisis? Blood Rev 2021; 50:100867. [PMID: 34304939 DOI: 10.1016/j.blre.2021.100867] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 07/12/2021] [Accepted: 07/13/2021] [Indexed: 02/07/2023]
Abstract
Despite the availability of hydroxyurea, the clinical use of the medication among patients with sickle cell disease (SCD) remains low in the United States. Given the high healthcare utilization cost, SCD requires new therapeutic approaches. Recent studies demonstrated bacterial overgrowth and dysbiosis-related intestinal pathophysiological changes in SCD. Intestinal microbes regulate neutrophil ageing. Aged and activated neutrophils contribute to the pathogenesis of vaso-occlusive crisis (VOC) in SCD. In this paper, we will review the pre-clinical and clinical data on how antibiotics might reduce the intestinal microbial density and influence the course of VOC. Based on these observations, we will discuss rationales for and potential challenges to antibiotic-based therapeutic approaches that may modify the clinical course of VOC in SCD.
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Affiliation(s)
- Connor Stewart
- Division of Hematology and Oncology, Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, New York 11203, United States of America
| | - Tim Jang
- Division of Hematology and Oncology, Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, New York 11203, United States of America
| | - George Mo
- Division of Hematology and Oncology, Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, New York 11203, United States of America
| | - Nader Mohamed
- Division of Hematology and Oncology, Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, New York 11203, United States of America
| | - Maria Poplawska
- Division of Hematology and Oncology, Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, New York 11203, United States of America
| | - Ogechukwu Egini
- Division of Hematology and Oncology, Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, New York 11203, United States of America
| | - Dibyendu Dutta
- Division of Hematology and Oncology, Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, New York 11203, United States of America.
| | - Seah H Lim
- Division of Hematology and Oncology, Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, New York 11203, United States of America.
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13
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Si X, Bi J, Chen Q, Cui H, Bao Y, Tian J, Shu C, Wang Y, Tan H, Zhang W, Chen Y, Li B. Effect of Blueberry Anthocyanin-Rich Extracts on Peripheral and Hippocampal Antioxidant Defensiveness: The Analysis of the Serum Fatty Acid Species and Gut Microbiota Profile. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2021; 69:3658-3666. [PMID: 33709697 DOI: 10.1021/acs.jafc.0c07637] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The current study investigated the positive effects of blueberry anthocyanin-rich extracts (BAE) on either peripheral or hippocampal antioxidant defensiveness and established the connection of the improved antioxidant status with the altered fatty acid species and gut microbiota profile. High-fat diet-induced oxidative stress in C57BL/6 mice was attenuated by BAE administration, which was reflected by strengthened antioxidant enzymes, alleviated hepatic steatosis, and improved hippocampal neuronal status. Serum lipidomics analysis indicated that the fatty acid species were altered toward the elevated unsaturated/saturated ratio, along with phospholipid species toward enriched n-3 polyunsaturated fatty acid compositions. The modulated antioxidant pattern could be attributed to the increased bacteria diversity, stimulated probiotics (Bifidobacterium and Lactobacillus) and short-chain fatty acid (SCFA) producers (Roseburia, Faecalibaculum, and Parabacteroides) improved by anthocyanins and their metabolites, which improved the colon environment, characterized by promoted SCFAs, restored colonic mucosa, and reorganized microbial structure. Thus, anthocyanin-rich dietary intervention is a promising approach for the defensiveness in human oxidative damage and neurodegeneration.
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Affiliation(s)
- Xu Si
- College of Food Science, Shenyang Agricultural University, Shenyang 110866, China
| | - Jinfeng Bi
- Chinese Academy of Agricultural Sciences (CAAS), Key Laboratory of Agro-Products Processing, National Risk Assessment Laboratory of Agro-Products Processing Quality and Safety, Ministry of Agriculture and Rural Affairs, Institute of Food Science and Technology, Beijing 100193, China
| | - Qinqin Chen
- Chinese Academy of Agricultural Sciences (CAAS), Key Laboratory of Agro-Products Processing, National Risk Assessment Laboratory of Agro-Products Processing Quality and Safety, Ministry of Agriculture and Rural Affairs, Institute of Food Science and Technology, Beijing 100193, China
| | - Huijun Cui
- College of Food Science, Shenyang Agricultural University, Shenyang 110866, China
| | - Yiwen Bao
- College of Food Science, Shenyang Agricultural University, Shenyang 110866, China
| | - Jinlong Tian
- College of Food Science, Shenyang Agricultural University, Shenyang 110866, China
| | - Chi Shu
- College of Food Science, Shenyang Agricultural University, Shenyang 110866, China
| | - Yuehua Wang
- College of Food Science, Shenyang Agricultural University, Shenyang 110866, China
| | - Hui Tan
- College of Food Science, Shenyang Agricultural University, Shenyang 110866, China
| | - Weijia Zhang
- College of Food Science, Shenyang Agricultural University, Shenyang 110866, China
| | - Yi Chen
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047, China
| | - Bin Li
- College of Food Science, Shenyang Agricultural University, Shenyang 110866, China
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14
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Jang T, Mo G, Stewart C, Egini O, Dutta D, Muthu J, Lim SH. Antibiotic use in adults during sickle cell vaso-occlusive crisis: Is it time for a controlled trial? Br J Haematol 2021; 193:1281-1283. [PMID: 33783844 DOI: 10.1111/bjh.17439] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Tim Jang
- Division of Hematology and Oncology, Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - George Mo
- Division of Hematology and Oncology, Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Connor Stewart
- Division of Hematology and Oncology, Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Ogechukwu Egini
- Division of Hematology and Oncology, Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Dibyendu Dutta
- Division of Hematology and Oncology, Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - John Muthu
- Division of Hematology and Oncology, Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Seah H Lim
- Division of Hematology and Oncology, Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
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15
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Lee P, Sinha AA, Soma VL, Cruz C, Wang T, Aroniadis O, Herold BC, Frenette PS, Goldman DL, Manwani D. Very low incidence of <i>Clostridioides difficile</i> infection in pediatric sickle cell disease patients. Haematologica 2020; 106:1489-1490. [PMID: 33054107 PMCID: PMC8094088 DOI: 10.3324/haematol.2019.244582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Indexed: 01/01/2023] Open
Affiliation(s)
- Philip Lee
- Department of Pediatrics, The Children's Hospital at Montefiore, Bronx
| | - Arpan A Sinha
- Jimmy Everest Section of Pediatric Hematology/Oncology, The University of Oklahoma Health Sciences Center, Oklahoma City
| | - Vijaya L Soma
- Department of Pediatrics, The Children's Hospital at Montefiore, Bronx, USA; Department of Pediatrics, The Albert Einstein College of Medicine, Bronx
| | - Carlos Cruz
- Department of Pediatrics, The Children's Hospital at Montefiore, Bronx
| | - Tao Wang
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx
| | - Olga Aroniadis
- Department of Medicine, Montefiore Medical Center, Bronx, USA; Department of Medicine, Albert Einstein College of Medicine, Bronx
| | - Betsy C Herold
- Department of Pediatrics, The Children's Hospital at Montefiore, Bronx, USA; Department of Pediatrics, The Albert Einstein College of Medicine, Bronx
| | - Paul S Frenette
- Department of Medicine, Albert Einstein College of Medicine, Bronx
| | - David L Goldman
- Department of Pediatrics, The Children's Hospital at Montefiore, Bronx, USA; Department of Pediatrics, The Albert Einstein College of Medicine, Bronx
| | - Deepa Manwani
- Department of Pediatrics, The Children's Hospital at Montefiore, Bronx, USA; Department of Pediatrics, The Albert Einstein College of Medicine, Bronx.
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16
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Dutta D, Li K, Methe B, Lim SH. Rifaximin on intestinally-related pathologic changes in sickle cell disease. Am J Hematol 2020; 95:E83-E86. [PMID: 31925798 DOI: 10.1002/ajh.25722] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Accepted: 01/03/2020] [Indexed: 11/05/2022]
Affiliation(s)
- Dibyendu Dutta
- Division of Hematology and Hemostasis, Department of Medicine New York Medical College Valhalla New York
| | - Kelvin Li
- Center for Medicine and the Microbiome University of Pittsburgh Pittsburgh Pennsylvania
| | - Barbara Methe
- Center for Medicine and the Microbiome University of Pittsburgh Pittsburgh Pennsylvania
| | - Seah H. Lim
- Division of Hematology and Hemostasis, Department of Medicine New York Medical College Valhalla New York
- Westchester Medical Center Cancer Institute Hawthorne New York
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