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Lundgren M, Steed LJ, Tamura R, Jonsdottir B, Gesualdo P, Crouch C, Sjöberg M, Hansson G, Hagopian WA, Ziegler AG, Rewers MJ, Lernmark Å, Toppari J, She JX, Akolkar B, Krischer JP, Haller MJ, Elding Larsson H. Analgesic antipyretic use among young children in the TEDDY study: no association with islet autoimmunity. BMC Pediatr 2017; 17:127. [PMID: 28511706 PMCID: PMC5434629 DOI: 10.1186/s12887-017-0884-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 05/09/2017] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND The use of analgesic antipyretics (ANAP) in children have long been a matter of controversy. Data on their practical use on an individual level has, however, been scarce. There are indications of possible effects on glucose homeostasis and immune function related to the use of ANAP. The aim of this study was to analyze patterns of analgesic antipyretic use across the clinical centers of The Environmental Determinants of Diabetes in the Young (TEDDY) prospective cohort study and test if ANAP use was a risk factor for islet autoimmunity. METHODS Data were collected for 8542 children in the first 2.5 years of life. Incidence was analyzed using logistic regression with country and first child status as independent variables. Holm's procedure was used to adjust for multiplicity of intercountry comparisons. Time to autoantibody seroconversion was analyzed using a Cox proportional hazards model with cumulative analgesic use as primary time dependent covariate of interest. For each categorization, a generalized estimating equation (GEE) approach was used. RESULTS Higher prevalence of ANAP use was found in the U.S. (95.7%) and Sweden (94.8%) compared to Finland (78.1%) and Germany (80.2%). First-born children were more commonly given acetaminophen (OR 1.26; 95% CI 1.07, 1.49; p = 0.007) but less commonly Non-Steroidal Anti-inflammatory Drugs (NSAID) (OR 0.86; 95% CI 0.78, 0.95; p = 0.002). Acetaminophen and NSAID use in the absence of fever and infection was more prevalent in the U.S. (40.4%; 26.3% of doses) compared to Sweden, Finland and Germany (p < 0.001). Acetaminophen or NSAID use before age 2.5 years did not predict development of islet autoimmunity by age 6 years (HR 1.02, 95% CI 0.99-1.09; p = 0.27). In a sub-analysis, acetaminophen use in children with fever weakly predicted development of islet autoimmunity by age 3 years (HR 1.05; 95% CI 1.01-1.09; p = 0.024). CONCLUSIONS ANAP use in young children is not a risk factor for seroconversion by age 6 years. Use of ANAP is widespread in young children, and significantly higher in the U.S. compared to other study sites, where use is common also in absence of fever and infection.
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Affiliation(s)
- Markus Lundgren
- Department of Clinical Sciences, Diabetes and Celiac disease unit, Lund University, Clinical Research Centre, Jan Waldenströms gata 35, 205 02, Malmö, Sweden.
| | - Leigh Johnson Steed
- Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Roy Tamura
- Health Informatics Institute, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Berglind Jonsdottir
- Department of Clinical Sciences, Diabetes and Celiac disease unit, Lund University, Clinical Research Centre, Jan Waldenströms gata 35, 205 02, Malmö, Sweden
| | - Patricia Gesualdo
- Barbara Davis Center for Childhood Diabetes, University of Colorado, Aurora, CO, USA
| | - Claire Crouch
- Pacific Northwest Diabetes Research Institute, Seattle, WA, USA
| | - Maija Sjöberg
- Department of Physiology, Institute of Biomedicine, University of Turku, and Department of Pediatrics, Turku University Hospital, Turku, Finland
| | - Gertie Hansson
- Department of Clinical Sciences, Diabetes and Celiac disease unit, Lund University, Clinical Research Centre, Jan Waldenströms gata 35, 205 02, Malmö, Sweden
| | | | - Anette G Ziegler
- Institute of Diabetes Research, Helmholtz Zentrum München, and Klinikum rechts der Isar, Technische Universität München, and Forschergruppe Diabetes e.V, Neuherberg, Germany
| | - Marian J Rewers
- Barbara Davis Center for Childhood Diabetes, University of Colorado, Aurora, CO, USA
| | - Åke Lernmark
- Department of Clinical Sciences, Diabetes and Celiac disease unit, Lund University, Clinical Research Centre, Jan Waldenströms gata 35, 205 02, Malmö, Sweden
| | - Jorma Toppari
- Department of Physiology, Institute of Biomedicine, University of Turku, and Department of Pediatrics, Turku University Hospital, Turku, Finland
| | - Jin-Xiong She
- Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Beena Akolkar
- National Institute of Diabetes & Digestive & Kidney Diseases, Bethesda, MD, USA
| | - Jeffrey P Krischer
- Health Informatics Institute, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Michael J Haller
- Department of Pediatrics, University of Florida, Gainesville, FL, USA
| | - Helena Elding Larsson
- Department of Clinical Sciences, Diabetes and Celiac disease unit, Lund University, Clinical Research Centre, Jan Waldenströms gata 35, 205 02, Malmö, Sweden
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Hennessy E, Rakovac Tisdall A, Murphy N, Carroll A, O'Gorman D, Breen L, Clarke C, Clynes M, Dowling P, Sreenan S. Elevated 12-hydroxyeicosatetraenoic acid (12-HETE) levels in serum of individuals with newly diagnosed Type 1 diabetes. Diabet Med 2017; 34:292-294. [PMID: 27353008 DOI: 10.1111/dme.13177] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/27/2016] [Indexed: 11/29/2022]
Affiliation(s)
- E Hennessy
- National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland
- 3U Diabetes, Dublin City University, Royal College of Surgeons in Ireland, Maynooth University, Dublin, Ireland
| | - A Rakovac Tisdall
- 3U Diabetes, Dublin City University, Royal College of Surgeons in Ireland, Maynooth University, Dublin, Ireland
- Connolly Hospital Blanchardstown, Dublin, Ireland
| | - N Murphy
- Children's University Hospital, Dublin, Ireland
| | - A Carroll
- Children's University Hospital, Dublin, Ireland
| | - D O'Gorman
- 3U Diabetes, Dublin City University, Royal College of Surgeons in Ireland, Maynooth University, Dublin, Ireland
- Centre for Preventive Medicine, School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - L Breen
- National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland
- 3U Diabetes, Dublin City University, Royal College of Surgeons in Ireland, Maynooth University, Dublin, Ireland
- Centre for Preventive Medicine, School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - C Clarke
- National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland
- 3U Diabetes, Dublin City University, Royal College of Surgeons in Ireland, Maynooth University, Dublin, Ireland
| | - M Clynes
- National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland
- 3U Diabetes, Dublin City University, Royal College of Surgeons in Ireland, Maynooth University, Dublin, Ireland
| | - P Dowling
- National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland
- 3U Diabetes, Dublin City University, Royal College of Surgeons in Ireland, Maynooth University, Dublin, Ireland
- Department of Biology, Maynooth University, Dublin, Ireland
| | - S Sreenan
- 3U Diabetes, Dublin City University, Royal College of Surgeons in Ireland, Maynooth University, Dublin, Ireland
- Connolly Hospital Blanchardstown, Dublin, Ireland
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Beumer W, Gibney SM, Drexhage RC, Pont-Lezica L, Doorduin J, Klein HC, Steiner J, Connor TJ, Harkin A, Versnel MA, Drexhage HA. The immune theory of psychiatric diseases: a key role for activated microglia and circulating monocytes. J Leukoc Biol 2012; 92:959-75. [PMID: 22875882 DOI: 10.1189/jlb.0212100] [Citation(s) in RCA: 257] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
This review describes a key role for mononuclear phagocytes in the pathogenesis of major psychiatric disorders. There is accumulating evidence for activation of microglia (histopathology and PET scans) and circulating monocytes (enhanced gene expression of immune genes, an overproduction of monocyte/macrophage-related cytokines) in patients with bipolar disorder, major depressive disorder, and schizophrenia. These data are strengthened by observations in animal models, such as the MIA models, the chronic stress models, and the NOD mouse model. In these animal models of depressive-, anxiety-, and schizophrenia-like behavior, similar activations of microglia and circulating monocytes can be found. These animal models also make in-depth pathogenic studies possible and show that microglia activation impacts neuronal development and function in brain areas congruent with the altered depressive and schizophrenia-like behaviors.
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Affiliation(s)
- Wouter Beumer
- Department of Immunology, Erasmus MC, Rotterdam, the Netherlands.
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