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Kang X, Ploner A, Ludvigsson JF, Williams DM, Larsson H, Pedersen NL, Wirdefeldt K. Clostridium difficile infection and risk of Parkinson's disease: a Swedish population-based cohort study. Eur J Neurol 2020; 27:2134-2141. [PMID: 32538502 DOI: 10.1111/ene.14400] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 06/04/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND PURPOSE Gastrointestinal inflammation has been implicated in Parkinson's disease (PD). The aim of this study was to examine whether individuals with a history of Clostridium difficile infection (CDI) are at elevated risk of PD. METHODS We performed a population-based cohort study using Swedish national register data. Adults aged ≥35 years were identified from the Swedish Population and Housing Census 1990 and followed during the period 1997-2013. Diagnoses of CDI and PD were extracted from the National Patient Register. Associations of CDI history with PD risk were estimated using Cox proportional hazards regression. We also explored whether the association differed by the source of CDI diagnosis (inpatient vs. outpatient), presence of recurrent infections, and pre-infection use of antibiotics. RESULTS Amongst the study population (N = 4 670 423), 34 868 (0.75%) had a history of CDI. A total of 165 and 47 035 incident PD cases were identified from individuals with and without CDI history, respectively. Across the entire follow-up, a 16% elevation of PD risk was observed among the CDI group [hazard ratio 1.16, 95% confidence interval (CI)1.00-1.36], which was mainly driven by increased PD risk within the first 2 years after CDI diagnosis (hazard ratio 1.38, 95% CI 1.12-1.69). In longer follow-up, CDI was not associated with subsequent PD occurrence. This temporal pattern of CDI-PD associations was generally observed across all CDI subgroups. CONCLUSIONS Clostridium difficile may be associated with an increased short-term PD risk, but this might be explained by reverse causation and/or surveillance bias. Our results do not imply that CDI history affects long-term PD risk.
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Affiliation(s)
- X Kang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - A Ploner
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - J F Ludvigsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Department of Pediatrics, Örebro University Hospital, Örebro, Sweden
| | - D M Williams
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
| | - H Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,School of Medical Sciences, Örebro University, Örebro, Sweden
| | - N L Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - K Wirdefeldt
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Huang T, Debelius J, Ploner A, Xiao X, Zhang T, Hu K, Zhang Z, Wang R, Ye W. Changes of the commensal microbiome during treatment are associated with clinical response in the nasopharyngeal carcinoma patients. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz252.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Karlsson IK, Ploner A, Song C, Gatz M, Pedersen NL, Hägg S. Genetic susceptibility to cardiovascular disease and risk of dementia. Transl Psychiatry 2017; 7:e1142. [PMID: 28556832 PMCID: PMC5534941 DOI: 10.1038/tp.2017.110] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 04/20/2017] [Accepted: 04/20/2017] [Indexed: 11/22/2022] Open
Abstract
Several studies have shown cardiovascular disease (CVD) to be associated with dementia, but it is not clear whether CVD per se increases the risk of dementia or whether the association is due to shared risk factors. We tested how a genetic risk score (GRS) for coronary artery disease (CAD) affects dementia risk after CVD in 13 231 Swedish twins. We also utilized summarized genome-wide association data to study genetic overlap between CAD and Alzheimer´s disease (AD), and additionally between shared risk factors and each disease. There was no direct effect of a CAD GRS on dementia (hazard ratio 0.99, 95% confidence interval (CI): 0.98-1.01). However, the GRS for CAD modified the association between CVD and dementia within 3 years of CVD diagnosis, ranging from a hazard ratio of 1.59 (95% CI: 1.05-2.41) in the first GRS quartile to 1.91 (95% CI: 1.28-2.86) in the fourth GRS quartile. Using summary statistics, we found no genetic overlap between CAD and AD. We did, however, find that both AD and CAD share a significant genetic overlap with lipids, but that the overlap arose from clearly distinct gene clusters. In conclusion, genetic susceptibility to CAD was found to modify the association between CVD and dementia, most likely through associations with shared risk factors.
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Affiliation(s)
- I K Karlsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, SE 171-77 Stockholm, Sweden. E-mail:
| | - A Ploner
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - C Song
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - M Gatz
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden,Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - N L Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden,Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - S Hägg
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Plymoth A, Rotzen-Ostlund M, Zweygberg-Wirgart B, Sundin CG, Ploner A, Nyren O, Linde A. Self-sampling for analysis of respiratory viruses in a large-scale epidemiological study in Sweden. ACTA ACUST UNITED AC 2015; 20. [PMID: 25811646 DOI: 10.2807/1560-7917.es2015.20.11.21063] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Viral diagnosis of respiratory tract infections has so far required sampling by health professionals,hampering large-scale epidemiological studies of virus-specific disease outcomes. As part of a population-based, prospective study of work-related risk factors for transmission of viral infections (SWEDE-I), we developed a scheme for self-sampling with nasal swabs. Random selection from the gainfully employed population of a medium-sized town in central Sweden resulted in a study cohort of 2,237 men and women aged 25 to 63 years. From September 2011 through May 2012, the cohort reported all instances of respiratory tract infection or gastroenteritis and participants concomitantly sent self-sampled nasal swabs for analysis using regular mail. Diagnosis of 14 viruses was performed. A total of 1,843 samples were received. The week-wise average delay between disease on set and arrival of the specimens at the laboratory varied between four and six days, and the corresponding median delay was between 3.5 and six days. In line with previous community-based studies, picorna- and coronaviruses dominated in specimens obtained from the self-sampling scheme. The results of self-sampling were contrasted to those from contemporaneous routine clinical sampling, on the same age group, in the adjacent Stockholm county. Although higher proportions of positive samples for respiratory syncytial virus and influenza were observed in the clinical sampling scheme, estimations of seasonality for influenza A and picornaviruses derived from both schemes were similar. Our findings show that nasal self-sampling is feasible in large-scale surveillance of respiratory infections and opens new prospects for population based,virologically verified research on virus spread,burden of disease, and effects of environmental factors or interventions.
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Affiliation(s)
- A Plymoth
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Eriksson L, Hall P, Czene K, Dos Santos Silva I, McCormack V, Bergh J, Bjohle J, Ploner A. Mammographic density and molecular subtypes of breast cancer. Br J Cancer 2012; 107:18-23. [PMID: 22644308 PMCID: PMC3389424 DOI: 10.1038/bjc.2012.234] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background: Gene expression profiling has led to a subclassification of breast cancers independent of established clinical parameters, such as the Sorlie–Perou subtypes. Mammographic density (MD) is one of the strongest risk factors for breast cancer, but it is unknown if MD is associated with molecular subtypes of this carcinoma. Methods: We investigated whether MD was associated with breast cancer subtypes in 110 women with breast cancer, operated in Stockholm, Sweden, during 1994 to 1996. Subtypes were defined using expression data from HGU133A+B chips. The MD of the unaffected breast was measured using the Cumulus software. We used multinomial logistic models to investigate the relationship between MD and Sorlie–Perou subtypes. Results: Although the distribution of molecular subtypes differed in women with high vs low MD, this was statistically non-significant (P=0.249), and further analyses revealed no association between the MD and Sorlie–Perou subtypes as a whole, nor with individual subtypes. Conclusion: These findings suggest that although MD is one of the strongest risk factors for breast cancer, it does not seem to be differentially associated with breast cancer molecular subtypes. However, larger studies with more comprehensive covariate information are needed to confirm these results.
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Affiliation(s)
- L Eriksson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, Stockholm 171 77, Sweden.
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Sandberg ME, Hartman M, Eloranta S, Ploner A, Hall P, Czene K. An epidemiologic study of the effect of adjuvant radiotherapy on 2D tumor characteristics and prognosis of contralateral breast cancer (CBC). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Dahlström LA, Ylitalo N, Ploner A, Andersson S, Rohan T, Dillner J, Adami H. P1137 Human papillomavirus infection and risk of in situ and invasive cervical adenocarcinoma. Int J Gynaecol Obstet 2009. [DOI: 10.1016/s0020-7292(09)62179-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Affiliation(s)
- J Smeds
- Department of Oncology and Pathology, Radiumhemmet, Karolinska Institute and University Hospital, Stockholm, Sweden
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Linderholm BK, Lehtio J, Ploner A, Pawitan Y, Skoog L, Lewensohn R. Protein profiles (proteomics) discriminating between relapses versus relapse-free survival after adjuvant tamoxifen in 272 patients with primary estrogen receptor (ER) and progesterone receptor (PgR) positive breast cancer. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.9615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- B. K. Linderholm
- Cancer Center Karolinska, Stockholm, Sweden; Karolinska Institute, Dept of Epidemiology & Biostatistics, Stockholm, Sweden; Karolinska Institute, Inst of Pathology & Cytology, Stockholm, Sweden
| | - J. Lehtio
- Cancer Center Karolinska, Stockholm, Sweden; Karolinska Institute, Dept of Epidemiology & Biostatistics, Stockholm, Sweden; Karolinska Institute, Inst of Pathology & Cytology, Stockholm, Sweden
| | - A. Ploner
- Cancer Center Karolinska, Stockholm, Sweden; Karolinska Institute, Dept of Epidemiology & Biostatistics, Stockholm, Sweden; Karolinska Institute, Inst of Pathology & Cytology, Stockholm, Sweden
| | - Y. Pawitan
- Cancer Center Karolinska, Stockholm, Sweden; Karolinska Institute, Dept of Epidemiology & Biostatistics, Stockholm, Sweden; Karolinska Institute, Inst of Pathology & Cytology, Stockholm, Sweden
| | - L. Skoog
- Cancer Center Karolinska, Stockholm, Sweden; Karolinska Institute, Dept of Epidemiology & Biostatistics, Stockholm, Sweden; Karolinska Institute, Inst of Pathology & Cytology, Stockholm, Sweden
| | - R. Lewensohn
- Cancer Center Karolinska, Stockholm, Sweden; Karolinska Institute, Dept of Epidemiology & Biostatistics, Stockholm, Sweden; Karolinska Institute, Inst of Pathology & Cytology, Stockholm, Sweden
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Marchionni M, Penna C, Ploner A, Farsi N, Campatelli C. [Pregnancy in women previously treated with conization of the uterine cervix]. Minerva Ginecol 1980; 32:27-30. [PMID: 7366885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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