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Michielsen L, Reinders MJT, Mahfouz A. Predicting cell population-specific gene expression from genomic sequence. Front Bioinform 2024; 4:1347276. [PMID: 38501113 PMCID: PMC10944912 DOI: 10.3389/fbinf.2024.1347276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 01/23/2024] [Indexed: 03/20/2024] Open
Abstract
Most regulatory elements, especially enhancer sequences, are cell population-specific. One could even argue that a distinct set of regulatory elements is what defines a cell population. However, discovering which non-coding regions of the DNA are essential in which context, and as a result, which genes are expressed, is a difficult task. Some computational models tackle this problem by predicting gene expression directly from the genomic sequence. These models are currently limited to predicting bulk measurements and mainly make tissue-specific predictions. Here, we present a model that leverages single-cell RNA-sequencing data to predict gene expression. We show that cell population-specific models outperform tissue-specific models, especially when the expression profile of a cell population and the corresponding tissue are dissimilar. Further, we show that our model can prioritize GWAS variants and learn motifs of transcription factor binding sites. We envision that our model can be useful for delineating cell population-specific regulatory elements.
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Affiliation(s)
- Lieke Michielsen
- Department of Human Genetics, Leiden University Medical Center, Leiden, Netherlands
- Leiden Computational Biology Center, Leiden University Medical Center, Leiden, Netherlands
- Delft Bioinformatics Lab, Delft University of Technology, Delft, Netherlands
| | - Marcel J. T. Reinders
- Department of Human Genetics, Leiden University Medical Center, Leiden, Netherlands
- Leiden Computational Biology Center, Leiden University Medical Center, Leiden, Netherlands
- Delft Bioinformatics Lab, Delft University of Technology, Delft, Netherlands
| | - Ahmed Mahfouz
- Department of Human Genetics, Leiden University Medical Center, Leiden, Netherlands
- Leiden Computational Biology Center, Leiden University Medical Center, Leiden, Netherlands
- Delft Bioinformatics Lab, Delft University of Technology, Delft, Netherlands
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2
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Berkhout JB, Poormoghadam D, Yi C, Kalsbeek A, Meijer OC, Mahfouz A. An integrated single-cell RNA-seq atlas of the mouse hypothalamic paraventricular nucleus links transcriptomic and functional types. J Neuroendocrinol 2024; 36:e13367. [PMID: 38281730 DOI: 10.1111/jne.13367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 11/30/2023] [Accepted: 12/30/2023] [Indexed: 01/30/2024]
Abstract
The hypothalamic paraventricular nucleus (PVN) is a highly complex brain region that is crucial for homeostatic regulation through neuroendocrine signaling, outflow of the autonomic nervous system, and projections to other brain areas. In the past years, single-cell datasets of the hypothalamus have contributed immensely to the current understanding of the diverse hypothalamic cellular composition. While the PVN has been adequately classified functionally, its molecular classification is currently still insufficient. To address this, we created a detailed atlas of PVN transcriptomic cell types by integrating various PVN single-cell datasets into a recently published hypothalamus single-cell transcriptome atlas. Furthermore, we functionally profiled transcriptomic cell types, based on relevant literature, existing retrograde tracing data, and existing single-cell data of a PVN-projection target region. Finally, we validated our findings with immunofluorescent stainings. In our PVN atlas dataset, we identify the well-known different neuropeptide types, each composed of multiple novel subtypes. We identify Avp-Tac1, Avp-Th, Oxt-Foxp1, Crh-Nr3c1, and Trh-Nfib as the most important neuroendocrine subtypes based on markers described in literature. To characterize the preautonomic functional population, we integrated a single-cell retrograde tracing study of spinally projecting preautonomic neurons into our PVN atlas. We identify these (presympathetic) neurons to cocluster with the Adarb2+ clusters in our dataset. Further, we identify the expression of receptors for Crh, Oxt, Penk, Sst, and Trh in the dorsal motor nucleus of the vagus, a key region that the pre-parasympathetic PVN neurons project to. Finally, we identify Trh-Ucn3 and Brs3-Adarb2 as some centrally projecting populations. In conclusion, our study presents a detailed overview of the transcriptomic cell types of the murine PVN and provides a first attempt to resolve functionality for the identified populations.
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Affiliation(s)
- J B Berkhout
- Division of Endocrinology, Department of Medicine, Leiden University Medical Centre, Leiden, The Netherlands
- Department of Human Genetics, Leiden University Medical Centre, Leiden, The Netherlands
| | - D Poormoghadam
- Laboratory of Endocrinology, Department of Laboratory Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Netherlands Institute for Neuroscience, Amsterdam, The Netherlands
| | - C Yi
- Laboratory of Endocrinology, Department of Laboratory Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Department of Endocrinology and Metabolism, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - A Kalsbeek
- Laboratory of Endocrinology, Department of Laboratory Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Netherlands Institute for Neuroscience, Amsterdam, The Netherlands
- Department of Endocrinology and Metabolism, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - O C Meijer
- Division of Endocrinology, Department of Medicine, Leiden University Medical Centre, Leiden, The Netherlands
| | - A Mahfouz
- Department of Human Genetics, Leiden University Medical Centre, Leiden, The Netherlands
- Division of Pattern Recognition and Bioinformatics, Department of Intelligent Systems, Technical University Delft, Delft, The Netherlands
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Zheng D, Wondergem A, Kloet S, Willemsen I, Balog J, Tapscott SJ, Mahfouz A, van den Heuvel A, van der Maarel SM. snRNA-seq analysis in multinucleated myogenic FSHD cells identifies heterogeneous FSHD transcriptome signatures associated with embryonic-like program activation and oxidative stress-induced apoptosis. Hum Mol Genet 2024; 33:284-298. [PMID: 37934801 PMCID: PMC10800016 DOI: 10.1093/hmg/ddad186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 09/22/2023] [Accepted: 10/21/2023] [Indexed: 11/09/2023] Open
Abstract
The sporadic nature of DUX4 expression in FSHD muscle challenges comparative transcriptome analyses between FSHD and control samples. A variety of DUX4 and FSHD-associated transcriptional changes have been identified, but bulk RNA-seq strategies prohibit comprehensive analysis of their spatiotemporal relation, interdependence and role in the disease process. In this study, we used single-nucleus RNA-sequencing of nuclei isolated from patient- and control-derived multinucleated primary myotubes to investigate the cellular heterogeneity in FSHD. Taking advantage of the increased resolution in snRNA-sequencing of fully differentiated myotubes, two distinct populations of DUX4-affected nuclei could be defined by their transcriptional profiles. Our data provides insights into the differences between these two populations and suggests heterogeneity in two well-known FSHD-associated transcriptional aberrations: increased oxidative stress and inhibition of myogenic differentiation. Additionally, we provide evidence that DUX4-affected nuclei share transcriptome features with early embryonic cells beyond the well-described cleavage stage, progressing into the 8-cell and blastocyst stages. Altogether, our data suggests that the FSHD transcriptional profile is defined by a mixture of individual and sometimes mutually exclusive DUX4-induced responses and cellular state-dependent downstream effects.
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Affiliation(s)
- Dongxu Zheng
- Department of Human Genetics, Leiden University Medical Center, Einthovenweg 20, 2333 ZC, Leiden, The Netherlands
| | - Annelot Wondergem
- Department of Human Genetics, Leiden University Medical Center, Einthovenweg 20, 2333 ZC, Leiden, The Netherlands
| | - Susan Kloet
- Department of Human Genetics, Leiden University Medical Center, Einthovenweg 20, 2333 ZC, Leiden, The Netherlands
| | - Iris Willemsen
- Department of Human Genetics, Leiden University Medical Center, Einthovenweg 20, 2333 ZC, Leiden, The Netherlands
| | - Judit Balog
- Department of Human Genetics, Leiden University Medical Center, Einthovenweg 20, 2333 ZC, Leiden, The Netherlands
| | - Stephen J Tapscott
- Division of Human Biology, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, Seattle, WA 98109, USA
| | - Ahmed Mahfouz
- Department of Human Genetics, Leiden University Medical Center, Einthovenweg 20, 2333 ZC, Leiden, The Netherlands
- Delft Bioinformatics Lab, Delft University of Technology, Van Mourik Broekmanweg 2628 XE, Delft, The Netherlands
| | - Anita van den Heuvel
- Department of Human Genetics, Leiden University Medical Center, Einthovenweg 20, 2333 ZC, Leiden, The Netherlands
| | - Silvère M van der Maarel
- Department of Human Genetics, Leiden University Medical Center, Einthovenweg 20, 2333 ZC, Leiden, The Netherlands
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Shehadeh M, Rahhal A, Shunnar K, Ahmed AO, AlKhalaila O, Abdelghani M, Mahfouz A, Alyafei S, Arabi A. Percutaneous coronary intervention can be safely performed with left ventricular thrombus without increasing stroke risk: A 5-year retrospective review using real-world data. Int J Cardiol 2024; 395:131415. [PMID: 37802297 DOI: 10.1016/j.ijcard.2023.131415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 09/04/2023] [Accepted: 10/02/2023] [Indexed: 10/08/2023]
Abstract
INTRODUCTION Left ventricular thrombus (LVT) increases the risk of ischemic stroke. However, it remains uncertain if the percutaneous coronary intervention (PCI) in the confirmed LVT setting further augments the stroke risk. Therefore, in this study, we evaluated the risk of stroke among patients with LVT undergoing CAG +/- PCI. METHODS This retrospective observational cohort study included all the patients encountered with LVT from 1st of April 2015, to 31st of March 2020. The study population was divided into two groups: Longobardo et al. (2018) [1] patients with LVT who underwent CAG +/- PCI; Solheim et al. (2010) [2] patients with LVT who did not undergo CAG +/- PCI. The primary outcome evaluated was stroke during the index admission, and the secondary outcomes included in-hospital mortality, all-cause mortality, and stroke at 12 months post-discharge. Logistic regression was used to determine the risk of stroke associated with PCI among patients with LVT, and a p-value<0.05 indicated statistical significance. RESULTS Of the 210 patients included, 119 underwent CAG +/- PCI, while 91 patients did not undergo CAG +/- PCI. Most of the patients were Asian (67%), male (96%), with a mean age of 56 years. Ischemic cardiomyopathy was the primary etiology of LVT in both groups (96% in the CAG +/- PCI group and 80% in non CAG +/- PCI group). During the index admission, stroke among patients with LVT did not differ between the CAG +/- PCI and non CAG +/- PCI groups (5% versus 3.3%; odds ratio (OR) 1.6, 95% confidence interval (CI) 0.34-6.4, p = 0.539; adjusted OR 0.9, 95% CI 0.09-10.6, p = 0.968). Similarly, in-hospital mortality, all-cause mortality, and stroke at 12 months did not differ between the study groups. CONCLUSION Performing CAG +/- PCI among patients with LVT was not associated with an increased risk of stroke during admission or within 12 months in comparison to patients who did not undergo CAG +/- PCI, which may reassure cardiologists to perform CAG +/- PCI among patients with LVT safely.
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Affiliation(s)
- Mohanad Shehadeh
- Cardiology Department, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Alaa Rahhal
- Pharmacy Department, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Khaled Shunnar
- Cardiology Department, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.
| | - Ashraf Omer Ahmed
- Internal Medicine Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Osama AlKhalaila
- Cardiology Department, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Mohamed Abdelghani
- Cardiology Department, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Ahmed Mahfouz
- Pharmacy Department, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Sumaya Alyafei
- Pharmacy Department, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Abdulrahman Arabi
- Cardiology Department, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
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Nazar Z, Al Hail M, Al-Shaibi S, Hussain TA, Abdelkader NN, Pallivalapila A, Thomas B, Kassem WE, Hanssens Y, Mahfouz A, Ryan C, Stewart D. Investigating physicians' views on non-formulary prescribing: a qualitative study using the theoretical domains framework. Int J Clin Pharm 2023; 45:1424-1433. [PMID: 37454024 PMCID: PMC10682051 DOI: 10.1007/s11096-023-01616-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 06/16/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Well-designed and well-maintained drug formularies serve as a reliable resource to guide prescribing decisions; they are associated with improved medicine safety and increased efficiency, while also serving as a cost-effective tool to help manage and predict medicine expenditure. Multiple studies have investigated the inappropriate prescribing of non-formulary drugs (NFDs) with statistics indicating that up to 70% of NFD usage being inappropriate or not following the ascribed NFD policies. AIM To explore physicians' views and influences on their prescribing of non-formulary drugs. METHOD Data collection and analysis were underpinned using the Theoretical Domains Framework (TDF). Thirteen semi-structured interviews were conducted within Hamad Medical Corporation, the main provider of secondary and tertiary healthcare in Qatar, with physicians who had submitted a NFD request in the preceding 12 months. RESULTS Three overarching themes were identified: providing evidence-based care for individual patients; influences of others; and formulary management issues. Subthemes were mapped to specific TDF domains: environmental context and resources; social influences; professional role and identity; beliefs about consequences; goals; intentions. CONCLUSION The behavioral influences identified in this study can be mapped to behavior change strategies facilitating the development of an intervention to promote appropriate prescribing of NFDs with implications for medicine safety and healthcare efficiency.
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Affiliation(s)
- Zachariah Nazar
- College of Pharmacy, QU Health, Qatar University, Doha, Qatar.
| | - Moza Al Hail
- Women's Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Samaher Al-Shaibi
- Pharmacy department, Mohammed Al-Mana College for Medical Sciences, Dammam, Saudi Arabia
| | | | | | | | - Binny Thomas
- Women's Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Wessam El Kassem
- Women's Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Yolande Hanssens
- Women's Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
| | | | - Cristin Ryan
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin, Ireland
| | - Derek Stewart
- College of Pharmacy, QU Health, Qatar University, Doha, Qatar
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6
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Elsabeeny WY, Magdy M, Mohamed AE, Mahfouz A, Alaziz Wafy MA, Al-Demery A. Erector spinae plane block for perioperative analgesia in an adolescent patient undergoing major thoracic surgery with multiple rib resection: A case report. Rev Esp Anestesiol Reanim (Engl Ed) 2023; 70:596-601. [PMID: 37678456 DOI: 10.1016/j.redare.2022.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 06/28/2022] [Indexed: 09/09/2023]
Abstract
Pain following thoracotomy incisions, particularly involving multiple rib resections, can be devastating. We report our experience using erector spinae plane block with catheter placement for perioperative pain management in a 16 year old patient with Ewing sarcoma. The patient required major thoracic surgery involving resection of the 7th, 8th, 9th and 10th ribs and part of the diaphragm to remove the tumour, followed by mesh reconstruction. Ultrasound guided erector spinae plane block is a simple technique that can provide excellent static and dynamic pain control following major thoracic surgery in adolescents.
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Affiliation(s)
- W Y Elsabeeny
- Anestesia y manejo del dolor, Instituto Nacional del Cáncer, Universidad de El Cairo, El Cairo, Egypt.
| | - M Magdy
- Anestesia y manejo del dolor, Instituto Nacional del Cáncer, Universidad de El Cairo, El Cairo, Egypt
| | - A E Mohamed
- Anestesia y manejo del dolor, Instituto Nacional del Cáncer, Universidad de El Cairo, El Cairo, Egypt
| | - A Mahfouz
- Oncología Quirúrgica, Instituto Nacional del Cáncer, Universidad de El Cairo, El Cairo, Egypt
| | - M A Alaziz Wafy
- Oncología Quirúrgica, Instituto Nacional del Cáncer, Universidad de El Cairo, El Cairo, Egypt
| | - A Al-Demery
- Oncología Quirúrgica, Instituto Nacional del Cáncer, Universidad de El Cairo, El Cairo, Egypt
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Alalawneh M, Rachid O, Abdallah I, Mahfouz A, Elewa H, Danjuma MIM, Mohamed AE, Awaisu A. Trends in prescribing and outcomes in obese versus non-obese patients receiving rivaroxaban therapy: an observational study using real-world data. Eur J Clin Pharmacol 2023; 79:1675-1685. [PMID: 37816816 PMCID: PMC10663176 DOI: 10.1007/s00228-023-03572-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 09/17/2023] [Indexed: 10/12/2023]
Abstract
PURPOSE To investigate real-world prescribing trends and clinical outcomes based on body mass index (BMI) categorization in patients who received rivaroxaban therapy. METHODS This was a retrospective cohort study involving all patients who received rivaroxaban therapy across all Hamad Medical Corporation (HMC) hospitals from 2015 to 2020. RESULTS The number of patients initiated on rivaroxaban therapy significantly increased from 152 (3.3%) in 2015 to 1342 (28.9%) in 2020 (p <0.001). Within BMI categories, a similar increasing trend was observed in underweight, normal, and overweight patients, while from 2018 to 2020, there was a decreasing trend in rivaroxaban prescribing in all obese classes. The prevalence rate of all-cause mortality differed significantly between the BMI groups, with the highest mortality being among morbidly obese patients (BMI ≥ 40 kg/m2) (p< 0.001). On the other hand, no significant differences were found between the BMI groups in terms of bleeding, pulmonary embolism, deep vein thrombosis and stroke incidences. Multivariate logistic regression analyses showed that the likelihood of all-cause mortality was significantly higher in overweight and all categories of obese patients compared to underweight patients: overweight (OR: 5.3, 95% CI: 2.3-11.9, p< 0.001); obese class 1 (OR: 5.4, 95% CI: 2.3 - 12.2, p< 0.001); obese class 2 (OR: 6.5, 95% CI: 2.7 - 15.6, p< 0.001); and obese class 3 (OR: 3.7, 95% CI: 1.6 - 8.7, p = 0.003). CONCLUSIONS Rivaroxaban prescribing has significantly increased over the years across general population, with a noticeable decline in obese population during the last few years (from 2018 onwards). Furthermore, an appreciable association was evident between all-cause mortality and BMI of these patients.
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Affiliation(s)
- Majdoleen Alalawneh
- College of Pharmacy, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Ousama Rachid
- College of Pharmacy, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Ibtihal Abdallah
- Clinical Pharmacy Services, Hamad General Hospital, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar
| | - Ahmed Mahfouz
- Pharmacy Department, Heart Hospital, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar
| | - Hazem Elewa
- College of Pharmacy, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Mohammed Ibn-Mas'ud Danjuma
- Department of Internal Medicine, Hamad General Hospital, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar
- College of Medicine, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Asmaa Ezzeldin Mohamed
- Clinical Pharmacy Services, Hamad General Hospital, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar
| | - Ahmed Awaisu
- College of Pharmacy, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar.
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Eltager M, Abdelaal T, Charrout M, Mahfouz A, Reinders MJT, Makrodimitris S. Benchmarking variational AutoEncoders on cancer transcriptomics data. PLoS One 2023; 18:e0292126. [PMID: 37796856 PMCID: PMC10553230 DOI: 10.1371/journal.pone.0292126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 09/13/2023] [Indexed: 10/07/2023] Open
Abstract
Deep generative models, such as variational autoencoders (VAE), have gained increasing attention in computational biology due to their ability to capture complex data manifolds which subsequently can be used to achieve better performance in downstream tasks, such as cancer type prediction or subtyping of cancer. However, these models are difficult to train due to the large number of hyperparameters that need to be tuned. To get a better understanding of the importance of the different hyperparameters, we examined six different VAE models when trained on TCGA transcriptomics data and evaluated on the downstream tasks of cluster agreement with cancer subtypes and survival analysis. We studied the effect of the latent space dimensionality, learning rate, optimizer, initialization and activation function on the quality of subsequent downstream tasks on the TCGA samples. We found β-TCVAE and DIP-VAE to have a good performance, on average, despite being more sensitive to hyperparameters selection. Based on these experiments, we derived recommendations for selecting the different hyperparameters settings. To ensure generalization, we tested all hyperparameter configurations on the GTEx dataset. We found a significant correlation (ρ = 0.7) between the hyperparameter effects on clustering performance in the TCGA and GTEx datasets. This highlights the robustness and generalizability of our recommendations. In addition, we examined whether the learned latent spaces capture biologically relevant information. Hereto, we measured the correlation and mutual information of the different representations with various data characteristics such as gender, age, days to metastasis, immune infiltration, and mutation signatures. We found that for all models the latent factors, in general, do not uniquely correlate with one of the data characteristics nor capture separable information in the latent factors even for models specifically designed for disentanglement.
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Affiliation(s)
- Mostafa Eltager
- Delft Bioinformatics Lab, Delft University of Technology, Delft, The Netherlands
| | - Tamim Abdelaal
- Delft Bioinformatics Lab, Delft University of Technology, Delft, The Netherlands
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Mohammed Charrout
- Delft Bioinformatics Lab, Delft University of Technology, Delft, The Netherlands
| | - Ahmed Mahfouz
- Delft Bioinformatics Lab, Delft University of Technology, Delft, The Netherlands
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
- Leiden Computational Biology Center, Leiden University Medical Center, Leiden, The Netherlands
| | - Marcel J. T. Reinders
- Delft Bioinformatics Lab, Delft University of Technology, Delft, The Netherlands
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
- Leiden Computational Biology Center, Leiden University Medical Center, Leiden, The Netherlands
| | - Stavros Makrodimitris
- Delft Bioinformatics Lab, Delft University of Technology, Delft, The Netherlands
- Department of Medical Oncology, Erasmus Medical Center, Rotterdam, The Netherlands
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9
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Michielsen L, Lotfollahi M, Strobl D, Sikkema L, Reinders MT, Theis F, Mahfouz A. Single-cell reference mapping to construct and extend cell-type hierarchies. NAR Genom Bioinform 2023; 5:lqad070. [PMID: 37502708 PMCID: PMC10370450 DOI: 10.1093/nargab/lqad070] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 07/10/2023] [Indexed: 07/29/2023] Open
Abstract
Single-cell genomics is now producing an ever-increasing amount of datasets that, when integrated, could provide large-scale reference atlases of tissue in health and disease. Such large-scale atlases increase the scale and generalizability of analyses and enable combining knowledge generated by individual studies. Specifically, individual studies often differ regarding cell annotation terminology and depth, with different groups specializing in different cell type compartments, often using distinct terminology. Understanding how these distinct sets of annotations are related and complement each other would mark a major step towards a consensus-based cell-type annotation reflecting the latest knowledge in the field. Whereas recent computational techniques, referred to as 'reference mapping' methods, facilitate the usage and expansion of existing reference atlases by mapping new datasets (i.e. queries) onto an atlas; a systematic approach towards harmonizing dataset-specific cell-type terminology and annotation depth is still lacking. Here, we present 'treeArches', a framework to automatically build and extend reference atlases while enriching them with an updatable hierarchy of cell-type annotations across different datasets. We demonstrate various use cases for treeArches, from automatically resolving relations between reference and query cell types to identifying unseen cell types absent in the reference, such as disease-associated cell states. We envision treeArches enabling data-driven construction of consensus atlas-level cell-type hierarchies and facilitating efficient usage of reference atlases.
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Affiliation(s)
| | | | - Daniel Strobl
- Institute of Computational Biology, Helmholtz Zentrum München, Munich, Germany
- Institute of Clinical Chemistry and Pathobiochemistry, TUM School of Medicine, Technical University of Munich, 81675 Munich, Germany
| | - Lisa Sikkema
- Institute of Computational Biology, Helmholtz Zentrum München, Munich, Germany
- TUM School of Life Sciences Weihenstephan, Technical University of Munich, Germany
| | - Marcel J T Reinders
- Department of Human Genetics, Leiden University Medical Center, 2333ZC Leiden, The Netherlands
- Leiden Computational Biology Center, Leiden University Medical Center, 2333ZC Leiden, The Netherlands
- Delft Bioinformatics Lab, Delft University of Technology, 2628XE Delft, The Netherlands
| | - Fabian J Theis
- To whom correspondence should be addressed. Tel: +49 89 3187 43260;
| | - Ahmed Mahfouz
- Correspondence may also be addressed to Ahmed Mahfouz. Tel: +31 71 52 69513;
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10
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Heezen LGM, Abdelaal T, van Putten M, Aartsma-Rus A, Mahfouz A, Spitali P. Spatial transcriptomics reveal markers of histopathological changes in Duchenne muscular dystrophy mouse models. Nat Commun 2023; 14:4909. [PMID: 37582915 PMCID: PMC10427630 DOI: 10.1038/s41467-023-40555-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 08/02/2023] [Indexed: 08/17/2023] Open
Abstract
Duchenne muscular dystrophy is caused by mutations in the DMD gene, leading to lack of dystrophin. Chronic muscle damage eventually leads to histological alterations in skeletal muscles. The identification of genes and cell types driving tissue remodeling is a key step to developing effective therapies. Here we use spatial transcriptomics in two Duchenne muscular dystrophy mouse models differing in disease severity to identify gene expression signatures underlying skeletal muscle pathology and to directly link gene expression to muscle histology. We perform deconvolution analysis to identify cell types contributing to histological alterations. We show increased expression of specific genes in areas of muscle regeneration (Myl4, Sparc, Hspg2), fibrosis (Vim, Fn1, Thbs4) and calcification (Bgn, Ctsk, Spp1). These findings are confirmed by smFISH. Finally, we use differentiation dynamic analysis in the D2-mdx muscle to identify muscle fibers in the present state that are predicted to become affected in the future state.
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Affiliation(s)
- L G M Heezen
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - T Abdelaal
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
- Systems and Biomedical Engineering Department, Faculty of Engineering Cairo University, Giza, Egypt
- Delft Bioinformatics Lab, Delft University of Technology, Delft, The Netherlands
| | - M van Putten
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - A Aartsma-Rus
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - A Mahfouz
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
- Delft Bioinformatics Lab, Delft University of Technology, Delft, The Netherlands
- Leiden Computational Biology Center, Leiden University Medical Center, Leiden, The Netherlands
| | - P Spitali
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands.
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11
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Al‐Sharshani D, Velayutham D, Samara M, Gazal R, Al Haj Zen A, Ismail MA, Ahmed M, Nasrallah G, Younes S, Rizk N, Hammuda S, Qoronfleh MW, Farrell T, Zayed H, Abdulrouf PV, AlDweik M, Silang JPB, Rahhal A, Al‐Jurf R, Mahfouz A, Salam A, Al Rifai H, Al‐Dewik NI. Association of single nucleotide polymorphisms with dyslipidemia and risk of metabolic disorders in the State of Qatar. Mol Genet Genomic Med 2023; 11:e2178. [PMID: 37147786 PMCID: PMC10422074 DOI: 10.1002/mgg3.2178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 03/10/2023] [Accepted: 03/15/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND Dyslipidemia is recognized as one of the risk factors of cardiovascular diseases (CVDs), type 2 diabetes mellitus (T2DM), and non-alcoholic fatty liver disease (NAFLD). OBJECTIVE The study aimed to investigate the association between selected single nucleotide polymorphisms (SNPs) with dyslipidemia and increased susceptibility risks of CVD, NAFLD, and/or T2DM in dyslipidemia patients in comparison with healthy control individuals from the Qatar genome project. METHODS A community-based cross-sectional study was conducted among 2933 adults (859 dyslipidemia patients and 2074 healthy control individuals) from April to December 2021 to investigate the association between 331 selected SNPs with dyslipidemia and increased susceptibility risks of CVD, NAFLD and/or T2DM, and covariates. RESULTS The genotypic frequencies of six SNPs were found to be significantly different in dyslipidemia patients subjects compared to the control group among males and females. In males, three SNPs were found to be significant, the rs11172113 in over-dominant model, the rs646776 in recessive and over-dominant models, and the rs1111875 in dominant model. On the other hand, two SNPs were found to be significant in females, including rs2954029 in recessive model, and rs1801251 in dominant and recessive models. The rs17514846 SNP was found for dominant and over-dominant models among males and only the dominant model for females. We found that the six SNPs linked to gender type had an influence in relation to disease susceptibility. When controlling for the four covariates (gender, obesity, hypertension, and diabetes), the difference between dyslipidemia and the control group remained significant for the six variants. Finally, males were three times more likely to have dyslipidemia in comparison with females, hypertension was two times more likely to be present in the dyslipidemia group, and diabetes was six times more likely to be in the dyslipidemia group. CONCLUSION The current investigation provides evidence of association for a common SNP to coronary heart disease and suggests a sex-dependent effect and encourage potential therapeutic applications.
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Affiliation(s)
- Dalal Al‐Sharshani
- Heart Hospital (HH)Hamad Medical Corporation (HMC)DohaQatar
- Genomics and Precision Medicine (GPM), College of Health & Life Science (CHLS)Hamad Bin Khalifa University (HBKU)DohaQatar
| | - Dinesh Velayutham
- Liberal Arts and Science (LAS)Hamad Bin Khalifa University (HBKU)DohaQatar
| | - Muthanna Samara
- Department of PsychologyKingston University LondonKingston upon ThamesLondonUK
| | - Reham Gazal
- Department of Research, Women's Wellness and Research Center (WWRC)Hamad Medical Corporation (HMC)DohaQatar
| | - Ayman Al Haj Zen
- College of Health & Life Science (CHLS)Hamad Bin Khalifa University (HBKU)DohaQatar
| | | | - Mahmoud Ahmed
- Department of Mathematics, Statistics and Physics, College of Arts and SciencesQatar University (QU)DohaQatar
| | - Gheyath Nasrallah
- Department of Biomedical Science, College of Health Sciences, Member of QU HealthQatar University (QU)DohaQatar
| | - Salma Younes
- Department of Biomedical Science, College of Health Sciences, Member of QU HealthQatar University (QU)DohaQatar
| | - Nasser Rizk
- Department of Biomedical Science, College of Health Sciences, Member of QU HealthQatar University (QU)DohaQatar
| | - Sara Hammuda
- Department of PsychologyKingston University LondonKingston upon ThamesLondonUK
| | - M. Walid Qoronfleh
- Research & Policy DivisionQ3CG Research Institute (QRI)7227 Rachel DriveYpsilantiMichiganUSA
- 21HealthStreet CompanyLondonUK
| | - Thomas Farrell
- Department of Research, Women's Wellness and Research Center (WWRC)Hamad Medical Corporation (HMC)DohaQatar
| | - Hatem Zayed
- Department of Biomedical Science, College of Health Sciences, Member of QU HealthQatar University (QU)DohaQatar
| | - Palli Valapila Abdulrouf
- Department of Research, Women's Wellness and Research Center (WWRC)Hamad Medical Corporation (HMC)DohaQatar
| | - Manar AlDweik
- Department of Research, Women's Wellness and Research Center (WWRC)Hamad Medical Corporation (HMC)DohaQatar
| | - John Paul Ben Silang
- Department of Research, Women's Wellness and Research Center (WWRC)Hamad Medical Corporation (HMC)DohaQatar
| | - Alaa Rahhal
- Heart Hospital (HH)Hamad Medical Corporation (HMC)DohaQatar
| | - Rana Al‐Jurf
- Department of Biomedical Science, College of Health Sciences, Member of QU HealthQatar University (QU)DohaQatar
| | - Ahmed Mahfouz
- Heart Hospital (HH)Hamad Medical Corporation (HMC)DohaQatar
| | - Amar Salam
- Department of Cardiology, Al Khor Hospital (AKH)Hamad Medical Corporation (HMC)DohaQatar
| | - Hilal Al Rifai
- Neonatal Intensive Care Unit (NICU), Newborn Screening Unit, Department of Pediatrics and Neonatology, Women's Wellness and Research Center (WWRC)Hamad Medical Corporation (HMC)DohaQatar
| | - Nader I. Al‐Dewik
- Genomics and Precision Medicine (GPM), College of Health & Life Science (CHLS)Hamad Bin Khalifa University (HBKU)DohaQatar
- Department of Research, Women's Wellness and Research Center (WWRC)Hamad Medical Corporation (HMC)DohaQatar
- Hamad Medical Corporation (HMC)DohaQatar
- Neonatal Intensive Care Unit (NICU), Newborn Screening Unit, Department of Pediatrics and Neonatology, Women's Wellness and Research Center (WWRC)Hamad Medical Corporation (HMC)DohaQatar
- Faculty of Health and Social Care Sciences, Kingston UniversitySt. George's University of LondonLondonUK
- Translational and Precision Medicine Research, Women's Wellness and Research Center (WWRC)Hamad Medical Corporation (HMC)DohaQatar
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12
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Biharie K, Michielsen L, Reinders MJT, Mahfouz A. Cell type matching across species using protein embeddings and transfer learning. Bioinformatics 2023; 39:i404-i412. [PMID: 37387141 DOI: 10.1093/bioinformatics/btad248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023] Open
Abstract
MOTIVATION Knowing the relation between cell types is crucial for translating experimental results from mice to humans. Establishing cell type matches, however, is hindered by the biological differences between the species. A substantial amount of evolutionary information between genes that could be used to align the species is discarded by most of the current methods since they only use one-to-one orthologous genes. Some methods try to retain the information by explicitly including the relation between genes, however, not without caveats. RESULTS In this work, we present a model to transfer and align cell types in cross-species analysis (TACTiCS). First, TACTiCS uses a natural language processing model to match genes using their protein sequences. Next, TACTiCS employs a neural network to classify cell types within a species. Afterward, TACTiCS uses transfer learning to propagate cell type labels between species. We applied TACTiCS on scRNA-seq data of the primary motor cortex of human, mouse, and marmoset. Our model can accurately match and align cell types on these datasets. Moreover, our model outperforms Seurat and the state-of-the-art method SAMap. Finally, we show that our gene matching method results in better cell type matches than BLAST in our model. AVAILABILITY AND IMPLEMENTATION The implementation is available on GitHub (https://github.com/kbiharie/TACTiCS). The preprocessed datasets and trained models can be downloaded from Zenodo (https://doi.org/10.5281/zenodo.7582460).
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Affiliation(s)
- Kirti Biharie
- Delft Bioinformatics Lab, Delft University of Technology, Delft 2628XE, The Netherlands
- Department of Human Genetics, Leiden University Medical Center, Leiden 2333ZC, The Netherlands
- Leiden Computational Biology Center, Leiden University Medical Center, Leiden 2333ZC, The Netherlands
| | - Lieke Michielsen
- Delft Bioinformatics Lab, Delft University of Technology, Delft 2628XE, The Netherlands
- Department of Human Genetics, Leiden University Medical Center, Leiden 2333ZC, The Netherlands
- Leiden Computational Biology Center, Leiden University Medical Center, Leiden 2333ZC, The Netherlands
| | - Marcel J T Reinders
- Delft Bioinformatics Lab, Delft University of Technology, Delft 2628XE, The Netherlands
- Department of Human Genetics, Leiden University Medical Center, Leiden 2333ZC, The Netherlands
- Leiden Computational Biology Center, Leiden University Medical Center, Leiden 2333ZC, The Netherlands
| | - Ahmed Mahfouz
- Delft Bioinformatics Lab, Delft University of Technology, Delft 2628XE, The Netherlands
- Department of Human Genetics, Leiden University Medical Center, Leiden 2333ZC, The Netherlands
- Leiden Computational Biology Center, Leiden University Medical Center, Leiden 2333ZC, The Netherlands
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13
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Novella-Rausell C, Grudniewska M, Peters DJ, Mahfouz A. A comprehensive mouse kidney atlas enables rare cell population characterization and robust marker discovery. iScience 2023; 26:106877. [PMID: 37275529 PMCID: PMC10238935 DOI: 10.1016/j.isci.2023.106877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 03/24/2023] [Accepted: 05/10/2023] [Indexed: 06/07/2023] Open
Abstract
The kidney's cellular diversity is on par with its physiological intricacy; yet identifying cell populations and their markers remains challenging. Here, we created a comprehensive atlas of the healthy adult mouse kidney (MKA: Mouse Kidney Atlas) by integrating 140.000 cells and nuclei from 59 publicly available single-cell and single-nuclei RNA-sequencing datasets from eight independent studies. To harmonize annotations across datasets, we built a hierarchical model of the cell populations. Our model allows the incorporation of novel cell populations and the refinement of known profiles as more datasets become available. Using MKA and the learned model of cellular hierarchies, we predicted previously missing cell annotations from several studies. The MKA allowed us to identify reproducible markers across studies for poorly understood cell types and transitional states, which we verified using existing data from micro-dissected samples and spatial transcriptomics.
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Affiliation(s)
- Claudio Novella-Rausell
- Department of Human Genetics, Leiden University Medical Centre, 2333 ZA Leiden, the Netherlands
- GenomeScan, 2333 BZ Leiden, the Netherlands
| | | | - Dorien J.M. Peters
- Department of Human Genetics, Leiden University Medical Centre, 2333 ZA Leiden, the Netherlands
| | - Ahmed Mahfouz
- Department of Human Genetics, Leiden University Medical Centre, 2333 ZA Leiden, the Netherlands
- Leiden Computational Biology Center, Leiden University Medical Center, Leiden, the Netherlands
- Delft Bioinformatics Lab, Delft University of Technology, Delft, the Netherlands
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14
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Al-Badriyeh D, Kaddoura R, AlMaraghi F, Homosy A, Hail MA, El-Kassem W, Rouf PVA, Fadul A, Mahfouz A, Alyafei SA, Abushanab D. Impact of clinical pharmacist interventions on economic outcomes in a cardiology setting in Qatar. Curr Probl Cardiol 2023:101838. [PMID: 37244514 DOI: 10.1016/j.cpcardiol.2023.101838] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 05/19/2023] [Accepted: 05/22/2023] [Indexed: 05/29/2023]
Abstract
We sought to investigate the economic impact of preventing adverse events in a cardiology setting in Qatar as an effect of the clinical pharmacist as an intervention. This is a retrospective study of interventions by clinical pharmacists within an adult cardiology setting in a public healthcare setting (i.e Hamad Medical Corporation). The study included interventions that took place in March 2018, July 15, 2018-August 15, 2018, and January 2019. The economic impact was measured via calculating the total benefit, defined as the sum of the cost savings and the cost avoidance. Sensitivity analyses were adopted to confirm the robustness of the results. The pharmacist intervened in 262 patients, resulting in 845 interventions, with appropriate therapy (58.6%) and dosing/administration (30.2%) being the most frequent categories of reported interventions. Cost savings and cost avoidance resulted in QAR-11,536 (USD-3,169) and QAR1,607,484 (USD 441,616), respectively, yielding a total benefit of QAR1,595,948 (USD438,447) per three months and QAR6,383,792 (USD1,753,789) per a year.
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Affiliation(s)
| | - Rasha Kaddoura
- Department of Pharmacy, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Fatima AlMaraghi
- Department of Pharmacy, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Ahmed Homosy
- Department of Pharmacy, Al-Wakra Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Moza Al Hail
- Department of Pharmacy, Hamad Bin Khalifa Medical City, Hamad Medical Corporation, Doha, Qatar
| | - Wessam El-Kassem
- Department of Pharmacy, Hamad Bin Khalifa Medical City, Hamad Medical Corporation, Doha, Qatar
| | | | - Abdalla Fadul
- Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Ahmed Mahfouz
- Department of Pharmacy, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | | | - Dina Abushanab
- Department of Pharmacy, Hamad Bin Khalifa Medical City, Hamad Medical Corporation, Doha, Qatar.
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15
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Bouland GA, Marinus KI, van Kesteren RE, Smit AB, Mahfouz A, Reinders MJT. Single-cell RNA sequencing data reveals rewiring of transcriptional relationships in Alzheimer's Disease associated with risk variants. medRxiv 2023:2023.05.15.23289992. [PMID: 37292975 PMCID: PMC10246028 DOI: 10.1101/2023.05.15.23289992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Understanding how genetic risk variants contribute to Alzheimer's Disease etiology remains a challenge. Single-cell RNA sequencing (scRNAseq) allows for the investigation of cell type specific effects of genomic risk loci on gene expression. Using seven scRNAseq datasets totalling >1.3 million cells, we investigated differential correlation of genes between healthy individuals and individuals diagnosed with Alzheimer's Disease. Using the number of differential correlations of a gene to estimate its involvement and potential impact, we present a prioritization scheme for identifying probable causal genes near genomic risk loci. Besides prioritizing genes, our approach pin-points specific cell types and provides insight into the rewiring of gene-gene relationships associated with Alzheimer's.
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Affiliation(s)
- Gerard A Bouland
- Delft Bioinformatics Lab, Delft University of Technology, Delft, The Netherlands
- Department of Human Genetics, Leiden University Medical Center, Leiden 2333ZC, The Netherlands
| | - Kevin I Marinus
- Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ronald E van Kesteren
- Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - August B Smit
- Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ahmed Mahfouz
- Delft Bioinformatics Lab, Delft University of Technology, Delft, The Netherlands
- Department of Human Genetics, Leiden University Medical Center, Leiden 2333ZC, The Netherlands
- Leiden Computational Biology Center, Leiden University Medical Center, Leiden 2333ZC, The Netherlands
| | - Marcel J T Reinders
- Delft Bioinformatics Lab, Delft University of Technology, Delft, The Netherlands
- Department of Human Genetics, Leiden University Medical Center, Leiden 2333ZC, The Netherlands
- Leiden Computational Biology Center, Leiden University Medical Center, Leiden 2333ZC, The Netherlands
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16
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Bouland GA, Mahfouz A, Reinders MJT. Consequences and opportunities arising due to sparser single-cell RNA-seq datasets. Genome Biol 2023; 24:86. [PMID: 37085823 PMCID: PMC10120229 DOI: 10.1186/s13059-023-02933-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 04/10/2023] [Indexed: 04/23/2023] Open
Abstract
With the number of cells measured in single-cell RNA sequencing (scRNA-seq) datasets increasing exponentially and concurrent increased sparsity due to more zero counts being measured for many genes, we demonstrate here that downstream analyses on binary-based gene expression give similar results as count-based analyses. Moreover, a binary representation scales up to ~ 50-fold more cells that can be analyzed using the same computational resources. We also highlight the possibilities provided by binarized scRNA-seq data. Development of specialized tools for bit-aware implementations of downstream analytical tasks will enable a more fine-grained resolution of biological heterogeneity.
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Affiliation(s)
- Gerard A Bouland
- Delft Bioinformatics Lab, Delft University of Technology, Delft, The Netherlands
- Department of Human Genetics, Leiden University Medical Center, Leiden, 2333ZC, The Netherlands
| | - Ahmed Mahfouz
- Delft Bioinformatics Lab, Delft University of Technology, Delft, The Netherlands.
- Department of Human Genetics, Leiden University Medical Center, Leiden, 2333ZC, The Netherlands.
- Leiden Computational Biology Center, Leiden University Medical Center, Leiden, 2333ZC, The Netherlands.
| | - Marcel J T Reinders
- Delft Bioinformatics Lab, Delft University of Technology, Delft, The Netherlands.
- Department of Human Genetics, Leiden University Medical Center, Leiden, 2333ZC, The Netherlands.
- Leiden Computational Biology Center, Leiden University Medical Center, Leiden, 2333ZC, The Netherlands.
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17
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Rahhal A, khir F, Sawaf B, Mahfouz A, Alyafei S, Arabi A. TICAGRELOR VERSUS CLOPIDOGREL POST FIBRINOLYSIS IN ST-ELEVATION MYOCARDIAL INFARCTION: A SYSTEMATIC REVIEW AND META-ANALYSIS. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)01744-8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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18
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Habets PC, Kalafatakis K, Dzyubachyk O, van der Werff SJ, Keo A, Thakrar J, Mahfouz A, Pereira AM, Russell GM, Lightman SL, Meijer OC. Transcriptional and cell type profiles of cortical brain regions showing ultradian cortisol rhythm dependent responses to emotional face stimulation. Neurobiol Stress 2023; 22:100514. [PMID: 36660181 PMCID: PMC9842700 DOI: 10.1016/j.ynstr.2023.100514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 01/02/2023] [Accepted: 01/02/2023] [Indexed: 01/05/2023] Open
Abstract
The characteristic endogenous circadian rhythm of plasma glucocorticoid concentrations is made up from an underlying ultradian pulsatile secretory pattern. Recent evidence has indicated that this ultradian cortisol pulsatility is crucial for normal emotional response in man. In this study, we investigate the anatomical transcriptional and cell type signature of brain regions sensitive to a loss of ultradian rhythmicity in the context of emotional processing. We combine human cell type and transcriptomic atlas data of high spatial resolution with functional magnetic resonance imaging (fMRI) data. We show that the loss of cortisol ultradian rhythm alters emotional processing response in cortical brain areas that are characterized by transcriptional and cellular profiles of GABAergic function. We find that two previously identified key components of rapid non-genomic GC signaling - the ANXA1 gene and retrograde endocannabinoid signaling - show most significant differential expression (q = 3.99e-10) and enrichment (fold enrichment = 5.56, q = 9.09e-4). Our results further indicate that specific cell types, including a specific NPY-expressing GABAergic neuronal cell type, and specific G protein signaling cascades underly the cerebral effects of a loss of ultradian cortisol rhythm. Our results provide a biological mechanistic underpinning of our fMRI findings, indicating specific cell types and cascades as a target for manipulation in future experimental studies.
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Affiliation(s)
- Philippe C. Habets
- Leiden University Medical Center, Department of Medicine, Division of Endocrinology, 2300 RC Leiden, the Netherlands,Amsterdam University Medical Centre, Department of Psychiatry, Department of Anatomy and Neurosciences, 1081 HZ, Amsterdam, the Netherlands,Corresponding author. Leiden University Medical Center, Department of Medicine, Division of Endocrinology, 2300 RC Leiden, the Netherlands.
| | - Konstantinos Kalafatakis
- Henry Wellcome Laboratories of Integrative Neuroscience and Endocrinology, Bristol Medical School, University of Bristol, BS1 3NY, Bristol, United Kingdom,Institute of Health Science Education, Barts and the London School of Medicine & Dentistry, Queen Mary University of London Malta Campus, VCT 2520, Victoria Gozo, Malta
| | - Oleh Dzyubachyk
- Department of Radiology, Division of Medical Image Processing, Leiden University Medical Center, 2333 ZA, Leiden, the Netherlands,Leiden University Medical Center, Department of Cell and Chemical Biology, Section Electron Microscopy, 2300 RC, Leiden, the Netherlands
| | - Steven J.A. van der Werff
- Department of Psychiatry, Leiden University Medical Center LUMC, Leiden, the Netherlands,Leiden Institute for Brain and Cognition, Leiden, the Netherlands
| | - Arlin Keo
- Leiden Computational Biology Center, Leiden University Medical Center, Leiden, the Netherlands,Delft Bioinformatics Lab, Delft University of Technology, Delft, the Netherlands
| | - Jamini Thakrar
- Henry Wellcome Laboratories of Integrative Neuroscience and Endocrinology, Bristol Medical School, University of Bristol, BS1 3NY, Bristol, United Kingdom
| | - Ahmed Mahfouz
- Leiden Computational Biology Center, Leiden University Medical Center, Leiden, the Netherlands,Delft Bioinformatics Lab, Delft University of Technology, Delft, the Netherlands,Department of Human Genetics, Leiden University Medical Center, Leiden, the Netherlands
| | - Alberto M. Pereira
- Leiden University Medical Center, Department of Medicine, Division of Endocrinology, 2300 RC Leiden, the Netherlands,Department of Endocrinology & Metabolism, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Georgina M. Russell
- Henry Wellcome Laboratories of Integrative Neuroscience and Endocrinology, Bristol Medical School, University of Bristol, BS1 3NY, Bristol, United Kingdom
| | - Stafford L. Lightman
- Henry Wellcome Laboratories of Integrative Neuroscience and Endocrinology, Bristol Medical School, University of Bristol, BS1 3NY, Bristol, United Kingdom
| | - Onno C. Meijer
- Leiden University Medical Center, Department of Medicine, Division of Endocrinology, 2300 RC Leiden, the Netherlands,Leiden Institute for Brain and Cognition, Leiden, the Netherlands
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19
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Elbashir M, ElHajj MS, Rainkie D, Kheir N, Hamou F, Abdulrhim S, Mahfouz A, Alyafei S, Awaisu A. Evaluation of Health Literacy Levels and Associated Factors Among Patients with Acute Coronary Syndrome and Heart Failure in Qatar. Patient Prefer Adherence 2023; 17:89-105. [PMID: 36642998 PMCID: PMC9835006 DOI: 10.2147/ppa.s385246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 12/17/2022] [Indexed: 01/09/2023] Open
Abstract
PURPOSE To determine the prevalence of inadequate health literacy and its associated risk factors among patients with acute coronary syndrome (ACS) and/or heart failure (HF) in Qatar. PATIENTS AND METHODS This cross-sectional observational study was conducted among patients with ACS and/or HF attending the national Heart Hospital in Qatar. Health literacy was assessed using the abbreviated version of the Test of Functional Health Literacy in Adults (S-TOFHLA) and the Three-item Brief Health Literacy Screen (3-item BHLS). RESULTS Three hundred patients with ACS and/or HF, majority male (88%) and non-Qatari (94%), participated in the study. The median (IQR) age of the participants was 55 (11) years. The prevalence of inadequate to marginal health literacy ranged between 36% and 54%. There were statistically significant differences in health literacy level between patients based on their marital status (p=0.010), education (p≤0.001), ability to speak any of Arabic, English, Hindi, Urdu, Malayalam, or other languages (p-values ≤0.001 to 0.035), country of origin (p≤0.001), occupation (p≤0.001), and receiving information from a pharmacist (p=0.008), a physiotherapist (p≤0.001), or a nurse (p=0.004). CONCLUSION Inadequate health literacy is common among patients with ACS and/or HF. This study suggests a need for developing strategies to assist healthcare professionals in improving health literacy skills among patients with ACS and HF. A combination of interventions may be needed to improve patients' understanding of their disease and medications, and ultimately overall health outcomes.
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Affiliation(s)
- Marwa Elbashir
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
- Pharmacy Department, Airport Health Center, Primary Health Care Corporation, Doha, Qatar
| | - Maguy Saffouh ElHajj
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Daniel Rainkie
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Nadir Kheir
- College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
| | - Fatima Hamou
- Pharmacy Department, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Sara Abdulrhim
- Pharmacy Department, Aspetar Orthopedic and Sports Medicine Hospital, Doha, Qatar
| | - Ahmed Mahfouz
- Pharmacy Department, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Sumaya Alyafei
- Pharmacy Department, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Ahmed Awaisu
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
- Correspondence: Ahmed Awaisu, Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar, Tel +974 4403 5596, Fax +974 4403 5551, Email
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20
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Mohamed SSI, Qasim HM, Mahfouz A, Osman MA, Ahmed AOE, Al‐Azewi SH, Yassin MA, Fareed S. Chronic myelogenous leukemia presenting with Morel Lavallée lesion: A case report of a rare presentation. Clin Case Rep 2022; 10:e6807. [PMID: 36590661 PMCID: PMC9794922 DOI: 10.1002/ccr3.6807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 11/12/2022] [Accepted: 12/14/2022] [Indexed: 12/29/2022] Open
Abstract
Chronic myelogenous leukemia is a myeloproliferative neoplasm characterized by the BCR-ABL1 fusion gene and the development of the Philadelphia chromosome, which leads to an increase in granulocytes and bone marrow myeloid precursors in the blood, it can lead to many possible complications depending on the disease stage at the time of diagnosis. The Morel-Lavallée lesion (MLL) is a closed traumatic soft-tissue degloving injury, that results from the separation of the hypodermis from the underlying fascia, with resultant hemo-lymphatic fluid collection between the tissue layers. We report a case of a 48-year-old male patient, with no chronic illnesses, who presented with 2 weeks history of posterior chest wall pain and swelling. Initial investigation showed a white blood cell count of 364.4 × 103/μl. Bone marrow pathology report findings were consistent with chronic myeloid leukemia (CML), and the BCR-ABL test came positive. CT chest with contrast showed a large chest wall lesion, suggestive of a Morel-Lavallee lesion. Ultrasound-guided aspiration of the lesion yielded 20 mm of fluid from the thick hematoma. Histopathology of the fluid showed Necrotic debris with mixed inflammation. Patient's condition improved, and he was discharged on Dasatinib with follow-up in hematology and surgery clinics.
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Affiliation(s)
| | - Hana Mahmoud Qasim
- Division of Hematology, Oncology Department, National Center for Cancer and ResearchHamad Medical CorporationDohaQatar
| | - Ahmed Mahfouz
- Radiology DepartmentHamad Medical CorporationDohaQatar
| | - Maab A. Osman
- Internal Medicine DepartmentHamad Medical CorporationDohaQatar
| | | | - Safa H. Al‐Azewi
- Division of Hematology, Oncology Department, National Center for Cancer and ResearchHamad Medical CorporationDohaQatar
| | - Mohamad A. Yassin
- Division of Hematology, Oncology Department, National Center for Cancer and ResearchHamad Medical CorporationDohaQatar
| | - Shehab Fareed
- Division of Hematology, Oncology Department, National Center for Cancer and ResearchHamad Medical CorporationDohaQatar
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Schinkelshoek M, Mahfouz A, Huijbers M, Koning F, Fronczek R, Lammers G. Novel genes associated with hypocretin-producing neurons identified by gene expression profiling. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.441] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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22
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Wang G, Heijs B, Kostidis S, Rietjens RG, Koning M, Yuan L, Tiemeier GL, Mahfouz A, Dumas SJ, Giera M, Kers J, Chuva de Sousa Lopes SM, van den Berg CW, van den Berg BM, Rabelink TJ. Spatial dynamic metabolomics identifies metabolic cell fate trajectories in human kidney differentiation. Cell Stem Cell 2022; 29:1580-1593.e7. [DOI: 10.1016/j.stem.2022.10.008] [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] [Received: 08/18/2022] [Revised: 10/07/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022]
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Rahhal A, Mahfouz A, Khir F, Abdelghani M, Alkhalaila O, Aljundi A, Ashour A, Alahmad Y, Alyafei S, Arabi A. Impact of high-intensity statin therapy on glycemic control post-acute coronary syndrome using real-world data. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Statins use has been linked with increased risk of new onset diabetes and impaired glycemic control in the JUPITER trial and meta-analyses of randomized controlled trials. Nevertheless, the evidence is scarce in the real-world clinical settings, particularly among those receiving high-intensity statin post-acute coronary syndrome (ACS).
Methods
We conducted a retrospective observational study to determine the impact of statin use post-ACS on glycosylated hemoglobin (HbA1c) and the incidence of diabetes. The study included adults admitted with ACS between January 1, 2017 and December 31, 2018 and newly started on a high-intensity statin (rosuvastatin or atorvastatin). The outcomes assessed within 12 months of statin initiation were: (a) HbA1c before and after statin use among diabetic and non-diabetic patients; (b) incidence of diabetes. Paired sample t-test was used to compare HbA1c values pre and post statin use.
Results
Of the 1,253 patients included, 627 received rosuvastatin and 626 received atorvastatin following ACS. Most of the patients were Asian (77.3%), male (95.8%) with a median age of 51 years. The baseline HbA1c was 7.2±2.2% and 45% of the study population were diabetic at baseline. Among non-diabetic patients, statin use resulted in HbA1c increase from 5.7±0.7% to 6.0±0.8%, p<0.001, while among diabetic patients who were receiving treatment for diabetes, HbA1c decreased from 8.8±1.9% to 7.8±1.9%, p<0.001. New onset diabetes occurred in 41 (6%) of the non-diabetic patients, of whom 13 (1.9%) were receiving atorvastatin, while 28 (4.1%) were on rosuvastatin, p-value = 0.032. The use of both statins resulted in a significant increase of HbA1c among non-diabetic patients as demonstrated in Figure 1.
Conclusion
High intensity statin post-ACS was associated with increased HbA1c among non-diabetic patients. In particular, rosuvastatin significantly increased the new onset of diabetes compared to atorvastatin which might provide preference of atorvastatin use over rosuvastatin among non-diabetic patients post-acute coronary syndrome.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Rahhal
- Hamad Medical Corporation Heart Hospital , Doha , Qatar
| | - A Mahfouz
- Hamad Medical Corporation Heart Hospital , Doha , Qatar
| | - F Khir
- Hamad Medical Corporation , Doha , Qatar
| | - M Abdelghani
- Hamad Medical Corporation Heart Hospital , Doha , Qatar
| | - O Alkhalaila
- Hamad Medical Corporation Heart Hospital , Doha , Qatar
| | - A Aljundi
- Hamad Medical Corporation Heart Hospital , Doha , Qatar
| | - A Ashour
- Hamad Medical Corporation , Doha , Qatar
| | - Y Alahmad
- Hamad Medical Corporation Heart Hospital , Doha , Qatar
| | - S Alyafei
- Hamad Medical Corporation Heart Hospital , Doha , Qatar
| | - A Arabi
- Hamad Medical Corporation Heart Hospital , Doha , Qatar
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Rahhal A, Najim M, Aljundi AH, Mahfouz A, Alyafei SM, Awaisu A, Habib MB, Obeidat I, Faisal MM, Alanzi MA, Nair AP, Elhassan A, Al-Dushain A, Abdelmajid AA, Abdelgader AE, Moursi AMA, Alharafsheh AEN, Kamar MRA, Goravey W, Omar AS, Abukhattab M, Khatib MY, Mohamedali MG, AlMaslamani MAR, Alemadi S. Adding colchicine to tocilizumab in hospitalized patients with severe COVID-19 pneumonia: An open-label randomized controlled trial. Medicine (Baltimore) 2022; 101:e30618. [PMID: 36181009 PMCID: PMC9524530 DOI: 10.1097/md.0000000000030843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Colchicine acts upstream in the cytokines cascade by inhibiting the nod-like receptor protein 3 (NLRP3) inflammasome while interleukin 6 (IL-6) receptor antagonists, such as tocilizumab, block the end result of the cytokines cascade. Hence, adding colchicine to tocilizumab with the aim of blocking the early and end products of the cytokines cascade, might reduce the risk of developing cytokine storm. METHODS AND ANALYSIS We aim to conduct an open-label randomized controlled trial to evaluate the efficacy and safety of adding colchicine to tocilizumab among patients with severe COVID-19 pneumonia to reduce the rate of invasive mechanical ventilation and mortality. We will include patients with severe COVID-19 pneumonia who received tocilizumab according to our local guidelines. Enrolled patients will be then randomized in 1:1 to colchicine versus no colchicine. Patients will be followed up for 30 days. The primary outcome is the rate of invasive mechanical ventilation and will be determined using Cox proportional hazard model. DISCUSSION Given colchicine's ease of use, low cost, good safety profile, and having different anti-inflammatory mechanism of action than other IL-6 blockade, colchicine might serve as a potential anti-inflammatory agent among patients with severe COVID-19 pneumonia. This study will provide valuable insights on the use of colchicine in severe COVID-19 when added to IL-6 antagonists. ETHICS AND DISSEMINATION The Medical Research Center and Institutional Review Board at Hamad Medical Corporation in Qatar approved the study protocol (MRC-01-21-299). Results of the analysis will be submitted for publication in a peer-reviewed journal.
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Affiliation(s)
- Alaa Rahhal
- Pharmacy Department, Hamad Medical Corporation, Doha, Qatar
- *Correspondence: Alaa Rahhal, Heart Hospital, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar (e-mail: )
| | - Mostafa Najim
- Internal Medicine Department, Rochester Regional Health - Unity Hospital, NY, USA
| | | | - Ahmed Mahfouz
- Pharmacy Department, Hamad Medical Corporation, Doha, Qatar
| | | | - Ahmed Awaisu
- College of Pharmacy, Qatar University, Doha, Qatar
| | - Mhd, Baraa Habib
- Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar
| | - Ibrahim Obeidat
- Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar
| | | | | | | | - Areeg Elhassan
- Infectious Diseases Department, Hamad Medical Corporation, Doha, Qatar
| | | | | | | | | | | | | | - Wael Goravey
- Infectious Diseases Department, Hamad Medical Corporation, Doha, Qatar
| | - Amr Salah Omar
- Cardiothoracic Surgery/Cardiac Anaesthesia Department, Hamad Medical Corporation, Doha, Qatar
| | - Mohammed Abukhattab
- Cardiothoracic Surgery/Cardiac Anaesthesia Department, Hamad Medical Corporation, Doha, Qatar
| | | | | | | | - Samar Alemadi
- Rheumatology Department, Hamad Medical Corporation, Doha, Qatar
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Wang G, Heijs B, Kostidis S, Mahfouz A, Rietjens RGJ, Bijkerk R, Koudijs A, van der Pluijm LAK, van den Berg CW, Dumas SJ, Carmeliet P, Giera M, van den Berg BM, Rabelink TJ. Analyzing cell-type-specific dynamics of metabolism in kidney repair. Nat Metab 2022; 4:1109-1118. [PMID: 36008550 PMCID: PMC9499864 DOI: 10.1038/s42255-022-00615-8] [Citation(s) in RCA: 49] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 07/11/2022] [Indexed: 11/20/2022]
Abstract
A common drawback of metabolic analyses of complex biological samples is the inability to consider cell-to-cell heterogeneity in the context of an organ or tissue. To overcome this limitation, we present an advanced high-spatial-resolution metabolomics approach using matrix-assisted laser desorption/ionization mass spectrometry imaging (MALDI-MSI) combined with isotope tracing. This method allows mapping of cell-type-specific dynamic changes in central carbon metabolism in the context of a complex heterogeneous tissue architecture, such as the kidney. Combined with multiplexed immunofluorescence staining, this method can detect metabolic changes and nutrient partitioning in targeted cell types, as demonstrated in a bilateral renal ischemia-reperfusion injury (bIRI) experimental model. Our approach enables us to identify region-specific metabolic perturbations associated with the lesion and throughout recovery, including unexpected metabolic anomalies in cells with an apparently normal phenotype in the recovery phase. These findings may be relevant to an understanding of the homeostatic capacity of the kidney microenvironment. In sum, this method allows us to achieve resolution at the single-cell level in situ and hence to interpret cell-type-specific metabolic dynamics in the context of structure and metabolism of neighboring cells.
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Affiliation(s)
- Gangqi Wang
- Department of Internal Medicine (Nephrology) & Einthoven Laboratory of Vascular and Regenerative Medicine, Leiden University Medical Center, Leiden, the Netherlands
- The Novo Nordisk Foundation Center for Stem Cell Medicine (reNEW), Leiden University Medical Center, Leiden, the Netherlands
| | - Bram Heijs
- The Novo Nordisk Foundation Center for Stem Cell Medicine (reNEW), Leiden University Medical Center, Leiden, the Netherlands
- Center of Proteomics and Metabolomics, Leiden University Medical Center, Leiden, the Netherlands
| | - Sarantos Kostidis
- Center of Proteomics and Metabolomics, Leiden University Medical Center, Leiden, the Netherlands
| | - Ahmed Mahfouz
- Department of Human Genetics, Leiden University Medical Center, Leiden, the Netherlands
- Leiden Computational Biology Center, Leiden University Medical Center, Leiden, the Netherlands
- Delft Bioinformatics Lab, Delft University of Technology, Delft, the Netherlands
| | - Rosalie G J Rietjens
- Department of Internal Medicine (Nephrology) & Einthoven Laboratory of Vascular and Regenerative Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Roel Bijkerk
- Department of Internal Medicine (Nephrology) & Einthoven Laboratory of Vascular and Regenerative Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Angela Koudijs
- Department of Internal Medicine (Nephrology) & Einthoven Laboratory of Vascular and Regenerative Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Loïs A K van der Pluijm
- Department of Internal Medicine (Nephrology) & Einthoven Laboratory of Vascular and Regenerative Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Cathelijne W van den Berg
- Department of Internal Medicine (Nephrology) & Einthoven Laboratory of Vascular and Regenerative Medicine, Leiden University Medical Center, Leiden, the Netherlands
- The Novo Nordisk Foundation Center for Stem Cell Medicine (reNEW), Leiden University Medical Center, Leiden, the Netherlands
| | - Sébastien J Dumas
- Laboratory of Angiogenesis and Vascular Metabolism, Department of Oncology, KU Leuven and Center for Cancer Biology, VIB, Leuven, Belgium
| | - Peter Carmeliet
- Laboratory of Angiogenesis and Vascular Metabolism, Department of Oncology, KU Leuven and Center for Cancer Biology, VIB, Leuven, Belgium
- Laboratory of Angiogenesis and Vascular Heterogeneity, Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Martin Giera
- The Novo Nordisk Foundation Center for Stem Cell Medicine (reNEW), Leiden University Medical Center, Leiden, the Netherlands
- Center of Proteomics and Metabolomics, Leiden University Medical Center, Leiden, the Netherlands
| | - Bernard M van den Berg
- Department of Internal Medicine (Nephrology) & Einthoven Laboratory of Vascular and Regenerative Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Ton J Rabelink
- Department of Internal Medicine (Nephrology) & Einthoven Laboratory of Vascular and Regenerative Medicine, Leiden University Medical Center, Leiden, the Netherlands.
- The Novo Nordisk Foundation Center for Stem Cell Medicine (reNEW), Leiden University Medical Center, Leiden, the Netherlands.
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26
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Massouh Skorin R, Mahfouz A, Escovar la Riva P. Systematic review on active treatment for urinary fistula after partial nephrectomy. Actas Urol Esp 2022; 46:387-396. [PMID: 35780049 DOI: 10.1016/j.acuroe.2022.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 10/18/2021] [Accepted: 12/11/2021] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Urinary fistula is expected to become more frequent in urological practice as a result of expanding indication of partial nephrectomy given it's oncological results equivalent to those of radical nephrectomy but at a lower risk of progression to chronic kidney disease, lower cardiovascular morbidity, and overall mortality. OBJECTIVES Review and compare different techniques of contemporary active management for urinary fistula after partial nephrectomy. METHODS A systematic literature search on the MEDLINE database was conducted in March 2020, combining the terms: "urine leak", "urine leakage", "urinary leak" and "urinary fistula", with: "partial nephrectomy", "nephron sparing surgery" and "renal sparing surgery". This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Only articles related to active treatment were eligible. Abstracts in English and Spanish from the last two decades were screened. No restriction based on study design nor the length of follow-up. PRIMARY OUTCOMES 1) Leak resolution rate 2) Time course of leak resolution and 3) Number of interventions needed for resolution. RESULTS Multiple studies were found. There were no randomized controlled trials. Urinary fistula can be solved in many ways with active treatment, with a high success rate (97.5%), an average of 1.4 intervention-per-patients and a mean time for leak resolution of 11 days (median of 3 days). CONCLUSION There is a high risk of bias due to the study's methodology. There is a broad range of effective alternatives and various approaches to solve urinary fistula in an appropriate timing.
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Affiliation(s)
| | - A Mahfouz
- Hospital Clinico San Borja Arriaran, Santiago, Chile
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27
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van Unen V, Ouboter LF, Li N, Schreurs M, Abdelaal T, Kooy-Winkelaar Y, Beyrend G, Höllt T, Maljaars PWJ, Mearin ML, Mahfouz A, Witte AMC, Clemens CHM, Abraham S, Escher JC, Lelieveldt BPF, Pascutti MF, van der Meulen – de Jong AE, Koning F. Identification of a Disease-Associated Network of Intestinal Immune Cells in Treatment-Naive Inflammatory Bowel Disease. Front Immunol 2022; 13:893803. [PMID: 35812429 PMCID: PMC9260579 DOI: 10.3389/fimmu.2022.893803] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 05/11/2022] [Indexed: 12/21/2022] Open
Abstract
Chronic intestinal inflammation underlies inflammatory bowel disease (IBD). Previous studies indicated alterations in the cellular immune system; however, it has been challenging to interrogate the role of all immune cell subsets simultaneously. Therefore, we aimed to identify immune cell types associated with inflammation in IBD using high-dimensional mass cytometry. We analyzed 188 intestinal biopsies and paired blood samples of newly-diagnosed, treatment-naive patients (n=42) and controls (n=26) in two independent cohorts. We applied mass cytometry (36-antibody panel) to resolve single cells and analyzed the data with unbiased Hierarchical-SNE. In addition, imaging-mass cytometry (IMC) was performed to reveal the spatial distribution of the immune subsets in the tissue. We identified 44 distinct immune subsets. Correlation network analysis identified a network of inflammation-associated subsets, including HLA-DR+CD38+ EM CD4+ T cells, T regulatory-like cells, PD1+ EM CD8+ T cells, neutrophils, CD27+ TCRγδ cells and NK cells. All disease-associated subsets were validated in a second cohort. This network was abundant in a subset of patients, independent of IBD subtype, severity or intestinal location. Putative disease-associated CD4+ T cells were detectable in blood. Finally, imaging-mass cytometry revealed the spatial colocalization of neutrophils, memory CD4+ T cells and myeloid cells in the inflamed intestine. Our study indicates that a cellular network of both innate and adaptive immune cells colocalizes in inflamed biopsies from a subset of patients. These results contribute to dissecting disease heterogeneity and may guide the development of targeted therapeutics in IBD.
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Affiliation(s)
- Vincent van Unen
- Department of Immunology, Leiden University Medical Center, Leiden, Netherlands
- Institute for Immunity, Transplantation, and Infection, Stanford University School of Medicine, Stanford, CA, United States
| | - Laura F. Ouboter
- Department of Immunology, Leiden University Medical Center, Leiden, Netherlands
- Department of Gastroenterology, Leiden University Medical Center, Leiden, Netherlands
| | - Na Li
- Department of Immunology, Leiden University Medical Center, Leiden, Netherlands
| | - Mette Schreurs
- Department of Immunology, Leiden University Medical Center, Leiden, Netherlands
| | - Tamim Abdelaal
- Delft Bioinformatics Lab, Delft University of Technology, Delft, Netherlands
- Computer Graphics and Visualization, Delft University of Technology, Delft, Netherlands
| | | | - Guillaume Beyrend
- Department of Immunology, Leiden University Medical Center, Leiden, Netherlands
| | - Thomas Höllt
- Computer Graphics and Visualization, Delft University of Technology, Delft, Netherlands
- Department of Pediatrics, Leiden University Medical Center, Leiden, Netherlands
| | - P. W. Jeroen Maljaars
- Department of Gastroenterology, Leiden University Medical Center, Leiden, Netherlands
| | - M. Luisa Mearin
- Department of Human Genetics, Leiden University Medical Center, Leiden, Netherlands
| | - Ahmed Mahfouz
- Delft Bioinformatics Lab, Delft University of Technology, Delft, Netherlands
- Computer Graphics and Visualization, Delft University of Technology, Delft, Netherlands
- Leiden Computational Biology Center, Leiden University Medical Center, Leiden, Netherlands
| | - Anne M. C. Witte
- Department of Gastroenterology, Alrijne Hospital, Leiden, Netherlands
| | | | - Sunje Abraham
- Department of Gastroenterology, Alrijne Hospital, Leiden, Netherlands
| | - Johanna C. Escher
- Department of Pediatric Gastroenterology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Boudewijn P. F. Lelieveldt
- Pattern Recognition and Bioinformatics Group, Delft University of Technology, Delft, Netherlands
- Department of The Division of Imaging Processing (LKEB) Radiology, Leiden University Medical Center, Leiden, Netherlands
| | | | | | - Frits Koning
- Department of Immunology, Leiden University Medical Center, Leiden, Netherlands
- *Correspondence: Frits Koning,
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Baroudy GS, Othman F, Mahfouz A, Helmy S, Rafie I, AL Khulaifi AA. TCTAP C-123 Embolic Shower to Coronary and Cerebral Arteries From a Cardiac Myxoma. J Am Coll Cardiol 2022. [DOI: 10.1016/j.jacc.2022.03.255] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Ellatif SA, Abdel Razik ES, Abu-Serie MM, Mahfouz A, Shater AF, Saleh FM, Hassan MM, Alsanie WF, Altalhi A, Daigham GE, Mahfouz AY. Immunomodulatory Efficacy-Mediated Anti-HCV and Anti-HBV Potential of Kefir Grains; Unveiling the In Vitro Antibacterial, Antifungal, and Wound Healing Activities. Molecules 2022; 27:molecules27062016. [PMID: 35335377 PMCID: PMC8951848 DOI: 10.3390/molecules27062016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 03/15/2022] [Accepted: 03/16/2022] [Indexed: 11/23/2022]
Abstract
The utilization of fermented foods with health-promoting properties is becoming more popular around the world. Consequently, kefir, a fermented milk beverage made from kefir grains, was shown in numerous studies to be a probiotic product providing significant health benefits. Herein, we assessed the antibacterial and antifungal potential of kefir against a variety of pathogenic bacteria and fungi. This study also showed the effectiveness of kefir in healing wounds in human gastric epithelial cells (GES-1) by (80.78%) compared with control (55.75%) within 48 h. The quantitative polymerase chain reaction (qPCR) results of kefir-treated HCV- or HBV- infected cells found that 200 µg/mL of kefir can eliminate 92.36% of HCV and 75.71% of HBV relative to the untreated infected cells, whereas 800 µg/mL (the highest concentration) completely eradicated HCV and HBV. Moreover, the estimated IC50 values of kefir, at which HCV and HBV were eradicated by 50%, were 63.84 ± 5.81 µg/mL and 224.02 ± 14.36 µg/mL, correspondingly. Kefir can significantly suppress the elevation of TNF-α and upregulate IL-10 and INF-γ in both treated HCV- and HBV-infected cells. High-performance liquid chromatography (HPLC) and gas chromatography-mass spectrometry (GC-MS) analysis of kefir revealed the presence of numerous active metabolites which mainly contribute to the antimicrobial, antiviral, and immunomodulatory activities. This study demonstrated, for the first time, the anti-HBV efficacy of kefir while also illustrating the immunomodulatory impact in the treated HBV-infected cells. Accordingly, kefir represents a potent antiviral agent against both viral hepatitis C and B, as well as having antimicrobial and wound healing potential.
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Affiliation(s)
- Sawsan Abd Ellatif
- Bioprocess Development Department, Genetic Engineering and Biotechnology Research Institute (GEBRI), City for Scientific Research and Technology Applications, New Borg El-Arab, Alexandria 21934, Egypt;
| | - Elsayed S. Abdel Razik
- Plant Protection and Biomolecular Diagnosis Department, Arid Lands Cultivation Research Institute, City for Scientific Research and Technology Applications, New Borg El-Arab, Alexandria 21934, Egypt;
| | - Marwa M. Abu-Serie
- Medical Biotechnology Department, Genetic Engineering and Biotechnology Research Institute (GEBRI), City of Scientific Research and Technology Applications, New Borg El-Arab, Alexandria 21934, Egypt;
| | - Ahmed Mahfouz
- National Health Service Foundation Trust (NHS), Manchester University, Manchester M14 5RH, UK;
| | - Abdullah F. Shater
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk 71491, Saudi Arabia;
| | - Fayez M. Saleh
- Department of Medical Microbiology, Faculty of Medicine, University of Tabuk, Tabuk 71491, Saudi Arabia;
| | - Mohamed M. Hassan
- Department of Biology, College of Science, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia; (M.M.H.); (A.A.)
| | - Walaa F. Alsanie
- Department of Clinical Laboratory Sciences, The Faculty of Applied Medical Sciences, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia;
- Centre of Biomedical Sciences Research (CBSR), Deanship of Scientific Research, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| | - Abdullah Altalhi
- Department of Biology, College of Science, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia; (M.M.H.); (A.A.)
| | - Ghadir E. Daigham
- Botany and Microbiology Department, Faculty of Science, Al-Azhar University (Girls Branch), Cairo 11651, Egypt;
| | - Amira Y. Mahfouz
- Botany and Microbiology Department, Faculty of Science, Al-Azhar University (Girls Branch), Cairo 11651, Egypt;
- Correspondence:
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Rahhal A, Kasem M, Orabi B, Abuyousef S, Hamou F, Mahfouz A, Alyafei S, Hassan EA. IMPACT OF SACUBITRIL/VALSARTAN ON CLINICAL OUTCOMES IN HEART FAILURE USING REAL-WORLD DATA: A SYSTEMATIC REVIEW AND META-ANALYSIS. J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)01411-5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Eltager M, Abdelaal T, Mahfouz A, Reinders MJT. scMoC: single-cell multi-omics clustering. Bioinform Adv 2022; 2:vbac011. [PMID: 36699396 PMCID: PMC9710707 DOI: 10.1093/bioadv/vbac011] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 01/27/2022] [Accepted: 02/11/2022] [Indexed: 01/28/2023]
Abstract
Motivation Single-cell multi-omics assays simultaneously measure different molecular features from the same cell. A key question is how to benefit from the complementary data available and perform cross-modal clustering of cells. Results We propose Single-Cell Multi-omics Clustering (scMoC), an approach to identify cell clusters from data with comeasurements of scRNA-seq and scATAC-seq from the same cell. We overcome the high sparsity of the scATAC-seq data by using an imputation strategy that exploits the less-sparse scRNA-seq data available from the same cell. Subsequently, scMoC identifies clusters of cells by merging clusterings derived from both data domains individually. We tested scMoC on datasets generated using different protocols with variable data sparsity levels. We show that scMoC (i) is able to generate informative scATAC-seq data due to its RNA-guided imputation strategy and (ii) results in integrated clusters based on both RNA and ATAC information that are biologically meaningful either from the RNA or from the ATAC perspective. Availability and implementation The data used in this manuscript is publicly available, and we refer to the original manuscript for their description and availability. For convience sci-CAR data is available at NCBI GEO under the accession number of GSE117089. SNARE-seq data is available at NCBI GEO under the accession number of GSE126074. The 10X multiome data is available at the following link https://www.10xgenomics.com/resources/datasets/pbmc-from-a-healthy-donor-no-cell-sorting-3-k-1-standard-2-0-0. Supplementary information Supplementary data are available at Bioinformatics Advances online.
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Affiliation(s)
- Mostafa Eltager
- Delft Bioinformatics Lab, Delft University of Technology, Delft 2628XE, The Netherlands
| | - Tamim Abdelaal
- Delft Bioinformatics Lab, Delft University of Technology, Delft 2628XE, The Netherlands,Leiden Computational Biology Center, Leiden University Medical Center, Leiden 2333ZC, The Netherlands,Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, 2333ZC, The Netherlands
| | - Ahmed Mahfouz
- Delft Bioinformatics Lab, Delft University of Technology, Delft 2628XE, The Netherlands,Leiden Computational Biology Center, Leiden University Medical Center, Leiden 2333ZC, The Netherlands,Department of Human Genetics, Leiden University Medical Center, Leiden 2333ZC, The Netherlands
| | - Marcel J T Reinders
- Delft Bioinformatics Lab, Delft University of Technology, Delft 2628XE, The Netherlands,Leiden Computational Biology Center, Leiden University Medical Center, Leiden 2333ZC, The Netherlands,To whom correspondence should be addressed.
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Viho EMG, Buurstede JC, Berkhout JB, Mahfouz A, Meijer OC. Cell type specificity of glucocorticoid signaling in the adult mouse hippocampus. J Neuroendocrinol 2022; 34:e13072. [PMID: 34939259 PMCID: PMC9286676 DOI: 10.1111/jne.13072] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 10/14/2021] [Accepted: 11/18/2021] [Indexed: 12/14/2022]
Abstract
Glucocorticoid stress hormones are powerful modulators of brain function and can affect mood and cognitive processes. The hippocampus is a prominent glucocorticoid target and expresses both the glucocorticoid receptor (GR: Nr3c1) and the mineralocorticoid receptor (MR: Nr3c2). These nuclear steroid receptors act as ligand-dependent transcription factors. Transcriptional effects of glucocorticoids have often been deduced from bulk mRNA measurements or spatially informed individual gene expression. However, only sparse data exists allowing insights on glucocorticoid-driven gene transcription at the cell type level. Here, we used publicly available single-cell RNA sequencing data to assess the cell-type specificity of GR and MR signaling in the adult mouse hippocampus. The data confirmed that Nr3c1 and Nr3c2 expression differs across neuronal and non-neuronal cell populations. We analyzed co-expression with sex hormones receptors, transcriptional coregulators, and receptors for neurotransmitters and neuropeptides. Our results provide insights in the cellular basis of previous bulk mRNA results and allow the formulation of more defined hypotheses on the effects of glucocorticoids on hippocampal function.
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Affiliation(s)
- Eva M. G. Viho
- Division of EndocrinologyDepartment of MedicineLeiden University Medical CenterLeidenThe Netherlands
- Einthoven Laboratory for Experimental Vascular MedicineLeiden University Medical CenterLeidenThe Netherlands
| | - Jacobus C. Buurstede
- Division of EndocrinologyDepartment of MedicineLeiden University Medical CenterLeidenThe Netherlands
- Einthoven Laboratory for Experimental Vascular MedicineLeiden University Medical CenterLeidenThe Netherlands
| | - Jari B. Berkhout
- Division of EndocrinologyDepartment of MedicineLeiden University Medical CenterLeidenThe Netherlands
- Einthoven Laboratory for Experimental Vascular MedicineLeiden University Medical CenterLeidenThe Netherlands
- Department of Human GeneticsLeiden University Medical CenterLeidenThe Netherlands
| | - Ahmed Mahfouz
- Department of Human GeneticsLeiden University Medical CenterLeidenThe Netherlands
- Delft Bioinformatics LaboratoryDelft University of TechnologyDelftThe Netherlands
- Leiden Computational Biology CenterLeiden University Medical CenterLeidenThe Netherlands
| | - Onno C. Meijer
- Division of EndocrinologyDepartment of MedicineLeiden University Medical CenterLeidenThe Netherlands
- Einthoven Laboratory for Experimental Vascular MedicineLeiden University Medical CenterLeidenThe Netherlands
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33
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Morgana F, Opstelten R, Slot MC, Scott AM, van Lier RAW, Blom B, Mahfouz A, Amsen D. Single-Cell Transcriptomics Reveals Discrete Steps in Regulatory T Cell Development in the Human Thymus. J Immunol 2022; 208:384-395. [PMID: 34937744 DOI: 10.4049/jimmunol.2100506] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 11/05/2021] [Indexed: 12/13/2022]
Abstract
CD4+CD25+FOXP3+ regulatory T (Treg) cells control immunological tolerance. Treg cells are generated in the thymus (tTreg) or in the periphery. Their superior lineage fidelity makes tTregs the preferred cell type for adoptive cell therapy (ACT). How human tTreg cells develop is incompletely understood. By combining single-cell transcriptomics and flow cytometry, we in this study delineated three major Treg developmental stages in the human thymus. At the first stage, which we propose to name pre-Treg I, cells still express lineage-inappropriate genes and exhibit signs of TCR signaling, presumably reflecting recognition of self-antigen. The subsequent pre-Treg II stage is marked by the sharp appearance of transcription factor FOXO1 and features induction of KLF2 and CCR7, in apparent preparation for thymic exit. The pre-Treg II stage can further be refined based on the sequential acquisition of surface markers CD31 and GPA33. The expression of CD45RA, finally, completes the phenotype also found on mature recent thymic emigrant Treg cells. Remarkably, the thymus contains a substantial fraction of recirculating mature effector Treg cells, distinguishable by expression of inflammatory chemokine receptors and absence of CCR7. The developmental origin of these cells is unclear and warrants caution when using thymic tissue as a source of stable cells for ACT. We show that cells in the major developmental stages can be distinguished using the surface markers CD1a, CD27, CCR7, and CD39, allowing for their viable isolation. These insights help identify fully mature tTreg cells for ACT and can serve as a basis for further mechanistic studies into tTreg development.
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Affiliation(s)
- Florencia Morgana
- Department of Hematopoiesis, Sanquin Research, Amsterdam, the Netherlands.,Landsteiner Laboratory, Amsterdam UMC, University of Amsterdam, the Netherlands
| | - Rianne Opstelten
- Department of Hematopoiesis, Sanquin Research, Amsterdam, the Netherlands.,Landsteiner Laboratory, Amsterdam UMC, University of Amsterdam, the Netherlands
| | - Manon C Slot
- Department of Hematopoiesis, Sanquin Research, Amsterdam, the Netherlands.,Landsteiner Laboratory, Amsterdam UMC, University of Amsterdam, the Netherlands
| | - Andrew M Scott
- Tumor Targeting Laboratory, Olivia Newton-John Cancer Research Institute, Melbourne, Australia.,School of Cancer Medicine, La Trobe University, Melbourne, Australia
| | - René A W van Lier
- Department of Hematopoiesis, Sanquin Research, Amsterdam, the Netherlands.,Landsteiner Laboratory, Amsterdam UMC, University of Amsterdam, the Netherlands
| | - Bianca Blom
- Department of Experimental Immunology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Ahmed Mahfouz
- Department of Human Genetics, Leiden University Medical Center, Leiden, the Netherlands.,Delft Bioinformatics Lab, Delft University of Technology, Delft, the Netherlands; and
| | - Derk Amsen
- Department of Hematopoiesis, Sanquin Research, Amsterdam, the Netherlands; .,Landsteiner Laboratory, Amsterdam UMC, University of Amsterdam, the Netherlands.,Amsterdam Institute for Infection and Immunity, University of Amsterdam, Amsterdam, the Netherlands
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34
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Ferraro F, Fevga C, Bonifati V, Mandemakers W, Mahfouz A, Reinders M. Correcting Differential Gene Expression Analysis for Cyto-Architectural Alterations in Substantia Nigra of Parkinson's Disease Patients Reveals Known and Potential Novel Disease-Associated Genes and Pathways. Cells 2022; 11:cells11020198. [PMID: 35053314 PMCID: PMC8774027 DOI: 10.3390/cells11020198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 12/31/2021] [Accepted: 01/04/2022] [Indexed: 11/16/2022] Open
Abstract
Several studies have analyzed gene expression profiles in the substantia nigra to better understand the pathological mechanisms causing Parkinson’s disease (PD). However, the concordance between the identified gene signatures in these individual studies was generally low. This might have been caused by a change in cell type composition as loss of dopaminergic neurons in the substantia nigra pars compacta is a hallmark of PD. Through an extensive meta-analysis of nine previously published microarray studies, we demonstrated that a big proportion of the detected differentially expressed genes was indeed caused by cyto-architectural alterations due to the heterogeneity in the neurodegenerative stage and/or technical artefacts. After correcting for cell composition, we identified a common signature that deregulated the previously unreported ammonium transport, as well as known biological processes such as bioenergetic pathways, response to proteotoxic stress, and immune response. By integrating with protein interaction data, we shortlisted a set of key genes, such as LRRK2, PINK1, PRKN, and FBXO7, known to be related to PD, others with compelling evidence for their role in neurodegeneration, such as GSK3β, WWOX, and VPC, and novel potential players in the PD pathogenesis. Together, these data show the importance of accounting for cyto-architecture in these analyses and highlight the contribution of multiple cell types and novel processes to PD pathology, providing potential new targets for drug development.
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Affiliation(s)
- Federico Ferraro
- Erasmus MC, Department of Clinical Genetics, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands; (F.F.); (C.F.); (V.B.); (W.M.)
| | - Christina Fevga
- Erasmus MC, Department of Clinical Genetics, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands; (F.F.); (C.F.); (V.B.); (W.M.)
| | - Vincenzo Bonifati
- Erasmus MC, Department of Clinical Genetics, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands; (F.F.); (C.F.); (V.B.); (W.M.)
| | - Wim Mandemakers
- Erasmus MC, Department of Clinical Genetics, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands; (F.F.); (C.F.); (V.B.); (W.M.)
| | - Ahmed Mahfouz
- Delft Bioinformatics Labaratory, Delft University of Technology, 2628 XE Delft, The Netherlands;
- Leiden Computational Biology Center, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
- Department of Human Genetics, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Marcel Reinders
- Delft Bioinformatics Labaratory, Delft University of Technology, 2628 XE Delft, The Netherlands;
- Leiden Computational Biology Center, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
- Department of Human Genetics, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
- Section Molecular Epidemiology, Department of Biomedical Data Sciences, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
- Correspondence:
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35
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Mohammed N, Mousa T, Mahfouz A. Antithrombotic therapy after transcatheter aortic valve replacement. Heart Views 2022; 23:10-15. [PMID: 35757447 PMCID: PMC9231539 DOI: 10.4103/heartviews.heartviews_36_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 04/06/2022] [Indexed: 11/26/2022] Open
Abstract
Transcatheter aortic valve replacement (TAVR) is a treatment option for patients with asymptomatic severe aortic stenosis who are candidates for a bioprosthesis across the entire spectrum of risk. TAVR carries a risk for thrombotic and bleeding events, focusing on the importance of defining the optimal antithrombotic regimen. Patients undergoing TAVR are mostly elderly and have many comorbidities such as atrial fibrillation (AF) requiring oral anticoagulants (OACs) or coronary artery disease requiring antiplatelet agents. After TAVR among patients without baseline indications for OAC, recent data suggest dual-antiplatelet therapy is associated with an increased risk for bleeding events, particularly early postprocedure compared with single-antiplatelet therapy with aspirin. The risk of leaflet thrombosis in patients undergoing TAVR raised concern about the use of OAC in patients without an initial indication for anticoagulation therapy. Although it showed effectiveness in modulating thrombus formation at the valve level, the bleeding hazard has shown to be unacceptably high, and the net benefit of combining antiplatelet and OAC therapy is unproven. For patients with indications for the use of long-term OAC, such as those with AF, adding antiplatelet therapy increases bleeding events. A favorable effect of new OAC agents over Vitamin K antagonists is debatable. Overall, single-antiplatelet therapy and OAC appear to be reasonable strategies in patients without and with indications for concurrent anticoagulation, respectively. This article aims to review the available published studies and recommendations in the literature regarding the use of antithrombotic therapy post-TAVR.
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36
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Groen N, Leenders F, Mahfouz A, Munoz-Garcia A, Muraro MJ, de Graaf N, Rabelink TJ, Hoeben R, van Oudenaarden A, Zaldumbide A, Reinders MJT, de Koning EJP, Carlotti F. Single-Cell Transcriptomics Links Loss of Human Pancreatic β-Cell Identity to ER Stress. Cells 2021; 10:3585. [PMID: 34944092 PMCID: PMC8700697 DOI: 10.3390/cells10123585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 11/25/2021] [Accepted: 12/10/2021] [Indexed: 11/30/2022] Open
Abstract
The maintenance of pancreatic islet architecture is crucial for proper β-cell function. We previously reported that disruption of human islet integrity could result in altered β-cell identity. Here we combine β-cell lineage tracing and single-cell transcriptomics to investigate the mechanisms underlying this process in primary human islet cells. Using drug-induced ER stress and cytoskeleton modification models, we demonstrate that altering the islet structure triggers an unfolding protein response that causes the downregulation of β-cell maturity genes. Collectively, our findings illustrate the close relationship between endoplasmic reticulum homeostasis and β-cell phenotype, and strengthen the concept of altered β-cell identity as a mechanism underlying the loss of functional β-cell mass.
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Affiliation(s)
- Nathalie Groen
- Department of Internal Medicine, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (N.G.); (F.L.); (A.M.-G.); (N.d.G.); (T.J.R.); (E.J.P.d.K.)
| | - Floris Leenders
- Department of Internal Medicine, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (N.G.); (F.L.); (A.M.-G.); (N.d.G.); (T.J.R.); (E.J.P.d.K.)
| | - Ahmed Mahfouz
- Leiden Computational Biology Center, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (A.M.); (M.J.T.R.)
- Delft Bioinformatics Lab, Delft University of Technology, 2628 XE Delft, The Netherlands
- Department of Human Genetics, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Amadeo Munoz-Garcia
- Department of Internal Medicine, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (N.G.); (F.L.); (A.M.-G.); (N.d.G.); (T.J.R.); (E.J.P.d.K.)
| | - Mauro J. Muraro
- Hubrecht Institute, KNAW (Royal Netherlands Academy of Arts and Sciences), 3584 CT Utrecht, The Netherlands; (M.J.M.); (A.v.O.)
| | - Natascha de Graaf
- Department of Internal Medicine, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (N.G.); (F.L.); (A.M.-G.); (N.d.G.); (T.J.R.); (E.J.P.d.K.)
| | - Ton. J. Rabelink
- Department of Internal Medicine, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (N.G.); (F.L.); (A.M.-G.); (N.d.G.); (T.J.R.); (E.J.P.d.K.)
| | - Rob Hoeben
- Department of Cell and Chemical Biology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (R.H.); (A.Z.)
| | - Alexander van Oudenaarden
- Hubrecht Institute, KNAW (Royal Netherlands Academy of Arts and Sciences), 3584 CT Utrecht, The Netherlands; (M.J.M.); (A.v.O.)
- Molecular Cancer Research, University Medical Center Utrecht, 3584 CT Utrecht, The Netherlands
| | - Arnaud Zaldumbide
- Department of Cell and Chemical Biology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (R.H.); (A.Z.)
| | - Marcel J. T. Reinders
- Leiden Computational Biology Center, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (A.M.); (M.J.T.R.)
- Delft Bioinformatics Lab, Delft University of Technology, 2628 XE Delft, The Netherlands
- Department of Human Genetics, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Eelco J. P. de Koning
- Department of Internal Medicine, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (N.G.); (F.L.); (A.M.-G.); (N.d.G.); (T.J.R.); (E.J.P.d.K.)
- Hubrecht Institute, KNAW (Royal Netherlands Academy of Arts and Sciences), 3584 CT Utrecht, The Netherlands; (M.J.M.); (A.v.O.)
| | - Françoise Carlotti
- Department of Internal Medicine, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (N.G.); (F.L.); (A.M.-G.); (N.d.G.); (T.J.R.); (E.J.P.d.K.)
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Bouland GA, Mahfouz A, Reinders MJT. Differential analysis of binarized single-cell RNA sequencing data captures biological variation. NAR Genom Bioinform 2021; 3:lqab118. [PMID: 34988441 PMCID: PMC8693570 DOI: 10.1093/nargab/lqab118] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 11/04/2021] [Accepted: 12/03/2021] [Indexed: 12/11/2022] Open
Abstract
Single-cell RNA sequencing data is characterized by a large number of zero counts, yet there is growing evidence that these zeros reflect biological variation rather than technical artifacts. We propose to use binarized expression profiles to identify the effects of biological variation in single-cell RNA sequencing data. Using 16 publicly available and simulated datasets, we show that a binarized representation of single-cell expression data accurately represents biological variation and reveals the relative abundance of transcripts more robustly than counts.
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Affiliation(s)
- Gerard A Bouland
- Delft Bioinformatics Lab, Delft University of Technology, Delft 2628 XE, The Netherlands
| | - Ahmed Mahfouz
- Delft Bioinformatics Lab, Delft University of Technology, Delft 2628 XE, The Netherlands
| | - Marcel J T Reinders
- Delft Bioinformatics Lab, Delft University of Technology, Delft 2628 XE, The Netherlands
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Rahhal A, Omar AS, Aljundi A, Kasem M, Mahfouz A, Alyafei S. Successful use of intravenous B-blocker therapy in cardiogenic shock supported with venoarterial extracorporeal membrane oxygenation: A case series. Curr Probl Cardiol 2021; 47:101071. [PMID: 34838902 DOI: 10.1016/j.cpcardiol.2021.101071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 11/13/2021] [Accepted: 11/21/2021] [Indexed: 11/19/2022]
Abstract
Tachycardia in cardiogenic shock (CS) might reduce the cardiac output (CO) by decreasing the ventricular filling time. Nevertheless, heart rate (HR) control with agents that possess negative inotropy might decrease the CO. Therefore, controlling the tachycardia in the setting of CS remains controversial. We herein describe four cases of patients presenting with myocardial infarction complicated with CS that required rescue venoarterial extracorporeal membrane oxygenation (VA-ECMO) initiation. Tachycardia was present with HR ∼130-140 beats per minute after VA-ECMO initiation, and hence esmolol was infused continuously at a starting dose of 10-20 mcg/kg/min and titrated according to HR. With the use of esmolol to control the HR in the setting of CS supported with VA-ECMO, lactate cleared, and echocardiographic parameters improved, allowing the four cases to be successfully decannulated from ECMO. Our report indicates that short-acting beta-blocker could be safely used in the complex scenario of severe tachycardia while supported with VA-ECMO.
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Affiliation(s)
- Alaa Rahhal
- Department of Pharmacy, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.
| | - Amr Salah Omar
- Department of Cardiothoracic Surgery/Cardiac Anesthesia and Intensive Care, Heart Hospital, Hamad Medical Corporation, Doha, Qatar; Department of Critical Care Medicine, Beni Suef University, Egypt; Weill Cornell Medical College, Doha, Qatar
| | - Amer Aljundi
- Department of Pharmacy, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Mohamed Kasem
- Department of Pharmacy, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Ahmed Mahfouz
- Department of Pharmacy, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Sumaya Alyafei
- Department of Pharmacy, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
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Keo A, Dzyubachyk O, van der Grond J, van Hilten JJ, Reinders MJT, Mahfouz A. Transcriptomic Signatures Associated With Regional Cortical Thickness Changes in Parkinson's Disease. Front Neurosci 2021; 15:733501. [PMID: 34658772 PMCID: PMC8519261 DOI: 10.3389/fnins.2021.733501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 09/08/2021] [Indexed: 11/16/2022] Open
Abstract
Cortical atrophy is a common manifestation in Parkinson's disease (PD), particularly in advanced stages of the disease. To elucidate the molecular underpinnings of cortical thickness changes in PD, we performed an integrated analysis of brain-wide healthy transcriptomic data from the Allen Human Brain Atlas and patterns of cortical thickness based on T1-weighted anatomical MRI data of 149 PD patients and 369 controls. For this purpose, we used partial least squares regression to identify gene expression patterns correlated with cortical thickness changes. In addition, we identified gene expression patterns underlying the relationship between cortical thickness and clinical domains of PD. Our results show that genes whose expression in the healthy brain is associated with cortical thickness changes in PD are enriched in biological pathways related to sumoylation, regulation of mitotic cell cycle, mitochondrial translation, DNA damage responses, and ER-Golgi traffic. The associated pathways were highly related to each other and all belong to cellular maintenance mechanisms. The expression of genes within most pathways was negatively correlated with cortical thickness changes, showing higher expression in regions associated with decreased cortical thickness (atrophy). On the other hand, sumoylation pathways were positively correlated with cortical thickness changes, showing higher expression in regions with increased cortical thickness (hypertrophy). Our findings suggest that alterations in the balanced interplay of these mechanisms play a role in changes of cortical thickness in PD and possibly influence motor and cognitive functions.
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Affiliation(s)
- Arlin Keo
- Leiden Computational Biology Center, Leiden University Medical Center, Leiden, Netherlands
- Delft Bioinformatics Lab, Delft University of Technology, Delft, Netherlands
| | - Oleh Dzyubachyk
- Department of Radiology, Leiden University Medical Center, Leiden, Netherlands
| | | | | | - Marcel J. T. Reinders
- Leiden Computational Biology Center, Leiden University Medical Center, Leiden, Netherlands
- Delft Bioinformatics Lab, Delft University of Technology, Delft, Netherlands
- Department of Human Genetics, Leiden University Medical Center, Leiden, Netherlands
| | - Ahmed Mahfouz
- Leiden Computational Biology Center, Leiden University Medical Center, Leiden, Netherlands
- Delft Bioinformatics Lab, Delft University of Technology, Delft, Netherlands
- Department of Human Genetics, Leiden University Medical Center, Leiden, Netherlands
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Heezen L, Mahfouz A, Aartsma-Rus A, Spitali P. DMD - BIOMARKERS. Neuromuscul Disord 2021. [DOI: 10.1016/j.nmd.2021.07.179] [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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Bourgonje AR, Hu S, Spekhorst LM, Zhernakova DV, Vich Vila A, Li Y, Voskuil MD, van Berkel LA, Bley Folly B, Charrout M, Mahfouz A, Reinders MJT, van Heck JIP, Joosten LAB, Visschedijk MC, van Dullemen HM, Faber KN, Samsom JN, Festen EAM, Dijkstra G, Weersma RK. The Effect of Phenotype and Genotype on the Plasma Proteome in Patients with Inflammatory Bowel Disease. J Crohns Colitis 2021; 16:414-429. [PMID: 34491321 PMCID: PMC8919819 DOI: 10.1093/ecco-jcc/jjab157] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND AIMS Protein profiling in patients with inflammatory bowel diseases [IBD] for diagnostic and therapeutic purposes is underexplored. This study analysed the association between phenotype, genotype, and the plasma proteome in IBD. METHODS A total of 92 inflammation-related proteins were quantified in plasma of 1028 patients with IBD (567 Crohn's disease [CD]; 461 ulcerative colitis [UC]) and 148 healthy individuals to assess protein-phenotype associations. Corresponding whole-exome sequencing and global screening array data of 919 patients with IBD were included to analyse the effect of genetics on protein levels (protein quantitative trait loci [pQTL] analysis). Intestinal mucosal RNA sequencing and faecal metagenomic data were used for complementary analyses. RESULTS Thirty-two proteins were differentially abundant between IBD and healthy individuals, of which 22 proteins were independent of active inflammation; 69 proteins were associated with 15 demographic and clinical factors. Fibroblast growth factor-19 levels were decreased in CD patients with ileal disease or a history of ileocecal resection. Thirteen novel cis-pQTLs were identified and 10 replicated from previous studies. One trans-pQTL of the fucosyltransferase 2 [FUT2] gene [rs602662] and two independent cis-pQTLs of C-C motif chemokine 25 [CCL25] affected plasma CCL25 levels. Intestinal gene expression data revealed an overlapping cis-expression [e]QTL-variant [rs3745387] of the CCL25 gene. The FUT2 rs602662 trans-pQTL was associated with reduced abundances of faecal butyrate-producing bacteria. CONCLUSIONS This study shows that genotype and multiple disease phenotypes strongly associate with the plasma inflammatory proteome in IBD, and identifies disease-associated pathways that may help to improve disease management in the future.
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Affiliation(s)
| | | | | | - Daria V Zhernakova
- Department of Genetics, University Medical Center Groningen, Groningen, The Netherlands,Laboratory of Genomic Diversity, Center for Computer Technologies, ITMO University, St Petersburg, Russia
| | - Arnau Vich Vila
- Department of Gastroenterology and Hepatology, University Medical Center Groningen, Groningen, The Netherlands,Department of Genetics, University Medical Center Groningen, Groningen, The Netherlands
| | - Yanni Li
- Department of Gastroenterology and Hepatology, University Medical Center Groningen, Groningen, The Netherlands,Department of Genetics, University Medical Center Groningen, Groningen, The Netherlands
| | - Michiel D Voskuil
- Department of Gastroenterology and Hepatology, University Medical Center Groningen, Groningen, The Netherlands,Department of Genetics, University Medical Center Groningen, Groningen, The Netherlands
| | - Lisette A van Berkel
- Department of Pediatrics, Division of Gastroenterology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Brenda Bley Folly
- Department of Pediatrics, Division of Gastroenterology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Mohammed Charrout
- Delft Bioinformatics Lab, Delft University of Technology, Delft, The Netherlands,Leiden Computational Biology Center, Leiden University Medical Center, Leiden, The Netherlands
| | - Ahmed Mahfouz
- Delft Bioinformatics Lab, Delft University of Technology, Delft, The Netherlands,Leiden Computational Biology Center, Leiden University Medical Center, Leiden, The Netherlands,Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Marcel J T Reinders
- Delft Bioinformatics Lab, Delft University of Technology, Delft, The Netherlands,Leiden Computational Biology Center, Leiden University Medical Center, Leiden, The Netherlands
| | - Julia I P van Heck
- Department of Internal Medicine and Radboud Institute of Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Leo A B Joosten
- Department of Internal Medicine and Radboud Institute of Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marijn C Visschedijk
- Department of Gastroenterology and Hepatology, University Medical Center Groningen, Groningen, The Netherlands
| | - Hendrik M van Dullemen
- Department of Gastroenterology and Hepatology, University Medical Center Groningen, Groningen, The Netherlands
| | - Klaas Nico Faber
- Department of Gastroenterology and Hepatology, University Medical Center Groningen, Groningen, The Netherlands
| | - Janneke N Samsom
- Department of Pediatrics, Division of Gastroenterology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Eleonora A M Festen
- Department of Gastroenterology and Hepatology, University Medical Center Groningen, Groningen, The Netherlands,Department of Genetics, University Medical Center Groningen, Groningen, The Netherlands
| | - Gerard Dijkstra
- Department of Gastroenterology and Hepatology, University Medical Center Groningen, Groningen, The Netherlands
| | - Rinse K Weersma
- Corresponding author: Prof. Rinse K. Weersma, MD, PhD, Department of Gastroenterology and Hepatology, University of Groningen and University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands. Tel.: +31 50 361 26 20; fax: +31 50 361 93 06;
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Basha A, Ibrahim MIM, Hamad A, Chandra P, Omar NE, Abdullah MAJ, Aldapt MB, Hussein RM, Mahfouz A, Adel AA, Shwaylia HM, Ekeibed Y, AbuMousa R, Yassin MA. Efficacy and cost effectiveness of intravenous ferric carboxymaltose versus iron sucrose in adult patients with iron deficiency anaemia. PLoS One 2021; 16:e0255104. [PMID: 34375369 PMCID: PMC8354439 DOI: 10.1371/journal.pone.0255104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 07/10/2021] [Indexed: 11/18/2022] Open
Abstract
Background Iron deficiency anaemia (IDA) is a major health issues and common type of nutritional deficiency worldwide. For IDA treatment, intravenous (IV) iron is a useful therapy. Objective To determine the efficacy and cost-effectiveness (CE) of intravenous (IV) Ferric Carboxymaltose (FCM) versus IV Iron Sucrose (IS) in treating IDA. Data sources Electronic medical record i.e. Cerner® system. Target population Adults patients with iron deficiency anaemia. Time horizon A 12-month period (01/01/2018–31/12/2018). Perspective Hamad Medical Corporation (HMC, a public hospital). Intervention IV Ferric Carboxymaltose versus IV Iron Sucrose. Outcome measures With regard to responses to treatment i.e., efficacy of treatment with FCM & IS in IDA patients, hemoglobin (Hgb), ferritin, and transferrin saturation (TSAT) levels were the primary outcomes. Additionally, the researchers also collected levels of iron, platelet, white blood cell (WBC), red blood cell (RBC), mean corpuscular hemoglobin (MCH), and mean corpuscular volume (MCV). The costs i.e. resources consumed (obtained from NCCCR-HMC) and the CE of FCM versus IS were the secondary outcomes. Results of base-case analysis There was a significant improvement in Hgb, RBC and MCH levels in the IS group than the FCM group. The overall cost of IS therapy was significantly higher than FCM. The medication cost for FCM was approximately 6.5 times higher than IS, nonetheless, it is cheaper in terms of bed cost and nursing cost. The cost effectiveness (CE) ratio illustrated that FCM and IS were significantly different in terms of Hgb, ferritin and MCH levels. Further, Incremental Cost Effectiveness Ratio (ICER) indicated that further justifications and decisions need to be made for FCM when using Hgb, iron, TSAT, MCH and MCV levels as surrogate outcomes. Results of sensitivity analysis Not applicable. Limitations The study did not consider the clinical or humanistic outcome. Conclusions The higher cost of FCM versus IS can be offset by savings in healthcare personnel time and bed space. ICER indicated that further justifications and decisions need to be made for FCM when using Hgb, iron, TSAT, MCH and MCV levels as surrogate outcomes.
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Affiliation(s)
- Ahmad Basha
- National Center for Cancer Care and Research (NCCCR), Pharmacy Department, HMC, Doha, Qatar
- * E-mail:
| | | | - Anas Hamad
- National Center for Cancer Care and Research (NCCCR), Pharmacy Department, HMC, Doha, Qatar
| | - Prem Chandra
- National Center for Cancer Care and Research (NCCCR), Pharmacy Department, HMC, Doha, Qatar
| | - Nabil E. Omar
- National Center for Cancer Care and Research (NCCCR), Pharmacy Department, HMC, Doha, Qatar
| | | | - Mahmood B. Aldapt
- National Center for Cancer Care and Research, Hematology Department, HMC, Doha, Qatar
| | - Radwa M. Hussein
- National Center for Cancer Care and Research (NCCCR), Pharmacy Department, HMC, Doha, Qatar
| | - Ahmed Mahfouz
- Heart Hospital (HH), Pharmacy Department, HMC, Doha, Qatar
| | - Ahmad A. Adel
- National Center for Cancer Care and Research (NCCCR), Pharmacy Department, HMC, Doha, Qatar
| | - Hawraa M. Shwaylia
- National Center for Cancer Care and Research, Hematology Department, HMC, Doha, Qatar
| | - Yaslem Ekeibed
- National Center for Cancer Care and Research, Hematology Department, HMC, Doha, Qatar
| | - Rami AbuMousa
- National Center for Cancer Care and Research (NCCCR), Pharmacy Department, HMC, Doha, Qatar
| | - Mohamed A. Yassin
- National Center for Cancer Care and Research, Hematology Department, HMC, Doha, Qatar
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43
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Rahhal A, Khir F, Orabi B, Chbib S, Al-Khalaila O, Abdelghani MS, Osman O, Ashour AA, Al-Awad M, Mahfouz A, Awaisu A, Aljundi AH, Alahmad Y, Alyafei S, Arabi AR. A Comparative Study of High-intensity Rosuvastatin Versus Atorvastatin Therapy Post-acute Coronary Syndrome Using Real-world Data. Curr Probl Cardiol 2021; 47:100956. [PMID: 34363847 DOI: 10.1016/j.cpcardiol.2021.100956] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 07/30/2021] [Indexed: 11/03/2022]
Abstract
A high-intensity statin is recommended for the secondary prevention of cardiovascular diseases (CVD). However, real-world evidence of the effectiveness of rosuvastatin following acute coronary syndrome (ACS) is scarce. This retrospective cohort study included patients diagnosed with ACS to compare between the 2 high-intensity statin therapies (rosuvastatin vs atorvastatin) in terms of a primary composite outcome of CVD-associated death, non-fatal ACS, and non-fatal stroke at 1 month and 12 months post discharge. The primary effectiveness outcome did not differ between the 2 groups at 1 month (1.3% vs 1%; aHR = 1.64, 95% CI 0.55-4.94, P= 0.379) and at 12 months (4.8% vs 3.5%; aHR = 1.48, 95% CI 0.82-2.67, P= 0.199). Similarly, the 2 groups had comparable safety outcomes. In conclusion, the use of high-intensity rosuvastatin compared to high-intensity atorvastatin therapy in patients with ACS had resulted in comparable cardiovascular effectiveness and safety outcomes.
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Affiliation(s)
- Alaa Rahhal
- Heart Hospital, Hamad Medical Corporation, Doha, Qatar.
| | - Fadi Khir
- Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Bassant Orabi
- Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Salma Chbib
- Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | | | | | - Omnia Osman
- Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | | | | | - Ahmed Mahfouz
- Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Ahmed Awaisu
- College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | | | - Yaser Alahmad
- Heart Hospital, Hamad Medical Corporation, Doha, Qatar
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Vergoossen DLE, Keo A, Mahfouz A, Huijbers MG. Timing and localization of myasthenia gravis-related gene expression. Eur J Neurosci 2021; 54:5574-5585. [PMID: 34228850 PMCID: PMC8457065 DOI: 10.1111/ejn.15382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 06/01/2021] [Accepted: 07/01/2021] [Indexed: 11/29/2022]
Abstract
Myasthenia gravis (MG) is an acquired autoimmune disorder caused by autoantibodies binding acetylcholine receptors (AChR), muscle‐specific kinase (MuSK), agrin or low‐density lipoprotein receptor‐related protein 4 (Lrp4). These autoantibodies inhibit neuromuscular transmission by blocking the function of these proteins and thereby cause fluctuating skeletal muscle weakness. Several reports suggest that these autoantibodies might also affect the central nervous system (CNS) in MG patients. A comprehensive overview of the timing and localization of the expression of MG‐related antigens in other organs is currently lacking. To investigate the spatio‐temporal expression of MG‐related genes outside skeletal muscle, we used in silico tools to assess public expression databases. Acetylcholine esterase, nicotinic AChR α1 subunit, agrin, collagen Q, downstream of kinase‐7, Lrp4, MuSK and rapsyn were included as MG‐related genes because of their well‐known involvement in either congenital or autoimmune MG. We investigated expression of MG‐related genes in (1) all human tissues using GTEx data, (2) specific brain regions, (3) neurodevelopmental stages, and (4) cell types using datasets from the Allen Institute for Brain Sciences. MG‐related genes show heterogenous spatio‐temporal expression patterns in the human body as well as in the CNS. For each of these genes, several (new) tissues, brain areas and cortical cell types with (relatively) high expression were identified suggesting a potential role for these genes outside skeletal muscle. The possible presence of MG‐related antigens outside skeletal muscle suggests that autoimmune MG, congenital MG or treatments targeting the same proteins may affect MG‐related protein function in other organs.
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Affiliation(s)
- Dana L E Vergoossen
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Arlin Keo
- Leiden Computational Biology Center, Leiden University Medical Center, Leiden, The Netherlands.,Delft Bioinformatics Lab, Delft University of Technology, Delft, The Netherlands
| | - Ahmed Mahfouz
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands.,Leiden Computational Biology Center, Leiden University Medical Center, Leiden, The Netherlands.,Delft Bioinformatics Lab, Delft University of Technology, Delft, The Netherlands
| | - Maartje G Huijbers
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands.,Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
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45
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Coutinho de Almeida R, Mahfouz A, Mei H, Houtman E, den Hollander W, Soul J, Suchiman E, Lakenberg N, Meessen J, Huetink K, Nelissen RGHH, Ramos YFM, Reinders M, Meulenbelt I. Identification and characterization of two consistent osteoarthritis subtypes by transcriptome and clinical data integration. Rheumatology (Oxford) 2021; 60:1166-1175. [PMID: 32885253 PMCID: PMC7937023 DOI: 10.1093/rheumatology/keaa391] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 06/04/2020] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE To identify OA subtypes based on cartilage transcriptomic data in cartilage tissue and characterize their underlying pathophysiological processes and/or clinically relevant characteristics. METHODS This study includes n = 66 primary OA patients (41 knees and 25 hips), who underwent a joint replacement surgery, from which macroscopically unaffected (preserved, n = 56) and lesioned (n = 45) OA articular cartilage were collected [Research Arthritis and Articular Cartilage (RAAK) study]. Unsupervised hierarchical clustering analysis on preserved cartilage transcriptome followed by clinical data integration was performed. Protein-protein interaction (PPI) followed by pathway enrichment analysis were done for genes significant differentially expressed between subgroups with interactions in the PPI network. RESULTS Analysis of preserved samples (n = 56) resulted in two OA subtypes with n = 41 (cluster A) and n = 15 (cluster B) patients. The transcriptomic profile of cluster B cartilage, relative to cluster A (DE-AB genes) showed among others a pronounced upregulation of multiple genes involved in chemokine pathways. Nevertheless, upon investigating the OA pathophysiology in cluster B patients as reflected by differentially expressed genes between preserved and lesioned OA cartilage (DE-OA-B genes), the chemokine genes were significantly downregulated with OA pathophysiology. Upon integrating radiographic OA data, we showed that the OA phenotype among cluster B patients, relative to cluster A, may be characterized by higher joint space narrowing (JSN) scores and low osteophyte (OP) scores. CONCLUSION Based on whole-transcriptome profiling, we identified two robust OA subtypes characterized by unique OA, pathophysiological processes in cartilage as well as a clinical phenotype. We advocate that further characterization, confirmation and clinical data integration is a prerequisite to allow for development of treatments towards personalized care with concurrently more effective treatment response.
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Affiliation(s)
- Rodrigo Coutinho de Almeida
- Department of Biomedical Data Sciences, Section Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Ahmed Mahfouz
- Delft Bioinformatics Lab, Delft University of Technology, Delft, The Netherlands.,Leiden Computational Biology Center, Leiden, The Netherlands
| | - Hailiang Mei
- Sequence Analysis Support Core, Leiden University Medical Center, Leiden, The Netherlands
| | - Evelyn Houtman
- Department of Biomedical Data Sciences, Section Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Wouter den Hollander
- Department of Biomedical Data Sciences, Section Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jamie Soul
- Skeletal Research Group, Institute of Genetic Medicine, Newcastle University, Central Parkway, Newcastle upon Tyne, UK
| | - Eka Suchiman
- Department of Biomedical Data Sciences, Section Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Nico Lakenberg
- Department of Biomedical Data Sciences, Section Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jennifer Meessen
- Department of Biomedical Data Sciences, Section Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.,Department Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands
| | - Kasper Huetink
- Department Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands
| | - Rob G H H Nelissen
- Department Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands
| | - Yolande F M Ramos
- Department of Biomedical Data Sciences, Section Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Marcel Reinders
- Department of Biomedical Data Sciences, Section Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.,Delft Bioinformatics Lab, Delft University of Technology, Delft, The Netherlands.,Leiden Computational Biology Center, Leiden, The Netherlands
| | - Ingrid Meulenbelt
- Department of Biomedical Data Sciences, Section Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
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Abstract
Supervised methods are increasingly used to identify cell populations in single-cell data. Yet, current methods are limited in their ability to learn from multiple datasets simultaneously, are hampered by the annotation of datasets at different resolutions, and do not preserve annotations when retrained on new datasets. The latter point is especially important as researchers cannot rely on downstream analysis performed using earlier versions of the dataset. Here, we present scHPL, a hierarchical progressive learning method which allows continuous learning from single-cell data by leveraging the different resolutions of annotations across multiple datasets to learn and continuously update a classification tree. We evaluate the classification and tree learning performance using simulated as well as real datasets and show that scHPL can successfully learn known cellular hierarchies from multiple datasets while preserving the original annotations. scHPL is available at https://github.com/lcmmichielsen/scHPL .
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Affiliation(s)
- Lieke Michielsen
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
- Leiden Computational Biology Center, Leiden University Medical Center, Leiden, The Netherlands
- Delft Bioinformatics Lab, Delft University of Technology, Delft, The Netherlands
| | - Marcel J T Reinders
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
- Leiden Computational Biology Center, Leiden University Medical Center, Leiden, The Netherlands
- Delft Bioinformatics Lab, Delft University of Technology, Delft, The Netherlands
| | - Ahmed Mahfouz
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands.
- Leiden Computational Biology Center, Leiden University Medical Center, Leiden, The Netherlands.
- Delft Bioinformatics Lab, Delft University of Technology, Delft, The Netherlands.
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47
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Abstract
The power of single-cell RNA sequencing (scRNA-seq) in detecting cell heterogeneity or developmental process is becoming more and more evident every day. The granularity of this knowledge is further propelled when combining two batches of scRNA-seq into a single large dataset. This strategy is however hampered by technical differences between these batches. Typically, these batch effects are resolved by matching similar cells across the different batches. Current approaches, however, do not take into account that we can constrain this matching further as cells can also be matched on their cell type identity. We use an auto-encoder to embed two batches in the same space such that cells are matched. To accomplish this, we use a loss function that preserves: (1) cell-cell distances within each of the two batches, as well as (2) cell-cell distances between two batches when the cells are of the same cell-type. The cell-type guidance is unsupervised, i.e., a cell-type is defined as a cluster in the original batch. We evaluated the performance of our cluster-guided batch alignment (CBA) using pancreas and mouse cell atlas datasets, against six state-of-the-art single cell alignment methods: Seurat v3, BBKNN, Scanorama, Harmony, LIGER, and BERMUDA. Compared to other approaches, CBA preserves the cluster separation in the original datasets while still being able to align the two datasets. We confirm that this separation is biologically meaningful by identifying relevant differential expression of genes for these preserved clusters.
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Affiliation(s)
- Wenbo Yu
- Department of Control Science and Engineering, Harbin Institute of Technology, Harbin, China.,Delft Bioinformatics Lab, Delft University of Technology, Delft, Netherlands
| | - Ahmed Mahfouz
- Delft Bioinformatics Lab, Delft University of Technology, Delft, Netherlands.,Leiden Computational Biology Center, Leiden University Medical Center, Leiden, Netherlands.,Department of Human Genetics, Leiden University Medical Center, Leiden, Netherlands
| | - Marcel J T Reinders
- Delft Bioinformatics Lab, Delft University of Technology, Delft, Netherlands.,Leiden Computational Biology Center, Leiden University Medical Center, Leiden, Netherlands.,Department of Human Genetics, Leiden University Medical Center, Leiden, Netherlands
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48
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Keo A, Dzyubachyk O, van der Grond J, Hafkemeijer A, van de Berg WDJ, van Hilten JJ, Reinders MJT, Mahfouz A. Cingulate networks associated with gray matter loss in Parkinson's disease show high expression of cholinergic genes in the healthy brain. Eur J Neurosci 2021; 53:3727-3739. [PMID: 33792979 PMCID: PMC8251922 DOI: 10.1111/ejn.15216] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 03/16/2021] [Accepted: 03/21/2021] [Indexed: 12/25/2022]
Abstract
Structural covariance networks are able to identify functionally organized brain regions by gray matter volume covariance across a population. We examined the transcriptomic signature of such anatomical networks in the healthy brain using postmortem microarray data from the Allen Human Brain Atlas. A previous study revealed that a posterior cingulate network and anterior cingulate network showed decreased gray matter in brains of Parkinson's disease patients. Therefore, we examined these two anatomical networks to understand the underlying molecular processes that may be involved in Parkinson's disease. Whole brain transcriptomics from the healthy brain revealed upregulation of genes associated with serotonin, GPCR, GABA, glutamate, and RAS-signaling pathways. Our results also suggest involvement of the cholinergic circuit, in which genes NPPA, SOSTDC1, and TYRP1 may play a functional role. Finally, both networks were enriched for genes associated with neuropsychiatric disorders that overlap with Parkinson's disease symptoms. The identified genes and pathways contribute to healthy functions of the posterior and anterior cingulate networks and disruptions to these functions may in turn contribute to the pathological and clinical events observed in Parkinson's disease.
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Affiliation(s)
- Arlin Keo
- Leiden Computational Biology Center, Leiden University Medical Center, Leiden, The Netherlands.,Delft Bioinformatics Lab, Delft University of Technology, Delft, The Netherlands
| | - Oleh Dzyubachyk
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jeroen van der Grond
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Anne Hafkemeijer
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.,Department of Methodology and Statistics, Institute of Psychology, Leiden University, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
| | - Wilma D J van de Berg
- Department of Anatomy and Neurosciences, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
| | - Jacobus J van Hilten
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Marcel J T Reinders
- Leiden Computational Biology Center, Leiden University Medical Center, Leiden, The Netherlands.,Delft Bioinformatics Lab, Delft University of Technology, Delft, The Netherlands
| | - Ahmed Mahfouz
- Leiden Computational Biology Center, Leiden University Medical Center, Leiden, The Netherlands.,Delft Bioinformatics Lab, Delft University of Technology, Delft, The Netherlands.,Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
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49
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Eljilany I, Elewa H, Abdelsamad O, Abdelgelil M, Mahfouz A, Anany RA, Yafei SA, Al-Badriyeh D. Bridging vs Non-Bridging with Warfarin Peri-Procedural Management: Cost and Cost-Effectiveness Analyses. Curr Probl Cardiol 2021; 46:100839. [PMID: 34059316 DOI: 10.1016/j.cpcardiol.2021.100839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 03/08/2021] [Indexed: 10/21/2022]
Abstract
The warfarin peri-procedural management in Qatar is predominantly based on bridging (63%), compared to non-bridging. This study sought to perform a first-time cost analysis of current warfarin peri-procedural management practices, including a cost-effectiveness analysis (CEA) of predominant bridging vs predominant non-bridging practices. From the hospital perspective, a one-year decision-analytic model followed the cost and success consequences of the peri-procedural warfarin in a hypothetical cohort of 10,000 atrial fibrillation patients. Success was defined as survival with no adverse events. Outcome measures were the cost and success consequences of the 63% bridging (vs not-bridging) practice in the study setting, ie, Hamad Medical Corporation, Qatar, and the incremental cost-effectiveness ratio (ICER, cost/success) of the warfarin therapy when predominantly bridging based vs when predominantly non-bridging based. The model was based on Monte Carlo simulation, and sensitivity analyses were performed to confirm the robustness of the study conclusions. As per 63% bridging practices, the mean overall cost of peri-procedural warfarin management per patient was USD 3,260 (QAR 11,900), associated with an overall success rate of 0.752. Based on the CEA, predominant bridging was dominant (lower cost, higher effect) over the predominant non-bridging practice in 62.2% of simulated cases, with a cost-saving of up to USD 2,001 (QAR 7,303) at an average of USD 272 (QAR 993) and was cost-effective in 36.9% of cases. Being between cost-saving and cost-effective, compared to predominant non-bridging practices, the predominant use of bridging with warfarin seems to be a favorable strategy in atrial fibrillation patients.
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Affiliation(s)
- Islam Eljilany
- College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Hazem Elewa
- College of Pharmacy, QU Health, Qatar University, Doha, Qatar; Department of Pharmacy, Al Wakra Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Osama Abdelsamad
- Department of Pharmacy, Al Wakra Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Mohamed Abdelgelil
- Department of Pharmacy, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Ahmed Mahfouz
- Department of Pharmacy, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Rasha Al Anany
- Department of Pharmacy, Al Wakra Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Sumaya Al Yafei
- Department of Pharmacy, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
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Rahhal A, Mahfouz A, Al‐Amri M, Aljundi A, Khir F, Hamid Y, Alyafei S, Arabi AR. Impact of discharge education by clinical pharmacists on patients' adherence to post‐percutaneous coronary intervention medications: A retrospective cohort study using real‐world data. J Am Coll Clin Pharm 2021. [DOI: 10.1002/jac5.1369] [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: 11/08/2022]
Affiliation(s)
- Alaa Rahhal
- Pharmacy Department Heart Hospital, Hamad Medical Corporation Doha Qatar
| | - Ahmed Mahfouz
- Pharmacy Department Heart Hospital, Hamad Medical Corporation Doha Qatar
| | - Maha Al‐Amri
- Pharmacy Department Heart Hospital, Hamad Medical Corporation Doha Qatar
| | - Amer Aljundi
- Pharmacy Department Heart Hospital, Hamad Medical Corporation Doha Qatar
| | - Fadi Khir
- Internal Medicine Department Hamad General Hospital, Hamad Medical Corporation Doha Qatar
| | - Yousra Hamid
- Pharmacy Department Heart Hospital, Hamad Medical Corporation Doha Qatar
| | - Sumaya Alyafei
- Pharmacy Department Heart Hospital, Hamad Medical Corporation Doha Qatar
| | - Abdul Rahman Arabi
- Cardiology Department Heart Hospital, Hamad Medical Corporation Doha Qatar
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