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Hong C, Li H, Parel PM, Berg AR, Rodante J, Keel A, Teague HL, Playford MP, Chen MY, Zhou W, Sorokin AV, Bluemke DA, Mehta NN. Application of machine learning to identify top determinants of fibrofatty plaque burden by CCTA in humans with psoriasis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.213] [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: 11/12/2022] Open
Abstract
Abstract
Introduction
Fibrofatty plaque burden (FFB) is a high-risk, vulnerable plaque feature comprised of an atheromatous core and fibrous cap with increased risk of coronary artery disease (CAD) [1]. Psoriasis (PSO) is a chronic inflammatory disease linked with atherosclerotic risk and premature cardiovascular disease, driven in part by vulnerable plaque rupture [2,3]. Machine learning (ML) previously showed the prognostic value of FFB in predicting 5-year risk of cardiac-related mortality in patients with CAD [4]. Whether ML can predict FFB in psoriasis is understudied.
Purpose
To use ML to identify top determinants of FFB by CCTA in PSO.
Methods
320 consecutive participants with psoriasis were recruited as part of an ongoing cohort study, of whom 307 had FFB analyzed with coronary computed tomography angiography (CCTA) and quantified by QAngio CT (Medis, The Netherlands). 140 out of 182 potential determinants were subjected to ML algorithms analyzed by random forest and validated by 5-fold cross validation to select the top determinants based on R-square criteria. Lipid concentration and size were measured by nuclear magnetic resonance (NMR) and sdLDL-C was calculated by Sampson's formula.
Results
The top 21 determinants of FFB at baseline were grouped into 3 categories: cardiometabolic risk factors (BMI, sex, DBP, mean arterial pressure, exercise, heart rate, glucose, anxiety, psoriasis disease duration), clinical measurements (basophils, platelets, hemoglobin, RBC, alkaline phosphatase, ALT, creatinine, neutrophil-to-lymphocyte ratio), and lipoproteins (LDL particle size, apolipoprotein A1, apolipoprotein B-to-A1 ratio, calculated sdLDL-C).
Conclusion
ML confirmed that FFB strongly correlates with cardiometabolic risk factors, clinical measurements, and lipoproteins. Further investigations into these top determinants of FFB over time may provide insight into potential therapeutic interventions that decrease cardiovascular risk in patients with chronic inflammatory diseases and should be validated in larger studies.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): This study was supported by the National Heart, Lung and Blood Institute (NHLBI) IntramuralResearch Program (ZIA-HL-06193). This research was made possible through the NIH MedicalResearch Scholars Program, a public-private partnership supported jointly by the NIH andcontributions to the Foundation for the NIH from the Doris Duke Charitable Foundation,Genentech, the American Association for Dental Research, the Colgate-Palmolive Company, andother private donors.
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Affiliation(s)
- C Hong
- National Heart Lung and Blood Institute , Bethesda , United States of America
| | - H Li
- National Heart Lung and Blood Institute , Bethesda , United States of America
| | - P M Parel
- National Heart Lung and Blood Institute , Bethesda , United States of America
| | - A R Berg
- National Heart Lung and Blood Institute , Bethesda , United States of America
| | - J Rodante
- National Heart Lung and Blood Institute , Bethesda , United States of America
| | - A Keel
- National Heart Lung and Blood Institute , Bethesda , United States of America
| | - H L Teague
- National Heart Lung and Blood Institute , Bethesda , United States of America
| | - M P Playford
- National Heart Lung and Blood Institute , Bethesda , United States of America
| | - M Y Chen
- National Heart Lung and Blood Institute , Bethesda , United States of America
| | - W Zhou
- National Heart Lung and Blood Institute , Bethesda , United States of America
| | - A V Sorokin
- National Heart Lung and Blood Institute , Bethesda , United States of America
| | - D A Bluemke
- University of Wisconsin-Madison, Department of Radiology , Madison , United States of America
| | - N N Mehta
- National Heart Lung and Blood Institute , Bethesda , United States of America
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Puhl MD, Berg AR, Bechtholt AJ, Coyle JT. Availability of N-Methyl-d-Aspartate Receptor Coagonists Affects Cocaine-Induced Conditioned Place Preference and Locomotor Sensitization: Implications for Comorbid Schizophrenia and Substance Abuse. J Pharmacol Exp Ther 2015; 353:465-70. [PMID: 25788713 DOI: 10.1124/jpet.115.223099] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 03/09/2015] [Indexed: 11/22/2022] Open
Abstract
Schizophrenia is associated with high prevalence of substance abuse. Recent research suggests that dysregulation of N-methyl-d-aspartate receptor (NMDAR) function may play a role in the pathophysiology of both schizophrenia and drug addiction, and thus, may account for this high comorbidity. Our laboratory has developed two transgenic mouse lines that exhibit contrasting NMDAR activity based on the availability of the glycine modulatory site (GMS) agonists d-serine and glycine. Glycine transporter 1 knockdowns (GlyT1(+/-)) exhibit NMDAR hyperfunction, whereas serine racemase knockouts (SR(-/-)) exhibit NMDAR hypofunction. We characterized the behavior of these lines in a cocaine-induced (20 mg/kg) conditioned place preference (CPP) and locomotor sensitization paradigm. Compared with wild-type mice, GlyT1(+/-) mice displayed hastened extinction of CPP and robust cocaine-induced reinstatement. SR(-/-) mice appeared to immediately "forget" the learned preference, because they did not exhibit cocaine-induced reinstatement and also displayed attenuated locomotor sensitization. Treatment of GlyT1(+/-) mice with gavestinel (10 mg/kg on day 1; 5 mg/kg on days 2-17), a GMS antagonist, attenuated cocaine-induced CPP and caused them to immediately "forget" the learned preference. Treatment of SR(-/-) mice with d-serine (300 mg/kg on day 1; 150 mg/kg on days 2-17) to normalize brain levels caused them to avoid the cocaine-paired side of the chamber during extinction. These results highlight NMDAR dysfunction as a possible neural mechanism underlying comorbid schizophrenia and substance abuse. Also, these findings suggest drugs that directly or indirectly activate the NMDAR GMS could be an effective treatment of cocaine abuse.
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Affiliation(s)
- Matthew D Puhl
- Department of Psychiatry, Harvard Medical School (M.D.P., A.R.B., A.J.B., J.T.C.), and Laboratory for Psychiatric and Molecular Neuroscience (M.D.P., A.R.B., J.T.C.) and Behavioral Genetics Laboratory (A.J.B.), McLean Hospital, Belmont, Massachusetts
| | - Alexandra R Berg
- Department of Psychiatry, Harvard Medical School (M.D.P., A.R.B., A.J.B., J.T.C.), and Laboratory for Psychiatric and Molecular Neuroscience (M.D.P., A.R.B., J.T.C.) and Behavioral Genetics Laboratory (A.J.B.), McLean Hospital, Belmont, Massachusetts
| | - Anita J Bechtholt
- Department of Psychiatry, Harvard Medical School (M.D.P., A.R.B., A.J.B., J.T.C.), and Laboratory for Psychiatric and Molecular Neuroscience (M.D.P., A.R.B., J.T.C.) and Behavioral Genetics Laboratory (A.J.B.), McLean Hospital, Belmont, Massachusetts
| | - Joseph T Coyle
- Department of Psychiatry, Harvard Medical School (M.D.P., A.R.B., A.J.B., J.T.C.), and Laboratory for Psychiatric and Molecular Neuroscience (M.D.P., A.R.B., J.T.C.) and Behavioral Genetics Laboratory (A.J.B.), McLean Hospital, Belmont, Massachusetts
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Berg AR, Chepurnaia AN. [The association of risk of development of cardiomyopathies with polymorphic variants of genes of angiotensin converting enzyme, glutathione-S-transferase, interleukins 8 and 10]. Klin Lab Diagn 2014:24-27. [PMID: 25080784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The article presents the results of study of association of risk of development and clinical course of cardiomyopathies with polymorphic variants of genes ACE, GSTM1, IL8 and IL10. The purpose of research was to find out molecular genetic markers of risk of development and clinical course of various types of cardiomyopathies. The analysis used the DNA samples extracted from lymphocytes of peripheral venous blood of patients with cardiomyopathies (N = 89) and control group (N = 426). The standard analysis techniques of polymerase chain reaction and restriction fragment length polymorphism were applied to detect polymorphic loci of genes candidates. It is established that genotype of DD-polymorphic locus of I/DgeneACE is a marker of development of ischemic cardiomyopathy. The allele D is a marker of development of increased rate of manifestation of extra-systoles, growth of inter-ventricular septum and reduction of fraction of discharge in patients with cardiomyopathies.
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Santini MA, Balu DT, Puhl MD, Hill-Smith TE, Berg AR, Lucki I, Mikkelsen JD, Coyle JT. D-serine deficiency attenuates the behavioral and cellular effects induced by the hallucinogenic 5-HT(2A) receptor agonist DOI. Behav Brain Res 2013; 259:242-6. [PMID: 24269270 DOI: 10.1016/j.bbr.2013.11.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 08/06/2013] [Revised: 11/07/2013] [Accepted: 11/12/2013] [Indexed: 01/15/2023]
Abstract
Both the serotonin and glutamate systems have been implicated in the pathophysiology of schizophrenia, as well as in the mechanism of action of antipsychotic drugs. Psychedelic drugs act through the serotonin 2A receptor (5-HT2AR), and elicit a head-twitch response (HTR) in mice, which directly correlates to 5-HT2AR activation and is absent in 5-HT2AR knockout mice. The precise mechanism of this response remains unclear, but both an intrinsic cortico-cortical pathway and a thalamo-cortical pathway involving glutamate release have been proposed. Here, we used a genetic model of NMDAR hypofunction, the serine racemase knockout (SRKO) mouse, to explore the role of glutamatergic transmission in regulating 5-HT2AR-mediated cellular and behavioral responses. SRKO mice treated with the 5-HT2AR agonist (±)-2,5-dimethoxy-4-iodoamphetamine (DOI) showed a clearly diminished HTR and lower induction of c-fos mRNA. These altered functional responses in SRKO mice were not associated with changes in cortical or hippocampal 5-HT levels or in 5-HT2AR and metabotropic glutamate-2 receptor (mGluR2) mRNA and protein expression. Together, these findings suggest that D-serine-dependent NMDAR activity is involved in mediating the cellular and behavioral effects of 5-HT2AR activation.
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Affiliation(s)
- Martin A Santini
- Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; Laboratory for Psychiatric and Molecular Neuroscience, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Darrick T Balu
- Laboratory for Psychiatric and Molecular Neuroscience, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Matthew D Puhl
- Laboratory for Psychiatric and Molecular Neuroscience, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | | | - Alexandra R Berg
- Laboratory for Psychiatric and Molecular Neuroscience, McLean Hospital, Belmont, MA, USA
| | - Irwin Lucki
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA; Department of Pharmacology, University of Pennsylvania, Philadelphia, PA, USA
| | - Jens D Mikkelsen
- Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; Laboratory for Psychiatric and Molecular Neuroscience, McLean Hospital, Belmont, MA, USA
| | - Joseph T Coyle
- Laboratory for Psychiatric and Molecular Neuroscience, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
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Bhutani M, Mena E, Maric I, Tan E, Korde N, Berg AR, Minter AR, Weiss BM, Lindenberg L, Turkbey B, Aras O, Steinberg S, Kemp T, Calvo KR, Choyke PL, Kurdziel K, Landgren O. Abstract 369: Role of bone marrow angiogenesis in myeloma and its precursor disease: a prospective clinical trial. Cancer Res 2013. [DOI: 10.1158/1538-7445.am2013-369] [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] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Based on bone marrow (BM) biopsies, increased angiogenesis has been reported in multiple myeloma (MM) and smoldering multiple myeloma (SMM) patients compared with individuals with monoclonal gammopathy of undetermined significance (MGUS). In this prospective clinical trial open for MGUS, SMM and MM patients, we conducted BM biopsies and used immunohistochemistry to define microvessel density (MVD) in every patient; results were compared to results obtained from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and multiplex ELISA-based serum angiogenic cytokine assays.
Patients and Methods: We included 10 MGUS, 10 SMM and 10 MM patients. We performed DCE-MRI of entire lumbosacral spine to compare exchange rate constants (contrast agent transit from the extravascular compartment to the intravascular compartment, Kep; movement of contrast agent from plasma to extravascular extracellular space, Ktrans) with bone marrow biopsies immunostained with CD34 as measures of MVD, and serum angiogenic markers By ELISA to include EGF, Ang2, GCSF, BMP9, endoglin, Leptin, Follistatin, IL8, HGF, HBEGF, PLGF, VEGFC, VEGFD, FGF2, VEGFA. The association among continous parameters was determined by Spearman rank correlation. Trends in continuous parameters according to ordered categorical parameter were determined by Jonckheere-Terpstra test for trend. The parameters between two groups were compared using an exact Wilcoxon rank sum test.
Results: Both MVD and Kep increased along the myeloma spectrum (MGUS < SMM < MM). MVD and Kep were strongly correlated (r=0.93 and p=0.002). Ktrans was weakly to moderately well correlated with MVD (r=0.43 p=0.03). Higher Kep values were seen in MM/SMM vs. MGUS patients (median 7.1 vs. 3.9; p=0.08). Similarly, higher MVD values were seen in MM/SMM patients versus MGUS (median 20 vs. 15; p=0.01). As regards serum angiogenic markers, levels of HGF (r=0.45; p=0.02), Ang2(r=0.37 and p=0.06), and VEGFD (r=-0.35 and p=0.07), correlated with Kep. The levels of Ang2 (p=0.02), GCSF (p=0.06), follistatin (p=0.06), HGF (p=0.01), and VEGFA (p=0.02), were elevated in MM/SMM patients in comparison to MGUS. Other angiogenic cytokines did not correlate with MVD or Kep.
Conclusions: MVD and Kep (measured by DCE-MRI) were highly statistically correlated. MVD increased along the disease spectrum from MGUS to SMM to MM (p=0.008). Some, but not all, angiogenic biomarkers detected in peripheral blood were associated with increased vascularity in the bone marrow.
Citation Format: Manisha Bhutani, Esther Mena, Irina Maric, Esther Tan, Neha Korde, Alexandra R. Berg, Alex R. Minter, Brendan M. Weiss, Liza Lindenberg, Baris Turkbey, Omer Aras, Seth Steinberg, Troy Kemp, Katherine R. Calvo, Peter L. Choyke, Karen Kurdziel, Ola Landgren. Role of bone marrow angiogenesis in myeloma and its precursor disease: a prospective clinical trial. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 369. doi:10.1158/1538-7445.AM2013-369
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Affiliation(s)
| | - Esther Mena
- 2Molecular Imaging Program, CCR, NCI, NIH, Bethesda, MD
| | - Irina Maric
- 3Hematopathology Section, DLM, CCR, NIH, Bethesda, MD
| | - Esther Tan
- 1Multiple Myeloma Section, NCI, NIH, Bethesda, MD
| | - Neha Korde
- 1Multiple Myeloma Section, NCI, NIH, Bethesda, MD
| | | | | | | | | | - Baris Turkbey
- 2Molecular Imaging Program, CCR, NCI, NIH, Bethesda, MD
| | - Omer Aras
- 2Molecular Imaging Program, CCR, NCI, NIH, Bethesda, MD
| | - Seth Steinberg
- 4Biostatistics and Data Management Section, CCR, NCI, NIH, Bethesda, MD
| | - Troy Kemp
- 5Division of Cancer Epidemiology and Genetics, NCI, NIH, Bethesda, MD
| | | | | | | | - Ola Landgren
- 1Multiple Myeloma Section, NCI, NIH, Bethesda, MD
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Abstract
The unique case of a 60-year-old patient with a non-Hodgkin's B-cell lymphoma of the lymphoplasmacytic type and three associated monoclonal proteins, is described. The patient also exhibited various autoimmune phenomena that were consistent with the diagnoses of Sjögren's syndrome and autoimmune thyroiditis. The evolution from production of a single monoclonal protein (IgM-kappa) to three monoclonal proteins (IgG-kappa, IgA-kappa, and IgM-kappa) suggested that the lymphoplasmacytic cells were at different stages of terminal differentiation within a single neoplastic clone. The chronic antigenic stress imposed on the immune system by the autoimmune disorder may have played a role in the development of lymphoma and in the heavy chain immunoglobulin switching that occurred during the patients' clinical course.
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Berg AR, Linder J, Anderson RW, Tempero MA, Edney JA, Armitage JO. The undifferentiated malignant neoplasm. Identification of lymphoma arising in skeletal muscle by immunohistochemical analysis. JAMA 1985; 254:2625-6. [PMID: 2414476 DOI: 10.1001/jama.254.18.2625] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The undifferentiated malignant neoplasm presents a significant problem in the intelligent selection of therapy. Because of advances in chemotherapy, there are cancers that are effectively palliated, and sometimes cured if appropriately treated. Characterization of tumors by immunohistochemical stains drastically reduces the incidence of "undifferentiated" diagnoses and will optimize patient management, as illustrated by two cases of large-cell lymphoma arising in skeletal muscle.
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