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Lai PS, Lam NL, Gallery B, Lee AG, Adair-Rohani H, Alexander D, Balakrishnan K, Bisaga I, Chafe ZA, Clasen T, Díaz-Artiga A, Grieshop A, Harrison K, Hartinger SM, Jack D, Kaali S, Lydston M, Mortimer KM, Nicolaou L, Obonyo E, Okello G, Olopade C, Pillarisetti A, Pinto AN, Rosenthal JP, Schluger N, Shi X, Thompson C, Thompson LM, Volckens J, Williams KN, Balmes J, Checkley W, Ozoh OB. Household Air Pollution Interventions to Improve Health in Low- and Middle-Income Countries: An Official American Thoracic Society Research Statement. Am J Respir Crit Care Med 2024; 209:909-927. [PMID: 38619436 DOI: 10.1164/rccm.202402-0398st] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2024] Open
Abstract
Background: An estimated 3 billion people, largely in low- and middle-income countries, rely on unclean fuels for cooking, heating, and lighting to meet household energy needs. The resulting exposure to household air pollution (HAP) is a leading cause of pneumonia, chronic lung disease, and other adverse health effects. In the last decade, randomized controlled trials of clean cooking interventions to reduce HAP have been conducted. We aim to provide guidance on how to interpret the findings of these trials and how they should inform policy makers and practitioners.Methods: We assembled a multidisciplinary working group of international researchers, public health practitioners, and policymakers with expertise in household air pollution from within academia, the American Thoracic Society, funders, nongovernmental organizations, and global organizations, including the World Bank and the World Health Organization. We performed a literature search, convened four sessions via web conference, and developed consensus conclusions and recommendations via the Delphi method.Results: The committee reached consensus on 14 conclusions and recommendations. Although some trials using cleaner-burning biomass stoves or cleaner-cooking fuels have reduced HAP exposure, the committee was divided (with 55% saying no and 45% saying yes) on whether the studied interventions improved measured health outcomes.Conclusions: HAP is associated with adverse health effects in observational studies. However, it remains unclear which household energy interventions reduce exposure, improve health, can be scaled, and are sustainable. Researchers should engage with policy makers and practitioners working to scale cleaner energy solutions to understand and address their information needs.
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Agyapong PD, Jack D, Kaali S, Colicino E, Mujtaba MN, Chillrud SN, Osei M, Gennings C, Agyei O, Kinney PL, Kwarteng A, Perzanowski M, Dwommoh Prah RK, Tawiah T, Asante KP, Lee AG. Household Air Pollution and Child Lung Function: The Ghana Randomized Air Pollution and Health Study. Am J Respir Crit Care Med 2024; 209:716-726. [PMID: 38016085 DOI: 10.1164/rccm.202303-0623oc] [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: 03/31/2023] [Accepted: 11/28/2023] [Indexed: 11/30/2023] Open
Abstract
Rationale: The impact of a household air pollution (HAP) stove intervention on child lung function has been poorly described. Objectives: To assess the effect of a HAP stove intervention for infants prenatally to age 1 on, and exposure-response associations with, lung function at child age 4. Methods: The Ghana Randomized Air Pollution and Health Study randomized pregnant women to liquefied petroleum gas (LPG), improved biomass, or open-fire (control) stove conditions through child age 1. We quantified HAP exposure by repeated maternal and child personal carbon monoxide (CO) exposure measurements. Children performed oscillometry, an effort-independent lung function measurement, at age 4. We examined associations between Ghana Randomized Air Pollution and Health Study stove assignment and prenatal and infant CO measurements and oscillometry using generalized linear regression models. We used reverse distributed lag models to examine time-varying associations between prenatal CO and oscillometry. Measurements and Main Results: The primary oscillometry measure was reactance at 5 Hz, X5, a measure of elastic and inertial lung properties. Secondary measures included total, large airway, and small airway resistance at 5 Hz, 20 Hz, and the difference in resistance at 5 Hz and 20 Hz (R5, R20, and R5-20, respectively); area of reactance (AX); and resonant frequency. Of the 683 children who attended the lung function visit, 567 (83%) performed acceptable oscillometry. A total of 221, 106, and 240 children were from the LPG, improved biomass, and control arms, respectively. Compared with control, the improved biomass stove condition was associated with lower reactance at 5 Hz (X5 z-score: β = -0.25; 95% confidence interval [CI] = -0.39, -0.11), higher large airway resistance (R20 z-score: β = 0.34; 95% CI = 0.23, 0.44), and higher AX (AX z-score: β = 0.16; 95% CI = 0.06, 0.26), which is suggestive of overall worse lung function. The LPG stove condition was associated with higher X5 (X5 score: β = 0.16; 95% CI = 0.01, 0.31) and lower small airway resistance (R5-20 z-score: β = -0.15; 95% CI = -0.30, 0.0), which is suggestive of better small airway function. Higher average prenatal CO exposure was associated with higher R5 and R20, and distributed lag models identified sensitive windows of exposure between CO and X5, R5, R20, and R5-20. Conclusions: These data support the importance of prenatal HAP exposure on child lung function. Clinical trial registered with www.clinicaltrials.gov (NCT01335490).
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Affiliation(s)
- Prince Darko Agyapong
- Kintampo Health Research Centre, Research and Development, Division Ghana Health Service, Bono East Region Kintampo North, Ghana
| | - Darby Jack
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York
| | - Seyram Kaali
- Kintampo Health Research Centre, Research and Development, Division Ghana Health Service, Bono East Region Kintampo North, Ghana
| | | | - Mohammed Nuhu Mujtaba
- Kintampo Health Research Centre, Research and Development, Division Ghana Health Service, Bono East Region Kintampo North, Ghana
| | - Steven N Chillrud
- Lamont-Doherty Earth Observatory at Columbia University, Palisades, New York; and
| | - Musah Osei
- Kintampo Health Research Centre, Research and Development, Division Ghana Health Service, Bono East Region Kintampo North, Ghana
| | - Chris Gennings
- Department of Environmental Medicine and Public Health
- Institute for Exposomic Research, and
| | - Oscar Agyei
- Kintampo Health Research Centre, Research and Development, Division Ghana Health Service, Bono East Region Kintampo North, Ghana
| | - Patrick L Kinney
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts
| | - Adolphine Kwarteng
- Kintampo Health Research Centre, Research and Development, Division Ghana Health Service, Bono East Region Kintampo North, Ghana
| | - Matthew Perzanowski
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York
| | - Rebecca Kyerewaa Dwommoh Prah
- Kintampo Health Research Centre, Research and Development, Division Ghana Health Service, Bono East Region Kintampo North, Ghana
| | - Theresa Tawiah
- Kintampo Health Research Centre, Research and Development, Division Ghana Health Service, Bono East Region Kintampo North, Ghana
| | - Kwaku Poku Asante
- Kintampo Health Research Centre, Research and Development, Division Ghana Health Service, Bono East Region Kintampo North, Ghana
| | - Alison G Lee
- Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
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Daouda M, Kaali S, Spring E, Mujtaba MN, Jack D, Dwommoh Prah RK, Colicino E, Tawiah T, Gennings C, Osei M, Janevic T, Chillrud SN, Agyei O, Gould CF, Lee AG, Asante KP. Prenatal Household Air Pollution Exposure and Childhood Blood Pressure in Rural Ghana. Environ Health Perspect 2024; 132:37006. [PMID: 38506828 PMCID: PMC10953816 DOI: 10.1289/ehp13225] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 01/18/2024] [Accepted: 02/08/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND The association between prenatal household air pollution (HAP) exposure and childhood blood pressure (BP) is unknown. OBJECTIVE Within the Ghana Randomized Air Pollution and Health Study (GRAPHS) we examined time-varying associations between a) maternal prenatal and b) first-year-of-life HAP exposure with BP at 4 years of age and, separately, whether a stove intervention delivered prenatally and continued through the first year of life could improve BP at 4 years of age. METHODS GRAPHS was a cluster-randomized cookstove intervention trial wherein n = 1,414 pregnant women were randomized to one of two stove interventions: a) a liquefied petroleum gas (LPG) stove or improved biomass stove, or b) control (open fire cooking). Maternal HAP exposure over pregnancy and child HAP exposure over the first year of life was quantified by repeated carbon monoxide (CO) measurements; a subset of women (n = 368 ) also performed one prenatal and one postnatal personal fine particulate matter (PM 2.5 ) measurement. Systolic and diastolic BP (SBP and DBP) were measured in n = 667 4-y-old children along with their PM 2.5 exposure (n = 692 ). We examined the effect of the intervention on resting BP z -scores. We also employed reverse distributed lag models to examine time-varying associations between a) maternal prenatal and b) first-year-of-life HAP exposure and resting BP z -scores. Among those with PM 2.5 measures, we examined associations between PM 2.5 and resting BP z -scores. Sex-specific effects were considered. RESULTS Intention-to-treat analyses identified that DBP z -score at 4 years of age was lower among children born in the LPG arm (LPG β = - 0.20 ; 95% CI: - 0.36 , - 0.03 ) as compared with those in the control arm, and females were most susceptible to the intervention. Higher CO exposure in late gestation was associated with higher SBP and DBP z -score at 4 years of age, whereas higher late-first-year-of-life CO exposure was associated with higher DBP z -score. In the subset with PM 2.5 measurements, higher maternal postnatal PM 2.5 exposure was associated with higher SBP z -scores. DISCUSSION These findings suggest that prenatal and first-year-of-life HAP exposure are associated with child BP and support the need for reductions in exposure to HAP, with interventions such as cleaner cooking beginning in pregnancy. https://doi.org/10.1289/EHP13225.
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Affiliation(s)
- Misbath Daouda
- Department of Environmental Health Sciences, Mailman School of Public Health at Columbia University, New York, New York, USA
- Department of Environmental Health Sciences, School of Public Health, University of California, Berkeley, USA
| | - Seyram Kaali
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Ghana
| | - Emma Spring
- University of Michigan, Ann Arbor, Michigan, USA
| | - Mohammed N. Mujtaba
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Ghana
| | - Darby Jack
- Department of Environmental Health Sciences, Mailman School of Public Health at Columbia University, New York, New York, USA
| | - Rebecca Kyerewaa Dwommoh Prah
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Ghana
| | - Elena Colicino
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Theresa Tawiah
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Ghana
| | - Chris Gennings
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Musah Osei
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Ghana
| | - Teresa Janevic
- Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Steven N. Chillrud
- Lamont-Doherty Earth Observatory of Columbia University, New York, New York, USA
| | - Oscar Agyei
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Ghana
| | - Carlos F. Gould
- Department of Earth System Science, Stanford University, Stanford, California, USA
| | - Alison G. Lee
- Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Kwaku Poku Asante
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Ghana
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Gherasim A, Lee AG, Bernstein JA. Impact of Climate Change on Indoor Air Quality. Immunol Allergy Clin North Am 2024; 44:55-73. [PMID: 37973260 DOI: 10.1016/j.iac.2023.09.001] [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] [Indexed: 11/19/2023]
Abstract
Climate change may affect the quality of the indoor environment through heat and mass transfer between indoors and outdoors: first by a direct response to global warming itself and related extreme weather phenomena and second by indirect actions taken to reduce greenhouse gas emissions that can lead to increased concentrations of indoor air contaminants. Therefore, both indoor and outdoor air pollution contribute to poor indoor air quality in this context. Exposures to high concentrations of these pollutants contribute to inflammatory respiratory diseases. Climate change adaptation and mitigation measures could minimize these risks and bring associated health benefits.
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Affiliation(s)
- Alina Gherasim
- ALYATEC Environmental Exposure Chamber, 1 Place de l'Hôpital, Strasbourg, France
| | - Alison G Lee
- Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, New York, NY 10029, USA
| | - Jonathan A Bernstein
- Division of Rheumatology, Allergy and Immunology, University of Cincinnati College of Medicine, 231 Albert Sabin Way, Cincinnati, OH 45267, USA.
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Waisberg E, Ong J, Zaman N, Tavakkoli A, Lee AG. The Impact of COVID-19 on Ophthalmology Clinic and Surgical Volume. Ir Med J 2023; 116:884. [PMID: 38259186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
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Dubowski K, Braganza GT, Bozack A, Colicino E, DeFelice N, McGuinn L, Maru D, Lee AG. COVID-19 subphenotypes at hospital admission are associated with mortality: a cross-sectional study. Ann Med 2023; 55:12-23. [PMID: 36444856 PMCID: PMC10795648 DOI: 10.1080/07853890.2022.2148733] [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: 01/13/2022] [Accepted: 11/13/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND We have an incomplete understanding of COVID-19 characteristics at hospital presentation and whether underlying subphenotypes are associated with clinical outcomes and therapeutic responses. METHODS For this cross-sectional study, we extracted electronic health data from adults hospitalized between 1 March and 30 August 2020 with a PCR-confirmed diagnosis of COVID-19 at five New York City Hospitals. We obtained clinical and laboratory data from the first 24 h of the patient's hospitalization. Treatment with tocilizumab and convalescent plasma was assessed over hospitalization. The primary outcome was mortality; secondary outcomes included intubation, intensive care unit (ICU) admission and length of stay (LOS). First, we employed latent class analysis (LCA) to identify COVID-19 subphenotypes on admission without consideration of outcomes and assigned each patient to a subphenotype. We then performed robust Poisson regression to examine associations between COVID-19 subphenotype assignment and outcome. We explored whether the COVID-19 subphenotypes had a differential response to tocilizumab and convalescent plasma therapies. RESULTS A total of 4620 patients were included. LCA identified six subphenotypes, which were distinct by level of inflammation, clinical and laboratory derangements and ranged from a hypoinflammatory subphenotype with the fewest derangements to a hyperinflammatory with multiorgan dysfunction subphenotypes. Multivariable regression analyses found differences in risk for mortality, intubation, ICU admission and LOS, as compared to the hypoinflammatory subphenotype. For example, in multivariable analyses the moderate inflammation with fever subphenotype had 3.29 times the risk of mortality (95% CI 2.05, 5.28), while the hyperinflammatory with multiorgan failure subphenotype had 17.87 times the risk of mortality (95% CI 11.56, 27.63), as compared to the hypoinflammatory subphenotype. Exploratory analyses suggested that subphenotypes may differential respond to convalescent plasma or tocilizumab therapy. CONCLUSION COVID-19 subphenotype at hospital admission may predict risk for mortality, ICU admission and intubation and differential response to treatment.KEY MESSAGEThis cross-sectional study of COVID patients admitted to the Mount Sinai Health System, identified six distinct COVID subphenotypes on admission. Subphenotypes correlated with ICU admission, intubation, mortality and differential response to treatment.
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Affiliation(s)
- Kathryn Dubowski
- Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Giovanna T. Braganza
- School of Public Health, State University of New York, Downstate Health Sciences University, Brooklyn, NY, USA
| | - Anne Bozack
- School of Public Health, Environmental Health Sciences, University of California Berkeley, Berkeley, CA, USA
| | - Elena Colicino
- Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Nicholas DeFelice
- Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Laura McGuinn
- Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Duncan Maru
- Department of Global Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alison G. Lee
- Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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7
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Medgyesi DN, Mujtaba MN, Yang Q, Abubakari SW, Lee AG, Porter J, Chillrud SN, Kaali S, Jack DW, Asante KP. Geospatial determinants of maternal and child exposure to fine particulate matter in Kintampo, Ghana: Levels within the household and community, by surrounding building density and near roadways. J Expo Sci Environ Epidemiol 2023:10.1038/s41370-023-00606-1. [PMID: 37798345 PMCID: PMC10995107 DOI: 10.1038/s41370-023-00606-1] [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] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 09/15/2023] [Accepted: 09/20/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND Personal exposure to fine particulate matter (PM2.5) from household air pollution is well-documented in sub-Saharan Africa, but spatiotemporal patterns of exposure are poorly characterized. OBJECTIVE We used paired GPS and personal PM2.5 data to evaluate changes in exposure across location-time environments (e.g., household and community, during cooking and non-cooking hours), building density and proximity to roadways. METHODS Our study included 259 sessions of geolocated, gravimetrically-calibrated one-minute personal PM2.5 measurements from participants in the GRAPHS Child Lung Function Study. The household vicinity was defined using a 50-meter buffer around participants' homes. Community boundaries were developed using a spatial clustering algorithm applied to an open-source dataset of building footprints in Africa. For each GPS location, we estimated building density (500 m buffer) and proximity to roadways (100 m buffer). We estimated changes in PM2.5 exposure by location (household, community), time of day (morning/evening cooking hours, night), building density, and proximity to roadways using linear mixed effect models. RESULTS Relative to nighttime household exposure, PM2.5 exposure during evening cooking hours was 2.84 (95%CI = 2.70-2.98) and 1.80 (95%CI = 1.54-2.10) times higher in the household and community, respectively. Exposures were elevated in areas with the highest versus lowest quartile of building density (FactorQ1vsQ4 = 1.60, 95%CI = 1.42-1.80). The effect of building density was strongest during evening cooking hours, and influenced levels in both the household and community (31% and 65% relative increase from Q1 to Q4, respectively). Being proximal to a trunk, tertiary or track roadway increased exposure by a factor of 1.16 (95%CI = 1.07-1.25), 1.68 (95%CI = 1.45-1.95) and 1.27 (95%CI = 1.06-1.53), respectively. IMPACT Household air pollution from cooking with solid fuels in sub-Saharan Africa is a major environmental concern for maternal and child health. Our study advances previous knowledge by quantifying the impact of household cooking activities on air pollution levels in the community, and identifying two geographic features, building density and roadways, that contribute to maternal and child daily exposure. Household cooking contributes to higher air pollution levels in the community especially in areas with greater building density. Findings underscore the need for equitable clean household energy transitions that reach entire communities to reduce health risks from household and outdoor air pollution.
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Affiliation(s)
- Danielle N Medgyesi
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA.
| | - Mohammed Nuhu Mujtaba
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo, North Municipality, Ghana
| | - Qiang Yang
- Lamont-Doherty Earth Observatory, Columbia University, Palisades, NY, USA
- Elsevier Global STM Journals, New York, NY, USA
| | - Sulemana Watara Abubakari
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo, North Municipality, Ghana
| | - Alison G Lee
- Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jeremy Porter
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
- Department of Sociology, School of Humanities and Social Sciences, Brooklyn College, Brooklyn, NY, USA
| | - Steven N Chillrud
- Lamont-Doherty Earth Observatory, Columbia University, Palisades, NY, USA
| | - Seyram Kaali
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo, North Municipality, Ghana
| | - Darby W Jack
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Kwaku Poku Asante
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo, North Municipality, Ghana
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Kaali S, Jack DW, Mujtaba MN, Chillrud SN, Ae-Ngibise KA, Kinney PL, Boamah Kaali E, Gennings C, Colicino E, Osei M, Wylie BJ, Agyei O, Quinn A, Asante KP, Lee AG. Identifying sensitive windows of prenatal household air pollution on birth weight and infant pneumonia risk to inform future interventions. Environ Int 2023; 178:108062. [PMID: 37392730 PMCID: PMC10911234 DOI: 10.1016/j.envint.2023.108062] [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] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 06/02/2023] [Accepted: 06/22/2023] [Indexed: 07/03/2023]
Abstract
BACKGROUND Prenatal household air pollution impairs birth weight and increases pneumonia risk however time-varying associations have not been elucidated and may have implications for the timing of public health interventions. METHODS The Ghana Randomized Air Pollution and Health Study (GRAPHS) enrolled 1,414 pregnant women from Kintampo, Ghana and measured personal carbon monoxide (CO) exposure four times over pregnancy. Birth weight was measured within 72-hours of birth. Fieldworkers performed weekly pneumonia surveillance and referred sick children to study physicians. The primary pneumonia outcome was one or more physician-diagnosed severe pneumonia episode in the first year of life. We employed reverse distributed lag models to examine time-varying associations between prenatal CO exposure and birth weight and infant pneumonia risk. RESULTS Analyses included n = 1,196 mother-infant pairs. In models adjusting for child sex; maternal age, body mass index (BMI), ethnicity and parity at enrollment; household wealth index; number of antenatal visits; and evidence of placental malaria, prenatal CO exposures from 15 to 20 weeks gestation were inversely associated with birth weight. Sex-stratified models identified a similar sensitive window in males and a window at 10-weeks gestation in females. In models adjusting for child sex, maternal age, BMI and ethnicity, household wealth index, gestational age at delivery and average postnatal child CO exposure, CO exposure during 34-39 weeks gestation were positively associated with severe pneumonia risk, especially in females. CONCLUSIONS Household air pollution exposures in mid- and late- gestation are associated with lower birth weight and higher pneumonia risk, respectively. These findings support the urgent need for deployment of clean fuel stove interventions beginning in early pregnancy.
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Affiliation(s)
- Seyram Kaali
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Bono East Region, Kintampo, Ghana.
| | - Darby W Jack
- Department of Environmental Health Sciences, Mailman School of Public Health at Columbia University, 722 W 168(th) Street, New York, NY 10032, USA
| | - Mohammed N Mujtaba
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Bono East Region, Kintampo, Ghana
| | - Steven N Chillrud
- Lamont-Doherty Earth Observatory at Columbia University, Palisades, NY, USA
| | - Kenneth A Ae-Ngibise
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Bono East Region, Kintampo, Ghana
| | - Patrick L Kinney
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Ellen Boamah Kaali
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Bono East Region, Kintampo, Ghana
| | - Chris Gennings
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Elena Colicino
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Musah Osei
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Bono East Region, Kintampo, Ghana
| | - Blair J Wylie
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Oscar Agyei
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Bono East Region, Kintampo, Ghana
| | - Ashlinn Quinn
- Berkeley Air Monitoring Group, Fort Collins, CO, USA
| | - Kwaku Poku Asante
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Bono East Region, Kintampo, Ghana
| | - Alison G Lee
- Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Lee AG, Maley J, Hibbert K, Akgün KM, Hauschildt KE, Law A, Kaminski N, Hayes M, Gesthalter Y, Bosslet GT, Santhosh L, Witkin A, Hills-Dunlap K, Çoruh B, Gershengorn HB, Hardin CC. Medical Societies Must Choose Professional Meeting Locations Responsibly in a Post- Roe World. Ann Am Thorac Soc 2023; 20:781-784. [PMID: 36812378 PMCID: PMC10257035 DOI: 10.1513/annalsats.202211-928ip] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 02/22/2023] [Indexed: 02/24/2023] Open
Affiliation(s)
- Alison G. Lee
- Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jason Maley
- Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Kathryn Hibbert
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Kathleen M. Akgün
- Pulmonary, Critical Care and Sleep Medicine, Veterans Affairs Connecticut Healthcare System, New Haven, Connecticut
- Pulmonary, Critical Care and Sleep Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Katrina E. Hauschildt
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Anica Law
- The Pulmonary Center, Boston University School of Medicine, Boston, Massachusetts
| | - Naftali Kaminski
- Pulmonary, Critical Care and Sleep Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Margaret Hayes
- Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Yaron Gesthalter
- Division of Pulmonary, Critical Care, Allergy and Sleep, University of San Francisco, San Francisco, California
| | - Gabriel T. Bosslet
- Division of Pulmonary, Critical Care, Sleep, and Occupational Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Lekshmi Santhosh
- Division of Pulmonary, Critical Care, Allergy and Sleep, University of San Francisco, San Francisco, California
| | - Alison Witkin
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
- The Pulmonary Center, Boston University School of Medicine, Boston, Massachusetts
| | - Kelsey Hills-Dunlap
- Pulmonary Sciences and Critical Care, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Başak Çoruh
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, Washington
| | - Hayley B. Gershengorn
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Miami Miller School of Medicine, Miami, Florida; and
- Division of Critical Care Medicine, Albert Einstein College of Medicine, Bronx, New York
| | - C. Corey Hardin
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
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10
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Gould CF, Mujtaba MN, Yang Q, Boamah-Kaali E, Quinn AK, Manu G, Lee AG, Ae-Ngibise KA, Carrión D, Kaali S, Kinney PL, Jack DW, Chillrud SN, Asante KP. Using time-resolved monitor wearing data to study the effect of clean cooking interventions on personal air pollution exposures. J Expo Sci Environ Epidemiol 2023; 33:386-395. [PMID: 36274187 DOI: 10.1038/s41370-022-00483-0] [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] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 06/03/2023]
Abstract
BACKGROUND Personal monitoring can estimate individuals' exposures to environmental pollutants; however, accuracy depends on consistent monitor wearing, which is under evaluated. OBJECTIVE To study the association between device wearing and personal air pollution exposure. METHODS Using personal device accelerometry data collected in the context of a randomized cooking intervention in Ghana with three study arms (control, improved biomass, and liquified petroleum gas (LPG) arms; N = 1414), we account for device wearing to infer parameters of PM2.5 and CO exposure. RESULTS Device wearing was positively associated with exposure in the control and improved biomass arms, but weakly in the LPG arm. Inferred community-level air pollution was similar across study arms (~45 μg/m3). The estimated direct contribution of individuals' cooking to PM2.5 exposure was 64 μg/m3 for the control arm, 74 μg/m3 for improved biomass, and 6 μg/m3 for LPG. Arm-specific average PM2.5 exposure at near-maximum wearing was significantly lower in the LPG arm as compared to the improved biomass and control arms. Analysis of personal CO exposure mirrored PM2.5 results. CONCLUSIONS Personal monitor wearing was positively associated with average air pollution exposure, emphasizing the importance of high device wearing during monitoring periods and directly assessing device wearing for each deployment. SIGNIFICANCE We demonstrate that personal monitor wearing data can be used to refine exposure estimates and infer unobserved parameters related to the timing and source of environmental exposures. IMPACT STATEMENTS In a cookstove trial among pregnant women, time-resolved personal air pollution device wearing data were used to refine exposure estimates and infer unobserved exposure parameters, including community-level air pollution, the direct contribution of cooking to personal exposure, and the effect of clean cooking interventions on personal exposure. For example, in the control arm, while average 48 h personal PM2.5 exposure was 77 μg/m3, average predicted exposure at near-maximum daytime device wearing was 108 μg/m3 and 48 μg/m3 at zero daytime device wearing. Wearing-corrected average 48 h personal PM2.5 exposures were 50% lower in the LPG arm than the control and improved biomass and inferred direct cooking contributions to personal PM2.5 from LPG were 90% lower than the other arms. Our recommendation is that studies assessing personal exposures should examine the direct association between device wearing and estimated mean personal exposure.
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Affiliation(s)
- Carlos F Gould
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
- Department of Earth System Science, Stanford University, Stanford, CA, USA
| | - Mohammed Nuhu Mujtaba
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Bono East Region, Ghana
| | - Qiang Yang
- Lamont-Doherty Earth Observatory of Columbia University, Palisades, NY, USA
- Now at Elsevier Global STM Journals, New York, USA
| | - Ellen Boamah-Kaali
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Bono East Region, Ghana
| | | | - Grace Manu
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Bono East Region, Ghana
| | - Alison G Lee
- Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kenneth Ayuurebobi Ae-Ngibise
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Bono East Region, Ghana
| | - Daniel Carrión
- Department of Environmental Health Sciences, Yale University School of Public Health, New Haven, CT, USA
| | - Seyram Kaali
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Bono East Region, Ghana
| | | | - Darby W Jack
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Steven N Chillrud
- Lamont-Doherty Earth Observatory of Columbia University, Palisades, NY, USA.
| | - Kwaku Poku Asante
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Bono East Region, Ghana
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11
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Asante KP, Wylie BJ, Oppong FB, Quinn A, Gyaase S, Lee AG, Ae-Ngibise KA, Burkart K, Boamah-Kaali EA, Kaali S, Chillrud S, Kinney PL, Owusu-Agyei S, Jack D. Association between malaria and household air pollution interventions in a predominantly rural area of Ghana. Malar J 2023; 22:106. [PMID: 36959655 PMCID: PMC10037900 DOI: 10.1186/s12936-022-04431-z] [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: 11/29/2022] [Accepted: 12/24/2022] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND Though anecdotal evidence suggests that smoke from HAP has a repellent effect on mosquitoes, very little work has been done to assess the effect of biomass smoke on malaria infection. The study, therefore, sought to investigate the hypothesis that interventions to reduce household biomass smoke may have an unintended consequence of increasing placental malaria or increase malaria infection in the first year of life. METHODS This provides evidence from a randomized controlled trial among 1414 maternal-infant pairs in the Kintampo North and Kintampo South administrative areas of Ghana. Logistic regression was used to assess the association between study intervention assignment (LPG, Biolite or control) and placental malaria. Finally, an extended Cox model was used to assess the association between study interventions and all episodes of malaria parasitaemia in the first year of infant's life. RESULTS The prevalence of placental malaria was 24.6%. Out of this, 20.8% were acute infections, 18.7% chronic infections and 60.5% past infections. The study found no statistical significant association between the study interventions and all types of placental malaria (OR = 0.88; 95% CI 0.59-1.30). Of the 1165 infants, 44.6% experienced at least one episode of malaria parasitaemia in the first year of life. The incidence of first and/or only episode of malaria parasitaemia was however found to be similar among the study arms. CONCLUSION The findings suggest that cookstove interventions for pregnant women and infants, when combined with additional malaria prevention strategies, do not lead to an increased risk of malaria among pregnant women and infants.
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Affiliation(s)
- Kwaku Poku Asante
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Bono East Region, Ghana.
| | - Blair J Wylie
- Department of Obstetrics and Gynecology PH Building, Columbia University Medical Center, 16th Floor 622 West 168th Street, New York, NY, 10032, USA
| | - Felix B Oppong
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Bono East Region, Ghana
| | - Ashlinn Quinn
- Berkeley Air Monitoring Group, 1935 Addison St., Suite A, Berkeley, CA, 94704, USA
| | - Stephaney Gyaase
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Bono East Region, Ghana
| | - Alison G Lee
- Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kenneth Ayuurebobi Ae-Ngibise
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Bono East Region, Ghana
| | - Katrin Burkart
- Institute for Health Metrics and Evaluation, University of Washington, 2301 Fifth Ave., Seattle, WA, 98121, USA
| | - Ellen Abrafi Boamah-Kaali
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Bono East Region, Ghana
| | - Seyram Kaali
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Bono East Region, Ghana
| | - Steven Chillrud
- Lamont-Doherty Earth Observatory at Columbia University, Palisades, NY, USA
| | - Patrick L Kinney
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Seth Owusu-Agyei
- Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
| | - Darby Jack
- Department of Environmental Health Sciences, Mailman School of Public Health at Columbia University, 722 W 168th Street, New York, NY, 10032, USA
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12
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Silva RP, Huang Y, Nguyen AW, Hsieh CL, Olaluwoye OS, Kaoud TS, Wilen RE, Qerqez AN, Park JG, Khalil AM, Azouz LR, Le KC, Bohanon AL, DiVenere AM, Liu Y, Lee AG, Amengor DA, Shoemaker SR, Costello SM, Padlan EA, Marqusee S, Martinez-Sobrido L, Dalby KN, D'Arcy S, McLellan JS, Maynard JA. Identification of a conserved S2 epitope present on spike proteins from all highly pathogenic coronaviruses. eLife 2023; 12:e83710. [PMID: 36942851 PMCID: PMC10030117 DOI: 10.7554/elife.83710] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [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: 09/26/2022] [Accepted: 03/04/2023] [Indexed: 03/23/2023] Open
Abstract
To address the ongoing SARS-CoV-2 pandemic and prepare for future coronavirus outbreaks, understanding the protective potential of epitopes conserved across SARS-CoV-2 variants and coronavirus lineages is essential. We describe a highly conserved, conformational S2 domain epitope present only in the prefusion core of β-coronaviruses: SARS-CoV-2 S2 apex residues 980-1006 in the flexible hinge. Antibody RAY53 binds the native hinge in MERS-CoV and SARS-CoV-2 spikes on the surface of mammalian cells and mediates antibody-dependent cellular phagocytosis and cytotoxicity against SARS-CoV-2 spike in vitro. Hinge epitope mutations that ablate antibody binding compromise pseudovirus infectivity, but changes elsewhere that affect spike opening dynamics, including those found in Omicron BA.1, occlude the epitope and may evade pre-existing serum antibodies targeting the S2 core. This work defines a third class of S2 antibody while providing insights into the potency and limitations of S2 core epitope targeting.
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Affiliation(s)
- Rui P Silva
- Department of Molecular Biosciences, The University of Texas at AustinAustinUnited States
| | - Yimin Huang
- Department of Molecular Biosciences, The University of Texas at AustinAustinUnited States
| | - Annalee W Nguyen
- Department of Chemical Engineering, The University of Texas at AustinAustinUnited States
| | - Ching-Lin Hsieh
- Department of Molecular Biosciences, The University of Texas at AustinAustinUnited States
| | - Oladimeji S Olaluwoye
- Department of Chemistry and Biochemistry, The University of Texas at DallasDallasUnited States
| | - Tamer S Kaoud
- Division of Chemical Biology and Medicinal Chemistry, The University of Texas at AustinAustinUnited States
| | - Rebecca E Wilen
- Department of Chemical Engineering, The University of Texas at AustinAustinUnited States
| | - Ahlam N Qerqez
- Department of Chemical Engineering, The University of Texas at AustinAustinUnited States
| | - Jun-Gyu Park
- Texas Biomedical Research InstituteSan AntonioUnited States
- Laboratory of Veterinary Zoonosis, College of Veterinary Medicine, Chonnam National UniversityGwangjuRepublic of Korea
| | - Ahmed M Khalil
- Texas Biomedical Research InstituteSan AntonioUnited States
| | - Laura R Azouz
- Department of Chemical Engineering, The University of Texas at AustinAustinUnited States
| | - Kevin C Le
- Department of Chemical Engineering, The University of Texas at AustinAustinUnited States
| | - Amanda L Bohanon
- Department of Molecular Biosciences, The University of Texas at AustinAustinUnited States
| | - Andrea M DiVenere
- Department of Chemical Engineering, The University of Texas at AustinAustinUnited States
| | - Yutong Liu
- Department of Chemical Engineering, The University of Texas at AustinAustinUnited States
| | - Alison G Lee
- Department of Molecular Biosciences, The University of Texas at AustinAustinUnited States
| | - Dzifa A Amengor
- Department of Molecular Biosciences, The University of Texas at AustinAustinUnited States
| | - Sophie R Shoemaker
- Department of Molecular and Cell Biology, University of California, BerkeleyBerkeleyUnited States
| | - Shawn M Costello
- Biophysics Graduate Program, University of California, BerkeleyBerkeleyUnited States
| | | | - Susan Marqusee
- Department of Molecular and Cell Biology, University of California, BerkeleyBerkeleyUnited States
- Department of Chemistry, University of California, BerkeleyBerkeleyUnited States
| | | | - Kevin N Dalby
- Division of Chemical Biology and Medicinal Chemistry, The University of Texas at AustinAustinUnited States
| | - Sheena D'Arcy
- Department of Chemistry and Biochemistry, The University of Texas at DallasDallasUnited States
| | - Jason S McLellan
- Department of Molecular Biosciences, The University of Texas at AustinAustinUnited States
- LaMontagne Center for Infectious Diseases, The University of Texas at AustinAustinUnited States
| | - Jennifer A Maynard
- Department of Chemical Engineering, The University of Texas at AustinAustinUnited States
- LaMontagne Center for Infectious Diseases, The University of Texas at AustinAustinUnited States
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13
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Gould CF, Bejarano ML, Kioumourtzoglou MA, Lee AG, Pillarisetti A, Schlesinger SB, Terán E, Valarezo A, Jack DW. Widespread Clean Cooking Fuel Scale-Up and under-5 Lower Respiratory Infection Mortality: An Ecological Analysis in Ecuador, 1990-2019. Environ Health Perspect 2023; 131:37017. [PMID: 36989076 PMCID: PMC10056314 DOI: 10.1289/ehp11016] [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] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 01/09/2023] [Accepted: 02/10/2023] [Indexed: 05/18/2023]
Abstract
BACKGROUND Nationwide household transitions to the use of clean-burning cooking fuels are a promising pathway to reducing under-5 lower respiratory infection (LRI) mortality, the leading cause of child mortality globally, but such transitions are rare and evidence supporting an association between increased clean fuel use and improved health is limited. OBJECTIVES This study aimed to investigate the association between increased primary clean cooking fuel use and under-5 LRI mortality in Ecuador between 1990 and 2019. METHODS We documented cooking fuel use and cause-coded child mortalities at the canton (county) level in Ecuador from 1990 to 2019 (in four periods, 1988-1992, 1999-2003, 2008-2012, and 2015-2019). We characterized the association between clean fuel use and the rate of under-5 LRI mortalities at the canton level using quasi-Poisson generalized linear and generalized additive models, accounting for potential confounding variables that characterize wealth, urbanization, and child health care and vaccination rates, as well as canton and period fixed effects. We estimated averted under-5 LRI mortalities accrued over 30 y by predicting a counterfactual count of canton-period under-5 LRI mortalities were clean fuel use to not have increased and comparing with predicted canton-period under-5 LRI mortalities from our model and observed data. RESULTS From 1990 to 2019, the proportion of households primarily using a clean cooking fuel increased from 59% to 95%, and under-5 LRI mortality fell from 28 to 7 per 100,000 under-5 population. Canton-level clean fuel use was negatively associated with under-5 LRI mortalities in linear and nonlinear models. The nonlinear association suggested a threshold at approximately 60% clean fuel use, above which there was a negative association. Increases in clean fuel use between 1990 and 2019 were associated with an estimated 7,300 averted under-5 LRI mortalities (95% confidence interval: 2,600, 12,100), accounting for nearly 20% of the declines in under-5 LRI mortality observed in Ecuador over the study period. DISCUSSION Our findings suggest that the widespread household transition from using biomass to clean-burning fuels for cooking reduced under-5 LRI mortalities in Ecuador over the last 30 y. https://doi.org/10.1289/EHP11016.
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Affiliation(s)
- Carlos F. Gould
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
- Department of Earth System Science, Stanford University, Stanford, California, USA
| | - M. Lorena Bejarano
- Institute for Energy and Materials, Department of Mechanical Engineering, Universidad San Francisco de Quito, Quito, Ecuador
| | - Marianthi-Anna Kioumourtzoglou
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Alison G. Lee
- Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Ajay Pillarisetti
- Gangarosa Department of Environmental Health Science, Emory University Rollins School of Public Health, Atlanta, Georgia, USA
- Environmental Health Sciences, University of California, Berkeley, California, USA
| | | | - Enrique Terán
- Colegio de Ciencias de la Salud, Universidad San Francisco de Quito, Quito, Ecuador
| | - Alfredo Valarezo
- Institute for Energy and Materials, Department of Mechanical Engineering, Universidad San Francisco de Quito, Quito, Ecuador
| | - Darby W. Jack
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
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14
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Kaali S, Jack DW, Dwommoh Prah RK, Chillrud SN, Mujtaba MN, Kinney PL, Tawiah T, Yang Q, Oppong FB, Gould CF, Osei M, Wylie BJ, Agyei O, Perzanowski MS, Asante KP, Lee AG. Poor early childhood growth is associated with impaired lung function: Evidence from a Ghanaian pregnancy cohort. Pediatr Pulmonol 2022; 57:2136-2146. [PMID: 35614550 PMCID: PMC9398957 DOI: 10.1002/ppul.26015] [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: 01/24/2022] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Nearly 40% of African children under 5 are stunted. We leveraged the Ghana randomized air pollution and health study (GRAPHS) cohort to examine whether poorer growth was associated with worse childhood lung function. STUDY DESIGN GRAPHS measured infant weight and length at birth and 3, 6, 9,12 months, and 4 years of age. At age 4 years, n = 567 children performed impulse oscillometry. We employed multivariable linear regression to estimate associations between birth and age 4 years anthropometry and lung function. Next, we employed latent class growth analysis (LCGA) to generate growth trajectories through age 4 years. We employed linear regression to examine associations between growth trajectory assignment and lung function. RESULTS Birth weight and age 4 weight-for-age and height-for-age z-scores were inversely associated with airway resistance (e.g., R5 , or total airway resistance: birth weight β = -0.90 cmH2O/L/s, 95% confidence interval [CI]: -1.64, -0.16 per 1 kg increase; and R20 , or large airway resistance: age 4 height-for-age β = -0.40 cmH2O/L/s, 95% CI: -0.57, -0.22 per 1 unit z-score increase). Impaired growth trajectories identified through LCGA were associated with higher airway resistance, even after adjusting for age 4 body mass index. For example, children assigned to a persistently stunted trajectory had higher R5 (β = 2.71 cmH2O/L/s, 95% CI: 1.07, 4.34) and R20 (β = 1.43 cmH2O/L/s, 95% CI: 0.51, 2.36) as compared to normal. CONCLUSION Children with poorer anthropometrics through to age 4 years had higher airway resistance in early childhood. These findings have implications for lifelong lung health, including pneumonia risk in childhood and reduced maximally attainable lung function in adulthood.
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Affiliation(s)
- Seyram Kaali
- Kintampo Health Research Centre, Ghana Health Service, Brong Ahafo Region, Kintampo, Ghana
| | - Darby W. Jack
- Department of Environmental Health Sciences, Mailman School of Public Health at Columbia University, 722 W 168 Street, New York, NY USA 10032
| | | | - Steven N. Chillrud
- Lamont-Doherty Earth Observatory at Columbia University, Palisades, NY, USA
| | - Mohammed N. Mujtaba
- Kintampo Health Research Centre, Ghana Health Service, Brong Ahafo Region, Kintampo, Ghana
| | - Patrick L. Kinney
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Theresa Tawiah
- Kintampo Health Research Centre, Ghana Health Service, Brong Ahafo Region, Kintampo, Ghana
| | - Qiang Yang
- Lamont-Doherty Earth Observatory at Columbia University, Palisades, NY, USA
| | - Felix B. Oppong
- Kintampo Health Research Centre, Ghana Health Service, Brong Ahafo Region, Kintampo, Ghana
| | - Carlos F. Gould
- Department of Environmental Health Sciences, Mailman School of Public Health at Columbia University, 722 W 168 Street, New York, NY USA 10032
| | - Musah Osei
- Kintampo Health Research Centre, Ghana Health Service, Brong Ahafo Region, Kintampo, Ghana
| | - Blair J. Wylie
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Oscar Agyei
- Kintampo Health Research Centre, Ghana Health Service, Brong Ahafo Region, Kintampo, Ghana
| | - Matthew S. Perzanowski
- Department of Environmental Health Sciences, Mailman School of Public Health at Columbia University, 722 W 168 Street, New York, NY USA 10032
| | - Kwaku-Poku Asante
- Kintampo Health Research Centre, Ghana Health Service, Brong Ahafo Region, Kintampo, Ghana
| | - Alison G. Lee
- Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA 10029
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15
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Cromar KR, Lee AG, Harkema JR, Annesi-Maesano I. Science-Based Policy Recommendations for PM 2.5 in the United States. Am J Respir Crit Care Med 2022; 206:1067-1069. [PMID: 35856816 DOI: 10.1164/rccm.202203-0507ed] [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: 11/16/2022] Open
Affiliation(s)
- Kevin R Cromar
- New York University, Marron Institute of Urban Management, Brooklyn, New York, United States.,New York University School of Medicine, New York, New York, United States;
| | - Alison G Lee
- Icahn School of Medicine at Mount Sinai, Division of Pulmonary, Sleep and Critical Care Medicine, New York, New York, United States
| | - Jack R Harkema
- Michigan State University, Pathobiology, East Lansing, Michigan, United States
| | - Isabella Annesi-Maesano
- INSERM, Institut Desbrest of Epidemiology and Santé Publique, Montpellier University, Montpellier, France
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16
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Daouda M, Mujtaba MN, Yang Q, Seyram K, Lee AG, Tawiah T, Ae-Ngibise KA, Chillrud SN, Jack D, Asante KP. Prediction of personal exposure to PM 2.5 in mother-child pairs in rural Ghana. J Expo Sci Environ Epidemiol 2022; 32:629-636. [PMID: 35301434 PMCID: PMC9355911 DOI: 10.1038/s41370-022-00420-1] [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] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 02/01/2022] [Accepted: 02/02/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Air pollution epidemiological studies usually rely on estimates of long-term exposure to air pollutants, which are difficult to ascertain. This problem is accentuated in settings where sources of personal exposure differ from those of ambient concentrations, including household air pollution environments where cooking is an important source. OBJECTIVE The objective of this study was to assess the feasibility of estimating usual exposure to PM2.5 based on short-term measurements. METHODS We leveraged three types of short-term measurements from a cohort of mother-child pairs in 26 communities in rural Ghana: (A) personal exposure to PM2.5 in mothers and age four children, ambient PM2.5 concentrations (B) at the community level, and (C) at a central site. Baseline models were linear mixed models with a random intercept for community or for participant. Lowest root-mean-square-error (RMSE) was used to select the best-performing model. RESULTS We analyzed 240 community-days and 251 participant-days of PM2.5. Medians (IQR) of PM2.5 were 19.5 (36.5) μg/m3 for the central site, 28.7 (41.5) μg/m3 for the communities, 70.6 (56.9) μg/m3 for mothers, and 80.9 (74.1) μg/m3 for children. The ICCs (95% CI) for community ambient and personal exposure were 0.30 (0.17, 0.47) and 0.74 (0.65, 0.81) respectively. The sources of variability differed during the Harmattan season. Children's daily exposure was best predicted by models that used community ambient compared to mother's exposure as a predictor (log-scale RMSE: 0.165 vs 0.325). CONCLUSION Our results support the feasibility of predicting usual personal exposure to PM2.5 using short-term measurements in settings where household air pollution is an important source of exposure. Our results also suggest that mother's exposure may not be the best proxy for child's exposure at age four.
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Affiliation(s)
- Misbath Daouda
- Department of Environmental Health Sciences, Columbia Mailman School of Public Health, New York, NY, USA.
| | - Mohammed Nuhu Mujtaba
- Kintampo Health Research Centre, Ghana Health Service, Bono East Region, Kintampo, Ghana
| | - Qiang Yang
- Lamont-Doherty Earth Observatory of Columbia University, New York, NY, USA
| | - Kaali Seyram
- Kintampo Health Research Centre, Ghana Health Service, Bono East Region, Kintampo, Ghana
| | - Alison G Lee
- Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Theresa Tawiah
- Kintampo Health Research Centre, Ghana Health Service, Bono East Region, Kintampo, Ghana
| | - Kenneth A Ae-Ngibise
- Kintampo Health Research Centre, Ghana Health Service, Bono East Region, Kintampo, Ghana
| | - Steve N Chillrud
- Lamont-Doherty Earth Observatory of Columbia University, New York, NY, USA
| | - Darby Jack
- Department of Environmental Health Sciences, Columbia Mailman School of Public Health, New York, NY, USA
| | - Kwaku Poku Asante
- Kintampo Health Research Centre, Ghana Health Service, Bono East Region, Kintampo, Ghana
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17
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Lee AG, Tignor N, Cowell W, Colicino E, Bozack A, Baccarelli A, Wang P, Wright RJ. Associations between antenatal maternal asthma status and placental DNA methylation. Placenta 2022; 126:184-195. [PMID: 35858526 PMCID: PMC9679966 DOI: 10.1016/j.placenta.2022.06.008] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 06/09/2022] [Accepted: 06/17/2022] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Maternal asthma in pregnancy is associated with adverse perinatal and child health outcomes; however, mechanisms are poorly understood. METHODS The PRogramming of Intergenerational Stress Mechanisms (PRISM) prospective pregnancy cohort characterized asthma history during pregnancy via questionnaires and quantified placental DNAm using the Illumina Infinium HumanMethylation450 BeadChip. We performed epigenome-wide association analyses (n = 223) to estimate associations between maternal active or inactive asthma, as compared to never asthma, and placental differentially methylated positions (DMPs) and differentially variable positions (DVPs). Models adjusted for maternal pre-pregnancy body mass index, smoking status, parity, age and education level and child sex. P-values were FDR-adjusted. RESULTS One hundred and fifty-nine (71.3%) pregnant women reported no history of asthma (never asthma), 15 (6.7%) reported inactive, and 49 (22%) reported active antenatal asthma. Women predominantly self-identified as Black/Hispanic Black [88 (39.5%)] and Hispanic/non-Black [42 (18.8%)]. We identified 10 probes at FDR<0.05 and 4 probes at FDR<0.10 characterized by higher variability in maternal active asthma compared to never asthma mapping to GPX3, LHPP, PECAM1, ATAD3C, and ARHGEF4 and 2 probes characterized by lower variation mapping to CHMP4A and C5orf24. Amongst women with inactive asthma, we identified 52 probes, 41 at FDR<0.05 and an additional 11 at FDR <0.10, with higher variability compared to never asthma; BMP4, LHPP, PHYHIPL, and ZSCAN23 were associated with multiple DVPs. No associations were observed with DMPs. DISCUSSION We observed alterations in placental DNAm in women with antenatal asthma, as compared to women without a history of asthma. Further research is needed to understand the impact on fetal development.
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Affiliation(s)
- Alison G Lee
- Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Nicole Tignor
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Whitney Cowell
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Elena Colicino
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Anne Bozack
- Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA, USA
| | - Andrea Baccarelli
- Environmental Health Sciences, Mailman School of Public Health at Columbia University, New York, NY, USA
| | - Pei Wang
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rosalind J Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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18
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Bozack AK, Colicino E, Rodosthenous RS, Bloomquist TR, Baccarelli AA, Wright RO, Wright RJ, Lee AG. Breast milk-derived extracellular vesicle miRNAs are associated with maternal asthma and atopy. Epigenomics 2022; 14:727-739. [PMID: 35638388 PMCID: PMC9280402 DOI: 10.2217/epi-2022-0090] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background: Breast milk-derived extracellular vesicle (EV) miRNAs may program child health outcomes associated with maternal asthma and atopy. The authors investigated associations between maternal asthma/atopy and EV miRNAs in the Programming of Intergenerational Stress Mechanisms cohort. Methods: Breast milk-derived EV miRNAs collected 6.1 ± 5.9 weeks postnatally (n = 80 mothers) were profiled using the TaqMan OpenArray Human MicroRNA Panel. The authors assessed associations using adjusted robust regression. Results: Nine EV miRNAs were associated with asthma during pregnancy (a priori criteria: nominal p < 0.05; |Bregression| >0.2). miR-1290 was associated with asthma and atopy during pregnancy (p < 0.05; |Bregression| >0.2). Enriched Kyoto Encyclopedia of Genes and Genomes pathways included TGF-β signaling and extracellular matrix-receptor interaction (false discovery rate <0.05). Conclusion: In this study, maternal asthma and atopy were associated with breast milk-derived EV miRNAs. Additional studies are needed to understand whether EV miRNAs have direct effects on infant and child health.
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Affiliation(s)
- Anne K Bozack
- Department of Internal Medicine, Division of Pulmonary Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Elena Colicino
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rodosthenis S Rodosthenous
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
| | - Tessa R Bloomquist
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Andrea A Baccarelli
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rosalind J Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alison G Lee
- Department of Internal Medicine, Division of Pulmonary Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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19
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Nassikas NJ, Kraus A, Lee AG. Dying to Breathe: Air Pollution Adds Insult to Injury in COVID-19. Am J Respir Crit Care Med 2022; 206:368-369. [PMID: 35580063 DOI: 10.1164/rccm.202205-0838ed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Nicholas J Nassikas
- Beth Israel Deaconess Medical Center, 1859, Division of Pulmonary, Critical Care, and Sleep Medicine, Boston, Massachusetts, United States
| | - Adam Kraus
- Mount Sinai School of Medicine, 5925, Departments of Medicine and Pediatrics, New York, New York, United States
| | - Alison G Lee
- Mount Sinai School of Medicine, 5925, Division of Pulmonary, Sleep and Critical Care Medicine, New York, New York, United States;
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20
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Rosa MJ, Tamayo-Ortiz M, Mercado Garcia A, Rivera Rivera NY, Bush D, Lee AG, Solano-González M, Amarasiriwardena C, Téllez-Rojo MM, Wright RO, Wright RJ. Prenatal lead exposure and childhood lung function: Influence of maternal cortisol and child sex. Environ Res 2022; 205:112447. [PMID: 34875261 PMCID: PMC8760170 DOI: 10.1016/j.envres.2021.112447] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/22/2021] [Accepted: 11/24/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Maternal hypothalamic-pituitary-adrenal (HPA) axis disruption in pregnancy may contribute to the programming of childhood respiratory disease and may modify the effect of chemical toxins, like lead (Pb), on lung development. Child sex may further modify these effects. We sought to prospectively examine associations between maternal HPA axis disruption, prenatal Pb and childhood lung function and explore potential effect modification by maternal cortisol and child sex on the association between prenatal Pb and lung function outcomes. MATERIALS AND METHODS Analyses included 222 mothers and children enrolled in a longitudinal birth cohort study in Mexico City. Maternal diurnal salivary cortisol was assessed in pregnancy; cortisol awakening response (CAR) and diurnal slope were calculated. Blood Pb was measured during the second trimester of pregnancy. Post-bronchodilator lung function was tested at ages 8-11 years. Associations were modeled using generalized linear models with interaction terms, adjusting for covariates. RESULTS A higher (flatter) diurnal slope was associated with lower FEV1/FVC ratio (β: 0.433, 95%CI [-0.766, -0.101]). We did not find any main effect associations between prenatal Pb and lung function outcomes. We report an interaction between Pb and cortisol in relation to FEV1/FVC and FEF25-75% (pinteraction<0.05 for all). Higher prenatal Pb was associated with reduced FEV1/FVC only in children whose mothers had a high CAR. Higher prenatal Pb was also associated with reduced FEV1/FVC and FEF25-75% in mothers with a flatter diurnal slope. A 3-way interaction between prenatal Pb, CAR and sex on FEV1/FVC, indicated that boys born to women with high CAR and higher prenatal Pb levels had lower FEV1/FVC ratios (pinteraction = 0.067). CONCLUSIONS Associations between prenatal Pb and childhood lung function were modified by disrupted maternal cortisol in pregnancy and child sex. These findings underscore the need to consider complex interactions to fully elucidate effects of prenatal Pb exposure on childhood lung function.
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Affiliation(s)
- Maria José Rosa
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, 10029, New York, NY, USA.
| | - Marcela Tamayo-Ortiz
- Occupational Health Research Unit, Mexican Institute of Social Security (IMSS), Av. Cuahtemoc 330, Col. Doctores, 06720, Mexico City, Mexico.
| | - Adriana Mercado Garcia
- Center for Nutrition and Health Research, National Institute of Public Health, Av. Universidad #655 Col, Santa Maria Ahuacatitlan C.P, 62100, Cuernavaca, Morelos, Mexico.
| | - Nadya Y Rivera Rivera
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, 10029, New York, NY, USA.
| | - Douglas Bush
- Kravis Children's Hospital, Department of Pediatrics, Division of Pediatric Pulmonology, Icahn School of Medicine at Mount Sinai, 1184 Fifth Avenue, 10029, New York, NY, USA.
| | - Alison G Lee
- Division of Pulmonary, Critical Care and Sleep, Department of Medicine, Icahn School of Medicine at Mount Sinai, 1468 Madison Avenue, 10029, New York, NY, USA; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY, 10029, USA.
| | - Maritsa Solano-González
- Center for Nutrition and Health Research, National Institute of Public Health, Av. Universidad #655 Col, Santa Maria Ahuacatitlan C.P, 62100, Cuernavaca, Morelos, Mexico.
| | - Chitra Amarasiriwardena
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, 10029, New York, NY, USA.
| | - Martha Maria Téllez-Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Av. Universidad #655 Col, Santa Maria Ahuacatitlan C.P, 62100, Cuernavaca, Morelos, Mexico.
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, 10029, New York, NY, USA; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY, 10029, USA.
| | - Rosalind J Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, 10029, New York, NY, USA; Division of Pulmonary, Critical Care and Sleep, Department of Medicine, Icahn School of Medicine at Mount Sinai, 1468 Madison Avenue, 10029, New York, NY, USA; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY, 10029, USA.
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21
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Quinn AK, Adjei IA, Ae-Ngibise KA, Agyei O, Boamah-Kaali EA, Burkart K, Carrión D, Chillrud SN, Gould CF, Gyaase S, Jack DW, Kaali S, Kinney PL, Lee AG, Mujtaba MN, Oppong FB, Owusu-Agyei S, Yawson A, Wylie BJ, Asante KP. Corrigendum to "Prenatal household air pollutant exposure is associated with reduced size and gestational age at birth among a cohort of Ghanaian infants" [Environ. Int. 155 (2021) 106659]. Environ Int 2022; 158:107006. [PMID: 34924647 PMCID: PMC8673308 DOI: 10.1016/j.envint.2021.107006] [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] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
[This corrects the article PMC8628363.].
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Affiliation(s)
- Ashlinn K. Quinn
- Fogarty International Center, National Institutes of
Health, Bethesda, MD, USA
| | | | | | - Oscar Agyei
- Kintampo Health Research Centre, Kintampo, Ghana
| | | | | | - Daniel Carrión
- Icahn School of Medicine at Mount Sinai, New York, NY,
USA
| | - Steven N. Chillrud
- Mailman School of Public Health, Columbia University, New
York, NY, USA
- Lamont-Doherty Earth Observatory of Columbia University,
Palisades, NY, USA
| | - Carlos F. Gould
- Mailman School of Public Health, Columbia University, New
York, NY, USA
| | | | - Darby W. Jack
- Mailman School of Public Health, Columbia University, New
York, NY, USA
| | - Seyram Kaali
- Kintampo Health Research Centre, Kintampo, Ghana
| | | | - Alison G. Lee
- Icahn School of Medicine at Mount Sinai, New York, NY,
USA
| | | | | | - Seth Owusu-Agyei
- Kintampo Health Research Centre, Kintampo, Ghana
- Institute of Health Research, University of Health and
Allied Sciences, Ho, Ghana
| | - Abena Yawson
- Kintampo Health Research Centre, Kintampo, Ghana
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22
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Bozack A, Pierre S, DeFelice N, Colicino E, Jack D, Chillrud SN, Rundle A, Astua A, Quinn JW, McGuinn L, Yang Q, Johnson K, Masci J, Lukban L, Maru D, Lee AG. Long-Term Air Pollution Exposure and COVID-19 Mortality: A Patient-Level Analysis from New York City. Am J Respir Crit Care Med 2021; 205:651-662. [PMID: 34881681 DOI: 10.1164/rccm.202104-0845oc] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Risk factors for COVID-19 mortality may include environmental exposures, such as air pollution. OBJECTIVES Determine whether, amongst adults hospitalized with PCR-confirmed COVID-19, long-term air pollution exposure is associated with risk for mortality, intensive care unit (ICU) admission or intubation. METHODS We performed a retrospective analysis of SARS-CoV-2 PCR positive patients admitted to seven New York City hospitals from March 8, 2020 to August 30, 2020. The primary outcome was mortality; secondary outcomes were ICU admission and intubation. We estimated the annual average fine particulate matter (PM2.5), nitrogen dioxide (NO2) and black carbon (BC) concentrations at patients' residential addresses. We employed double-robust Poisson regression to analyze associations between annual average PM2.5, NO2 and BC exposure and COVID-19 outcomes, adjusting for age, sex, race/ethnicity, hospital, insurance and time from onset of the pandemic. RESULTS Of the 6,542 patients, 41% were female and aged median 65 years (IQR 53, 77). Over 50% self-identified as a person of color [N=1,687 (26%) Hispanic, N=1,659 (25%) Black]. Air pollution exposures were generally low. Overall, 31% (N=2,044) of the cohort died, 19% (N=1,237) were admitted to the ICU and 16% (1,051) were intubated. In multivariable models, higher long-term exposure to PM2.5 was associated with increased risk of mortality (RR 1.11, 95% CI 1.02, 1.21 per 1µg/m3 increase in PM2.5) and ICU admission (RR 1.13, 95% CI 1.00, 1.28 per 1µg/m3 increase in PM2.5). In multivariable models, neither NO2 nor BC exposure was associated with COVID-19 mortality, ICU admission or intubation. CONCLUSIONS Amongst patients hospitalized with COVID-19, higher long-term PM2.5 exposure was associated with increased risk of mortality and ICU admission. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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Affiliation(s)
- Anne Bozack
- University of California Berkeley, 1438, Berkeley, California, United States
| | - Stanley Pierre
- NYC Health and Hospitals Queens, New York, New York, United States
| | - Nicholas DeFelice
- Icahn School of Medicine at Mount Sinai, 5925, Environmental Medicine and Public Health, New York, New York, United States
| | - Elena Colicino
- Icahn School of Medicine at Mount Sinai, 5925, New York, New York, United States
| | - Darby Jack
- Columbia University Mailman School of Public Health, 33638, Environmental Health Sciences, New York, New York, United States
| | - Steven N Chillrud
- Lamont-Doherty Earth Observatory, 57699, Palisades, New York, United States
| | - Andrew Rundle
- Columbia University Mailman School of Public Health, 33638, New York, New York, United States
| | - Alfredo Astua
- Mount Sinai Health System, 5944, Internal Medicine, New York, New York, United States
| | - James W Quinn
- Columbia University Mailman School of Public Health, 33638, New York, New York, United States
| | - Laura McGuinn
- Icahn School of Medicine at Mount Sinai, 5925, Environmental Medicine and Public Health, New York, New York, United States
| | - Qiang Yang
- Lamont-Doherty Earth Observatory, 57699, Palisades, New York, United States
| | - Keely Johnson
- Icahn School of Medicine at Mount Sinai, 5925, Department of Internal Medicine, New York, New York, United States
| | - Joseph Masci
- Icahn School of Medicine at Mount Sinai, 5925, Division of Infectious Disease, New York, New York, United States
| | - Laureen Lukban
- Icahn School of Medicine at Mount Sinai, 5925, Pediatrics, New York, New York, United States
| | - Duncan Maru
- Icahn School of Medicine at Mount Sinai, 5925, Pediatrics, New York, New York, United States
| | - Alison G Lee
- Icahn School of Medicine at Mount Sinai, 5925, Division of Pulmonary, Sleep and Critical Care Medicine, New York, New York, United States;
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23
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Kinney PL, Asante KP, Lee AG, Ae-Ngibise KA, Burkart K, Boamah-Kaali E, Twumasi M, Gyaase S, Quinn A, Oppong FB, Wylie BJ, Kaali S, Chillrud S, Yawson A, Jack DW, Owusu-Agyei S. Prenatal and Postnatal Household Air Pollution Exposures and Pneumonia Risk: Evidence From the Ghana Randomized Air Pollution and Health Study. Chest 2021; 160:1634-1644. [PMID: 34298005 PMCID: PMC8628168 DOI: 10.1016/j.chest.2021.06.080] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 03/23/2021] [Revised: 06/14/2021] [Accepted: 06/16/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Nearly 40% of the world's population is exposed daily to household air pollution. The relative impact of prenatal and postnatal household air pollution exposure on early childhood pneumonia, a leading cause of mortality, is unknown. RESEARCH QUESTION Are prenatal or postnatal household air pollution, or both, associated with pneumonia risk in the first year of life? STUDY DESIGN AND METHODS The Ghana Randomized Air Pollution and Health Study enrolled 1,414 nonsmoking, pregnant women before 24 weeks' gestation with prospective follow-up to the child's age of 1 year. We measured 72-h personal household air pollution exposures, indexed by carbon monoxide (CO), four times prenatally and three times postnatally. Weekly fieldworker surveillance identified ill-appearing children for physician pneumonia assessment. We used quasi-Poisson models to examine associations between prenatal and postnatal CO and physician-diagnosed pneumonia and severe pneumonia. Sex-specific effects were examined. RESULTS Of the 1,306 live births, 1,141 infants were followed up with 55,605 child-weeks of fieldworker surveillance. The estimated risk for pneumonia and severe pneumonia in the first year of life increased by 10% (relative risk [RR], 1.10; 95% CI, 1.04-1.16) and 15% (RR, 1.15; 95% CI, 1.03-1.28), respectively, per 1-part per million (ppm) increase in average prenatal CO exposure and by 6% (RR, 1.06; 95% CI, 0.99-1.13) per 1-ppm increase in average postnatal CO exposure. Sex-stratified analyses suggest that in girls, higher prenatal CO exposure was associated with pneumonia risk, while no association was seen in boys. INTERPRETATION Prenatal household air pollution exposure increased risk of pneumonia and severe pneumonia in the first year of life. Clean-burning interventions may be most effective when begun prenatally. TRIAL REGISTRY ClinicalTrials.gov; No.: NCT01335490; URL: www.clinicaltrials.gov.
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Affiliation(s)
- Patrick L Kinney
- Department of Environmental Health, Boston University School of Public Health, Boston, MA.
| | - Kwaku-Poku Asante
- Kintampo Health Research Centre, Ghana Health Service, Brong Ahafo Region, Kintampo, Ghana
| | - Alison G Lee
- Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Kenneth A Ae-Ngibise
- Kintampo Health Research Centre, Ghana Health Service, Brong Ahafo Region, Kintampo, Ghana
| | - Katrin Burkart
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA
| | - Ellen Boamah-Kaali
- Kintampo Health Research Centre, Ghana Health Service, Brong Ahafo Region, Kintampo, Ghana
| | - Mieks Twumasi
- Kintampo Health Research Centre, Ghana Health Service, Brong Ahafo Region, Kintampo, Ghana
| | - Stephaney Gyaase
- Kintampo Health Research Centre, Ghana Health Service, Brong Ahafo Region, Kintampo, Ghana
| | - Ashlinn Quinn
- Fogarty International Center, National Institutes of Health, Bethesda, MD
| | - Felix B Oppong
- Kintampo Health Research Centre, Ghana Health Service, Brong Ahafo Region, Kintampo, Ghana
| | - Blair J Wylie
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA
| | - Seyram Kaali
- Kintampo Health Research Centre, Ghana Health Service, Brong Ahafo Region, Kintampo, Ghana
| | - Steven Chillrud
- Lamont-Doherty Earth Observatory, Columbia University, Palisades, NY
| | - Abena Yawson
- Kintampo Health Research Centre, Ghana Health Service, Brong Ahafo Region, Kintampo, Ghana
| | - Darby W Jack
- Department of Environmental Health Sciences, Mailman School of Public Health at Columbia University, New York, NY
| | - Seth Owusu-Agyei
- Kintampo Health Research Centre, Ghana Health Service, Brong Ahafo Region, Kintampo, Ghana
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24
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Boamah-Kaali E, Jack DW, Ae-Ngibise KA, Quinn A, Kaali S, Dubowski K, Oppong FB, Wylie BJ, Mujtaba MN, Gould CF, Gyaase S, Chillrud S, Owusu-Agyei S, Kinney PL, Asante KP, Lee AG. Prenatal and Postnatal Household Air Pollution Exposure and Infant Growth Trajectories: Evidence from a Rural Ghanaian Pregnancy Cohort. Environ Health Perspect 2021; 129:117009. [PMID: 34842444 PMCID: PMC8629028 DOI: 10.1289/ehp8109] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 10/19/2021] [Accepted: 10/22/2021] [Indexed: 05/26/2023]
Abstract
BACKGROUND The exposure-response association between prenatal and postnatal household air pollution (HAP) and infant growth trajectories is unknown. OBJECTIVES To evaluate associations between prenatal and postnatal HAP exposure and stove interventions on growth trajectories over the first year of life. METHODS The Ghana Randomized Air Pollution and Health Study enrolled n=1,414 pregnant women at ≤24wk gestation from Kintampo, Ghana, and randomized them to liquefied petroleum gas (LPG), improved biomass, or open fire (control) stoves. We quantified HAP exposure by repeated, personal prenatal and postnatal carbon monoxide (CO) and, in a subset, fine particulate matter [PM with an aerodynamic diameter of ≤2.5μm (PM2.5)] assessments. Length, weight, mid-upper arm circumference (MUAC) and head circumference (HC) were measured at birth, 3, 6, 9, and 12 months; weight-for-age, length-for-age (LAZ), and weight-for-length z (WLZ)-scores were calculated. For each anthropometric measure, we employed latent class growth analysis to generate growth trajectories over the first year of life and assigned each child to a trajectory group. We then employed ordinal logistic regression to determine associations between HAP exposures and growth trajectory assignments. Associations with stove intervention arm were also considered. RESULTS Of the 1,306 live births, 1,144 had valid CO data and anthropometric variables measured at least once. Prenatal HAP exposure increased risk for lower length [CO odds ratio (OR)= 1.17, 95% CI: 1.01, 1.35 per 1-ppm increase; PM2.5 OR= 1.07, 95% CI: 1.02, 1.13 per 10-μg/m3 increase], lower LAZ z-score (CO OR= 1.15, 95% CI: 1.01, 1.32 per 1-ppm increase) and stunting (CO OR= 1.25, 95% CI: 1.08, 1.45) trajectories. Postnatal HAP exposure increased risk for smaller HC (CO OR= 1.09, 95% CI: 1.04, 1.13 per 1-ppm increase), smaller MUAC and lower WLZ-score (PM2.5 OR= 1.07, 95% CI: 1.00, 1.14 and OR= 1.09, 95% CI: 1.01, 1.19 per 10-μg/m3 increase, respectively) trajectories. Infants in the LPG arm had decreased odds of having smaller HC and MUAC trajectories as compared with those in the open fire stove arm (OR= 0.58, 95% CI: 0.37, 0.92 and OR= 0.45, 95% CI: 0.22, 0.90, respectively). DISCUSSION Higher early life HAP exposure (during pregnancy and through the first year of life) was associated with poorer infant growth trajectories among children in rural Ghana. A cleaner-burning stove intervention may have improved some growth trajectories. https://doi.org/10.1289/EHP8109.
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Affiliation(s)
- Ellen Boamah-Kaali
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Bono East Region, Ghana
| | - Darby W. Jack
- Department of Environmental Health Sciences, Mailman School of Public Health at Columbia University, New York, New York, USA
| | - Kenneth A. Ae-Ngibise
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Bono East Region, Ghana
| | - Ashlinn Quinn
- Fogarty International Center, National Institutes of Health, Bethesda Maryland, USA
| | - Seyram Kaali
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Bono East Region, Ghana
| | - Kathryn Dubowski
- Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Felix B. Oppong
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Bono East Region, Ghana
| | - Blair J Wylie
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Mohammed N. Mujtaba
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Bono East Region, Ghana
| | - Carlos F. Gould
- Department of Environmental Health Sciences, Mailman School of Public Health at Columbia University, New York, New York, USA
| | - Stephaney Gyaase
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Bono East Region, Ghana
| | - Steven Chillrud
- Lamont-Doherty Earth Observatory at Columbia University, Palisades, New York, USA
| | - Seth Owusu-Agyei
- Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
| | - Patrick L. Kinney
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Kwaku Poku Asante
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Bono East Region, Ghana
| | - Alison G. Lee
- Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Bozack AK, Colicino E, Just AC, Wright RO, Baccarelli AA, Wright RJ, Lee AG. Associations between infant sex and DNA methylation across umbilical cord blood, artery, and placenta samples. Epigenetics 2021; 17:1080-1097. [PMID: 34569420 PMCID: PMC9542631 DOI: 10.1080/15592294.2021.1985300] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
DNA methylation (DNAm) is vulnerable to dysregulation by environmental exposures during epigenetic reprogramming that occurs in embryogenesis. Sexual dimorphism in environmentally induced DNAm dysregulation has been identified and therefore it is important to understand sex-specific DNAm patterns. DNAm at several autosomal sites has been consistently associated with sex in cord blood and placental foetal tissues. However, there is limited research comparing sex-specific DNAm across tissues, particularly differentially methylated regions (DMRs). This study leverages DNAm data measured using the Illumina HumanMethylation450 BeadChip in cord blood (N = 179), placenta (N = 229), and umbilical artery samples (N = 229) in the PRogramming of Intergenerational Stress Mechanisms (PRISM) cohort to identify autosomal DMRs and differentially methylated positions (DMPs). A replication analyses was conducted in an independent cohort (GEO Accession GSE129841). We identified 183, 257, and 419 DMRs and 2119, 2281, and 3405 DMPs (pBonferroni < 0.05) in cord blood, placenta, and artery samples, respectively. Thirty-nine DMRs overlapped in all three tissues, overlapping with genes involved in spermatogenesis (NKAPL, PIWIL2 and AURKC) and X-inactivation (LRIF1). In replication analysis, 85% of DMRs overlapped with those identified in PRISM. Overall, DMRs and DMPs had higher methylation levels among females in cord blood and artery samples, but higher methylation levels among males in placenta samples. Further research is necessary to understand biological mechanisms that contribute to differences in sex-specific DNAm signatures across tissues, as well as to determine if sexual dimorphism in the epigenome impacts response to environmental stressors.
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Affiliation(s)
- Anne K Bozack
- Division of Pulmonary Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Elena Colicino
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Allan C Just
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Andrea A Baccarelli
- Departments of Environmental Health Sciences and Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Rosalind J Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alison G Lee
- Division of Pulmonary Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Quinn AK, Adjei IA, Ae-Ngibise KA, Agyei O, Boamah-Kaali EA, Burkart K, Carrión D, Chillrud SN, Gould CF, Gyaase S, Jack DW, Kaali S, Kinney PL, Lee AG, Mujtaba MN, Oppong FB, Owusu-Agyei S, Yawson A, Wylie BJ, Asante KP. Prenatal household air pollutant exposure is associated with reduced size and gestational age at birth among a cohort of Ghanaian infants. Environ Int 2021; 155:106659. [PMID: 34134048 PMCID: PMC8628363 DOI: 10.1016/j.envint.2021.106659] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 05/06/2021] [Accepted: 05/18/2021] [Indexed: 05/14/2023]
Abstract
BACKGROUND Low birth weight and prematurity are important risk factors for death and disability, and may be affected by prenatal exposure to household air pollution (HAP). METHODS We investigate associations between maternal exposure to carbon monoxide (CO) during pregnancy and birth outcomes (birth weight, birth length, head circumference, gestational age, low birth weight, small for gestational age, and preterm birth) among 1288 live-born infants in the Ghana Randomized Air Pollution and Health Study (GRAPHS). We evaluate whether evidence of malaria during pregnancy, as determined by placental histopathology, modifies these associations. RESULTS We observed effects of CO on birth weight, birth length, and gestational age that were modified by placental malarial status. Among infants from pregnancies without evidence of placental malaria, each 1 ppm increase in CO was associated with reduced birth weight (-53.4 g [95% CI: -84.8, -21.9 g]), birth length (-0.3 cm [-0.6, -0.1 cm]), gestational age (-1.0 days [-1.8, -0.2 days]), and weight-for-age Z score (-0.08 standard deviations [-0.16, -0.01 standard deviations]). These associations were not observed in pregnancies with evidence of placental malaria. Each 1 ppm increase in maternal exposure to CO was associated with elevated odds of low birth weight (LBW, OR 1.14 [0.97, 1.33]) and small for gestational age (SGA, OR 1.14 [0.98, 1.32]) among all infants. CONCLUSIONS Even modest reductions in exposure to HAP among pregnant women could yield substantial public health benefits, underscoring a need for interventions to effectively reduce exposure. Adverse associations with HAP were discernible only among those without evidence of placental malaria, a key driver of impaired fetal growth in this malaria-endemic area.
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Affiliation(s)
- Ashlinn K Quinn
- Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| | | | | | - Oscar Agyei
- Kintampo Health Research Centre, Kintampo, Ghana
| | | | | | - Daniel Carrión
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Steven N Chillrud
- Mailman School of Public Health, Columbia University, New York, NY, USA; Lamont-Doherty Earth Observatory of Columbia University, Palisades, NY, USA
| | - Carlos F Gould
- Mailman School of Public Health, Columbia University, New York, NY, USA
| | | | - Darby W Jack
- Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Seyram Kaali
- Kintampo Health Research Centre, Kintampo, Ghana
| | | | - Alison G Lee
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | - Seth Owusu-Agyei
- Kintampo Health Research Centre, Kintampo, Ghana; Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
| | - Abena Yawson
- Kintampo Health Research Centre, Kintampo, Ghana
| | - Blair J Wylie
- Beth Israel Deaconess Medical Center, Boston, MA, USA.
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Jack DW, Ae-Ngibise KA, Gould CF, Boamah-Kaali E, Lee AG, Mujtaba MN, Chillrud S, Kaali S, Quinn AK, Gyaase S, Oppong FB, Carrión D, Agyei O, Burkhart K, Ana-Aro JA, Liu X, Berko YA, Wylie BJ, Etego SA, Whyatt R, Owusu-Agyei S, Kinney P, Asante KP. A cluster randomised trial of cookstove interventions to improve infant health in Ghana. BMJ Glob Health 2021; 6:bmjgh-2021-005599. [PMID: 34452940 PMCID: PMC8404442 DOI: 10.1136/bmjgh-2021-005599] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [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: 03/05/2021] [Accepted: 06/24/2021] [Indexed: 11/06/2022] Open
Abstract
Introduction Household air pollution from solid fuel combustion for cooking and heating is a leading cause of childhood morbidity and mortality worldwide. We hypothesised that clean cooking interventions delivered during pregnancy would improve child health. Methods We conducted a cluster randomised trial in rural Ghana to test whether providing pregnant women liquefied petroleum gas (LPG) cookstoves or improved biomass cookstoves would reduce personal carbon monoxide and fine particulate pollution exposure, increase birth weight and reduce physician-assessed severe pneumonia in the first 12 months of life, compared with control participants who continued to cook with traditional stoves. Primary analyses were intention-to-treat. The trial was registered with ClinicalTrials.gov and follow-up is complete. Results Enrolment began on 14 April 2014, and ended on 20 August 2015. We enrolled 1414 pregnant women; 361 in the LPG arm, 527 in the improved biomass cookstove arm and 526 controls. We saw no improvement in birth weight (the difference in mean birth weight for LPG arm births was 29 g lighter (95% CI −113 to 56, p=0.51) and for improved biomass arm births was 9 g heavier (95% CI −64 to 82, p=0.81), compared with control newborns) nor severe child pneumonia (the rate ratio for pneumonia in the LPG arm was 0.98 (95% CI 0.58 to 1.70; p=0.95) and for the improved biomass arm was 1.21 (95% CI 0.78 to 1.90; p=0.52), compared with the control arm). Air pollution exposures in the LPG arm remained above WHO health-based targets (LPG median particulate matter less than 2.5 microns in diameter (PM2.5) 45 µg/m³; IQR 32–65 vs control median PM2.5 67 µg/m³, IQR 46–97). Conclusions Neither prenatally-introduced LPG nor improved biomass cookstoves improved birth weight or reduced severe pneumonia risk in the first 12 months of life. We hypothesise that this is due to lower-than-expected exposure reductions in the intervention arms. Trial registration number NCT01335490.
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Affiliation(s)
- Darby W Jack
- Department of Environmental Health Sciences, Columbia University, New York, New York, USA
| | - Kenneth Ayuurebobi Ae-Ngibise
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Ghana
| | - Carlos F Gould
- Department of Environmental Health Sciences, Columbia University, New York, New York, USA
| | - Ellen Boamah-Kaali
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Ghana
| | - Alison G Lee
- Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Mohammed Nuhu Mujtaba
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Ghana
| | - Steven Chillrud
- Lamont-Doherty Earth Observatory, Columbia University, Palisades, New York, USA
| | - Seyram Kaali
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Ghana
| | - Ashlinn K Quinn
- Fogarty International Center, National Institutes of Health, Bethesda, Maryland, USA
| | - Stephaney Gyaase
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Ghana
| | - Felix Boakye Oppong
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Ghana
| | - Daniel Carrión
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Oscar Agyei
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Ghana
| | - Katrin Burkhart
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Joseph A Ana-Aro
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Ghana
| | - Xinhua Liu
- Department of Biostatistics, Columbia University, New York, New York, USA
| | - Yvonne Afrah Berko
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Ghana
| | - Blair J Wylie
- Center for Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Seeba Amenga Etego
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Ghana
| | - Robin Whyatt
- Department of Environmental Health Sciences, Columbia University, New York, New York, USA
| | | | - Patrick Kinney
- Department of Environmental Health, Boston University, Boston, Massachusetts, USA
| | - Kwaku Poku Asante
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Ghana
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Kaali S, Jack D, Lee AG. The Conundrum of Cleaner Cookstove Interventions: Necessary but Insufficient? Am J Respir Crit Care Med 2021; 203:1336-1338. [PMID: 33357118 PMCID: PMC8456526 DOI: 10.1164/rccm.202012-4353ed] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Seyram Kaali
- Kintampo Health Research Centre Ghana Health Service Kintampo, Ghana
| | - Darby Jack
- Department of Environmental Health Sciences Columbia University Mailman School of Public Health New York, New York
| | - Alison G Lee
- Division of Pulmonary, Critical Care and Sleep Medicine Icahn School of Medicine at Mount Sinai New York, New York
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29
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Poor HD, Rurak K, Howell D, Lee AG, Colicino E, Reynolds AS, Reilly K, Tolbert T, Mustafa A, Ventetuolo CE. Cardiac index is associated with oxygenation in COVID-19 acute respiratory distress syndrome. Pulm Circ 2021; 11:20458940211019626. [PMID: 34104425 PMCID: PMC8161862 DOI: 10.1177/20458940211019626] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 05/04/2021] [Indexed: 11/15/2022] Open
Abstract
Eleven participants with COVID-19 acute respiratory distress syndrome requiring mechanical ventilation underwent pulmonary artery catheterization for clinical indications. Clinical interventions or events concurrent with hemodynamic were recorded. Increased cardiac index was associated with worse hypoxemia. Modulation of cardiac index may improve hypoxemia in patients with COVID-19 acute respiratory distress syndrome.
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Affiliation(s)
- Hooman D Poor
- Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Kevin Rurak
- Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Daniel Howell
- Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Alison G Lee
- Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Elena Colicino
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Alexandra S Reynolds
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, USA.,Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Kaitlin Reilly
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, USA.,Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Thomas Tolbert
- Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Ali Mustafa
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Corey E Ventetuolo
- Department of Medicine, Brown University, Providence, USA.,Department of Health Services, Policy and Practice, Brown University, Providence, USA
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30
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Reynolds AS, Lee AG, Renz J, DeSantis K, Liang J, Powell CA, Ventetuolo CE, Poor HD. Reply to Chiang and Gupta and to Swenson et al.. Am J Respir Crit Care Med 2021; 203:390-391. [PMID: 33207124 PMCID: PMC7874328 DOI: 10.1164/rccm.202010-3974le] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
| | - Alison G Lee
- Icahn School of Medicine at Mount Sinai New York, New York
| | - Joshua Renz
- NovaSignal Corp. Los Angeles, California and
| | | | - John Liang
- Icahn School of Medicine at Mount Sinai New York, New York
| | | | | | - Hooman D Poor
- Icahn School of Medicine at Mount Sinai New York, New York
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31
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Reynolds AS, Lee AG, Renz J, DeSantis K, Liang J, Powell CA, Ventetuolo CE, Poor HD. Reply to Cherian et al.: Positive Bubble Study in Severe COVID-19 Indicates the Development of Anatomical Intrapulmonary Shunts in Response to Microvascular Occlusion. Am J Respir Crit Care Med 2021; 203:265-266. [PMID: 32997507 PMCID: PMC7874419 DOI: 10.1164/rccm.202009-3404le] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Affiliation(s)
| | - Alison G. Lee
- Icahn School of Medicine at Mount SinaiNew York, New York
| | | | | | - John Liang
- Icahn School of Medicine at Mount SinaiNew York, New York
| | | | | | - Hooman D. Poor
- Icahn School of Medicine at Mount SinaiNew York, New York
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32
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Reynolds AS, Lee AG, Renz J, DeSantis K, Liang J, Powell CA, Ventetuolo CE, Poor HD. Pulmonary Vascular Dilatation Detected by Automated Transcranial Doppler in COVID-19 Pneumonia. Am J Respir Crit Care Med 2020; 202:1037-1039. [PMID: 32757969 PMCID: PMC7528793 DOI: 10.1164/rccm.202006-2219le] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Affiliation(s)
| | - Alison G Lee
- Icahn School of Medicine at Mount Sinai, New York, New York
| | - Joshua Renz
- NovaSignal Corp, Los Angeles, California and
| | | | - John Liang
- Icahn School of Medicine at Mount Sinai, New York, New York
| | | | | | - Hooman D Poor
- Icahn School of Medicine at Mount Sinai, New York, New York
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33
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Hsieh CL, Goldsmith JA, Schaub JM, DiVenere AM, Kuo HC, Javanmardi K, Le KC, Wrapp D, Lee AG, Liu Y, Chou CW, Byrne PO, Hjorth CK, Johnson NV, Ludes-Meyers J, Nguyen AW, Park J, Wang N, Amengor D, Lavinder JJ, Ippolito GC, Maynard JA, Finkelstein IJ, McLellan JS. Structure-based design of prefusion-stabilized SARS-CoV-2 spikes. Science 2020. [PMID: 32703906 DOI: 10.1126/science:abd0826] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has led to accelerated efforts to develop therapeutics and vaccines. A key target of these efforts is the spike (S) protein, which is metastable and difficult to produce recombinantly. We characterized 100 structure-guided spike designs and identified 26 individual substitutions that increased protein yields and stability. Testing combinations of beneficial substitutions resulted in the identification of HexaPro, a variant with six beneficial proline substitutions exhibiting higher expression than its parental construct (by a factor of 10) as well as the ability to withstand heat stress, storage at room temperature, and three freeze-thaw cycles. A cryo-electron microscopy structure of HexaPro at a resolution of 3.2 angstroms confirmed that it retains the prefusion spike conformation. High-yield production of a stabilized prefusion spike protein will accelerate the development of vaccines and serological diagnostics for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
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Affiliation(s)
- Ching-Lin Hsieh
- Department of Molecular Biosciences, University of Texas, Austin, TX 78712, USA
| | - Jory A Goldsmith
- Department of Molecular Biosciences, University of Texas, Austin, TX 78712, USA
| | - Jeffrey M Schaub
- Department of Molecular Biosciences, University of Texas, Austin, TX 78712, USA
| | - Andrea M DiVenere
- Department of Chemical Engineering, University of Texas, Austin, TX 78712, USA
| | - Hung-Che Kuo
- Department of Molecular Biosciences, University of Texas, Austin, TX 78712, USA
| | - Kamyab Javanmardi
- Department of Molecular Biosciences, University of Texas, Austin, TX 78712, USA
| | - Kevin C Le
- Department of Chemical Engineering, University of Texas, Austin, TX 78712, USA
| | - Daniel Wrapp
- Department of Molecular Biosciences, University of Texas, Austin, TX 78712, USA
| | - Alison G Lee
- Department of Molecular Biosciences, University of Texas, Austin, TX 78712, USA
| | - Yutong Liu
- Department of Chemical Engineering, University of Texas, Austin, TX 78712, USA
| | - Chia-Wei Chou
- Department of Molecular Biosciences, University of Texas, Austin, TX 78712, USA
| | - Patrick O Byrne
- Department of Molecular Biosciences, University of Texas, Austin, TX 78712, USA
| | - Christy K Hjorth
- Department of Molecular Biosciences, University of Texas, Austin, TX 78712, USA
| | - Nicole V Johnson
- Department of Molecular Biosciences, University of Texas, Austin, TX 78712, USA
| | - John Ludes-Meyers
- Department of Molecular Biosciences, University of Texas, Austin, TX 78712, USA
| | - Annalee W Nguyen
- Department of Chemical Engineering, University of Texas, Austin, TX 78712, USA
| | - Juyeon Park
- Department of Molecular Biosciences, University of Texas, Austin, TX 78712, USA
| | - Nianshuang Wang
- Department of Molecular Biosciences, University of Texas, Austin, TX 78712, USA
| | - Dzifa Amengor
- Department of Molecular Biosciences, University of Texas, Austin, TX 78712, USA
| | - Jason J Lavinder
- Department of Molecular Biosciences, University of Texas, Austin, TX 78712, USA
- Department of Chemical Engineering, University of Texas, Austin, TX 78712, USA
| | - Gregory C Ippolito
- Department of Molecular Biosciences, University of Texas, Austin, TX 78712, USA
- Department of Oncology, Dell Medical School, University of Texas, Austin, TX 78712, USA
| | - Jennifer A Maynard
- Department of Chemical Engineering, University of Texas, Austin, TX 78712, USA.
| | - Ilya J Finkelstein
- Department of Molecular Biosciences, University of Texas, Austin, TX 78712, USA.
- Center for Systems and Synthetic Biology, University of Texas, Austin, TX 78712, USA
| | - Jason S McLellan
- Department of Molecular Biosciences, University of Texas, Austin, TX 78712, USA.
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Bozack AK, Colicino E, Rodosthenous R, Bloomquist TR, Baccarelli AA, Wright RO, Wright RJ, Lee AG. Associations between maternal lifetime stressors and negative events in pregnancy and breast milk-derived extracellular vesicle microRNAs in the programming of intergenerational stress mechanisms (PRISM) pregnancy cohort. Epigenetics 2020; 16:389-404. [PMID: 32777999 DOI: 10.1080/15592294.2020.1805677] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Maternal stress is associated with adverse child health. Breast milk microRNAs encapsulated in extracellular vesicles (EVs) are involved in mother-infant biochemical communication during early-life programming. We leverage the PRogramming of Intergenerational Stress Mechanisms (PRISM) pregnancy cohort to investigate associations between maternal stress and breast milk EV-microRNAs. Lifetime stress and negative life events (NLEs) during pregnancy were assessed using the Life Stressor Checklist-Revised (LSCR) and the Crisis in Family Systems-Revised surveys, respectively. RNA was extracted from breast milk EVs (N = 80; collected 6.1 ± 5.9 weeks postnatally), and microRNAs were profiled using the TaqMan OpenArray Human miRNA panel. Associations between stress scores and detection (yes/no) of 173 microRNAs identified in 20-80% of samples were assessed using logistic regression; associations with expression levels of 205 EV-microRNAs identified in >50% of samples were assessed using linear regression. In adjusted models, detection of 60 and 44 EV-microRNAs was associated with higher LSCR and NLE scores, respectively (p < 0.05). Expression level of 8 and 17 EV-microRNAs was associated with LSCR and NLE scores, respectively, at our a priori criteria of p < 0.05 and |Bregression|>0.2. Enriched KEGG pathways for microRNAs associated with stress scores included fatty acid metabolism and the Hippo signaling pathway. Maternal lifetime stress and NLEs during pregnancy were both associated with detection and expression level of breast milk EV-microRNAs, although associations with microRNA profiles differed between stress measures. Further research is needed to identify biological pathways impacted by associated microRNAs and investigate relationships with child health outcomes.Abbreviations: EV: extracellular vesicle; PRISM: PRogramming of Intergenerational Stress Mechanisms pregnancy cohort; LSCR: Life Stressor Checklist-Revised survey; NLE: negative life event; CRISYS-R: Crisis in Family Systems-Revised survey; KEGG: Kyoto Encyclopaedia of Genes and Genomes; NYC: New York City; SD: standard deviation; IQR: interquartile range; Cq: relative cycle threshold values; PCA: principal component analysis.
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Affiliation(s)
- Anne K Bozack
- Division of Pulmonary Medicine, Icahn School of Medicine at Mount Sinai, New York, USA.,Department of Environmental Medicine and Public Health, New York, NY, USA
| | - Elena Colicino
- Department of Environmental Medicine and Public Health, New York, NY, USA
| | | | - Tessa R Bloomquist
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Andrea A Baccarelli
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, New York, NY, USA
| | - Rosalind J Wright
- Department of Environmental Medicine and Public Health, New York, NY, USA
| | - Alison G Lee
- Division of Pulmonary Medicine, Icahn School of Medicine at Mount Sinai, New York, USA
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Lee AG, Cowell W, Kannan S, Ganguri HB, Nentin F, Wilson A, Coull BA, Wright RO, Baccarelli A, Bollati V, Wright RJ. Prenatal particulate air pollution and newborn telomere length: Effect modification by maternal antioxidant intakes and infant sex. Environ Res 2020; 187:109707. [PMID: 32474316 PMCID: PMC7844769 DOI: 10.1016/j.envres.2020.109707] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 05/16/2020] [Accepted: 05/17/2020] [Indexed: 05/22/2023]
Abstract
BACKGROUND Evidence links gestational exposure to particulate matter with an aerodynamic diameter of less than 2.5 μm (PM2.5) with changes in leukocyte telomere length in cord blood with some studies showing sex-specific effects. PM2.5 exposure in utero increases oxidative stress, which can impact telomere biology. Thus, maternal antioxidant intakes may also modify the particulate air pollution effects. METHODS We examined associations among prenatal PM2.5 exposure and newborn relative leukocyte telomere length (rLTL), and the modifying effects of maternal antioxidant intake and infant sex. We estimated daily PM2.5 exposures over gestation using a validated spatiotemporally resolved satellite-based model. Maternal dietary and supplemental antioxidant intakes over the prior three months were ascertained during the second trimester using the modified Block98 food frequency questionnaire; high and low antioxidant intakes were categorized based on a median split. We employed Bayesian distributed lag interaction models (BDLIMs) to identify both sensitive windows of exposure and cumulative effect estimates for prenatal PM2.5 exposure on newborn rLTL, and to examine effect modification by maternal antioxidant intakes. A 3-way interaction between PM2.5, maternal antioxidant intake and infant sex was also explored. RESULTS For the main effect of PM2.5, BDLIMs identified a sensitive window at 12-20 weeks gestation for the association between increased prenatal PM2.5 exposure and shorter newborn rLTL and a cumulative effect of PM2.5 over gestation on newborn telomere length [cumulative effect estimate (CEE) = -0.29 (95% CI -0.49 to -0.10) per 1μg/m3 increase in PM2.5]. In models examining maternal antioxidant intake effects, BDLIMs found that children born to mothers reporting low antioxidant intakes were most vulnerable [CEE of low maternal antioxidant intake = -0.31 (95% CI -0.55 to -0.06) vs high maternal antioxidant intake = -0.07 (95% CI -0.34 to 0.17) per 1μg/m3 increase in PM2.5]. In exploratory models examining effect modification by both maternal antioxidant intakes and infant sex, the cumulative effect remained significant only in boys whose mothers reported low antioxidant intakes [CEE = -0.38 (95% CI -0.80 to -0.004)]; no sensitive windows were identified in any group. CONCLUSIONS Prenatal PM2.5 exposure in mid-gestation was associated with reduced infant telomere length. Higher maternal antioxidant intakes mitigated these effects.
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Affiliation(s)
- Alison G Lee
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Whitney Cowell
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Srimathi Kannan
- Department of Metabolism, Endocrinology, and Diabetes, University of Michigan, Ann Arbor, MI, USA
| | | | - Farida Nentin
- Department of Obstetrics, Gynecology, and Reproductive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ander Wilson
- Department of Statistics, Colorado State University, Fort Collins, CO, USA
| | - Brent A Coull
- Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Andrea Baccarelli
- Departments of Environmental Health Sciences and Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Valentina Bollati
- EPIGET Lab, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Rosalind J Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Pediatrics, Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Hsieh CL, Goldsmith JA, Schaub JM, DiVenere AM, Kuo HC, Javanmardi K, Le KC, Wrapp D, Lee AG, Liu Y, Chou CW, Byrne PO, Hjorth CK, Johnson NV, Ludes-Meyers J, Nguyen AW, Park J, Wang N, Amengor D, Lavinder JJ, Ippolito GC, Maynard JA, Finkelstein IJ, McLellan JS. Structure-based design of prefusion-stabilized SARS-CoV-2 spikes. Science 2020; 369:1501-1505. [PMID: 32703906 PMCID: PMC7402631 DOI: 10.1126/science.abd0826] [Citation(s) in RCA: 785] [Impact Index Per Article: 196.3] [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: 05/30/2020] [Accepted: 07/13/2020] [Indexed: 12/16/2022]
Abstract
The COVID-19 pandemic has led to accelerated efforts to develop therapeutics and vaccines. A key target of these efforts is the spike (S) protein, which is metastable and difficult to produce recombinantly. Here, we characterized 100 structure-guided spike designs and identified 26 individual substitutions that increased protein yields and stability. Testing combinations of beneficial substitutions resulted in the identification of HexaPro, a variant with six beneficial proline substitutions exhibiting ~10-fold higher expression than its parental construct and the ability to withstand heat stress, storage at room temperature, and three freeze-thaw cycles. A 3.2 Å-resolution cryo-EM structure of HexaPro confirmed that it retains the prefusion spike conformation. High-yield production of a stabilized prefusion spike protein will accelerate the development of vaccines and serological diagnostics for SARS-CoV-2.
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Affiliation(s)
- Ching-Lin Hsieh
- Department of Molecular Biosciences, University of Texas, Austin, TX 78712, USA
| | - Jory A Goldsmith
- Department of Molecular Biosciences, University of Texas, Austin, TX 78712, USA
| | - Jeffrey M Schaub
- Department of Molecular Biosciences, University of Texas, Austin, TX 78712, USA
| | - Andrea M DiVenere
- Department of Chemical Engineering, University of Texas, Austin, TX 78712, USA
| | - Hung-Che Kuo
- Department of Molecular Biosciences, University of Texas, Austin, TX 78712, USA
| | - Kamyab Javanmardi
- Department of Molecular Biosciences, University of Texas, Austin, TX 78712, USA
| | - Kevin C Le
- Department of Chemical Engineering, University of Texas, Austin, TX 78712, USA
| | - Daniel Wrapp
- Department of Molecular Biosciences, University of Texas, Austin, TX 78712, USA
| | - Alison G Lee
- Department of Molecular Biosciences, University of Texas, Austin, TX 78712, USA
| | - Yutong Liu
- Department of Chemical Engineering, University of Texas, Austin, TX 78712, USA
| | - Chia-Wei Chou
- Department of Molecular Biosciences, University of Texas, Austin, TX 78712, USA
| | - Patrick O Byrne
- Department of Molecular Biosciences, University of Texas, Austin, TX 78712, USA
| | - Christy K Hjorth
- Department of Molecular Biosciences, University of Texas, Austin, TX 78712, USA
| | - Nicole V Johnson
- Department of Molecular Biosciences, University of Texas, Austin, TX 78712, USA
| | - John Ludes-Meyers
- Department of Molecular Biosciences, University of Texas, Austin, TX 78712, USA
| | - Annalee W Nguyen
- Department of Chemical Engineering, University of Texas, Austin, TX 78712, USA
| | - Juyeon Park
- Department of Molecular Biosciences, University of Texas, Austin, TX 78712, USA
| | - Nianshuang Wang
- Department of Molecular Biosciences, University of Texas, Austin, TX 78712, USA
| | - Dzifa Amengor
- Department of Molecular Biosciences, University of Texas, Austin, TX 78712, USA
| | - Jason J Lavinder
- Department of Molecular Biosciences, University of Texas, Austin, TX 78712, USA.,Department of Chemical Engineering, University of Texas, Austin, TX 78712, USA
| | - Gregory C Ippolito
- Department of Molecular Biosciences, University of Texas, Austin, TX 78712, USA.,Department of Oncology, Dell Medical School, University of Texas, Austin, TX 78712, USA
| | - Jennifer A Maynard
- Department of Chemical Engineering, University of Texas, Austin, TX 78712, USA.
| | - Ilya J Finkelstein
- Department of Molecular Biosciences, University of Texas, Austin, TX 78712, USA. .,Center for Systems and Synthetic Biology, University of Texas, Austin, TX 78712, USA
| | - Jason S McLellan
- Department of Molecular Biosciences, University of Texas, Austin, TX 78712, USA.
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Cowell W, Colicino E, Lee AG, Enlow MB, Flom JD, Berin C, Wright RO, Wright RJ. Data-driven discovery of mid-pregnancy immune markers associated with maternal lifetime stress: results from an urban pre-birth cohort. Stress 2020; 23:349-358. [PMID: 31664889 PMCID: PMC7210067 DOI: 10.1080/10253890.2019.1686612] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Changes to the maternal inflammatory milieu may be a mechanism through which maternal psychosocial stress is transmitted to the fetus. Research investigating a limited number of immune markers may miss important signals. We take a proteomics approach to investigate maternal lifetime stress and 92 biomarkers of immune system status. Participants were enrolled in an urban, dual-site (Boston, n = 301 and New York City, n = 110) pregnancy cohort. We measured maternal lifetime history of stress and trauma using the validated Life Stressor Checklist-Revised (LSC-R). We measured a panel of 92 immune-related proteins in mid-pregnancy serum using proximity extension assay technology. We leveraged the dual-site study design to perform variable selection and inference within the cohort. First, we used LASSO to select immune markers related to maternal stress among Boston mothers. Then, we performed OLS regression to examine associations between maternal stress and LASSO-selected proteins among New York City mothers. LASSO regression selected 19 immune proteins with non-null coefficients (CCL11, CCL23, CD244, CST5, CXCL1, CXCL5, CXCL10, CX3CL1, FGF-23, IL-5, IL-7, IL-10, IL-17C, MCP-2, MMP-1, SLAMF1, ST1A1, TNF-β, and TWEAK). Of these, only the chemotactic cytokine CX3CL1 (i.e. fractalkine) was significantly associated with maternal stress among the validation sample (percent change in LSC-R score per 1% increase in relative fractalkine expression: 0.74, 95% confidence interval: 0.19, 1.28). Expanding research suggests fractalkine plays an important role in many aspects of pregnancy and fetal development and is stress-sensitive. We found that maternal lifetime history of stress and trauma was significantly associated with elevated serum fractalkine levels during pregnancy.
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Affiliation(s)
- Whitney Cowell
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Elena Colicino
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alison G. Lee
- Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Julie D. Flom
- Department of Pediatrics, Kravis Children’s Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Cecilia Berin
- Department of Pediatrics, Kravis Children’s Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Robert O. Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rosalind J. Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Pediatrics, Kravis Children’s Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Lee AG, Kaali S, Quinn A, Delimini R, Burkart K, Opoku-Mensah J, Wylie BJ, Yawson AK, Kinney PL, Ae-Ngibise KA, Chillrud S, Jack D, Asante KP. Prenatal Household Air Pollution Is Associated with Impaired Infant Lung Function with Sex-Specific Effects. Evidence from GRAPHS, a Cluster Randomized Cookstove Intervention Trial. Am J Respir Crit Care Med 2020; 199:738-746. [PMID: 30256656 DOI: 10.1164/rccm.201804-0694oc] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
RATIONALE Approximately 2.8 billion people are exposed daily to household air pollution from polluting cookstoves. The effects of prenatal household air pollution on lung development are unknown. OBJECTIVES To prospectively examine associations between prenatal household air pollution and infant lung function and pneumonia in rural Ghana. METHODS Prenatal household air pollution exposure was indexed by serial maternal carbon monoxide personal exposure measurements. Using linear regression, we examined associations between average prenatal carbon monoxide and infant lung function at age 30 days, first in the entire cohort (n = 384) and then stratified by sex. Quasi-Poisson generalized additive models explored associations between infant lung function and pneumonia. MEASUREMENTS AND MAIN RESULTS Multivariable linear regression models showed that average prenatal carbon monoxide exposure was associated with reduced time to peak tidal expiratory flow to expiratory time (β = -0.004; P = 0.01), increased respiratory rate (β = 0.28; P = 0.01), and increased minute ventilation (β = 7.21; P = 0.05), considered separately, per 1 ppm increase in average prenatal carbon monoxide. Sex-stratified analyses suggested that girls were particularly vulnerable (time to peak tidal expiratory flow to expiratory time: β = -0.003, P = 0.05; respiratory rate: β = 0.36, P = 0.01; minute ventilation: β = 11.25, P = 0.01; passive respiratory compliance normalized for body weight: β = 0.005, P = 0.01). Increased respiratory rate at age 30 days was associated with increased risk for physician-assessed pneumonia (relative risk, 1.02; 95% confidence interval, 1.00-1.04) and severe pneumonia (relative risk, 1.04; 95% confidence interval, 1.00-1.08) in the first year of life. CONCLUSIONS Increased prenatal household air pollution exposure is associated with impaired infant lung function. Altered infant lung function may increase risk for pneumonia in the first year of life. These findings have implications for future respiratory health. Clinical trial registered with www.clinicaltrials.gov (NCT 01335490).
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Affiliation(s)
- Alison G Lee
- 1 Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Seyram Kaali
- 2 Kintampo Health Research Centre, Ghana Health Service, Brong Ahafo Region, Kintampo, Ghana
| | - Ashlinn Quinn
- 3 Fogarty International Center, National Institutes of Health, Bethesda, Maryland
| | - Rupert Delimini
- 4 Department of Biomedical Sciences, University of Health and Allied Services, Volta Region, Ghana
| | - Katrin Burkart
- 5 Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York
| | - Jones Opoku-Mensah
- 2 Kintampo Health Research Centre, Ghana Health Service, Brong Ahafo Region, Kintampo, Ghana
| | - Blair J Wylie
- 6 Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massacusetts
| | - Abena Konadu Yawson
- 2 Kintampo Health Research Centre, Ghana Health Service, Brong Ahafo Region, Kintampo, Ghana
| | - Patrick L Kinney
- 7 Department of Health, Boston University School of Public Health, Boston, Massachusetts; and
| | - Kenneth A Ae-Ngibise
- 2 Kintampo Health Research Centre, Ghana Health Service, Brong Ahafo Region, Kintampo, Ghana
| | - Steven Chillrud
- 8 Lamont-Doherty Earth Observatory at Columbia University, Palisades, New York
| | - Darby Jack
- 5 Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York
| | - Kwaku Poku Asante
- 2 Kintampo Health Research Centre, Ghana Health Service, Brong Ahafo Region, Kintampo, Ghana
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Carrión D, Kaali S, Kinney PL, Owusu-Agyei S, Chillrud S, Yawson AK, Quinn A, Wylie B, Ae-Ngibise K, Lee AG, Tokarz R, Iddrisu L, Jack DW, Asante KP. Examining the relationship between household air pollution and infant microbial nasal carriage in a Ghanaian cohort. Environ Int 2019; 133:105150. [PMID: 31518936 PMCID: PMC6868532 DOI: 10.1016/j.envint.2019.105150] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 08/19/2019] [Accepted: 09/02/2019] [Indexed: 05/05/2023]
Abstract
BACKGROUND Pneumonia, a leading cause of childhood mortality, is associated with household air pollution (HAP) exposure. Mechanisms between HAP and pneumonia are poorly understood, but studies suggest that HAP may increase the likelihood of bacterial, instead of viral, pneumonia. We assessed the relationship between HAP and infant microbial nasal carriage among 260 infants participating in the Ghana Randomized Air Pollution and Health Study (GRAPHS). METHODS Data are from GRAPHS, a cluster-randomized controlled trial of cookstove interventions (improved biomass or LPG) versus the 3-stone (baseline) cookstove. Infants were surveyed for pneumonia during the first year of life and had routine personal exposure assessments. Nasopharyngeal swabs collected from pneumonia cases (n = 130) and healthy controls (n = 130) were analyzed for presence of 22 common respiratory microbes by MassTag polymerase chain reaction. Data analyses included intention-to-treat (ITT) comparisons of microbial species presence by study arm, and exposure-response relationships. RESULTS In ITT analyses, 3-stone arm participants had a higher mean number of microbial species than the LPG (LPG: 2.71, 3-stone: 3.34, p < 0.0001, n = 260). This difference was driven by increased bacterial (p < 0.0001) rather than viral species presence (non-significant). Results were pronounced in pneumonia cases and attenuated in healthy controls. Higher prevalence bacterial species were Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis. Exposure-response relationships did not yield significant associations between measured CO and nasal microbial carriage. CONCLUSIONS Our intention-to-treat findings are consistent with a link between HAP and bacterial nasal carriage. No relationships were found for viral carriage. Given the null results in exposure-response analysis, it is likely that a pollutant besides CO is driving these differences.
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Affiliation(s)
| | - Seyram Kaali
- Kintampo Health Research Centre, Kintampo, Ghana
| | - Patrick L Kinney
- Department of Environmental Health, Boston University, Boston, USA
| | | | - Steven Chillrud
- Lamont-Doherty Earth Observatory, Columbia University, New York, USA
| | | | - Ashlinn Quinn
- Fogarty International Center, National Institutes of Health, Bethesda, USA
| | - Blair Wylie
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, USA
| | | | - Alison G Lee
- Icahn School of Medicine at Mount Sinai, New York, USA
| | - Rafal Tokarz
- Center for Infection and Immunity, Columbia University, New York, USA
| | | | - Darby W Jack
- Department of Environmental Health Sciences, Columbia University, New York, USA.
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Ae-Ngibise KA, Wylie BJ, Boamah-Kaali E, Jack DW, Oppong FB, Chillrud SN, Gyaase S, Kaali S, Agyei O, Kinney PL, Mujtaba M, Wright RJ, Asante KP, Lee AG. Prenatal maternal stress and birth outcomes in rural Ghana: sex-specific associations. BMC Pregnancy Childbirth 2019; 19:391. [PMID: 31664941 PMCID: PMC6819589 DOI: 10.1186/s12884-019-2535-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 09/24/2019] [Indexed: 01/08/2023] Open
Abstract
Background In developed countries, prenatal maternal stress has been associated with poor fetal growth, however this has not been evaluated in rural sub-Saharan Africa. We evaluated the effect of prenatal maternal stress on fetal growth and birth outcomes in rural Ghana. Methods Leveraging a prospective, rural Ghanaian birth cohort, we ascertained prenatal maternal negative life events, categorized scores as 0-2 (low stress; referent), 3-5 (moderate), and > 5 (high) among 353 pregnant women in the Kintampo North Municipality and Kintampo South District located within the middle belt of Ghana. We employed linear regression to determine associations between prenatal maternal stress and infant birth weight, head circumference, and length. We additionally examined associations between prenatal maternal stress and adverse birth outcome, including low birth weight, small for gestational age, or stillbirth. Effect modification by infant sex was examined. Results In all children, high prenatal maternal stress was associated with reduced birth length (β = − 0.91, p = 0.04; p-value for trend = 0.04). Among girls, moderate and high prenatal maternal stress was associated with reduced birth weight (β = − 0.16, p = 0.02; β = − 0.18, p = 0.04 respectively; p-value for trend = 0.04) and head circumference (β = − 0.66, p = 0.05; β = − 1.02, p = 0.01 respectively; p-value for trend = 0.01). In girls, high prenatal stress increased odds of any adverse birth outcome (OR 2.41, 95% CI 1.01-5.75; p for interaction = 0.04). Sex-specific analyses did not demonstrate significant effects in boys. Conclusions All infants, but especially girls, were vulnerable to effects of prenatal maternal stress on birth outcomes. Understanding risk factors for impaired fetal growth may help develop preventative public health strategies. Trial registration NCT01335490 (prospective registration). Date of Registration: April 14, 2011. Status of Registration: Completed.
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Affiliation(s)
- Kenneth Ayuurebobi Ae-Ngibise
- Ghana Health Service, Kintampo Health Research Centre, Brong Ahafo Region, Kintampo, Ghana.,School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
| | - Blair J Wylie
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Ellen Boamah-Kaali
- Ghana Health Service, Kintampo Health Research Centre, Brong Ahafo Region, Kintampo, Ghana
| | - Darby W Jack
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
| | - Felix Boakye Oppong
- Ghana Health Service, Kintampo Health Research Centre, Brong Ahafo Region, Kintampo, Ghana
| | - Steven N Chillrud
- Lamont-Doherty Earth Observatory at Columbia University, Palisades, NY, USA
| | - Stephaney Gyaase
- Ghana Health Service, Kintampo Health Research Centre, Brong Ahafo Region, Kintampo, Ghana
| | - Seyram Kaali
- Ghana Health Service, Kintampo Health Research Centre, Brong Ahafo Region, Kintampo, Ghana
| | - Oscar Agyei
- Ghana Health Service, Kintampo Health Research Centre, Brong Ahafo Region, Kintampo, Ghana
| | - Patrick L Kinney
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Mohammed Mujtaba
- Ghana Health Service, Kintampo Health Research Centre, Brong Ahafo Region, Kintampo, Ghana
| | - Rosalind J Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Pediatrics, Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kwaku Poku Asante
- Ghana Health Service, Kintampo Health Research Centre, Brong Ahafo Region, Kintampo, Ghana
| | - Alison G Lee
- Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, 1468 Madison Avenue, New York, NY, 10029, USA.
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Lee AG, Le Grand B, Hsu HHL, Chiu YHM, Brennan KJ, Bose S, Rosa MJ, Brunst KJ, Kloog I, Wilson A, Schwartz J, Morgan W, Coull BA, Wright RO, Baccarelli AA, Wright RJ. Prenatal fine particulate exposure associated with reduced childhood lung function and nasal epithelia GSTP1 hypermethylation: Sex-specific effects. Respir Res 2018; 19:76. [PMID: 29703190 PMCID: PMC5923186 DOI: 10.1186/s12931-018-0774-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 04/06/2018] [Indexed: 12/31/2022] Open
Abstract
Background In utero exposure to particulate matter with an aerodynamic diameter of less than 2.5 μm (PM2.5) has been linked to child lung function. Overlapping evidence suggests that child sex and exposure timing may modify effects and associations may be mediated through glutathione S-transferase P1 (GSTP1) methylation. Methods We prospectively examined associations among prenatal PM2.5 exposure and child lung function and GSTP1 methylation in an urban pregnancy cohort study. We employed a validated satellite-based spatiotemporally resolved prediction model to estimate daily prenatal PM2.5 exposure over gestation. We used Baysian distributed lag interaction models (BDLIMs) to identify sensitive windows for prenatal PM2.5 exposure on child lung function and nasal epithelia GSTP1 methylation at age 7 years, and to examine effect modification by child sex. Results BDLIMs identified a sensitive window for prenatal PM2.5 exposure at 35–40 weeks gestation [cumulative effect estimate (CEE) = − 0.10, 95%CI = − 0.19 to − 0.01, per μg/m3 increase in PM2.5] and at 36–40 weeks (CEE = − 0.12, 95%CI = − 0.20 to − 0.01) on FEV1 and FVC, respectively, in boys. BDLIMs also identified a sensitive window of exposure at 37–40 weeks gestation between higher prenatal PM2.5 exposure and increased GSTP1 percent methylation. The association between higher GSTP1 percent methylation and decreased FEV1 was borderline significant in the sample as a whole (β = − 0.37, SE = 0.20, p = 0.06) and in boys in stratified analyses (β = − 0.56, SE = 0.29, p = 0.05). Conclusions Prenatal PM2.5 exposure in late pregnancy was associated with impaired early childhood lung function and hypermethylation of GSTPI in DNA isolated from nasal epithelial cells. There was a trend towards higher GSTP1 percent methylation being associated with reduced FEV1. All findings were most evident among boys.
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Affiliation(s)
- Alison G Lee
- Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, 1236 Park Avenue, First Floor, New York, NY, 10029, USA.
| | - Blake Le Grand
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Hsiao-Hsien Leon Hsu
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Pediatrics, Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Yueh-Hsiu Mathilda Chiu
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Pediatrics, Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kasey J Brennan
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Sonali Bose
- Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, 1236 Park Avenue, First Floor, New York, NY, 10029, USA
| | - Maria José Rosa
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kelly J Brunst
- Department of Environmental Health, University of Cincinnati College of Medicine, 160 Panzeca Way, Cincinnati, OH, USA
| | - Itai Kloog
- Department of Geography and Environmental Development, Faculty of Humanities and Social Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Ander Wilson
- Department of Statistics, Colorado State University, Fort Collins, CO, USA
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Wayne Morgan
- Department of Pediatrics, University of Arizona, Tucson, Arizona, USA
| | - Brent A Coull
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Pediatrics, Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Andrea A Baccarelli
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Rosalind J Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Pediatrics, Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Chamberlain PD, Sadaka A, Berry S, Lee AG. Intermittent mydriasis associated with carotid vascular occlusion. Eye (Lond) 2017; 32:457-459. [PMID: 28799558 DOI: 10.1038/eye.2017.127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2016] [Accepted: 06/08/2017] [Indexed: 11/09/2022] Open
Abstract
PurposeTo describe two cases of stereotyped, intermittent, neurologically isolated, unilateral mydriasis in patients with a history of acquired internal carotid artery (ICA) occlusive disease on the ipsilateral side.PatientsTwo patients with intermittent mydriasis.MethodsCase Series.ResultsCase one: A 78-year-old man experienced 10 episodes of intermittent, unilateral, and painless mydriasis in the left eye and had 100% occlusion of the left ICA artery due to atherosclerotic disease. Case two: A 26-year-old woman with history of migraine developed new painless, intermittent episodes of unilateral mydriasis after sustaining chest trauma and was diagnosed with subsequent dissection and 65% occlusion of the ipsilateral ICA. Neither patient developed permanent anisocoria.ConclusionBenign episodic unilateral mydriasis (BEUM) typically presents in young women with a history of migraine. To our knowledge, these are the first cases of episodic, unilateral, neurologically isolated mydriasis associated with occlusive disease of the ICA in the English language ophthalmic literature. We hypothesize that transient dysfunction of the autonomic nervous system related to the ICA disease may account for the intermittent mydriatic episodes in these patients and we recommend consideration for imaging of the ICA in patients with atypical features for BEUM (for example, old age or males, non-isolated mydriasis, or recent trauma).
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Affiliation(s)
- P D Chamberlain
- Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, TX, USA.,Department of Ophthalmology, Baylor College of Medicine, Houston, TX, USA
| | - A Sadaka
- Department of Ophthalmology, Baylor College of Medicine, Houston, TX, USA
| | - S Berry
- Department of Ophthalmology, Baylor College of Medicine, Houston, TX, USA
| | - A G Lee
- Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, TX, USA.,Department of Ophthalmology, Baylor College of Medicine, Houston, TX, USA.,Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medical College, New York, NY, USA.,Department of Ophthalmology, University of Texas Medical Branch, Galveston, TX, USA.,Department of Ophthalmology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.,Department of Ophthalmology, UT MD Anderson Cancer Center, Houston, TX, USA
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43
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Lewis AM, Croughan WD, Aranibar N, Lee AG, Warrack B, Abu-Absi NR, Patel R, Drew B, Borys MC, Reily MD, Li ZJ. Understanding and Controlling Sialylation in a CHO Fc-Fusion Process. PLoS One 2016; 11:e0157111. [PMID: 27310468 PMCID: PMC4911072 DOI: 10.1371/journal.pone.0157111] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [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: 03/12/2016] [Accepted: 05/24/2016] [Indexed: 12/13/2022] Open
Abstract
A Chinese hamster ovary (CHO) bioprocess, where the product is a sialylated Fc-fusion protein, was operated at pilot and manufacturing scale and significant variation of sialylation level was observed. In order to more tightly control glycosylation profiles, we sought to identify the cause of variability. Untargeted metabolomics and transcriptomics methods were applied to select samples from the large scale runs. Lower sialylation was correlated with elevated mannose levels, a shift in glucose metabolism, and increased oxidative stress response. Using a 5-L scale model operated with a reduced dissolved oxygen set point, we were able to reproduce the phenotypic profiles observed at manufacturing scale including lower sialylation, higher lactate and lower ammonia levels. Targeted transcriptomics and metabolomics confirmed that reduced oxygen levels resulted in increased mannose levels, a shift towards glycolysis, and increased oxidative stress response similar to the manufacturing scale. Finally, we propose a biological mechanism linking large scale operation and sialylation variation. Oxidative stress results from gas transfer limitations at large scale and the presence of oxygen dead-zones inducing upregulation of glycolysis and mannose biosynthesis, and downregulation of hexosamine biosynthesis and acetyl-CoA formation. The lower flux through the hexosamine pathway and reduced intracellular pools of acetyl-CoA led to reduced formation of N-acetylglucosamine and N-acetylneuraminic acid, both key building blocks of N-glycan structures. This study reports for the first time a link between oxidative stress and mammalian protein sialyation. In this study, process, analytical, metabolomic, and transcriptomic data at manufacturing, pilot, and laboratory scales were taken together to develop a systems level understanding of the process and identify oxygen limitation as the root cause of glycosylation variability.
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Affiliation(s)
- Amanda M. Lewis
- Biologics Development, Global Manufacturing and Supply, Bristol-Myers Squibb Company, Devens, MA, United States of America
- * E-mail:
| | - William D. Croughan
- Biologics Development, Global Manufacturing and Supply, Bristol-Myers Squibb Company, Devens, MA, United States of America
| | - Nelly Aranibar
- Research and Development, Bristol-Myers Squibb Company, Princeton, NJ, United States of America
| | - Alison G. Lee
- Biologics Development, Global Manufacturing and Supply, Bristol-Myers Squibb Company, Devens, MA, United States of America
| | - Bethanne Warrack
- Research and Development, Bristol-Myers Squibb Company, Princeton, NJ, United States of America
| | - Nicholas R. Abu-Absi
- Biologics Development, Global Manufacturing and Supply, Bristol-Myers Squibb Company, Devens, MA, United States of America
| | - Rutva Patel
- Biologics Development, Global Manufacturing and Supply, Bristol-Myers Squibb Company, Devens, MA, United States of America
| | - Barry Drew
- Biologics Development, Global Manufacturing and Supply, Bristol-Myers Squibb Company, Devens, MA, United States of America
| | - Michael C. Borys
- Biologics Development, Global Manufacturing and Supply, Bristol-Myers Squibb Company, Devens, MA, United States of America
| | - Michael D. Reily
- Research and Development, Bristol-Myers Squibb Company, Princeton, NJ, United States of America
| | - Zheng Jian Li
- Biologics Development, Global Manufacturing and Supply, Bristol-Myers Squibb Company, Devens, MA, United States of America
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Godin SK, Zhang Z, Herken BW, Westmoreland JW, Lee AG, Mihalevic MJ, Yu Z, Sobol RW, Resnick MA, Bernstein KA. The Shu complex promotes error-free tolerance of alkylation-induced base excision repair products. Nucleic Acids Res 2016; 44:8199-215. [PMID: 27298254 PMCID: PMC5041462 DOI: 10.1093/nar/gkw535] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [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: 10/19/2015] [Accepted: 06/02/2016] [Indexed: 12/24/2022] Open
Abstract
Here, we investigate the role of the budding yeast Shu complex in promoting homologous recombination (HR) upon replication fork damage. We recently found that the Shu complex stimulates Rad51 filament formation during HR through its physical interactions with Rad55-Rad57. Unlike other HR factors, Shu complex mutants are primarily sensitive to replicative stress caused by MMS and not to more direct DNA breaks. Here, we uncover a novel role for the Shu complex in the repair of specific MMS-induced DNA lesions and elucidate the interplay between HR and translesion DNA synthesis. We find that the Shu complex promotes high-fidelity bypass of MMS-induced alkylation damage, such as N3-methyladenine, as well as bypassing the abasic sites generated after Mag1 removes N3-methyladenine lesions. Furthermore, we find that the Shu complex responds to ssDNA breaks generated in cells lacking the abasic site endonucleases. At each lesion, the Shu complex promotes Rad51-dependent HR as the primary repair/tolerance mechanism over error-prone translesion DNA polymerases. Together, our work demonstrates that the Shu complex's promotion of Rad51 pre-synaptic filaments is critical for high-fidelity bypass of multiple replication-blocking lesion.
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Affiliation(s)
- Stephen K Godin
- University of Pittsburgh School of Medicine, Department of Microbiology and Molecular Genetics, 5117 Centre Avenue, Pittsburgh, PA 15213, USA
| | - Zhuying Zhang
- University of Pittsburgh School of Medicine, Department of Microbiology and Molecular Genetics, 5117 Centre Avenue, Pittsburgh, PA 15213, USA Tsinghua University School of Medicine, Tsinghua University, Haidian District, Beijing 100084, China
| | - Benjamin W Herken
- University of Pittsburgh School of Medicine, Department of Microbiology and Molecular Genetics, 5117 Centre Avenue, Pittsburgh, PA 15213, USA
| | - James W Westmoreland
- Chromosome Stability Group, Laboratory of Molecular Genetics, National Institute of Environmental Health Sciences (NIEHS), National Institutes of Health, Research Triangle Park, NC 27709, USA
| | - Alison G Lee
- University of Pittsburgh School of Medicine, Department of Microbiology and Molecular Genetics, 5117 Centre Avenue, Pittsburgh, PA 15213, USA
| | - Michael J Mihalevic
- University of Pittsburgh School of Medicine, Department of Microbiology and Molecular Genetics, 5117 Centre Avenue, Pittsburgh, PA 15213, USA
| | - Zhongxun Yu
- Tsinghua University School of Medicine, Tsinghua University, Haidian District, Beijing 100084, China Department of Pharmacology & Chemical Biology, Pittsburgh, PA 15217, USA
| | - Robert W Sobol
- Department of Pharmacology & Chemical Biology, Pittsburgh, PA 15217, USA University of South Alabama Mitchell Cancer Institute, 1660 Springhill Avenue, Mobile, AL 36604, USA
| | - Michael A Resnick
- Chromosome Stability Group, Laboratory of Molecular Genetics, National Institute of Environmental Health Sciences (NIEHS), National Institutes of Health, Research Triangle Park, NC 27709, USA
| | - Kara A Bernstein
- University of Pittsburgh School of Medicine, Department of Microbiology and Molecular Genetics, 5117 Centre Avenue, Pittsburgh, PA 15213, USA
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Godin SK, Lee AG, Baird JM, Herken BW, Bernstein KA. Tryptophan biosynthesis is important for resistance to replicative stress in Saccharomyces cerevisiae. Yeast 2016; 33:183-9. [PMID: 26804060 DOI: 10.1002/yea.3150] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [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: 05/28/2015] [Revised: 01/13/2016] [Accepted: 01/14/2016] [Indexed: 12/26/2022] Open
Abstract
Acute tryptophan depletion is used to induce low levels of serotonin in the brain. This method has been widely used in psychiatric studies to evaluate the effect of low levels of serotonin, and is generally considered a safe and reversible procedure. Here we use the budding yeast Saccharomyces cerevisiae to study the effects of tryptophan depletion on growth rate upon exposure to DNA-damaging agents. Surprisingly, we found that budding yeast undergoing tryptophan depletion were more sensitive to DNA-damaging agents such as methyl methanesulphonate (MMS) and hydroxyurea (HU). We found that this defect was independent of several DNA repair pathways, such as homologous recombination, base excision repair and translesion synthesis, and that this damage sensitivity was not due to impaired S-phase signalling. Upon further analysis, we found that the DNA-damage sensitivity of tryptophan depletion was likely due to impaired protein synthesis. These studies describe an important source of variance in budding yeast when using tryptophan as an auxotrophic marker, particularly on studies focusing on DNA repair, and suggest that further testing of the effect of tryptophan depletion on DNA repair in mammalian cells is warranted. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Stephen K Godin
- Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, PA, USA.,University of Pittsburgh Cancer Institute, PA, USA
| | - Alison G Lee
- Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, PA, USA.,University of Pittsburgh Cancer Institute, PA, USA
| | - Jared M Baird
- Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, PA, USA.,University of Pittsburgh Cancer Institute, PA, USA
| | - Benjamin W Herken
- Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, PA, USA.,University of Pittsburgh Cancer Institute, PA, USA
| | - Kara A Bernstein
- Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, PA, USA.,University of Pittsburgh Cancer Institute, PA, USA
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Abstract
Ameloblastomas are histologically benign tumors derived from the odontogenic apparatus. Although these tumors are locally invasive, they rarely invade the paranasal sinuses, orbits, or intracranial cavity, and, thus, they rarely produce ophthalmologic signs and symptoms. In this report, we describe the neuro-ophthalmologic features of three patients with chronically aggressive ameloblastoma. Two of the patients developed a progressive and recurrent orbital apex and cavernous sinus syndromes. One of these patients is, to our knowledge, the first patient described with orbital and cavernous simus involvement by an ameloblastoma initially arising in the mandible. The other is only the second case described with bilateral orbital involvement. The third patient in this series developed a trigeminal sensory neuropathy as the only sign of the tumor. Although ameloblastomas are benign, slowly growing tumors, they may, often over a long period of time, cause significant neuro-ophthalmologic and orbital manifestutions that can only be partially ameliorated by surgery.
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47
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Rubinstein AL, Irazola VE, Bazzano LA, Sobrino E, Calandrelli M, Lanas F, Lee AG, Manfredi JA, Olivera H, Ponzo J, Seron P, He J. Detection and follow-up of chronic obstructive pulmonary disease (COPD) and risk factors in the Southern Cone of Latin America: the pulmonary risk in South America (PRISA) study. BMC Pulm Med 2011; 11:34. [PMID: 21627849 PMCID: PMC3116480 DOI: 10.1186/1471-2466-11-34] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [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: 05/03/2011] [Accepted: 06/01/2011] [Indexed: 11/30/2022] Open
Abstract
Background The World Health Organization has estimated that by 2030, chronic obstructive pulmonary disease will be the third leading cause of death worldwide. Most knowledge of chronic obstructive pulmonary disease is based on studies performed in Europe or North America and little is known about the prevalence, patient characteristics and change in lung function over time in patients in developing countries, such as those of Latin America. This lack of knowledge is in sharp contrast to the high levels of tobacco consumption and exposure to biomass fuels exhibited in Latin America, both major risk factors for the development of chronic obstructive pulmonary disease. Studies have also demonstrated that most Latin American physicians frequently do not follow international chronic obstructive pulmonary disease diagnostic and treatment guidelines. The PRISA Study will expand the current knowledge regarding chronic obstructive pulmonary disease and risk factors in Argentina, Chile and Uruguay to inform policy makers and health professionals on the best policies and practices to address this condition. Methods/Design PRISA is an observational, prospective cohort study with at least four years of follow-up. In the first year, PRISA has employed a randomized three-staged stratified cluster sampling strategy to identify 6,000 subjects from Marcos Paz and Bariloche, Argentina, Temuco, Chile, and Canelones, Uruguay. Information, such as comorbidities, socioeconomic status and tobacco and biomass exposure, will be collected and spirometry, anthropometric measurements, blood sampling and electrocardiogram will be performed. In year four, subjects will have repeat measurements taken. Discussion There is no longitudinal data on chronic obstructive pulmonary disease incidence and risk factors in the southern cone of Latin America, therefore this population-based prospective cohort study will fill knowledge gaps in the prevalence and incidence of chronic obstructive pulmonary disease, patient characteristics and changes in lung function over time as well as quality of life and health care resource utilization. Information gathered during the PRISA Study will inform public health interventions and prevention practices to reduce risk of COPD in the region.
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Affiliation(s)
- Adolfo L Rubinstein
- Centro de Excelencia en Salud Cardiovascular para el Cono Sur, Instituto de Efectividad Clínica y Sanitaria, (Emilio Ravignani 2024), Buenos Aires, (C1414CPV), Argentina.
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48
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Lo C, Busch S, Lee AG, Searle G, Lamb R, Cramer A, Winter MC, Coleman RE, Dixon M, Bundred NJ, Landberg G. Abstract P4-05-05: Stromal Response to 14-Day Preoperative Therapy in Postmenopausal Oestrogen Receptor Positive Breast Cancer. Cancer Res 2010. [DOI: 10.1158/0008-5472.sabcs10-p4-05-05] [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: Stromal-epithelial interaction is a key factor in tumour progression. Cancer-associated fibroblasts (CAFs) and macrophage infiltration have been associated with early relapse in breast cancer. Bisphosphonates are effective inhibitors of osteoclast activation in metastatic breast cancer but also have a general inhibitory effect on breast cancer progression. In order to monitor a potential tumour stromal response in breast cancer during treatment with an aromatase inhibitor and a bisphosphonate we analysed pre-and post-treatment samples from a neoadjuvant window study and focused on the presence of macrophages and CAFs.
Materials and methods: Tissue microarrays (TMAs) from surgical samples and pre-operative core biopsies were immunohistochemically stained for aSMA (CAF marker), CD68 (macrophages) and epithelial proliferation (Ki67). In order to validate if the presence of macrophages and aSMA could be monitored by the TMA approach, we initially analysed a screening cohort of 144 breast cancer samples. We then studied pre-and post-treatment samples from 110 postmenopausal ER-positive invasive breast cancer patients randomised to receive 14 days of preoperative treatment (placebo, Letrozole, or Letrozole plus Zoledronate). Results: In the screening cohort, we observed significant links between aSMA positive fibroblasts and disease recurrence as well as between CD68 positive macrophages and tumour size, grade, lymph node positivity and recurrence. This validated the use of TMAs for stromal analyses and furthersupported a link with key tumour biological events. In both treatment arms, there was a significant drop in absolute Ki67 value compared to placebo (-9.3% Letrozole and -13.1% combination reduction versus 1% increase, P<0.001). Post-treatment CD68 (median 35, range 3 to 117) was significantly linked to a Ki67 drop (p=0.045). Interestingly, this effect was mainly observed in the combination treatment group (p=0.002). aSMA expression was unaffected during treatment in 52%, increased in 35% and decreased in 13% of cases. Patients with aSMA reduction post treatment had a larger Ki67 fall compared to patients with increase or no change in aSMA (p=0.007).
Conclusion: Short term treatment response in the epithelial component of cancers was paralleled by specific responses in the tumour stromal component. These novel findings suggest that bisphosphonates and aromatase inhibitors have major effects on tumour stroma in vivo which might augment their inhibitory effect on tumour progression.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P4-05-05.
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Affiliation(s)
- C Lo
- University of Manchester, United Kingdom; University of Edingburgh, United Kingdom; University of Sheffield, United Kingdom; University Hospital of South Manchester, United Kingdom
| | - S Busch
- University of Manchester, United Kingdom; University of Edingburgh, United Kingdom; University of Sheffield, United Kingdom; University Hospital of South Manchester, United Kingdom
| | - AG Lee
- University of Manchester, United Kingdom; University of Edingburgh, United Kingdom; University of Sheffield, United Kingdom; University Hospital of South Manchester, United Kingdom
| | - G Searle
- University of Manchester, United Kingdom; University of Edingburgh, United Kingdom; University of Sheffield, United Kingdom; University Hospital of South Manchester, United Kingdom
| | - R Lamb
- University of Manchester, United Kingdom; University of Edingburgh, United Kingdom; University of Sheffield, United Kingdom; University Hospital of South Manchester, United Kingdom
| | - A Cramer
- University of Manchester, United Kingdom; University of Edingburgh, United Kingdom; University of Sheffield, United Kingdom; University Hospital of South Manchester, United Kingdom
| | - MC Winter
- University of Manchester, United Kingdom; University of Edingburgh, United Kingdom; University of Sheffield, United Kingdom; University Hospital of South Manchester, United Kingdom
| | - RE Coleman
- University of Manchester, United Kingdom; University of Edingburgh, United Kingdom; University of Sheffield, United Kingdom; University Hospital of South Manchester, United Kingdom
| | - M Dixon
- University of Manchester, United Kingdom; University of Edingburgh, United Kingdom; University of Sheffield, United Kingdom; University Hospital of South Manchester, United Kingdom
| | - NJ Bundred
- University of Manchester, United Kingdom; University of Edingburgh, United Kingdom; University of Sheffield, United Kingdom; University Hospital of South Manchester, United Kingdom
| | - G. Landberg
- University of Manchester, United Kingdom; University of Edingburgh, United Kingdom; University of Sheffield, United Kingdom; University Hospital of South Manchester, United Kingdom
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Abstract
The concept of psychological androgyny, because of its implications for sex roles, social change, and human development, is presently of special theoretical interest. Psychologically androgynous persons, as identified by the Bern Sex Role Inventory (BSRI), score higher on both its femininity and masculinity scales. Given the psychometric properties of the BSRI, it can be hypothesized that androgynous persons will have higher social desirability scores. Yet, the "masculine male" and the "feminine female" may be the most socially desirable, in that they conform to normative expectations. Consequently it can also be hypothesized that individuals who are either masculine-typed males or feminine-typed females on the BSRI will have the higher social desirability scores. Neither prediction was found to be entirely accurate; instead, androgynous and feminine-typed individuals were found to have higher social desirability scores. Moreover, the data reveal that the BSRI femininity scale has social desirability characteristics which are sex-specific.
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Affiliation(s)
- A G Lee
- Washington State University, Women Studies Program, Pullman 99164, USA
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50
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Randhawa S, Shah VA, Kardon RH, Lee AG. An internuclear ophthalmoplegia with ipsilateral abduction deficit: half and half syndrome. BMJ Case Rep 2009; 2009:bcr2006099135. [PMID: 21687160 DOI: 10.1136/bcr.2006.099135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- S Randhawa
- Department of Ophthalmology and Visual Sciences,The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
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