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Lorant C, Zigmantaviciute J, Ali N, Bonnevier U, Tejde M, von Zur-Mühlen B, Eriksson BM, Bergqvist A, Westman G. The risk factors associated with post-transplantation BKPyV nephropathy and BKPyV DNAemia: a prospective study in kidney transplant recipients. BMC Infect Dis 2024; 24:245. [PMID: 38388351 PMCID: PMC10885533 DOI: 10.1186/s12879-024-09093-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 02/03/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND BK polyomavirus (BKPyV) infection after kidney transplantation can lead to serious complications such as BKPyV-associated nephropathy (BKPyVAN) and graft loss. The aim of this study was to investigate the incidence of BKPyVAN after implementing a BKPyV screening program, to map the distribution of BKPyV genotypes and subtypes in the Uppsala-Örebro region and to identify host and viral risk factors for clinically significant events. METHODS This single-center prospective cohort study included kidney transplant patients aged ≥ 18 years at the Uppsala University Hospital in Sweden between 2016 and 2018. BKPyV DNA was analyzed in plasma and urine every 3 months until 18 months after transplantation. Also genotype and subtype were determined. A logistic regression model was used to analyze selected risk factors including recipient sex and age, AB0 incompatibility and rejection treatment prior to BKPyVAN or high-level BKPyV DNAemia. RESULTS In total, 205 patients were included. Of these, 151 (73.7%) followed the screening protocol with 6 plasma samples, while184 (89.8%) were sampled at least 5 times. Ten (4.9%) patients developed biopsy confirmed BKPyVAN and 33 (16.1%) patients met criteria for high-level BKPyV DNAemia. Male sex (OR 2.85, p = 0.025) and age (OR 1.03 per year, p = 0.020) were identified as significant risk factors for developing BKPyVAN or high-level BKPyV DNAemia. BKPyVAN was associated with increased viral load at 3 months post transplantation (82,000 vs. < 400 copies/mL; p = 0.0029) and with transient, high-level DNAemia (n = 7 (27%); p < 0.0001). The most common genotypes were subtype Ib2 (n = 50 (65.8%)) and IVc2 (n = 20 (26.3%)). CONCLUSIONS Male sex and increasing age are related to an increased risk of BKPyVAN or high-level BKPyV DNAemia. BKPyVAN is associated with transient, high-level DNAemia but no differences related to viral genotype were detected.
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Affiliation(s)
- Camilla Lorant
- Department of Medical Sciences, Section of Infectious Diseases, Uppsala University, SE-751 85, Uppsala, Sweden.
| | - Justina Zigmantaviciute
- Department of Medical Sciences, Clinical Microbiology, Uppsala University, Uppsala, Sweden
- Clinical Microbiology and Infection Control, Uppsala University Hospital, Uppsala, Sweden
| | - Naima Ali
- Clinical Microbiology and Infection Control, Uppsala University Hospital, Uppsala, Sweden
| | | | - Mattias Tejde
- Department of Nephrology, Falun Hospital, Falun, Sweden
| | - Bengt von Zur-Mühlen
- Department of Surgical Sciences, Section of Transplantation Surgery, Uppsala University, Uppsala, Sweden
| | - Britt-Marie Eriksson
- Department of Medical Sciences, Section of Infectious Diseases, Uppsala University, SE-751 85, Uppsala, Sweden
| | - Anders Bergqvist
- Department of Medical Sciences, Clinical Microbiology, Uppsala University, Uppsala, Sweden
- Clinical Microbiology and Infection Control, Uppsala University Hospital, Uppsala, Sweden
| | - Gabriel Westman
- Department of Medical Sciences, Section of Infectious Diseases, Uppsala University, SE-751 85, Uppsala, Sweden
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Macmillan DS, Bergqvist A, Burgess-Allen E, Callan I, Dawick J, Carrick B, Ellis G, Ferro R, Goyak K, Smulders C, Stackhouse RA, Troyano E, Westmoreland C, Ramón BS, Rocha V, Zhang X. The last resort requirement under REACH: From principle to practice. Regul Toxicol Pharmacol 2024; 147:105557. [PMID: 38142814 DOI: 10.1016/j.yrtph.2023.105557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 11/30/2023] [Accepted: 12/18/2023] [Indexed: 12/26/2023]
Abstract
REACH (Registration, Evaluation, Authorisation and Restriction of Chemicals) is a European Union regulation that aims to protect human health and the environment from the risks posed by chemicals. Article 25 clearly states that: "[i]n order to avoid animal testing, testing on vertebrate animals for the purposes of this Regulation shall be undertaken only as a last resort." In practice, however, the standard information requirements under REACH are still primarily filled using animal studies. This paper presents examples illustrating that animal testing is not always undertaken only as a last resort. Six over-arching issues have been identified which contribute to this: (1) non-acceptance of existing animal or non-animal data, (2) non-acceptance of read-across, (3) inflexible administrative processes, (4) redundancy of testing, (5) testing despite animal welfare concerns and (6) testing for cosmetic-only ingredients. We, members of the Animal-Free Safety Assessment (AFSA) Collaboration, who work together to accelerate the global adoption of non-animal approaches for chemical safety assessment, herein propose several recommendations intended to aid the European Commission, the European Chemicals Agency and registrants to protect human health and the environment while avoiding unnecessary animal tests - truly upholding the last resort requirement in REACH.
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Affiliation(s)
- Donna S Macmillan
- Humane Society International/Europe, Av. des Arts 50, 1000, Bruxelles, Belgium.
| | - Anders Bergqvist
- Global Product Compliance (Europe) AB, Ideon Beta 5, Scheelevägen 17, 223 63, Lund, Sweden
| | | | - Ian Callan
- Innospec Limited, Oil Sites Road, Ellesmere Port, Cheshire, CH65 4EY, United Kingdom
| | - James Dawick
- Innospec Limited, Oil Sites Road, Ellesmere Port, Cheshire, CH65 4EY, United Kingdom
| | - Benjamin Carrick
- Kenvue, Johnson & Johnson Consumer Services EAME Ltd, 50-100 Holmers Farm Way, High Wycombe, HP12 4EG, United Kingdom
| | - Graham Ellis
- DSM-Firmenich, Rue de la Bergere 7, Satigny, Switzerland
| | - Roberto Ferro
- Unilever, Via Lever Gibbs 3, Casalpusterlengo, LO, Italy
| | - Katy Goyak
- ExxonMobil Biomedical Sciences, Inc., 1545 US Route 22 East, Annandale, NJ, 08801, United States
| | | | | | | | - Carl Westmoreland
- Safety & Environmental Assurance Centre, Unilever, Colworth Science Park, Sharnbrook, United Kingdom
| | | | - Vanessa Rocha
- Givaudan, 717 Ridgedale Ave, East Hanover, NJ, 07936, United States
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Devi P, Engdahl K, Punga T, Bergqvist A. Next-Generation Sequencing Analysis of CpG Methylation of a Tumor Suppressor Gene SHP-1 Promoter in Stable Cell Lines and HCV-Positive Patients. Viruses 2022; 14:v14112352. [PMID: 36366451 PMCID: PMC9695419 DOI: 10.3390/v14112352] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 10/19/2022] [Accepted: 10/22/2022] [Indexed: 02/01/2023] Open
Abstract
Hepatitis C virus (HCV) is the major causative pathogen associated with hepatocellular carcinoma and liver cirrhosis. The main virion component, the Core (C) protein, is involved in multiple aspects of HCV pathology including oncogenesis and immune evasion. In this study, we established a next-generation bisulfite sequencing (NGS-BS) protocol to analyze the CpG methylation profile at the tumor suppressor gene SHP-1 P2 promoter as a model system. Our data show that HCV C protein expression in the immortalized T cells correlated with a specific CpG methylation profile at the SHP-1 P2. The NGS-BS on HCV-positive (HCV+) patient-derived PBMCs revealed a considerably different CpG methylation profile compared to the HCV C protein immortalized T cells. Notably, the CpG methylation profile was very similar in healthy and HCV+ PBMCs, suggesting that the SHP-1 P2 CpG methylation profile is not altered in the HCV+ individuals. Collectively, the NGS-BS is a highly sensitive method that can be used to quantitatively characterize the CpG methylation status at the level of individual CpG position and also allows the characterization of cis-acting effects on epigenetic regulation.
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Affiliation(s)
- Priya Devi
- Department of Medical Sciences, Uppsala University, SE 75185 Uppsala, Sweden
| | - Katarina Engdahl
- Department of Medical Sciences, Uppsala University, SE 75185 Uppsala, Sweden
| | - Tanel Punga
- Department of Medical Biochemistry and Microbiology, Uppsala University, SE 75123 Uppsala, Sweden
| | - Anders Bergqvist
- Department of Medical Sciences, Uppsala University, SE 75185 Uppsala, Sweden
- Clinical Microbiology and Hospital Infection Control, Uppsala University Hospital, SE 75185 Uppsala, Sweden
- Correspondence: ; Tel.: +46-186113937
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Mori M, Clausson CM, Sanden C, Jönsson J, Andersson CK, Siddhuraj P, Shikhagaie M, Åkesson K, Bergqvist A, Löfdahl CG, Erjefält JS. Expansion of Phenotypically Altered Dendritic Cell Populations in the Small Airways and Alveolar Parenchyma in Patients with Chronic Obstructive Pulmonary Disease. J Innate Immun 2022; 15:188-203. [PMID: 35998572 PMCID: PMC10643891 DOI: 10.1159/000526080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 05/06/2022] [Indexed: 11/19/2022] Open
Abstract
Contrasting the antigen-presenting dendritic cells (DCs) in the conducting airways, the alveolar DC populations in human lungs have remained poorly investigated. Consequently, little is known about how alveolar DCs are altered in diseases such as chronic obstructive pulmonary disease (COPD). This study maps multiple tissue DC categories in the distal lung across COPD severities. Specifically, single-multiplex immunohistochemistry was applied to quantify langerin/CD207+, CD1a+, BDCA2+, and CD11c+ subsets in distal lung compartments from patients with COPD (GOLD stage I-IV) and never-smoking and smoking controls. In the alveolar parenchyma, increased numbers of CD1a+langerin- (p < 0.05) and BDCA-2+ DCs (p < 0.001) were observed in advanced COPD compared with controls. Alveolar CD11c+ DCs also increased in advanced COPD (p < 0.01). In small airways, langerin+ and BDCA-2+ DCs were also significantly increased. Contrasting the small airway DCs, most alveolar DC subsets frequently extended luminal protrusions. Importantly, alveolar and small airway langerin+ DCs in COPD lungs displayed site-specific marker profiles. Further, multiplex immunohistochemistry with single-cell quantification was used to specifically profile langerin DCs and reveal site-specific expression patterns of the maturation and activation markers S100, fascin, MHC2, and B7. Taken together, our results show that clinically advanced COPD is associated with increased levels of multiple alveolar DC populations exhibiting features of both adaptive and innate immunity phenotypes. This expansion is likely to contribute to the distal lung immunopathology in COPD patients.
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Affiliation(s)
- Michiko Mori
- Department of Experimental Medical Sciences, Lund University, Lund, Sweden
| | | | | | | | | | | | - Medya Shikhagaie
- Department of Experimental Medical Sciences, Lund University, Lund, Sweden
| | - Karolina Åkesson
- Department of Experimental Medical Sciences, Lund University, Lund, Sweden
| | - Anders Bergqvist
- Department of Respiratory Medicine and Allergology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Claes-Göran Löfdahl
- Department of Respiratory Medicine and Allergology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Jonas S. Erjefält
- Department of Experimental Medical Sciences, Lund University, Lund, Sweden
- Department of Respiratory Medicine and Allergology, Skåne University Hospital, Lund University, Lund, Sweden
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Lagedal R, Eriksson O, Sörman A, Huckriede JB, Kristensen B, Franzén S, Larsson A, Bergqvist A, Alving K, Forslund A, Persson B, Ekdahl KN, Garcia de Frutos P, Nilsson B, Nicolaes GAF, Lipcsey M, Hultström M, Frithiof R. Impaired Antibody Response Is Associated with Histone-Release, Organ Dysfunction and Mortality in Critically Ill COVID-19 Patients. J Clin Med 2022; 11:jcm11123419. [PMID: 35743491 PMCID: PMC9225468 DOI: 10.3390/jcm11123419] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/24/2022] [Accepted: 06/10/2022] [Indexed: 02/06/2023] Open
Abstract
Purpose: the pathophysiologic mechanisms explaining differences in clinical outcomes following COVID-19 are not completely described. This study aims to investigate antibody responses in critically ill patients with COVID-19 in relation to inflammation, organ failure and 30-day survival. Methods: All patients with PCR-verified COVID-19 and gave consent, and who were admitted to a tertiary Intensive care unit (ICU) in Sweden during March–September 2020 were included. Demography, repeated blood samples and measures of organ function were collected. Analyses of anti-SARS-CoV-2 antibodies (IgM, IgA and IgG) in plasma were performed and correlated to patient outcome and biomarkers of inflammation and organ failure. Results: A total of 115 patients (median age 62 years, 77% male) were included prospectively. All patients developed severe respiratory dysfunction, and 59% were treated with invasive ventilation. Thirty-day mortality was 22.6% for all included patients. Patients negative for any anti-SARS-CoV-2 antibody in plasma during ICU admission had higher 30-day mortality compared to patients positive for antibodies. Patients positive for IgM had more ICU-, ventilator-, renal replacement therapy- and vasoactive medication-free days. IgA antibody concentrations correlated negatively with both SAPS3 and maximal SOFA-score and IgM-levels correlated negatively with SAPS3. Patients with antibody levels below the detection limit had higher plasma levels of extracellular histones on day 1 and elevated levels of kidney and cardiac biomarkers, but showed no signs of increased inflammation, complement activation or cytokine release. After adjusting for age, positive IgM and IgG antibodies were still associated with increased 30-day survival, with odds ratio (OR) 7.1 (1.5–34.4) and 4.2 (1.1–15.7), respectively. Conclusion: In patients with severe COVID-19 requiring intensive care, a poor antibody response is associated with organ failure, systemic histone release and increased 30-day mortality.
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Affiliation(s)
- Rickard Lagedal
- Department of Surgical Sciences, Anaesthesia and Intensive Care, Uppsala University, 752 36 Uppsala, Sweden; (S.F.); (M.L.); (M.H.); (R.F.)
- Correspondence:
| | - Oskar Eriksson
- Department of Immunology, Genetics and Pathology, Uppsala University, 752 36 Uppsala, Sweden; (O.E.); (A.S.); (B.P.); (K.N.E.); (B.N.)
- Department of Medical Biochemistry and Microbiology, Uppsala University, 752 36 Uppsala, Sweden
| | - Anna Sörman
- Department of Immunology, Genetics and Pathology, Uppsala University, 752 36 Uppsala, Sweden; (O.E.); (A.S.); (B.P.); (K.N.E.); (B.N.)
| | - Joram B. Huckriede
- Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, 6211 LK Maastricht, The Netherlands; (J.B.H.); (G.A.F.N.)
| | | | - Stephanie Franzén
- Department of Surgical Sciences, Anaesthesia and Intensive Care, Uppsala University, 752 36 Uppsala, Sweden; (S.F.); (M.L.); (M.H.); (R.F.)
| | - Anders Larsson
- Department of Medical Sciences, Uppsala University, 752 36 Uppsala, Sweden;
| | - Anders Bergqvist
- Department of Medical Sciences, Section of Clinical Microbiology, Uppsala University, 752 36 Uppsala, Sweden;
- Clinical Microbiology and Hospital Infection Control, Uppsala University Hospital, 752 36 Uppsala, Sweden
| | - Kjell Alving
- Department of Women’s and Children’s Health, Uppsala University, 752 36 Uppsala, Sweden; (K.A.); (A.F.)
| | - Anders Forslund
- Department of Women’s and Children’s Health, Uppsala University, 752 36 Uppsala, Sweden; (K.A.); (A.F.)
| | - Barbro Persson
- Department of Immunology, Genetics and Pathology, Uppsala University, 752 36 Uppsala, Sweden; (O.E.); (A.S.); (B.P.); (K.N.E.); (B.N.)
| | - Kristina N. Ekdahl
- Department of Immunology, Genetics and Pathology, Uppsala University, 752 36 Uppsala, Sweden; (O.E.); (A.S.); (B.P.); (K.N.E.); (B.N.)
- Linneus Centre for Biomaterials Chemistry, Linneus University, 392 31 Kalmar, Sweden
| | - Pablo Garcia de Frutos
- Department of Cell Death and Proliferation, IIBB-CSIC, IDIBAPS and CIBERCV, 08036 Barcelona, Spain;
| | - Bo Nilsson
- Department of Immunology, Genetics and Pathology, Uppsala University, 752 36 Uppsala, Sweden; (O.E.); (A.S.); (B.P.); (K.N.E.); (B.N.)
| | - Gerry A. F. Nicolaes
- Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, 6211 LK Maastricht, The Netherlands; (J.B.H.); (G.A.F.N.)
| | - Miklos Lipcsey
- Department of Surgical Sciences, Anaesthesia and Intensive Care, Uppsala University, 752 36 Uppsala, Sweden; (S.F.); (M.L.); (M.H.); (R.F.)
- Hedenstierna Laboratory, Anesthesiology and Intensive Care, Department of Surgical Sciences, Uppsala University, 752 36 Uppsala, Sweden
| | - Michael Hultström
- Department of Surgical Sciences, Anaesthesia and Intensive Care, Uppsala University, 752 36 Uppsala, Sweden; (S.F.); (M.L.); (M.H.); (R.F.)
- Unit for Integrative Physiology, Department of Medical Cell Biology, Uppsala University, 752 36 Uppsala, Sweden
| | - Robert Frithiof
- Department of Surgical Sciences, Anaesthesia and Intensive Care, Uppsala University, 752 36 Uppsala, Sweden; (S.F.); (M.L.); (M.H.); (R.F.)
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Devi P, Punga T, Bergqvist A. Activation of the Ca2+/NFAT Pathway by Assembly of Hepatitis C Virus Core Protein into Nucleocapsid-like Particles. Viruses 2022; 14:v14040761. [PMID: 35458491 PMCID: PMC9031069 DOI: 10.3390/v14040761] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 03/31/2022] [Accepted: 04/03/2022] [Indexed: 02/05/2023] Open
Abstract
Hepatitis C virus (HCV) is the primary pathogen responsible for liver cirrhosis and hepatocellular carcinoma. The main virion component, the core (C) protein, has been linked to several aspects of HCV pathology, including oncogenesis, immune evasion and stress responses. We and others have previously shown that C expression in various cell lines activates Ca2+ signaling and alters Ca2+ homeostasis. In this study, we identified two distinct C protein regions that are required for the activation of Ca2+/NFAT signaling. In the basic N-terminal domain, which has been implicated in self-association of C, amino acids 1–68 were critical for NFAT activation. Sedimentation analysis of four mutants in this domain revealed that association of the C protein into nucleocapsid-like particles correlated with NFAT-activated transcription. The internal, lipid droplet-targeting domain was not required for NFAT-activated transcription. Finally, the C-terminal ER-targeting domain was required in extenso for the C protein to function. Our results indicate that targeting of HCV C to the ER is necessary but not sufficient for inducing Ca2+/NFAT signaling. Taken together, our data are consistent with a model whereby proteolytic intermediates of C with an intact transmembrane ER-anchor assemble into pore-like structures in the ER membrane.
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Affiliation(s)
- Priya Devi
- Department of Medical Sciences, Uppsala University, SE 75185 Uppsala, Sweden;
| | - Tanel Punga
- Department of Medical Biochemistry and Microbiology, Uppsala University, SE 75123 Uppsala, Sweden;
| | - Anders Bergqvist
- Department of Medical Sciences, Uppsala University, SE 75185 Uppsala, Sweden;
- Clinical Microbiology and Hospital Infection Control, Uppsala University Hospital, SE 75185 Uppsala, Sweden
- Correspondence: ; Tel.: +46-186113937
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Lorant C, Westman G, Bergqvist A, von Zur-Mühlen B, Eriksson BM. Risk Factors for Developing BK Virus-Associated Nephropathy: A Single-Center Retrospective Cohort Study of Kidney Transplant Recipients. Ann Transplant 2021; 27:e934738. [PMID: 35017458 PMCID: PMC8764870 DOI: 10.12659/aot.934738] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background BK virus (BKV) infection after kidney transplantation leads to BKV-associated nephropathy (BKVAN) in up to 10% of recipients, and is associated with an increased risk of allograft dysfunction or loss. The objective of this study was to estimate the incidence of BKVAN and to analyze whether enhanced induction is associated with an increased risk of BKVAN, possibly justifying more intensive surveillance. Material/Methods This was a single-center retrospective cohort study. All patients who underwent kidney transplantation or simultaneous pancreas and kidney transplantation at the Uppsala University Hospital in Sweden between 2005 and 2014 were included, a period when BKV screening was not yet implemented. The effect of enhanced induction, defined as treatment with thymoglobulin, rituximab, and/or eculizumab, often in combination with IVIg and glycosorb, immunoadsorption and/or plasmapheresis/apheresis, was analyzed in a multivariable Cox proportional hazards model together with sex, age, cytomegalovirus mismatch (donor+/recipient−) and rejection treatment as co-predictors. Further, the effects of BKVAN on graft survival was analyzed in a univariable Cox proportional hazards model. Results In total 44 of 928 (4.7%) patients developed a biopsy-verified BKVAN 4.8 (1.5–34.2) months after transplantation. Male sex was identified as a risk factor (HR 2.02, P=0.04) but not enhanced induction. Patients with BKVAN experienced a significantly higher risk of graft loss (HR 4.37, P<0.001). Conclusions Male sex, but not enhanced induction, was found to be a risk factor for BKVAN development after kidney transplantation. BKVAN is associated with an increased risk of graft loss.
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Affiliation(s)
- Camilla Lorant
- Department of Medical Sciences, Section of Infectious Diseases, Uppsala University, Uppsala, Sweden
| | - Gabriel Westman
- Department of Medical Sciences, Section of Infectious Diseases, Uppsala University, Uppsala, Sweden
| | - Anders Bergqvist
- Department of Medical Sciences, Clinical Microbiology and Infection Control, Uppsala University, Uppsala, Sweden
| | - Bengt von Zur-Mühlen
- Department of Surgical Sciences, Section of Transplantation Surgery, Uppsala University, Uppsala, Sweden
| | - Britt-Marie Eriksson
- Department of Medical Sciences, Section of Infectious Diseases, Uppsala University, Uppsala, Sweden
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Huckriede J, Anderberg SB, Morales A, de Vries F, Hultström M, Bergqvist A, Ortiz-Pérez JT, Sels JW, Wichapong K, Lipcsey M, van de Poll M, Larsson A, Luther T, Reutelingsperger C, de Frutos PG, Frithiof R, Nicolaes GAF. Evolution of NETosis markers and DAMPs have prognostic value in critically ill COVID-19 patients. Sci Rep 2021; 11:15701. [PMID: 34344929 PMCID: PMC8333321 DOI: 10.1038/s41598-021-95209-x] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 07/13/2021] [Indexed: 12/22/2022] Open
Abstract
Coronavirus disease 19 (COVID-19) presents with disease severities of varying degree. In its most severe form, infection may lead to respiratory failure and multi-organ dysfunction. Here we study the levels and evolution of the damage associated molecular patterns (DAMPS) cell free DNA (cfDNA), extracellular histone H3 (H3) and neutrophil elastase (NE), and the immune modulators GAS6 and AXL in relation to clinical parameters, ICU scoring systems and mortality in patients (n = 100) with severe COVID-19. cfDNA, H3, NE, GAS6 and AXL were increased in COVID-19 patients compared to controls. These measures associated with occurrence of clinical events and intensive care unit acquired weakness (ICUAW). cfDNA and GAS6 decreased in time in patients surviving to 30 days post ICU admission. A decrease of 27.2 ng/mL cfDNA during ICU stay associated with patient survival, whereas levels of GAS6 decreasing more than 4.0 ng/mL associated with survival. The presence of H3 in plasma was a common feature of COVID-19 patients, detected in 38% of the patients at ICU admission. NETosis markers cfDNA, H3 and NE correlated well with parameters of tissue damage and neutrophil counts. Furthermore, cfDNA correlated with lowest p/f ratio and a lowering in cfDNA was observed in patients with ventilator-free days.
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Affiliation(s)
- Joram Huckriede
- Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, P.O. Box 616, 6200 MD, Maastricht, the Netherlands
| | - Sara Bülow Anderberg
- Department of Surgical Sciences, Section for Anaesthesia & Intensive Care, Uppsala University, Uppsala, Sweden
| | - Albert Morales
- Department of Cell Death and Proliferation, IIBB-CSIC, IDIBAPS, and BCLC, CIBEREHD, Barcelona, Spain
| | - Femke de Vries
- Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, P.O. Box 616, 6200 MD, Maastricht, the Netherlands
| | - Michael Hultström
- Department of Surgical Sciences, Section for Anaesthesia & Intensive Care, Uppsala University, Uppsala, Sweden
- Department of Medical Cell Biology, Integrative Physiology, Uppsala University, Uppsala, Sweden
| | - Anders Bergqvist
- Department of Medical Sciences, Clinical Microbiology, Uppsala University, Uppsala, Sweden
| | - José T Ortiz-Pérez
- Cardiology Department, Hospital Clinic Barcelona and CIBERCV, Barcelona, Spain
| | - Jan Willem Sels
- Department of Intensive Care Medicine, Maastricht University Medical Centre MUMC+), Maastricht, the Netherlands
- Department of Cardiology, Maastricht University Medical Centre, MUMC+), Maastricht, the Netherlands
| | - Kanin Wichapong
- Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, P.O. Box 616, 6200 MD, Maastricht, the Netherlands
| | - Miklos Lipcsey
- Department of Surgical Sciences, Section for Anaesthesia & Intensive Care, Uppsala University, Uppsala, Sweden
- Hedenstierna Laboratory, Anaesthesiology and Intensive Care Medicine, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Marcel van de Poll
- Department of Intensive Care Medicine, Maastricht University Medical Centre MUMC+), Maastricht, the Netherlands
- Department of Surgery, Maastricht University Medical Centre (MUMC+), School for Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, the Netherlands
| | - Anders Larsson
- Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala, Sweden
| | - Tomas Luther
- Department of Surgical Sciences, Section for Anaesthesia & Intensive Care, Uppsala University, Uppsala, Sweden
| | - Chris Reutelingsperger
- Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, P.O. Box 616, 6200 MD, Maastricht, the Netherlands
| | - Pablo Garcia de Frutos
- Department of Cell Death and Proliferation, IIBB-CSIC, IDIBAPS and CIBERCV, Barcelona, Spain
| | - Robert Frithiof
- Department of Surgical Sciences, Section for Anaesthesia & Intensive Care, Uppsala University, Uppsala, Sweden
| | - Gerry A F Nicolaes
- Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, P.O. Box 616, 6200 MD, Maastricht, the Netherlands.
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9
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Hoffman T, Kolstad L, Lindahl JF, Albinsson B, Bergqvist A, Rönnberg B, Lundkvist Å. Diagnostic Potential of a Luminex-Based Coronavirus Disease 2019 Suspension Immunoassay (COVID-19 SIA) for the Detection of Antibodies against SARS-CoV-2. Viruses 2021; 13:v13060993. [PMID: 34073484 PMCID: PMC8227055 DOI: 10.3390/v13060993] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 05/23/2021] [Accepted: 05/24/2021] [Indexed: 02/07/2023] Open
Abstract
Due to the current, rapidly increasing Coronavirus disease 2019 (COVID-19) pandemic, efficient and highly specific diagnostic methods are needed. The receptor-binding part of the spike (S) protein, S1, has been suggested to be highly virus-specific; it does not cross-react with antibodies against other coronaviruses. Three recombinant partial S proteins of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) expressed in mammalian or baculovirus-insect cells were evaluated as antigens in a Luminex-based suspension immunoassay (SIA). The best performing antigen (S1; amino acids 16-685) was selected and further evaluated by serum samples from 76 Swedish patients or convalescents with COVID-19 (previously PCR and/or serologically confirmed), 200 pre-COVID-19 individuals (180 blood donors and 20 infants), and 10 patients with acute Epstein-Barr virus infection. All 76 positive samples showed detectable antibodies to S1, while none of the 210 negative controls gave a false positive antibody reaction. We further compared the COVID-19 SIA with a commercially available enzyme immunoassay and a previously evaluated COVID-19 rapid antibody test. The results revealed an overall assay sensitivity of 100%, a specificity of 100% for both IgM and IgG, a quantitative ability at concentrations up to 25 BAU/mL, and a better performance as compared to the commercial assays, suggesting the COVID-19 SIA as a most valuable tool for efficient laboratory-based serology.
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Affiliation(s)
- Tove Hoffman
- Department of Medical Biochemistry and Microbiology, Zoonosis Science Centre, Uppsala University, Husargatan 3, SE-751 23 Uppsala, Sweden; (L.K.); (J.F.L.); (B.A.); (B.R.); (Å.L.)
- Correspondence:
| | - Linda Kolstad
- Department of Medical Biochemistry and Microbiology, Zoonosis Science Centre, Uppsala University, Husargatan 3, SE-751 23 Uppsala, Sweden; (L.K.); (J.F.L.); (B.A.); (B.R.); (Å.L.)
| | - Johanna F. Lindahl
- Department of Medical Biochemistry and Microbiology, Zoonosis Science Centre, Uppsala University, Husargatan 3, SE-751 23 Uppsala, Sweden; (L.K.); (J.F.L.); (B.A.); (B.R.); (Å.L.)
| | - Bo Albinsson
- Department of Medical Biochemistry and Microbiology, Zoonosis Science Centre, Uppsala University, Husargatan 3, SE-751 23 Uppsala, Sweden; (L.K.); (J.F.L.); (B.A.); (B.R.); (Å.L.)
- Laboratory of Clinical Microbiology, Uppsala University Hospital, Dag Hammarskjölds väg 38, SE-752 37 Uppsala, Sweden;
| | - Anders Bergqvist
- Laboratory of Clinical Microbiology, Uppsala University Hospital, Dag Hammarskjölds väg 38, SE-752 37 Uppsala, Sweden;
- Department of Medical Sciences, Uppsala University, Dag Hammarskjölds väg 38, SE-751 84 Uppsala, Sweden
| | - Bengt Rönnberg
- Department of Medical Biochemistry and Microbiology, Zoonosis Science Centre, Uppsala University, Husargatan 3, SE-751 23 Uppsala, Sweden; (L.K.); (J.F.L.); (B.A.); (B.R.); (Å.L.)
- Laboratory of Clinical Microbiology, Uppsala University Hospital, Dag Hammarskjölds väg 38, SE-752 37 Uppsala, Sweden;
| | - Åke Lundkvist
- Department of Medical Biochemistry and Microbiology, Zoonosis Science Centre, Uppsala University, Husargatan 3, SE-751 23 Uppsala, Sweden; (L.K.); (J.F.L.); (B.A.); (B.R.); (Å.L.)
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10
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Frithiof R, Bergqvist A, Järhult JD, Lipcsey M, Hultström M. Presence of SARS-CoV-2 in urine is rare and not associated with acute kidney injury in critically ill COVID-19 patients. Crit Care 2020; 24:587. [PMID: 32993742 PMCID: PMC7523248 DOI: 10.1186/s13054-020-03302-w] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 09/21/2020] [Indexed: 11/10/2022]
Affiliation(s)
- Robert Frithiof
- Anesthesia and Intensive Care Medicine, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
| | - Anders Bergqvist
- Clinical Microbiology and Infection Medicine, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.,Clinical Microbiology and Hospital Infection Control, Uppsala University Hospital, Uppsala, Sweden
| | - Josef D Järhult
- Zoonosis Science Center, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Miklos Lipcsey
- Anesthesia and Intensive Care Medicine, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.,Hedenstierna Laboratory, CIRRUS, Anesthesiology and Intensive Care, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Michael Hultström
- Anesthesia and Intensive Care Medicine, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.,Integrative Physiology, Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden
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11
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Bösl K, Ianevski A, Than TT, Andersen PI, Kuivanen S, Teppor M, Zusinaite E, Dumpis U, Vitkauskiene A, Cox RJ, Kallio-Kokko H, Bergqvist A, Tenson T, Merits A, Oksenych V, Bjørås M, Anthonsen MW, Shum D, Kaarbø M, Vapalahti O, Windisch MP, Superti-Furga G, Snijder B, Kainov D, Kandasamy RK. Common Nodes of Virus-Host Interaction Revealed Through an Integrated Network Analysis. Front Immunol 2019; 10:2186. [PMID: 31636628 PMCID: PMC6787150 DOI: 10.3389/fimmu.2019.02186] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 08/29/2019] [Indexed: 12/22/2022] Open
Abstract
Viruses are one of the major causes of acute and chronic infectious diseases and thus a major contributor to the global burden of disease. Several studies have shown how viruses have evolved to hijack basic cellular pathways and evade innate immune response by modulating key host factors and signaling pathways. A collective view of these multiple studies could advance our understanding of virus-host interactions and provide new therapeutic perspectives for the treatment of viral diseases. Here, we performed an integrative meta-analysis to elucidate the 17 different host-virus interactomes. Network and bioinformatics analyses showed how viruses with small genomes efficiently achieve the maximal effect by targeting multifunctional and highly connected host proteins with a high occurrence of disordered regions. We also identified the core cellular process subnetworks that are targeted by all the viruses. Integration with functional RNA interference (RNAi) datasets showed that a large proportion of the targets are required for viral replication. Furthermore, we performed an interactome-informed drug re-purposing screen and identified novel activities for broad-spectrum antiviral agents against hepatitis C virus and human metapneumovirus. Altogether, these orthogonal datasets could serve as a platform for hypothesis generation and follow-up studies to broaden our understanding of the viral evasion landscape.
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Affiliation(s)
- Korbinian Bösl
- Centre of Molecular Inflammation Research, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Aleksandr Ianevski
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Thoa T Than
- Institut Pasteur Korea, Seongnam, South Korea
| | - Petter I Andersen
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Suvi Kuivanen
- Department of Virology, University of Helsinki, Helsinki, Finland
| | - Mona Teppor
- Institute of Technology, University of Tartu, Tartu, Estonia
| | - Eva Zusinaite
- Institute of Technology, University of Tartu, Tartu, Estonia
| | - Uga Dumpis
- Pauls Stradins Clinical University Hospital, Riga, Latvia
| | - Astra Vitkauskiene
- Department of Laboratory Medicine, Lithuanian University of Health Science, Kaunas, Lithuania
| | - Rebecca J Cox
- Department of Clinical Science, Influenza Centre, University of Bergen, Bergen, Norway
| | - Hannimari Kallio-Kokko
- Department of Virology and Immunology, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
| | - Anders Bergqvist
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Tanel Tenson
- Institute of Technology, University of Tartu, Tartu, Estonia
| | - Andres Merits
- Institute of Technology, University of Tartu, Tartu, Estonia
| | - Valentyn Oksenych
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Magnar Bjørås
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Marit W Anthonsen
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - David Shum
- Institut Pasteur Korea, Seongnam, South Korea
| | - Mari Kaarbø
- Department of Microbiology, Oslo University Hospital, Oslo, Norway
| | - Olli Vapalahti
- Department of Veterinary Biosciences, University of Helsinki, Helsinki, Finland
| | | | - Giulio Superti-Furga
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria.,Center for Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Berend Snijder
- Department of Biology, Institute of Molecular Systems Biology, ETH Zürich, Zurich, Switzerland
| | - Denis Kainov
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Institute of Technology, University of Tartu, Tartu, Estonia
| | - Richard K Kandasamy
- Centre of Molecular Inflammation Research, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Centre for Molecular Medicine Norway (NCMM), Nordic EMBL Partnership, University of Oslo and Oslo University Hospital, Oslo, Norway.,Program in Innate Immunity, Division of Infectious Diseases and Immunology, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
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12
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Ianevski A, Zusinaite E, Shtaida N, Kallio-Kokko H, Valkonen M, Kantele A, Telling K, Lutsar I, Letjuka P, Metelitsa N, Oksenych V, Dumpis U, Vitkauskiene A, Stašaitis K, Öhrmalm C, Bondeson K, Bergqvist A, Cox RJ, Tenson T, Merits A, Kainov DE. Low Temperature and Low UV Indexes Correlated with Peaks of Influenza Virus Activity in Northern Europe during 2010⁻2018. Viruses 2019; 11:v11030207. [PMID: 30832226 PMCID: PMC6466003 DOI: 10.3390/v11030207] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 02/18/2019] [Accepted: 02/28/2019] [Indexed: 12/21/2022] Open
Abstract
With the increasing pace of global warming, it is important to understand the role of meteorological factors in influenza virus (IV) epidemics. In this study, we investigated the impact of temperature, UV index, humidity, wind speed, atmospheric pressure, and precipitation on IV activity in Norway, Sweden, Finland, Estonia, Latvia and Lithuania during 2010–2018. Both correlation and machine learning analyses revealed that low temperature and UV indexes were the most predictive meteorological factors for IV epidemics in Northern Europe. Our in vitro experiments confirmed that low temperature and UV radiation preserved IV infectivity. Associations between these meteorological factors and IV activity could improve surveillance and promote development of accurate predictive models for future influenza outbreaks in the region.
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Affiliation(s)
- Aleksandr Ianevski
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, 7028 Trondheim, Norway.
| | - Eva Zusinaite
- Institute of Technology, University of Tartu, 50090 Tartu, Estonia.
| | | | | | - Miia Valkonen
- Helsinki University Hospital (HUS) and University of Helsinki, 00290 Helsinki, Finland.
| | - Anu Kantele
- Helsinki University Hospital (HUS) and University of Helsinki, 00290 Helsinki, Finland.
| | - Kaidi Telling
- Institute of Technology, University of Tartu, 50090 Tartu, Estonia.
| | - Irja Lutsar
- Institute of Medical Microbiology, University of Tartu, 50411 Tartu, Estonia.
| | | | | | - Valentyn Oksenych
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, 7028 Trondheim, Norway.
| | - Uga Dumpis
- Latvian Biomedical Research and Study Centre, 1067 Riga, Latvia.
| | - Astra Vitkauskiene
- Department of Laboratory Medicine, Lithuanian University of Health Science, 44307 Kaunas, Lithuania.
| | - Kestutis Stašaitis
- Department of Emergency Medicine, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania.
| | - Christina Öhrmalm
- Department of Medical Sciences, Uppsala University, 75309 Uppsala, Sweden.
| | - Kåre Bondeson
- Department of Medical Sciences, Uppsala University, 75309 Uppsala, Sweden.
| | - Anders Bergqvist
- Department of Medical Sciences, Uppsala University, 75309 Uppsala, Sweden.
| | - Rebecca J Cox
- Influenza Centre, Department of Clinical Science, University of Bergen, 5021 Bergen, Norway.
| | - Tanel Tenson
- Institute of Technology, University of Tartu, 50090 Tartu, Estonia.
| | - Andres Merits
- Institute of Technology, University of Tartu, 50090 Tartu, Estonia.
| | - Denis E Kainov
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, 7028 Trondheim, Norway.
- Institute of Technology, University of Tartu, 50090 Tartu, Estonia.
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13
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Ianevski A, Zusinaite E, Kuivanen S, Strand M, Lysvand H, Teppor M, Kakkola L, Paavilainen H, Laajala M, Kallio-Kokko H, Valkonen M, Kantele A, Telling K, Lutsar I, Letjuka P, Metelitsa N, Oksenych V, Bjørås M, Nordbø SA, Dumpis U, Vitkauskiene A, Öhrmalm C, Bondeson K, Bergqvist A, Aittokallio T, Cox RJ, Evander M, Hukkanen V, Marjomaki V, Julkunen I, Vapalahti O, Tenson T, Merits A, Kainov D. Novel activities of safe-in-human broad-spectrum antiviral agents. Antiviral Res 2018; 154:174-182. [PMID: 29698664 PMCID: PMC7113852 DOI: 10.1016/j.antiviral.2018.04.016] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Revised: 04/16/2018] [Accepted: 04/20/2018] [Indexed: 12/03/2022]
Abstract
According to the WHO, there is an urgent need for better control of viral diseases. Re-positioning existing safe-in-human antiviral agents from one viral disease to another could play a pivotal role in this process. Here, we reviewed all approved, investigational and experimental antiviral agents, which are safe in man, and identified 59 compounds that target at least three viral diseases. We tested 55 of these compounds against eight different RNA and DNA viruses. We found novel activities for dalbavancin against echovirus 1, ezetimibe against human immunodeficiency virus 1 and Zika virus, as well as azacitidine, cyclosporine, minocycline, oritavancin and ritonavir against Rift valley fever virus. Thus, the spectrum of antiviral activities of existing antiviral agents could be expanded towards other viral diseases. 339 approved, investigational and experimental safe-in-human antivirals were identified. 59 compounds, which target ≥3 viral diseases, were selected. 55 of the 59 compounds were tested against 8 RNA and DNA viruses. 7 compounds were found to possess novel antiviral activities.
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Affiliation(s)
- Aleksandr Ianevski
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim 7028, Norway.
| | - Eva Zusinaite
- Institute of Technology, University of Tartu, Tartu 50090, Estonia.
| | - Suvi Kuivanen
- Department of Virology, University of Helsinki, Helsinki 00014, Finland.
| | - Mårten Strand
- Department of Clinical Microbiology, Umeå University, Umeå 90185, Sweden.
| | - Hilde Lysvand
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim 7491, Norway.
| | - Mona Teppor
- Institute of Technology, University of Tartu, Tartu 50090, Estonia.
| | - Laura Kakkola
- Institute of Biomedicine, University of Turku, Turku 20520, Finland.
| | | | - Mira Laajala
- Department of Biological and Environmental Science, University of Jyväskylä, Jyväskylä 40500, Finland.
| | - Hannimari Kallio-Kokko
- Department of Virology and Immunology, University of Helsinki, Helsinki University Hospital, Helsinki 00014, Finland.
| | - Miia Valkonen
- Helsinki University Hospital, Helsinki 00014, Finland.
| | - Anu Kantele
- Helsinki University Hospital, Helsinki 00014, Finland.
| | - Kaidi Telling
- Institute of Medical Microbiology, University of Tartu, Tartu 50411, Estonia.
| | - Irja Lutsar
- Institute of Medical Microbiology, University of Tartu, Tartu 50411, Estonia.
| | | | | | - Valentyn Oksenych
- St. Olavs Hospital, Trondheim University Hospital, Clinic of Medicine, Trondheim 7006, Norway.
| | - Magnar Bjørås
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim 7491, Norway.
| | - Svein Arne Nordbø
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim 7491, Norway; Department of Medical Microbiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim 7006, Norway.
| | - Uga Dumpis
- Pauls Stradins Clinical University Hospital, Riga 1002, Latvia.
| | - Astra Vitkauskiene
- Department of Laboratory Medicine, Lithuanian University of Health Science, Kaunas 44307, Lithuania.
| | - Christina Öhrmalm
- Department of Medical Sciences, Uppsala University, Uppsala 75309, Sweden.
| | - Kåre Bondeson
- Department of Medical Sciences, Uppsala University, Uppsala 75309, Sweden.
| | - Anders Bergqvist
- Department of Medical Sciences, Uppsala University, Uppsala 75309, Sweden.
| | - Tero Aittokallio
- Institute for Molecular Medicine Finland, FIMM, University of Helsinki, Helsinki 00290, Finland; Department of Mathematics and Statistics, University of Turku, Turku 20014, Finland.
| | - Rebecca J Cox
- Influenza Centre, Department of Clinical Science, University of Bergen, Bergen 5021, Norway.
| | - Magnus Evander
- Department of Clinical Microbiology, Umeå University, Umeå 90185, Sweden.
| | - Veijo Hukkanen
- Institute of Biomedicine, University of Turku, Turku 20520, Finland.
| | - Varpu Marjomaki
- Department of Biological and Environmental Science, University of Jyväskylä, Jyväskylä 40500, Finland.
| | - Ilkka Julkunen
- Institute of Biomedicine, University of Turku, Turku 20520, Finland.
| | - Olli Vapalahti
- Department of Virology, University of Helsinki and Helsinki University Hospital, Helsinki 00014, Finland; Department of Veterinary Biosciences, University of Helsinki, Helsinki 00014, Finland.
| | - Tanel Tenson
- Institute of Technology, University of Tartu, Tartu 50090, Estonia.
| | - Andres Merits
- Institute of Technology, University of Tartu, Tartu 50090, Estonia.
| | - Denis Kainov
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim 7028, Norway; Institute of Technology, University of Tartu, Tartu 50090, Estonia.
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14
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Sverrild A, Kiilerich P, Brejnrod A, Pedersen R, Porsbjerg C, Bergqvist A, Erjefält JS, Kristiansen K, Backer V. Eosinophilic airway inflammation in asthmatic patients is associated with an altered airway microbiome. J Allergy Clin Immunol 2016; 140:407-417.e11. [PMID: 28042058 DOI: 10.1016/j.jaci.2016.10.046] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2015] [Revised: 10/10/2016] [Accepted: 10/25/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND Asthmatic patients have higher microbiome diversity and an altered composition, with more Proteobacteria and less Bacteroidetes compared with healthy control subjects. Studies comparing airway inflammation and the airway microbiome are sparse, especially in subjects not receiving anti-inflammatory treatment. OBJECTIVE We sought to describe the relationship between the airway microbiome and patterns of airway inflammation in steroid-free patients with asthma and healthy control subjects. METHODS Bronchoalveolar lavage fluid was collected from 23 steroid-free nonsmoking patients with asthma and 10 healthy control subjects. Bacterial DNA was extracted from and subjected to Illumina MiSeq sequencing of the 16S rDNA V4 region. Eosinophils and neutrophils in the submucosa were quantified by means of immunohistochemical identification and computerized image analysis. Induced sputum was obtained, and airway hyperresponsiveness to mannitol and fraction of exhaled nitric oxide values were measured. Relationships between airway microbial diversity and composition and inflammatory profiles were analyzed. RESULTS In asthmatic patients airway microbial composition was associated with airway eosinophilia and AHR to mannitol but not airway neutrophilia. The overall composition of the airway microbiome of asthmatic patients with the lowest levels of eosinophils but not asthmatic patients with the highest levels of eosinophils deviated significantly from that of healthy subjects. Asthmatic patients with the lowest levels of eosinophils had an altered bacterial abundance profile, with more Neisseria, Bacteroides, and Rothia species and less Sphingomonas, Halomonas, and Aeribacillus species compared with asthmatic patients with more eosinophils and healthy control subjects. CONCLUSION The level of eosinophilic airway inflammation correlates with variations in the microbiome across asthmatic patients, whereas neutrophilic airway inflammation does not. This warrants further investigation on molecular pathways involved in both patients with eosinophilic and those with noneosinophilic asthma.
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Affiliation(s)
| | - Pia Kiilerich
- Department of Biology, University of Copenhagen, Denmark
| | - Asker Brejnrod
- Department of Biology, University of Copenhagen, Denmark
| | | | | | - Anders Bergqvist
- Respiratory Medicine and Allergology and Experimental Medical Science, Lund University, Lund, Sweden
| | - Jonas S Erjefält
- Respiratory Medicine and Allergology and Experimental Medical Science, Lund University, Lund, Sweden
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15
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Pretolani M, Bergqvist A, Thabut G, Dombret MC, Knapp D, Hamidi F, Alavoine L, Taillé C, Chanez P, Erjefält JS, Aubier M. Effectiveness of bronchial thermoplasty in patients with severe refractory asthma: Clinical and histopathologic correlations. J Allergy Clin Immunol 2016; 139:1176-1185. [PMID: 27609656 DOI: 10.1016/j.jaci.2016.08.009] [Citation(s) in RCA: 141] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Revised: 07/08/2016] [Accepted: 08/08/2016] [Indexed: 01/02/2023]
Abstract
BACKGROUND The effectiveness of bronchial thermoplasty (BT) has been reported in patients with severe asthma, yet its effect on different bronchial structures remains unknown. OBJECTIVE We sought to examine the effect of BT on bronchial structures and to explore the association with clinical outcome in patients with severe refractory asthma. METHODS Bronchial biopsy specimens (n = 300) were collected from 15 patients with severe uncontrolled asthma before and 3 months after BT. Immunostained sections were assessed for airway smooth muscle (ASM) area, subepithelial basement membrane thickness, nerve fibers, and epithelial neuroendocrine cells. Histopathologic findings were correlated with clinical parameters. RESULTS BT significantly improved asthma control and quality of life at both 3 and 12 months and decreased the numbers of severe exacerbations and the dose of oral corticosteroids. At 3 months, this clinical benefit was accompanied by a reduction in ASM area (median values before and after BT, respectively: 19.7% [25th-75th interquartile range (IQR), 15.9% to 22.4%] and 5.3% [25th-75th IQR], 3.5% to 10.1%, P < .001), subepithelial basement membrane thickening (4.4 μm [25th-75th IQR, 4.0-4.7 μm] and 3.9 μm [25th-75th IQR, 3.7-4.6 μm], P = 0.02), submucosal nerves (1.0 ‰ [25th-75th IQR, 0.7-1.3 ‰] immunoreactivity and 0.3 ‰ [25th-75th IQR, 0.1-0.5 ‰] immunoreactivity, P < .001), ASM-associated nerves (452.6 [25th-75th IQR, 196.0-811.2] immunoreactive pixels per mm2 and 62.7 [25th-75th IQR, 0.0-230.3] immunoreactive pixels per mm2, P = .02), and epithelial neuroendocrine cells (4.9/mm2 [25th-75th IQR, 0-16.4/mm2] and 0.0/mm2 [25th-75th IQR, 0-0/mm2], P = .02). Histopathologic parameters were associated based on Asthma Control Test scores, numbers of exacerbations, and visits to the emergency department (all P ≤ .02) 3 and 12 months after BT. CONCLUSION BT is a treatment option in patients with severe therapy-refractory asthma that downregulates selectively structural abnormalities involved in airway narrowing and bronchial reactivity, particularly ASM, neuroendocrine epithelial cells, and bronchial nerve endings.
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Affiliation(s)
- Marina Pretolani
- Inserm UMR1152, Physiopathology and Epidemiology of Respiratory Diseases, Paris, France; Paris Diderot University, Faculty of Medicine, Bichat campus, Paris, France; Laboratory of Excellence, INFLAMEX, Université Sorbonne Paris Cité, and DHU FIRE, Paris, France
| | | | - Gabriel Thabut
- Inserm UMR1152, Physiopathology and Epidemiology of Respiratory Diseases, Paris, France; Paris Diderot University, Faculty of Medicine, Bichat campus, Paris, France; Laboratory of Excellence, INFLAMEX, Université Sorbonne Paris Cité, and DHU FIRE, Paris, France; Unit of Airway Inflammation, Lund University, Lund, Sweden; Department of Pneumology B, Bichat-Claude Bernard University Hospital, Paris, France; Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Marie-Christine Dombret
- Inserm UMR1152, Physiopathology and Epidemiology of Respiratory Diseases, Paris, France; Paris Diderot University, Faculty of Medicine, Bichat campus, Paris, France; Laboratory of Excellence, INFLAMEX, Université Sorbonne Paris Cité, and DHU FIRE, Paris, France; Department of Pneumology A, Bichat-Claude Bernard University Hospital, Paris, France; Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Dominique Knapp
- Inserm UMR1152, Physiopathology and Epidemiology of Respiratory Diseases, Paris, France; Paris Diderot University, Faculty of Medicine, Bichat campus, Paris, France; Laboratory of Excellence, INFLAMEX, Université Sorbonne Paris Cité, and DHU FIRE, Paris, France; Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Fatima Hamidi
- Inserm UMR1152, Physiopathology and Epidemiology of Respiratory Diseases, Paris, France; Paris Diderot University, Faculty of Medicine, Bichat campus, Paris, France; Laboratory of Excellence, INFLAMEX, Université Sorbonne Paris Cité, and DHU FIRE, Paris, France
| | - Loubna Alavoine
- Clinical Investigation Center, Bichat-Claude Bernard University Hospital, Paris, France
| | - Camille Taillé
- Inserm UMR1152, Physiopathology and Epidemiology of Respiratory Diseases, Paris, France; Paris Diderot University, Faculty of Medicine, Bichat campus, Paris, France; Laboratory of Excellence, INFLAMEX, Université Sorbonne Paris Cité, and DHU FIRE, Paris, France; Department of Pneumology A, Bichat-Claude Bernard University Hospital, Paris, France; Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Pascal Chanez
- Inserm U1067 and CNRS UMR7733, Department of Respiratory Diseases, APHM Aix-Marseille University, Marseille, France
| | | | - Michel Aubier
- Inserm UMR1152, Physiopathology and Epidemiology of Respiratory Diseases, Paris, France; Paris Diderot University, Faculty of Medicine, Bichat campus, Paris, France; Laboratory of Excellence, INFLAMEX, Université Sorbonne Paris Cité, and DHU FIRE, Paris, France; Department of Pneumology A, Bichat-Claude Bernard University Hospital, Paris, France; Assistance Publique des Hôpitaux de Paris, Paris, France.
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Porsbjerg C, Baines K, Gibson P, Bergqvist A, Erjefält JS, Sverrild A, Backer V. IL-33 is related to innate immune activation and sensitization to HDM in mild steroid-free asthma. Clin Exp Allergy 2016; 46:564-74. [DOI: 10.1111/cea.12702] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 11/24/2015] [Accepted: 12/18/2015] [Indexed: 01/03/2023]
Affiliation(s)
- C. Porsbjerg
- Respiratory Research Unit; Bispebjerg Hospital; Copenhagen Denmark
| | - K. Baines
- Centre for Asthma and Respiratory Disease; The University of Newcastle; Newcastle NSW Australia
| | - P. Gibson
- Centre for Asthma and Respiratory Disease; The University of Newcastle; Newcastle NSW Australia
| | - A. Bergqvist
- Respiratory Medicine and Allergology and Experimental Medical Science; Lund University; Lund Sweden
| | - J. S. Erjefält
- Respiratory Medicine and Allergology and Experimental Medical Science; Lund University; Lund Sweden
| | - A. Sverrild
- Respiratory Research Unit; Bispebjerg Hospital; Copenhagen Denmark
| | - V. Backer
- Respiratory Research Unit; Bispebjerg Hospital; Copenhagen Denmark
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Sverrild A, Bergqvist A, Baines KJ, Porsbjerg C, Andersson CK, Thomsen SF, Hoffmann HJ, Gibson P, Erjefält JS, Backer V. Airway responsiveness to mannitol in asthma is associated with chymase-positive mast cells and eosinophilic airway inflammation. Clin Exp Allergy 2016; 46:288-97. [DOI: 10.1111/cea.12609] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 06/16/2015] [Accepted: 07/24/2015] [Indexed: 12/23/2022]
Affiliation(s)
- A. Sverrild
- University Hospital Bispebjerg; Copenhagen Denmark
| | - A. Bergqvist
- Respiratory Medicine and Allergology and Experimental Medical Science; Lund University; Lund Sweden
| | - K. J. Baines
- Centre for Asthma and Respiratory Disease; The University of Newcastle; Newcastle NSW Australia
| | - C. Porsbjerg
- University Hospital Bispebjerg; Copenhagen Denmark
| | - C. K. Andersson
- Respiratory Medicine and Allergology and Experimental Medical Science; Lund University; Lund Sweden
| | - S. F. Thomsen
- Department of Dermatology; Bispebjerg Hospital; Copenhagen Denmark
| | - H. J. Hoffmann
- Department of Pulmonary Medicine B; Institute for Clinical Medicine; Aarhus University; Aarhus Denmark
| | - P. Gibson
- Centre for Asthma and Respiratory Disease; The University of Newcastle; Newcastle NSW Australia
| | - J. S. Erjefält
- Respiratory Medicine and Allergology and Experimental Medical Science; Lund University; Lund Sweden
| | - V. Backer
- University Hospital Bispebjerg; Copenhagen Denmark
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Gela A, Kasetty G, Mörgelin M, Bergqvist A, Erjefält JS, Pease JE, Egesten A. Osteopontin binds and modulates functions of eosinophil-recruiting chemokines. Allergy 2016; 71:58-67. [PMID: 26411293 DOI: 10.1111/all.12771] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2015] [Indexed: 01/11/2023]
Abstract
BACKGROUND Allergic asthma is characterized by eosinophilic inflammation and airway obstruction. There is also an increased risk of pulmonary infection caused by Streptococcus pneumoniae, in particular during severe asthma where high levels of the glycoprotein, osteopontin (OPN), are present in the airways. Eosinophils can be recruited by chemokines activating the receptor CCR3 including eotaxin-1/CCL11, eotaxin-2/CCL24, eotaxin-3/CCL26, RANTES/CCL5, and MEC/CCL28. In addition to inducing chemotaxis, several of these molecules have defensin-like antibacterial properties. This study set out to elucidate the functional consequences of OPN binding to eosinophil-recruiting chemokines. METHODS Antibacterial activities of the chemokines were investigated using viable count assays and electron microscopy. Binding studies were performed by means of surface plasmon resonance. The potential interference of OPN with antibacterial, receptor-activating, and lipopolysaccharide-neutralizing abilities of these chemokines was investigated. RESULTS We found that OPN bound all eosinophil-recruiting chemokines with high affinity except for CCL5. The eosinophil-recruiting chemokines all displayed bactericidal activity against S. pneumoniae, but only CCL26 and CCL28 retained high antibacterial activity in the presence of sodium chloride at physiologic concentrations. Preincubation of the chemokines with OPN strongly inhibited their antibacterial activity against S. pneumoniae but did not affect their ability to activate CCR3. All chemokines investigated showed LPS-neutralizing activity that was impaired by OPN only in the case of CCL24. CONCLUSIONS The data suggest that OPN may impair host defense activities of the chemokines without affecting their eosinophil-recruiting properties. This could be one mechanism explaining the increased vulnerability to acquire pneumococcal infection in parallel with sustained allergic inflammation in asthma.
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Affiliation(s)
- A. Gela
- Division of Respiratory Medicine & Allergology; Department of Clinical Sciences; Skåne University Hospital; Lund University; Lund Sweden
| | - G. Kasetty
- Division of Respiratory Medicine & Allergology; Department of Clinical Sciences; Skåne University Hospital; Lund University; Lund Sweden
| | - M. Mörgelin
- Division of Infection Medicine; Department of Clinical Sciences; Skåne University Hospital; Lund University; Lund Sweden
| | - A. Bergqvist
- Division of Respiratory Medicine & Allergology; Department of Clinical Sciences; Skåne University Hospital; Lund University; Lund Sweden
| | - J. S. Erjefält
- Division of Respiratory Medicine & Allergology; Department of Clinical Sciences; Skåne University Hospital; Lund University; Lund Sweden
| | - J. E. Pease
- Leukocyte Biology Section; NHLI; Faculty of Medicine; Imperial College of Science, Technology and Medicine; London UK
| | - A. Egesten
- Division of Respiratory Medicine & Allergology; Department of Clinical Sciences; Skåne University Hospital; Lund University; Lund Sweden
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Jonsson A, Bergqvist A, Andersson R. Assessing the number of fire fatalities in a defined population. J Safety Res 2015; 55:99-103. [PMID: 26683552 DOI: 10.1016/j.jsr.2015.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 08/09/2015] [Accepted: 10/01/2015] [Indexed: 06/05/2023]
Abstract
INTRODUCTION Fire-related fatalities and injuries have become a growing governmental concern in Sweden, and a national vision zero strategy has been adopted stating that nobody should get killed or seriously injured from fires. There is considerable uncertainty, however, regarding the numbers of both deaths and injuries due to fires. Different national sources present different numbers, even on deaths, which obstructs reliable surveillance of the problem over time. We assume the situation is similar in other countries. This study seeks to assess the true number of fire-related deaths in Sweden by combining sources, and to verify the coverage of each individual source. By doing so, we also wish to demonstrate the possibilities of improved surveillance practices. METHOD Data from three national sources were collected and matched; a special database on fatal fires held by The Swedish Contingencies Agency (nationally responsible for fire prevention), a database on forensic medical examinations held by the National Board of Forensic Medicine, and the cause of death register held by the Swedish National Board of Health and Welfare. RESULTS The results disclose considerable underreporting in the single sources. The national database on fatal fires, serving as the principal source for policy making on fire prevention matters, underestimates the true situation by 20%. Its coverage of residential fires appears to be better than other fires. CONCLUSIONS Systematic safety work and informed policy-making presuppose access to correct and reliable numbers. By combining several different sources, as suggested in this study, the national database on fatal fires is now considerably improved and includes regular matching with complementary sources.
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Affiliation(s)
- Anders Jonsson
- Division of Risk Management, Department of Health and Environmental Sciences, Karlstad University, Karlstad SE-651 88, Sweden; Evaluation & Monitoring Department, Swedish Civil Contingencies Agency, Karlstad SE-651 81, Sweden.
| | - Anders Bergqvist
- Swedish Fire Protection Association, Stockholm SE-115 87, Sweden
| | - Ragnar Andersson
- Division of Risk Management, Department of Health and Environmental Sciences, Karlstad University, Karlstad SE-651 88, Sweden
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Shikhagaie MM, Andersson CK, Mori M, Kortekaas Krohn I, Bergqvist A, Dahl R, Ekblad E, Hoffmann HJ, Bjermer L, Erjefält JS. Mapping of TLR5 and TLR7 in central and distal human airways and identification of reduced TLR expression in severe asthma. Clin Exp Allergy 2014; 44:184-96. [PMID: 24447081 DOI: 10.1111/cea.12176] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Revised: 06/30/2013] [Accepted: 07/02/2013] [Indexed: 12/19/2022]
Abstract
BACKGROUND The toll-like receptors, TLR5 and TLR7, have recently been proposed in asthma immunopathogenesis. While supporting data come from animal or in vitro studies, little is known about TLR5 and TLR7 expression in human asthmatic airways. METHODS Advanced immunohistochemical mapping of TLR5 and TLR7 was performed on bronchial and transbronchial biopsies from healthy individuals and patients with moderate and severe asthma. RESULTS TLR5 was identified in multiple structural cells; bronchial epithelium, alveolar type II pneumocytes, plasma cells, macrophages and neutrophils. Contrary to bronchial TLR5, which had a basolateral expression, alveolar TLR5 had polarized apical localization. Patients with severe asthma had decreased total and epithelial TLR5 expression compared to controls and moderate asthmatics (P < 0.001). TLR7 expression was found in several structural cells and asthma-related immune cells. Whereas TLR7 expression was decreased in severe asthmatics (P < 0.001), nerve-associated TLR7 increased (P = 0.035). Within the asthma groups, both TLR5 and TLR7 expression correlated with multiple lung function parameters. CONCLUSIONS Our results reveal broad expression patterns of TLR5 and TLR7 in the lung and that the expression is decreased in severe asthma. Hence, severe asthmatics may suffer from insufficient TLR signalling during viral or bacterial infections leading to poor and impaired defence mechanisms.
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Affiliation(s)
- M M Shikhagaie
- Department of Experimental Medical Science, Lund University, Lund, Sweden
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Bergqvist A, Andersson CK, Hoffmann HJ, Mori M, Shikhagaie M, Krohn IK, Dahl R, Bjermer L, Erjefält JS. Marked epithelial cell pathology and leukocyte paucity in persistently symptomatic severe asthma. Am J Respir Crit Care Med 2014; 188:1475-7. [PMID: 24328780 DOI: 10.1164/rccm.201308-1444le] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Shikhagaie M, Bergqvist A, Andersson C, Mori M, Krohn K, Dahl R, Hoffman HJ, Bjermer L, Erjefält J. Altered distribution patterns of TLR5 and TLR7 in the central airways of severe asthmatics (P4427). The Journal of Immunology 2013. [DOI: 10.4049/jimmunol.190.supp.206.2] [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] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
Toll-like receptors are a major class of pattern and damage recognition receptors controlling innate immune responses. TLR5 recognizes bacterial flagellin and TLR7 identifies single stranded viral RNA. The present study characterizes TLR5 and TLR7 expression pattern in central airways of asthmatics. Methods: Bronchial biopsies were obtained from healthy controls, uncontrolled asthmatics on inhaled glucocorticoids, and severe asthmatics on oral glucocorticoids. Subjects were classified according to GINA guidelines and asthma control score. Tissue sections were processed for immunohistochemical identification of TLR positive cells. Results: TLR5 immunoreactivity was identified in the airway epithelium, glands, smooth muscle, alveolar macrophages and plasma cells. In the airway epithelium, TLR5 had mainly a basolateral distribution. In severe asthmatics the overall and epithelial TLR5 immunoreactivity were significantly decreased. TLR7 displayed a distinct peri-nuclear expression. Quantification of the epithelial TLR7 immunoreactivity showed a significantly decreased expression in severe asthmatics compared to healthy controls and uncontrolled asthma. TLR7 expression was also detected in nerve cells, NK cells and mast cells. Conclusions: Our data suggest that patients with severe asthma have decreased expression of TLR5 and TLR7 compared to healthy controls and uncontrolled asthmatics. This altered expression may reflect a dysfunctional immune-regulation in severe asthmatics.
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Affiliation(s)
| | - Anders Bergqvist
- 2Dept of Respiratory Medicine and Allergology, Lund University, Lund, Sweden
| | - Cecilia Andersson
- 2Dept of Respiratory Medicine and Allergology, Lund University, Lund, Sweden
| | - Michiko Mori
- 1Dept of Exp Medical Science, Lund University, Lund, Sweden
| | | | | | | | - Leif Bjermer
- 2Dept of Respiratory Medicine and Allergology, Lund University, Lund, Sweden
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Mori M, Andersson CK, Svedberg KA, Glader P, Bergqvist A, Shikhagaie M, Löfdahl CG, Erjefält JS. Appearance of remodelled and dendritic cell-rich alveolar-lymphoid interfaces provides a structural basis for increased alveolar antigen uptake in chronic obstructive pulmonary disease. Thorax 2013; 68:521-31. [PMID: 23412435 DOI: 10.1136/thoraxjnl-2012-202879] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [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: 01/22/2023]
Abstract
RATIONALE The alveolar pathology in chronic obstructive pulmonary disease (COPD) involves antigen-driven immune events. However, the induction sites of alveolar adaptive immune responses have remained poorly investigated. OBJECTIVES To explore the hypothesis that interfaces between the alveolar lumen and lymphoid aggregates (LAs) provide a structural basis for increased alveolar antigen uptake in COPD lungs. METHODS Lung samples from patients with mild (Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage I), moderate-severe (GOLD II-III), and very severe (GOLD IV) COPD were subjected to detailed histological assessments of adaptive immune system components. Never smokers and smokers without COPD served as controls. RESULTS Quantitative histology, involving computerised three-dimensional reconstructions, confirmed a rich occurrence of alveolar-restricted LAs and revealed, for the first time, that the vast majority of vascular or bronchiolar associated LAs had alveolar interfaces but also an intricate network of lymphatic vessels. Uniquely to COPD lungs, the interface epithelium had transformed into a columnar phenotype. Accumulation of langerin (CD207)(+) dendritic cells occurred in the interface epithelium in patients with COPD but not controls. The antigen-capturing capacity of langerin(+) dendritic cells was confirmed by increased alveolar protrusions and physical T cell contact. Several of these immune remodelling parameters correlated with lung function parameters. CONCLUSIONS Severe stages of COPD are associated with an emergence of remodelled and dendritic cell-rich alveolar-lymphoid interfaces. This novel type of immune remodelling, which predicts an increased capacity to respond to alveolar antigens, is suggested to contribute to aggravated inflammation in COPD.
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Affiliation(s)
- Michiko Mori
- Department of Experimental Medical Science, Lund University, Lund, Sweden
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Andersson CK, Tufvesson E, Aronsson D, Bergqvist A, Mori M, Bjermer L, Erjefält JS. Alveolar mast cells shift to an FcεRI-expressing phenotype in mild atopic asthma: a novel feature in allergic asthma pathology. Allergy 2011; 66:1590-7. [PMID: 21958156 DOI: 10.1111/j.1398-9995.2011.02723.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND A unique feature of alveolar mast cells is their low high-affinity IgE receptor (FcεRI) expression. Recent discoveries in uncontrolled asthma suggest that the appearance of FcεRI-expressing alveolar mast cells may be a novel disease-specific feature of allergic asthma. This study investigates whether increased FcεRI-expressing alveolar mast cells are present in patients with mild allergic asthma or even in non-asthmatic allergic rhinitis patients (AR) who have developed bronchial hyperactivity (BHR). METHODS Bronchial and alveolar tissues were obtained from healthy controls, AR patients with or without BHR, and AR patients with concurrent asthma. Samples were processed for immunohistochemical identification of MC(T) and MC(TC) and expression of FcεRI and surface-bound IgE. RESULTS Bronchial mast cell expression of FcεRI was high in all groups. In contrast, in the alveolar tissue, the expression of FcεRI on mast cells was low in healthy controls and in the AR patient groups, whereas a high expression was present in AR patients with concurrent asthma (P = 0.006 compared to controls). The asthmatics had a 29-fold increase in numbers (P = 0.006) and a 19-fold increase in proportion (P = 0.007) of alveolar mast cells that expressed surface-bound IgE. CONCLUSIONS The present data show that alveolar mast cells in patients with mild atopic asthma, but not atopic patients with AR, have turned into a highly FcεRI- and IgE-expressing phenotype. These data support the hypothesis that increased FcεRI expression on alveolar mast cells is a novel disease-specific feature of allergic asthma that is important for understanding asthma phenotypes and designing new therapeutic strategies.
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Affiliation(s)
- C K Andersson
- Department of Respiratory Medicine and Allergology, Lund University, Lund, Sweden
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Andersson CK, Bergqvist A, Mori M, Mauad T, Bjermer L, Erjefält JS. Mast cell–associated alveolar inflammation in patients with atopic uncontrolled asthma. J Allergy Clin Immunol 2011; 127:905-12.e1-7. [DOI: 10.1016/j.jaci.2011.01.022] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2010] [Revised: 12/22/2010] [Accepted: 01/12/2011] [Indexed: 01/20/2023]
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Melin A, Lundholm C, Malki N, Swahn ML, Sparen P, Bergqvist A. Endometriosis as a prognostic factor for cancer survival. Int J Cancer 2010; 129:948-55. [PMID: 20949560 DOI: 10.1002/ijc.25718] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2010] [Accepted: 09/21/2010] [Indexed: 12/24/2022]
Abstract
Studies have shown an increased risk of malignancies in women with endometriosis. Little is known about the impact of endometriosis on cancer survival. We investigated whether the survival after a diagnosis of a malignancy differs in women with a previously diagnosed endometriosis compared to other women. Women with a first time diagnosis of a malignancy in 1969-2005, were identified using the National Swedish Cancer Register (NSCR). By use of the National Swedish Patient Register (NSPR) we identified all women with a diagnosis of endometriosis during the same period and linked these patients with the data from the NSCR. The cohort comprised 4,278 women with endometriosis and a malignancy, and 41,831 randomly selected matched women without endometriosis. Cox regression was used for all calculations to obtain crude and adjusted cause specific mortality rates, measured as hazard ratios (HR) with 95% confidence intervals (CI). A total of 46,109 women entered the study. There was a statistically significant better survival for women with endometriosis for all malignancies combined (HR=0.92) and for breast cancer (HR=0.86) and ovarian cancer (HR=0.81) specifically. For breast cancer the survival enhancing effect in women with endometriosis decreased with increasing parity. There was poorer survival in malignant melanoma for women with endometriosis (HR=1.52). The survival in a malignancy is better in women with a previously diagnosed endometriosis compared to women without endometriosis especially for breast and ovarian cancers. The prognosis of malignant melanoma is poorer in women with endometriosis.
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Affiliation(s)
- A Melin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
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Jiang Y, Zhao J, Hua M, Zhen X, Yan G, Hu Y, Sun H, Selvaggi L, Zannoni GF, Tagliaferri V, De Cicco S, Vellone VG, Romualdi D, Lanzone A, Guido M, Fassbender A, Vodolazkaia AV, Bossuyt XB, Kyama MK, Meuleman CM, Peeraer KP, Tomassetti CT, D'Hooghe TM, Lumini A, Nanni L, Manna C, Pappalardo S, Melin A, Lundholm C, Malki N, Swahn ML, Sparen P, Bergqvist A, Manna C, Crescenzi F, Farrag A, Sallam HN, Zou L, Ding G, Zhang R, Sheng J, Huang H, von Kleinsorgen C, Wilson T, Thiel-Moder U, Ebert AD, Reinfandt M, Papadopolous T, Melo AS, Rodrigues JK, Dib LA, Andrade AZ, Donabela FC, Ferriani RA, Navarro PA, Tocci A, Royo P, Lucchini C, Ramos P, Alcazar JL, Habara T, Terada S, Yoshioka N, Hayashi N, Haouzi D, Assou S, Monzo C, Anahory T, Dechaud H, De Vos J, Hamamah S, Gonzalez-Ramos R, Rojas C, Rocco J, Poch A, Sovino H, Kohen P, Munoz A, Devoto L, Aygen MA, Atakul T, Oner G, Ozgun MT, Sahin Y, Ozturk F, Li R, Qiao J, Zhylkova I, Feskov A, Feskova I, Somova O, Chumakova N, Bontekoe S, Blake D, Heineman MJ, Williams EC, Johnson NP, Motta A, Colaci D, Horton M, Faut M, Bisioli C, Kopcow L, de Zuniga I, Wiener-Megnazi Z, Khaytov M, Lahav - Baratz S, Shiloh H, Koifman M, Oslander R, Dirnfeld M, Sundqvist J, Andersson KL, Scarselli G, Gemzell-Danielsson K, Lalitkumar PGL, Tokushige N, Markham R, Crossett B, Ahn S, Nelaturi V, Khan A, Fraser IS, Van Vaerenbergh I, Fatemi HM, Blockeel C, Van Lommel L, In't Veld P, Schuit F, Kolibianakis EM, Devroey P, Bourgain C, Sugino N, Tamura I, Lee R, Maekawa R, Gelbaya T, Gordts S, D'Hooghe TN, Gergolet M, Nardo LG, Yu H, Wang H, Huang H, Lee C, Soong Y, Kremenska Y, Masliy Y, Goncharova Y, Kremenskoy M, Veselovskyy V, Zukin V, Sudoma I, Delgado-Rosas F, Gomez R, Tamarit S, Abad A, Simon C, Pellicer A, Racicot M, Dean NL, Antaki R, Menard S, Kadoch IJ, Garcia-Guzman R, Cabrera Romero L, Hernandez J, Palumbo A, Marshall E, Lowry J, Maybin JA, Collins F, Critchley HOD, Saunders PTK, Chaudhury K, Jana SK, Banerjee P, Mukherjee S, Chakravarty BN, Allegra A, Marino A, Lama A, Santoro A, Agueli C, Mazzola S, Volpes A, Delvoux B, de Graaff AA, D'Hooghe TM, Kyama CM, Dunselman GAJ, Romano A, Caccavo D, Pellegrino NM, Totaro I, Panzarino M, Nardelli C, Depalo R, Flores R, Montanana V, Monzo A, Polo P, Garcia-Gimeno T, Cabo A, Rubio JM, Pellicer A, de Graaff AA, Dunselman GAJ, Beets GL, van Lankveld JJ, Kim HY, Lee BS, Cho SH, Choi YS, Seo SK, Lee KE, Yang HI, Abubakirov A, Vacheyshvili T, Krechetova L, Ziganshina M, Demura T, Nazarenko T, Fulop I, Rucz A, Herczegh SZ, Ujvari A, Takacs SZ, Szakonyi T, Lopez - Muniz A, Zamora L, Serra O, Guix C, Lopez-Teijon M, Benadiva C, Alvarez JG, Goudakou M, Karkanaki A, Kalogeraki A, Mataliotakis I, Kalogiannidis I, Prapas I, Hosie M, Thomson KJ, Penny CB, Thomson KJ, Penny C, Hosie MJ, McKinnon B, Klaeser B, Bersinger N, Mueller MD, Horcajadas JA, Martinez-Conejero JA, Montesinos M, Morgan M, Fortuno S, Simon C, Pellicer A, Yi KW, Shin JH, Park HT, Kim T, Kim SH, Hur JY, Chan RWS, Chan YY, Ng EHY, Yeung WSB, Santulli P, Borghese B, Chopin N, Marcellin L, de Ziegler D, Chapron C, Elnashar A, Badawy A, Mosbah A, Tzioras S, Polyzos NP, Messini CI, Papanikolaou EG, Valachis A, Patavoukas E, Mauri D, Badawy A, Messinis IE, Acar N, Hirota Y, Tranguch S, Daikoku T, Burnum KE, Xie H, Kodama A, Osuga Y, Ustunel I, Friedman DB, Caprioli RM, Dey SK, Mitra A, Sahu R, Pal M, Bhattachrayya AK, Bhattachrya J, Ferrero S, Remorgida V, Rollandi GA, Biscaldi E, Cho S, Choi YS, Kim HY, Seo SK, Yang HI, Lee KE, Shin JH, Lee BS, Arena E, Morando A, Remorgida V, Ferrero S, Tomazevic T, Ban-Frangez H, Virant-Klun I, Verdenik I, Pozlep B, Vrtacnik-Bokal E, Valenzano Menada M, Biscaldi E, Remorgida V, Morotti M, Venturini PL, Rollandi GA, Ferrero S, Dimitriadis E, Salamonsen LA, Hannan N, O'Connor O, Rombauts L, Stoikos C, Mahmoudi M, Shaikh A, Mousavifar N, Rastin M, Baharara J, Tabasi N, Takemura Y, Fujimoto A, Osuga Y, Tsutsumi R, Ooi N, Yano T, Taketani Y, Karkanaki A, Goudakou M, Kalogiannidis I, Panagiotidis I, Prapas Y, Zhang D, Lv PP, Ding GL, Zhang RJ, Zou LB, Xu GF, Gao HJ, Zhu YM, Sheng JZ, Huang HF, Martinez-Conejero JA, Labarta E, Alama P, Pellicer A, Horcajadas JA, Bosch E. Posters * Endometriosis, Endometrium and Implantation. Hum Reprod 2010. [DOI: 10.1093/humrep/de.25.s1.242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Saha R, Svedberg P, Johansson F, Bergqvist A, Boivin J, Bunting L, Tsibulsky I, Kalebic N, Harrison C, Sozou PD, Hartshorne GM, Stoop D, Nekkebroeck J, Devroey P, Dean JH, Chapman M, Sullivan EA, Overbeek A, van den Berg MH, van Leeuwen FE, Lambalk CB, Kaspers GJL, van Dulmen-den Broeder E, Mutsaerts M, Huiting HG, Groen H, Kuchenbecker WKH, Land JA, Stolk RP, Hoek A. Session 69: Factors Influencing Fertility and Infertility Treatment. Hum Reprod 2010. [DOI: 10.1093/humrep/de.25.s1.69] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Nnoaham KE, Sivananthan S, Hummelshoj L, Jenkinson C, Webster P, Kennedy SH, Zondervan KT, Vodolazkaia A, Fassbender A, Kyama CM, Bokor A, Clerinx P, Gevaert O, Schols D, Huskens D, Meuleman C, Peeraer K, Tomassetti C, De Moor B, D'Hooghe TM, Opoien HK, Fedorcsak P, Abyholm T, Tanbo TG, Tanbo TG, Kavallaris A, Hornemann A, Bohlmann M, Griesinger G, Chalvatzas N, Diedrich K, Benaglia L, Pasin R, Somigliana E, Vercellini P, Ragni G, Fedele L, Bergqvist A, Lundholm C, Malki N, Swahn ML, Sparen P, Melin A. Session 05: Endometriosis: Impact, Diagnosis and Surgery. Hum Reprod 2010. [DOI: 10.1093/humrep/de.25.s1.5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Lennerstrand J, Bondeson K, Bergqvist A, Blomberg J, Oberg B. [New antiviral agents against hepatitis C in clinical trials. Hope for a cure--but resistance problems must be overcomed]. Lakartidningen 2009; 106:3254-3260. [PMID: 20101837] [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] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Abstract
BACKGROUND Several epidemiological studies have shown an increased cancer risk among women with endometriosis, especially ovarian cancer. Infertility and nulliparity are also known risk factors for different types of cancer. The aim of this study is to investigate cancer risk among women with endometriosis, stratifying for parity. METHODS Women discharged from a hospital, with the diagnosis of endometriosis from 1969 to 2002, were identified using the National Swedish Inpatient Register. Data were linked to the National Swedish Cancer Register to identify cases of cancer and to the Swedish Multi-Generation Register to calculate parity and age at first birth. Standardized incidence ratios (SIR) were calculated. RESULTS A total of 63,630 women entered the study. To exclude cancers already present at the time of endometriosis diagnosis, the first year of follow-up was excluded, leaving a number of 3,822 cases of cancer. There was no increased overall risk of cancer (SIR 1.01) among women with endometriosis. Endometriosis was associated with elevated risks for endocrine tumours (SIR 1.38), ovarian cancer (SIR 1.37), renal cancer (SIR 1.36), thyroid cancer (SIR 1.33), brain tumours (SIR 1.27), malignant melanoma (SIR 1.23) and breast cancer (SIR 1.08), as well as a reduced risk for cervical cancer (SIR 0.71). There were no significant differences between nulliparous and parous women with endometriosis regarding cancer risk for any of the cancer types. There was a non-significant decrease in risk of ovarian cancer with increasing parity for women with endometriosis. CONCLUSIONS Women with endometriosis have an increased risk for several malignancies. The increased risks do not seem to be related to parity.
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Affiliation(s)
- A Melin
- Department of Obstetrics and Gynaecology, Karolinska University Hospital, Huddinge, K57, Stockholm, Sweden.
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Falconer H, Mwenda JM, Chai DC, Wagner C, Song XY, Mihalyi A, Simsa P, Kyama C, Cornillie FJ, Bergqvist A, Fried G, D'Hooghe TM. Treatment with anti-TNF monoclonal antibody (c5N) reduces the extent of induced endometriosis in the baboon. Hum Reprod 2006; 21:1856-62. [PMID: 16517562 DOI: 10.1093/humrep/del044] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Inflammatory cytokines, including interleukin (IL)-1, IL-6, IL-8 and tumour necrosis factor-alpha (TNF-alpha), are important in the pathogenesis of endometriosis. We assessed the efficacy of anti-TNF monoclonal antibody (mAb, c5N), known to prevent induced endometriosis in baboons, in reducing established endometriosis in baboons. METHODS This prospective, randomized, blinded, controlled study was conducted in baboons at the Institute of Primate Research (IPR), Nairobi, Kenya. Endometriosis was induced in 18 adult female baboons (Papio anubis) with regular menstrual cycles and a normal pelvis; the extent of endometriosis was documented by videolaparoscopy 25 days later. The baboons were then randomly assigned to receive a single infusion of either placebo (n=7, 5 ml/kg) or c5N (n=11, 5 mg/kg). Follow-up laparoscopy was performed 25 days later to document any differences in the number, surface area and estimated volume of lesions between the two groups and between the first and the second laparoscopies in each group. Representative biopsies of at least one endometriotic lesion per baboon were obtained at the final laparoscopy. RESULTS Significant reductions in total surface area, estimated total volume of endometriotic lesions and both number and surface area of red lesions were observed after treatment with c5N, but not after placebo treatment, when compared to the initial laparoscopy. Conversely, a significant increase in the number of typical and red lesions was observed after placebo treatment when compared to the initial laparoscopy. Neither c5N nor placebo treatment affected the menstrual cycle. CONCLUSION In baboons with induced endometriosis, anti-TNF-mAb (c5N) treatment significantly reduced the extent of endometriosis, mainly due to reducing both the number and surface area of red lesions. These findings suggest that anti-TNF-mAb therapy may have therapeutic potential for active peritoneal endometriosis.
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Affiliation(s)
- H Falconer
- Department of Obstetrics and Gynaecology, Karolinska Hospital, Stockholm, Sweden, and Department of Obstetrics and Gynaecology, Leuven University Fertility Center, Belgium
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Abstract
BACKGROUND Several observations of the coexistence of endometriosis and cancer have been published. One study concerning endometriosis patients from 1969 to 1986 showed an overall relative cancer risk of 1.2 and relative risks for breast cancer, ovarian cancer and non-Hodgkin's lymphoma to be 1.3, 1.9 and 1.8, respectively. The aim of this study was to see whether these risk ratios stand in an extended study with longer follow-up. METHODS Women discharged from a hospital, with a diagnosis of endometriosis from 1969 to 2000, were identified using the National Swedish Inpatient Register. Data were linked to the National Swedish Cancer Register to identify cases of cancer. Data on hysterectomies and oophorectomies were available. Standardized incidence ratios (SIR) were calculated. RESULTS 64 492 women entered the study. First year of follow-up was excluded, leaving 3349 cases of cancer. There was no increased overall risk of cancer [SIR 1.04, 95% CI 1.00-1.07]. Elevated risks were found for ovarian cancer (SIR 1.43, 95% CI 1.19-1.71), endocrine tumours (SIR 1.36, 95% CI 1.15-1.61), non-Hodgkin's lymphoma (SIR 1.24, 95% CI 1.02-1.49) and brain tumours (SIR 1.22, 95% CI 1.04-1.41). Women with early diagnosed and long-standing endometriosis had a higher risk of ovarian cancer, with SIR of 2.01 and 2.23, respectively. The average age at endometriosis diagnosis was 39.4, indicating that there are the moderate/severe cases that are included in this study. Women who had a hysterectomy before or at the time of the endometriosis diagnosis did not show an increased risk of ovarian cancer. CONCLUSION Women with endometriosis have an increased risk of some malignancies, particularly ovarian cancer, and the risk increases with early diagnosed or long-standing disease. Hysterectomy may have a preventive effect against ovarian cancer.
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Affiliation(s)
- A Melin
- Department of Obstetrics & Gynaecology, Karolinska University Hospital Huddinge, Stockholm, Sweden.
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Crosignani PG, Luciano A, Ray A, Bergqvist A. Subcutaneous depot medroxyprogesterone acetate versus leuprolide acetate in the treatment of endometriosis-associated pain. Hum Reprod 2005; 21:248-56. [PMID: 16176939 DOI: 10.1093/humrep/dei290] [Citation(s) in RCA: 110] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND A clinical study compared efficacy and safety of depot medroxyprogesterone acetate (DMPA) with leuprolide for endometriosis-associated pain. METHODS This multicentre, 18 month, evaluator-blinded, comparator-controlled trial randomized 300 women with laparoscopically diagnosed endometriosis to 6 month treatment with subcutaneous injection of 104 mg/0.65 ml DMPA (DMPA-SC 104) every 3 months or leuprolide (3.75 mg monthly or 11.25 mg every 3 months), with 12 months post-treatment follow-up. Endpoints included patient response to treatment in five signs/symptoms (dysmenorrhoea, dyspareunia, pelvic pain, pelvic tenderness, induration) and changes in bone mineral density (BMD) and productivity at 6 and 18 months. RESULTS DMPA-SC 104 and leuprolide produced equivalent (P < 0.02) reductions in at least four pain categories and significant (P < 0.001) improvements in composite score at months 6 and 18. At month 6, reductions in total hip and lumbar spine BMD were significantly less (P < 0.001) with DMPA-SC 104 versus leuprolide. BMD returned to pre-treatment levels 12 months post-treatment in the DMPA-SC 104 but not the leuprolide group. Total productivity also significantly (P < or = 0.05) improved in both groups at 6 and 18 months. CONCLUSIONS DMPA-SC 104 reduces endometriosis-associated pain as effectively as leuprolide and improves productivity with significantly less BMD decline.
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Affiliation(s)
- P G Crosignani
- I Clinica Ostetrica e Ginecologica - Università di Milano, Via Commenda 12 20122 Milano, Italy
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Sundström S, Ota S, Dimberg LY, Masucci MG, Bergqvist A. Hepatitis C virus core protein induces an anergic state characterized by decreased interleukin-2 production and perturbation of mitogen-activated protein kinase responses. J Virol 2005; 79:2230-9. [PMID: 15681425 PMCID: PMC546561 DOI: 10.1128/jvi.79.4.2230-2239.2005] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Alterations of cytokine responses are thought to favor the establishment of persistent hepatitis C virus (HCV) infections, enhancing the risk of liver cirrhosis and hepatocellular carcinoma. Here we demonstrate that the expression of the HCV core (C) protein in stably transfected T cells correlates with a selective reduction of interleukin-2 (IL-2) promoter activity and IL-2 production in response to T-cell receptor triggering, whereas the activation of IL-4, IL-10, gamma interferon, and tumor necrosis factor alpha was moderately increased. This altered cytokine expression profile was associated with a perturbation of mitogen-activated protein (MAP) kinase responses. Extracellular regulated kinase and p38 were constitutively phosphorylated in C-expressing cells, while triggering of the costimulatory c-Jun N-terminal kinase (JNK) signaling cascade and activation of the CD28 response element within the IL-2 promoter appeared to be impaired. The perturbations of MAP kinase phosphorylation could be eliminated by cyclosporine A-mediated inhibition of nuclear factor of activated T cells, suggesting that the inactivation of JNK signaling and hyporesponsiveness to IL-2 induction were downstream consequences of C-induced Ca(2+) flux in a manner that mimics the induction of clonal anergy.
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Affiliation(s)
- Sara Sundström
- Microbiology and Tumor Biology Centre, Karolinska Institutet, SE-171 77 Stockholm, Sweden
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Lettesjö H, Hansson T, Bergqvist A, Grönlund J, Dannaeus A. Enhanced interleukin-18 levels in the peripheral blood of children with coeliac disease. Clin Exp Immunol 2005; 139:138-43. [PMID: 15606624 PMCID: PMC1809275 DOI: 10.1111/j.1365-2249.2005.02661.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Coeliac disease (CoD) is a small intestinal disorder characterized by villous atrophy, crypt cell hyperplasia and an increased production of T helper cell type 1 (Th1) cytokines. Interleukin (IL)-18 is a pro-inflammatory cytokine that has a crucial role in maintaining the Th1 response. In this study, the serum levels of IL-18 were measured in children with CoD or other gastrointestinal diseases in order to evaluate the possibility of using IL-18 as a disease activity marker. IL-18 levels were higher in samples from CoD patients [median 443 pg/ml (148-885)] compared to healthy controls [median 205 pg/ml (11-379)], P <0.05. In contrast, the levels of IL-18 were not enhanced significantly in the serum from patients with inflammatory bowel disease (IBD) [median 324 pg/ml (207-546)] or in the disease control group [median 303 pg/ml (2-689)]. In CoD patients, after 2 weeks of gluten challenge (GC), serum IL-18 was unchanged [median 268 pg/ml (59-458)] compared to patients on a gluten-free diet [median 220 pg/ml (53-600)], while IL-18 was increased after 12 weeks of GC [median 551 pg/ml (94-952)], P <0.01. The IL-18 levels correlated with IgA anti-transglutaminase antibody levels (rs=0.59, P=0.016) in serum from untreated CoD patients, and IL-18 also followed the degree of small intestinal villous atrophy in 12 out of 19 CoD patients. Our results support the view that serum IL-18 concentrations in children with CoD follow disease activity, suggesting a role for IL-18 in the induction of an inflammatory Th1-response after gluten exposure.
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Affiliation(s)
- H Lettesjö
- Department of Gastrointestinal Research, Pharmacia Diagnostics, Uppsala, Sweden.
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Bruse C, Radu D, Bergqvist A. In situ localization of mRNA for the fibrinolytic factors uPA, PAI-1 and uPAR in endometriotic and endometrial tissue. Mol Hum Reprod 2004; 10:159-66. [PMID: 14981142 DOI: 10.1093/molehr/gah033] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Endometriotic tissue grows invasively. The plasminogen-activating system is suggested to participate in degradation of extracellular matrix (ECM) and modulation of cell adhesion and migration. We have previously demonstrated elevated levels of the fibrinolytic factors urokinase plasminogen activator (uPA) and plasminogen activator inhibitor (PAI-1) in endometriotic tissue and endometrium from women with endometriosis. The aim of the present study was to localize the uPA, PAI-1 and urokinase plasminogen activator receptor (uPAR) mRNA in endometriotic tissue and in endometrium both from women with and without endometriosis. With in situ hybridization, we found that uPA mRNA seems to be up-regulated in endometriotic glands and endometrial stroma as well as PAI-1 mRNA in endometriotic and endometrial stroma from women with endometriosis. uPAR mRNA likewise appears to be up-regulated in both glands and stroma in endometriotic tissue and in endometrial glands from patients compared to endometrial glands and stroma from healthy women. These differences might be important for menstrual shedding and adherence of endometrial fragments to peritoneal lining in women developing endometriosis and for the invasive growth of endometriotic tissue.
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Affiliation(s)
- C Bruse
- Department of Obstetrics and Gynaecology, Huddinge University Hospital, SE-141 86 Stockholm, Sweden.
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Abstract
Although the hepatitis C virus (HCV) genome is synthesized by the virus-encoded RNA-dependent RNA polymerase NS5B, other viral and cellular factors are assumed to be required for template-specific initiation and regulation of RNA-synthesis. The cellular protein La, which normally associates with RNA polymerase III transcripts, also interacts with the 5'- and 3'-untranslated regions of several RNA viruses, including HCV. To investigate whether other viral gene products may be involved in this interaction, we constructed an HCV cDNA expression library in bacteriophage T7 allowing portions of the HCV polyprotein to be displayed on the phage surface. Screening of the phage library against La resulted in selection of clones displaying the N-terminal region of HCV NS5A. Co-precipitation of full-length and truncated forms of recombinant NS5A with La revealed that the N-terminal region of NS5A was both necessary and sufficient for binding to La. Although this region of NS5A is essential for HCV replication, the role of the NS5A-La interaction in the infected cell remains to be established.
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Affiliation(s)
- Hamid Houshmand
- Department of Medical Biochemistry and Microbiology, Uppsala University, Biomedical Centre, Uppsala, Sweden
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Bergqvist A, Sundström S, Dimberg LY, Gylfe E, Masucci MG. The hepatitis C virus core protein modulates T cell responses by inducing spontaneous and altering T-cell receptor-triggered Ca2+ oscillations. J Biol Chem 2003; 278:18877-83. [PMID: 12639962 DOI: 10.1074/jbc.m300185200] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Alterations of cytokine responses are thought to favor the establishment of persistent hepatitis C virus (HCV) infection, enhancing the risk of liver cirrhosis and hepatocellular carcinoma. Expression of the HCV core (C) protein modulates transcription of the IL-2 promoter in T lymphocytes by activating the nuclear factor of activated T lymphocyte (NFAT) pathway. Here we report on the effect of HCV C on Ca2+ signaling, which is essential for activation of NFAT. Expression of HCV C correlated with increased levels of cytosolic Ca2+ and spontaneous Ca2+ oscillations in transfected Jurkat cells. Triggering of the T-cell receptor induced a prolonged Ca2+ response characterized by vigorous high frequent oscillations in a high proportion of the responding cells. This was associated with decreased sizes and accelerated emptying of the intracellular calcium stores. The effect of HCV C on calcium mobilization was not dependent on phospholipase C-gamma 1 (PLC-gamma) activity or increased inositol 1,4,5-trisphosphate (IP3) production and did not require functional IP3 receptors, suggesting that insertion of the viral protein in the endoplasmic reticulum membrane may be sufficient to promote Ca2+ leakage with dramatic downstream consequences on the magnitude and duration of the response. Our data suggest that expression of HCV C in infected T lymphocytes may contribute to the establishment of persistent infections by inducing Ca2+ oscillations that regulate both the efficacy and information content of Ca2+ signals and are ultimately responsible for induction of gene expression and functional differentiation.
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Affiliation(s)
- Anders Bergqvist
- Microbiology and Tumor Biology Centre, Karolinska Institutet, SE-17177 Stockholm, Sweden.
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Bergqvist A, D'Hooghe T. Mini symposium on pathogenesis of endometriosis and treatment of endometriosis-associated subfertility. Introduction: the endometriosis enigma. Hum Reprod Update 2002; 8:79-83. [PMID: 11866243 DOI: 10.1093/humupd/8.1.79] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Bergqvist
- Department of Clinical Sciences, Karolinska Institutet, Stockholm, Sweden.
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Bergqvist A, Theorell T. Changes in quality of life after hormonal treatment of endometriosis. Acta Obstet Gynecol Scand 2001; 80:628-37. [PMID: 11437721] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
BACKGROUND To assess whether hormonal treatment of endometriosis improves quality of life for women with endometriosis. METHODS In a prospective, randomized, double-blind, double-dummy study on 48 women with verified endometriosis, the pain pattern and quality of life were registered before, during and after treatment with nafarelin or medroxyprogesterone acetate. The distribution of the studied parameters were tested by means of a Skewness test. ANOVA analysis was used for normally distributed variables and Friedman's analysis and Mann-Whitney U-test for non normally distributed variables. RESULTS There was a difference between the 30 women who participated all through the study and the 18 who dropped out. It was noticeable that anxiety-depression and sleep disturbances were significantly more common among the drop outs. There was a significant reduction in symptom score during the study, without any significant difference between the treatment groups. The sleep disturbances and anxiety-depression score improved significantly from before treatment to the end of the follow-up, but the anxiety-depression score increased during the nafarelin treatment period. There was a statistically significant improvement of paid working life in the nafarelin treated group. All the other psycho-social parameters as well as emotional balance improved during the study period without difference between groups. CONCLUSION When hormonal treatment is planned it is very important to take into consideration previous psychosocial experiences of the patient. Factors of importance for quality of life such as sleep disturbances and anxiety-depression improved significantly after treatment with nafarelin or medroxyprogesterone acetate.
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Affiliation(s)
- A Bergqvist
- Department of Obstetrics and Gynecology, Huddinge University Hospital and Division of Psychosocial Factors and Health, Karolinska Institutet, Stockholm, Sweden
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Bergqvist A, Bruse C, Carlberg M, Carlström K. Interleukin 1beta, interleukin-6, and tumor necrosis factor-alpha in endometriotic tissue and in endometrium. Fertil Steril 2001; 75:489-95. [PMID: 11239529 DOI: 10.1016/s0015-0282(00)01752-0] [Citation(s) in RCA: 132] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To compare the levels of IL-1beta, IL-6, and TNFalpha in endometriotic tissue and in endometrium from women with endometriosis and healthy controls. DESIGN Open. SETTING Department of Obstetrics and Gynecology at a university hospital. PATIENT(S) Twenty-six women with endometriosis and 22 controls operated on for clinical indications. INTERVENTION(S) ELISA in homogenized tissue samples collected during surgery. MAIN OUTCOME MEASURE(S) Levels of IL-1beta, IL-6, and TNFalpha in tissue homogenates. RESULT(S) The three types of tissue differed significantly with respect to all three cytokines. Endometriotic tissue had significantly higher concentrations of IL-1beta than endometrium from both patients with endometriosis and healthy controls. Both endometriotic tissue and endometrium from patients had significantly higher concentrations of IL-6, and endometriotic tissue had significantly lower concentration of TNFalpha than did endometrium from controls. IL-1beta showed a cycle phase dependence that was significant in endometrium from patients, being higher in the secretory than in the follicular phase. IL-1beta was significantly higher in endometrioma than in lesions of other localizations. Concentrations of IL-1beta and IL-6 were positively correlated in endometriotic tissue and in endometrium from controls. No other significant correlations were found. CONCLUSION(S) This study has shown a significant production of IL-1beta, IL-6, and TNFalpha in endometriotic tissue and endometrium, with significant differences between the tissue types, indicating a deviating cytokine pattern in both endometriotic tissue and endometrium from women with endometriosis compared with that from healthy controls.
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Affiliation(s)
- A Bergqvist
- Department of Obstetrics and Gynecology, Huddinge University Hospital, and Karolinska Institutet, Stockhom, Sweden.
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Abstract
Most patients infected with hepatitis C virus (HCV) become chronic carriers. Viruses that efficiently establish persistent infections must have effective ways of evading host defenses. In the case of HCV, little is known about how chronic infections are established or maintained. Besides hepatocytes, several reports suggest that HCV can infect T and B lymphocytes. Since T cells are essential for viral clearance, direct or indirect effects of HCV on T-cell function could influence the outcome of infection. Given that T-cell growth and differentiation require the cytokine interleukin 2 (IL-2), we asked whether HCV might modulate synthesis of IL-2. Portions of the HCV polyprotein were expressed in Jurkat cells under a variety of conditions. We found that the highly conserved HCV core protein, in combination with other stimuli, was able to dramatically activate transcription from the IL-2 promoter. The carboxy-terminal hydrophobic portion of the core protein was required for this activity. Activation was dependent on nuclear factor of activated T cells (NFAT), occurred in cells deficient in the tyrosine kinase p56(lck), and could be blocked by addition of cyclosporin A and by depletion of calcium. These results suggest that the HCV core protein can activate transcription of the IL-2 promoter through the NFAT pathway. This novel activity may have consequences for T-cell development and establishment of persistent infections.
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Affiliation(s)
- A Bergqvist
- Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, Missouri, USA.
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Abstract
The effects of goserelin and nafarelin were compared in a prospective, randomized, open, parallel study of 6 months' treatment of 252 women with symptomatic, laparoscopically proven endometriosis. Twenty-eight departments of obstetrics and gynecology in Sweden, Norway, Denmark and Finland were included. Evaluations were made every 3 months for quantification of pain, bleeding and adverse events and convenience of treatment, and at 3 months after the end of treatment, when a control laparoscopy was performed for evaluation of changes in endometriotic lesion size, color and location. Thirty-nine patients withdrew and 113 women given goserelin and 100 women given nafarelin completed the study. There were no statistically significant differences between the groups, either in adverse events or in bleeding. There were no correlations between location, lesion size or type of lesion, and symptom score in either group, or between treatments with regard to change in endometriosis score. In both groups, the percentage of red and black lesions was reduced while the proportion of white lesions increased. The pain score was significantly reduced in both groups. Local irritation in the nasal mucosa was reported in both groups, mostly in the nafarelin-treated group. The goserelin-treated group also reported local symptoms at the injection site. We conclude that there is no statistically significant difference in treatment results or side-effects between goserelin and nafarelin when used for the treatment of endometriosis.
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Affiliation(s)
- A Bergqvist
- Department of Obstetrics and Gynecology, Huddinge University Hospital, S-141 86, Huddinge, Sweden
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Bergqvist A, Nejaty H, Fröysa B, Bruse C, Carlberg M, Sjöblom P, Söder O. Production of interleukins 1beta, 6 and 8 and tumor necrosis factor alpha in separated and cultured endometrial and endometriotic stromal and epithelial cells. Gynecol Obstet Invest 2000; 50:1-6. [PMID: 10895019 DOI: 10.1159/000010269] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The production of IL-1beta, IL-6, IL-8 and TNF-alpha was studied in short-time culture of separated stromal and epithelial cells. The cytokine secretion into culture medium was analyzed using immunoassay to evaluate the cytokine protein levels and bioassay to assess the bioactivity of the cytokines. Tissue samples of endometrium and ovarian endometriomas were obtained from 4 patients operated on for clinical reasons. Only IL-8 was found in all samples. IL-1beta and TNF-alpha were detected in the culture medium from most stromal cell samples, but in fewer media from epithelial cell samples. IL-6 was measurable in a few medium samples. Few of the samples displayed a bioactivity. There was no obvious difference between endometrium and endometriotic cell samples besides the production of IL-8 that seems to be lower in endometriotic tissue.
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Affiliation(s)
- A Bergqvist
- Department of Obstetrics and Gynecology, Huddinge University Hospital, Sweden.
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Carlberg M, Nejaty J, Fröysa B, Guan Y, Söder O, Bergqvist A. Elevated expression of tumour necrosis factor alpha in cultured granulosa cells from women with endometriosis. Hum Reprod 2000; 15:1250-5. [PMID: 10831550 DOI: 10.1093/humrep/15.6.1250] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Fertilization and oocyte cleavage rates have previously been demonstrated to be lower for women with endometriosis undergoing IVF compared with controls. This might be related to impaired oocyte function, possibly due to an inflammatory milieu in the pelvis of these women, where an elevated concentration of many cytokines is documented. The aim of this study was to examine whether granulosa cells from women with endometriosis deviated with respect to production of the inflammatory cytokines interleukin-1beta, interleukin-6, interleukin-8 and tumour necrosis factor alpha (TNFalpha) compared with granulosa cells from healthy women, undergoing IVF for male infertility. The effect of human chorionic gonadotrophin on cytokine production was also investigated. Granulosa cells in follicular fluid were obtained at oocyte retrieval for IVF. Incubated cell culture media were analysed by enzyme-linked immunosorbent assay. The basal production of all four cytokines was higher in cells from women with endometriosis when compared to controls, although the increase was only significant for TNFalpha. Chorionic gonadotrophin had no significant effect, although it had a tendency to suppress cytokine release in both patient categories. Whether aberrant cytokine production in granulosa cells from women with endometriosis may disturb fertilizing capacity of oocytes requires study.
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Affiliation(s)
- M Carlberg
- Department of Clinical Sciences, Huddinge University Hospital, Sweden
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Mårtenson D, Bergqvist A, Tomson G, Cronholm T. [Protect enthusiasm of the teachers in medical education!]. Lakartidningen 2000; 97:1455-6, 1459. [PMID: 10765630] [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] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Affiliation(s)
- D Mårtenson
- Institutionen för humaniora, informatik och samhällsvetenskap, Karolinska institutet
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Bergqvist A, Bergquist C, Nordenskjöld F. [Endometriosis--an inflammatory disease in women. Pain and reduced fertility are serious symptoms]. Lakartidningen 2000; 97:815-8. [PMID: 10741020] [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] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Endometriosis is a common disease with serious consequences for the patient and for society. Until now there has been no reliable method for diagnosing endometriosis besides direct visualization, e.g. utilizing laparoscopy. IVF offers the most successful treatment of endometriosis-related infertility, and a patient should be offered that treatment after one year of infertility. Waiting lists are often rather long, and other treatment modalities might be attempted while waiting for IVF. Pharmacological treatment does not increase the chances of pregnancy, while surgical extirpation of mild to moderate endometriosis might well result in a pregnancy earlier than anticipated.
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Janson PO, Bergqvist A, Von Schoultz B, Milsom I. [Gynecology in the new millenium. Increased responsibility of gynecologists for women's health]. Lakartidningen 2000; 97:830-3. [PMID: 10741023] [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] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Affiliation(s)
- P O Janson
- Avdelningen för obstetrik och gynekologi, Göteborgs universitet
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