1
|
Dharmayat KI, Vallejo-Vaz AJ, Stevens CA, Brandts JM, Lyons AR, Groselj U, Abifadel M, Aguilar-Salinas CA, Alhabib K, Alkhnifsawi M, Almahmeed W, Alnouri F, Alonso R, Al-Rasadi K, Ashavaid TF, Banach M, Béliard S, Binder C, Bourbon M, Chlebus K, Corral P, Cruz D, Descamps OS, Drogari E, Durst R, Ezhov MV, Genest J, Harada-Shiba M, Holven KB, Humphries SE, Khovidhunkit W, Lalic K, Laufs U, Liberopoulos E, Roeters van Lennep J, Lima-Martinez MM, Lin J, Maher V, März W, Miserez AR, Mitchenko O, Nawawi H, Panayiotou AG, Paragh G, Postadzhiyan A, Reda A, Reiner Ž, Reyes X, Sadiq F, Sahebkar A, Schunkert H, Shek AB, Stroes E, Su TC, Subramaniam T, Susekov A, Vázquez Cárdenas A, Huong Truong T, Tselepis AD, Vohnout B, Wang L, Yamashita S, Al-Sarraf A, Al-Sayed N, Davletov K, Dwiputra B, Gaita D, Kayikcioglu M, Latkovskis G, Marais AD, Thushara Matthias A, Mirrakhimov E, Nordestgaard BG, Petrulioniene Z, Pojskic B, Sadoh W, Tilney M, Tomlinson B, Tybjærg-Hansen A, Viigimaa M, Catapano AL, Freiberger T, Hovingh GK, Mata P, Soran H, Raal F, Watts GF, Schreier L, Bañares V, Greber-Platzer S, Baumgartner-Kaut M, de Gier C, Dieplinger H, Höllerl F, Innerhofer R, Karall D, Lischka J, Ludvik B, Mäser M, Scholl-Bürgi S, Thajer A, Toplak H, Demeure F, Mertens A, Balligand JL, Stephenne X, Sokal E, Petrov I, Goudev A, Nikolov F, Tisheva S, Yotov Y, Tzvetkov I, Hegele RA, Gaudet D, Brunham L, Ruel I, McCrindle B, Cuevas A, Perica D, Symeonides P, Trogkanis E, Kostis A, Ioannou A, Mouzarou A, Georgiou A, Stylianou A, Miltiadous G, Iacovides P, Deltas C, Vrablik M, Urbanova Z, Jesina P, Tichy L, Hyanek J, Dvorakova J, Cepova J, Sykora J, Buresova K, Pipek M, Pistkova E, Bartkova I, S|ulakova A, Toukalkova L, Spenerova M, Maly J, Benn M, Bendary A, Elbahry A, Ferrières J, Ferrieres D, Peretti N, Bruckert E, Gallo A, Valero R, Mourre F, Aouchiche K, Reynaud R, Tounian P, Lemale J, Boccara F, Moulin P, Charrières S, Di Filippo M, Cariou B, Paillard F, Dourmap C, Pradignac A, Verges B, Simoneau I, Farnier M, Cottin Y, Yelnik C, Hankard R, Schiele F, Durlach V, Sultan A, Carrié A, Rabès JP, Sanin V, Schmieder R, Ates S, Rizos CV, Skoumas I, Tziomalos K, Rallidis L, Kotsis V, Doumas M, Skalidis E, Kolovou G, Kolovou V, Garoufi A, Koutagiar I, Polychronopoulos G, Kiouri E, Antza C, Zacharis E, Attilakos A, Sfikas G, Koumaras C, Anagnostis P, Anastasiou G, Liamis G, Adamidis PS, Milionis H, Lambadiari V, Stabouli S, Filippatos T, Mollaki V, Tsaroumi A, Lamari F, Proyias P, Harangi M, Reddy LL, Shah SAV, Ponde CK, Dalal JJ, Sawhney JP, Verma IC, Hosseini S, Jamialahmadi T, Alareedh M, Shaghee F, Rhadi SH, Abduljalal M, Alfil S, Kareem H, Cohen H, Leitersdorf E, Schurr D, Shpitzen S, Arca M, Averna M, Bertolini S, Calandra S, Tarugi P, Casula M, Galimberti F, Gazzotti M, Olmastroni E, Sarzani R, Ferri C, Repetti E, Giorgino F, Suppressa P, Bossi AC, Borghi C, Muntoni S, Cipollone F, Scicali R, Pujia A, Passaro A, Berteotti M, Pecchioli V, Pisciotta L, Mandraffino G, Pellegatta F, Mombelli G, Branchi A, Fiorenza AM, Pederiva C, Werba JP, Parati G, Nascimbeni F, Iughetti L, Fortunato G, Cavallaro R, Iannuzzo G, Calabrò P, Cefalù AB, Capra ME, Zambon A, Pirro M, Sbrana F, Trenti C, Minicocci I, Federici M, Del Ben M, Buonuomo PS, Moffa S, Pipolo A, Citroni N, Guardamagna O, Lia S, Benso A, Biolo GB, Maroni L, Lupi A, Bonanni L, Rinaldi E, Zenti MG, Masuda D, Mahfouz L, Jambart S, Ayoub C, Ghaleb Y, Kasim NAM, Nor NSM, Al-Khateeb A, Kadir SHSA, Chua YA, Razman AZ, Nazli SA, Ranai NM, Latif AZA, Torres MTM, Mehta R, Martagon AJ, Ramirez GAG, Antonio-Villa NE, Vargas-Vazquez A, Elias-Lopez D, Retana GG, Encinas BR, Macias JJC, Zazueta AR, Alvarado RM, Portano JDM, Lopez HA, Sauque-Reyna L, Gomez Herrera LG, Simental Mendia LE, Aguilar HG, Cooremans ER, Aparicio BP, Zubieta VM, Gonzalez PAC, Ferreira-Hermosillo A, Portilla NC, Dominguez GJ, Garcia AYR, Arriaga Cazares HE, Gonzalez Gonzalez JR, Mendez Valencia CV, Padilla Padilla FG, Prado RM, De los Rios Ibarra MO, Arjona Villica~na RD, Acevedo Rivera KJ, Carrera RA, Alvarez JA, Amezcua Martinez JC, Barrera Bustillo MDLR, Vargas GC, Chacon RC, Figueroa Andrade MH, Ortega AF, Alcala HG, Garcia de Leon LE, Guzman BG, Gardu~no Garcia JJ, Garnica Cuellar JC, Gomez Cruz JR, Garcia AH, Holguin Almada JR, Herrera UJ, Sobrevilla FL, Rodriguez EM, Sibaja CM, Medrano Rodriguez AB, Morales Oyervides JC, Perez Vazquez DI, Reyes Rodriguez EA, Osorio MLR, Saucedo JR, Tamayo MT, Valdez Talavera LA, Vera Arroyo LE, Zepeda Carrillo EA, Galema-Boers A, Weigman A, Bogsrud MP, Malik M, Shah S, Khan SA, Rana MA, Batool H, Starostecka E, Konopka A, Lewek J, Bielecka-Dąbrowa A, Gach A, Jóźwiak J, Pajkowski M, Romanowska-Kocejko M, Żarczyńska-Buchowiecka M, Hellmann M, Chmara M, Wasąg B, Parczewska A, Gilis-Malinowska N, Borowiec-Wolna J, Stróżyk A, Michalska-Grzonkowska A, Chlebus I, Kleinschmidt M, Wojtecka A, Zdrojewski T, Myśliwiec M, Hennig M, Medeiros AM, Alves AC, Almeida AF, Lopes A, Guerra A, Bilhoto C, Simões F, Silva F, Lobarinhas G, Gama G, Palma I, Salgado JM, Matos LD, Moura MD, Virtuoso MJ, Tavares M, Ferreira P, Pais P, Garcia P, Coelho R, Ribeiro R, Correia S, Sadykova D, Slastnikova E, Alammari D, Mawlawi HA, Alsahari A, Khudary AA, Alrowaily NL, Rajkovic N, Popovic L, Singh S, Rasulic I, Petakov A, Lalic NM, Peng FK, Vasanwala RF, Venkatesh SA, Raslova K, Fabryova L, Nociar J, Šaligova J, Potočňáková L, Kozárová M, Varga T, Kadurova M, Debreova M, Novodvorsky P, Gonova K, Klabnik A, Buganova I, Battelino T, Bizjan BJ, Debeljak M, Kovac J, Mlinaric M, Molk N, Sikonja J, Sustar U, Podkrajsek KT, Muñiz-Grijalvo O, Díaz-Díaz JL, de Andrés R, Fuentes-Jiménez F, Blom D, Miserez EB, Shipton JL, Ganokroj P, Futema M, Ramaswami U, Alieva RB, Fozilov KG, Khoshimov SU, Nizamov UI, Abdullaeva GJ, Kan LE, Abdullaev AA, Zakirova DV, Do DL, Nguyen MNT, Kim NT, Le TT, Le HA, Santos R, Ray KK. Familial hypercholesterolaemia in children and adolescents from 48 countries: a cross-sectional study. Lancet 2024; 403:55-66. [PMID: 38101429 DOI: 10.1016/s0140-6736(23)01842-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 08/21/2023] [Accepted: 08/29/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Approximately 450 000 children are born with familial hypercholesterolaemia worldwide every year, yet only 2·1% of adults with familial hypercholesterolaemia were diagnosed before age 18 years via current diagnostic approaches, which are derived from observations in adults. We aimed to characterise children and adolescents with heterozygous familial hypercholesterolaemia (HeFH) and understand current approaches to the identification and management of familial hypercholesterolaemia to inform future public health strategies. METHODS For this cross-sectional study, we assessed children and adolescents younger than 18 years with a clinical or genetic diagnosis of HeFH at the time of entry into the Familial Hypercholesterolaemia Studies Collaboration (FHSC) registry between Oct 1, 2015, and Jan 31, 2021. Data in the registry were collected from 55 regional or national registries in 48 countries. Diagnoses relying on self-reported history of familial hypercholesterolaemia and suspected secondary hypercholesterolaemia were excluded from the registry; people with untreated LDL cholesterol (LDL-C) of at least 13·0 mmol/L were excluded from this study. Data were assessed overall and by WHO region, World Bank country income status, age, diagnostic criteria, and index-case status. The main outcome of this study was to assess current identification and management of children and adolescents with familial hypercholesterolaemia. FINDINGS Of 63 093 individuals in the FHSC registry, 11 848 (18·8%) were children or adolescents younger than 18 years with HeFH and were included in this study; 5756 (50·2%) of 11 476 included individuals were female and 5720 (49·8%) were male. Sex data were missing for 372 (3·1%) of 11 848 individuals. Median age at registry entry was 9·6 years (IQR 5·8-13·2). 10 099 (89·9%) of 11 235 included individuals had a final genetically confirmed diagnosis of familial hypercholesterolaemia and 1136 (10·1%) had a clinical diagnosis. Genetically confirmed diagnosis data or clinical diagnosis data were missing for 613 (5·2%) of 11 848 individuals. Genetic diagnosis was more common in children and adolescents from high-income countries (9427 [92·4%] of 10 202) than in children and adolescents from non-high-income countries (199 [48·0%] of 415). 3414 (31·6%) of 10 804 children or adolescents were index cases. Familial-hypercholesterolaemia-related physical signs, cardiovascular risk factors, and cardiovascular disease were uncommon, but were more common in non-high-income countries. 7557 (72·4%) of 10 428 included children or adolescents were not taking lipid-lowering medication (LLM) and had a median LDL-C of 5·00 mmol/L (IQR 4·05-6·08). Compared with genetic diagnosis, the use of unadapted clinical criteria intended for use in adults and reliant on more extreme phenotypes could result in 50-75% of children and adolescents with familial hypercholesterolaemia not being identified. INTERPRETATION Clinical characteristics observed in adults with familial hypercholesterolaemia are uncommon in children and adolescents with familial hypercholesterolaemia, hence detection in this age group relies on measurement of LDL-C and genetic confirmation. Where genetic testing is unavailable, increased availability and use of LDL-C measurements in the first few years of life could help reduce the current gap between prevalence and detection, enabling increased use of combination LLM to reach recommended LDL-C targets early in life. FUNDING Pfizer, Amgen, Merck Sharp & Dohme, Sanofi-Aventis, Daiichi Sankyo, and Regeneron.
Collapse
|
2
|
Klemenčič S, Lipovšek JK, Turin A, Dovč K, Bratina N, Shmueli-Goetz Y, Trebušak Podkrajšek K, Repič Lampret B, Jenko Bizjan B, Karakatič S, Battelino T, Drobnič Radobuljac M. Attachment in close relationships and glycemic outcomes in children with type 1 diabetes. Child Adolesc Psychiatry Ment Health 2023; 17:121. [PMID: 37848951 PMCID: PMC10583356 DOI: 10.1186/s13034-023-00672-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 10/10/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Our aim was to determine whether child attachment to parents, parent attachment style, and morning cortisol levels were related to diabetes outcomes measured by average glycated hemoglobin (HbA1c), HbA1c variability over 4 years and time in range (TIR) in children with type 1 diabetes (T1D). RESEARCH DESIGN AND METHODS 101 children with T1D and one of their parents were assessed at baseline for child attachment (Child Attachment Interview; CAI) and parent attachment (Relationship Structures Questionnaire; ECR-RS). Serum samples were collected for cortisol measurements before the interviews. HbA1c levels were measured during a 4-year follow-up period at regular 3-monthly visits, and data for TIR were exported from blood glucose measuring devices. Multivariate linear regression models were constructed to identify independent predictors of glycemic outcomes. RESULTS More girls than boys exhibited secure attachment to their mothers. The results of the regression models showed that securely attached girls (CAI) had higher average HbA1c than did insecurely attached girls (B = -0.64, p = 0.03). In boys, the more insecure the parent's attachment style, the worse the child's glycemic outcome: the higher the average Hb1Ac (B = 0.51, p = 0.005), the higher the HbA1c variability (B = 0.017, p = 0.011), and the lower the TIR (B = -8.543, p = 0.002). CONCLUSIONS Attachment in close relationships is associated with glycemic outcomes in children with T1D, and we observed significant differences between sexes. A sex- and attachment-specific approach is recommended when treating children with less favorable glycemic outcomes. Special attention and tailored support should be offered to securely attached girls in transferring responsibility for diabetes care and at least to male children of insecurely attached parents to prevent suboptimal glycemic control. Further studies in larger samples and more daily cortisol measurements may help us better understand the links between stress response, attachment and T1D.
Collapse
Affiliation(s)
- Simona Klemenčič
- Department of Pediatric Endocrinology, Diabetes and Metabolic Diseases, University Children's Hospital Ljubljana, University Medical Centre Ljubljana, Bohoričeva Ulica 20, 1000, Ljubljana, Slovenia.
| | - Jasna Klara Lipovšek
- Centre for Mental Health, University Psychiatric Clinic Ljubljana, Ljubljana, Slovenia
| | - Anja Turin
- Centre for Mental Health, University Psychiatric Clinic Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Klemen Dovč
- Department of Pediatric Endocrinology, Diabetes and Metabolic Diseases, University Children's Hospital Ljubljana, University Medical Centre Ljubljana, Bohoričeva Ulica 20, 1000, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Nataša Bratina
- Department of Pediatric Endocrinology, Diabetes and Metabolic Diseases, University Children's Hospital Ljubljana, University Medical Centre Ljubljana, Bohoričeva Ulica 20, 1000, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Yael Shmueli-Goetz
- Anna Freud National Centre for Children and Families and Psychoanalysis Unit, University College London, London, UK
| | - Katarina Trebušak Podkrajšek
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- Clinical Institute of Special Laboratory Diagnostics, University Children's Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Barbka Repič Lampret
- Clinical Institute of Special Laboratory Diagnostics, University Children's Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Barbara Jenko Bizjan
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- Clinical Institute of Special Laboratory Diagnostics, University Children's Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Sašo Karakatič
- Institute of Informatics, Faculty of Electrical Engineering and Computer Science, University of Maribor, Maribor, Slovenia
| | - Tadej Battelino
- Department of Pediatric Endocrinology, Diabetes and Metabolic Diseases, University Children's Hospital Ljubljana, University Medical Centre Ljubljana, Bohoričeva Ulica 20, 1000, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Maja Drobnič Radobuljac
- Centre for Mental Health, University Psychiatric Clinic Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| |
Collapse
|
3
|
Avčin SL, Črepinšek K, Jenko Bizjan B, Šket R, Kovač J, Vrhovšek B, Blazina J, Blatnik O, Kordič R, Kitanovski L, Jazbec J, Debeljak M, Tesovnik T. Integrative Transcriptomic Profiling of the Wilms Tumor. Cancers (Basel) 2023; 15:3846. [PMID: 37568662 PMCID: PMC10416970 DOI: 10.3390/cancers15153846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/21/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
Our study aimed to identify relevant transcriptomic biomarkers for the Wilms tumor, the most common pediatric kidney cancer, independent of the histological type and stage. Using next-generation sequencing, we analyzed the miRNA profiles of 74 kidney samples, which were divided into two independent groups: fresh frozen tissue and formalin-fixed paraffin-embedded tissue samples. Subsequent mRNA expression profiling and pathway analysis were performed to establish the interplay and potential involvement of miRNAs and mRNA in the Wilms tumor. Comparative analysis, irrespective of post-dissection tissue processing, revealed 41 differentially expressed miRNAs, with 27 miRNAs having decreased expression and 14 miRNAs having increased expression in the Wilms tumor tissue compared to healthy kidney tissue. Among global mRNA transcriptomic profile differences, cross-sectional analysis suggested a limited list of genes potentially regulated by differentially expressed miRNAs in the Wilms tumor. This study identified the comprehensive miRNA and mRNA profile of the Wilms tumor using next-generation sequencing and bioinformatics approach, providing better insights into the pathogenesis of the Wilms tumor. The identified Wilms tumor miRNAs have potential as biomarkers for the diagnosis and treatment of the Wilms tumor, regardless of histological subtype and disease stage.
Collapse
Affiliation(s)
- Simona Lucija Avčin
- Department of Haematology and Oncology, University Children’s Hospital, University Medical Centre Ljubljana (UMC), 1000 Ljubljana, Slovenia; (S.L.A.)
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Klementina Črepinšek
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
- Institute of Special Laboratory Diagnostic, University Children’s Hospital, University Medical Centre Ljubljana (UMC), 1000 Ljubljana, Slovenia
| | - Barbara Jenko Bizjan
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
- Institute of Special Laboratory Diagnostic, University Children’s Hospital, University Medical Centre Ljubljana (UMC), 1000 Ljubljana, Slovenia
| | - Robert Šket
- Institute of Special Laboratory Diagnostic, University Children’s Hospital, University Medical Centre Ljubljana (UMC), 1000 Ljubljana, Slovenia
| | - Jernej Kovač
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
- Institute of Special Laboratory Diagnostic, University Children’s Hospital, University Medical Centre Ljubljana (UMC), 1000 Ljubljana, Slovenia
| | - Blaž Vrhovšek
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
- Institute of Special Laboratory Diagnostic, University Children’s Hospital, University Medical Centre Ljubljana (UMC), 1000 Ljubljana, Slovenia
| | - Jerca Blazina
- Department of Pathology, Institute of Oncology Ljubljana, 1000 Ljubljana, Slovenia
| | - Olga Blatnik
- Department of Pathology, Institute of Oncology Ljubljana, 1000 Ljubljana, Slovenia
| | - Robert Kordič
- Department of Pediatric Surgery, University Children’s Hospital, University Medical Centre Ljubljana (UMC), 1000 Ljubljana, Slovenia
| | - Lidija Kitanovski
- Department of Haematology and Oncology, University Children’s Hospital, University Medical Centre Ljubljana (UMC), 1000 Ljubljana, Slovenia; (S.L.A.)
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Janez Jazbec
- Department of Haematology and Oncology, University Children’s Hospital, University Medical Centre Ljubljana (UMC), 1000 Ljubljana, Slovenia; (S.L.A.)
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Maruša Debeljak
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
- Institute of Special Laboratory Diagnostic, University Children’s Hospital, University Medical Centre Ljubljana (UMC), 1000 Ljubljana, Slovenia
| | - Tine Tesovnik
- Institute of Special Laboratory Diagnostic, University Children’s Hospital, University Medical Centre Ljubljana (UMC), 1000 Ljubljana, Slovenia
| |
Collapse
|
4
|
Janezic S, Mahnic A, Kuhar U, Kovač J, Jenko Bizjan B, Koritnik T, Tesovnik T, Šket R, Krapež U, Slavec B, Malovrh T, Battelino T, Rupnik M, Zohar Cretnik T. SARS-CoV-2 molecular epidemiology in Slovenia, January to September 2021. Euro Surveill 2023; 28:2200451. [PMID: 36820641 PMCID: PMC9951254 DOI: 10.2807/1560-7917.es.2023.28.8.2200451] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
BackgroundSequencing of SARS-CoV-2 PCR-positive samples was introduced in Slovenia in January 2021. Our surveillance programme comprised three complementary schemes: (A) non-targeted sequencing of at least 10% of samples, (B) sequencing of samples positive after PCR screening for variants of concern (VOC) and (C) sequencing as per epidemiological indication.AimWe present the analysis of cumulative data of the non-targeted surveillance of SARS-CoV-2 and variant-dependent growth kinetics for the five most common variants in Slovenia for the first 9 months of 2021.MethodsSARS-CoV-2 PCR-positive samples, from January to September 2021, were selected for sequencing according to the national surveillance plan. Growth kinetics studies were done on Vero E6 cells.ResultsAltogether 15,175 genomes were sequenced and 64 variants were detected, of which three successively prevailed. Variant B.1.258.17 was detected in ca 80% of samples in January and was replaced, within 9 weeks, by the Alpha variant. The number of cases decreased substantially during the summer of 2021. However, the introduction of the Delta variant caused a fourth wave and completely outcompeted other variants. Other VOC were only detected in small numbers. Infection of Vero E6 cells showed higher replication rates for the variants Alpha and Delta, compared with B.1.258.17, B.1.258, and B.1.1.70, which dominated in Slovenia before the introduction of the Alpha and Delta variants.ConclusionInformation on SARS-CoV-2 variant diversity provided context to the epidemiological data of PCR-positive cases, contributed to control of the initial spread of known VOC and influenced epidemiological measures.
Collapse
Affiliation(s)
- Sandra Janezic
- National Laboratory for Health, Environment and Food, Maribor, Slovenia
| | - Aleksander Mahnic
- National Laboratory for Health, Environment and Food, Maribor, Slovenia
| | - Urška Kuhar
- Institute of Microbiology and Parasitology, Veterinary Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Jernej Kovač
- Clinical Institute of Special Laboratory Diagnostics, University Children's Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Barbara Jenko Bizjan
- Clinical Institute of Special Laboratory Diagnostics, University Children's Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Tom Koritnik
- National Laboratory for Health, Environment and Food, Maribor, Slovenia
| | - Tine Tesovnik
- Clinical Institute of Special Laboratory Diagnostics, University Children's Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Robert Šket
- Clinical Institute of Special Laboratory Diagnostics, University Children's Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Uroš Krapež
- Institute for Poultry, Birds, Small Mammals, and Reptiles, Veterinary Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Brigita Slavec
- Institute for Poultry, Birds, Small Mammals, and Reptiles, Veterinary Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Tadej Malovrh
- Institute of Microbiology and Parasitology, Veterinary Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Tadej Battelino
- Clinical Institute of Special Laboratory Diagnostics, University Children's Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Maja Rupnik
- National Laboratory for Health, Environment and Food, Maribor, Slovenia
| | | | | | - CISLD NGS team
- Members of the CISLD NGS team, UMC Ljubljana are listed under Collaborators
| | | |
Collapse
|
5
|
Sustar U, Groselj U, Khan SA, Shafi S, Khan I, Kovac J, Bizjan BJ, Battelino T, Sadiq F. A homozygous variant in the GPIHBP1 gene in a child with severe hypertriglyceridemia and a systematic literature review. Front Genet 2022; 13:983283. [PMID: 36051701 PMCID: PMC9424485 DOI: 10.3389/fgene.2022.983283] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 07/18/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Due to nonspecific symptoms, rare dyslipidaemias are frequently misdiagnosed, overlooked, and undertreated, leading to increased risk for severe cardiovascular disease, pancreatitis and/or multiple organ failures before diagnosis. Better guidelines for the recognition and early diagnosis of rare dyslipidaemias are urgently required. Methods: Genomic DNA was isolated from blood samples of a Pakistani paediatric patient with hypertriglyceridemia, and from his parents and siblings. Next-generation sequencing (NGS) was performed, and an expanded dyslipidaemia panel was employed for genetic analysis. Results: The NGS revealed the presence of a homozygous missense pathogenic variant c.230G>A (NM_178172.6) in exon 3 of the GPIHBP1 (glycosylphosphatidylinositol-anchored high-density lipoprotein-binding protein 1) gene resulting in amino acid change p.Cys77Tyr (NP_835466.2). The patient was 5.5 years old at the time of genetic diagnosis. The maximal total cholesterol and triglyceride levels were measured at the age of 10 months (850.7 mg/dl, 22.0 mmol/L and 5,137 mg/dl, 58.0 mmol/L, respectively). The patient had cholesterol deposits at the hard palate, eruptive xanthomas, lethargy, poor appetite, and mild splenomegaly. Both parents and sister were heterozygous for the familial variant in the GPIHBP1 gene. Moreover, in the systematic review, we present 62 patients with pathogenic variants in the GPIHBP1 gene and clinical findings, associated with hyperlipoproteinemia. Conclusion: In a child with severe hypertriglyceridemia, we identified a pathogenic variant in the GPIHBP1 gene causing hyperlipoproteinemia (type 1D). In cases of severe elevations of plasma cholesterol and/or triglycerides genetic testing for rare dyslipidaemias should be performed as soon as possible for optimal therapy and patient management.
Collapse
Affiliation(s)
- Ursa Sustar
- Department of Endocrinology, Diabetes and Metabolism, University Children’s Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Urh Groselj
- Department of Endocrinology, Diabetes and Metabolism, University Children’s Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- Division of Cardiovascular Medicine, Department of Medicine, Stanford University, Stanford, CA, United States
- *Correspondence: Urh Groselj, ; Fouzia Sadiq,
| | - Sabeen Abid Khan
- Department of Paediatrics, Shifa College of Medicine, Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | - Saeed Shafi
- Department of Anatomy, Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | - Iqbal Khan
- Department of Vascular Surgery, Shifa International Hospital, Islamabad, Pakistan
- Department of Vascular Surgery, Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | - Jernej Kovac
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- Clinical Institute for Special Laboratory Diagnostics, University Children’s Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Barbara Jenko Bizjan
- Clinical Institute for Special Laboratory Diagnostics, University Children’s Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Tadej Battelino
- Department of Endocrinology, Diabetes and Metabolism, University Children’s Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Fouzia Sadiq
- Directorate of Research, Shifa Tameer-e-Millat University, Islamabad, Pakistan
- *Correspondence: Urh Groselj, ; Fouzia Sadiq,
| |
Collapse
|
6
|
Sustar U, Mlinaric M, Kovac J, Arens S, Bizjan BJ, Podkrajsek KT, Danne T, Battelino T, Kordonouri O, Groselj U. Universal Screening for Familial Hypercholesterolemia in Two Populations. J Clin Lipidol 2022. [DOI: 10.1016/j.jacl.2022.05.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
|
7
|
Zajec A, Trebušak Podkrajšek K, Tesovnik T, Šket R, Čugalj Kern B, Jenko Bizjan B, Šmigoc Schweiger D, Battelino T, Kovač J. Pathogenesis of Type 1 Diabetes: Established Facts and New Insights. Genes (Basel) 2022; 13:genes13040706. [PMID: 35456512 PMCID: PMC9032728 DOI: 10.3390/genes13040706] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [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: 03/28/2022] [Revised: 04/13/2022] [Accepted: 04/13/2022] [Indexed: 01/08/2023] Open
Abstract
Type 1 diabetes (T1D) is an autoimmune disease characterized by the T-cell-mediated destruction of insulin-producing β-cells in pancreatic islets. It generally occurs in genetically susceptible individuals, and genetics plays a major role in the development of islet autoimmunity. Furthermore, these processes are heterogeneous among individuals; hence, different endotypes have been proposed. In this review, we highlight the interplay between genetic predisposition and other non-genetic factors, such as viral infections, diet, and gut biome, which all potentially contribute to the aetiology of T1D. We also discuss a possible active role for β-cells in initiating the pathological processes. Another component in T1D predisposition is epigenetic influences, which represent a link between genetic susceptibility and environmental factors and may account for some of the disease heterogeneity. Accordingly, a shift towards personalized therapies may improve the treatment results and, therefore, result in better outcomes for individuals in the long-run. There is also a clear need for a better understanding of the preclinical phases of T1D and finding new predictive biomarkers for earlier diagnosis and therapy, with the final goal of reverting or even preventing the development of the disease.
Collapse
Affiliation(s)
- Ana Zajec
- Division of Paediatrics, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; (A.Z.); (K.T.P.); (T.T.); (R.Š.); (B.Č.K.); (B.J.B.); (D.Š.S.); (T.B.)
- Department of Paediatrics, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Katarina Trebušak Podkrajšek
- Division of Paediatrics, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; (A.Z.); (K.T.P.); (T.T.); (R.Š.); (B.Č.K.); (B.J.B.); (D.Š.S.); (T.B.)
- Department of Paediatrics, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Tine Tesovnik
- Division of Paediatrics, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; (A.Z.); (K.T.P.); (T.T.); (R.Š.); (B.Č.K.); (B.J.B.); (D.Š.S.); (T.B.)
| | - Robert Šket
- Division of Paediatrics, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; (A.Z.); (K.T.P.); (T.T.); (R.Š.); (B.Č.K.); (B.J.B.); (D.Š.S.); (T.B.)
| | - Barbara Čugalj Kern
- Division of Paediatrics, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; (A.Z.); (K.T.P.); (T.T.); (R.Š.); (B.Č.K.); (B.J.B.); (D.Š.S.); (T.B.)
- Department of Paediatrics, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Barbara Jenko Bizjan
- Division of Paediatrics, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; (A.Z.); (K.T.P.); (T.T.); (R.Š.); (B.Č.K.); (B.J.B.); (D.Š.S.); (T.B.)
- Department of Paediatrics, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Darja Šmigoc Schweiger
- Division of Paediatrics, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; (A.Z.); (K.T.P.); (T.T.); (R.Š.); (B.Č.K.); (B.J.B.); (D.Š.S.); (T.B.)
- Department of Paediatrics, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Tadej Battelino
- Division of Paediatrics, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; (A.Z.); (K.T.P.); (T.T.); (R.Š.); (B.Č.K.); (B.J.B.); (D.Š.S.); (T.B.)
- Department of Paediatrics, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Jernej Kovač
- Division of Paediatrics, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; (A.Z.); (K.T.P.); (T.T.); (R.Š.); (B.Č.K.); (B.J.B.); (D.Š.S.); (T.B.)
- Department of Paediatrics, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
- Correspondence:
| |
Collapse
|
8
|
Dovc K, Van Name M, Jenko Bizjan B, Rusak E, Piona C, Yesiltepe‐Mutlu G, Mentink R, Frontino G, Macedoni M, Ferreira SH, Serra‐Caetano J, Galhardo J, Pelicand J, Silvestri F, Sherr J, Chobot A, Biester T. Continuous glucose monitoring use and glucose variability in very young children with type 1 diabetes (VibRate): A multinational prospective observational real-world cohort study. Diabetes Obes Metab 2022; 24:564-569. [PMID: 34820985 PMCID: PMC9306649 DOI: 10.1111/dom.14607] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 11/05/2021] [Accepted: 11/20/2021] [Indexed: 12/14/2022]
Affiliation(s)
- Klemen Dovc
- Department of Pediatric Endocrinology, Diabetes and Metabolic DiseasesUMC ‐ University Children's HospitalLjubljanaSlovenia
- Faculty of MedicineUniversity of LjubljanaLjubljanaSlovenia
| | - Michelle Van Name
- Department of Pediatrics, Section of EndocrinologyYale School of MedicineNew HavenConnecticut
| | - Barbara Jenko Bizjan
- Department of Pediatric Endocrinology, Diabetes and Metabolic DiseasesUMC ‐ University Children's HospitalLjubljanaSlovenia
- Faculty of MedicineUniversity of LjubljanaLjubljanaSlovenia
| | - Ewa Rusak
- Department of Children's DiabetologyMedical University of SilesiaKatowicePoland
| | - Claudia Piona
- Pediatric Diabetes and Metabolic Disorders Unit, Regional Center for Pediatric DiabetesUniversity City Hospital of VeronaVeronaItaly
| | - Gul Yesiltepe‐Mutlu
- Department of Pediatric Endocrinology and DiabetesKoç University HospitalIstanbulTurkey
- School of MedicineKoç UniversityIstanbulTurkey
| | - Rosaline Mentink
- Diaboss (Pediatric and Adolescent Diabetes Clinic)AmsterdamThe Netherlands
- Department of PediatricsOLVGAmsterdamThe Netherlands
| | - Giulio Frontino
- Diabetes Research Institute, IRCCS San Raffaele HospitalMilanItaly
| | - Maddalena Macedoni
- Department of PediatricsUniversity of Milan, V. Buzzi Children's HospitalMilanItaly
| | - Sofia Helena Ferreira
- Pediatric Endocrinology and Diabetology Unit, Department of PediatricsCentro Hospitalar Universitário de São JoãoPortoPortugal
| | - Joana Serra‐Caetano
- Pediatric Endocrinology, Growth and Diabetology Unit, Coimbra Pediatric HospitalCoimbra Universitary and Hospital Centre (CHUC)CoimbraPortugal
| | - Júlia Galhardo
- Paediatric Endocrinology and Diabetes Unit, Hospital de Dona Estefânia ‐ Central Lisbon University Hospital Center and Lisbon Medical Sciences Faculty – Nova Medical SchoolLisbonPortugal
| | - Julie Pelicand
- Pediatric and Adolescent Diabetes Program, Department of PediatricsSan Camilo HospitalSan FelipeChile
- Medicine SchoolUniversidad de ValparaisoSan FelipeChile
| | - Francesca Silvestri
- Pediatric Diabetology Unit, Department of Maternal and Infantile HealthSapienza University of RomeRomeItaly
| | - Jennifer Sherr
- Department of Pediatrics, Section of EndocrinologyYale School of MedicineNew HavenConnecticut
| | - Agata Chobot
- Department of PediatricsInstitute of Medical Sciences, University of OpoleOpolePoland
- Department of PediatricsUniversity Clinical Hospital in OpoleOpolePoland
| | - Torben Biester
- AUF DER BULT, Diabetes Center for Children and AdolescentsHannoverGermany
| | | |
Collapse
|
9
|
Bozovičar K, Molek P, Bizjan BJ, Bratkovič T. Ligand Selection for Affinity Chromatography Using Phage Display. Methods Mol Biol 2022; 2466:159-185. [PMID: 35585318 DOI: 10.1007/978-1-0716-2176-9_12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Phage display coupled with in vitro affinity selection to mimic evolutionary principles has propelled the discovery of specific binding peptides and proteins for diverse applications, including affinity chromatography. By tailoring screening conditions, ligands with desired predefined properties, such as pH- or ion strength-responsive binding, can be identified from phage-displayed combinatorial peptide libraries. Initial hit peptides can be further optimized through directed evolution by focused mutagenesis and rescreening. Quantitative analysis of eluted binders with next-generation sequencing (NGS) assists in reducing enrichment bias and simplifies picking the most promising ligand candidate(s) through enrichment ranking. We describe, in detail, procedures of ligand selection for affinity chromatography using peptide phage display library screening, focused mutagenesis, and NGS. Furthermore, we outline the subsequent workflow for ligand characterization and affinity column construction.
Collapse
Affiliation(s)
- Krištof Bozovičar
- Department of Pharmaceutical Biology, Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia
| | - Peter Molek
- Department of Pharmaceutical Biology, Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia
| | - Barbara Jenko Bizjan
- Clinical Institute of Special Laboratory Diagnostics, University Children's Hospital, University Medical Center, Ljubljana, Slovenia
| | - Tomaž Bratkovič
- Department of Pharmaceutical Biology, Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia.
| |
Collapse
|
10
|
Šket R, Kotnik P, Bizjan BJ, Kocen V, Mlinarič M, Tesovnik T, Debeljak M, Battelino T, Kovač J. Heterozygous Genetic Variants in Autosomal Recessive Genes of the Leptin-Melanocortin Signalling Pathway Are Associated With the Development of Childhood Obesity. Front Endocrinol (Lausanne) 2022; 13:832911. [PMID: 35574020 PMCID: PMC9105721 DOI: 10.3389/fendo.2022.832911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 03/23/2022] [Indexed: 11/29/2022] Open
Abstract
Monogenic obesity is a severe, genetically determined disorder that affects up to 1/1000 newborns. Recent reports on potential new therapeutics and innovative clinical approaches have highlighted the need for early identification of individuals with rare genetic variants that can alter the functioning of the leptin-melanocortin signalling pathway, in order to speed up clinical intervention and reduce the risk of chronic complications. Therefore, next-generation DNA sequencing of central genes in the leptin-melanocortin pathway was performed in 1508 children and adolescents with and without obesity, aged 2-19 years. The recruited cohort comprised approximately 5% of the national paediatric population with obesity. The model-estimated effect size of rare variants in the leptin-melanocortin signalling pathway on longitudinal weight gain between carriers and non-carriers was derived. In total, 21 (1.4%) participants had known disease-causing heterozygous variants (DCVs) in the genes under investigation, and 62 (4.1%) participants were carriers of rare variants of unknown clinical significance (VUS). The estimated frequency of potential genetic variants associated with obesity (including rare VUS) ranged between 1/150 (VUS and DCV) and 1/850 (DCV) and differed significantly between participants with and without obesity. On average, the variants identified would result in approximately 7.6 kg (7.0-12.9 kg at the 95th percentile of body weight) (girls) and 8.4 kg (8.2-14.4 kg) (boys) of additional weight gain in carriers at age 18 years compared with subjects without obesity. In conclusion, children with a genetic predisposition to obesity can be promptly identified and may account for more than 6% of obesity cases. Early identification of genetic variants in the LEPR, PCSK1, POMC, MC3R and MC4R genes could reduce the societal burden and improve the clinical management of early severe childhood obesity and its implementation should be further investigated.
Collapse
Affiliation(s)
- Robert Šket
- Clinical Institute of Special Laboratory Diagnostics, University Children’s Hospital, University Medical Center Ljubljana (UMC), Ljubljana, Slovenia
| | - Primož Kotnik
- Department of Pediatrics Endocrinology, Diabetes and Metabolic Diseases, University Children’s Hospital, University Medical Center Ljubljana (UMC), Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Barbara Jenko Bizjan
- Clinical Institute of Special Laboratory Diagnostics, University Children’s Hospital, University Medical Center Ljubljana (UMC), Ljubljana, Slovenia
| | - Valentina Kocen
- Clinical Institute of Special Laboratory Diagnostics, University Children’s Hospital, University Medical Center Ljubljana (UMC), Ljubljana, Slovenia
| | - Matej Mlinarič
- Department of Pediatrics Endocrinology, Diabetes and Metabolic Diseases, University Children’s Hospital, University Medical Center Ljubljana (UMC), Ljubljana, Slovenia
| | - Tine Tesovnik
- Clinical Institute of Special Laboratory Diagnostics, University Children’s Hospital, University Medical Center Ljubljana (UMC), Ljubljana, Slovenia
| | - Maruša Debeljak
- Clinical Institute of Special Laboratory Diagnostics, University Children’s Hospital, University Medical Center Ljubljana (UMC), Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Tadej Battelino
- Department of Pediatrics Endocrinology, Diabetes and Metabolic Diseases, University Children’s Hospital, University Medical Center Ljubljana (UMC), Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Jernej Kovač
- Clinical Institute of Special Laboratory Diagnostics, University Children’s Hospital, University Medical Center Ljubljana (UMC), Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- *Correspondence: Jernej Kovač,
| |
Collapse
|
11
|
Tesovnik T, Jenko Bizjan B, Šket R, Debeljak M, Battelino T, Kovač J. Technological Approaches in the Analysis of Extracellular Vesicle Nucleotide Sequences. Front Bioeng Biotechnol 2021; 9:787551. [PMID: 35004647 PMCID: PMC8733665 DOI: 10.3389/fbioe.2021.787551] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 11/11/2021] [Indexed: 12/12/2022] Open
Abstract
Together with metabolites, proteins, and lipid components, the EV cargo consists of DNA and RNA nucleotide sequence species, which are part of the intracellular communication network regulating specific cellular processes and provoking distinct target cell responses. The extracellular vesicle (EV) nucleotide sequence cargo molecules are often investigated in association with a particular pathology and may provide an insight into the physiological and pathological processes in hard-to-access organs and tissues. The diversity and biological function of EV nucleotide sequences are distinct regarding EV subgroups and differ in tissue- and cell-released EVs. EV DNA is present mainly in apoptotic bodies, while there are different species of EV RNAs in all subgroups of EVs. A limited sample volume of unique human liquid biopsy provides a small amount of EVs with limited isolated DNA and RNA, which can be a challenging factor for EV nucleotide sequence analysis, while the additional difficulty is technical variability of molecular nucleotide detection. Every EV study is challenged with its first step of the EV isolation procedure, which determines the EV's purity, yield, and diameter range and has an impact on the EV's downstream analysis with a significant impact on the final result. The gold standard EV isolation procedure with ultracentrifugation provides a low output and not highly pure isolated EVs, while modern techniques increase EV's yield and purity. Different EV DNA and RNA detection techniques include the PCR procedure for nucleotide sequence replication of the molecules of interest, which can undergo a small-input EV DNA or RNA material. The nucleotide sequence detection approaches with their advantages and disadvantages should be considered to appropriately address the study problem and to extract specific EV nucleotide sequence information with the detection using qPCR or next-generation sequencing. Advanced next-generation sequencing techniques allow the detection of total EV genomic or transcriptomic data even at the single-molecule resolution and thus, offering a sensitive and accurate EV DNA or RNA biomarker detection. Additionally, with the processes where the EV genomic or transcriptomic data profiles are compared to identify characteristic EV differences in specific conditions, novel biomarkers could be discovered. Therefore, a suitable differential expression analysis is crucial to define the EV DNA or RNA differences between conditions under investigation. Further bioinformatics analysis can predict molecular cell targets and identify targeted and affected cellular pathways. The prediction target tools with functional studies are essential to help specify the role of the investigated EV-targeted nucleotide sequences in health and disease and support further development of EV-related therapeutics. This review will discuss the biological diversity of human liquid biopsy-obtained EV nucleotide sequences DNA and RNA species reported as potential biomarkers in health and disease and methodological principles of their detection, from human liquid biopsy EV isolation, EV nucleotide sequence extraction, techniques for their detection, and their cell target prediction.
Collapse
Affiliation(s)
- Tine Tesovnik
- Institute for Special Laboratory Diagnostics, University Medical Centre Ljubljana, University Children’s Hospital, Ljubljana, Slovenia
| | - Barbara Jenko Bizjan
- Institute for Special Laboratory Diagnostics, University Medical Centre Ljubljana, University Children’s Hospital, Ljubljana, Slovenia
| | - Robert Šket
- Institute for Special Laboratory Diagnostics, University Medical Centre Ljubljana, University Children’s Hospital, Ljubljana, Slovenia
| | - Maruša Debeljak
- Institute for Special Laboratory Diagnostics, University Medical Centre Ljubljana, University Children’s Hospital, Ljubljana, Slovenia
| | - Tadej Battelino
- Department of Pediatric Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, University Children’s Hospital, Ljubljana, Slovenia
- Faculty of Medicine, Chair of Paediatrics, University of Ljubljana, Ljubljana, Slovenia
| | - Jernej Kovač
- Institute for Special Laboratory Diagnostics, University Medical Centre Ljubljana, University Children’s Hospital, Ljubljana, Slovenia
| |
Collapse
|
12
|
Jazbinšek S, Kolenc D, Bošnjak R, Faganel Kotnik B, Zadravec Zaletel L, Jenko Bizjan B, Vipotnik Vesnaver T, Battelino T, Janež A, Jensterle M, Kotnik P. Prevalence of Endocrine and Metabolic Comorbidities in a National Cohort of Patients with Craniopharyngioma. Horm Res Paediatr 2021; 93:46-57. [PMID: 32460296 DOI: 10.1159/000507702] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 04/03/2020] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The major part of craniopharyngioma (CP) morbidity is the tumor and/or treatment-related damage, which results in impaired function of the hypothalamic-pituitary axes and metabolic derangements. The aim of the study was to analyze the prevalence of long-term endocrine and metabolic comorbidities in a national cohort of CP patients based on the age at diagnosis and histology criteria. DESIGN A retrospective-prospective longitudinal cohort analysis. METHODS Forty-six patients with CP treated from 1979 onwards (19 with childhood-onset disease) in a single university institution were included in our study. Median follow-up from presentation was 12.8 years (interquartile range: 8.3-22.2 years) and comparable between age-at-diagnosis and histological subtype groups. Data on tumor histology were extracted from patients' records and re-evaluated if tissue samples were available (n = 32). RESULTS Childhood-onset patients presented more frequently with headache, and adult-onset with visual impairment. Prevalence of at least one pituitary axis affected increased from 54% at presentation to 100% at follow-up in childhood-onset and from 41 to 93% in adult-onset CP. Growth hormone deficiency, central diabetes insipidus, and panhypopituitarism were more prevalent in childhood-onset adamantinomatous CP (aCP) and least prevalent in adult-onset papillary CP (pCP). At follow-up, metabolic syndrome (MetS) was diagnosed in 80% of childhood-onset and 68% of adult-onset patients (p = 0.411). In the latter group, it tended to be more frequent in the aCP than pCP subtype (80 vs. 50%, p = 0.110). CONCLUSIONS Long-term endocrine and metabolic complications are very frequent in childhood- and adult-onset CP patients of both histological subtypes. The prevalence of MetS was higher compared to the largest cohort previously reported.
Collapse
Affiliation(s)
- Sončka Jazbinšek
- Department of Endocrinology, Diabetes and Metabolism, University Children's Hospital, University Medical Center Ljubljana, Ljubljana, Slovenia.,Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Danijela Kolenc
- Institute of Pathology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Roman Bošnjak
- Medical Faculty, University of Ljubljana, Ljubljana, Slovenia.,Department of Neurosurgery, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Barbara Faganel Kotnik
- Medical Faculty, University of Ljubljana, Ljubljana, Slovenia.,Department of Hematology and Oncology, University Children's Hospital, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Lorna Zadravec Zaletel
- Medical Faculty, University of Ljubljana, Ljubljana, Slovenia.,Department of Radiotherapy, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Barbara Jenko Bizjan
- Medical Faculty, University of Ljubljana, Ljubljana, Slovenia.,Unit of Special Laboratory Diagnostics, University Children's Hospital, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Tina Vipotnik Vesnaver
- Medical Faculty, University of Ljubljana, Ljubljana, Slovenia.,Clinical Institute of Radiology, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Tadej Battelino
- Department of Endocrinology, Diabetes and Metabolism, University Children's Hospital, University Medical Center Ljubljana, Ljubljana, Slovenia.,Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Andrej Janež
- Medical Faculty, University of Ljubljana, Ljubljana, Slovenia.,Department of Endocrinology, Diabetes and Metabolism, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Mojca Jensterle
- Medical Faculty, University of Ljubljana, Ljubljana, Slovenia.,Department of Endocrinology, Diabetes and Metabolism, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Primož Kotnik
- Department of Endocrinology, Diabetes and Metabolism, University Children's Hospital, University Medical Center Ljubljana, Ljubljana, Slovenia, .,Medical Faculty, University of Ljubljana, Ljubljana, Slovenia,
| |
Collapse
|
13
|
Redenšek S, Jenko Bizjan B, Trošt M, Dolžan V. Clinical and Clinical-Pharmacogenetic Models for Prediction of the Most Common Psychiatric Complications Due to Dopaminergic Treatment in Parkinson's Disease. Int J Neuropsychopharmacol 2020; 23:496-504. [PMID: 32710539 PMCID: PMC7689202 DOI: 10.1093/ijnp/pyaa028] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 03/28/2020] [Accepted: 04/13/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The most common psychiatric complications due to dopaminergic treatment in Parkinson's disease are visual hallucinations and impulse control disorders. Their development depends on clinical and genetic factors. METHODS We evaluated the simultaneous effect of 16 clinical and 34 genetic variables on the occurrence of visual hallucinations and impulse control disorders. Altogether, 214 Parkinson's disease patients were enrolled. Their demographic, clinical, and genotype data were obtained. Clinical and clinical-pharmacogenetic models were built by The Least Absolute Shrinkage and Selection Operator penalized logistic regression. The predictive capacity was evaluated with the cross-validated area under the receiver operating characteristic curve (AUC). RESULTS The clinical-pharmacogenetic index for prediction of visual hallucinations encompassed age at diagnosis (OR = 0.99), rapid eye movement (REM) sleep behavior disorder (OR = 2.27), depression (OR = 1.0002), IL6 rs1800795 (OR = 0.99), GPX1 s1050450 (OR = 1.07), COMT rs165815 (OR = 0.69), MAOB rs1799836 (OR = 0.97), DRD3 rs6280 (OR = 1.32), and BIRC5 rs8073069 (OR = 0.94). The clinical-pharmacogenetic index for prediction of impulse control disorders encompassed age at diagnosis (OR = 0.95), depression (OR = 1.75), beta-blockers (OR = 0.99), coffee consumption (OR = 0.97), NOS1 rs2682826 (OR = 1.15), SLC6A3 rs393795 (OR = 1.27), SLC22A1 rs628031 (OR = 1.19), DRD2 rs1799732 (OR = 0.88), DRD3 rs6280 (OR = 0.88), and NRG1 rs3924999 (OR = 0.96). The cross-validated AUCs of clinical and clinical-pharmacogenetic models for visual hallucinations were 0.60 and 0.59, respectively. The AUCs of clinical and clinical-pharmacogenetic models for impulse control disorders were 0.72 and 0.71, respectively. The AUCs show that the addition of selected genetic variables to the analysis does not contribute to better prediction of visual hallucinations and impulse control disorders. CONCLUSIONS Models could be improved by a larger cohort and by addition of other types of Parkinson's disease biomarkers to the analysis.
Collapse
Affiliation(s)
- Sara Redenšek
- Pharmacogenetics Laboratory, Institute of Biochemistry, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Barbara Jenko Bizjan
- Pharmacogenetics Laboratory, Institute of Biochemistry, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia,University Children’s Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Maja Trošt
- Department of Neurology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Vita Dolžan
- Pharmacogenetics Laboratory, Institute of Biochemistry, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia,Correspondence: Vita Dolžan, MD, PhD, Institute of Biochemistry, Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia ()
| |
Collapse
|
14
|
Chalikiopoulou C, Bizjan BJ, Leventopoulos G, Smaili K, Blagus T, Menti A, Liopetas J, John A, Ali BR, Dolzan V, Hahalis GN, Patrinos GP, Katsila T. Multiomics Analysis Coupled with Text Mining Identify Novel Biomarker Candidates for Recurrent Cardiovascular Events. OMICS 2020; 24:205-215. [PMID: 32176569 DOI: 10.1089/omi.2019.0216] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Recurrent cardiovascular events remain an enigma that accounts for >30% of deaths worldwide. While heredity and human genetics variation play a key role, host-environment interactions offer a sound conceptual framework to dissect the molecular basis of recurrent cardiovascular events from genes and proteins to metabolites, thus accounting for environmental contributions as well. We report here a multiomics systems science approach so as to map interindividual variability in susceptibility to recurrent cardiovascular events. First, we performed data and text mining through a mixed-methods content analysis to select genomic variants, 10 single nucleotide polymorphisms, and microRNAs (miR-10a, miR-21, and miR-20a), minimizing bias in candidate marker selection. Next, we validated our in silico data in a patient cohort suffering from recurrent cardiovascular events (a cross-sectional study design and sampling). Our findings report a key role in low-density lipoprotein clearance for rs11206510 (p < 0.01) and rs515135 (p < 0.05). miR-10a (p < 0.05) was significantly associated with heart failure, while increased expression levels for miR-21 and miR-20a associated with atherosclerosis. In addition, liquid chromatography-mass spectrometry-based (LC-MS-based) proteomics analyses identified that vascular diameter and cholesterol levels are among the key factors to be considered in recurrent cardiovascular events. From a methodology innovation standpoint, this study offers a strategy to enhance the signal-to-noise ratios in mapping novel biomarker candidates wherein each research and conceptual step were interrogated for their validity and in turn, enriched one another, ideally translating information growth to knowledge growth.
Collapse
Affiliation(s)
| | - Barbara Jenko Bizjan
- Unit of Special Laboratory Diagnostics, University Children's Hospital, UMC, Ljubljana, Slovenia
| | | | - Kalliopi Smaili
- Department of Cardiology, Patras University Hospital Rio, Patras, Greece
| | - Tanja Blagus
- Pharmacogenetics Laboratory, Institute of Biochemistry, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Ariadni Menti
- Department of Cardiology, Patras University Hospital Rio, Patras, Greece
| | - John Liopetas
- Department of Pharmacy, School of Health Sciences, University of Patras, Patras, Greece
| | - Anne John
- Department of Pathology, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Bassam R Ali
- Department of Pathology, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Vita Dolzan
- Pharmacogenetics Laboratory, Institute of Biochemistry, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - George N Hahalis
- Department of Cardiology, Patras University Hospital Rio, Patras, Greece
| | - George P Patrinos
- Department of Pharmacy, School of Health Sciences, University of Patras, Patras, Greece.,Department of Pathology, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates.,Zayed Center of Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Theodora Katsila
- Department of Pharmacy, School of Health Sciences, University of Patras, Patras, Greece.,Institute of Chemical Biology, National Hellenic Research Centre, Athens, Greece
| |
Collapse
|
15
|
Dovc K, Piona C, Yeşiltepe Mutlu G, Bratina N, Jenko Bizjan B, Lepej D, Nimri R, Atlas E, Muller I, Kordonouri O, Biester T, Danne T, Phillip M, Battelino T. Faster Compared With Standard Insulin Aspart During Day-and-Night Fully Closed-Loop Insulin Therapy in Type 1 Diabetes: A Double-Blind Randomized Crossover Trial. Diabetes Care 2020; 43:29-36. [PMID: 31575640 DOI: 10.2337/dc19-0895] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 09/03/2019] [Indexed: 02/03/2023]
Abstract
OBJECTIVE We evaluated the safety and efficacy of day-and-night fully closed-loop insulin therapy using faster (Faster-CL) compared with standard insulin aspart (Standard-CL) in young adults with type 1 diabetes. RESEARCH DESIGN AND METHODS In a double-blind, randomized, crossover trial, 20 participants with type 1 diabetes on insulin pump therapy (11 females, aged 21.3 ± 2.3 years, HbA1c 7.5 ± 0.5% [58.5 ± 5.5 mmol/mol]) underwent two 27-h inpatient periods with unannounced afternoon moderate-vigorous exercise and unannounced/uncovered meals. We compared Faster-CL and Standard-CL in random order. During both interventions, the fuzzy-logic control algorithm DreaMed GlucoSitter was used. Glucose sensor data were analyzed by intention-to-treat principle with the difference (between Faster-CL and Standard-CL) in proportion of time in range 70-180 mg/dL (TIR) over 27 h as the primary end point. RESULTS The proportion of TIR was similar for both arms: 53.3% (83% overnight) in Faster-CL and 57.9% (88% overnight) in Standard-CL (P = 0.170). The proportion of time in hypoglycemia <70 mg/dL was 0.0% for both groups. Baseline-adjusted interstitial prandial glucose increments 1 h after meals were greater in Faster-CL compared with Standard-CL (P = 0.017). The gaps between measured plasma insulin and estimated insulin-on-board levels at the beginning, at the end, and 2 h after the exercise were smaller in the Standard-CL group (P = 0.029, P = 0.003, and P = 0.004, respectively). No severe adverse events occurred. CONCLUSIONS Fully closed-loop insulin delivery using either faster or standard insulin aspart was safe and efficient in achieving near-normal glucose concentrations outside postprandial periods. The closed-loop algorithm was better adjusted to the standard insulin aspart.
Collapse
Affiliation(s)
- Klemen Dovc
- Department of Pediatric Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre-University Children's Hospital, Ljubljana, Slovenia
| | - Claudia Piona
- Pediatric Diabetes and Metabolic Disorders Unit, University City Hospital, Verona, Italy
| | - Gül Yeşiltepe Mutlu
- Department of Pediatric Endocrinology and Diabetes, Koç University Hospital, İstanbul, Turkey
| | - Natasa Bratina
- Department of Pediatric Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre-University Children's Hospital, Ljubljana, Slovenia
| | - Barbara Jenko Bizjan
- Department of Pediatric Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre-University Children's Hospital, Ljubljana, Slovenia
| | - Dusanka Lepej
- Department of Pulmonology, University Medical Centre-University Children's Hospital, Ljubljana, Slovenia
| | - Revital Nimri
- The Jesse Z. and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Centre for Childhood Diabetes, Schneider Children's Medical Centre of Israel, Petah Tikva, Israel
| | - Eran Atlas
- DreaMed Diabetes Ltd., Petah Tikva, Israel
| | - Ido Muller
- DreaMed Diabetes Ltd., Petah Tikva, Israel
| | - Olga Kordonouri
- Diabetes Centre for Children and Adolescents, Kinder- und Jugendkrankenhaus Auf der Bult, Hannover, Germany
| | - Torben Biester
- Diabetes Centre for Children and Adolescents, Kinder- und Jugendkrankenhaus Auf der Bult, Hannover, Germany
| | - Thomas Danne
- Diabetes Centre for Children and Adolescents, Kinder- und Jugendkrankenhaus Auf der Bult, Hannover, Germany
| | - Moshe Phillip
- The Jesse Z. and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Centre for Childhood Diabetes, Schneider Children's Medical Centre of Israel, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tadej Battelino
- Department of Pediatric Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre-University Children's Hospital, Ljubljana, Slovenia .,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| |
Collapse
|
16
|
Jenko Bizjan B, Katsila T, Tesovnik T, Šket R, Debeljak M, Matsoukas MT, Kovač J. Challenges in identifying large germline structural variants for clinical use by long read sequencing. Comput Struct Biotechnol J 2019; 18:83-92. [PMID: 32099591 PMCID: PMC7026727 DOI: 10.1016/j.csbj.2019.11.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [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: 09/01/2019] [Revised: 11/07/2019] [Accepted: 11/21/2019] [Indexed: 12/30/2022] Open
Abstract
Genomic structural variations, previously considered rare events, are widely recognized as a major source of inter-individual variability and hence, a major hurdle in optimum patient stratification and disease management. Herein, we focus on large complex germline structural variations and present challenges towards target treatment via the synergy of state-of-the-art approaches and information technology tools. A complex structural variation detection remains challenging, as there is no gold standard for identifying such genomic variations with long reads, especially when the chromosomal rearrangement in question is a few Mb in length. A clinical case with a large complex chromosomal rearrangement serves as a paradigm. We feel that functional validation and data interpretation are of outmost importance for information growth to be translated into knowledge growth and hence, new working practices are highlighted.
Collapse
Affiliation(s)
- Barbara Jenko Bizjan
- Clinical Institute of Special Laboratory Diagnostics, University Children’s Hospital, UMC, Ljubljana, Slovenia
| | - Theodora Katsila
- Institute of Chemical Biology, National Hellenic Research Centre, Athens, Greece
| | - Tine Tesovnik
- Clinical Institute of Special Laboratory Diagnostics, University Children’s Hospital, UMC, Ljubljana, Slovenia
| | - Robert Šket
- Clinical Institute of Special Laboratory Diagnostics, University Children’s Hospital, UMC, Ljubljana, Slovenia
| | - Maruša Debeljak
- Clinical Institute of Special Laboratory Diagnostics, University Children’s Hospital, UMC, Ljubljana, Slovenia
| | | | - Jernej Kovač
- Clinical Institute of Special Laboratory Diagnostics, University Children’s Hospital, UMC, Ljubljana, Slovenia
| |
Collapse
|
17
|
Redenšek S, Jenko Bizjan B, Trošt M, Dolžan V. Clinical-Pharmacogenetic Predictive Models for Time to Occurrence of Levodopa Related Motor Complications in Parkinson's Disease. Front Genet 2019; 10:461. [PMID: 31156712 PMCID: PMC6532453 DOI: 10.3389/fgene.2019.00461] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Accepted: 04/30/2019] [Indexed: 12/25/2022] Open
Abstract
The response to dopaminergic treatment in Parkinson's disease depends on many clinical and genetic factors. The very common motor fluctuations (MF) and dyskinesia affect approximately half of patients after 5 years of treatment with levodopa. We did an evaluation of a combined effect of 16 clinical parameters and 34 single nucleotide polymorphisms to build clinical and clinical-pharmacogenetic models for prediction of time to occurrence of motor complications and to compare their predictive abilities. In total, 220 Parkinson's disease patients were included in the analysis. Their demographic, clinical, and genotype data were obtained. The combined effect of clinical and genetic factors was assessed using The Least Absolute Shrinkage and Selection Operator penalized regression in the Cox proportional hazards model. Clinical and clinical-pharmacogenetic models were constructed. The predictive capacity of the models was evaluated with the cross-validated area under time-dependent receiver operating characteristic curve. Clinical-pharmacogenetic model included age at diagnosis (HR = 0.99), time from diagnosis to initiation of levodopa treatment (HR = 1.24), COMT rs165815 (HR = 0.90), DRD3 rs6280 (HR = 1.03), and BIRC5 rs9904341 (HR = 0.95) as predictive factors for time to occurrence of MF. Furthermore, clinical-pharmacogenetic model for prediction of time to occurrence of dyskinesia included female sex (HR = 1.07), age at diagnosis (HR = 0.97), tremor-predominant Parkinson's disease (HR = 0.88), beta-blockers (HR = 0.95), alcohol consumption (HR = 0.99), time from diagnosis to initiation of levodopa treatment (HR = 1.15), CAT rs1001179 (HR = 1.27), SOD2 rs4880 (HR = 0.95), NOS1 rs2293054 (HR = 0.99), COMT rs165815 (HR = 0.92), and SLC22A1 rs628031 (HR = 0.80). Areas under the curves for clinical and clinical-pharmacogenetic models for MF after 5 years of levodopa treatment were 0.68 and 0.70, respectively. Areas under the curves for clinical and clinical-pharmacogenetic models for dyskinesia after 5 years of levodopa treatment were 0.71 and 0.68, respectively. These results show that clinical-pharmacogenetic models do not have better ability to predict time to occurrence of motor complications in comparison to the clinical ones despite the significance of several polymorphisms. Models could be improved by a larger sample size and by additional polymorphisms, epigenetic predictors or serum biomarkers.
Collapse
Affiliation(s)
- Sara Redenšek
- Pharmacogenetics Laboratory, Institute of Biochemistry, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Barbara Jenko Bizjan
- Pharmacogenetics Laboratory, Institute of Biochemistry, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Maja Trošt
- Department of Neurology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Vita Dolžan
- Pharmacogenetics Laboratory, Institute of Biochemistry, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| |
Collapse
|