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Abstract
Dr Schumacher was a force in rheumatology for more than half a century through his multiple roles as a researcher, clinician, mentor, and educator. He is not likely to be soon forgotten by the rheumatology community; however, it is hoped that this chapter can provide a faithful recollection that will help bring his memory to life for some and that rings true to those who knew him and learned from him.
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Affiliation(s)
- Joshua F Baker
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Daniel G Baker
- Kira Biotech Pty Ltd, Fortitude Valley, Queensland, Australia
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2
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Anand S, Littler DR, Mobbs JI, Braun A, Baker DG, Tennant L, Purcell AW, Vivian JP, Rossjohn J. Complimentary electrostatics dominate T Cell Receptor binding to a psoriasis-associated-peptide-antigen presented by Human Leukocyte Antigen (HLA) C*06:02. J Biol Chem 2023:104930. [PMID: 37330172 PMCID: PMC10371836 DOI: 10.1016/j.jbc.2023.104930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/05/2023] [Accepted: 06/13/2023] [Indexed: 06/19/2023] Open
Abstract
Psoriasis is a chronic skin disease characterised by hyperproliferative epidermal lesions infiltrated by autoreactive T cells. Individuals expressing the Human Leukocyte antigen (HLA) C*06:02 allele are at highest risk for developing psoriasis. An autoreactive T cell clone (termed Vα3S1/Vβ13S1) isolated from psoriatic plaques is selective for HLA-C*06:02-presenting a peptide derived from the melanocyte-specific auto-antigen ADAMTSL5 (VRSRRCLRL). Here we determine the crystal structure of this psoriatic TCR-HLA-C*06:02- ADAMTSL5 complex with a stabilised peptide. Docking of the TCR involves an extensive complementary charge network formed between negatively charged TCR residues interleaving with exposed arginine residues from the self-peptide and the HLA-C*06:02 α1 helix. We probed these interactions through mutagenesis and activation assays. The charged interface spans the polymorphic region of the C1/C2 HLA group. Notably the peptide binding groove of HLA C*06:02 appears exquisitely suited for presenting highly charged Arg-rich epitopes recognised by this acidic psoriatic TCR. Overall, we provide a structural basis for understanding engagement of melanocyte antigen-presenting cells by a TCR implicated in psoriasis, while simultaneously expanding our knowledge of how TCRs engage HLA-C.
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Affiliation(s)
- Sushma Anand
- Infection and Immunity Program & Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton Victoria, Australia
| | - Dene R Littler
- Infection and Immunity Program & Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton Victoria, Australia
| | - Jesse I Mobbs
- Infection and Immunity Program & Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton Victoria, Australia
| | - Asolina Braun
- Infection and Immunity Program & Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton Victoria, Australia
| | - Daniel G Baker
- Janssen Research & Development, LLC, Horsham, Philadelphia, Pennsylvania, USA
| | - Luke Tennant
- Infection and Immunity Program & Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton Victoria, Australia
| | - Anthony W Purcell
- Infection and Immunity Program & Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton Victoria, Australia
| | - Julian P Vivian
- Infection and Immunity Program & Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton Victoria, Australia
| | - Jamie Rossjohn
- Infection and Immunity Program & Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton Victoria, Australia; Institute of Infection and Immunity, Cardiff University, School of Medicine, Cardiff, UK.
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3
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Cormier P, Freitas TT, Loturco I, Turner A, Virgile A, Haff GG, Blazevich AJ, Agar-Newman D, Henneberry M, Baker DG, McGuigan M, Alcaraz PE, Bishop C. Within Session Exercise Sequencing During Programming for Complex Training: Historical Perspectives, Terminology, and Training Considerations. Sports Med 2022; 52:2371-2389. [PMID: 35816233 DOI: 10.1007/s40279-022-01715-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2022] [Indexed: 10/17/2022]
Abstract
The primary aim of this narrative review was to outline the historical genesis of resistance training strategies that incorporate high-load, low-velocity exercises and low-load, high-velocity exercises in the same training session allowing for different "exercise sequences" to be simultaneously implemented. Discrepancies between scientific works and the terminology used within contemporary sport science publications are identified. Upon review of the literature, we propose "complex training" to be considered an umbrella term with 4 different implementations, generally used to indicate a method in which movement velocity or load is altered between sets and/or exercises within the same session with the aim of improving slow and fast force expression. We propose the following terminology for said implementations: contrast training-exercise sequence with alternating high-load and low-load (higher-velocity) exercises in a set-by-set fashion within the same session (corresponding with 'contrast pairs' and 'intra-contrast rest'); descending training-several sets of high-load (e.g., back squat) exercises completed before the execution of several sets of low-load, higher-velocity (e.g., vertical jump) exercises within the same session; ascending training-several sets of low-load, higher-velocity exercises completed before several sets of high-load exercises within the same session; and French contrast training-subset of contrast training in which a series of exercises are performed in sequence within a single session: heavy compound exercise, plyometric exercise, light-to-moderate load compound exercise that maximises movement speed (i.e., external power), and a plyometric exercise (often assisted). Finally, practical applications and training considerations are presented.
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Affiliation(s)
- Patrick Cormier
- Canadian Sport Institute Pacific, Victoria, BC, Canada.,Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada
| | - Tomás T Freitas
- UCAM Research Center for High Performance Sport, Catholic University of Murcia, UCAM, Murcia, Spain. .,NAR, Nucleus of High Performance in Sport, São Paulo, Brazil. .,SCS, Strength & Conditioning Society, Rome, Italy. .,Faculty of Sport, Catholic University of Murcia, Murcia, Spain.
| | - Irineu Loturco
- NAR, Nucleus of High Performance in Sport, São Paulo, Brazil
| | - Anthony Turner
- Faculty of Science and Technology, London Sport Institute, Middlesex University, London, UK
| | - Adam Virgile
- College of Nursing and Health Sciences, University of Vermont, Vermont, USA
| | - G Gregory Haff
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia.,School of Health and Society, University of Salford, Manchester, UK
| | - Anthony J Blazevich
- SCS, Strength & Conditioning Society, Rome, Italy.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Dana Agar-Newman
- Canadian Sport Institute Pacific, Victoria, BC, Canada.,Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada
| | - Molly Henneberry
- Canadian Sport Institute Pacific, Victoria, BC, Canada.,Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada
| | - Daniel G Baker
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Michael McGuigan
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia.,Department of Sport and Exercise Science, Auckland University of Technology, Auckland, New Zealand
| | - Pedro E Alcaraz
- UCAM Research Center for High Performance Sport, Catholic University of Murcia, UCAM, Murcia, Spain.,SCS, Strength & Conditioning Society, Rome, Italy
| | - Chris Bishop
- Faculty of Science and Technology, London Sport Institute, Middlesex University, London, UK
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Silveira PA, Kupresanin F, Romano A, Hsu WH, Lo TH, Ju X, Chen HT, Roberts H, Baker DG, Clark GJ. Anti-Mouse CD83 Monoclonal Antibody Targeting Mature Dendritic Cells Provides Protection Against Collagen Induced Arthritis. Front Immunol 2022; 13:784528. [PMID: 35222372 PMCID: PMC8866188 DOI: 10.3389/fimmu.2022.784528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 01/17/2022] [Indexed: 11/13/2022] Open
Abstract
Antibodies targeting the activation marker CD83 can achieve immune suppression by targeting antigen-presenting mature dendritic cells (DC). This study investigated the immunosuppressive mechanisms of anti-CD83 antibody treatment in mice and tested its efficacy in a model of autoimmune rheumatoid arthritis. A rat anti-mouse CD83 IgG2a monoclonal antibody, DCR-5, was developed and functionally tested in mixed leukocyte reactions, demonstrating depletion of CD83+ conventional (c)DC, induction of regulatory DC (DCreg), and suppression of allogeneic T cell proliferation. DCR-5 injection into mice caused partial splenic cDC depletion for 2-4 days (mostly CD8+ and CD83+ cDC affected) with a concomitant increase in DCreg and regulatory T cells (Treg). Mice with collagen induced arthritis (CIA) treated with 2 or 6 mg/kg DCR-5 at baseline and every three days thereafter until euthanasia at day 36 exhibited significantly reduced arthritic paw scores and joint pathology compared to isotype control or untreated mice. While both doses reduced anti-collagen antibodies, only 6 mg/kg achieved significance. Treatment with 10 mg/kg DCR-5 was ineffective. Immunohistological staining of spleens at the end of CIA model with CD11c, CD83, and FoxP3 showed greater DC depletion and Treg induction in 6 mg/kg compared to 10 mg/kg DCR-5 treated mice. In conclusion, DCR-5 conferred protection from arthritis by targeting CD83, resulting in selective depletion of mature cDC and subsequent increases in DCreg and Treg. This highlights the potential for anti-CD83 antibodies as a targeted therapy for autoimmune diseases.
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Affiliation(s)
- Pablo A Silveira
- Dendritic Cell Research, ANZAC Research Institute, Sydney, NSW, Australia.,Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Fiona Kupresanin
- Dendritic Cell Research, ANZAC Research Institute, Sydney, NSW, Australia
| | - Adelina Romano
- Dendritic Cell Research, ANZAC Research Institute, Sydney, NSW, Australia
| | - Wei-Hsun Hsu
- Dendritic Cell Research, ANZAC Research Institute, Sydney, NSW, Australia.,Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Tsun-Ho Lo
- Dendritic Cell Research, ANZAC Research Institute, Sydney, NSW, Australia
| | - Xinsheng Ju
- Dendritic Cell Research, ANZAC Research Institute, Sydney, NSW, Australia.,Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Hsiao-Ting Chen
- Dendritic Cell Research, ANZAC Research Institute, Sydney, NSW, Australia.,Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | | | | | - Georgina J Clark
- Dendritic Cell Research, ANZAC Research Institute, Sydney, NSW, Australia.,Sydney Medical School, University of Sydney, Sydney, NSW, Australia.,Kira Biotech Pty Ltd., Brisbane, QLD, Australia
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5
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Lim JJ, Jones CM, Loh TJ, Ting YT, Zareie P, Loh KL, Felix NJ, Suri A, McKinnon M, Stevenaert F, Sharma RK, Klareskog L, Malmström V, Baker DG, Purcell AW, Reid HH, La Gruta NL, Rossjohn J. The shared susceptibility epitope of HLA-DR4 binds citrullinated self-antigens and the TCR. Sci Immunol 2021; 6:6/58/eabe0896. [PMID: 33863750 DOI: 10.1126/sciimmunol.abe0896] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 03/18/2021] [Indexed: 12/11/2022]
Abstract
Individuals expressing HLA-DR4 bearing the shared susceptibility epitope (SE) have an increased risk of developing rheumatoid arthritis (RA). Posttranslational modification of self-proteins via citrullination leads to the formation of neoantigens that can be presented by HLA-DR4 SE allomorphs. However, in T cell-mediated autoimmunity, the interplay between the HLA molecule, posttranslationally modified epitope(s), and the responding T cell repertoire remains unclear. In HLA-DR4 transgenic mice, we show that immunization with a Fibβ-74cit69-81 peptide led to a population of HLA-DR4Fibβ-74cit69-81 tetramer+ T cells that exhibited biased T cell receptor (TCR) β chain usage, which was attributable to selective clonal expansion from the preimmune repertoire. Crystal structures of pre- and postimmune TCRs showed that the SE of HLA-DR4 represented a main TCR contact zone. Immunization with a double citrullinated epitope (Fibβ-72,74cit69-81) altered the responding HLA-DR4 tetramer+ T cell repertoire, which was due to the P2-citrulline residue interacting with the TCR itself. We show that the SE of HLA-DR4 has dual functionality, namely, presentation and a direct TCR recognition determinant. Analogous biased TCR β chain usage toward the Fibβ-74cit69-81 peptide was observed in healthy HLA-DR4+ individuals and patients with HLA-DR4+ RA, thereby suggesting a link to human RA.
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Affiliation(s)
- Jia Jia Lim
- Infection and Immunity Program and Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria 3800, Australia
| | - Claerwen M Jones
- Infection and Immunity Program and Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria 3800, Australia
| | - Tiing Jen Loh
- Infection and Immunity Program and Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria 3800, Australia
| | - Yi Tian Ting
- Infection and Immunity Program and Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria 3800, Australia
| | - Pirooz Zareie
- Infection and Immunity Program and Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria 3800, Australia
| | - Khai L Loh
- Infection and Immunity Program and Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria 3800, Australia
| | - Nathan J Felix
- Janssen Research & Development LLC, Horsham, Philadelphia, PA, USA
| | - Anish Suri
- Janssen Research & Development, Turnhoutseweg 30, BE-2340, Beerse, Belgium
| | - Murray McKinnon
- Janssen Research & Development LLC, Horsham, Philadelphia, PA, USA
| | | | - Ravi K Sharma
- Rheumatology Division, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, 17177 Stockholm, Sweden
| | - Lars Klareskog
- Rheumatology Division, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, 17177 Stockholm, Sweden
| | - Vivianne Malmström
- Rheumatology Division, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, 17177 Stockholm, Sweden
| | - Daniel G Baker
- Janssen Research & Development LLC, Horsham, Philadelphia, PA, USA
| | - Anthony W Purcell
- Infection and Immunity Program and Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria 3800, Australia
| | - Hugh H Reid
- Infection and Immunity Program and Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria 3800, Australia. .,Australian Research Council Centre of Excellence in Advanced Molecular Imaging, Monash University, Clayton, Victoria 3800, Australia
| | - Nicole L La Gruta
- Infection and Immunity Program and Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria 3800, Australia.
| | - Jamie Rossjohn
- Infection and Immunity Program and Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria 3800, Australia. .,Australian Research Council Centre of Excellence in Advanced Molecular Imaging, Monash University, Clayton, Victoria 3800, Australia.,Institute of Infection and Immunity, Cardiff University, School of Medicine, Heath Park, Cardiff CF14 4XN, UK
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Maynard C, Mikuls TR, Cannon GW, England BR, Conaghan PG, Østergaard M, Baker DG, Kerr G, George MD, Barton JL, Baker JF. Sex Differences in the Achievement of Remission and Low Disease Activity in Rheumatoid Arthritis. Arthritis Care Res (Hoboken) 2020; 72:326-333. [PMID: 30875461 DOI: 10.1002/acr.23873] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 03/05/2019] [Indexed: 01/21/2023]
Abstract
OBJECTIVE In rheumatoid arthritis, whether women are less likely to achieve low disease activity is unclear. We evaluated sex differences in remission and low disease activity, comparing different clinical and imaging measures. METHODS We used data from the Veterans Affairs Rheumatoid Arthritis (VARA) registry and from 2 clinical trials. Remission and low disease activity were defined using composite scores, individual items (tender joints, swollen joints, erythrocyte sedimentation rate [ESR], C-reactive protein [CRP] level, and evaluator/patient global assessment), and magnetic resonance imaging (MRI). In the VARA registry, we assessed the likelihood of point remission at any time during follow-up using logistic regression, and time to sustained remission (2 consecutive visits) using Cox proportional hazards models. In the clinical trials, logistic regression models evaluated the likelihood of low clinical and MRI activity at 52 weeks. RESULTS Among 2,463 patients in VARA, women (10.2%) were less likely to be in Disease Activity Score in 28 joints (DAS28)-ESR remission in follow-up (odds ratio [OR] 0.71 [95% confidence interval (95% CI) 0.55-0.91]; P < 0.01) and had a longer time to sustained DAS28-ESR remission. This difference was not observed for DAS28-CRP, Clinical Disease Activity Index, or Routine Assessment of Patient Index Data 3. Women were more likely to achieve favorable individual components except for an ESR <30 mm/hour (OR 0.72 [95% CI 0.57-0.90]; P < 0.01). Among 353 trial participants (83.7% women), women had reduced rates of DAS28-ESR remission (OR 0.39 [95% CI 0.21-0.72]; P = 0.003) but similar rates of low MRI synovitis and osteitis. CONCLUSION The comparison of remission rates between men and women varies based on the disease activity measure, with sex-specific differences in ESR resulting in reliably lower rates of remission among women. There were no differences in MRI measures.
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Affiliation(s)
- Carson Maynard
- University of Pennsylvania, Perelman School of Medicine, Philadelphia
| | - Ted R Mikuls
- Veterans Affairs Nebraska-Western Iowa Health Care System and University of Nebraska Medical Center, Omaha
| | - Grant W Cannon
- Salt Lake City Veterans Affairs Medical Center and University of Utah, Salt Lake City
| | - Bryant R England
- Veterans Affairs Nebraska-Western Iowa Health Care System and University of Nebraska Medical Center, Omaha
| | - Philip G Conaghan
- University of Leeds and NIHR Leeds Biomedical Research Centre, Leeds, UK
| | - Mikkel Østergaard
- Copenhagen Center for Arthritis Research, Rigshospitalet, Glostrup, and University of Copenhagen, Copenhagen, Denmark
| | - Daniel G Baker
- Janssen Research and Development, LLC, Horsham, Pennsylvania
| | - Gail Kerr
- Washington DC Veterans Affairs Medical Center, Georgetown University, and Howard University, Washington, DC
| | - Michael D George
- University of Pennsylvania, Perelman School of Medicine, Philadelphia
| | | | - Joshua F Baker
- Philadelphia Veterans Affairs Medical Center and University of Pennsylvania, Philadelphia
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7
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Galea R, Nel HJ, Talekar M, Liu X, Ooi JD, Huynh M, Hadjigol S, Robson KJ, Ting YT, Cole S, Cochlin K, Hitchcock S, Zeng B, Yekollu S, Boks M, Goh N, Roberts H, Rossjohn J, Reid HH, Boyd BJ, Malaviya R, Shealy DJ, Baker DG, Madakamutil L, Kitching AR, O'Sullivan BJ, Thomas R. PD-L1- and calcitriol-dependent liposomal antigen-specific regulation of systemic inflammatory autoimmune disease. JCI Insight 2019; 4:126025. [PMID: 31487265 DOI: 10.1172/jci.insight.126025] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 08/21/2019] [Indexed: 12/29/2022] Open
Abstract
Autoimmune diseases resulting from MHC class II-restricted autoantigen-specific T cell immunity include the systemic inflammatory autoimmune conditions rheumatoid arthritis and vasculitis. While currently treated with broad-acting immunosuppressive drugs, a preferable strategy is to regulate antigen-specific effector T cells (Teffs) to restore tolerance by exploiting DC antigen presentation. We targeted draining lymph node (dLN) phagocytic DCs using liposomes encapsulating 1α,25-dihydroxyvitamin D3 (calcitriol) and antigenic peptide to elucidate mechanisms of tolerance used by DCs and responding T cells under resting and immunized conditions. PD-L1 expression was upregulated in dLNs of immunized relative to naive mice. Subcutaneous administration of liposomes encapsulating OVA323-339 and calcitriol targeted dLN PD-L1hi DCs of immunized mice and reduced their MHC class II expression. OVA323-339/calcitriol liposomes suppressed expansion, differentiation, and function of Teffs and induced Foxp3+ and IL-10+ peripheral Tregs in an antigen-specific manner, which was dependent on PD-L1. Peptide/calcitriol liposomes modulated CD40 expression by human DCs and promoted Treg induction in vitro. Liposomes encapsulating calcitriol and disease-associated peptides suppressed the severity of rheumatoid arthritis and Goodpasture's vasculitis models with suppression of antigen-specific memory T cell differentiation and function. Accordingly, peptide/calcitriol liposomes leverage DC PD-L1 for antigen-specific T cell regulation and induce antigen-specific tolerance in inflammatory autoimmune diseases.
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Affiliation(s)
- Ryan Galea
- The University of Queensland Diamantina Institute, The University of Queensland, Woolloongabba, Queensland, Australia
| | - Hendrik J Nel
- The University of Queensland Diamantina Institute, The University of Queensland, Woolloongabba, Queensland, Australia
| | - Meghna Talekar
- The University of Queensland Diamantina Institute, The University of Queensland, Woolloongabba, Queensland, Australia
| | - Xiao Liu
- The University of Queensland Diamantina Institute, The University of Queensland, Woolloongabba, Queensland, Australia
| | - Joshua D Ooi
- Centre for Inflammatory Diseases, Monash University Department of Medicine, Monash Medical Centre, Clayton, Victoria, Australia
| | - Megan Huynh
- Centre for Inflammatory Diseases, Monash University Department of Medicine, Monash Medical Centre, Clayton, Victoria, Australia
| | - Sara Hadjigol
- Centre for Inflammatory Diseases, Monash University Department of Medicine, Monash Medical Centre, Clayton, Victoria, Australia
| | - Kate J Robson
- Centre for Inflammatory Diseases, Monash University Department of Medicine, Monash Medical Centre, Clayton, Victoria, Australia
| | - Yi Tian Ting
- Infection and Immunity Program and Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia
| | - Suzanne Cole
- Discovery Immunology, Janssen Research & Development LLC, Spring House, Pennsylvania, USA
| | - Karyn Cochlin
- Discovery Immunology, Janssen Research & Development LLC, Spring House, Pennsylvania, USA
| | - Shannon Hitchcock
- Discovery Immunology, Janssen Research & Development LLC, Spring House, Pennsylvania, USA
| | - Bijun Zeng
- The University of Queensland Diamantina Institute, The University of Queensland, Woolloongabba, Queensland, Australia
| | - Suman Yekollu
- The University of Queensland Diamantina Institute, The University of Queensland, Woolloongabba, Queensland, Australia
| | - Martine Boks
- The University of Queensland Diamantina Institute, The University of Queensland, Woolloongabba, Queensland, Australia
| | - Natalie Goh
- The University of Queensland Diamantina Institute, The University of Queensland, Woolloongabba, Queensland, Australia
| | | | - Jamie Rossjohn
- Infection and Immunity Program and Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia.,Australian Research Council Centre of Excellence in Advanced Molecular Imaging, Monash University, Clayton, Victoria, Australia.,Institute of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Hugh H Reid
- Infection and Immunity Program and Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia
| | - Ben J Boyd
- Drug Delivery, Disposition and Dynamics and Australian Research Council Centre of Excellence in Convergent Bio-Nano Science and Technology, Monash Institute of Pharmaceutical Sciences, Parkville, Victoria, Australia
| | - Ravi Malaviya
- Discovery Immunology, Janssen Research & Development LLC, Spring House, Pennsylvania, USA
| | - David J Shealy
- Discovery Immunology, Janssen Research & Development LLC, Spring House, Pennsylvania, USA
| | - Daniel G Baker
- Discovery Immunology, Janssen Research & Development LLC, Spring House, Pennsylvania, USA
| | - Loui Madakamutil
- Discovery Immunology, Janssen Research & Development LLC, Spring House, Pennsylvania, USA
| | - A Richard Kitching
- Centre for Inflammatory Diseases, Monash University Department of Medicine, Monash Medical Centre, Clayton, Victoria, Australia.,Departments of Nephrology and Paediatric Nephrology, Monash Health, Clayton, Victoria, Australia
| | - Brendan J O'Sullivan
- The University of Queensland Diamantina Institute, The University of Queensland, Woolloongabba, Queensland, Australia
| | - Ranjeny Thomas
- The University of Queensland Diamantina Institute, The University of Queensland, Woolloongabba, Queensland, Australia
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8
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Boks MP, Houtepen LC, Xu Z, He Y, Ursini G, Maihofer AX, Rajarajan P, Yu Q, Xu H, Wu Y, Wang S, Shi JP, Hulshoff Pol HE, Strengman E, Rutten BPF, Jaffe AE, Kleinman JE, Baker DG, Hol EM, Akbarian S, Nievergelt CM, De Witte LD, Vinkers CH, Weinberger DR, Yu J, Kahn RS. Genetic vulnerability to DUSP22 promoter hypermethylation is involved in the relation between in utero famine exposure and schizophrenia. NPJ Schizophr 2018; 4:16. [PMID: 30131491 PMCID: PMC6104043 DOI: 10.1038/s41537-018-0058-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 06/29/2018] [Accepted: 07/03/2018] [Indexed: 01/27/2023]
Abstract
Epigenetic changes may account for the doubled risk to develop schizophrenia in individuals exposed to famine in utero. We therefore investigated DNA methylation in a unique sample of patients and healthy individuals conceived during the great famine in China. Subsequently, we examined two case-control samples without famine exposure in whole blood and brain tissue. To shed light on the causality of the relation between famine exposure and DNA methylation, we exposed human fibroblasts to nutritional deprivation. In the famine-exposed schizophrenia patients, we found significant hypermethylation of the dual specificity phosphatase 22 (DUSP22) gene promoter (Chr6:291687-293285) (N = 153, p = 0.01). In this sample, DUSP22 methylation was also significantly higher in patients independent of famine exposure (p = 0.025), suggesting that hypermethylation of DUSP22 is also more generally involved in schizophrenia risk. Similarly, DUSP22 methylation was also higher in two separate case-control samples not exposed to famine using DNA from whole blood (N = 64, p = 0.03) and postmortem brains (N = 214, p = 0.007). DUSP22 methylation showed strong genetic regulation across chromosomes by a region on chromosome 16 which was consistent with new 3D genome interaction data. The presence of a direct link between famine and DUSP22 transcription was supported by data from cultured human fibroblasts that showed increased methylation (p = 0.048) and expression (p = 0.019) in response to nutritional deprivation (N = 10). These results highlight an epigenetic locus that is genetically regulated across chromosomes and that is involved in the response to early-life exposure to famine and that is relevant for a major psychiatric disorder.
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Affiliation(s)
- M P Boks
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - L C Houtepen
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Z Xu
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Y He
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
| | - G Ursini
- Lieber Institute for Brain Development, Johns Hopkins Medical Campus, Baltimore, USA
| | - A X Maihofer
- Department of Psychiatry, University of California, La Jolla, San Diego, CA, USA.,VA Center of Excellence for Stress and Mental Health, San Diego, CA, USA.,Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - P Rajarajan
- Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Q Yu
- Department of Epidemiology and Health Statistics, School of Public Health, Jilin University, Changchun, China
| | - H Xu
- Department of Epidemiology and Health Statistics, School of Public Health, Jilin University, Changchun, China
| | - Y Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Jilin University, Changchun, China
| | - S Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Jilin University, Changchun, China
| | - J P Shi
- Department of Epidemiology and Health Statistics, School of Public Health, Jilin University, Changchun, China
| | - H E Hulshoff Pol
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
| | - E Strengman
- Molecular Pathology, Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - B P F Rutten
- School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - A E Jaffe
- Lieber Institute for Brain Development, Johns Hopkins Medical Campus, Baltimore, USA
| | - J E Kleinman
- Lieber Institute for Brain Development, Johns Hopkins Medical Campus, Baltimore, USA
| | - D G Baker
- Department of Psychiatry, University of California, La Jolla, San Diego, CA, USA.,VA Center of Excellence for Stress and Mental Health, San Diego, CA, USA.,Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - E M Hol
- Brain Center Rudolf Magnus, Department of Translational Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands
| | - S Akbarian
- Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, USA
| | - C M Nievergelt
- Department of Psychiatry, University of California, La Jolla, San Diego, CA, USA.,VA Center of Excellence for Stress and Mental Health, San Diego, CA, USA.,Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - L D De Witte
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
| | - C H Vinkers
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
| | - D R Weinberger
- Lieber Institute for Brain Development, Johns Hopkins Medical Campus, Baltimore, USA
| | - J Yu
- Department of Epidemiology and Health Statistics, School of Public Health, Jilin University, Changchun, China
| | - R S Kahn
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands.,Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, USA
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9
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Rutten BPF, Vermetten E, Vinkers CH, Ursini G, Daskalakis NP, Pishva E, de Nijs L, Houtepen LC, Eijssen L, Jaffe AE, Kenis G, Viechtbauer W, van den Hove D, Schraut KG, Lesch KP, Kleinman JE, Hyde TM, Weinberger DR, Schalkwyk L, Lunnon K, Mill J, Cohen H, Yehuda R, Baker DG, Maihofer AX, Nievergelt CM, Geuze E, Boks MPM. Longitudinal analyses of the DNA methylome in deployed military servicemen identify susceptibility loci for post-traumatic stress disorder. Mol Psychiatry 2018; 23:1145-1156. [PMID: 28630453 PMCID: PMC5984086 DOI: 10.1038/mp.2017.120] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Revised: 04/12/2017] [Accepted: 04/13/2017] [Indexed: 11/08/2022]
Abstract
In order to determine the impact of the epigenetic response to traumatic stress on post-traumatic stress disorder (PTSD), this study examined longitudinal changes of genome-wide blood DNA methylation profiles in relation to the development of PTSD symptoms in two prospective military cohorts (one discovery and one replication data set). In the first cohort consisting of male Dutch military servicemen (n=93), the emergence of PTSD symptoms over a deployment period to a combat zone was significantly associated with alterations in DNA methylation levels at 17 genomic positions and 12 genomic regions. Evidence for mediation of the relation between combat trauma and PTSD symptoms by longitudinal changes in DNA methylation was observed at several positions and regions. Bioinformatic analyses of the reported associations identified significant enrichment in several pathways relevant for symptoms of PTSD. Targeted analyses of the significant findings from the discovery sample in an independent prospective cohort of male US marines (n=98) replicated the observed relation between decreases in DNA methylation levels and PTSD symptoms at genomic regions in ZFP57, RNF39 and HIST1H2APS2. Together, our study pinpoints three novel genomic regions where longitudinal decreases in DNA methylation across the period of exposure to combat trauma marks susceptibility for PTSD.
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Affiliation(s)
- B P F Rutten
- School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - E Vermetten
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
- Research Centre for Military Mental Healthcare, Ministry of Defence, Utrecht, The Netherlands
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - C H Vinkers
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
| | - G Ursini
- Lieber Institute for Brain Development, Johns Hopkins Medical Campus, Baltimore, MD, USA
| | - N P Daskalakis
- Department of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai and Mental Health Patient Care Center, James J. Peters Veterans Affairs Medical Center, New York, NY, USA
| | - E Pishva
- School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - L de Nijs
- School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - L C Houtepen
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
| | - L Eijssen
- School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - A E Jaffe
- Lieber Institute for Brain Development, Johns Hopkins Medical Campus, Baltimore, MD, USA
| | - G Kenis
- School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - W Viechtbauer
- School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - D van den Hove
- School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, The Netherlands
- Division of Molecular Psychiatry, Laboratory of Translational Neuroscience, Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - K G Schraut
- Division of Molecular Psychiatry, Laboratory of Translational Neuroscience, Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - K-P Lesch
- School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, The Netherlands
- Division of Molecular Psychiatry, Laboratory of Translational Neuroscience, Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - J E Kleinman
- Lieber Institute for Brain Development, Johns Hopkins Medical Campus, Baltimore, MD, USA
| | - T M Hyde
- Lieber Institute for Brain Development, Johns Hopkins Medical Campus, Baltimore, MD, USA
| | - D R Weinberger
- Lieber Institute for Brain Development, Johns Hopkins Medical Campus, Baltimore, MD, USA
- Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Department of Neurology and Neuroscience, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Institute of Genetic Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - L Schalkwyk
- Molecular and Cellular Biosciences Research Group, University of Essex, Colchester, UK
| | - K Lunnon
- University of Exeter Medical School, Exeter University, Exeter, UK
| | - J Mill
- University of Exeter Medical School, Exeter University, Exeter, UK
| | - H Cohen
- Anxiety and Stress Research Unit, Ministry of Health Mental Health Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - R Yehuda
- Department of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai and Mental Health Patient Care Center, James J. Peters Veterans Affairs Medical Center, New York, NY, USA
| | - D G Baker
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- VA Center of Excellence for Stress and Mental Health, San Diego, CA, USA
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - A X Maihofer
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- VA Center of Excellence for Stress and Mental Health, San Diego, CA, USA
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - C M Nievergelt
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- VA Center of Excellence for Stress and Mental Health, San Diego, CA, USA
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - E Geuze
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
- Research Centre for Military Mental Healthcare, Ministry of Defence, Utrecht, The Netherlands
| | - M P M Boks
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
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10
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Duncan LE, Ratanatharathorn A, Aiello AE, Almli LM, Amstadter AB, Ashley-Koch AE, Baker DG, Beckham JC, Bierut LJ, Bisson J, Bradley B, Chen CY, Dalvie S, Farrer LA, Galea S, Garrett ME, Gelernter JE, Guffanti G, Hauser MA, Johnson EO, Kessler RC, Kimbrel NA, King A, Koen N, Kranzler HR, Logue MW, Maihofer AX, Martin AR, Miller MW, Morey RA, Nugent NR, Rice JP, Ripke S, Roberts AL, Saccone NL, Smoller JW, Stein DJ, Stein MB, Sumner JA, Uddin M, Ursano RJ, Wildman DE, Yehuda R, Zhao H, Daly MJ, Liberzon I, Ressler KJ, Nievergelt CM, Koenen KC. Largest GWAS of PTSD (N=20 070) yields genetic overlap with schizophrenia and sex differences in heritability. Mol Psychiatry 2018; 23:666-673. [PMID: 28439101 PMCID: PMC5696105 DOI: 10.1038/mp.2017.77] [Citation(s) in RCA: 275] [Impact Index Per Article: 45.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 01/19/2017] [Accepted: 02/15/2017] [Indexed: 12/12/2022]
Abstract
The Psychiatric Genomics Consortium-Posttraumatic Stress Disorder group (PGC-PTSD) combined genome-wide case-control molecular genetic data across 11 multiethnic studies to quantify PTSD heritability, to examine potential shared genetic risk with schizophrenia, bipolar disorder, and major depressive disorder and to identify risk loci for PTSD. Examining 20 730 individuals, we report a molecular genetics-based heritability estimate (h2SNP) for European-American females of 29% that is similar to h2SNP for schizophrenia and is substantially higher than h2SNP in European-American males (estimate not distinguishable from zero). We found strong evidence of overlapping genetic risk between PTSD and schizophrenia along with more modest evidence of overlap with bipolar and major depressive disorder. No single-nucleotide polymorphisms (SNPs) exceeded genome-wide significance in the transethnic (overall) meta-analysis and we do not replicate previously reported associations. Still, SNP-level summary statistics made available here afford the best-available molecular genetic index of PTSD-for both European- and African-American individuals-and can be used in polygenic risk prediction and genetic correlation studies of diverse phenotypes. Publication of summary statistics for ∼10 000 African Americans contributes to the broader goal of increased ancestral diversity in genomic data resources. In sum, the results demonstrate genetic influences on the development of PTSD, identify shared genetic risk between PTSD and other psychiatric disorders and highlight the importance of multiethnic/racial samples. As has been the case with schizophrenia and other complex genetic disorders, larger sample sizes are needed to identify specific risk loci.
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Affiliation(s)
- L E Duncan
- Department of Psychiatry, Stanford University, Stanford, CA, USA
- Broad Institute of MIT and Harvard, Stanley Center for Psychiatric Research, Boston, MA, USA
- The Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
| | | | - A E Aiello
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA
| | - L M Almli
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - A B Amstadter
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - A E Ashley-Koch
- Department of Medicine, Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, USA
| | - D G Baker
- Veterans Affairs San Diego Healthcare System and Veterans Affairs Center of Excellence for Stress and Mental Health, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, San Diego, CA, USA
| | - J C Beckham
- Veterans Affairs Durham Healthcare System, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - L J Bierut
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
| | - J Bisson
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - B Bradley
- Atlanta VA Medical Center, Atlanta, GA, USA
- Department of Psychiatry, Emory University, Atlanta, GA, USA
| | - C-Y Chen
- The Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetic Research, and Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard University, Cambridge, MA, USA
| | - S Dalvie
- Division of Human Genetics, University of Cape Town, Cape Town, South Africa
| | - L A Farrer
- Biomedical Genetics, Boston University School of Medicine, Boston, MA, USA
| | - S Galea
- Boston University School of Public Health, Boston, MA, USA
| | - M E Garrett
- Department of Medicine, Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, USA
| | - J E Gelernter
- Department of Psychiatry, Yale University School of Medicine and VA CT Healthcare System, New Haven, CT, USA
| | - G Guffanti
- Department of Psychiatry, Harvard University, Cambridge, MA, USA
- Department of Psychiatry, McLean Hospital, Belmont, MA, USA
| | - M A Hauser
- Department of Medicine, Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, USA
| | - E O Johnson
- RTI International, Research Triangle Park, NC, USA
| | - R C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - N A Kimbrel
- Veterans Affairs Durham Healthcare System, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - A King
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - N Koen
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- MRC Unit on Anxiety & Stress Disorders, Groote Schuur Hospital, Cape Town, South Africa
| | - H R Kranzler
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine and VISN 4 MIRECC, Crescenz VAMC, Philadelphia, PA, USA
| | - M W Logue
- VA Boston Healthcare System, Jamaica Plain, MA, USA
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - A X Maihofer
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - A R Martin
- Broad Institute of MIT and Harvard, Stanley Center for Psychiatric Research, Boston, MA, USA
- The Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
| | - M W Miller
- VA Boston Healthcare System, Jamaica Plain, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - R A Morey
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
- Durham VA Medical Center, Durham, NC, USA
| | - N R Nugent
- Division of Behavioral Genetics, Department of Psychiatry, Rhode Island Hospital, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - J P Rice
- Department of Psychiatry, Washington University, St Louis, MO, USA
| | - S Ripke
- Broad Institute of MIT and Harvard, Stanley Center for Psychiatric Research, Boston, MA, USA
- The Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry and Psychotherapy, Charité, Campus Mitte, Berlin, Germany
| | - A L Roberts
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health Cambridge, MA, USA
| | - N L Saccone
- Department of Genetics, Washington University, St Louis, MO, USA
| | - J W Smoller
- Broad Institute of MIT and Harvard, Stanley Center for Psychiatric Research, Boston, MA, USA
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetic Research, and Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - D J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- MRC Unit on Anxiety & Stress Disorders, Groote Schuur Hospital, Cape Town, South Africa
| | - M B Stein
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA, USA
| | - J A Sumner
- Center for Cardiovascular Behavioral Health, Columbia University Medical Center, New York, NY, USA
| | - M Uddin
- Department of Psychology and Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - R J Ursano
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - D E Wildman
- Department of Molecular & Integrative Physiology and Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - R Yehuda
- James J. Peters Bronx Veterans Affairs and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, Bronx, NY, USA
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, Bronx, NY, USA
| | - H Zhao
- Department of Biostatistics, Yale University, New Haven, CT, USA
| | - M J Daly
- Broad Institute of MIT and Harvard, Stanley Center for Psychiatric Research, Boston, MA, USA
- The Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
| | - I Liberzon
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
- VA Ann Arbor Health System, Ann Arbor, MI, USA
| | - K J Ressler
- Department of Psychiatry, Harvard University, Cambridge, MA, USA
- Department of Psychiatry, McLean Hospital, Belmont, MA, USA
| | - C M Nievergelt
- Veterans Affairs San Diego Healthcare System and Veterans Affairs Center of Excellence for Stress and Mental Health, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, San Diego, CA, USA
| | - K C Koenen
- Broad Institute of MIT and Harvard, Stanley Center for Psychiatric Research, Boston, MA, USA
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetic Research, and Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Cambridge, MA, USA
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11
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Ting YT, Petersen J, Ramarathinam SH, Scally SW, Loh KL, Thomas R, Suri A, Baker DG, Purcell AW, Reid HH, Rossjohn J. The interplay between citrullination and HLA-DRB1 polymorphism in shaping peptide binding hierarchies in rheumatoid arthritis. J Biol Chem 2018; 293:3236-3251. [PMID: 29317506 DOI: 10.1074/jbc.ra117.001013] [Citation(s) in RCA: 60] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Revised: 12/21/2017] [Indexed: 12/22/2022] Open
Abstract
The HLA-DRB1 locus is strongly associated with rheumatoid arthritis (RA) susceptibility, whereupon citrullinated self-peptides bind to HLA-DR molecules bearing the shared epitope (SE) amino acid motif. However, the differing propensity for citrullinated/non-citrullinated self-peptides to bind given HLA-DR allomorphs remains unclear. Here, we used a fluorescence polarization assay to determine a hierarchy of binding affinities of 34 self-peptides implicated in RA against three HLA-DRB1 allomorphs (HLA-DRB1*04:01/*04:04/*04:05) each possessing the SE motif. For all three HLA-DRB1 allomorphs, we observed a strong correlation between binding affinity and citrullination at P4 of the bound peptide ligand. A differing hierarchy of peptide-binding affinities across the three HLA-DRB1 allomorphs was attributable to the β-chain polymorphisms that resided outside the SE motif and were consistent with sequences of naturally presented peptide ligands. Structural determination of eight HLA-DR4-self-epitope complexes revealed strict conformational convergence of the P4-Cit and surrounding HLA β-chain residues. Polymorphic residues that form part of the P1 and P9 pockets of the HLA-DR molecules provided a structural basis for the preferential binding of the citrullinated self-peptides to the HLA-DR4 allomorphs. Collectively, we provide a molecular basis for the interplay between citrullination of self-antigens and HLA polymorphisms that shape peptide-HLA-DR4 binding affinities in RA.
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Affiliation(s)
- Yi Tian Ting
- From the Infection and Immunity Program and Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute Monash University, and
| | - Jan Petersen
- From the Infection and Immunity Program and Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute Monash University, and.,the Australian Research Council Centre of Excellence in Advanced Molecular Imaging, Monash University, Clayton, Victoria 3800, Australia
| | - Sri H Ramarathinam
- From the Infection and Immunity Program and Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute Monash University, and
| | - Stephen W Scally
- From the Infection and Immunity Program and Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute Monash University, and
| | - Khai L Loh
- From the Infection and Immunity Program and Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute Monash University, and
| | - Ranjeny Thomas
- the University of Queensland Diamantina Institute, Translational Research Institute, Princess Alexandra Hospital, Brisbane 4102, Australia
| | - Anish Suri
- the Janssen Research and Development, Pharmaceutical Companies of Johnson & Johnson, Turnhoutseweg 30, B-2340-Beerse, Belgium
| | - Daniel G Baker
- the Janssen Research and Development, LLC, Spring House, Pennsylvania 19002, and
| | - Anthony W Purcell
- From the Infection and Immunity Program and Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute Monash University, and
| | - Hugh H Reid
- From the Infection and Immunity Program and Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute Monash University, and .,the Australian Research Council Centre of Excellence in Advanced Molecular Imaging, Monash University, Clayton, Victoria 3800, Australia
| | - Jamie Rossjohn
- From the Infection and Immunity Program and Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute Monash University, and .,the Australian Research Council Centre of Excellence in Advanced Molecular Imaging, Monash University, Clayton, Victoria 3800, Australia.,the Institute of Infection and Immunity, Cardiff University School of Medicine, Heath Park, Cardiff CF14 4XN, Wales, United Kingdom
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12
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Mobbs JI, Illing PT, Dudek NL, Brooks AG, Baker DG, Purcell AW, Rossjohn J, Vivian JP. The molecular basis for peptide repertoire selection in the human leucocyte antigen (HLA) C*06:02 molecule. J Biol Chem 2017; 292:17203-17215. [PMID: 28855257 DOI: 10.1074/jbc.m117.806976] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 08/18/2017] [Indexed: 12/31/2022] Open
Abstract
Human leukocyte antigen (HLA)-C*06:02 is identified as the allele associated with the highest risk for the development of the autoimmune skin disease psoriasis. However, the diversity and mode of peptide presentation by the HLA-C*06:02 molecule remains unclear. Here, we describe the endogenous peptide repertoire of ∼3,000 sequences for HLA-C*06:02 that defines the peptide-binding motif for this HLA allomorph. We found that HLA-C*06:02 predominantly presents nonamer peptides with dominant arginine anchors at the P2 and P7 positions and a preference for small hydrophobic residues at the C terminus (PΩ). To determine the structural basis of this selectivity, we determined crystal structures of HLA-C*06:02 in complex with two self-peptides (ARTELYRSL and ARFNDLRFV) and an analogue of a melanocyte autoantigen (ADAMTSL5, VRSRR-abu-LRL) implicated in psoriasis. These structures revealed that HLA-C*06:02 possesses a deep peptide-binding groove comprising two electronegative B- and E-pockets that coincide with the preference for P2 and P7 arginine anchors. The ADAMTSL5 autoantigen possessed a P7-Leu instead of the P7-Arg residue, but nevertheless was accommodated within the HLA-C*06:02 antigen-binding cleft. Collectively, our results provide the structural basis for understanding peptide repertoire selection in HLA-C*06:02.
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Affiliation(s)
- Jesse I Mobbs
- From the Infection and Immunity Program and Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton 3800, Victoria, Australia
| | - Patricia T Illing
- From the Infection and Immunity Program and Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton 3800, Victoria, Australia
| | - Nadine L Dudek
- From the Infection and Immunity Program and Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton 3800, Victoria, Australia
| | - Andrew G Brooks
- the Department of Microbiology and Immunology, University of Melbourne, Peter Doherty Institute for Infection and Immunity, Melbourne 3000, Australia
| | - Daniel G Baker
- Janssen Research & Development, LLC, Horsham, Philadelphia, Pennsylvania 19044
| | - Anthony W Purcell
- From the Infection and Immunity Program and Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton 3800, Victoria, Australia,
| | - Jamie Rossjohn
- From the Infection and Immunity Program and Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton 3800, Victoria, Australia, .,the Australian Research Council Centre of Excellence in Advanced Molecular Imaging, Monash University, Clayton 3800, Victoria, Australia, and.,the Institute of Infection and Immunity, Cardiff University, School of Medicine, Cardiff CF14 4XN, Wales, United Kingdom
| | - Julian P Vivian
- From the Infection and Immunity Program and Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton 3800, Victoria, Australia, .,the Australian Research Council Centre of Excellence in Advanced Molecular Imaging, Monash University, Clayton 3800, Victoria, Australia, and
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13
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Baker JF, Østergaard M, Emery P, Baker DG, Conaghan PG. Development and validation of rheumatoid arthritis magnetic resonance imaging inflammation thresholds associated with lack of damage progression. Clin Exp Rheumatol 2017; 35:607-613. [PMID: 28134079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 12/20/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES To determine thresholds for rheumatoid arthritis (RA) magnetic resonance imaging scores (RAMRIS) associated with a low risk of structural damage progression. METHODS MRI of the dominant hand was performed and RAMRIS scores determined at weeks 0, 24, and 52. X-rays were performed and van der Heijde-Sharp scores (vdHS) determined. In a development cohort (n=297) the changes in MRI erosion score and vdHS score were determined over the 24-week to 52-week interval and progression was defined as change >0.5. We identified 24-week thresholds for synovitis and osteitis that provided >90% sensitivity for imaging progression over the 24 to 52-week interval. The performance of these cut-offs was tested in a validation cohort (n=217). RESULTS In the development cohort, synovitis or osteitis scores ≤3 by 24 weeks were associated with a low probability of progression on MRI and x-ray. The coefficient for osteitis was stronger than that of synovitis in models predicting x-ray and MRI progression. Therefore, a total inflammation score was weighted on osteitis (x2). An inflammation score ≤9 was more frequently attained than DAS28 remission (64 vs. 38) and was associated with low probability of progression regardless of attainment of clinical remission. In the validation cohort, there was a low odds of MRI progression among those with low synovitis [OR 0.27 (0.086,0.82) p=0.02], osteitis [OR 0.20 (0.085, 0.49) p<0.001] and inflammation scores [OR 0.12 (0.033, 0.41) p=0.001]. CONCLUSIONS Attainment of low MRI single-hand synovitis and osteitis is not uncommon and predicts a lack of structural progression in RA, independent of clinical remission.
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Affiliation(s)
- Joshua F Baker
- Philadelphia Veterans Affairs Medical Center; University of Pennsylvania, School of Medicine; and Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, USA.
| | - Mikkel Østergaard
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup; and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Paul Emery
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK
| | | | - Philip G Conaghan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK
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George MD, Østergaard M, Conaghan PG, Emery P, Baker DG, Baker JF. Obesity and rates of clinical remission and low MRI inflammation in rheumatoid arthritis. Ann Rheum Dis 2017; 76:1743-1746. [PMID: 28606966 DOI: 10.1136/annrheumdis-2017-211569] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 05/09/2017] [Accepted: 05/10/2017] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Obesity has been proposed as a risk factor for refractory rheumatoid arthritis (RA). We evaluated the impact of obesity on achieving clinical and imaging definitions of low disease activity. METHODS This study evaluated 470 patients with RA from GO-BEFORE and GO-FORWARD randomised clinical trials. Included patients had blinded clinical disease activity measures and MRI at baseline, 24 and 52 weeks. Synovitis, osteitis and total inflammation scores were determined using the RA MRI scoring system. Multivariable logistic regression analyses compared odds of achieving Disease Activity Score using 28 joints and C-reactive protein (DAS28-CRP) remission, low component measures, or low MRI inflammation measures at 24 weeks in patients with obesity versus no obesity. RESULTS At 24 weeks, patients with obesity were significantly less likely to achieve DAS28(CRP) remission (OR 0.47; 95% CI 0.24 to 0.92, p=0.03). In contrast, patients with obesity had similar odds of achieving low synovitis (OR 0.94; 95% CI 0.51 to 1.72, p=0.84) and inflammation scores (OR 1.16; 95% CI 0.61 to 2.22, p=0.64) and greater odds of achieving low osteitis scores (OR 2.06; 95% CI 1.10 to 3.84, p=0.02) versus normal weight patients. CONCLUSIONS Patients with RA and obesity have lower rates of DAS28 remission but similar rates of low MRI activity compared with patients without obesity, suggesting that obesity and its associated comorbidities can bias clinical disease activity measures. TRIAL REGISTRATION NUMBER NCT00361335 and NCT00264550; Post-results.
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Affiliation(s)
- Michael D George
- School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Mikkel Østergaard
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Philip G Conaghan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK
| | - Paul Emery
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK
| | - Daniel G Baker
- Janssen Research & Development, LLC, Horsham, Philadelphia, Pennsylvania, USA
| | - Joshua F Baker
- School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA.,Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Baker DG. Comparison of Strength Levels Between Players From Within the Same Club Who Were Selected vs. Not Selected to Play in the Grand Final of the National Rugby League Competition. J Strength Cond Res 2017; 31:1461-1467. [PMID: 28538293 DOI: 10.1519/jsc.0000000000001604] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
A number of studies have established that higher levels of strength and power, tested at the end of the preseason, distinguish between playing level in professional rugby league. How this may impact the ability of players to get selected for final payoff games some 30 weeks later has not been fully investigated. The purpose of this study was to compare measures of upper- and lower-body strength between players from the same professional club, designated as those 17 players who attained selection and played in the team that won the Grand Final of the National Rugby League competition (GF) and those who did not attain selection (NSGF). Players were tested and compared for 1 repetition maximum bench press and full squat strength levels at the end of the preparation period, 30 weeks before the GF, using traditional significance analysis of variance and effect size (ES) statistics. Furthermore, the players were analyzed according to the 2 broad positional playing groups of forwards (FWD) and backs (BL). The results demonstrated that overall, the GF players were stronger than NSGF players by approximately 10 and 15%, respectively, for the upper and lower body. When analyzed according to positional groupings, there were significant differences and large ES for GF forwards, who were significantly stronger, heavier, and older than NSGF FWD players. For the BL groups, the differences between the groups were not significant. Because of the intense physical collisions inherent in rugby league, it would appear that higher levels of strength afford players greater performance benefits, resiliency against injury, and greater likelihood of being selected in the most important games at the end of the season.
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Affiliation(s)
- Daniel G Baker
- School of Exercise and Health Sciences, Edith Cowan University, Joondalup, Australia
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Baker JF, Conaghan PG, Emery P, Baker DG, Ostergaard M. Relationship of patient-reported outcomes with MRI measures in rheumatoid arthritis. Ann Rheum Dis 2016; 76:486-490. [PMID: 27432355 DOI: 10.1136/annrheumdis-2016-209463] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 06/10/2016] [Accepted: 06/28/2016] [Indexed: 11/04/2022]
Abstract
PurposeWe assessed whether MRI measures of synovitis, osteitis and bone erosion were associated with patient-reported outcomes (PROs) in a longitudinal clinical trial setting among patients with rheumatoid arthritis (RA).MethodsThis longitudinal cohort of 291 patients with RA was derived from the MRI substudy of the GO-BEFORE randomised controlled trial of golimumab among methotrexate-naïve patients. Correlations between RAMRIS scores (synovitis, osteitis, bone erosion) and physical function (Health Assessment Questionnaire (HAQ)), pain and global patient scores were determined at 0, 12, 24 and 52 weeks. Correlations between interval changes were also assessed. Multivariable regression models using robust generalised estimating equations evaluated associations over all time-points and their relationship to other clinical disease activity measures.ResultsGreater synovitis, osteitis and bone erosion scores were positively associated with HAQ at all time-points (all p<0.05) and with pain and patient global scores at 24 and 52 weeks. Over all visits, synovitis was associated with HAQ, pain and patient global scores (p≤0.03) independent of clinical disease activity measures. Improvements in synovitis and bone erosion were also associated with improvements in PROs. Less improvement in synovitis and progression in MRI erosion at 52 weeks were both independently associated with worsening in all PROs at 52 weeks while progression on X-ray was not associated. Similar associations were observed across treatment groups.ConclusionsMRI measures of inflammation and structural damage correlate independently with physical function, pain and patient global assessments. These observations support the validity of MRI biomarkers.Trial registration numberNCT00264537; Post-results.
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Affiliation(s)
- Joshua F Baker
- Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
- School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Philip G Conaghan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK
| | - Paul Emery
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK
| | - Daniel G Baker
- Janssen Research & Development, LLC, Horsham, Pennsylvania, USA
| | - Mikkel Ostergaard
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup, Denmark
- Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Thurmond RL, Greenspan A, Radziszewski W, Xu XL, Miao Y, Chen B, Ge T, Zhou B, Baker DG, Pavlova D, Ritchlin CT, Tanaka Y, Takeuchi T, Smolen JS. Toreforant, A Histamine H4 Receptor Antagonist, in Patients with Active Rheumatoid Arthritis Despite Methotrexate Therapy: Results of 2 Phase II Studies. J Rheumatol 2016; 43:1637-42. [DOI: 10.3899/jrheum.160164] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2016] [Indexed: 11/22/2022]
Abstract
Objective.To assess toreforant (selective histamine H4 receptor antagonist) in active rheumatoid arthritis (RA).Methods.In a phase IIa, double-blind, placebo-controlled test, 86 patients were randomized (2:1) to once-daily toreforant 100 mg or placebo for 12 weeks. In phase IIb, double-blind, placebo-controlled, dose-range–finding evaluations, 272 patients were randomized (1:1:1:1) to once-daily placebo or toreforant 3/10/30 mg. Primary efficacy endpoints for both studies were Week 12 changes in 28-joint Disease Activity Score–C-reactive protein (DAS28-CRP).Results.Phase IIa testing was terminated prematurely (patient fatality; secondary hemophagocytic lymphohistiocytosis). Posthoc analyses indicated toreforant 100 mg/day reduced RA signs/symptoms through Week 12. Phase IIb testing, however, showed no significant Week 12 improvement in DAS28-CRP with toreforant.Conclusion.Toreforant was not effective in phase IIb testing.
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Boers M, Aletaha D, Mela CM, Baker DG, Smolen JS. Glucocorticoid Effect on Radiographic Progression in Placebo Arms of Rheumatoid Arthritis Biologics Trials. J Rheumatol 2016; 43:1024-6. [PMID: 27036379 DOI: 10.3899/jrheum.150932] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 02/19/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To assess the effect of glucocorticoids (GC) on damage progression in placebo-biologic arms of rheumatoid arthritis (RA) biologics trials. METHODS Posthoc metaanalysis of 2 infliximab (IFX) trials (established and early RA) and 1 tocilizumab (TCZ) trial (established RA). RESULTS The proportion of patients receiving GC was 38%-64%, baseline damage was 11-82 Sharp/van der Heijde points, and progression in the placebo groups was 0.5-4.8 points in 6 months. In the pooled IFX studies, GC cotreatment reduced 6-month progression by 2.6 points (95% CI 0.6-4.5). In the TCZ study (progression rate 0.5 Genant points), no such difference was seen. CONCLUSION GC cotreatment may affect results in RA trials.
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Affiliation(s)
- Maarten Boers
- From the Department of Epidemiology and Biostatistics, and Amsterdam Rheumatology and Immunology Center, VU University Medical Center, Amsterdam, the Netherlands; Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria; Roche Products Ltd., Welwyn Garden City, UK; Janssen Research and Development, Spring House, Pennsylvania, USA.M. Boers, MD, PhD, MSc, Professor of Clinical Epidemiology, Department of Epidemiology and Biostatistics, VU University Medical Center; D. Aletaha, MD, MSc, Associate Professor of Medicine, Division of Rheumatology, Department of Medicine 3, Medical University of Vienna; C.M. Mela, PhD, MSc, BSc, Clinical Development Scientist, Roche Products Ltd.; D.G. Baker, MD, Vice President Immunology, Janssen Research and Development; J.S. Smolen, MD, Professor of Medicine, Division of Rheumatology, Department of Medicine 3, Medical University of Vienna.
| | - Daniel Aletaha
- From the Department of Epidemiology and Biostatistics, and Amsterdam Rheumatology and Immunology Center, VU University Medical Center, Amsterdam, the Netherlands; Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria; Roche Products Ltd., Welwyn Garden City, UK; Janssen Research and Development, Spring House, Pennsylvania, USA.M. Boers, MD, PhD, MSc, Professor of Clinical Epidemiology, Department of Epidemiology and Biostatistics, VU University Medical Center; D. Aletaha, MD, MSc, Associate Professor of Medicine, Division of Rheumatology, Department of Medicine 3, Medical University of Vienna; C.M. Mela, PhD, MSc, BSc, Clinical Development Scientist, Roche Products Ltd.; D.G. Baker, MD, Vice President Immunology, Janssen Research and Development; J.S. Smolen, MD, Professor of Medicine, Division of Rheumatology, Department of Medicine 3, Medical University of Vienna
| | - Christopher M Mela
- From the Department of Epidemiology and Biostatistics, and Amsterdam Rheumatology and Immunology Center, VU University Medical Center, Amsterdam, the Netherlands; Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria; Roche Products Ltd., Welwyn Garden City, UK; Janssen Research and Development, Spring House, Pennsylvania, USA.M. Boers, MD, PhD, MSc, Professor of Clinical Epidemiology, Department of Epidemiology and Biostatistics, VU University Medical Center; D. Aletaha, MD, MSc, Associate Professor of Medicine, Division of Rheumatology, Department of Medicine 3, Medical University of Vienna; C.M. Mela, PhD, MSc, BSc, Clinical Development Scientist, Roche Products Ltd.; D.G. Baker, MD, Vice President Immunology, Janssen Research and Development; J.S. Smolen, MD, Professor of Medicine, Division of Rheumatology, Department of Medicine 3, Medical University of Vienna
| | - Daniel G Baker
- From the Department of Epidemiology and Biostatistics, and Amsterdam Rheumatology and Immunology Center, VU University Medical Center, Amsterdam, the Netherlands; Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria; Roche Products Ltd., Welwyn Garden City, UK; Janssen Research and Development, Spring House, Pennsylvania, USA.M. Boers, MD, PhD, MSc, Professor of Clinical Epidemiology, Department of Epidemiology and Biostatistics, VU University Medical Center; D. Aletaha, MD, MSc, Associate Professor of Medicine, Division of Rheumatology, Department of Medicine 3, Medical University of Vienna; C.M. Mela, PhD, MSc, BSc, Clinical Development Scientist, Roche Products Ltd.; D.G. Baker, MD, Vice President Immunology, Janssen Research and Development; J.S. Smolen, MD, Professor of Medicine, Division of Rheumatology, Department of Medicine 3, Medical University of Vienna
| | - Josef S Smolen
- From the Department of Epidemiology and Biostatistics, and Amsterdam Rheumatology and Immunology Center, VU University Medical Center, Amsterdam, the Netherlands; Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria; Roche Products Ltd., Welwyn Garden City, UK; Janssen Research and Development, Spring House, Pennsylvania, USA.M. Boers, MD, PhD, MSc, Professor of Clinical Epidemiology, Department of Epidemiology and Biostatistics, VU University Medical Center; D. Aletaha, MD, MSc, Associate Professor of Medicine, Division of Rheumatology, Department of Medicine 3, Medical University of Vienna; C.M. Mela, PhD, MSc, BSc, Clinical Development Scientist, Roche Products Ltd.; D.G. Baker, MD, Vice President Immunology, Janssen Research and Development; J.S. Smolen, MD, Professor of Medicine, Division of Rheumatology, Department of Medicine 3, Medical University of Vienna
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Baker JF, Conaghan PG, Emery P, Baker DG, Østergaard M. Validity of early MRI structural damage end points and potential impact on clinical trial design in rheumatoid arthritis. Ann Rheum Dis 2015; 75:1114-9. [PMID: 26091907 DOI: 10.1136/annrheumdis-2014-206934] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 06/06/2015] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To evaluate the construct validity of the rheumatoid arthritis MRI score (RAMRIS) erosion evaluation as structural damage end point and to assess the potential impact of incorporation in clinical trials. METHODS In a randomised trial of early methotrexate-naïve RA (GO-BEFORE), RAMRIS scores were determined from MRIs and van der Heijde-Sharp (vdHS) scores from radiographs, at baseline, week 12, week 24 and week 52. Progression in damage scores was defined as change >0.5. Associations of X-ray and MRI outcomes with clinical features were evaluated for convergent validity. Iterative Wilcoxon rank sum tests and tests of proportion estimated the sample size required to detect differences between combination therapy (methotrexate+golimumab) and methotrexate-monotherapy arms in (A) change in damage score and (B) proportion of patients progressing. RESULTS Patients with early MRI progression had higher DAS28, C reactive protein (CRP) and vdHS at baseline, and higher 2-year HAQ. Associations were similar to those with 1-year vdHS progression. Differences in change in structural damage between treatment arms achieved significance with fewer subjects when 12-week or 24-week MRI erosion score was the outcome (150 patients; 100 among an enriched sample with baseline-synovitis >5) compared with the 52-week vdHS (275 patients). Differences in the proportion progressing could be detected in 234 total subjects with 12-week MRI in an enriched sample whereas 1-year X-ray required between 468 and 1160 subjects. CONCLUSIONS Early MRI erosion progression is a valid measure of structural damage that could substantially decrease sample size and study duration if used as structural damage end point in RA clinical trials.
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Affiliation(s)
- Joshua F Baker
- Philadelphia Veterans' Affairs Medical Center, Philadelphia, Pennsylvania, USA University of Pennsylvania, School of Medicine, Philadelphia, Pennsylvania, USA Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Philip G Conaghan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK
| | - Paul Emery
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK
| | - Daniel G Baker
- Janssen Research & Development, LLC., Horsham, Pennsylvania, USA
| | - Mikkel Østergaard
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, University of Copenhagen, Copenhagen, Denmark
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Acheson DT, Geyer MA, Baker DG, Nievergelt CM, Yurgil K, Risbrough VB. Conditioned fear and extinction learning performance and its association with psychiatric symptoms in active duty Marines. Psychoneuroendocrinology 2015; 51:495-505. [PMID: 25444643 PMCID: PMC4345165 DOI: 10.1016/j.psyneuen.2014.09.030] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2014] [Revised: 09/29/2014] [Accepted: 09/29/2014] [Indexed: 12/20/2022]
Abstract
BACKGROUND Posttraumatic Stress Disorder (PTSD) is a major public health concern, especially given the recent wars in Iraq and Afghanistan. Nevertheless, despite a sharp increase in the incidence of psychiatric disorders in returning veterans, empirically based prevention strategies are still lacking. To develop effective prevention and treatment strategies, it is necessary to understand the underlying biological mechanisms contributing to PTSD and other trauma related symptoms. METHODS The "Marine Resiliency Study II" (MRS-II; October 2011-October 2013) Neurocognition project is an investigation of neurocognitive performance in Marines about to be deployed to Afghanistan. As part of this investigation, 1195 Marines and Navy corpsmen underwent a fear conditioning and extinction paradigm and psychiatric symptom assessment prior to deployment. The current study assesses (1) the effectiveness of the fear potentiated startle paradigm in producing fear learning and extinction and (2) the association of performance in the paradigm with baseline psychiatric symptom classes (healthy: n=923, PTSD symptoms: n=42, anxiety symptoms: n=37, and depression symptoms: n=12). RESULTS Results suggest that the task was effective in producing differential fear learning and fear extinction in this cohort. Further, distinct patterns emerged differentiating the PTSD and anxiety symptom classes from both healthy and depression classes. During fear acquisition, the PTSD symptom group was the only group to show deficient discrimination between the conditioned stimulus (CS+) and safety cue (CS-), exhibiting larger startle responses during the safety cue compared to the healthy group. During extinction learning, the PTSD symptom group showed significantly less reduction in their CS+ responding over time compared to the healthy group, as well as reduced extinction of self-reported anxiety to the CS+ by the end of the extinction session. Conversely, the anxiety symptom group showed normal safety signal discrimination and extinction of conditioned fear, but exhibited increased baseline startle reactivity and potentiated startle to CS+, as well as higher self-reported anxiety to both cues. The depression symptom group showed similar physiological and self-report measures as the healthy group. DISCUSSION These data are consistent with the idea that safety signal discrimination is a relatively specific marker of PTSD symptoms compared to general anxiety and depression symptoms. Further research is needed to determine if deficits in fear inhibition vs. exaggerated fear responding are separate biological "domains" across anxiety disorders that may predict differential biological mechanisms and possibly treatment needs. Future longitudinal analyses will examine whether poor learning of safety signals provides a marker of vulnerability to develop PTSD or is specific to symptom state.
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Affiliation(s)
- D T Acheson
- Department of Psychiatry, University of California San Diego, United States
| | - M A Geyer
- Department of Psychiatry, University of California San Diego, United States; Mental Illness Research, Education and Clinical Center, VA San Diego Healthcare System, United States
| | - D G Baker
- Department of Psychiatry, University of California San Diego, United States; Center for Excellence in Stress and Mental Health, VA San Diego Healthcare System, United States
| | - C M Nievergelt
- Department of Psychiatry, University of California San Diego, United States; Center for Excellence in Stress and Mental Health, VA San Diego Healthcare System, United States
| | - K Yurgil
- Center for Excellence in Stress and Mental Health, VA San Diego Healthcare System, United States
| | - V B Risbrough
- Department of Psychiatry, University of California San Diego, United States; Center for Excellence in Stress and Mental Health, VA San Diego Healthcare System, United States.
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Baker JF, Smolen JS, Aletaha D, Shults J, Conaghan PG, Emery P, Baker DG, Ostergaard M. Reply: To PMID 24757132. Arthritis Rheumatol 2014; 66:3245-6. [PMID: 25132673 DOI: 10.1002/art.38810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Joshua F Baker
- Philadelphia VA Medical Center, and University of Pennsylvania, Philadelphia, PA
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Baker JF, Ostergaard M, George M, Shults J, Emery P, Baker DG, Conaghan PG. Greater body mass independently predicts less radiographic progression on X-ray and MRI over 1-2 years. Ann Rheum Dis 2014; 73:1923-8. [PMID: 25091439 DOI: 10.1136/annrheumdis-2014-205544] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Greater body mass index (BMI) has been associated with less radiographic progression in rheumatoid arthritis (RA). We evaluated the association between BMI and joint damage progression as measured by X-ray and MRI. METHODS 1068 subjects with RA from two clinical trials of golimumab (GO-BEFORE and GO-FORWARD) had radiographs performed at weeks 0, 52 and 104 and evaluated using the van der Heijde-Sharp (vdHS) scoring system. Contrast-enhanced MRIs of the dominant wrist and hand were obtained at weeks 0, 12, 24, 52 and 104. Multivariable logistic regression evaluated the risk of radiographic progression for each BMI category (<25, 25-30, >30 kg/m(2)). Within GO-BEFORE, piecewise, robust generalised estimating equations marginal models assessed the probability of MRI erosion progression for each BMI category. Multivariable linear regression models assessed baseline associations between BMI and bone oedema (a precursor of bone erosion). RESULTS Higher BMI category was associated with a lower probability of progression in vdHS score at weeks 52 and 104 independent of potential confounders. Higher BMI was also independently associated with a lower probability of progression in MRI erosion score over 2 years. Subjects with greater BMI demonstrated less bone oedema independent of differences in other disease severity measures, including MRI synovitis in the same joints. CONCLUSIONS Greater BMI is associated with a lower risk of progression on X-ray and MRI over 2 years. Subjects with greater BMI also demonstrate less bone oedema at baseline. Greater BMI may indicate a less aggressive RA phenotype and aid in risk stratification.
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Affiliation(s)
- Joshua F Baker
- Division of Rheumatology, Philadelphia Veterans' Affairs Medical Center, Philadelphia, Pennsylvania, USA Division of Rheumatology, University of Pennsylvania, School of Medicine, Philadelphia, Pennsylvania, USA Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Mikkel Ostergaard
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, Copenhagen, Denmark Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Michael George
- Division of Rheumatology, University of Pennsylvania, School of Medicine, Philadelphia, Pennsylvania, USA
| | - Justine Shults
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Paul Emery
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK NIHR Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton Hospital, Leeds, UK
| | - Daniel G Baker
- Janssen Research & Development, LLC, Spring House, Pennsylvania, USA
| | - Philip G Conaghan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK NIHR Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton Hospital, Leeds, UK
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Baker JF, Conaghan PG, Smolen JS, Aletaha D, Shults J, Emery P, Baker DG, Østergaard M. Development and Validation of Modified Disease Activity Scores in Rheumatoid Arthritis: Superior Correlation With Magnetic Resonance Imaging-Detected Synovitis and Radiographic Progression. Arthritis Rheumatol 2014; 66:794-802. [DOI: 10.1002/art.38304] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Accepted: 11/26/2013] [Indexed: 11/10/2022]
Affiliation(s)
- Joshua F. Baker
- University of Pennsylvania and Philadelphia VA Medical Center; Philadelphia
| | - Philip G. Conaghan
- University of Leeds, NIHR Leeds Musculoskeletal Biomedical Research Unit, and Leeds Teaching Hospitals NHS Trust; Leeds UK
| | | | | | | | - Paul Emery
- University of Leeds, NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Institute of Rheumatic and Musculoskeletal Medicine, Leeds Teaching Hospitals NHS Trust, and Chapel Allerton Hospital; Leeds UK
| | - Daniel G. Baker
- Janssen Research and Development, LLC; Spring House Pennsylvania
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Baker JF, Østergaard M, Emery P, Hsia EC, Lu J, Baker DG, Conaghan PG. Early MRI measures independently predict 1-year and 2-year radiographic progression in rheumatoid arthritis: secondary analysis from a large clinical trial. Ann Rheum Dis 2013; 73:1968-74. [DOI: 10.1136/annrheumdis-2013-203444] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Baker DG. 10-year changes in upper body strength and power in elite professional rugby league players--the effect of training age, stage, and content. J Strength Cond Res 2013; 27:285-92. [PMID: 23358318 DOI: 10.1519/jsc.0b013e318270fc6b] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The purpose of this investigation was to observe changes in maximal upper body strength and power across a 10-year period in professional athletes who were experienced resistance trainers. Six professional rugby league players were observed with test data reported according to 2 important training stages in their professional careers. The first stage (1996-1998) monitored the changes as the subjects strived to establish themselves as elite professionals in their sport. The remaining test data are from the latter stage (2000-2006), which is characterized by a longer competition schedule and shorter periods devoted to improving physical preparation. The changes in upper body strength, assessed by the 1 repetition maximum bench press and mean maximum power during bench press throws with various barbell resistances of 40-80 kg, were assessed by effect size (ES) and smallest worthwhile change (SWC) statistics. Large increases in strength and power of approximately 22-23% were reported across the 10-year period, however, only small changes (as determined by ES) in strength or power occurred after year 2000 till 2006. This result of only small changes in strength or power despite 6 years of intense resistance training was attributed to 3 main factors. Key among them are the possible existence of a "strength ceiling" for experienced resistance trainers, the Long-term Athlete Development model, and possibly an inappropriate volume of strength-endurance training from 2004 to 2005. The fact that an SWC in strength and power occurred in the year after the cessation of strength-endurance training suggests that training program manipulation is still an influencing factor in continuing strength and power gains in experienced resistance trainers.
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Affiliation(s)
- Daniel G Baker
- Faculty of Computing, Health and Science, Edith Cowan University, Joondulup, Western Australia, Australia.
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Baker JF, Mehta NN, Baker DG, Toedter G, Shults J, Von Feldt JM, Leonard MB. Vitamin D, metabolic dyslipidemia, and metabolic syndrome in rheumatoid arthritis. Am J Med 2012; 125:1036.e9-1036.e15. [PMID: 22800875 DOI: 10.1016/j.amjmed.2012.01.025] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [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: 10/26/2011] [Revised: 12/21/2011] [Accepted: 01/09/2012] [Indexed: 12/11/2022]
Abstract
PURPOSE Vitamin D deficiency is a potential risk factor for cardiometabolic disease. We investigated the associations between vitamin D and dyslipidemia and the metabolic syndrome in patients with rheumatoid arthritis, a group at high risk for cardiovascular disease. METHODS Serum 25(OH)vitamin D and lipoprotein levels were measured at baseline in a random sample of 499 participants, ages 18-85 years, enrolled in a randomized trial of golimumab (GOlimumab Before Employing methotrexate as the First-line Option in the treatment of Rheumatoid arthritis of Early onset or GO-BEFORE Trial). Participants had rheumatoid arthritis with active disease, and were naïve to methotrexate and biologic therapies. Multivariable linear regression was performed to assess associations between vitamin D levels and lipoprotein fractions. Multivariable logistic regression was performed to determine the odds of hyperlipidemia and the metabolic syndrome in participants with vitamin D deficiency (<20 ng/mL). RESULTS In multivariable linear regression, vitamin D levels (per 10 ng/mL) were associated inversely with low-density lipoprotein (β: -0.029 [-0.049, -0.0091], P=.004) and triglyceride (β: -0.094 [-0.15, -0.039] P=.001) levels, adjusted for demographic, cardiovascular, and disease-specific variables. Vitamin D and high-density lipoprotein levels were not associated in univariate or multivariate analyses. Vitamin D deficiency was associated independently with an increased odds of hyperlipidemia (odds ratio 1.72; 95% confidence interval, 1.10-2.45; P=.014) and metabolic syndrome (odds ratio 3.45; 95% confidence interval, 1.75-6.80; P <.001) in adjusted models. CONCLUSIONS In conclusion, vitamin D deficiency was associated with the metabolic syndrome and dyslipidemia in rheumatoid arthritis, suggesting a potential role in cardiovascular disease risk. Large-scale, prospective studies are needed to determine if vitamin D supplementation improves lipoprotein levels and reduces cardiovascular risk in rheumatoid arthritis.
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Affiliation(s)
- Joshua F Baker
- Department of Medicine, Division of Rheumatology, University of Pennsylvania, Philadelphia, PA 19104, USA.
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Baker JF, Baker DG, Toedter G, Shults J, Von Feldt JM, Leonard MB. Associations between vitamin D, disease activity, and clinical response to therapy in rheumatoid arthritis. Clin Exp Rheumatol 2012; 30:658-64. [PMID: 22776409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2011] [Accepted: 11/28/2011] [Indexed: 06/01/2023]
Abstract
OBJECTIVES Vitamin D deficiency is a potential risk factor for autoimmunity. Prior studies of the association between vitamin D levels and rheumatoid arthritis (RA) disease activity have yielded conflicting results. METHODS Serum 25(OH)vitamin D levels were measured at baseline in 499 participants with active RA, ages 18-85 years, enrolled in a randomised clinical trial of golimumab (Go-Before Trial). Subjects were methotrexate and biologic therapy naïve. Multivariable linear regression was used to assess associations between vitamin D levels and disease activity scores (DAS28), van der Heijde-Sharp (vdHS) erosion scores, and serum inflammatory markers. Generalised estimating equations were used to evaluate the associations between vitamin D status and the response to therapy over 52 weeks, using the DAS28 and ACR response. RESULTS Forty-eight percent of participants were vitamin D deficient, defined as serum 25(OH)vitamin D <20 ng/mL. Deficiency was not associated with greater DAS28 (β-0.021 [95% CI -0.22, 0.18]), adjusted for age, race, sex, BMI, disease duration and glomerular filtration rate. Vitamin D deficiency was not associated with baseline vdHS scores or inflammatory markers in adjusted or unadjusted models. There was no association between baseline vitamin D deficiency and change in DAS28 (β = -0.024 [-0.30, 0.25]), proportion meeting ACR response (OR 0.82 [0.56, 1.20]), or radiographic progression at 52 weeks (OR 0.91 [0.59-1.40]). CONCLUSIONS Vitamin D levels were not associated with RA disease activity, inflammatory markers, or vdHS scores at baseline. Furthermore, there was no association between baseline vitamin D level and response to therapy or radiographic progression.
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Affiliation(s)
- Joshua F Baker
- Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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Genovese MC, Cohen SB, Wofsy D, Weinblatt ME, Firestein GS, Brahn E, Strand V, Baker DG, Tong SE. A 24-week, randomized, double-blind, placebo-controlled, parallel group study of the efficacy of oral SCIO-469, a p38 mitogen-activated protein kinase inhibitor, in patients with active rheumatoid arthritis. J Rheumatol 2011; 38:846-54. [PMID: 21285160 DOI: 10.3899/jrheum.100602] [Citation(s) in RCA: 100] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To evaluate the efficacy, safety, and tolerability of oral SCIO-469, a p38 MAPK inhibitor that blocks tumor necrosis factor-α, interleukin-1ß, and cyclooxygenase-2 synthesis in patients with active rheumatoid arthritis (RA). METHODS Patients were randomized to receive SCIO-469 at either 30 or 60 mg three times daily in an immediate-release (IR) formulation or at 100 mg once daily in an extended-release (ER) formulation, or placebo for 24 weeks. The primary endpoint was American College of Rheumatology (ACR)20 response at Week 12. Safety was monitored through Week 26. RESULTS Overall, 302 patients were randomized: 76 to placebo, 75 to 30 mg IR, 73 to 60 mg IR, and 78 to 100 mg ER. There were no significant differences in ACR20 responses at Week 12 between SCIO-469 and placebo. Declines in C-reactive protein and erythrocyte sedimentation rate during early treatment did not persist to Week 12 and were not a consequence of decreased SCIO-469 plasma levels. The 60 mg IR regimen showed a dose-limiting toxicity manifested by elevations in alanine aminotransferase. Adverse events were common in all groups (79.7% and 86.7% through 13 and 26 weeks, respectively). Twenty-one patients reported 28 serious adverse events (SAE). SAE were more common with IR SCIO-469 than with placebo (7% vs 4%) but were not reported with ER SCIO-469. CONCLUSION In all regimens tested, SCIO-469 showed no greater efficacy compared to placebo in patients with RA. The transient effect of SCIO-469 on acute-phase reactants suggests a complex role of p38 MAPK in inflammation.
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Affiliation(s)
- Mark C Genovese
- Division of Immunology and Rheumatology,Stanford University, 1000 Welch Road #203, Palo Alto, CA 94304, USA.
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Baker DG, Newton RU. Effect of Kinetically Altering a Repetition via the Use of Chain Resistance on Velocity During the Bench Press. J Strength Cond Res 2009; 23:1941-6. [DOI: 10.1519/jsc.0b013e3181b3dd09] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Baker DG. Ability and validity of three different methods of assessing upper-body strength-endurance to distinguish playing rank in professional rugby league players. J Strength Cond Res 2009; 23:1578-82. [PMID: 19620904 DOI: 10.1519/jsc.0b013e3181b0708d] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
To date, little study has been performed to determine the importance of upper-body strength-endurance (S-E) to success in rugby league football. Furthermore, debate exists as to which type of S-E testing, absolute resistance or relative percent S-E testing, where performance is gauged with an absolute resistance in kilograms or with a set percentage of 1 repetition maximum (1RM), respectively, would garner more informative results. To this end, 3 different methods of assessing S-E (1 relative and 2 absolute S-E) were investigated to determine their effectiveness and validity for distinguishing between rugby league players of different ranking. In study 1, 26 players of similar strength, but different playing ranking, performed a bench press test with a resistance of 60% of their 1RM to determine if any differences existed between the groups in how many repetitions could be completed with the same relative percentage resistance. The fact that no significant difference existed between the groups in repetitions performed indicated that this test of relative S-E did not differentiate playing rank in rugby league. In study 2, 38 subjects performed tests with absolute resistances of 60 and 102.5 kg (bench press repetitions-to-fatigue (BP RTF) 60 and 102.5, respectively) in an effort to determine the merits of absolute S-E testing. Both tests significantly differentiated playing rank, but on the basis of how many repetitions were performed, only the BP RTF 60 could be considered a valid test of S-E. Absolute S-E testing with a moderate resistance of 60 kg appears to be a valid and effective test for discriminating playing rank in rugby league players.
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Affiliation(s)
- Daniel G Baker
- School of Biomedical and Sports Science, Edith Cowan University, Joodalup, 6027 Western Australia, Australia.
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Simmons AN, Matthews SC, Strigo IA, Donovan H, Baker DG, Paulus MP. Anticipatory processing in combat related PTSD. Neuroimage 2009. [DOI: 10.1016/s1053-8119(09)72146-9] [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: 11/26/2022] Open
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Visvanathan S, Wagner C, Rojas J, Kay J, Dasgupta B, Matteson EL, Mack M, Baker DG, Rahman MU. E-selectin, interleukin 18, serum amyloid a, and matrix metalloproteinase 9 are associated with clinical response to golimumab plus methotrexate in patients with active rheumatoid arthritis despite methotrexate therapy. J Rheumatol 2009; 36:1371-9. [PMID: 19487269 DOI: 10.3899/jrheum.080755] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To assess the effect of golimumab (human monoclonal antibody to tumor necrosis factor-alpha) plus methotrexate (MTX) on selected inflammatory biomarkers, and to determine if these effects predict clinical response in rheumatoid arthritis (RA). METHODS Sera from adults with active RA despite MTX therapy, who received subcutaneous injections of placebo + MTX (MTX alone, n = 34) or golimumab 50 or 100 mg every 2 or 4 weeks + MTX (n = 137), were analyzed for levels of C-reactive protein (CRP), serum amyloid A (SAA), interleukin 18 (IL-18), E-selectin, matrix metalloproteinase 9 (MMP-9), and tissue inhibitor of matrix metalloproteinase 1 (TIMP-1). RESULTS Golimumab + MTX treatment significantly decreased serum CRP, SAA, IL-18, E-selectin, TIMP-1, and MMP-9 levels (median percent changes of -4.1% to -74.3% across treatment groups) versus MTX alone (-5.8% to 9.7%) when first measured at Week 4; decreases were sustained through Week 16. Larger magnitudes of decrease in all biomarkers were observed for clinical responders versus nonresponders. For golimumab + MTX, regression analyses including all biomarkers and select clinical measures showed that reductions in levels of several markers (SAA, E-selectin, MMP-9) as early as Week 4 correlated significantly with improvement in swollen joint count (SJC) at Week 16, as did reductions in E-selectin with improvement in tender joint count at Week 16. After accounting for the biomarkers, however, treatment group was no longer significant for SJC. CONCLUSION Significant decreases in several inflammatory biomarkers were associated with golimumab + MTX therapy. Decreases in serum levels of SAA, E-selectin, and MMP-9 at Week 4 may be useful in predicting clinical response at Week 16.
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Affiliation(s)
- Sudha Visvanathan
- Centocor Research and Development, Inc., Malvern, Pennsylvania, USA.
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Baker DG, Newton RU. Change in power output across a high-repetition set of bench throws and jump squats in highly trained athletes. J Strength Cond Res 2008; 21:1007-11. [PMID: 18076274 DOI: 10.1519/r-22376.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Athletes experienced in maximal-power and power-endurance training performed 1 set of 2 common power training exercises in an effort to determine the effects of moderately high repetitions upon power output levels throughout the set. Twenty-four and 15 athletes, respectively, performed a set of 10 repetitions in both the bench throw (BT P60) and jump squat exercise (JS P60) with a resistance of 60 kg. For both exercises, power output was highest on either the second (JS P60) or the third repetition (BT P60) and was then maintained until the fifth repetition. Significant declines in power output occurred from the sixth repetition onwards until the 10th repetition (11.2% for BT P60 and 5% for JS P60 by the 10th repetition). These findings suggest that athletes attempting to increase maximal power limit their repetitions to 2 to 5 when using resistances of 35 to 45% 1RM in these exercises.
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Affiliation(s)
- Daniel G Baker
- School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Perth, Western Australia.
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Visvanathan S, van der Heijde D, Deodhar A, Wagner C, Baker DG, Han J, Braun J. Effects of infliximab on markers of inflammation and bone turnover and associations with bone mineral density in patients with ankylosing spondylitis. Ann Rheum Dis 2008; 68:175-82. [PMID: 18495735 PMCID: PMC2605572 DOI: 10.1136/ard.2007.084426] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.0] [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] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To evaluate the relationship between bone mineral density (BMD) and biomarkers of bone turnover and inflammation in patients with ankylosing spondylitis (AS) treated with infliximab. METHODS Patients (n = 279) were randomly assigned (3:8) to receive placebo or 5 mg/kg infliximab every 6 weeks through week 96. At week 24, placebo-treated patients crossed over to infliximab 5 mg/kg. Starting at week 36, patients treated with infliximab received dose escalations to 7.5 mg/kg. Hip and spine BMD were measured (baseline, week 24, week 102) using dual-energy x-ray absorptiometry. Sera were analysed (baseline, week 24, week 102) for levels of bone alkaline phosphatase (BAP), osteocalcin, C-terminal cross-linking telopeptide of type I collagen (CTX), interleukin-6 (IL-6), vascular endothelial growth factor (VEGF) and transforming growth factor-beta. RESULTS Patients treated with infliximab showed significantly greater median increases in BMD of the spine (2.5%, p<0.001) and hip (0.5%, p = 0.033) at week 24 than those who received placebo (0.5% and 0.2% respectively). Baseline levels of IL-6, VEGF, osteocalcin, BAP and CTX were significantly correlated with increases in spinal BMD at weeks 24 and 102 in the infliximab group. In a multiple regression analysis, high baseline osteocalcin levels and early increases in BAP at week 2 were significantly associated with increases in BMD scores of the spine (week 102) and hip (weeks 24 and 102) in the infliximab group. CONCLUSIONS Patients with AS who received infliximab showed significant increases in BMD scores over 2 years. While many significant correlations were observed between BMD scores of the hip and spine and biomarker levels, high baseline osteocalcin levels and early increases in BAP were consistently associated with increases in BMD scores.
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Affiliation(s)
- S Visvanathan
- Centocor Research and Development, Inc., 200 Great Valley Parkway, Mailstop RA-1-4, Malvern, PA 19355, USA.
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Baker DG, Newton RU. Comparison of Lower Body Strength, Power, Acceleration, Speed, Agility, and Sprint Momentum to Describe and Compare Playing Rank among Professional Rugby League Players. J Strength Cond Res 2008; 22:153-8. [DOI: 10.1519/jsc.0b013e31815f9519] [Citation(s) in RCA: 184] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Visvanathan S, Keenan GF, Baker DG, Levinson AI, Wagner CL. Response to pneumococcal vaccine in patients with early rheumatoid arthritis receiving infliximab plus methotrexate or methotrexate alone. J Rheumatol 2007; 34:952-7. [PMID: 17444589] [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: 05/15/2023]
Abstract
OBJECTIVE We assessed whether the addition of anti-tumor necrosis factor (TNF) agent to methotrexate (MTX) therapy might alter the response of patients with rheumatoid arthritis (RA) to pneumococcal vaccination. METHODS Seventy patients with early RA (n = 20, 36, and 14 in the infliximab 3 mg/kg plus MTX, infliximab 6 mg/kg plus MTX, and placebo plus MTX groups, respectively) were included in an analysis of patients enrolled in an ASPIRE substudy. Patients received 0.5 ml pneumococcal vaccine (Pneumovax) 34 weeks after initiation of study treatment; patient sera were collected 4 weeks later (week 38). Antibody responses were tested using enzyme immunoassay methods for reactivity to a panel of 12 serotypes of the pneumococcal vaccine. RESULTS No significant difference in response to Pneumovax was observed between the infliximab plus MTX and placebo plus MTX groups. Roughly 80%-85% of patients responded to at least one serotype; however, only 20%-25% of patients in the different treatment groups responded to at least 6 different serotypes. Comparable proportions of patients in the 3 treatment groups responded to an increasing number (> or = 1 to > or = 6) of different serotypes. Patients < 45 years of age and those receiving oral corticosteroids generally appeared to respond better than those age 45 to 65 years and those not receiving oral corticosteroids. CONCLUSION All treatment groups in this study had lower responses to vaccine than would be expected in the normal population. However, the addition of the anti-TNF agent infliximab to MTX therapy did not appear to affect the response of patients with RA to pneumococcal vaccination.
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Affiliation(s)
- Sudha Visvanathan
- Clinical Pharmacology and Experimental Medicine, Medical Affairs, and Immunology, Centocor Research and Development, Inc., Malvern, Pennsylvania 19355, USA
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Baker DG, Newton RU. Adaptations in upper-body maximal strength and power output resulting from long-term resistance training in experienced strength-power athletes. J Strength Cond Res 2006; 20:541-6. [PMID: 16937966 DOI: 10.1519/r-16024.1] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The purpose of this investigation was to observe changes in maximal upper-body strength and power and shifts in the load-power curve across a multiyear period in experienced resistance trainers. Twelve professional rugby league players who regularly performed combined maximal strength and power training were observed across a 4-year period with test data reported every 2 years (years 1998, 2000, and 2002). Upper-body strength was assessed by the 1 repetition maximum bench press and maximum power during bench press throws (BT Pmax) with various barbell resistances of 40-80 kg. During the initial testing, players also were identified as elite (n = 6) or subelite (n = 6), depending upon whether they participated in the elite first-division national league or second-division league. This subgrouping allowed for a comparison of the scope of changes dependent upon initial strength and training experience. The subelite group was significantly younger, less strong, and less powerful than the elite group, but no other difference existed in height or body mass in 1998. Across the 4-year period, significant increases in strength occurred for the group as a whole and larger increases were observed for the subelite than the elite group, verifying the limited scope that exists for strength gain in more experienced, elite resistance-trained athletes. A similar trend occurred for changes in BT Pmax. This long-term observation confirms that the rate of progress in strength and power development diminishes with increased strength levels and resistance training experience. Furthermore, it also indicates that strength and power can still be increased despite a high volume of concurrent resistance and endurance training.
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Affiliation(s)
- Daniel G Baker
- School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Joondalup, Australia.
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Boudreau MD, Taylor HW, Baker DG, Means JC. Dietary Exposure to 2-Aminoanthracene Induces Morphological and Immunocytochemical Changes in Pancreatic Tissues of Fisher-344 Rats. Toxicol Sci 2006; 93:50-61. [PMID: 16760417 DOI: 10.1093/toxsci/kfl033] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Toxic chemicals ingested as the result of environmental exposures or other risk factors such as cigarette smoking may increase the risk of developing cancer and other diseases such as diabetes. 2-Aminoanthracene (2-AA) was investigated to determine toxic effects of chronic dietary exposure upon major organ systems including the pancreas. Fisher-344 rats were fed 2-AA (50-100 mg/kg of diet) and euthanized at 14, 30, 63, and 80 days. Growth, tissue histological, immunocytochemical, and clinical pathological end points were examined at each time point. Significantly elevated plasma glucose and glycated hemoglobins and reduced serum protein levels were recognized after 80 days of feeding (100 mg/kg of diet 2-AA group). Similar results were observed in rats exposed to 75 mg/kg of diet but appeared to be absent in the 50-mg/kg group. An unexpected pattern of responses suggestive of diabetic sequelae was observed in a glucose tolerance test conducted during the seventh week. After 63 and 80 days, large cytoplasmic vacuoles in islet cells were observed by light microscopy. In addition, the immunocytochemical study demonstrated beta cell insulin insufficiency at 63 and 80 days. No inflammatory infiltration of the islets was observed. These findings suggest that depletion of secretory granules occurred in the beta cells. Necrotic changes occurred in the acinar cells of the pancreas with increasing duration and dose of 2-AA. The cytological, immunocytochemical, and histological results demonstrate that chronic dietary exposure to 2-amino anthracene alters the endocrine and exocrine pancreas cellular morphology and induces diabetic-like symptoms in the Fisher-344 rat.
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Affiliation(s)
- M D Boudreau
- Department of Physiology, Louisiana State University, School of Veterinary Medicine, Baton Rouge, Louisiana 70803, USA
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Abstract
It has been posited that certain balances in strength should exist for opposing muscle groups (e.g., hamstrings and quadriceps) or actions (e.g., internal and external rotation of the shoulder) to improve sports performance or limit the likelihood of injury. Typically, expensive laboratory equipment such as isokinetic devices has been used to evaluate strength balances. The purpose of this study was to determine if two popular field tests of strength could be used to assess a concise strength balance in roughly opposing muscle actions for the shoulder girdle. The two opposing movement actions of pressing away from the shoulder girdle and pulling in towards the shoulder girdle were assessed via the 1 repetition maximum bench press (1RM BP) and 1 repetition maximum pull-up (1RM PU), respectively. Forty-two rugby league players, comprising 21 national league (NRL) and 21 state league (SRL) players, who regularly performed both exercises in their training, served as subjects in this investigation. The equivalence of the strength ratio (BP/PU x 100) and correlation between tests were also examined. The pooled data exhibited a strength ratio of 97.7% (9.0%) and correlation of r = 0.81 between the 1RM BP of 130.1 +/- 20.2 kg and 1RM PU of 133.1 +/- 17.1 kg. The small standard deviation exhibited tends to indicate that athletes should exhibit a concise ratio of around 100% if pressing and pulling strength have been addressed fairly equally in training. However, some athletes may have body types, preexisting injuries, or training histories that predispose them to either excelling or performing poorly during strength activities for either upper body pressing or pulling actions, with differences in strength of up to 15% existing in some individuals. These factors need to be taken into account when prescribing training based upon the strength ratio between pressing and pulling strength.
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Affiliation(s)
- Daniel G Baker
- School of Biomedical and Sport Science, Edith Cowan University, Joondalup, Australia.
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Baker DG, Newton RU. An Analysis of the Ratio and Relationship Between Upper Body Pressing and Pulling Strength. J Strength Cond Res 2004. [DOI: 10.1519/00124278-200408000-00036] [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: 11/08/2022]
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Gottlieb AB, Chaudhari U, Mulcahy LD, Li S, Dooley LT, Baker DG. Infliximab monotherapy provides rapid and sustained benefit for plaque-type psoriasis. J Am Acad Dermatol 2003; 48:829-35. [PMID: 12789171 DOI: 10.1067/mjd.2003.307] [Citation(s) in RCA: 124] [Impact Index Per Article: 5.9] [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: 11/22/2022]
Abstract
BACKGROUND Effective, rapid-acting, safe therapies are needed for the long-term treatment of psoriasis. OBJECTIVE We sought to evaluate infliximab monotherapy in maintaining clinical benefit in psoriasis. METHODS A total of 33 patients received 3 doses of 5 or 10 mg/kg of infliximab or placebo at weeks 0, 2, and 6 (double-blind phase). During the open-label phase (weeks 10-26), responding patients were evaluated for relapse (loss of at least half of the improvement in the Psoriasis Area Severity Index score at week 10) and retreated with open-label infliximab (5 or 10 mg/kg) as needed. Placebo nonresponders were treated with an induction regimen of infliximab (5 or 10 mg/kg) and followed up through week 26. RESULTS In all, 29 patients received either 5 or 10 mg/kg of infliximab in the open-label extension. At week 26, psoriasis area severity index response was maintained in 40% and 73% of patients receiving 5 and 10 mg/kg of infliximab, respectively. CONCLUSION Infliximab produced a rapid, effective, and sustainable (through week 26) effect in patients with moderate to severe psoriasis.
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Affiliation(s)
- Alice B Gottlieb
- Clinical Research Center, University of Medicine and Dentistry of New Jersey-The Robert Wood Johnson Medical School, New Brunswick, NJ 08901-0019, USA.
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Abstract
OBJECTIVES (1) To replicate a study of the efficacy of Argentum nitricum 12X in the reduction of test anxiety as demonstrated previously. (2) To investigate the correlation between individuals identified to match the A. nitricum profile and the reduction of test anxiety. To compare traditionally prepared homeopathic A. nitricum 12X with radionically-prepared A. nitricum 12X and placebo. DESIGN A double blind, placebo-controlled, randomised clinical trial with three arms. SETTING The study was conducted at Southern Cross University, Lismore, Australia. SUBJECTS Sixty-two test anxious university students. INTERVENTIONS Subjects were randomised to one of three groups: traditionally prepared homeopathic A. nitricum 12X, radionically-prepared A. nitricum 12X, or placebo. After screening, each group received treatment twice a day for 4 days after which they were re-tested. OUTCOME MEASURES Primary: The Revised Test Anxiety Scale. Secondary: The Test Anxiety Scale; 36-item A. nitricum questionnaire. RESULTS The results of this study did not replicate the Stanton study. No correlation between the reduction of test anxiety and the A. nitricum profile was demonstrated. No significant differences between treatments were demonstrated. CONCLUSION This study demonstrated that homeopathic A. nitricum 12X does not reduce test anxiety in a general population of university students.
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Affiliation(s)
- D G Baker
- School of Natural and Complementary Medicine, Southern Cross University, Lismore, Australia.
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Gottlieb AB, Chaudhari U, Baker DG, Perate M, Dooley LT. The National Psoriasis Foundation Psoriasis Score (NPF-PS) system versus the Psoriasis Area Severity Index (PASI) and Physician's Global Assessment (PGA): a comparison. J Drugs Dermatol 2003; 2:260-6. [PMID: 12848110] [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: 03/03/2023]
Abstract
The Psoriasis Area and Severity Index (PASI) and Physician Global Assessment (PGA) are commonly used, but fail to measure quality of life and the patient's perception of well-being. In response to these limitations, the National Psoriasis Foundation (NPF) Medical Advisory Board has developed the NPF Psoriasis Score (NPF-PS). This article evaluates the degree of concordance between NPF-PS, PASI, and PGA scores via an investigator-initiated, single-center, double-blind, placebo-controlled study of thirty-three patients with moderate to severe plaque psoriasis. Our results indicated that NPF-PS was strongly correlated with PASI and PGA in this study, while better reflecting patient perception. This is the first report of a double-blind placebo-controlled study demonstrating this concordance.
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Affiliation(s)
- Alice B Gottlieb
- Clinical Research Center, UMDNJ-Robert Wood Johnson Medical School, 51 French Street, New Brunswick, NJ 08901-0019, USA.
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LeBlanc KA, Bellanger D, Rhynes KV, Baker DG, Stout RW. Tissue attachment strength of prosthetic meshes used in ventral and incisional hernia repair. A study in the New Zealand White rabbit adhesion model. Surg Endosc 2002; 16:1542-6. [PMID: 12098033 DOI: 10.1007/s00464-001-8271-y] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.9] [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: 02/25/2002] [Accepted: 03/05/2002] [Indexed: 10/27/2022]
Abstract
BACKGROUND Many prosthetic materials are used in incisional hernia repair, including polypropylene (PP) and expanded polytetrafluoroethylene (ePTFE). However, PP forms severe adhesions and ePTFE has raised concerns about the adequacy of tissue attachment. METHODS The early tissue attachment strength of PP and two new forms of ePTFE (DLM and DLMC) was compared in a rabbit model (n = 12) in which disks of the three meshes (n = 8 of each material) were implanted against the abdominal wall for 3 days. RESULTS Tensiometer testing found that DLMC mesh had significantly greater attachment strength than PP (p = 0.02). Histologic studies indicated that this was due to cellular ingrowth. Tissue adhesions were observed with all eight PP disks, one DLMC disk, and none of the DLM disks. CONCLUSION Modified forms of ePTFE mesh may provide abdominal wall repairs that are as strong or stronger than those obtained with PP, with early tissue attachment and without adhesions.
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Affiliation(s)
- K A LeBlanc
- Surgical Specialty Group, Medical Plaza, Suite 612, 7777 Hennessy Boulevard, Suite 612, Baton Rouge, LA 70808, USA.
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45
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Strawn JR, Ekhator NN, Anthenelli RM, Baker DG, Maxwell RA, Hill KK, Geracioti TD. Intra- and inter-individual relationships between central and peripheral serotonergic activity in humans: a serial cerebrospinal fluid sampling study. Life Sci 2002; 71:1219-25. [PMID: 12095542 DOI: 10.1016/s0024-3205(02)01828-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [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: 11/27/2022]
Abstract
Data are lacking concerning the longitudinal covariability and cross-sectional balance between central and peripheral 5-HIAA concentrations in humans and on the possible associations between tobacco smoking or post-traumatic stress disorder (PTSD) and CSF and plasma 5-HIAA concentrations. Using serial cerebrospinal fluid (CSF) and blood sampling, we determined the concentrations of 5-HIAA in CSF and plasma over 6 h, and examined their relationships in healthy volunteers and patients with PTSD-both smokers and nonsmokers. Patients with PTSD and healthy volunteers had very similar CSF 5-HIAA concentrations. Significant and positive correlations between CSF and plasma 5-HIAA levels were observed within individuals, but this CNS-peripheral 5-HIAA relationship was significantly reduced in smokers (nonsmokers: mean r = 0.559 +/- 0.072; smokers: mean r = 0.329 +/- 0.064 p < 0.038). No significant cross-sectional, interindividual correlation of mean CSF and mean plasma 5-HIAA was seen (r = 0.094). These data show that changes in CSF 5-HIAA levels within an individual over time are largely reflected in plasma 5-HIAA, albeit significantly less so in smokers. The present results therefore suggest that clinically, longitudinal determination of plasma 5-HIAA concentrations within an individual patient can be used to make inferences about relative changes in integrated CSF 5-HIAA concentrations. However, plasma 5-HIAA concentrations provide no significant information about absolute levels of the serotonin metabolite in the CSF.
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Affiliation(s)
- J R Strawn
- Department of Psychiatry, Cincinnati VAMC and University of Cincinnati College of Medicine, Cincinnati, OH, USA.
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46
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Schlesinger N, Detry MA, Holland BK, Baker DG, Beutler AM, Rull M, Hoffman BI, Schumacher HR. Local ice therapy during bouts of acute gouty arthritis. J Rheumatol 2002; 29:331-4. [PMID: 11838852] [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: 02/23/2023]
Abstract
OBJECTIVE To evaluate the effect of local application of ice on duration and severity of acute gouty arthritis. METHODS Nineteen patients with acute gout were enrolled and randomized into 2 groups. Group A (n = 10) received topical ice therapy, oral prednisone 30 mg PO tapered to 0 over 6 days and colchicine 0.6 mg/day. Group B was the control group (n = 9), given the same regimen but without the ice therapy. The patients were followed for one week. RESULTS The mean reduction in pain for those patients treated with ice therapy was 7.75 cm (on 10 cm visual analog scale) with standard deviation +/- 2.58 compared with 4.42 cm (+/- SD 2.96) for the control group. Using a Wilcoxon rank-sum test there was a significant difference (p = 0.021 ) in pain reduction between the ice therapy and control groups. Joint circumference and synovial fluid volume also tended to be more effectively reduced after one week of therapy in the ice group compared with controls, but these did not achieve statistical significance. CONCLUSION The group treated with ice had a significantly greater reduction in pain compared with the control group. Although the clinical improvement was impressive, due to the small sample size we could not show statistically significant improvement in all the variables that tended to suggest that effect was more than simply analgesic. Cold applications may be a useful adjunct to treatment of acute gouty arthritis.
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Affiliation(s)
- Naomi Schlesinger
- Department of Medicine and New Jersey Medical School-University of Medicine and Dentistry of New Jersey, Newark, USA
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47
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Stout RW, Cho DY, Gaunt SD, Taylor HW, Baker DG. Transcutaneous blood gas monitoring in the rat. Comp Med 2001; 51:524-33. [PMID: 11924815] [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: 02/24/2023]
Abstract
Transcutaneous blood gas (TCBG) analysis is a noninvasive alternative method of estimation of blood gas tensions. The objective of the study reported here was to validate this method against standard blood gas (STBG) analysis in adult and juvenile Sprague-Dawley rats. We sought to establish the optimal TCBG probe site and temperature, to establish probe temperatures that would not cause thermal burns, to evaluate correlations between blood gas values (PaCO2 and PaO2) determined by use of TCBG and STBG, and to evaluate the sensitivity of the TCBG unit to changes in arterial blood gas partial pressures. Our results indicated that: in general, the xyphoid area was the optimal site for probe placement, with 44.5 degrees C being the optimal probe temperature for the highest correlation, but thermal burns may be a problem; probe temperatures of 42.5 degrees C (adults) and 42.0 degrees C (juveniles) do not cause thermal burns when left in place for three hours; probe temperatures of 44 degrees C (adults) and 42 degrees C (juveniles) resulted in moderate correlation between PaCO2 and PtcCO2; and the TCBG unit adequately responded to changes in arterial blood gas partial pressures. Neither PtcCO2 or PtcO2 reflect actual values of PaCO2 or PaO2, respectively. We concluded that TCBG analysis may be used as an indicator of change in PaCO2 with sufficient animal numbers under tightly controlled conditions, but not as an indicator of change in PaO2 in adult and juvenile rats.
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Affiliation(s)
- R W Stout
- Department of Pathobiological Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge 70803, USA
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48
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Baker DG, McQuarrie IG, Murray MG, Lund LM, Dashevsky BA, Mendenhall CL. Diagnostic status and treatment recommendations for Persian Gulf War Veterans with multiple nonspecific symptoms. Mil Med 2001; 166:972-81. [PMID: 11725326] [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: 02/22/2023] Open
Abstract
BACKGROUND Unexplained symptoms have frequently been observed in deployed Persian Gulf War veterans (GWVs). Using factor analysis, the Centers for Disease Control and Prevention (CDC) has established criteria for Gulf War illness (GWI). We report here on the prevalence of GWI, identify comorbidities, and compare these with those of veterans without GWI. METHODS GWVs who consented to complete questionnaires and laboratory measures were given complete physical and mental health examinations. Outcome measures included CDC criteria for GWI, the Medical Outcomes Study Short Form 36 (SF-36), clinical and laboratory evaluations, and structured psychiatric interviews. RESULTS One hundred twenty GWVs were enrolled, and 89 received complete physical and mental health examinations; 83% met CDC criteria for GWI. Veterans with GWI (1) were older, (2) reported more combat exposure, (3) scored higher on measures of depression, post-traumatic stress disorder, and fibromyalgia, and (4) had poorer health-related quality of life. More than half had anxiety or depressive disorders, and 93% had at least one medical and/or psychiatric diagnosis. The SF-36 predicted mental health status with a positive predictive value of 81.58. By adding the Hamilton D rating for depression, the positive predictive value increased to 88.57. INTERPRETATION The CDC criteria accurately identified GWVs negative for GWI. Most GWVs were positive for GWI. Neither CDC criteria nor CDC severity rankings distinguish between veterans with psychiatric syndromes and those without: both groups endorsed the same symptoms. More than half of those with GWI had a treatable anxiety or depressive disorder. The SF-36 was a valid predictor of mental health status, particularly when paired with the Hamilton depression interview.
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Affiliation(s)
- D G Baker
- Department of Psychiatry, and Department of Medicine, Cincinnati Veterans Affairs Medical Center, Cincinnati, OH 45220, and University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
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Beutler AM, Rull M, Schlesinger N, Baker DG, Hoffman BI, Schumacher HR. Treatment with allopurinol decreases the number of acute gout attacks despite persistently elevated serum uric acid levels. Clin Exp Rheumatol 2001; 19:595. [PMID: 11579724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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Geracioti TD, Baker DG, Ekhator NN, West SA, Hill KK, Bruce AB, Schmidt D, Rounds-Kugler B, Yehuda R, Keck PE, Kasckow JW. CSF norepinephrine concentrations in posttraumatic stress disorder. Am J Psychiatry 2001; 158:1227-30. [PMID: 11481155 DOI: 10.1176/appi.ajp.158.8.1227] [Citation(s) in RCA: 333] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Despite evidence of hyperresponsive peripheral and central nervous system (CNS) noradrenergic activity in posttraumatic stress disorder (PTSD), direct measures of CNS norepinephrine in PTSD have been lacking. The goal of this study was to determine serial CSF norepinephrine levels in patients with PTSD. METHOD CSF samples were obtained serially over a 6-hour period in 11 male combat veterans with chronic PTSD and eight healthy men through an indwelling subarachnoid catheter. Thus the authors were able to determine hourly CSF norepinephrine concentrations under baseline (unstressed) conditions. Severity of the patients' PTSD symptoms was assessed with the Clinician-Administered PTSD Scale. RESULTS CSF norepinephrine concentrations were significantly higher in the men with PTSD than in the healthy men. Moreover, CSF norepinephrine levels strongly and positively correlated with the severity of PTSD symptoms. Plasma norepinephrine concentrations showed no significant relationship with the severity of PTSD symptoms. CONCLUSIONS These findings reveal the presence of greater CNS noradrenergic activity under baseline conditions in patients with chronic PTSD than in healthy subjects and directly link this pathophysiologic observation with the severity of the clinical posttraumatic stress syndrome.
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Affiliation(s)
- T D Geracioti
- Mental Health Service, Veterans Affairs Medical Center, 3200 Vine St., Cincinnati, OH 45220, USA.
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