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Sarwar S, Tome ME, Billheimer D, Spier C, Smith CL, Persky D, Schmelz M. Optimizing assessment of CD30 expression in Hodgkin lymphoma by controlling for low expression. Histol Histopathol 2024; 39:319-331. [PMID: 37377225 DOI: 10.14670/hh-18-644] [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] [Indexed: 06/29/2023]
Abstract
Since the approval of brentuximab vedotin (BV), assessment of CD30 status by immunohistochemistry gained increasing importance in the clinical management of patients diagnosed with CD30-expressing lymphomas, including classical Hodgkin lymphoma (CHL). Paradoxically, patients with low or no CD30 expression respond to BV. This discrepancy may be due to lack of standardization in CD30 staining methods. In this study, we examined 29 cases of CHL and 4 cases of nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) for CD30 expression using a staining protocol that was designed to detect low CD30 expression levels, and an evaluation system similar to the Allred scoring system used for breast cancer evaluation. For CHL, 10% of cases had low scores and 3% were CD30 negative, with 3 cases in which the majority of tumor cells showed very weak staining. Unexpectedly, one of four cases of NLPHL was positive. We demonstrate intra-patient heterogeneity in CD30 expression levels and staining patterns in tumor cells. Three CHL cases with weak staining may have been missed without the use of control tissue for low expression. Thus, standardization of CD30 immunohistochemical staining with use of known low-expressing controls may aid in proper CD30 assessment and subsequent therapeutic stratification of patients.
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Affiliation(s)
- Shoib Sarwar
- Department of Pathology, University of Arizona, Tucson, AZ, USA
| | - Margaret E Tome
- Department of Pathology, University of Arizona, Tucson, AZ, USA
- Department of Pharmacology, University of Arizona, Tucson, AZ, USA
| | - Dean Billheimer
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, AZ, USA
| | - Catherine Spier
- Department of Pathology, University of Arizona, Tucson, AZ, USA
| | - Catharine L Smith
- Pharmacology and Toxicology, College of Pharmacy, University of Arizona, Tucson, AZ, USA
| | - Daniel Persky
- University of Arizona Cancer Center, Tucson, AZ, USA
| | - Monika Schmelz
- Department of Pathology, University of Arizona, Tucson, AZ, USA.
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Sans-Fuentes M, Sierra LA, Cruz NS, Rubio V, Lutrick K, Hamm K, Connick E, Shroff P, Billheimer D, Sorensen R, Dinsmore A, Wolfersteig W, Ayers S, Nikolich-Zugich J, Doubeni C, Tilburt J, Rosales C, Moreno F, Derksen D, Oesterle S, Sabo S, Parthasarathy S. Temporal Changes in Vaccine-Specific Willingness Across Race/Ethnicity Following Serious Adverse Event Reports. Am J Public Health 2024; 114:S37-S40. [PMID: 37944076 PMCID: PMC10785178 DOI: 10.2105/ajph.2023.307484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2023] [Indexed: 11/12/2023]
Affiliation(s)
- Maria Sans-Fuentes
- Maria Sans-Fuentes, Elizabeth Connick, and Dean Billheimer are with BIO5 Institute, University of Arizona, Tucson. Lidia Azurdia Sierra, Nina Santa Cruz, Victoria Rubio, Puneet Shroff, and Sairam Parthasarathy are with the Department of Medicine, College of Medicine-Tucson, University of Arizona, Tucson. Karen Lutrick and Cecilia Rosales are with the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson. Kathryn Hamm, Wendy Wolfersteig, Stephanie Ayers, and Sabrina Oesterle are with the Southwest Interdisciplinary Research Center, Arizona State University, Phoenix. Ronald Sorensen and Alicia Dinsmore are with the Department of Family and Community Medicine, University of Arizona, Tucson. Janko Nikolich-Zugich is with the Department of Immunobiology, University of Arizona, Tucson. Chyke Doubeni and Jon Tilburt are with the Department of Family and Community Medicine, Mayo Clinic, Scottsdale, AZ. Francisco Moreno and Daniel Derksen are with the University of Arizona Health Sciences, Tucson. Samantha Sabo is with the Center for Health Equity Research, Northern Arizona University, Flagstaff
| | - Lidia Azurdia Sierra
- Maria Sans-Fuentes, Elizabeth Connick, and Dean Billheimer are with BIO5 Institute, University of Arizona, Tucson. Lidia Azurdia Sierra, Nina Santa Cruz, Victoria Rubio, Puneet Shroff, and Sairam Parthasarathy are with the Department of Medicine, College of Medicine-Tucson, University of Arizona, Tucson. Karen Lutrick and Cecilia Rosales are with the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson. Kathryn Hamm, Wendy Wolfersteig, Stephanie Ayers, and Sabrina Oesterle are with the Southwest Interdisciplinary Research Center, Arizona State University, Phoenix. Ronald Sorensen and Alicia Dinsmore are with the Department of Family and Community Medicine, University of Arizona, Tucson. Janko Nikolich-Zugich is with the Department of Immunobiology, University of Arizona, Tucson. Chyke Doubeni and Jon Tilburt are with the Department of Family and Community Medicine, Mayo Clinic, Scottsdale, AZ. Francisco Moreno and Daniel Derksen are with the University of Arizona Health Sciences, Tucson. Samantha Sabo is with the Center for Health Equity Research, Northern Arizona University, Flagstaff
| | - Nina Santa Cruz
- Maria Sans-Fuentes, Elizabeth Connick, and Dean Billheimer are with BIO5 Institute, University of Arizona, Tucson. Lidia Azurdia Sierra, Nina Santa Cruz, Victoria Rubio, Puneet Shroff, and Sairam Parthasarathy are with the Department of Medicine, College of Medicine-Tucson, University of Arizona, Tucson. Karen Lutrick and Cecilia Rosales are with the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson. Kathryn Hamm, Wendy Wolfersteig, Stephanie Ayers, and Sabrina Oesterle are with the Southwest Interdisciplinary Research Center, Arizona State University, Phoenix. Ronald Sorensen and Alicia Dinsmore are with the Department of Family and Community Medicine, University of Arizona, Tucson. Janko Nikolich-Zugich is with the Department of Immunobiology, University of Arizona, Tucson. Chyke Doubeni and Jon Tilburt are with the Department of Family and Community Medicine, Mayo Clinic, Scottsdale, AZ. Francisco Moreno and Daniel Derksen are with the University of Arizona Health Sciences, Tucson. Samantha Sabo is with the Center for Health Equity Research, Northern Arizona University, Flagstaff
| | - Victoria Rubio
- Maria Sans-Fuentes, Elizabeth Connick, and Dean Billheimer are with BIO5 Institute, University of Arizona, Tucson. Lidia Azurdia Sierra, Nina Santa Cruz, Victoria Rubio, Puneet Shroff, and Sairam Parthasarathy are with the Department of Medicine, College of Medicine-Tucson, University of Arizona, Tucson. Karen Lutrick and Cecilia Rosales are with the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson. Kathryn Hamm, Wendy Wolfersteig, Stephanie Ayers, and Sabrina Oesterle are with the Southwest Interdisciplinary Research Center, Arizona State University, Phoenix. Ronald Sorensen and Alicia Dinsmore are with the Department of Family and Community Medicine, University of Arizona, Tucson. Janko Nikolich-Zugich is with the Department of Immunobiology, University of Arizona, Tucson. Chyke Doubeni and Jon Tilburt are with the Department of Family and Community Medicine, Mayo Clinic, Scottsdale, AZ. Francisco Moreno and Daniel Derksen are with the University of Arizona Health Sciences, Tucson. Samantha Sabo is with the Center for Health Equity Research, Northern Arizona University, Flagstaff
| | - Karen Lutrick
- Maria Sans-Fuentes, Elizabeth Connick, and Dean Billheimer are with BIO5 Institute, University of Arizona, Tucson. Lidia Azurdia Sierra, Nina Santa Cruz, Victoria Rubio, Puneet Shroff, and Sairam Parthasarathy are with the Department of Medicine, College of Medicine-Tucson, University of Arizona, Tucson. Karen Lutrick and Cecilia Rosales are with the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson. Kathryn Hamm, Wendy Wolfersteig, Stephanie Ayers, and Sabrina Oesterle are with the Southwest Interdisciplinary Research Center, Arizona State University, Phoenix. Ronald Sorensen and Alicia Dinsmore are with the Department of Family and Community Medicine, University of Arizona, Tucson. Janko Nikolich-Zugich is with the Department of Immunobiology, University of Arizona, Tucson. Chyke Doubeni and Jon Tilburt are with the Department of Family and Community Medicine, Mayo Clinic, Scottsdale, AZ. Francisco Moreno and Daniel Derksen are with the University of Arizona Health Sciences, Tucson. Samantha Sabo is with the Center for Health Equity Research, Northern Arizona University, Flagstaff
| | - Kathryn Hamm
- Maria Sans-Fuentes, Elizabeth Connick, and Dean Billheimer are with BIO5 Institute, University of Arizona, Tucson. Lidia Azurdia Sierra, Nina Santa Cruz, Victoria Rubio, Puneet Shroff, and Sairam Parthasarathy are with the Department of Medicine, College of Medicine-Tucson, University of Arizona, Tucson. Karen Lutrick and Cecilia Rosales are with the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson. Kathryn Hamm, Wendy Wolfersteig, Stephanie Ayers, and Sabrina Oesterle are with the Southwest Interdisciplinary Research Center, Arizona State University, Phoenix. Ronald Sorensen and Alicia Dinsmore are with the Department of Family and Community Medicine, University of Arizona, Tucson. Janko Nikolich-Zugich is with the Department of Immunobiology, University of Arizona, Tucson. Chyke Doubeni and Jon Tilburt are with the Department of Family and Community Medicine, Mayo Clinic, Scottsdale, AZ. Francisco Moreno and Daniel Derksen are with the University of Arizona Health Sciences, Tucson. Samantha Sabo is with the Center for Health Equity Research, Northern Arizona University, Flagstaff
| | - Elizabeth Connick
- Maria Sans-Fuentes, Elizabeth Connick, and Dean Billheimer are with BIO5 Institute, University of Arizona, Tucson. Lidia Azurdia Sierra, Nina Santa Cruz, Victoria Rubio, Puneet Shroff, and Sairam Parthasarathy are with the Department of Medicine, College of Medicine-Tucson, University of Arizona, Tucson. Karen Lutrick and Cecilia Rosales are with the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson. Kathryn Hamm, Wendy Wolfersteig, Stephanie Ayers, and Sabrina Oesterle are with the Southwest Interdisciplinary Research Center, Arizona State University, Phoenix. Ronald Sorensen and Alicia Dinsmore are with the Department of Family and Community Medicine, University of Arizona, Tucson. Janko Nikolich-Zugich is with the Department of Immunobiology, University of Arizona, Tucson. Chyke Doubeni and Jon Tilburt are with the Department of Family and Community Medicine, Mayo Clinic, Scottsdale, AZ. Francisco Moreno and Daniel Derksen are with the University of Arizona Health Sciences, Tucson. Samantha Sabo is with the Center for Health Equity Research, Northern Arizona University, Flagstaff
| | - Puneet Shroff
- Maria Sans-Fuentes, Elizabeth Connick, and Dean Billheimer are with BIO5 Institute, University of Arizona, Tucson. Lidia Azurdia Sierra, Nina Santa Cruz, Victoria Rubio, Puneet Shroff, and Sairam Parthasarathy are with the Department of Medicine, College of Medicine-Tucson, University of Arizona, Tucson. Karen Lutrick and Cecilia Rosales are with the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson. Kathryn Hamm, Wendy Wolfersteig, Stephanie Ayers, and Sabrina Oesterle are with the Southwest Interdisciplinary Research Center, Arizona State University, Phoenix. Ronald Sorensen and Alicia Dinsmore are with the Department of Family and Community Medicine, University of Arizona, Tucson. Janko Nikolich-Zugich is with the Department of Immunobiology, University of Arizona, Tucson. Chyke Doubeni and Jon Tilburt are with the Department of Family and Community Medicine, Mayo Clinic, Scottsdale, AZ. Francisco Moreno and Daniel Derksen are with the University of Arizona Health Sciences, Tucson. Samantha Sabo is with the Center for Health Equity Research, Northern Arizona University, Flagstaff
| | - Dean Billheimer
- Maria Sans-Fuentes, Elizabeth Connick, and Dean Billheimer are with BIO5 Institute, University of Arizona, Tucson. Lidia Azurdia Sierra, Nina Santa Cruz, Victoria Rubio, Puneet Shroff, and Sairam Parthasarathy are with the Department of Medicine, College of Medicine-Tucson, University of Arizona, Tucson. Karen Lutrick and Cecilia Rosales are with the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson. Kathryn Hamm, Wendy Wolfersteig, Stephanie Ayers, and Sabrina Oesterle are with the Southwest Interdisciplinary Research Center, Arizona State University, Phoenix. Ronald Sorensen and Alicia Dinsmore are with the Department of Family and Community Medicine, University of Arizona, Tucson. Janko Nikolich-Zugich is with the Department of Immunobiology, University of Arizona, Tucson. Chyke Doubeni and Jon Tilburt are with the Department of Family and Community Medicine, Mayo Clinic, Scottsdale, AZ. Francisco Moreno and Daniel Derksen are with the University of Arizona Health Sciences, Tucson. Samantha Sabo is with the Center for Health Equity Research, Northern Arizona University, Flagstaff
| | - Ronald Sorensen
- Maria Sans-Fuentes, Elizabeth Connick, and Dean Billheimer are with BIO5 Institute, University of Arizona, Tucson. Lidia Azurdia Sierra, Nina Santa Cruz, Victoria Rubio, Puneet Shroff, and Sairam Parthasarathy are with the Department of Medicine, College of Medicine-Tucson, University of Arizona, Tucson. Karen Lutrick and Cecilia Rosales are with the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson. Kathryn Hamm, Wendy Wolfersteig, Stephanie Ayers, and Sabrina Oesterle are with the Southwest Interdisciplinary Research Center, Arizona State University, Phoenix. Ronald Sorensen and Alicia Dinsmore are with the Department of Family and Community Medicine, University of Arizona, Tucson. Janko Nikolich-Zugich is with the Department of Immunobiology, University of Arizona, Tucson. Chyke Doubeni and Jon Tilburt are with the Department of Family and Community Medicine, Mayo Clinic, Scottsdale, AZ. Francisco Moreno and Daniel Derksen are with the University of Arizona Health Sciences, Tucson. Samantha Sabo is with the Center for Health Equity Research, Northern Arizona University, Flagstaff
| | - Alicia Dinsmore
- Maria Sans-Fuentes, Elizabeth Connick, and Dean Billheimer are with BIO5 Institute, University of Arizona, Tucson. Lidia Azurdia Sierra, Nina Santa Cruz, Victoria Rubio, Puneet Shroff, and Sairam Parthasarathy are with the Department of Medicine, College of Medicine-Tucson, University of Arizona, Tucson. Karen Lutrick and Cecilia Rosales are with the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson. Kathryn Hamm, Wendy Wolfersteig, Stephanie Ayers, and Sabrina Oesterle are with the Southwest Interdisciplinary Research Center, Arizona State University, Phoenix. Ronald Sorensen and Alicia Dinsmore are with the Department of Family and Community Medicine, University of Arizona, Tucson. Janko Nikolich-Zugich is with the Department of Immunobiology, University of Arizona, Tucson. Chyke Doubeni and Jon Tilburt are with the Department of Family and Community Medicine, Mayo Clinic, Scottsdale, AZ. Francisco Moreno and Daniel Derksen are with the University of Arizona Health Sciences, Tucson. Samantha Sabo is with the Center for Health Equity Research, Northern Arizona University, Flagstaff
| | - Wendy Wolfersteig
- Maria Sans-Fuentes, Elizabeth Connick, and Dean Billheimer are with BIO5 Institute, University of Arizona, Tucson. Lidia Azurdia Sierra, Nina Santa Cruz, Victoria Rubio, Puneet Shroff, and Sairam Parthasarathy are with the Department of Medicine, College of Medicine-Tucson, University of Arizona, Tucson. Karen Lutrick and Cecilia Rosales are with the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson. Kathryn Hamm, Wendy Wolfersteig, Stephanie Ayers, and Sabrina Oesterle are with the Southwest Interdisciplinary Research Center, Arizona State University, Phoenix. Ronald Sorensen and Alicia Dinsmore are with the Department of Family and Community Medicine, University of Arizona, Tucson. Janko Nikolich-Zugich is with the Department of Immunobiology, University of Arizona, Tucson. Chyke Doubeni and Jon Tilburt are with the Department of Family and Community Medicine, Mayo Clinic, Scottsdale, AZ. Francisco Moreno and Daniel Derksen are with the University of Arizona Health Sciences, Tucson. Samantha Sabo is with the Center for Health Equity Research, Northern Arizona University, Flagstaff
| | - Stephanie Ayers
- Maria Sans-Fuentes, Elizabeth Connick, and Dean Billheimer are with BIO5 Institute, University of Arizona, Tucson. Lidia Azurdia Sierra, Nina Santa Cruz, Victoria Rubio, Puneet Shroff, and Sairam Parthasarathy are with the Department of Medicine, College of Medicine-Tucson, University of Arizona, Tucson. Karen Lutrick and Cecilia Rosales are with the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson. Kathryn Hamm, Wendy Wolfersteig, Stephanie Ayers, and Sabrina Oesterle are with the Southwest Interdisciplinary Research Center, Arizona State University, Phoenix. Ronald Sorensen and Alicia Dinsmore are with the Department of Family and Community Medicine, University of Arizona, Tucson. Janko Nikolich-Zugich is with the Department of Immunobiology, University of Arizona, Tucson. Chyke Doubeni and Jon Tilburt are with the Department of Family and Community Medicine, Mayo Clinic, Scottsdale, AZ. Francisco Moreno and Daniel Derksen are with the University of Arizona Health Sciences, Tucson. Samantha Sabo is with the Center for Health Equity Research, Northern Arizona University, Flagstaff
| | - Janko Nikolich-Zugich
- Maria Sans-Fuentes, Elizabeth Connick, and Dean Billheimer are with BIO5 Institute, University of Arizona, Tucson. Lidia Azurdia Sierra, Nina Santa Cruz, Victoria Rubio, Puneet Shroff, and Sairam Parthasarathy are with the Department of Medicine, College of Medicine-Tucson, University of Arizona, Tucson. Karen Lutrick and Cecilia Rosales are with the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson. Kathryn Hamm, Wendy Wolfersteig, Stephanie Ayers, and Sabrina Oesterle are with the Southwest Interdisciplinary Research Center, Arizona State University, Phoenix. Ronald Sorensen and Alicia Dinsmore are with the Department of Family and Community Medicine, University of Arizona, Tucson. Janko Nikolich-Zugich is with the Department of Immunobiology, University of Arizona, Tucson. Chyke Doubeni and Jon Tilburt are with the Department of Family and Community Medicine, Mayo Clinic, Scottsdale, AZ. Francisco Moreno and Daniel Derksen are with the University of Arizona Health Sciences, Tucson. Samantha Sabo is with the Center for Health Equity Research, Northern Arizona University, Flagstaff
| | - Chyke Doubeni
- Maria Sans-Fuentes, Elizabeth Connick, and Dean Billheimer are with BIO5 Institute, University of Arizona, Tucson. Lidia Azurdia Sierra, Nina Santa Cruz, Victoria Rubio, Puneet Shroff, and Sairam Parthasarathy are with the Department of Medicine, College of Medicine-Tucson, University of Arizona, Tucson. Karen Lutrick and Cecilia Rosales are with the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson. Kathryn Hamm, Wendy Wolfersteig, Stephanie Ayers, and Sabrina Oesterle are with the Southwest Interdisciplinary Research Center, Arizona State University, Phoenix. Ronald Sorensen and Alicia Dinsmore are with the Department of Family and Community Medicine, University of Arizona, Tucson. Janko Nikolich-Zugich is with the Department of Immunobiology, University of Arizona, Tucson. Chyke Doubeni and Jon Tilburt are with the Department of Family and Community Medicine, Mayo Clinic, Scottsdale, AZ. Francisco Moreno and Daniel Derksen are with the University of Arizona Health Sciences, Tucson. Samantha Sabo is with the Center for Health Equity Research, Northern Arizona University, Flagstaff
| | - Jon Tilburt
- Maria Sans-Fuentes, Elizabeth Connick, and Dean Billheimer are with BIO5 Institute, University of Arizona, Tucson. Lidia Azurdia Sierra, Nina Santa Cruz, Victoria Rubio, Puneet Shroff, and Sairam Parthasarathy are with the Department of Medicine, College of Medicine-Tucson, University of Arizona, Tucson. Karen Lutrick and Cecilia Rosales are with the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson. Kathryn Hamm, Wendy Wolfersteig, Stephanie Ayers, and Sabrina Oesterle are with the Southwest Interdisciplinary Research Center, Arizona State University, Phoenix. Ronald Sorensen and Alicia Dinsmore are with the Department of Family and Community Medicine, University of Arizona, Tucson. Janko Nikolich-Zugich is with the Department of Immunobiology, University of Arizona, Tucson. Chyke Doubeni and Jon Tilburt are with the Department of Family and Community Medicine, Mayo Clinic, Scottsdale, AZ. Francisco Moreno and Daniel Derksen are with the University of Arizona Health Sciences, Tucson. Samantha Sabo is with the Center for Health Equity Research, Northern Arizona University, Flagstaff
| | - Cecilia Rosales
- Maria Sans-Fuentes, Elizabeth Connick, and Dean Billheimer are with BIO5 Institute, University of Arizona, Tucson. Lidia Azurdia Sierra, Nina Santa Cruz, Victoria Rubio, Puneet Shroff, and Sairam Parthasarathy are with the Department of Medicine, College of Medicine-Tucson, University of Arizona, Tucson. Karen Lutrick and Cecilia Rosales are with the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson. Kathryn Hamm, Wendy Wolfersteig, Stephanie Ayers, and Sabrina Oesterle are with the Southwest Interdisciplinary Research Center, Arizona State University, Phoenix. Ronald Sorensen and Alicia Dinsmore are with the Department of Family and Community Medicine, University of Arizona, Tucson. Janko Nikolich-Zugich is with the Department of Immunobiology, University of Arizona, Tucson. Chyke Doubeni and Jon Tilburt are with the Department of Family and Community Medicine, Mayo Clinic, Scottsdale, AZ. Francisco Moreno and Daniel Derksen are with the University of Arizona Health Sciences, Tucson. Samantha Sabo is with the Center for Health Equity Research, Northern Arizona University, Flagstaff
| | - Francisco Moreno
- Maria Sans-Fuentes, Elizabeth Connick, and Dean Billheimer are with BIO5 Institute, University of Arizona, Tucson. Lidia Azurdia Sierra, Nina Santa Cruz, Victoria Rubio, Puneet Shroff, and Sairam Parthasarathy are with the Department of Medicine, College of Medicine-Tucson, University of Arizona, Tucson. Karen Lutrick and Cecilia Rosales are with the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson. Kathryn Hamm, Wendy Wolfersteig, Stephanie Ayers, and Sabrina Oesterle are with the Southwest Interdisciplinary Research Center, Arizona State University, Phoenix. Ronald Sorensen and Alicia Dinsmore are with the Department of Family and Community Medicine, University of Arizona, Tucson. Janko Nikolich-Zugich is with the Department of Immunobiology, University of Arizona, Tucson. Chyke Doubeni and Jon Tilburt are with the Department of Family and Community Medicine, Mayo Clinic, Scottsdale, AZ. Francisco Moreno and Daniel Derksen are with the University of Arizona Health Sciences, Tucson. Samantha Sabo is with the Center for Health Equity Research, Northern Arizona University, Flagstaff
| | - Daniel Derksen
- Maria Sans-Fuentes, Elizabeth Connick, and Dean Billheimer are with BIO5 Institute, University of Arizona, Tucson. Lidia Azurdia Sierra, Nina Santa Cruz, Victoria Rubio, Puneet Shroff, and Sairam Parthasarathy are with the Department of Medicine, College of Medicine-Tucson, University of Arizona, Tucson. Karen Lutrick and Cecilia Rosales are with the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson. Kathryn Hamm, Wendy Wolfersteig, Stephanie Ayers, and Sabrina Oesterle are with the Southwest Interdisciplinary Research Center, Arizona State University, Phoenix. Ronald Sorensen and Alicia Dinsmore are with the Department of Family and Community Medicine, University of Arizona, Tucson. Janko Nikolich-Zugich is with the Department of Immunobiology, University of Arizona, Tucson. Chyke Doubeni and Jon Tilburt are with the Department of Family and Community Medicine, Mayo Clinic, Scottsdale, AZ. Francisco Moreno and Daniel Derksen are with the University of Arizona Health Sciences, Tucson. Samantha Sabo is with the Center for Health Equity Research, Northern Arizona University, Flagstaff
| | - Sabrina Oesterle
- Maria Sans-Fuentes, Elizabeth Connick, and Dean Billheimer are with BIO5 Institute, University of Arizona, Tucson. Lidia Azurdia Sierra, Nina Santa Cruz, Victoria Rubio, Puneet Shroff, and Sairam Parthasarathy are with the Department of Medicine, College of Medicine-Tucson, University of Arizona, Tucson. Karen Lutrick and Cecilia Rosales are with the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson. Kathryn Hamm, Wendy Wolfersteig, Stephanie Ayers, and Sabrina Oesterle are with the Southwest Interdisciplinary Research Center, Arizona State University, Phoenix. Ronald Sorensen and Alicia Dinsmore are with the Department of Family and Community Medicine, University of Arizona, Tucson. Janko Nikolich-Zugich is with the Department of Immunobiology, University of Arizona, Tucson. Chyke Doubeni and Jon Tilburt are with the Department of Family and Community Medicine, Mayo Clinic, Scottsdale, AZ. Francisco Moreno and Daniel Derksen are with the University of Arizona Health Sciences, Tucson. Samantha Sabo is with the Center for Health Equity Research, Northern Arizona University, Flagstaff
| | - Samantha Sabo
- Maria Sans-Fuentes, Elizabeth Connick, and Dean Billheimer are with BIO5 Institute, University of Arizona, Tucson. Lidia Azurdia Sierra, Nina Santa Cruz, Victoria Rubio, Puneet Shroff, and Sairam Parthasarathy are with the Department of Medicine, College of Medicine-Tucson, University of Arizona, Tucson. Karen Lutrick and Cecilia Rosales are with the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson. Kathryn Hamm, Wendy Wolfersteig, Stephanie Ayers, and Sabrina Oesterle are with the Southwest Interdisciplinary Research Center, Arizona State University, Phoenix. Ronald Sorensen and Alicia Dinsmore are with the Department of Family and Community Medicine, University of Arizona, Tucson. Janko Nikolich-Zugich is with the Department of Immunobiology, University of Arizona, Tucson. Chyke Doubeni and Jon Tilburt are with the Department of Family and Community Medicine, Mayo Clinic, Scottsdale, AZ. Francisco Moreno and Daniel Derksen are with the University of Arizona Health Sciences, Tucson. Samantha Sabo is with the Center for Health Equity Research, Northern Arizona University, Flagstaff
| | - Sairam Parthasarathy
- Maria Sans-Fuentes, Elizabeth Connick, and Dean Billheimer are with BIO5 Institute, University of Arizona, Tucson. Lidia Azurdia Sierra, Nina Santa Cruz, Victoria Rubio, Puneet Shroff, and Sairam Parthasarathy are with the Department of Medicine, College of Medicine-Tucson, University of Arizona, Tucson. Karen Lutrick and Cecilia Rosales are with the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson. Kathryn Hamm, Wendy Wolfersteig, Stephanie Ayers, and Sabrina Oesterle are with the Southwest Interdisciplinary Research Center, Arizona State University, Phoenix. Ronald Sorensen and Alicia Dinsmore are with the Department of Family and Community Medicine, University of Arizona, Tucson. Janko Nikolich-Zugich is with the Department of Immunobiology, University of Arizona, Tucson. Chyke Doubeni and Jon Tilburt are with the Department of Family and Community Medicine, Mayo Clinic, Scottsdale, AZ. Francisco Moreno and Daniel Derksen are with the University of Arizona Health Sciences, Tucson. Samantha Sabo is with the Center for Health Equity Research, Northern Arizona University, Flagstaff
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Ramírez DM, Gutenkunst S, Lothrop N, Quijada C, Chaires M, Cortez I, Sandoval F, Camargo FJ, Gallardo EV, Torabzadeh E, Wagoner R, Lopez-Galvez N, Ingram M, Billheimer D, Wolf AM, Beamer PI. What a mix! Volatile organic compounds and worker exposure in small business beauty salons in Tucson, Arizona. Front Public Health 2023; 11:1300291. [PMID: 38164445 PMCID: PMC10757921 DOI: 10.3389/fpubh.2023.1300291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 11/24/2023] [Indexed: 01/03/2024] Open
Abstract
Introduction Small business beauty salons have volatile organic compounds (VOCs) in their workplace air. VOCs are present as ingredients in beauty or hair products. They may also form because of chemical reactions, where thermal-styling elements accelerate the volatilization of these compounds. Uncertainties remain about the relationship between air pollutant concentrations and the variety of beauty salon activities in a work shift. Investigating these associations can help determine high-risk services, associated products, and at-risk workers. Methods In this exploratory study, female community health workers recruited beauty salons from target zip codes in predominately Latino neighborhoods, including primarily Spanish-speaking small businesses. We collected salon chemical inventories, business characteristics, and participant activity logs to understand how chemicals and activities influence the total and specific VOC concentrations. We sampled personal total VOCs and specific VOCs from the same shop during the participant work shift. We also measured personal total VOCs for four work shifts per shop. Results A linear mixed effects model of log VOCs on the fixed effect of activity and the random effects of salon and shift within the salon showed that the variance between salons explains over half (55%) of the total variance and is 4.1 times bigger than for shifts within salons. Summa canisters detected 31 specific VOCs, and hazard scores ranged between 0 and 4.3. 2-Propanol (isopropyl alcohol) was the only VOC detected in all shifts of all salons. Discussion In this study, differences in VOC measurements were primarily between salons. These differences may result from differences in ventilation, services rendered, and product lines applied.
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Affiliation(s)
- Denise Moreno Ramírez
- Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, United States
| | | | - Nathan Lothrop
- Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, United States
| | - Carolina Quijada
- Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, United States
| | - Marvin Chaires
- Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, United States
| | - Imelda Cortez
- Sonora Environmental Research Institute, Inc., Tucson, AZ, United States
| | - Flor Sandoval
- Sonora Environmental Research Institute, Inc., Tucson, AZ, United States
| | - Fernanda J. Camargo
- Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, United States
| | - Emma V. Gallardo
- Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, United States
| | - Elmira Torabzadeh
- BIO5 Institute, The University of Arizona, Tucson, AZ, United States
| | - Rietta Wagoner
- Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, United States
| | - Nicolas Lopez-Galvez
- College of Health and Human Services School of Public Health, San Diego State University, San Diego, CA, United States
| | - Maia Ingram
- Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, United States
| | - Dean Billheimer
- Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, United States
- BIO5 Institute, The University of Arizona, Tucson, AZ, United States
| | - Ann Marie Wolf
- Sonora Environmental Research Institute, Inc., Tucson, AZ, United States
| | - Paloma I. Beamer
- Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, United States
- BIO5 Institute, The University of Arizona, Tucson, AZ, United States
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4
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Corenblum MJ, McRobbie-Johnson A, Carruth E, Bernard K, Luo M, Mandarino LJ, Peterson S, Sans-Fuentes MA, Billheimer D, Maley T, Eggers ED, Madhavan L. Parallel neurodegenerative phenotypes in sporadic Parkinson's disease fibroblasts and midbrain dopamine neurons. Prog Neurobiol 2023; 229:102501. [PMID: 37451330 DOI: 10.1016/j.pneurobio.2023.102501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 06/29/2023] [Accepted: 07/10/2023] [Indexed: 07/18/2023]
Abstract
Understanding the mechanisms causing Parkinson's disease (PD) is vital to the development of much needed early diagnostics and therapeutics for this debilitating condition. Here, we report cellular and molecular alterations in skin fibroblasts of late-onset sporadic PD subjects, that were recapitulated in matched induced pluripotent stem cell (iPSC)-derived midbrain dopamine (DA) neurons, reprogrammed from the same fibroblasts. Specific changes in growth, morphology, reactive oxygen species levels, mitochondrial function, and autophagy, were seen in both the PD fibroblasts and DA neurons, as compared to their respective controls. Additionally, significant alterations in alpha synuclein expression and electrical activity were also noted in the PD DA neurons. Interestingly, although the fibroblast and neuronal phenotypes were similar to each other, they differed in their nature and scale. Furthermore, statistical analysis revealed potential novel associations between various clinical measures of the PD subjects and the different fibroblast and neuronal data. In essence, these findings encapsulate spontaneous, in-tandem, disease-related phenotypes in both sporadic PD fibroblasts and iPSC-based DA neurons, from the same patient, and generates an innovative model to investigate PD mechanisms with a view towards rational disease stratification and precision treatments.
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Affiliation(s)
- M J Corenblum
- Department of Neurology, University of Arizona, Tucson, AZ, United States
| | - A McRobbie-Johnson
- Physiological Sciences Graduate Program, University of Arizona, Tucson, AZ, United States
| | - E Carruth
- Physiology Undergraduate Program, University of Arizona, Tucson, AZ, United States
| | - K Bernard
- Physiological Sciences Graduate Program, University of Arizona, Tucson, AZ, United States
| | - M Luo
- Department of Medicine, University of Arizona, Tucson, AZ, United States
| | - L J Mandarino
- Department of Medicine, University of Arizona, Tucson, AZ, United States
| | - S Peterson
- Statistical Consulting Lab, BIO5 Institute, University of Arizona, Tucson, AZ, United States
| | - M A Sans-Fuentes
- Statistical Consulting Lab, BIO5 Institute, University of Arizona, Tucson, AZ, United States
| | - D Billheimer
- Statistical Consulting Lab, BIO5 Institute, University of Arizona, Tucson, AZ, United States
| | - T Maley
- Physiological Sciences Graduate Program, University of Arizona, Tucson, AZ, United States
| | - E D Eggers
- Departments of Physiology and Biomedical Engineering, University of Arizona, Tucson, AZ, United States
| | - L Madhavan
- Department of Neurology, University of Arizona, Tucson, AZ, United States; Evelyn F McKnight Brain Institute and BIO5 Institute, University of Arizona, Tucson, AZ, United States.
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5
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Koska J, Hu Y, Furtado J, Billheimer D, Nedelkov D, Allison M, Budoff MJ, McClelland RL, Reaven P. Association of apolipoproteins C-I and C-II truncations with coronary heart disease and progression of coronary artery calcium: Multi-Ethnic Study of Atherosclerosis. Atherosclerosis 2023; 380:117214. [PMID: 37573768 PMCID: PMC10810047 DOI: 10.1016/j.atherosclerosis.2023.117214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 07/18/2023] [Accepted: 08/02/2023] [Indexed: 08/15/2023]
Abstract
BACKGROUND AND AIMS Higher truncated-to-native proteoform ratios of apolipoproteins (apo) C-I (C-I'/C-I) and C-II (C-II'/C-II) are associated with less atherogenic lipid profiles. We examined prospective relationships of C-I'/C-II and C-II'/C-II with coronary heart disease (CHD) and coronary artery calcium (CAC). METHODS ApoC-I and apoC-II proteoforms were measured by mass spectrometry immunoassay in 5790 MESA baseline plasma samples. CHD events (myocardial infarction, resuscitated cardiac arrest, fatal CHD, n = 434) were evaluated for up to 17 years. CAC was measured 1-4 times over 10 years for incident CAC (if baseline CAC = 0), and changes (follow-up adjusted for baseline) in CAC score and density (if baseline CAC>0). RESULTS C-II'/C-II was inversely associated with CHD (n = 434 events) after adjusting for non-lipid cardiovascular risk factors (Hazard ratio: 0.89 [95% CI: 0.81-0.98] per SD), however, the association was attenuated after further adjustment for HDL levels (0.93 [0.83-1.03]). There was no association between C-I'/C-I and CHD (0.98 [0.88-1.08]). C-II'/C-II was positively associated with changes in CAC score (3.4% [95%CI: 0.6, 6.3]) and density (6.3% [0.3, 4.2]), while C-I'/C-I was inversely associated with incident CAC (Risk ratio: 0.89 [95% CI: 0.81, 0.98]) in fully adjusted models that included plasma lipids. Total apoC-I and apoC-II concentrations were not associated with CHD, incident CAC or change in CAC score. CONCLUSIONS Increased apoC-II truncation was associated with reduced CHD, possibly explained by differences in lipid metabolism. Increased apoC-I and apoC-II truncations were also associated with less CAC progression and/or development of denser coronary plaques.
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Affiliation(s)
- Juraj Koska
- Phoenix VA Health Care System, 650 E Indian School Rd CS111E, Phoenix, AZ, 85012, USA.
| | - Yueming Hu
- Isoformix Inc., 9830 S. 51st Suite B-113, Phoenix, AZ, 85044, USA
| | - Jeremy Furtado
- Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA
| | - Dean Billheimer
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Ave, Tucson, AZ, 85724, USA
| | - Dobrin Nedelkov
- Isoformix Inc., 9830 S. 51st Suite B-113, Phoenix, AZ, 85044, USA
| | - Matthew Allison
- Department of Family Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Matthew J Budoff
- Lundquist Institute at Harbor-University of California, Los Angeles (UCLA), 1124 W Carson St., Torrance, CA, 90502, USA
| | - Robyn L McClelland
- Department of Biostatistics, University of Washington, 6200 NE 74th St. Bldg. 29 Suite 210, Seattle, WA, 98115, USA
| | - Peter Reaven
- College of Health Solutions, Arizona State University, 550 N 3rd St, Phoenix, AZ, 85004, USA
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6
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Sinari S, Koska J, Hu Y, Furtado J, Jensen MK, Budoff MJ, Nedelkov D, McClelland RL, Billheimer D, Reaven P. Apo CIII Proteoforms, Plasma Lipids, and Cardiovascular Risk in MESA. Arterioscler Thromb Vasc Biol 2023; 43:1560-1571. [PMID: 37317850 PMCID: PMC10516344 DOI: 10.1161/atvbaha.123.319035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 05/31/2023] [Indexed: 06/16/2023]
Abstract
BACKGROUND Apo CIII (apolipoprotein CIII) is an important regulator of triglyceride metabolism and was associated with cardiovascular risk in several cohorts. It is present in 4 major proteoforms, a native peptide (CIII0a), and glycosylated proteoforms with zero (CIII0b), 1 (CIII1, most abundant), or 2 (CIII2) sialic acids, which may differentially modify lipoprotein metabolism. We studied the relationships of these proteoforms with plasma lipids and cardiovascular risk. METHODS Apo CIII proteoforms were measured by mass spectrometry immunoassay in baseline plasma samples of 5791 participants of Multi-Ethnic Study of Atherosclerosis, an observational community-based cohort. Standard plasma lipids were collected for up to 16 years and cardiovascular events (myocardial infarction, resuscitated cardiac arrest, or stroke) were adjudicated for up to 17 years. RESULTS Apo CIII proteoform composition differed by age, sex, race and ethnicity, body mass index, and fasting glucose. Notably, CIII1 was lower in older participants, men and Black and Chinese (versus White) participants, and higher in obesity and diabetes. In contrast, CIII2 was higher in older participants, men, Black, and Chinese persons, and lower in Hispanic individuals and obesity. Higher CIII2 to CIII1 ratio (CIII2/III1) was associated with lower triglycerides and higher HDL (high-density lipoprotein) in cross-sectional and longitudinal models, independently of clinical and demographic risk factors and total apo CIII. The associations of CIII0a/III1 and CIII0b/III1 with plasma lipids were weaker and varied through cross-sectional and longitudinal analyses. Total apo CIII and CIII2/III1 were positively associated with cardiovascular disease risk (n=669 events, hazard ratios, 1.14 [95% CI, 1.04-1.25] and 1.21 [1.11-1.31], respectively); however, the associations were attenuated after adjustment for clinical and demographic characteristics (1.07 [0.98-1.16]; 1.07 [0.97-1.17]). In contrast, CIII0b/III1 was inversely associated with cardiovascular disease risk even after full adjustment including plasma lipids (0.86 [0.79-0.93]). CONCLUSIONS Our data indicate differences in clinical and demographic relationships of apo CIII proteoforms, and highlight the importance of apo CIII proteoform composition in predicting future lipid patterns and cardiovascular disease risk.
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Affiliation(s)
- Shripad Sinari
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ
| | | | | | - Jeremy Furtado
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Majken K Jensen
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Public Health, University of Copenhagen, Copenhagen, DK
| | - Matthew J. Budoff
- Lundquist Institute at Harbor-University of California, Los Angeles (UCLA), Torrance, CA
| | | | | | - Dean Billheimer
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ
| | - Peter Reaven
- College of Health Solutions, Arizona State University, Phoenix, AZ
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7
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Bleecker ER, Meyers DA, Billheimer D, Li H, Newbold P, Kwiatek J, Hirsch I, Katial R, Li X. Clinical Implications of Longitudinal Blood Eosinophil Counts in Patients With Severe Asthma. J Allergy Clin Immunol Pract 2023; 11:1805-1813. [PMID: 36868471 DOI: 10.1016/j.jaip.2023.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 02/08/2023] [Accepted: 02/14/2023] [Indexed: 03/05/2023]
Abstract
BACKGROUND The stability and variability of blood eosinophil counts (BECs) to phenotype patients with severe asthma is not fully understood. OBJECTIVE This post hoc, longitudinal, pooled analysis of placebo-arm patients from 2 phase 3 studies evaluated the clinical implications of BEC stability and variability in moderate-to-severe asthma. METHODS This analysis included patients from SIROCCO and CALIMA who received maintenance medium- to high-dosage inhaled corticosteroids plus long-acting β2-agonists; 2:1 patients with BECs of 300 cells/μL or higher and less than 300 cells/μL were enrolled. The BECs were measured 6 times over 1 year in a centralized laboratory. Exacerbations, lung function, and Asthma Control Questionnaire 6 scores were documented across patients grouped by BEC (<300 cells/μL or ≥300 cells/μL) and variability (<80% or ≥80% BECs less than or greater than 300 cells/μL). RESULTS Among 718 patients, 42.2% (n = 303) had predominantly high, 30.9% (n = 222) had predominantly low, and 26.9% (n = 193) had variable BECs. Prospective exacerbation rates (mean ± SD) were significantly greater in patients with predominantly high (1.39 ± 2.20) and variable (1.41 ± 2.09) BECs versus predominantly low (1.05 ± 1.66) BECs. Similar results were observed for the number of exacerbations while on placebo. CONCLUSIONS Although patients with variable BECs had intermittently high and low BECs, they experienced similar exacerbation rates to the predominantly high group, which were greater than those in the predominantly low group. A high BEC supports an eosinophilic phenotype in clinical settings without additional measurements, whereas a low BEC requires repeated measurements because it could reflect intermittently high or predominantly low BECs.
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Affiliation(s)
- Eugene R Bleecker
- Department of Medicine, University of Arizona College of Medicine, Tucson, Ariz.
| | - Deborah A Meyers
- Department of Medicine, University of Arizona College of Medicine, Tucson, Ariz
| | - Dean Billheimer
- Arizona Statistical Consulting, University of Arizona College of Public Health, Tucson, Ariz
| | - Huashi Li
- Department of Medicine, University of Arizona College of Medicine, Tucson, Ariz
| | - Paul Newbold
- Late-stage Respiratory & Immunology, AstraZeneca, Gaithersburg, Md
| | - Justin Kwiatek
- BioPharmaceuticals Medical, AstraZeneca, Gaithersburg, Md
| | - Ian Hirsch
- Biometrics, Vaccines & Immune Therapies, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK
| | - Rohit Katial
- BioPharmaceuticals Medical, AstraZeneca, Gaithersburg, Md
| | - Xingnan Li
- Department of Medicine, University of Arizona College of Medicine, Tucson, Ariz
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8
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Guerra S, Ledford JG, Melén E, Lavi I, Carsin AE, Stern DA, Zhai J, Vidal M, Bustamante M, Addison KJ, Vallecillo RG, Billheimer D, Koppelman GH, Garcia-Aymerich J, Lemonnier N, Fitó M, Dobaño C, Kebede Merid S, Kull I, McEachan RRC, Wright J, Chatzi L, Kogevinas M, Porta D, Narduzzi S, Ballester F, Esplugues A, Zabaleta C, Irizar A, Sunyer J, Halonen M, Bousquet J, Martinez FD, Anto JM. Creatine Kinase Is Decreased in Childhood Asthma. Am J Respir Crit Care Med 2023; 207:544-552. [PMID: 35876143 PMCID: PMC10870915 DOI: 10.1164/rccm.202010-3746oc] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 07/22/2022] [Indexed: 02/02/2023] Open
Abstract
Rationale: The identification of novel molecules associated with asthma may provide insights into the mechanisms of disease and their potential clinical implications. Objectives: To conduct a screening of circulating proteins in childhood asthma and to study proteins that emerged from human studies in a mouse model of asthma. Methods: We included 2,264 children from eight birth cohorts from the Mechanisms of the Development of ALLergy project and the Tucson Children's Respiratory Study. In cross-sectional analyses, we tested 46 circulating proteins for association with asthma in the selection stage and carried significant signals forward to a validation and replication stage. As CK (creatine kinase) was the only protein consistently associated with asthma, we also compared whole blood CK gene expression between subjects with and without asthma (n = 249) and used a house dust mite (HDM)-challenged mouse model to gain insights into CK lung expression and its role in the resolution of asthma phenotypes. Measurements and Main Results: As compared with the lowest CK tertile, children in the highest tertile had significantly lower odds for asthma in selection (adjusted odds ratio, 95% confidence interval: 0.31; 0.15-0.65; P = 0.002), validation (0.63; 0.42-0.95; P = 0.03), and replication (0.40; 0.16-0.97; P = 0.04) stages. Both cytosolic CK forms (CKM and CKB) were underexpressed in blood from asthmatics compared with control subjects (P = 0.01 and 0.006, respectively). In the lungs of HDM-challenged mice, Ckb expression was reduced, and after the HDM challenge, a CKB inhibitor blocked the resolution of airway hyperresponsiveness and reduction of airway mucin. Conclusions: Circulating concentrations and gene expression of CK are inversely associated with childhood asthma. Mouse models support a possible direct involvement of CK in asthma protection via inhibition of airway hyperresponsiveness and reduction of airway mucin.
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Affiliation(s)
- Stefano Guerra
- Asthma and Airway Disease Research Center
- ISGlobal, Barcelona, Spain
| | - Julie G. Ledford
- Asthma and Airway Disease Research Center
- Department of Cellular and Molecular Medicine
| | - Erik Melén
- Department of Clinical Science and Education and
- Sachs’ Children’s and Youth Hospital, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | | | - Anne-Elie Carsin
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Hospital del Mar Medical Research Institute, Barcelona, Spain
| | | | - Jing Zhai
- Asthma and Airway Disease Research Center
| | - Marta Vidal
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Barcelona, Spain
| | - Mariona Bustamante
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | | | | | - Dean Billheimer
- BIO5 Institute, and
- Department of Epidemiology and Biostatistics, University of Arizona Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| | - Gerard H. Koppelman
- Groningen Research Institute for Asthma and COPD, Groningen, the Netherlands
- Department of Pediatric Pulmonology and Pediatric Allergology, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Judith Garcia-Aymerich
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Nathanaël Lemonnier
- Institute for Advanced Biosciences, UGA-INSERM U1209-CNRS UMR5309, Site Santé, Allée des Alpes, 38700 La Tronche, France
| | - Montserrat Fitó
- Cardiovascular Risk and Nutrition Group and
- CIBER de Fisiopatología de la Obesidad y Nutricion (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Carlota Dobaño
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Barcelona, Spain
| | | | - Inger Kull
- Department of Clinical Science and Education and
- Sachs’ Children’s and Youth Hospital, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | | | - John Wright
- Bradford Institute for Health Research, Bradford, United Kingdom
| | - Leda Chatzi
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Manolis Kogevinas
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Daniela Porta
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Silvia Narduzzi
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Ferran Ballester
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Nursing School, Universitat de València, Valencia, Spain
- FISABIO–Universitat Jaume I–Universitat de València Joint Research Unit of Epidemiology and Environmental Health, Valencia, Spain
| | - Ana Esplugues
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Nursing School, Universitat de València, Valencia, Spain
- FISABIO–Universitat Jaume I–Universitat de València Joint Research Unit of Epidemiology and Environmental Health, Valencia, Spain
| | - Carlos Zabaleta
- Pediatrics Service, Hospital de Zumárraga, Gipuzkoa, Spain
- Group of Environmental Epidemiology and Child Development, Biodonostia Health Research Institute, San Sebastian, Spain
| | - Amaia Irizar
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Group of Environmental Epidemiology and Child Development, Biodonostia Health Research Institute, San Sebastian, Spain
| | - Jordi Sunyer
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Hospital del Mar Medical Research Institute, Barcelona, Spain
| | | | - Jean Bousquet
- University Hospital Montpellier, France; and
- Respiratory and Environmental Epidemiology Team, INSERM 1018, CESP Centre, Villejuif, France
| | | | - Josep M. Anto
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Hospital del Mar Medical Research Institute, Barcelona, Spain
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9
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Jung AM, Beitel SC, Gutenkunst SL, Billheimer D, Jahnke SA, Littau SR, White M, Hoppe-Jones C, Cherrington NJ, Burgess JL. Excretion of polybrominated diphenyl ethers and AhR activation in breastmilk among firefighters. Toxicol Sci 2023; 192:kfad017. [PMID: 36856729 PMCID: PMC10109531 DOI: 10.1093/toxsci/kfad017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
Excretion of toxicants accumulated from firefighter exposures through breastmilk represents a potential hazard. We investigated if firefighting exposures could increase the concentration of polybrominated diphenyl ethers (PBDEs) and aryl hydrocarbon receptor (AhR) activation in excreted breastmilk. Firefighters and non-firefighters collected breastmilk samples prior to any firefighting responses (baseline) and at 2, 8, 24, 48, and 72 hours after a structural fire (firefighters only). Five PBDE analytes (BDEs 15, 28, 47, 99, and 153) detected in at least 90% of samples were summed for analyses. The AhR in vitro DR CALUX® bioassay assessed the mixture of dioxin-like compounds and toxicity from breastmilk extracts. Baseline PBDEs and AhR response were compared between firefighters and non-firefighters. Separate linear mixed models assessed changes in sum of PBDEs and AhR response among firefighters over time and effect modification by interior or exterior response was assessed. Baseline PBDE concentrations and AhR responses did not differ between the 21 firefighters and 10 non-firefighters. There were no significant changes in sum of PBDEs or AhR response among firefighters over time post-fire, and no variation by interior or exterior response. Plots of sum of PBDEs and AhR response over time demonstrated individual variation but no consistent pattern. Currently, our novel study results do not support forgoing breastfeeding after a fire exposure. However, given study limitations and the potential hazard of accumulated toxicants from firefighter exposures excreted via breastfeeding, future studies should consider additional contaminants and measures of toxicity by which firefighting may impact maternal and child health.
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Affiliation(s)
- Alesia M Jung
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona 85724, USA
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona 85724, USA
| | - Shawn C Beitel
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona 85724, USA
| | - Shannon L Gutenkunst
- Statistics Consulting Lab, BIO5 Institute, University of Arizona, Tucson, Arizona 85721, USA
- Southwest Environmental Health Sciences Center, University of Arizona, Tucson, Arizona 85721, USA
| | - Dean Billheimer
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona 85724, USA
- Statistics Consulting Lab, BIO5 Institute, University of Arizona, Tucson, Arizona 85721, USA
- Southwest Environmental Health Sciences Center, University of Arizona, Tucson, Arizona 85721, USA
| | - Sara A Jahnke
- Center for Fire, Rescue, & EMS Health Research, NDRI-USA, Leawood, Kansas 66224, USA
| | - Sally R Littau
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona 85724, USA
| | - Mandie White
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona 85724, USA
| | | | - Nathan J Cherrington
- Southwest Environmental Health Sciences Center, University of Arizona, Tucson, Arizona 85721, USA
- Department of Pharmacology and Toxicology, R. Ken Coit College of Pharmacy, University of Arizona, Tucson, Arizona 85721, USA
| | - Jefferey L Burgess
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona 85724, USA
- Southwest Environmental Health Sciences Center, University of Arizona, Tucson, Arizona 85721, USA
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10
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Corenblum MJ, McRobbie-Johnson A, Carruth E, Bernard K, Luo M, Mandarino LJ, Peterson S, Billheimer D, Maley T, Eggers ED, Madhavan L. Parallel Neurodegenerative Phenotypes in Sporadic Parkinson's Disease Fibroblasts and Midbrain Dopamine Neurons. bioRxiv 2023:2023.02.10.527867. [PMID: 36798207 PMCID: PMC9934693 DOI: 10.1101/2023.02.10.527867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Understanding the mechanisms causing Parkinson's disease (PD) is vital to the development of much needed early diagnostics and therapeutics for this debilitating condition. Here, we report cellular and molecular alterations in skin fibroblasts of late-onset sporadic PD subjects, that were recapitulated in matched induced pluripotent stem cell (iPSC)-derived midbrain dopamine (DA) neurons, reprogrammed from the same fibroblasts. Specific changes in growth, morphology, reactive oxygen species levels, mitochondrial function, and autophagy, were seen in both the PD fibroblasts and DA neurons, as compared to their respective controls. Additionally, significant alterations in alpha synuclein expression and electrical activity were also noted in the PD DA neurons. Interestingly, although the fibroblast and neuronal phenotypes were similar to each other, they also differed in their nature and scale. Furthermore, statistical analysis revealed novel associations between various clinical measures of the PD subjects and the different fibroblast and neuronal data. In essence, these findings encapsulate spontaneous, in-tandem, disease-related phenotypes in both sporadic PD fibroblasts and iPSC-based DA neurons, from the same patient, and generates an innovative model to investigate PD mechanisms with a view towards rational disease stratification and precision treatments.
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11
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Frost KL, Jilek JL, Sinari S, Klein RR, Billheimer D, Wright SH, Cherrington NJ. Renal Transporter Alterations in Patients with Chronic Liver Diseases: Nonalcoholic Steatohepatitis, Alcohol-Associated, Viral Hepatitis, and Alcohol-Viral Combination. Drug Metab Dispos 2023; 51:155-164. [PMID: 36328481 PMCID: PMC9900843 DOI: 10.1124/dmd.122.001038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 10/17/2022] [Accepted: 10/19/2022] [Indexed: 11/06/2022] Open
Abstract
Alterations in hepatic transporters have been identified in precirrhotic chronic liver diseases (CLDs) that result in pharmacokinetic variations causing adverse drug reactions (ADRs). However, the effect of CLD on the expression of renal transporters is unknown despite the overwhelming evidence of kidney injury in CLD patients. This study determines the transcriptomic and proteomic expression profiles of renal drug transporters in patients with defined CLD etiology. Renal biopsies were obtained from patients with a history of CLD etiologies, including nonalcoholic fatty liver disease (NAFLD), nonalcoholic steatohepatitis (NASH), alcohol-associated liver disease (ALD), viral hepatitis C (HCV), and combination ALD/HCV. A significant decrease in organic anion transporter (OAT)-3 was identified in NASH, ALD, HCV, and ALD/HCV (1.56 ± 1.10; 1.01 ± 0.46; 1.03 ± 0.43; 0.86 ± 0.57 pmol/mg protein) relative to control (2.77 ± 1.39 pmol/mg protein). Additionally, a decrease was shown for OAT4 in NASH (24.9 ± 5.69 pmol/mg protein) relative to control (43.8 ± 19.9 pmol/mg protein) and in urate transporter 1 (URAT1) for ALD and HCV (1.56 ± 0.15 and 1.65 ± 0.69 pmol/mg protein) relative to control (4.69 ± 4.59 pmol/mg protein). These decreases in organic anion transporter expression could result in increased and prolonged systemic exposure to drugs and possible toxicity. Renal transporter changes, in addition to hepatic transporter alterations, should be considered in dose adjustments for CLD patients for a more accurate disposition profile. It is important to consider a multiorgan approach to altered pharmacokinetics of drugs prescribed to CLD patients to prevent ADRs and improve patient outcomes. SIGNIFICANCE STATEMENT: Chronic liver diseases are known to elicit alterations in hepatic transporters that result in a disrupted pharmacokinetic profile for various drugs. However, it is unknown if there are alterations in renal transporters during chronic liver disease, despite strong indications of renal dysfunction associated with chronic liver disease. Identifying renal transporter expression changes in patients with chronic liver disease facilitates essential investigations on the multifaceted relationship between liver dysfunction and kidney physiology to offer dose adjustments and prevent adverse drug reactions.
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Affiliation(s)
- Kayla L Frost
- College of Pharmacy, Department of Pharmacology and Toxicology, The University of Arizona, Tucson, Arizona
| | - Joseph L Jilek
- College of Pharmacy, Department of Pharmacology and Toxicology, The University of Arizona, Tucson, Arizona
| | - Shripad Sinari
- Center for Biomedical Informatics and Biostatistics, The University of Arizona, Tucson, Arizona
| | - Robert R Klein
- Department of Pathology, Banner University Medical Center, Tucson, Arizona
| | - Dean Billheimer
- Center for Biomedical Informatics and Biostatistics, The University of Arizona, Tucson, Arizona
| | - Stephen H Wright
- Department of Physiology, The University of Arizona, Tucson, Arizona
| | - Nathan J Cherrington
- College of Pharmacy, Department of Pharmacology and Toxicology, The University of Arizona, Tucson, Arizona;
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12
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Divo MJ, Marin JM, Casanova C, Cabrera Lopez C, Pinto-Plata VM, Marin-Oto M, Polverino F, de-Torres JP, Billheimer D, Celli BR. Comorbidities and mortality risk in adults younger than 50 years of age with chronic obstructive pulmonary disease. Respir Res 2022; 23:267. [PMID: 36167533 PMCID: PMC9516817 DOI: 10.1186/s12931-022-02191-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 08/24/2022] [Indexed: 11/24/2022] Open
Abstract
Rationale and objective Patients with chronic obstructive pulmonary disease (COPD), usually diagnosed after the 6th decade, frequently suffer from comorbidities. Whether COPD patients 50 years or younger (Young COPD) have similar comorbidities with the same frequency and mortality impact as aged-matched controls or older COPD patients is unknown. Methods We compared comorbidity number, prevalence and type in 3 groups of individuals with ≥ 10 pack-years of smoking: A Young (≤ 50 years) COPD group (n = 160), an age-balanced control group without airflow obstruction (n = 125), and Old (> 50 years) COPD group (n = 1860). We also compared survival between the young COPD and control subjects. Using Cox proportional model, we determined the comorbidities associated with mortality risk and generated Comorbidomes for the “Young” and “Old” COPD groups. Results The severity distribution by GOLD spirometric stages and BODE quartiles were similar between Young and Old COPD groups. After adjusting for age, sex, and pack-years, the prevalence of subjects with at least one comorbidity was 31% for controls, 77% for the Young, and 86% for older COPD patients. Compared to controls, “Young” COPDs’ had a nine-fold increased mortality risk (p < 0.0001). “Comorbidomes” differed between Young and Old COPD groups, with tuberculosis, substance use, and bipolar disorders being distinct comorbidities associated with increased mortality risk in the Young COPD group. Conclusions Young COPD patients carry a higher comorbidity prevalence and mortality risk compared to non-obstructed control subjects. Young COPD differed from older COPD patients by the behavioral-related comorbidities that increase their risk of premature death. Supplementary Information The online version contains supplementary material available at 10.1186/s12931-022-02191-7.
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Affiliation(s)
- Miguel J Divo
- Pulmonary and Critical Care Division, Brigham and Women's Hospital and Spaulding Rehabilitation Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
| | - José M Marin
- Respiratory Service, Hospital Universitario Miguel Servet-IISAragón & CIBER Enfermedades Respiratorias, Avda Isabel la Catolica 1-3, 50006, Saragossa, Spain
| | - Ciro Casanova
- Pulmonary Department, Hospital Universitario La Candelaria, Universidad de La Laguna, Carretera del Rosario n 145, 38010, Santa Cruz de Tenerife, Spain
| | - Carlos Cabrera Lopez
- Respiratory Service, Hospital Universitario de Gran Canaria Dr. Negrin, Las Palmas, Canary Islands, Spain
| | - Victor M Pinto-Plata
- Pulmonary and Critical Care Division Chair, Lahey Hospital and Medical Center, Burlington, MA, USA
| | - Marta Marin-Oto
- Pulmonary Department, Hospital Clínico Universitario Lozano Blesa, Saragossa, Spain
| | | | - Juan P de-Torres
- Division of Respirology and Sleep Medicine, Queen's University, Kingston, Canada
| | - Dean Billheimer
- BIO5 Institute, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Bartolome R Celli
- Pulmonary and Critical Care Division, Brigham and Women's Hospital and Spaulding Rehabilitation Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA
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13
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Moreno Ramírez D, Gutenkunst S, Honan J, Ingram M, Quijada C, Chaires M, Sneed SJ, Sandoval F, Spitz R, Carvajal S, Billheimer D, Wolf AM, Beamer PI. Thinking on your feet: Beauty and auto small businesses maneuver the risks of the COVID-19 pandemic. Front Public Health 2022; 10:921704. [PMID: 36106169 PMCID: PMC9465998 DOI: 10.3389/fpubh.2022.921704] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 07/21/2022] [Indexed: 01/22/2023] Open
Abstract
On March 11, 2020, the World Health Organization officially declared SARS-CoV-2 a pandemic, and governments and health institutions enacted various public health measures to decrease its transmission rate. The COVID-19 pandemic made occupational health disparities for small businesses more visible and created an unprecedented financial burden, particularly for those located in communities of color. In part, communities of color experienced disproportionate mortality and morbidity rates from COVID-19 due to their increased exposure. The COVID-19 pandemic has prompted the public to reflect on risks daily. Risk perception is a critical factor influencing how risk gets communicated and perceived by individuals, groups, and communities. This study explores competing risk perceptions regarding COVID-19, economic impacts, vaccination, and disinfectant exposures of workers at beauty salons and auto shops in Tucson, Arizona, using a perceived risk score measured on a scale of 1-10, with higher scores indicating more perceived risk. The primary differences between respondents at beauty salons and auto shops regarding their perceived risks of COVID-19 vaccination were between the vaccinated and unvaccinated. For every group except the unvaccinated, the perceived risk score of getting the COVID-19 vaccine was low, and the score of not getting the COVID-19 vaccine was high. Study participants in different demographic groups ranked economic risk the highest compared to the other five categories: getting the COVID-19 vaccine, not getting the COVID-19 vaccine, COVID-19, disinfection, and general. A meaningful increase of four points in the perceived risk score of not getting the COVID-19 vaccine was associated with a 227% (95% CI: 27%, 740%) increase in the odds of being vaccinated. Analyzing these data collected during the coronavirus pandemic may provide insight into how to promote the health-protective behavior of high-risk workers and employers in the service sector during times of new novel threats (such as a future pandemic or crisis) and how they process competing risks.
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Affiliation(s)
- Denise Moreno Ramírez
- Community, Environment and Policy Department, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, United States
| | | | - Jenna Honan
- Community, Environment and Policy Department, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, United States
| | - Maia Ingram
- Health Promotion Sciences Department, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, United States
| | - Carolina Quijada
- Community, Environment and Policy Department, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, United States
| | - Marvin Chaires
- Community, Environment and Policy Department, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, United States
| | - Sam J. Sneed
- Community, Environment and Policy Department, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, United States
| | - Flor Sandoval
- Sonora Environmental Research Institute, Tucson, AZ, United States
| | - Rachel Spitz
- Sonora Environmental Research Institute, Tucson, AZ, United States
| | - Scott Carvajal
- Health Promotion Sciences Department, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, United States
| | - Dean Billheimer
- BIO5 Institute, The University of Arizona, Tucson, AZ, United States,Epidemiology and Biostatistics Department, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, United States
| | - Ann Marie Wolf
- Sonora Environmental Research Institute, Tucson, AZ, United States
| | - Paloma I. Beamer
- Community, Environment and Policy Department, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, United States,BIO5 Institute, The University of Arizona, Tucson, AZ, United States,*Correspondence: Paloma I. Beamer
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14
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Koska J, Furtado J, Hu Y, Sinari S, Budoff MJ, Billheimer D, Nedelkov D, McClelland RL, Reaven PD. Plasma proteoforms of apolipoproteins C-I and C-II are associated with plasma lipids in the Multi-Ethnic Study of Atherosclerosis. J Lipid Res 2022; 63:100263. [PMID: 35952903 PMCID: PMC9494236 DOI: 10.1016/j.jlr.2022.100263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/23/2022] [Accepted: 07/09/2022] [Indexed: 11/23/2022] Open
Abstract
Apolipoproteins (apo) C-I and C-II are key regulators of triglyceride and HDL metabolism. Both exist as full-size native and truncated (apoC-I'; apoC-II') posttranslational proteoforms. However, the determinants and the role of these proteoforms in lipid metabolism are unknown. Here, we measured apoC-I and apoC-II proteoforms by mass spectrometry immunoassay in baseline and 10-year follow-up plasma samples from the Multi-Ethnic Study of Atherosclerosis. We found that baseline total apoC-I (mean = 9.2 mg/dl) was lower in African Americans (AA), Chinese Americans (CA), and Hispanics (by 1.8; 1.0; 1.0 mg/dl vs. whites), higher in women (by 1.2 mg/dl), and positively associated with plasma triglycerides and HDL. Furthermore, we observed that the truncated-to-native apoC-I ratio (apoC-I'/C-I) was lower in CA, negatively associated with triglycerides, and positively associated with HDL. We determined that total apoC-II (8.8 mg/dl) was lower in AA (by 0.8 mg/dl) and higher in CA and Hispanics (by 0.5 and 0.4 mg/dl), positively associated with triglycerides, and negatively associated with HDL. In addition, apoC-II'/C-II was higher in AA and women, negatively associated with triglycerides, and positively associated with HDL. We showed that the change in triglycerides was positively associated with changes in total apoC-I and apoC-II and negatively associated with changes in apoC-I'/C-I and apoC-II'/C-II, whereas the change in HDL was positively associated with changes in total apoC-I and apoC-II'/C-II and negatively associated with change in total apoC-II. This study documents racial/ethnic variation in apoC-I and apoC-II plasma levels and highlights apolipoprotein posttranslational modification as a potential regulator of plasma lipids.
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Affiliation(s)
- Juraj Koska
- Phoenix VA Health Care System, Phoenix, AZ, USA.
| | - Jeremy Furtado
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | - Shripad Sinari
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | | | - Dean Billheimer
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | | | | | - Peter D Reaven
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
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15
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Honan J, Ingram M, Quijada C, Chaires M, Fimbres J, Ornelas C, Sneed S, Stauber L, Spitz R, Sandoval F, Carvajal S, Billheimer D, Wolf AM, Beamer P. Understanding the Impacts of the COVID-19 Pandemic on Small Businesses and Workers Using Quantitative and Qualitative Methods. Ann Work Expo Health 2022; 67:87-100. [PMID: 35849088 PMCID: PMC9384486 DOI: 10.1093/annweh/wxac048] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 05/06/2022] [Accepted: 06/27/2022] [Indexed: 01/14/2023] Open
Abstract
The COVID-19 pandemic has simultaneously exacerbated and elucidated inequities in resource distribution for small businesses across the United States in terms of worker health and the financial stability of both owners and employees. This disparity was further intensified by the constantly changing and sometimes opposing health and safety guidelines and recommendations to businesses from the local, state, and federal government agencies. To better understand how the pandemic has impacted small businesses, a cross-sectional survey was administered to owners, managers, and workers (n = 45) in the beauty and auto shop sectors from Southern Arizona. The survey identified barriers to safe operation that these businesses faced during the pandemic, illuminated worker concerns about COVID-19, and elicited perceptions of how workplaces have changed since the novel coronavirus outbreak of 2019. A combination of open-ended and close-ended questions explored how businesses adapted to the moving target of pandemic safety recommendations, as well as how the pandemic affected businesses and workers more generally. Almost all the beauty salons surveyed had to close their doors (22/25), either temporarily or permanently, due to COVID-19, while most of the auto repair shops were able to stay open (13/20). Beauty salons were more likely to implement exposure controls meant to limit transmission with customers and coworkers, such as wearing face masks and disallowing walk-ins, and were also more likely to be affected by pandemic-related issues, such as reduced client load and sourcing difficulties. Auto shops, designated by the state of Arizona to be 'essential' businesses, were less likely to have experienced financial precarity due to the pandemic. Content analysis of open-ended questions using the social-ecological model documented current and future worker concerns, namely financial hardships from lockdowns and the long-term viability of their business, unwillingness of employees to return to work, uncertainty regarding the progression of the pandemic, conflict over suitable health and safety protocols, and personal or family health and well-being (including anxiety and/or stress). Findings from the survey indicate that small businesses did not have clear guidance from policymakers during the pandemic and that the enacted regulations and guidelines focused on either health and safety or finances, but rarely both. Businesses often improvised and made potentially life-changing decisions with little to no support. This analysis can be used to inform future pandemic preparedness plans for small businesses that are cost-efficient, effective at reducing environmental exposures, and ultimately more likely to be implemented by the workers.
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Affiliation(s)
- Jenna Honan
- Author to whom correspondence should be addressed. Tel: 520-626-0006; e-mail:
| | - Maia Ingram
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Carolina Quijada
- Department of Community, Environment, and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Marvin Chaires
- Department of Community, Environment, and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Jocelyn Fimbres
- Department of Community, Environment, and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Catherine Ornelas
- Department of Community, Environment, and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Sam Sneed
- Department of Community, Environment, and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Leah Stauber
- Department of Community, Environment, and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Rachel Spitz
- Sonora Environmental Research Institute, Tucson, AZ, USA
| | - Flor Sandoval
- Sonora Environmental Research Institute, Tucson, AZ, USA
| | - Scott Carvajal
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Dean Billheimer
- Department of Epidemiology and Biostatitics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Ann Marie Wolf
- Sonora Environmental Research Institute, Tucson, AZ, USA
| | - Paloma Beamer
- Department of Community, Environment, and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
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16
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Francisco D, Wang Y, Marshall C, Conway M, Addison KJ, Billheimer D, Kimura H, Numata M, Chu HW, Voelker DR, Kraft M, Ledford JG. Small Peptide Derivatives Within the Carbohydrate Recognition Domain of SP-A2 Modulate Asthma Outcomes in Mouse Models and Human Cells. Front Immunol 2022; 13:900022. [PMID: 35874703 PMCID: PMC9304716 DOI: 10.3389/fimmu.2022.900022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 06/16/2022] [Indexed: 11/13/2022] Open
Abstract
Surfactant Protein-A (SP-A) is an innate immune modulator that regulates a variety of pulmonary host defense functions. We have shown that SP-A is dysfunctional in asthma, which could be partly due to genetic heterogeneity. In mouse models and primary bronchial epithelial cells from asthmatic participants, we evaluated the functional significance of a particular single nucleotide polymorphism of SP-A2, which results in an amino acid substitution at position 223 from glutamine (Q) to lysine (K) within the carbohydrate recognition domain (CRD). We found that SP-A 223Q humanized mice had greater protection from inflammation and mucin production after IL-13 exposure as compared to SP-A-2 223K mice. Likewise, asthmatic participants with two copies the major 223Q allele demonstrated better lung function and asthma control as compared to asthmatic participants with two copies of the minor SP-A 223K allele. In primary bronchial epithelial cells from asthmatic participants, full-length recombinant SP-A 223Q was more effective at reducing IL-13-induced MUC5AC gene expression compared to SP-A 223K. Given this activity, we developed 10 and 20 amino acid peptides of SP-A2 spanning position 223Q. We show that the SP-A 223Q peptides reduce eosinophilic inflammation, mucin production and airways hyperresponsiveness in a house dust mite model of asthma, protect from lung function decline during an IL-13 challenge model in mice, and decrease IL-13-induced MUC5AC gene expression in primary airway epithelial cells from asthmatic participants. These results suggest that position 223 within the CRD of SP-A2 may modulate several outcomes relevant to asthma, and that short peptides of SP-A2 retain anti-inflammatory properties similar to that of the endogenous protein.
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Affiliation(s)
- Dave Francisco
- Department of Medicine, University of Arizona, Tucson, AZ, United States
- Asthma and Airway Disease Research Center, University of Arizona Health Sciences, Tucson, AZ, United States
| | - Ying Wang
- Department of Medicine, University of Arizona, Tucson, AZ, United States
- Asthma and Airway Disease Research Center, University of Arizona Health Sciences, Tucson, AZ, United States
| | - Craig Marshall
- Department of Medicine, University of Arizona, Tucson, AZ, United States
| | - Michelle Conway
- Department of Medicine, University of Arizona, Tucson, AZ, United States
| | - Kenneth J. Addison
- Asthma and Airway Disease Research Center, University of Arizona Health Sciences, Tucson, AZ, United States
| | - Dean Billheimer
- Asthma and Airway Disease Research Center, University of Arizona Health Sciences, Tucson, AZ, United States
| | - Hiroki Kimura
- Department of Medicine, University of Arizona, Tucson, AZ, United States
- Asthma and Airway Disease Research Center, University of Arizona Health Sciences, Tucson, AZ, United States
| | - Mari Numata
- Department of Medicine, National Jewish Health, Denver, CO, United States
| | - Hong W. Chu
- Department of Medicine, National Jewish Health, Denver, CO, United States
| | - Dennis R. Voelker
- Department of Medicine, National Jewish Health, Denver, CO, United States
| | - Monica Kraft
- Department of Medicine, University of Arizona, Tucson, AZ, United States
- Asthma and Airway Disease Research Center, University of Arizona Health Sciences, Tucson, AZ, United States
| | - Julie G. Ledford
- Asthma and Airway Disease Research Center, University of Arizona Health Sciences, Tucson, AZ, United States
- Department of Cellular and Molecular Medicine, University of Arizona, Tucson, AZ, United States
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17
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Davidson S, Jahnke S, Jung AM, Burgess JL, Jacobs ET, Billheimer D, Farland LV. Anti-Müllerian Hormone Levels among Female Firefighters. Int J Environ Res Public Health 2022; 19:5981. [PMID: 35627519 PMCID: PMC9141260 DOI: 10.3390/ijerph19105981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 05/11/2022] [Accepted: 05/12/2022] [Indexed: 02/04/2023]
Abstract
Female firefighters have occupational exposures which may negatively impact their reproductive health. Anti-müllerian hormone (AMH) is a clinical marker of ovarian reserve. We investigated whether AMH levels differed in female firefighters compared to non-firefighters and whether there was a dose-dependent relationship between years of firefighting and AMH levels. Female firefighters from a pre-existing cohort completed a cross-sectional survey regarding their occupational and health history and were asked to recruit a non-firefighter friend or relative. All participants provided a dried blood spot (DBS) for AMH analysis. Linear regression was used to assess the relationship between firefighting status and AMH levels. Among firefighters, the influence of firefighting-related exposures was evaluated. Firefighters (n = 106) and non-firefighters (n = 58) had similar age and BMI. Firefighters had a lower mean AMH compared to non-firefighters (2.93 ng/mL vs. 4.37 ng/mL). In multivariable adjusted models, firefighters had a 33% lower AMH value than non-firefighters (-33.38%∆ (95% CI: -54.97, -1.43)). Years of firefighting was not associated with a decrease in AMH. Firefighters in this study had lower AMH levels than non-firefighters. More research is needed to understand the mechanisms by which firefighting could reduce AMH and affect fertility.
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Affiliation(s)
- Samantha Davidson
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA; (S.D.); (A.M.J.); (E.T.J.); (D.B.)
| | - Sara Jahnke
- Center for Fire, Rescue & EMS Health Research, NDRI-USA, Inc., Leawood, KS 66224, USA;
| | - Alesia M. Jung
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA; (S.D.); (A.M.J.); (E.T.J.); (D.B.)
- Department of Community, Environment & Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA;
| | - Jefferey L. Burgess
- Department of Community, Environment & Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA;
- Cancer Prevention and Control Program, University of Arizona Cancer Center, Tucson, AZ 85719, USA
| | - Elizabeth T. Jacobs
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA; (S.D.); (A.M.J.); (E.T.J.); (D.B.)
- Cancer Prevention and Control Program, University of Arizona Cancer Center, Tucson, AZ 85719, USA
| | - Dean Billheimer
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA; (S.D.); (A.M.J.); (E.T.J.); (D.B.)
| | - Leslie V. Farland
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA; (S.D.); (A.M.J.); (E.T.J.); (D.B.)
- Cancer Prevention and Control Program, University of Arizona Cancer Center, Tucson, AZ 85719, USA
- Department of Obstetrics and Gynecology, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA
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18
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Hoyer-Kimura C, Konhilas JP, Mansour HM, Polt R, Doyle KP, Billheimer D, Hay M. Neurofilament light: a possible prognostic biomarker for treatment of vascular contributions to cognitive impairment and dementia. J Neuroinflammation 2021; 18:236. [PMID: 34654436 PMCID: PMC8520282 DOI: 10.1186/s12974-021-02281-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 09/20/2021] [Indexed: 12/29/2022] Open
Abstract
Background Decreased cerebral blood flow and systemic inflammation during heart failure (HF) increase the risk for vascular contributions to cognitive impairment and dementia (VCID) and Alzheimer disease-related dementias (ADRD). We previously demonstrated that PNA5, a novel glycosylated angiotensin 1–7 (Ang-(1–7)) Mas receptor (MasR) agonist peptide, is an effective therapy to rescue cognitive impairment in our preclinical model of VCID. Neurofilament light (NfL) protein concentration is correlated with cognitive impairment and elevated in neurodegenerative diseases, hypoxic brain injury, and cardiac disease. The goal of the present study was to determine (1) if treatment with Ang-(1–7)/MasR agonists can rescue cognitive impairment and decrease VCID-induced increases in NfL levels as compared to HF-saline treated mice and, (2) if NfL levels correlate with measures of cognitive function and brain cytokines in our VCID model. Methods VCID was induced in C57BL/6 male mice via myocardial infarction (MI). At 5 weeks post-MI, mice were treated with daily subcutaneous injections for 24 days, 5 weeks after MI, with PNA5 or angiotensin 1–7 (500 microg/kg/day or 50 microg/kg/day) or saline (n = 15/group). Following the 24-day treatment protocol, cognitive function was assessed using the Novel Object Recognition (NOR) test. Cardiac function was measured by echocardiography and plasma concentrations of NfL were quantified using a Quanterix Simoa assay. Brain and circulating cytokine levels were determined with a MILLIPLEX MAP Mouse High Sensitivity Multiplex Immunoassay. Treatment groups were compared via ANOVA, significance was set at p < 0.05. Results Treatment with Ang-(1–7)/MasR agonists reversed VCID-induced cognitive impairment and significantly decreased NfL levels in our mouse model of VCID as compared to HF-saline treated mice. Further, NfL levels were significantly negatively correlated with cognitive scores and the concentrations of multiple pleiotropic cytokines in the brain. Conclusions These data show that treatment with Ang-(1–7)/MasR agonists rescues cognitive impairment and decreases plasma NfL relative to HF-saline-treated animals in our VCID mouse model. Further, levels of NfL are significantly negatively correlated with cognitive function and with several brain cytokine concentrations. Based on these preclinical findings, we propose that circulating NfL might be a candidate for a prognostic biomarker for VCID and may also serve as a pharmacodynamic/response biomarker for therapeutic target engagement.
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Affiliation(s)
| | - John P Konhilas
- Department of Physiology, The University of Arizona, Tucson, AZ, USA.,Department of Nutritional Sciences, The University of Arizona, Tucson, AZ, USA.,Department of Biomedical Engineering, The University of Arizona, Tucson, AZ, USA.,Sarver Molecular Cardiovascular Research Program, The University of Arizona, Tucson, AZ, USA
| | - Heidi M Mansour
- Department of Pharmacy, Skaggs Pharmaceutical Sciences Center, The University of Arizona, Tucson, AZ, USA.,Department of Medicine, Division of Translational and Regenerative Medicine, The University of Arizona, Tucson, AZ, USA
| | - Robin Polt
- Department of Chemistry and Biochemistry, The University of Arizona, Tucson, AZ, USA
| | - Kristian P Doyle
- Department of Immunobiology, The University of Arizona, Tucson, AZ, USA
| | - Dean Billheimer
- Department of Epidemiology and Biostatistics, The University of Arizona, Tucson, AZ, USA
| | - Meredith Hay
- Department of Physiology, The University of Arizona, Tucson, AZ, USA.,Department of Neurology, The University of Arizona, Tucson, AZ, USA.,Evelyn F. McKnight Brain Institute, The University of Arizona, Tucson, AZ, USA.,ProNeurogen, Inc, The University of Arizona, Tucson, AZ, USA
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19
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Hallmark B, Wegienka G, Havstad S, Billheimer D, Ownby D, Mendonca EA, Gress L, Stern DA, Myers JB, Khurana Hershey GK, Hoepner L, Miller RL, Lemanske RF, Jackson DJ, Gold DR, O'Connor GT, Nicolae DL, Gern JE, Ober C, Wright AL, Martinez FD. Chromosome 17q12-21 Variants Are Associated with Multiple Wheezing Phenotypes in Childhood. Am J Respir Crit Care Med 2021; 203:864-870. [PMID: 33535024 DOI: 10.1164/rccm.202003-0820oc] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Rationale: Birth cohort studies have identified several temporal patterns of wheezing, only some of which are associated with asthma. Whether 17q12-21 genetic variants, which are closely associated with asthma, are also associated with childhood wheezing phenotypes remains poorly explored.Objectives: To determine whether wheezing phenotypes, defined by latent class analysis (LCA), are associated with nine 17q12-21 SNPs and if so, whether these relationships differ by race/ancestry.Methods: Data from seven U.S. birth cohorts (n = 3,786) from the CREW (Children's Respiratory Research and Environment Workgroup) were harmonized to represent whether subjects wheezed in each year of life from birth until age 11 years. LCA was then performed to identify wheeze phenotypes. Genetic associations between SNPs and wheeze phenotypes were assessed separately in European American (EA) (n = 1,308) and, for the first time, in African American (AA) (n = 620) children.Measurements and Main Results: The LCA best supported four latent classes of wheeze: infrequent, transient, late-onset, and persistent. Odds of belonging to any of the three wheezing classes (vs. infrequent) increased with the risk alleles for multiple SNPs in EA children. Only one SNP, rs2305480, showed increased odds of belonging to any wheezing class in both AA and EA children.Conclusions: These results indicate that 17q12-21 is a "wheezing locus," and this association may reflect an early life susceptibility to respiratory viruses common to all wheezing children. Which children will have their symptoms remit or reoccur during childhood may be independent of the influence of rs2305480.
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Affiliation(s)
- Brian Hallmark
- Asthma and Airway Disease Research Center.,BIO5 Institute
| | - Ganesa Wegienka
- Department of Public Health Sciences, Henry Ford Hospital and Health System, Detroit, Michigan
| | - Suzanne Havstad
- Department of Public Health Sciences, Henry Ford Hospital and Health System, Detroit, Michigan
| | | | - Dennis Ownby
- Department of Public Health Sciences, Henry Ford Hospital and Health System, Detroit, Michigan
| | - Eneida A Mendonca
- Department of Biostatistics and Medical Informatics, University of Wisconsin, Madison, Wisconsin.,Department of Pediatrics and.,Regenstrief Institute, Indiana University, Indianapolis, Indiana
| | - Lisa Gress
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | | | - Jocelyn Biagini Myers
- Division of Asthma Research, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Gurjit K Khurana Hershey
- Division of Asthma Research, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Lori Hoepner
- Department of Environmental and Occupational Health Sciences, Downstate Health Sciences University School of Public Health, State University of New York, Brooklyn, New York.,Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University, New York, New York
| | - Rachel L Miller
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Robert F Lemanske
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Daniel J Jackson
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Diane R Gold
- The Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - George T O'Connor
- Department of Pediatrics, Boston University, Boston, Massachusetts; and
| | - Dan L Nicolae
- Department of Human Genetics and.,Department of Statistics, University of Chicago, Chicago, Illinois
| | - James E Gern
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | | | - Anne L Wright
- Asthma and Airway Disease Research Center.,Department of Pediatrics, University of Arizona, Tucson, Arizona
| | - Fernando D Martinez
- Asthma and Airway Disease Research Center.,Department of Pediatrics, University of Arizona, Tucson, Arizona
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20
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Alkhatib NS, McBride A, Bhattacharjee S, Ramos K, Erstad B, Slack M, Billheimer D, Abraham I. Pricing methods in outcome-based contracting: δ5: risk of efficacy failure-based pricing. J Med Econ 2020; 23:1246-1255. [PMID: 32845204 DOI: 10.1080/13696998.2020.1815029] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
AIMS Six Delta is a six-dimensional independent platform for outcome-based pricing/contracting. The fifth dimension (δ5) estimates prices on the basis of the risk of efficacy failure of a drug. We describe this dimension's methodology and present a proof-of-concept application to the treatment of non-small cell lung cancer (NSCLC) with EGFR mutation with osimertinib. MATERIALS AND METHODS The risk of efficacy failure pricing dimension utilizes a seven-step method: (1) defining risk; (2) extracting data; (3) predicting models; (4) performing Monte Carlo Simulation (MCS) to estimate risk of efficacy failure; 5) estimating ranges for a payback; (6) adjusting for medical inflation; and (7) performing Monte Carlo Simulation (MCS) to estimate the DSPRisk of efficacy failure. A proof-of-concept exercise with osimertinib in NSCLC was performed for two hypothetical outcome-based contracts: 1-year (2019-2020) and 2-year (2019-2021). We estimated the risk of efficacy failure for osimertinib in terms of overall and progression-free survival versus standard of care. We used the estimated risk to estimate the price reduction on the wholesale acquisition cost (WAC) for the two hypothetical contracts: a 1-year (2019-2020) and 2-year contract (2019-2021). From this we estimated the DSPRisk of efficacy failure. RESULTS Based on the risk of OS and PFS efficacy failure for osimertinib in OS and PFS, in the 1-year contract, the DSPRisk of efficacy failure was estimated at $12,652 (or -13.44% the 2018 WAC) for a 30-day prescription. For the 2-year contract (2019-2021), the DSPRisk of efficacy failure was estimated at $13,019 (or -10.93% the 2018 WAC). CONCLUSIONS We demonstrated that pricing methods based on risk of efficacy failure methods can be integrated into our proposed Six Delta platform for outcome-based pricing/contracting.
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Affiliation(s)
- Nimer S Alkhatib
- Center for Health Outcomes and Pharmaco Economic Research, College of Pharmacy, University of Arizona, Tucson, AZ, USA
- College of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Ali McBride
- Department of Pharmacy Practice and Science, College of Pharmacy, University of Arizona, Tucson, AZ, USA
- Banner University Medical Center, Tucson, AZ, USA
- University of Arizona Cancer Center, University of Arizona, Tucson, AZ, USA
| | - Sandipan Bhattacharjee
- Center for Health Outcomes and Pharmaco Economic Research, College of Pharmacy, University of Arizona, Tucson, AZ, USA
- Department of Pharmacy Practice and Science, College of Pharmacy, University of Arizona, Tucson, AZ, USA
| | - Kenneth Ramos
- Institute of Bio Sciences and Technology, Texas A&M University, Houston, TX, USA
| | - Brian Erstad
- Center for Health Outcomes and Pharmaco Economic Research, College of Pharmacy, University of Arizona, Tucson, AZ, USA
- Department of Pharmacy Practice and Science, College of Pharmacy, University of Arizona, Tucson, AZ, USA
| | - Marion Slack
- Center for Health Outcomes and Pharmaco Economic Research, College of Pharmacy, University of Arizona, Tucson, AZ, USA
- Department of Pharmacy Practice and Science, College of Pharmacy, University of Arizona, Tucson, AZ, USA
| | - Dean Billheimer
- Center for Biomedical Informatics & Biostatistics, University of Arizona, Tucson, AZ, USA
| | - Ivo Abraham
- Center for Health Outcomes and Pharmaco Economic Research, College of Pharmacy, University of Arizona, Tucson, AZ, USA
- Department of Pharmacy Practice and Science, College of Pharmacy, University of Arizona, Tucson, AZ, USA
- University of Arizona Cancer Center, University of Arizona, Tucson, AZ, USA
- Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, AZ, USA
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21
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Ivanova A, Israel E, LaVange LM, Peters MC, Denlinger LC, Moore WC, Bacharier LB, Marquis MA, Gotman NM, Kosorok MR, Tomlinson C, Mauger DT, Georas SN, Wright RJ, Noel P, Rosner GL, Akuthota P, Billheimer D, Bleecker ER, Cardet JC, Castro M, DiMango EA, Erzurum SC, Fahy JV, Fajt ML, Gaston BM, Holguin F, Jain S, Kenyon NJ, Krishnan JA, Kraft M, Kumar R, Liu MC, Ly NP, Moy JN, Phipatanakul W, Ross K, Smith LJ, Szefler SJ, Teague WG, Wechsler ME, Wenzel SE, White SR. The precision interventions for severe and/or exacerbation-prone asthma (PrecISE) adaptive platform trial: statistical considerations. J Biopharm Stat 2020; 30:1026-1037. [PMID: 32941098 PMCID: PMC7954787 DOI: 10.1080/10543406.2020.1821705] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 08/17/2020] [Indexed: 12/24/2022]
Abstract
The Precision Interventions for Severe and/or Exacerbation-prone Asthma (PrecISE) study is an adaptive platform trial designed to investigate novel interventions to severe asthma. The study is conducted under a master protocol and utilizes a crossover design with each participant receiving up to five interventions and at least one placebo. Treatment assignments are based on the patients' biomarker profiles and precision health methods are incorporated into the interim and final analyses. We describe key elements of the PrecISE study including the multistage adaptive enrichment strategy, early stopping of an intervention for futility, power calculations, and the primary analysis strategy.
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Affiliation(s)
| | - Elliot Israel
- Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | | | | | | | | | | | | | | | | | | | | | | | | | - Patricia Noel
- Division of Lung Diseases, National Heart, Lung and Blood Institute (NHLBI), National Institutes of Health, Bethesda, MD
| | | | - Praveen Akuthota
- Asthma and Airway Disease Research Center, University of Arizona, Tucson
| | - Dean Billheimer
- Asthma and Airway Disease Research Center, University of Arizona, Tucson
| | | | | | | | | | | | | | - Merritt L. Fajt
- Wells Center for Pediatric Research, Indiana University, Indianapolis
| | | | | | | | | | - Jerry A. Krishnan
- Asthma and Airway Disease Research Center, University of Arizona, Tucson
| | | | | | | | - Ngoc P. Ly
- Rush University Medical Center, Chicago, IL
| | - James N. Moy
- Boston Children’s Hospital and Harvard Medical School, Boston, MA
| | - Wanda Phipatanakul
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD
| | - Kristie Ross
- UH Rainbow Babies and Children’s Hospitals, Cleveland, OH
| | | | - Stanley J. Szefler
- Children’s Hospital Colorado and University of Colorado School of Medicine, Aurora, CO
| | | | | | - Sally E. Wenzel
- National Jewish Health, Denver, CO, and University of Colorado School of Medicine, Aurora, CO
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22
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Skiba MB, Hopkins LL, Hopkins AL, Billheimer D, Funk JL. Nonvitamin, Nonmineral Dietary Supplement Use in Individuals with Rheumatoid Arthritis. J Nutr 2020; 150:2451-2459. [PMID: 32805045 PMCID: PMC7540062 DOI: 10.1093/jn/nxaa197] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 02/27/2020] [Accepted: 06/18/2020] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Over-the-counter, natural product-based (nonvitamin, nonmineral) dietary supplement (NVNM DS) use is common in adults with rheumatoid arthritis (RA), a group at risk for drug-DS interactions, due to polypharmacy, but this use is underreported to health care providers. Recent dramatic changes in US sales of specific NVNM DS suggest that the prevalence and types of NVNM DS used in RA populations may also have shifted. OBJECTIVES A study was undertaken to identify current and past use of specific NVNM DS for RA disease treatment and to examine associations between use of NVNM DS, RA pharmaceuticals, and/or vitamin or mineral (VM) DS. METHODS We developed a survey instrument to capture current and ever use of specific NVNM DS, VM DS, and RA pharmaceuticals, with 696 subjects self-reporting an RA diagnosis recruited online or in clinic for survey participation. Analyses were limited to 611 subjects reporting RA diagnosis after age 18 y and treatment with specific RA pharmaceuticals. RESULTS Most participants reported DS use, with current usage prevalence 49.6% (n = 303), 83.5% (n = 510), or 87.6% (n = 535) for NVNM, VM, or any DS, respectively. While not having appeared in previous RA surveys, turmeric and ginger were among the top 3 NVNM DS in current use, along with fish oil/ω-3 (n-3) PUFA. Concurrent NVNM DS use was reported by 48.2% (n = 243) of participants currently using RA pharmaceuticals (n = 504) and was more common in those using disease-modifying antirheumatic drugs only (no biologics). Most methotrexate users (83%) reported concurrent folate supplementation, with one-third also using turmeric, which is notable because methotrexate and turmeric have been associated with hepatotoxicity. CONCLUSION Individuals with RA commonly use NVNM DS in combination with RA pharmaceuticals, including a previously undocumented but popular use of turmeric or ginger supplements with an unclear risk/benefit ratio.
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Affiliation(s)
- Meghan B Skiba
- Department of Health Promotion Sciences, University of Arizona, Tucson, AZ, USA,Department of Medicine, University of Arizona, Tucson, AZ, USA
| | - Laura L Hopkins
- Department of Medicine, University of Arizona, Tucson, AZ, USA,Department of Nutritional Sciences, University of Arizona, Tucson, AZ, USA
| | - Allison L Hopkins
- Department of Anthropology, Texas A&M University, College Station, TX, USA
| | - Dean Billheimer
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, AZ, USA
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23
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Miller DC, Beamer P, Billheimer D, Subbian V, Sorooshian A, Campbell BS, Mosier JM. Aerosol Risk with Noninvasive Respiratory Support in Patients with COVID-19. J Am Coll Emerg Physicians Open 2020; 1:521-526. [PMID: 32838370 PMCID: PMC7280651 DOI: 10.1002/emp2.12152] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 05/18/2020] [Accepted: 05/19/2020] [Indexed: 01/04/2023] Open
Abstract
Objectives This study evaluates aerosol production with high‐flow nasal cannula (HFNC) and noninvasive positive pressure ventilation (NIPPV) compared to 6 L/min by low‐flow nasal cannula. Methods Two healthy volunteers were randomized to control (6 L/min by low‐flow nasal cannula), NIPPV, or HFNC using block randomization. NIPPV conditions were studied using continuous positive airway pressures of 5, 10, and 15 cm H2O with an FiO2 of 1.0 delivered via full‐face mask. HFNC conditions included flow rates of 30 and 40 L/min with an FiO2 of 1.0 with and without coughing. HFNC and low‐flow nasal cannula conditions were repeated with and without participants wearing a surgical mask. Six aerosol sizes (0.3, 1.0, 2.5, 5, and 10 µm) and total aerosol mass were measured at 2 and 6 ft from the participant's nasopharynx. Results There was no significant difference in aerosol production between either HFNC or NIPPV and control. There was also no significant difference with the use of a procedural mask over the HFNC. There was significant variation between the 2 participants, but in neither case was there a difference compared to control. There was an aerosol‐time trend, but there does not appear to be a difference between either flow rate, pressure, or control. Furthermore, there was no accumulation of total aerosol particles over the total duration of the experiment in both HFNC and NIPPV conditions. Conclusions HFNC and NIPPV did not increase aerosol production compared to 6 L/min by low‐flow nasal cannula in this experiment involving healthy volunteers.
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Affiliation(s)
- David C Miller
- Department of Medicine, Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine University of Arizona College of Medicine Tucson AZ
| | - Paloma Beamer
- Community, Environment & Policy Department, Mel & Enid Zuckerman College of Public Health University of Arizona Tucson AZ.,Department of Chemical & Environmental Engineering, College of Engineering University of Arizona Tucson AZ.,BIO5 Institute University of Arizona Tucson AZ.,Asthma and Airways Disease Research Center University of Arizona Tucson AZ
| | - Dean Billheimer
- BIO5 Institute University of Arizona Tucson AZ.,Asthma and Airways Disease Research Center University of Arizona Tucson AZ.,Epidemiology and Biostatistics Department, Mel & Enid Zuckerman College of Public Health University of Arizona Tucson AZ
| | - Vignesh Subbian
- BIO5 Institute University of Arizona Tucson AZ.,Systems and Industrial Engineering, College of Engineering University of Arizona Tucson AZ.,Biomedical Engineering, College of Engineering University of Arizona Tucson AZ
| | - Armin Sorooshian
- Department of Chemical & Environmental Engineering, College of Engineering University of Arizona Tucson AZ.,Department of Hydrology and Atmospheric Sciences University of Arizona Tucson AZ
| | - Beth Salvagio Campbell
- Department of Emergency Medicine University of Arizona College of Medicine Tucson Arizona
| | - Jarrod M Mosier
- Department of Medicine, Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine University of Arizona College of Medicine Tucson AZ.,Department of Emergency Medicine University of Arizona College of Medicine Tucson Arizona
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24
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Kimura H, Francisco D, Conway M, Martinez FD, Vercelli D, Polverino F, Billheimer D, Kraft M. Type 2 inflammation modulates ACE2 and TMPRSS2 in airway epithelial cells. J Allergy Clin Immunol 2020; 146:80-88.e8. [PMID: 32422146 PMCID: PMC7227558 DOI: 10.1016/j.jaci.2020.05.004] [Citation(s) in RCA: 230] [Impact Index Per Article: 57.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/05/2020] [Accepted: 05/07/2020] [Indexed: 01/04/2023]
Abstract
Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has dramatically changed our world, country, communities, and families. There is controversy regarding risk factors for severe COVID-19 disease. It has been suggested that asthma and allergy are not highly represented as comorbid conditions associated with COVID-19. Objective Our aim was to extend our work in IL-13 biology to determine whether airway epithelial cell expression of 2 key mediators critical for SARS-CoV-2 infection, namely, angiotensin-converting enzyme 2 (ACE2) and transmembrane protease, serine 2 (TMPRSS2), are modulated by IL-13. Methods We determined effects of IL-13 treatment on ACE2 and TMPRSS2 expression ex vivo in primary airway epithelial cells from participants with and without type 2 asthma obtained by bronchoscopy. We also examined expression of ACE2 and TMPRSS2 in 2 data sets containing gene expression data from nasal and airway epithelial cells from children and adults with asthma and allergic rhinitis. Results IL-13 significantly reduced ACE2 and increased TMPRSS2 expression ex vivo in airway epithelial cells. In 2 independent data sets, ACE2 expression was significantly reduced and TMPRSS2 expression was significantly increased in the nasal and airway epithelial cells in type 2 asthma and allergic rhinitis. ACE2 expression was significantly negatively associated with type 2 cytokines, whereas TMPRSS2 expression was significantly positively associated with type 2 cytokines. Conclusion IL-13 modulates ACE2 and TMPRSS2 expression in airway epithelial cells in asthma and atopy. This deserves further study with regard to any effects that asthma and atopy may render in the setting of COVID-19 infection.
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Affiliation(s)
- Hiroki Kimura
- Department of Medicine, College of Medicine Tucson, University of Arizona Health Sciences, Tucson, Ariz
| | - Dave Francisco
- Department of Medicine, College of Medicine Tucson, University of Arizona Health Sciences, Tucson, Ariz
| | - Michelle Conway
- Department of Medicine, College of Medicine Tucson, University of Arizona Health Sciences, Tucson, Ariz
| | - Fernando D Martinez
- Asthma and Airway Disease Research Center, College of Medicine Tucson, University of Arizona Health Sciences, Tucson, Ariz
| | - Donata Vercelli
- Asthma and Airway Disease Research Center, College of Medicine Tucson, University of Arizona Health Sciences, Tucson, Ariz
| | - Francesca Polverino
- Department of Medicine, College of Medicine Tucson, University of Arizona Health Sciences, Tucson, Ariz
| | - Dean Billheimer
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Ariz
| | - Monica Kraft
- Department of Medicine, College of Medicine Tucson, University of Arizona Health Sciences, Tucson, Ariz.
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25
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Beamer PI, Furlong M, Lothrop N, Guerra S, Billheimer D, Stern DA, Zhai J, Halonen M, Wright AL, Martinez FD. CC16 Levels into Adult Life Are Associated with Nitrogen Dioxide Exposure at Birth. Am J Respir Crit Care Med 2019; 200:600-607. [PMID: 30789752 PMCID: PMC6727155 DOI: 10.1164/rccm.201808-1488oc] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 02/20/2019] [Indexed: 12/27/2022] Open
Abstract
Rationale: Lung function and growth are adversely associated with nitrogen dioxide (NO2) exposure. Lower levels of circulating club cell secretory protein (CC16) in childhood are also associated with subsequent decreased lung function. NO2 exposure may induce epithelial damage in lungs and alter club cell proliferation and morphology.Objectives: To determine if increased ambient NO2 levels at participants' home addresses in early life were associated with decreased levels of CC16 from age 6 to 32 years.Methods: Participants were enrolled at birth in the Tucson Children's Respiratory Study and had circulating CC16 measured at least once between age 6 and 32. Linear mixed models were used to determine the association between estimated ambient NO2 exposure at participants' home address at birth or age 6 with CC16 levels from age 6 to 32.Measurements and Main Results: NO2 exposures at birth or age 6 were available for 777 children with one or more CC16 measurement. We found a negative association between NO2 exposure and CC16 levels, with a 4.7% (95% confidence interval, -8.6 to -0.7) decrease in CC16 levels from age 6 to 32 per interquartile range increase in NO2 exposure (6.0 ppb) at the participants' birth address. We observed modification by race (p interaction = 0.04), with stronger associations among participants with at least one black parent (-29.6% [95% confidence interval, -42.9% to -13.2%] per interquartile range). NO2 at participant's age 6 address was not significantly associated with CC16 levels (-1.9%; 95% confidence interval, -6.3 to 2.6).Conclusions: Higher exposure to NO2 at birth is associated with persistently low levels of CC16 from 6 to 32 years.
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Affiliation(s)
- Paloma I. Beamer
- Asthma and Airway Disease Research Center
- Mel and Enid Zuckerman College of Public Health, and
- Bio5 Institute, University of Arizona, Tucson, Arizona
| | | | - Nathan Lothrop
- Asthma and Airway Disease Research Center
- Mel and Enid Zuckerman College of Public Health, and
| | - Stefano Guerra
- Asthma and Airway Disease Research Center
- Mel and Enid Zuckerman College of Public Health, and
- Bio5 Institute, University of Arizona, Tucson, Arizona
| | - Dean Billheimer
- Mel and Enid Zuckerman College of Public Health, and
- Bio5 Institute, University of Arizona, Tucson, Arizona
| | | | - Jing Zhai
- Asthma and Airway Disease Research Center
- Mel and Enid Zuckerman College of Public Health, and
| | | | | | - Fernando D. Martinez
- Asthma and Airway Disease Research Center
- Bio5 Institute, University of Arizona, Tucson, Arizona
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26
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Affiliation(s)
- Dean Billheimer
- Department of Biostatistics and Epidemiology, University of Arizona, Tucson, AZ
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27
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Gerald JK, Hallmark B, Billheimer D, Martinez FD, Gerald LB. Are Latino children of Mexican origin with asthma less responsive to inhaled corticosteroids than white children? J Allergy Clin Immunol Pract 2019; 7:2419-2421. [PMID: 30857938 DOI: 10.1016/j.jaip.2019.02.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 02/15/2019] [Accepted: 02/15/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Joe K Gerald
- Department of Community Environment and Policy, The Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, Ariz; The Asthma and Airways Disease Research Center, The University of Arizona, Tucson, Ariz.
| | - Brian Hallmark
- The Asthma and Airways Disease Research Center, The University of Arizona, Tucson, Ariz; The BIO5 Institute, The University of Arizona, Tucson, Ariz
| | - Dean Billheimer
- The Asthma and Airways Disease Research Center, The University of Arizona, Tucson, Ariz; The BIO5 Institute, The University of Arizona, Tucson, Ariz; Department of Epidemiology and Biostatistics, The Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, Ariz
| | - Fernando D Martinez
- The Asthma and Airways Disease Research Center, The University of Arizona, Tucson, Ariz; The BIO5 Institute, The University of Arizona, Tucson, Ariz; Department of Pediatrics, The University of Arizona College of Medicine, The University of Arizona, Tucson, Ariz
| | - Lynn B Gerald
- The Asthma and Airways Disease Research Center, The University of Arizona, Tucson, Ariz; Department of Health Promotion Sciences, The Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, Ariz
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Li H, Fan J, Vitali F, Berghout J, Aberasturi D, Li J, Wilson L, Chiu W, Pumarejo M, Han J, Kenost C, Koripella PC, Pouladi N, Billheimer D, Bedrick EJ, Lussier YA. Novel disease syndromes unveiled by integrative multiscale network analysis of diseases sharing molecular effectors and comorbidities. BMC Med Genomics 2018; 11:112. [PMID: 30598089 PMCID: PMC6311938 DOI: 10.1186/s12920-018-0428-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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] [Indexed: 12/03/2022] Open
Abstract
Background Forty-two percent of patients experience disease comorbidity, contributing substantially to mortality rates and increased healthcare costs. Yet, the possibility of underlying shared mechanisms for diseases remains not well established, and few studies have confirmed their molecular predictions with clinical datasets. Methods In this work, we integrated genome-wide association study (GWAS) associating diseases and single nucleotide polymorphisms (SNPs) with transcript regulatory activity from expression quantitative trait loci (eQTL). This allowed novel mechanistic insights for noncoding and intergenic regions. We then analyzed pairs of SNPs across diseases to identify shared molecular effectors robust to multiple test correction (False Discovery Rate FDReRNA < 0.05). We hypothesized that disease pairs found to be molecularly convergent would also be significantly overrepresented among comorbidities in clinical datasets. To assess our hypothesis, we used clinical claims datasets from the Healthcare Cost and Utilization Project (HCUP) and calculated significant disease comorbidities (FDRcomorbidity < 0.05). We finally verified if disease pairs resulting molecularly convergent were also statistically comorbid more than by chance using the Fisher’s Exact Test. Results Our approach integrates: (i) 6175 SNPs associated with 238 diseases from ~ 1000 GWAS, (ii) eQTL associations from 19 tissues, and (iii) claims data for 35 million patients from HCUP. Logistic regression (controlled for age, gender, and race) identified comorbidities in HCUP, while enrichment analyses identified cis- and trans-eQTL downstream effectors of GWAS-identified variants. Among ~ 16,000 combinations of diseases, 398 disease-pairs were prioritized by both convergent eQTL-genetics (RNA overlap enrichment, FDReRNA < 0.05) and clinical comorbidities (OR > 1.5, FDRcomorbidity < 0.05). Case studies of comorbidities illustrate specific convergent noncoding regulatory elements. An intergenic architecture of disease comorbidity was unveiled due to GWAS and eQTL-derived convergent mechanisms between distinct diseases being overrepresented among observed comorbidities in clinical datasets (OR = 8.6, p-value = 6.4 × 10− 5 FET). Conclusions These comorbid diseases with convergent eQTL genetic mechanisms suggest clinical syndromes. While it took over a decade to confirm the genetic underpinning of the metabolic syndrome, this study is likely highlighting hundreds of new ones. Further, this knowledge may improve the clinical management of comorbidities with precision and shed light on novel approaches of drug repositioning or SNP-guided precision molecular therapy inclusive of intergenic risks. Electronic supplementary material The online version of this article (10.1186/s12920-018-0428-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Haiquan Li
- Center for Biomedical Informatics and Biostatistics, The University of Arizona, Tucson, AZ, 85721, USA. .,Department of Medicine at the College of Medicine-Tucson, The University of Arizona, Tucson, AZ, 85721, USA. .,Graduate Interdisciplinary Program in Statistics, The University of Arizona, Tucson, AZ, 85721, USA. .,Department of Biosystems Engineering, The University of Arizona, Tucson, AZ, 85721, USA.
| | - Jungwei Fan
- Center for Biomedical Informatics and Biostatistics, The University of Arizona, Tucson, AZ, 85721, USA.,Department of Medicine at the College of Medicine-Tucson, The University of Arizona, Tucson, AZ, 85721, USA
| | - Francesca Vitali
- Center for Biomedical Informatics and Biostatistics, The University of Arizona, Tucson, AZ, 85721, USA.,Department of Medicine at the College of Medicine-Tucson, The University of Arizona, Tucson, AZ, 85721, USA.,University of Arizona Health Sciences, The University of Arizona, Tucson, AZ, 85721, USA
| | - Joanne Berghout
- Center for Biomedical Informatics and Biostatistics, The University of Arizona, Tucson, AZ, 85721, USA.,Department of Medicine at the College of Medicine-Tucson, The University of Arizona, Tucson, AZ, 85721, USA.,The Center for Applied Genetics and Genomics Medicine, The University of Arizona, Tucson, AZ, 85721, USA.,The Center for Innovation in Brain Science, The University of Arizona, Tucson, AZ, 85721, USA
| | - Dillon Aberasturi
- Center for Biomedical Informatics and Biostatistics, The University of Arizona, Tucson, AZ, 85721, USA.,Department of Medicine at the College of Medicine-Tucson, The University of Arizona, Tucson, AZ, 85721, USA.,Graduate Interdisciplinary Program in Statistics, The University of Arizona, Tucson, AZ, 85721, USA
| | - Jianrong Li
- Center for Biomedical Informatics and Biostatistics, The University of Arizona, Tucson, AZ, 85721, USA.,Department of Medicine at the College of Medicine-Tucson, The University of Arizona, Tucson, AZ, 85721, USA.,University of Arizona Health Sciences, The University of Arizona, Tucson, AZ, 85721, USA
| | - Liam Wilson
- Center for Biomedical Informatics and Biostatistics, The University of Arizona, Tucson, AZ, 85721, USA
| | - Wesley Chiu
- Center for Biomedical Informatics and Biostatistics, The University of Arizona, Tucson, AZ, 85721, USA
| | - Minsu Pumarejo
- Center for Biomedical Informatics and Biostatistics, The University of Arizona, Tucson, AZ, 85721, USA
| | - Jiali Han
- Center for Biomedical Informatics and Biostatistics, The University of Arizona, Tucson, AZ, 85721, USA.,Department of Medicine at the College of Medicine-Tucson, The University of Arizona, Tucson, AZ, 85721, USA.,Department of Systems & Industrial Engineering, The University of Arizona, Tucson, AZ, 85721, USA
| | - Colleen Kenost
- Center for Biomedical Informatics and Biostatistics, The University of Arizona, Tucson, AZ, 85721, USA.,Department of Medicine at the College of Medicine-Tucson, The University of Arizona, Tucson, AZ, 85721, USA
| | - Pradeep C Koripella
- Center for Biomedical Informatics and Biostatistics, The University of Arizona, Tucson, AZ, 85721, USA.,Department of Medicine at the College of Medicine-Tucson, The University of Arizona, Tucson, AZ, 85721, USA
| | - Nima Pouladi
- Center for Biomedical Informatics and Biostatistics, The University of Arizona, Tucson, AZ, 85721, USA.,Department of Medicine at the College of Medicine-Tucson, The University of Arizona, Tucson, AZ, 85721, USA
| | - Dean Billheimer
- Center for Biomedical Informatics and Biostatistics, The University of Arizona, Tucson, AZ, 85721, USA.,Graduate Interdisciplinary Program in Statistics, The University of Arizona, Tucson, AZ, 85721, USA.,University of Arizona Health Sciences, The University of Arizona, Tucson, AZ, 85721, USA.,Epidemiology and Biostatistics Department, College of Public Health, The University of Arizona, Tucson, AZ, 85721, USA
| | - Edward J Bedrick
- Center for Biomedical Informatics and Biostatistics, The University of Arizona, Tucson, AZ, 85721, USA.,Graduate Interdisciplinary Program in Statistics, The University of Arizona, Tucson, AZ, 85721, USA.,University of Arizona Health Sciences, The University of Arizona, Tucson, AZ, 85721, USA.,Epidemiology and Biostatistics Department, College of Public Health, The University of Arizona, Tucson, AZ, 85721, USA
| | - Yves A Lussier
- Center for Biomedical Informatics and Biostatistics, The University of Arizona, Tucson, AZ, 85721, USA. .,Department of Medicine at the College of Medicine-Tucson, The University of Arizona, Tucson, AZ, 85721, USA. .,Graduate Interdisciplinary Program in Statistics, The University of Arizona, Tucson, AZ, 85721, USA. .,The Center for Applied Genetics and Genomics Medicine, The University of Arizona, Tucson, AZ, 85721, USA. .,The Center for Innovation in Brain Science, The University of Arizona, Tucson, AZ, 85721, USA. .,UA Cancer Center, The University of Arizona, Tucson, AZ, 85721, USA. .,University of Arizona Health Sciences, The University of Arizona, Tucson, AZ, 85721, USA.
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Gerald JK, Fisher JM, Brown MA, Clemens CJ, Moore MA, Carvajal SC, Bryson D, Stefan N, Billheimer D, Gerald LB. School-supervised use of a once-daily inhaled corticosteroid regimen: A cluster randomized trial. J Allergy Clin Immunol 2018; 143:755-764. [PMID: 30118728 DOI: 10.1016/j.jaci.2018.06.048] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 06/22/2018] [Accepted: 06/28/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND School-supervised use of a once-daily inhaled corticosteroid regimen (supervised therapy) can improve medication adherence and asthma control. OBJECTIVE We sought to evaluate the effectiveness of supervised therapy in a unique setting and population. METHODS We conducted a cluster randomized trial of supervised therapy in 20 elementary schools with a disproportionate enrollment of low-income Latino students. Schools were purposively selected, matched, and randomized to receive 9 months of supervised therapy with mometasone furoate or usual care. All English- or Spanish-speaking students with self-reported asthma were eligible. The Asthma Control Questionnaire (ACQ) was interviewer administered quarterly at school. Students in supervised therapy schools were hypothesized to have lower ACQ scores than students in usual-care schools. RESULTS Of 393 enrolled students, 189 students receiving immediate intervention and 143 students receiving delayed intervention provided 1 or more ACQ data points, were between 6 and 10 years of age, and were included in the primary analysis. At baseline, 39% of students reported taking a controller medication, and 24% had well-controlled asthma. Eighty percent of students receiving immediate intervention were prescribed mometasone. Schools administered 98% of prescribed doses when students attended school. Absences, weekends, and holidays reduced calendar adherence to 53%. During the first year, the mean ACQ score for students receiving immediate and delayed intervention was 1.55 (95% CI, 1.41-1.70) and 1.64 (95% CI, 1.47-1.80), respectively. The estimated treatment effect was -0.08 (95% CI, -0.31 to 0.14). DISCUSSION Compared with usual care, supervised therapy did not improve asthma control among this population of Latino students. Additional research is warranted to confirm these results.
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Affiliation(s)
- Joe K Gerald
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Ariz; Asthma and Airways Disease Research Center, University of Arizona, Tucson, Ariz.
| | | | - Mark A Brown
- Department of Pediatrics, University of Colorado, Denver, Colo; The Breathing Institute, Children's Hospital Colorado, Denver, Colo
| | - Conrad J Clemens
- Department of Pediatrics, University of Arizona College of Medicine, University of Arizona, Tucson, Ariz
| | - Melissa A Moore
- Department of Pediatrics, University of Arizona College of Medicine, University of Arizona, Tucson, Ariz
| | - Scott C Carvajal
- Department of Health Promotion Sciences, the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Ariz
| | - Donna Bryson
- American Lung Association of Southern Arizona, Tucson, Ariz
| | - Nikki Stefan
- Department of Health Services, Tucson Unified School District, Tucson, Ariz
| | - Dean Billheimer
- BIO5 Institute, University of Arizona, Tucson, Ariz; Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Ariz
| | - Lynn B Gerald
- Asthma and Airways Disease Research Center, University of Arizona, Tucson, Ariz; Department of Health Promotion Sciences, the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Ariz
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Skiba MB, Luis PB, Alfarara C, Billheimer D, Schneider C, Funk JL. Curcuminoid Content and Safety-Related Markers of Quality of Turmeric Dietary Supplements Sold in an Urban Retail Marketplace in the United States. Mol Nutr Food Res 2018; 62:e1800143. [PMID: 29808963 PMCID: PMC6277232 DOI: 10.1002/mnfr.201800143] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 05/08/2018] [Indexed: 01/25/2023]
Abstract
SCOPE Turmeric is a top selling dietary supplement (DS) in the United States with rapidly expanding usage. Therefore, turmeric DS formulations available for sale in an urban US retail marketplace are analyzed, and point of sale information is related to measures of quality relevant to safety. METHODS AND RESULTS Eighty-seven unique turmeric DS are identified; a majority (94%) contained turmeric-derived curcuminoid extracts (TD-CE), which are combined with other bioactives in 47% of products, including piperine (24%), an additive that could alter the metabolism of concurrent medications. While curcuminoid content is within 80% of anticipated for a majority of products analyzed (n = 35), curcuminoid composition (% curcumin) did not meet US Pharmacopeia (USP) criteria for TD-CE in 59% and is suggestive of possible unlabeled use of synthetic curcumin in some. Lead content is associated with the inclusion of turmeric root and exceeded USP limits in one product. Residues of toxic class 1 or 2 solvents, which are not needed for TD-CE isolation, are present in 71% of products, although quantified levels were within USP-specified limits. CONCLUSION Assessment of turmeric DS quality at point of sale is difficult for consumers and may best be managed in partnership with knowledgeable healthcare professionals.
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Affiliation(s)
- Meghan B Skiba
- Mel and Enid Zuckerman College of Public Health, Department of Health Promotion Sciences, University of Arizona, Tucson, Arizona,College of Medicine, Department of Medicine, University of Arizona, Tucson, Arizona
| | - Paula B. Luis
- School of Medicine, Department of Pharmacology, Vanderbilt University, Nashville, Tennessee
| | - Chelsea Alfarara
- College of Medicine, Department of Medicine, University of Arizona, Tucson, Arizona
| | - Dean Billheimer
- Mel and Enid Zuckerman College of Public Health, Department of Health Promotion Sciences, University of Arizona, Tucson, Arizona
| | - Claus Schneider
- School of Medicine, Department of Pharmacology, Vanderbilt University, Nashville, Tennessee
| | - Janet L Funk
- College of Medicine, Department of Medicine, University of Arizona, Tucson, Arizona
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Abstract
Continuous-time Markov models are commonly used to analyze longitudinal transitions between multiple disease states in panel data, where participants' disease states are only observed at multiple time points, and the exact state paths between observations are unknown. However, when covariate effects are incorporated and allowed to vary for different transitions, the number of potential parameters to estimate can become large even when the number of covariates is moderate, and traditional maximum likelihood estimation and subset model selection procedures can easily become unstable due to overfitting. We propose a novel regularized continuous-time Markov model with the elastic net penalty, which is capable of simultaneous variable selection and estimation for large number of parameters. We derive an efficient coordinate descent algorithm to solve the penalized optimization problem, which is fully automatic and data driven. We further consider an extension where one of the states is death, and time of death is exactly known but the state path leading to death is unknown. The proposed method is extensively evaluated in a simulation study, and demonstrated in an application to real-world data on airflow limitation state transitions.
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Affiliation(s)
- Shuang Huang
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, Arizona, U.S.A
| | - Chengcheng Hu
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, Arizona, U.S.A
| | - Melanie L Bell
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, Arizona, U.S.A
| | - Dean Billheimer
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, Arizona, U.S.A
| | - Stefano Guerra
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, Arizona, U.S.A
| | - Denise Roe
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, Arizona, U.S.A
| | - Monica M Vasquez
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, Arizona, U.S.A
| | - Edward J Bedrick
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, Arizona, U.S.A
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Li H, Canet MJ, Clarke JD, Billheimer D, Xanthakos SA, Lavine JE, Erickson RP, Cherrington NJ. Pediatric Cytochrome P450 Activity Alterations in Nonalcoholic Steatohepatitis. Drug Metab Dispos 2017; 45:1317-1325. [PMID: 28986475 PMCID: PMC5697442 DOI: 10.1124/dmd.117.077644] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [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: 07/18/2017] [Accepted: 09/28/2017] [Indexed: 01/01/2023] Open
Abstract
Variable drug responses depend on individual variation in the activity of drug-metabolizing enzymes, including cytochrome P450 enzymes (CYP). As the most common chronic liver disease in children and adults, nonalcoholic steatohepatitis (NASH) has been identified as a source of significant interindividual variation in hepatic drug metabolism. Compared with adults, children present age-related differences in pharmacokinetics and pharmacodynamics. The purpose of this study was to determine the impact of fatty liver disease severity on the activity of a variety of CYP enzymes in children and adolescents. Healthy and nonalcoholic fatty liver disease pediatric subjects aged 12-21 years inclusive received an oral cocktail of four probe drugs: caffeine (CYP1A2, 100 mg), omeprazole (CYP2C19, 20 mg), losartan (CYP2C9, 25 mg), and midazolam (CYP3A4, 2 mg). Venous blood and urine were collected before administration and 1, 2, 4, and 6 hours after administration. Concentrations of the parent drugs and CYP-specific metabolites were quantified in plasma and urine using liquid chromatography with tandem mass spectrometry. In plasma, the decreased metabolic area under the curve (AUC) ratio, defined as the metabolite AUC to parent AUC, of omeprazole indicated significant decreases of CYP2C19 (P = 0.002) enzymatic activities in NASH adolescents, while the urine analyses did not show significant differences and were highly variable. A comparison between the present in vivo pediatric studies and a previous ex vivo study in adults indicates distinct differences in the activities of CYP1A2 and CYP2C9. These data demonstrate that pediatric NASH presents an altered pattern of CYP activity and NASH should be considered as a confounder of drug metabolism for certain CYP enzymes. These differences could lead to future investigations that may reveal unexpected variable drug responses that should be considered in pediatric dosage recommendations.
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Affiliation(s)
- Hui Li
- Department of Pharmacology and Toxicology (H.L., M.J.C., J.D.C., N.J.C.), Department of Epidemiology and Biostatistics (D.B.), and Department of Pediatrics (R.P.E.), University of Arizona, Tucson, Arizona; Cincinnati Children's Hospital, University of Cincinnati, Cincinnati, Ohio (S.A.X.); Columbia University, New York, New York (J.E.L.)
| | - Mark J Canet
- Department of Pharmacology and Toxicology (H.L., M.J.C., J.D.C., N.J.C.), Department of Epidemiology and Biostatistics (D.B.), and Department of Pediatrics (R.P.E.), University of Arizona, Tucson, Arizona; Cincinnati Children's Hospital, University of Cincinnati, Cincinnati, Ohio (S.A.X.); Columbia University, New York, New York (J.E.L.)
| | - John D Clarke
- Department of Pharmacology and Toxicology (H.L., M.J.C., J.D.C., N.J.C.), Department of Epidemiology and Biostatistics (D.B.), and Department of Pediatrics (R.P.E.), University of Arizona, Tucson, Arizona; Cincinnati Children's Hospital, University of Cincinnati, Cincinnati, Ohio (S.A.X.); Columbia University, New York, New York (J.E.L.)
| | - Dean Billheimer
- Department of Pharmacology and Toxicology (H.L., M.J.C., J.D.C., N.J.C.), Department of Epidemiology and Biostatistics (D.B.), and Department of Pediatrics (R.P.E.), University of Arizona, Tucson, Arizona; Cincinnati Children's Hospital, University of Cincinnati, Cincinnati, Ohio (S.A.X.); Columbia University, New York, New York (J.E.L.)
| | - Stavra A Xanthakos
- Department of Pharmacology and Toxicology (H.L., M.J.C., J.D.C., N.J.C.), Department of Epidemiology and Biostatistics (D.B.), and Department of Pediatrics (R.P.E.), University of Arizona, Tucson, Arizona; Cincinnati Children's Hospital, University of Cincinnati, Cincinnati, Ohio (S.A.X.); Columbia University, New York, New York (J.E.L.)
| | - Joel E Lavine
- Department of Pharmacology and Toxicology (H.L., M.J.C., J.D.C., N.J.C.), Department of Epidemiology and Biostatistics (D.B.), and Department of Pediatrics (R.P.E.), University of Arizona, Tucson, Arizona; Cincinnati Children's Hospital, University of Cincinnati, Cincinnati, Ohio (S.A.X.); Columbia University, New York, New York (J.E.L.)
| | - Robert P Erickson
- Department of Pharmacology and Toxicology (H.L., M.J.C., J.D.C., N.J.C.), Department of Epidemiology and Biostatistics (D.B.), and Department of Pediatrics (R.P.E.), University of Arizona, Tucson, Arizona; Cincinnati Children's Hospital, University of Cincinnati, Cincinnati, Ohio (S.A.X.); Columbia University, New York, New York (J.E.L.)
| | - Nathan J Cherrington
- Department of Pharmacology and Toxicology (H.L., M.J.C., J.D.C., N.J.C.), Department of Epidemiology and Biostatistics (D.B.), and Department of Pediatrics (R.P.E.), University of Arizona, Tucson, Arizona; Cincinnati Children's Hospital, University of Cincinnati, Cincinnati, Ohio (S.A.X.); Columbia University, New York, New York (J.E.L.)
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Berry CE, Billheimer D, Jenkins IC, Lu ZJ, Stern DA, Gerald LB, Carr TF, Guerra S, Morgan WJ, Wright AL, Martinez FD. A Distinct Low Lung Function Trajectory from Childhood to the Fourth Decade of Life. Am J Respir Crit Care Med 2017; 194:607-12. [PMID: 27585385 DOI: 10.1164/rccm.201604-0753oc] [Citation(s) in RCA: 135] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
RATIONALE Low maximally attained lung function increases the risk of chronic obstructive pulmonary disease irrespective of the subsequent rate of lung function decline. OBJECTIVES We aimed to determine if there were individuals with a distinct, persistently low lung function trajectory in the CRS (Tucson Children's Respiratory Study). METHODS The CRS, an ongoing birth cohort study, enrolled 1,246 participants between 1980 and 1984. Latent class linear mixed effects modeling of the ratio of FEV1 to FVC was used to identify distinct lung function trajectories among participants with two or more spirometry measurements between ages 11 and 32 years. MEASUREMENTS AND MAIN RESULTS Among 599 participants with 2,142 observations, a model with two distinct trajectories (a low trajectory [n = 56; 9.3%] and a normal trajectory) fit the data significantly better than a model with only one trajectory (P = 0.0007). As compared with those with a normal trajectory, participants with a persistently low trajectory were more likely to have a history of maternal asthma (20.0% vs. 9.9%; P = 0.02); early life lower respiratory illness caused by respiratory syncytial virus (41.2% vs. 21.4%; P = 0.001); and physician-diagnosed active asthma at age 32 years (43.9% vs. 16.2%; P < 0.001). Individuals with a persistently low trajectory also demonstrated lower lung function as measured by average maximal expiratory flow at functional residual capacity during infancy and at age 6 years. CONCLUSIONS A distinct group of individuals in a nonselected population demonstrates a persistently low lung function trajectory that may be partly established at birth and predisposes them to chronic obstructive pulmonary disease later in life.
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Affiliation(s)
| | - Dean Billheimer
- 3 BIO5 Institute, University of Arizona, Tucson, Arizona.,4 Department of Epidemiology and Biostatistics and
| | - Isaac C Jenkins
- 5 Fred Hutchinson Cancer Research Center, Seattle, Washington; and
| | - Zhenqiang J Lu
- 3 BIO5 Institute, University of Arizona, Tucson, Arizona
| | | | - Lynn B Gerald
- 2 Arizona Respiratory Center and.,6 Department of Health Promotion Sciences, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona
| | - Tara F Carr
- 1 Department of Medicine and.,2 Arizona Respiratory Center and
| | - Stefano Guerra
- 1 Department of Medicine and.,2 Arizona Respiratory Center and.,7 CREAL Center, Pompeu Fabra University, Barcelona, Spain
| | - Wayne J Morgan
- 8 Department of Pediatrics, University of Arizona College of Medicine, Tucson, Arizona.,2 Arizona Respiratory Center and
| | - Anne L Wright
- 8 Department of Pediatrics, University of Arizona College of Medicine, Tucson, Arizona.,2 Arizona Respiratory Center and
| | - Fernando D Martinez
- 8 Department of Pediatrics, University of Arizona College of Medicine, Tucson, Arizona.,2 Arizona Respiratory Center and.,3 BIO5 Institute, University of Arizona, Tucson, Arizona
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Lothrop N, Hussaini K, Billheimer D, Beamer P. Community-level characteristics and environmental factors of child respiratory illnesses in Southern Arizona. BMC Public Health 2017; 17:516. [PMID: 28545417 PMCID: PMC5445507 DOI: 10.1186/s12889-017-4424-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 05/15/2017] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Lower respiratory illnesses (LRIs) and asthma are common diseases in children <5 years of age. Few studies have investigated the relationships between multiple, home-based social and environmental risk factors and asthma and LRIs in children. Of those that have, none have focused exclusively on children <5 years of age, who are more physiologically vulnerable and spend more time at home compared to older children. Further, no studies have done so at the community level. METHODS We modeled relationships between emergency department visits and hospitalization rates for asthma and LRIs for children <5 years and geographic risk factors, including socio-economic and housing characteristics, ambient air pollution levels, and population density in Maricopa and Pima Counties, Arizona, from 2005 to 2009. We used a generalized linear model with a negative binomial observation distribution and an offset for the population of very young children in each tract. To reduce multicollinearity among predictors, socio-economic characteristics, and ambient air pollutant levels were combined into unit-less indices using the principal components analysis (PCA). Housing characteristics variables did not exhibit moderate-to-high correlations and thus were not included in PCA. Spatial autocorrelation among regression model residuals was assessed with the Global Moran's I test. RESULTS Following the regression analyses, almost all predictors were significantly related to at least one disease outcome. Lower socio-economic status (SES) and reduced population density were associated with asthma hospitalization rates and both LRI outcomes (p values <0.001). After adjusting for differences between counties, Pima County residence was associated with lower asthma and LRI hospitalization rates. No spatial autocorrelation was found among multiple regression model residuals (p values >0.05). CONCLUSIONS Our study revealed complex, multi-factorial associations between predictors and outcomes. Findings indicate that many rural areas with lower SES have distinct factors for childhood respiratory diseases that require further investigation. County-wide differences in maternal characteristics or agricultural land uses (not tested here) may also play a role in Pima County residence protecting against hospitalizations, when compared to Maricopa County. By better understanding this and other relationships, more focused public health interventions at the community level could be developed to reduce and better control these diseases in children <5 years, who are more physiologically vulnerable.
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Affiliation(s)
- Nathan Lothrop
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., PO 245210, Tucson, AZ 85724 USA
| | - Khaleel Hussaini
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., PO 245210, Tucson, AZ 85724 USA
- Biomedical Informatics, College of Medicine, University of Arizona, Tucson, AZ 85724 USA
| | - Dean Billheimer
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., PO 245210, Tucson, AZ 85724 USA
- BIO5 Institute, University of Arizona, Tucson, AZ 85724 USA
| | - Paloma Beamer
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., PO 245210, Tucson, AZ 85724 USA
- BIO5 Institute, University of Arizona, Tucson, AZ 85724 USA
- Arizona Respiratory Center, University of Arizona, Tucson, AZ 85724 USA
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Xu H, Radabaugh T, Lu Z, Galligan M, Billheimer D, Vercelli D, Wright AL, Monks TJ, Halonen M, Lau SS. Exploration of early-life candidate biomarkers for childhood asthma using antibody arrays. Pediatr Allergy Immunol 2016; 27:696-701. [PMID: 27434124 PMCID: PMC5526199 DOI: 10.1111/pai.12613] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/16/2016] [Indexed: 01/12/2023]
Abstract
BACKGROUND Proteomic approaches identifying biomarkers have been applied to asthma to only a very limited extent. METHODS With an antibody array (RayBiotech, Norcross, GA, USA), the relative intensity and rank differences of 444 proteins were compared in 24 plasma samples obtained at age 3, 11 from children with and 12 without asthma diagnoses at ages 5 and 9. Protein candidates identified by antibody array were quantitated by ELISA in an enlarged sample. Proteins found to differentiate children with and without asthma were also examined for association with known Year 1 asthma risk factors, eczema, and wheeze. RESULTS In the antibody array, four proteins had rank differences between asthma and non-asthma groups (FDR <0.1). By ELISA, mean log (±s.e.m.) erythropoietin (EPO) level (IU/l) was lower (0.750 ± 0.048 vs. 0.898 ± 0.035; p = 0.006) and mean (±s.e.m.) soluble GP130 (sGP130) level (ng/ml) was higher in the asthma vs. the non-asthma group (302 ± 13 vs. 270 ± 8; p = 0.041). The other 2 array proteins (galactin-3 and eotaxin-3) did not differ by ELISA by asthma. EPO related to the asthma risk factor, first year eczema, whereas sGP130 related to first year wheeze. CONCLUSIONS Through two independent assessments, age 3 plasma levels of EPO and sGP130 were found related to childhood asthma.
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Affiliation(s)
- Haili Xu
- Southwest Environmental Health Sciences Center, The University of Arizona, Tucson, AZ, USA.,Department of Pharmacology, The University of Arizona, Tucson, AZ, USA
| | - Timothy Radabaugh
- Southwest Environmental Health Sciences Center, The University of Arizona, Tucson, AZ, USA.,Department of Pharmacology and Toxicology, College of Pharmacy, The University of Arizona, Tucson, AZ, USA
| | - Zhenqiang Lu
- Southwest Environmental Health Sciences Center, The University of Arizona, Tucson, AZ, USA.,Department of Epidemiology and Biostatistics, College of Public Health, The University of Arizona, Tucson, AZ, USA
| | - Michael Galligan
- Southwest Environmental Health Sciences Center, The University of Arizona, Tucson, AZ, USA.,Department of Pharmacology and Toxicology, College of Pharmacy, The University of Arizona, Tucson, AZ, USA
| | - Dean Billheimer
- Southwest Environmental Health Sciences Center, The University of Arizona, Tucson, AZ, USA.,Department of Epidemiology and Biostatistics, College of Public Health, The University of Arizona, Tucson, AZ, USA.,Bio5 Institute, The University of Arizona, Tucson, AZ, USA.,Statistics Consulting Laboratory, The University of Arizona, Tucson, AZ, USA
| | - Donata Vercelli
- Southwest Environmental Health Sciences Center, The University of Arizona, Tucson, AZ, USA.,Bio5 Institute, The University of Arizona, Tucson, AZ, USA.,Department of Cellular and Molecular Medicine, The University of Arizona, Tucson, AZ, USA.,Arizona Respiratory Center, The University of Arizona, Tucson, AZ, USA.,Arizona Center for the Biology of Complex Disease, The University of Arizona, Tucson, AZ, USA
| | - Anne L Wright
- Arizona Respiratory Center, The University of Arizona, Tucson, AZ, USA.,Department of Pediatrics, College of Medicine, The University of Arizona, Tucson, AZ, USA
| | - Terrence J Monks
- Southwest Environmental Health Sciences Center, The University of Arizona, Tucson, AZ, USA.,Department of Pharmacology and Toxicology, College of Pharmacy, The University of Arizona, Tucson, AZ, USA.,Bio5 Institute, The University of Arizona, Tucson, AZ, USA.,Arizona Center for the Biology of Complex Disease, The University of Arizona, Tucson, AZ, USA
| | - Marilyn Halonen
- Department of Pharmacology, The University of Arizona, Tucson, AZ, USA.,Bio5 Institute, The University of Arizona, Tucson, AZ, USA.,Arizona Respiratory Center, The University of Arizona, Tucson, AZ, USA.,Arizona Center for the Biology of Complex Disease, The University of Arizona, Tucson, AZ, USA
| | - Serrine S Lau
- Southwest Environmental Health Sciences Center, The University of Arizona, Tucson, AZ, USA. .,Department of Pharmacology and Toxicology, College of Pharmacy, The University of Arizona, Tucson, AZ, USA. .,Bio5 Institute, The University of Arizona, Tucson, AZ, USA. .,Arizona Center for the Biology of Complex Disease, The University of Arizona, Tucson, AZ, USA.
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Abstract
The usual candidate distributions for modeling compositions, the Dirichlet and the logistic normal distribution, do not include zero components in their support. Methods have been developed and refined for dealing with zeros that are rounded, or due to a value being below a detection level. Methods have also been developed for zeros in compositions arising from count data. However, essential zeros, cases where a component is truly absent, in continuous compositions are still a problem.The most promising approach is based on extending the logistic normal distribution to model essential zeros using a mixture of additive logistic normal distributions of different dimension, related by common parameters. We continue this approach, and by imposing an additional constraint, develop a likelihood, and show ways of estimating parameters for location and dispersion. The proposed likelihood, conditional on parameters for the probability of zeros, is a mixture of additive logistic normal distributions of different dimensions whose location and dispersion parameters are projections of a common location or dispersion parameter. For some simple special cases, we contrast the relative efficiency of different location estimators.
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Beamer PI, Lothrop N, Lu Z, Ascher R, Ernst K, Stern DA, Billheimer D, Wright AL, Martinez FD. Spatial clusters of child lower respiratory illnesses associated with community-level risk factors. Pediatr Pulmonol 2016; 51:633-42. [PMID: 26436763 PMCID: PMC5349765 DOI: 10.1002/ppul.23332] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 08/11/2015] [Accepted: 09/07/2015] [Indexed: 11/06/2022]
Abstract
Identifying geographic areas with increased incidence of disease may elucidate community-level risk factors for intervention development. Lower respiratory illnesses (LRIs) are the leading cause of death in children and are associated with other morbidities. We assessed geographic clustering of LRIs and evaluated if these spatial patterns and associated risk factors differed by phenotype. Participants enrolled at birth in the Tucson Children's Respiratory Study were followed through age three for physician diagnosed LRIs. Spatial clustering analysis, based upon each participant's birth address, was performed for four LRI phenotypes. We conducted principal component analysis at the census tract level to generate indices for lower socioeconomic status (SES), poorer housing conditions, and increased air pollution. Enrollment addresses were mapped for 812 subjects, of whom 58.4%, 33.5%, 34.2%, and 23.4% had any LRI, a wheezing LRI, a viral LRI, and a respiratory syncytial virus (RSV) LRI, respectively. Patterns of spatial clustering and associated risk factors differed by LRI phenotype. Multivariable regression analyses showed that wheezing LRI clusters were associated with increased air pollution (OR = 1.18, P = 0.01). Being in a viral cluster was associated with poorer housing conditions (OR = 1.28, P = 0.01), while being in a RSV cluster was associated with increased air pollution (OR = 1.14, P = 0.006), poorer housing conditions (OR = 1.54, P = 0.003), and higher SES (OR = 0.77, P = 0.001). Our use of social and environmental indices allowed us to identify broad contextual factors that may contribute to increased incidence of LRIs in specific geographic regions. To reduce LRI incidence, multifaceted interventions should be developed at the community level. Pediatr Pulmonol. 2016;51:633-642. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Paloma I Beamer
- Arizona Respiratory Center, University of Arizona, Tucson, Arizona.,Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona.,Bio5 Institute, University of Arizona, Tucson, Arizona
| | - Nathan Lothrop
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| | - Zhenqiang Lu
- Bio5 Institute, University of Arizona, Tucson, Arizona
| | - Rebecca Ascher
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| | - Kacey Ernst
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| | - Debra A Stern
- Arizona Respiratory Center, University of Arizona, Tucson, Arizona
| | - Dean Billheimer
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona.,Bio5 Institute, University of Arizona, Tucson, Arizona
| | - Anne L Wright
- Arizona Respiratory Center, University of Arizona, Tucson, Arizona
| | - Fernando D Martinez
- Arizona Respiratory Center, University of Arizona, Tucson, Arizona.,Bio5 Institute, University of Arizona, Tucson, Arizona
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Beamer PI, Klimecki WT, Loh M, Van Horne YO, Sugeng AJ, Lothrop N, Billheimer D, Guerra S, Lantz RC, Canales RA, Martinez FD. Association of Children's Urinary CC16 Levels with Arsenic Concentrations in Multiple Environmental Media. Int J Environ Res Public Health 2016; 13:E521. [PMID: 27223295 PMCID: PMC4881146 DOI: 10.3390/ijerph13050521] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 05/06/2016] [Accepted: 05/16/2016] [Indexed: 02/08/2023]
Abstract
Arsenic exposure has been associated with decreased club cell secretory protein (CC16) levels in adults. Further, both arsenic exposure and decreased levels of CC16 in childhood have been associated with decreased adult lung function. Our objective was to determine if urinary CC16 levels in children are associated with arsenic concentrations in environmental media collected from their homes. Yard soil, house dust, and tap water were taken from 34 homes. Urine and toenail samples were collected from 68 children. All concentrations were natural log-transformed prior to data analysis. There were associations between urinary CC16 and arsenic concentration in soil (b = -0.43, p = 0.001, R² = 0.08), water (b = -0.22, p = 0.07, R² = 0.03), house dust (b = -0.37, p = 0.07, R² = 0.04), and dust loading (b = -0.21, p = 0.04, R² = 0.04). In multiple analyses, only the concentration of arsenic in soil was associated with urinary CC16 levels (b = -0.42, p = 0.02, R² = 0.14 (full model)) after accounting for other factors. The association between urinary CC16 and soil arsenic may suggest that localized arsenic exposure in the lungs could damage the airway epithelium and predispose children for diminished lung function. Future work to assess this possible mechanism should examine potential associations between airborne arsenic exposures, CC16 levels, lung function, and other possible confounders in children in arsenic-impacted communities.
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Affiliation(s)
- Paloma I Beamer
- Asthma and Airways Disease Research Center, University of Arizona, 1501 N. Campbell Ave., Tucson, AZ 85724, USA.
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA.
- Department of Chemical and Environmental Engineering, University of Arizona, 1133 E. James E. Rogers Way, Tucson, AZ 85721, USA.
| | - Walter T Klimecki
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA.
- Department of Pharmacology and Toxicology, College of Pharmacy, University of Arizona, P.O. Box 210207, Tucson, AZ 85724, USA.
| | - Miranda Loh
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA.
- Institute of Occupational Medicine, Research Avenue North, Riccarton, Edinburgh EH14 4AP, UK.
| | - Yoshira Ornelas Van Horne
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA.
| | - Anastasia J Sugeng
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA.
| | - Nathan Lothrop
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA.
| | - Dean Billheimer
- Asthma and Airways Disease Research Center, University of Arizona, 1501 N. Campbell Ave., Tucson, AZ 85724, USA.
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA.
| | - Stefano Guerra
- Asthma and Airways Disease Research Center, University of Arizona, 1501 N. Campbell Ave., Tucson, AZ 85724, USA.
| | - Robert Clark Lantz
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA.
- Department of Cellular and Molecular Medicine, University of Arizona, P.O. Box 245044, Tucson, AZ 85724, USA.
| | - Robert A Canales
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA.
| | - Fernando D Martinez
- Asthma and Airways Disease Research Center, University of Arizona, 1501 N. Campbell Ave., Tucson, AZ 85724, USA.
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Koska J, Yassine H, Trenchevska O, Sinari S, Schwenke DC, Yen FT, Billheimer D, Nelson RW, Nedelkov D, Reaven PD. Disialylated apolipoprotein C-III proteoform is associated with improved lipids in prediabetes and type 2 diabetes. J Lipid Res 2016; 57:894-905. [PMID: 26945091 DOI: 10.1194/jlr.p064816] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Indexed: 11/20/2022] Open
Abstract
The apoC-III proteoform containing two sialic acid residues (apoC-III2) has different in vitro effects on lipid metabolism compared with asialylated (apoC-III0) or the most abundant monosialylated (apoC-III1) proteoforms. Cross-sectional and longitudinal associations between plasma apoC-III proteoforms (by mass spectrometric immunoassay) and plasma lipids were tested in two randomized clinical trials: ACT NOW, a study of pioglitazone in subjects with impaired glucose tolerance (n = 531), and RACED (n = 296), a study of intensive glycemic control and atherosclerosis in type 2 diabetes patients. At baseline, higher relative apoC-III2 and apoC-III2/apoC-III1 ratios were associated with lower triglycerides and total cholesterol in both cohorts, and with lower small dense LDL in the RACED. Longitudinally, changes in apoC-III2/apoC-III1 were inversely associated with changes in triglycerides in both cohorts, and with total and small dense LDL in the RACED. apoC-III2/apoC-III1 was also higher in patients treated with PPAR-γ agonists and was associated with reduced cardiovascular events in the RACED control group. Ex vivo studies of apoC-III complexes with higher apoC-III2/apoC-III1 showed attenuated inhibition of VLDL uptake by HepG2 cells and LPL-mediated lipolysis, providing possible functional explanations for the inverse association between a higher apoC-III2/apoC-III1 and hypertriglyceridemia, proatherogenic plasma lipid profiles, and cardiovascular risk.
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Affiliation(s)
- Juraj Koska
- Phoenix Veterans Affairs Health Care System, Phoenix, AZ
| | | | | | | | | | - Frances T Yen
- Université de Lorraine, URAFPA, INSERM, Vandoeuvre-lès-Nancy, France
| | | | | | | | - Peter D Reaven
- Phoenix Veterans Affairs Health Care System, Phoenix, AZ
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Beamer PI, Lothrop N, Stern DA, Billheimer D, Wright AL, Martinez FD. Increased wheezing risk with diesel exposure among children of younger mothers. Eur Respir J 2015; 46:853-5. [PMID: 25882808 DOI: 10.1183/09031936.00227214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 03/03/2015] [Indexed: 11/05/2022]
Affiliation(s)
- Paloma I Beamer
- Arizona Respiratory Center, University of Arizona, Tucson, AZ, USA Environmental Health Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA Bio5 Institute, University of Arizona, Tucson, AZ, USA
| | - Nathan Lothrop
- Environmental Health Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Debra A Stern
- Arizona Respiratory Center, University of Arizona, Tucson, AZ, USA
| | - Dean Billheimer
- Bio5 Institute, University of Arizona, Tucson, AZ, USA Agricultural and Biosystems Engineering, College of Agriculture and Life Sciences, University of Arizona, Tucson, AZ, USA
| | - Anne L Wright
- Arizona Respiratory Center, University of Arizona, Tucson, AZ, USA
| | - Fernando D Martinez
- Arizona Respiratory Center, University of Arizona, Tucson, AZ, USA Bio5 Institute, University of Arizona, Tucson, AZ, USA
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Billheimer D, Gerner EW, McLaren CE, LaFleur B. Combined benefit of prediction and treatment: a criterion for evaluating clinical prediction models. Cancer Inform 2014; 13:93-103. [PMID: 25336898 PMCID: PMC4197927 DOI: 10.4137/cin.s13780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 06/29/2014] [Accepted: 07/01/2014] [Indexed: 11/22/2022] Open
Abstract
Clinical treatment decisions rely on prognostic evaluation of a patient’s future health outcomes. Thus, predictive models under different treatment options are key factors for making good decisions. While many criteria exist for judging the statistical quality of a prediction model, few are available to measure its clinical utility. As a consequence, we may find that the addition of a clinical covariate or biomarker improves the statistical quality of the model, but has little effect on its clinical usefulness. We focus on the setting where a treatment decision may reduce a patient’s risk of a poor outcome, but also comes at a cost; this may be monetary, inconvenience, or the potential side effects. This setting is exemplified by cancer chemoprevention, or the use of statins to reduce the risk of cardiovascular disease. We propose a novel approach to assessing a prediction model using a formal decision analytic framework. We combine the predictive model’s ability to discriminate good from poor outcome with the net benefit afforded by treatment. In this framework, reduced risk is balanced against the cost of treatment. The relative cost–benefit of treatment provides a useful index to assist patient decisions. This index also identifies the relevant clinical risk regions where predictive improvement is needed. Our approach is illustrated using data from a colorectal adenoma chemoprevention trial.
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Affiliation(s)
- Dean Billheimer
- Agricultural and Biosystems Engineering, College of Agriculture and Life Sciences, Tucson, AZ. ; The BIO5 Institute, The University of Arizona, Tucson, AZ
| | | | - Christine E McLaren
- Department of Epidemiology and Genetic Epidemiology Research Institute, University of California Irvine, Irvine, CA
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Yassine HN, Jackson AM, Borges CR, Billheimer D, Koh H, Smith D, Reaven P, Lau SS, Borchers CH. The application of multiple reaction monitoring and multi-analyte profiling to HDL proteins. Lipids Health Dis 2014; 13:8. [PMID: 24397693 PMCID: PMC3900256 DOI: 10.1186/1476-511x-13-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Accepted: 12/26/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND HDL carries a rich protein cargo and examining HDL protein composition promises to improve our understanding of its functions. Conventional mass spectrometry methods can be lengthy and difficult to extend to large populations. In addition, without prior enrichment of the sample, the ability of these methods to detect low abundance proteins is limited. Our objective was to develop a high-throughput approach to examine HDL protein composition applicable to diabetes and cardiovascular disease (CVD). METHODS We optimized two multiplexed assays to examine HDL proteins using a quantitative immunoassay (Multi-Analyte Profiling- MAP) and mass spectrometric-based quantitative proteomics (Multiple Reaction Monitoring-MRM). We screened HDL proteins using human xMAP (90 protein panel) and MRM (56 protein panel). We extended the application of these two methods to HDL isolated from a group of participants with diabetes and prior cardiovascular events and a group of non-diabetic controls. RESULTS We were able to quantitate 69 HDL proteins using MAP and 32 proteins using MRM. For several common proteins, the use of MRM and MAP was highly correlated (p < 0.01). Using MAP, several low abundance proteins implicated in atherosclerosis and inflammation were found on HDL. On the other hand, MRM allowed the examination of several HDL proteins not available by MAP. CONCLUSIONS MAP and MRM offer a sensitive and high-throughput approach to examine changes in HDL proteins in diabetes and CVD. This approach can be used to measure the presented HDL proteins in large clinical studies.
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Affiliation(s)
- Hussein N Yassine
- Department of Medicine, University of Southern California, Los Angeles, CA, USA.
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Spivey CA, Chisholm-Burns MA, Damadzadeh B, Billheimer D. Determining the effect of immunosuppressant adherence on graft failure risk among renal transplant recipients. Clin Transplant 2013; 28:96-104. [DOI: 10.1111/ctr.12283] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2013] [Indexed: 01/06/2023]
Affiliation(s)
| | | | - Bita Damadzadeh
- Zuckerman College of Public Health; University of Arizona; Tucson AZ USA
| | - Dean Billheimer
- College of Agriculture and Life Sciences; BIO5 Institute; University of Arizona; Tucson AZ USA
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45
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Yassine H, Borges CR, Schaab MR, Billheimer D, Stump C, Reaven P, Lau SS, Nelson R. Mass spectrometric immunoassay and MRM as targeted MS-based quantitative approaches in biomarker development: potential applications to cardiovascular disease and diabetes. Proteomics Clin Appl 2013; 7:528-40. [PMID: 23696124 DOI: 10.1002/prca.201200028] [Citation(s) in RCA: 44] [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: 04/25/2012] [Revised: 02/04/2013] [Accepted: 03/30/2013] [Indexed: 12/29/2022]
Abstract
Type 2 diabetes mellitus (T2DM) is an important risk factor for cardiovascular disease (CVD)--the leading cause of death in the United States. Yet not all subjects with T2DM are at equal risk for CVD complications; the challenge lies in identifying those at greatest risk. Therapies directed toward treating conventional risk factors have failed to significantly reduce this residual risk in T2DM patients. Thus newer targets and markers are needed for the development and testing of novel therapies. Herein we review two complementary MS-based approaches--mass spectrometric immunoassay (MSIA) and MS/MS as MRM--for the analysis of plasma proteins and PTMs of relevance to T2DM and CVD. Together, these complementary approaches allow for high-throughput monitoring of many PTMs and the absolute quantification of proteins near the low picomolar range. In this review article, we discuss the clinical relevance of the high density lipoprotein (HDL) proteome and Apolipoprotein A-I PTMs to T2DM and CVD as well as provide illustrative MSIA and MRM data on HDL proteins from T2DM patients to provide examples of how these MS approaches can be applied to gain new insight regarding cardiovascular risk factors. Also discussed are the reproducibility, interpretation, and limitations of each technique with an emphasis on their capacities to facilitate the translation of new biomarkers into clinical practice.
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Affiliation(s)
- Hussein Yassine
- Department of Medicine, University of Southern California, Los Angeles, CA, USA
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Rocconi R, Pannell L, Billheimer D, Blandford J, Schambeau L, Finan M. A novel proteomic-based screening method for ovarian cancer using cervi- covaginal fluids: A window into the abdomen. Gynecol Oncol 2013. [DOI: 10.1016/j.ygyno.2013.04.118] [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]
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47
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Hanusch KU, Janssen CH, Billheimer D, Jenkins I, Spurgeon E, Lowry CA, Raison CL. Whole-body hyperthermia for the treatment of major depression: associations with thermoregulatory cooling. Am J Psychiatry 2013; 170:802-4. [PMID: 23820835 DOI: 10.1176/appi.ajp.2013.12111395] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Xu H, Radabaugh T, Lu Z, Billheimer D, Vercelli D, Halonen M, Lau SS. Validation of an Early Life Candidate Biomarker for Childhood Asthma. FASEB J 2013. [DOI: 10.1096/fasebj.27.1_supplement.1107.2] [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: 11/11/2022]
Affiliation(s)
- Haili Xu
- Southwest Environmental Health Sciences CenterThe University of ArizonaTucsonAZ
- Dept of PharmacologyThe University of ArizonaTucsonAZ
| | - Timothy Radabaugh
- Southwest Environmental Health Sciences CenterThe University of ArizonaTucsonAZ
- Dept of Pharmacology and ToxicologyThe University of ArizonaTucsonAZ
| | - Zhenqiang Lu
- Southwest Environmental Health Sciences CenterThe University of ArizonaTucsonAZ
- Bio5 InstituteThe University of ArizonaTucsonAZ
| | - Dean Billheimer
- Statistics Consulting LaboratoryThe University of ArizonaTucsonAZ
- Dept of Agricultural and Biosystems EngineeringThe University of ArizonaTucsonAZ
| | - Donata Vercelli
- Arizona Respiratory CenterThe University of ArizonaTucsonAZ
- Arizona Center for the Biology of Complex DiseaseThe University of ArizonaTucsonAZ
| | - Marilyn Halonen
- Dept of PharmacologyThe University of ArizonaTucsonAZ
- Arizona Respiratory CenterThe University of ArizonaTucsonAZ
| | - Serrine S Lau
- Southwest Environmental Health Sciences CenterThe University of ArizonaTucsonAZ
- Dept of Pharmacology and ToxicologyThe University of ArizonaTucsonAZ
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Marri PR, Stern DA, Wright AL, Billheimer D, Martinez FD. Asthma-associated differences in microbial composition of induced sputum. J Allergy Clin Immunol 2012; 131:346-52.e1-3. [PMID: 23265859 DOI: 10.1016/j.jaci.2012.11.013] [Citation(s) in RCA: 270] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Revised: 11/13/2012] [Accepted: 11/14/2012] [Indexed: 11/25/2022]
Abstract
BACKGROUND It is increasingly evident that microbial colonization of the respiratory tract might have a role in the pathogenesis of asthma. OBJECTIVE We sought to characterize and compare the microbiome of induced sputum in asthmatic and nonasthmatic adults. METHODS Induced sputum samples were obtained from 10 nonasthmatic subjects and 10 patients with mild active asthma (8/10 were not using inhaled corticosteroids). Total DNA was extracted from sputum supernatants and amplified by using primers specific for the V6 hypervariable region of bacterial 16s rRNA. Samples were barcoded, and equimolar concentrations of 20 samples were pooled and sequenced with the 454 GS FLX sequencer. Sequences were assigned to bacterial taxa by comparing them with 16s rRNA sequences in the Ribosomal Database Project. RESULTS All sputum samples contained 5 major bacterial phyla: Firmicutes, Proteobacteria, Actinobacteria, Fusobacterium, and Bacteroidetes, with the first 3 phyla accounting for more than 90% of the total sequences. Proteobacteria were present in higher proportions in asthmatic patients (37% vs 15%, P < .001). In contrast, Firmicutes (47% vs 63%, P = .17) and Actinobacteria (10% vs 14%, P = .36) were found more frequently in samples from nonasthmatic subjects, although this was not statistically significant. Hierarchical clustering produced 2 significant clusters: one contained primarily asthmatic samples and the second contained primarily nonasthmatic samples. In addition, samples from asthmatic patients had greater bacterial diversity compared with samples from nonasthmatic subjects. CONCLUSION Patients with mild asthma have an altered microbial composition in the respiratory tract that is similar to that observed in patients with more severe asthma.
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Xu H, Radabaugh T, Lu Z, Billheimer D, Vercelli D, Halonen M, Lau SS. Discovery of Early Life Plasma Protein Signatures for Asthma Development. FASEB J 2012. [DOI: 10.1096/fasebj.26.1_supplement.1122.2] [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: 11/11/2022]
Affiliation(s)
- Haili Xu
- Southwest Environmental Health Sciences CenterThe University of ArizonaTucsonAZ
- Department of PharmacologyCollege of MedicineThe University of ArizonaTucsonAZ
| | - Timothy Radabaugh
- Southwest Environmental Health Sciences CenterThe University of ArizonaTucsonAZ
- Department of Pharmacology and ToxicologyCollege of PharmacyThe University of ArizonaTucsonAZ
| | - Zhenqiang Lu
- Southwest Environmental Health Sciences CenterThe University of ArizonaTucsonAZ
- Bio5 InstituteThe University of ArizonaTucsonAZ
| | - Dean Billheimer
- Statistics Consulting LaboratoryThe University of ArizonaTucsonAZ
- Department of Agricultural and Biosystems EngineeringThe University of ArizonaTucsonAZ
| | - Donata Vercelli
- Arizona Respiratory CenterThe University of ArizonaTucsonAZ
- Arizona Center for the Biology of Complex DiseaseThe University of ArizonaTucsonAZ
| | - Marilyn Halonen
- Department of PharmacologyCollege of MedicineThe University of ArizonaTucsonAZ
- Arizona Respiratory CenterThe University of ArizonaTucsonAZ
| | - Serrine S Lau
- Southwest Environmental Health Sciences CenterThe University of ArizonaTucsonAZ
- Department of Pharmacology and ToxicologyCollege of PharmacyThe University of ArizonaTucsonAZ
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