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Hadaegh F, Asgari S, Hashemi P, Baghbani-Oskouei A, Eskandari F, Azizi F, Tohidi M. All-cancer incidence in Tehranian adults: more than a decade of follow-up-results from the Tehran Lipid and Glucose Study. Public Health 2020; 181:189-195. [PMID: 32088600 DOI: 10.1016/j.puhe.2020.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 12/31/2019] [Accepted: 01/09/2020] [Indexed: 01/04/2023]
Abstract
OBJECTIVES To investigate the incidence rates for different malignancies and assess the risk factors for all-cancer incidence in Tehran. STUDY DESIGN Cohort study. METHODS This study consists of 8599 participants aged ≥ 30 years who were free of cancer (3935 men). Cancer diagnosis was based on pathology reports. Sex-stratified crude incidence rates and age-standardized incidence rates (ASRs) using Segi's method were calculated for all-cancers. Multivariate Poisson regression models were used to evaluate associations of potential risk factors, including sex, age, obesity status (body mass index [BMI]: 25-30 kg/m2 as reference), education, smoking status, and diabetes mellitus with the incidence of cancers among the population. Incidence rate ratios (IRRs) with 95% confidence interval (CI) were also reported. RESULTS During a median follow-up of 13.9 years, there were 130 and 129 incident cancers for men and women, respectively; the corresponding ASRs were 356.1 and 243.6 per 100,000 person-years, respectively. The three most incident cancers among men were gastrointestinal (GI) (ASR = 127.5), hematopoietic (ASR = 99.5), and reproductive system malignancies (ASR = 46.3). The most common incident cancers in women were breast cancer (ASR = 92.1), GI (ASR = 65.4), and reproductive system malignancies (ASR = 16.8). Among risk factors for cancer incidence, age (IRR [95% CI]: 1.05 [1.03-1.06]) and having a BMI < 25 kg/m2 (IRR [95% CI]: 1.38 [1.01-1.90]) had a statistically significant association with incident cancer. CONCLUSIONS The high rates of cancers in Tehran during more than a decade of follow-up calls for a need to define risk factors as well as to implement programs for early screening.
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Affiliation(s)
- F Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - S Asgari
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - P Hashemi
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - A Baghbani-Oskouei
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - F Eskandari
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - F Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - M Tohidi
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Rezazadeh H, Eskandari F, Moghadam MB, Ormoz E. Variable selection in finite mixture of generalized estimating equations. COMMUN STAT-SIMUL C 2020. [DOI: 10.1080/03610918.2019.1711406] [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: 10/25/2022]
Affiliation(s)
- H. Rezazadeh
- Department of Statistics, Faculty of Statistics, Mathematics and Computer, Allameh Tabataba’i University, Tehran, Iran
| | - F. Eskandari
- Department of Statistics, Faculty of Statistics, Mathematics and Computer, Allameh Tabataba’i University, Tehran, Iran
| | - M. Bameni Moghadam
- Department of Statistics, Faculty of Statistics, Mathematics and Computer, Allameh Tabataba’i University, Tehran, Iran
| | - E. Ormoz
- Department of Mathematics and Statistics, Faculty of Sciences, Mashhad Branch, Islamic Azad University, Mashhad, Iran
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Naseri H, Eskandari F, Jaafari MR, Khamesipour A, Abbasi A, Badiee A. PEGylation of cationic liposomes encapsulating soluble Leishmania
antigens reduces the adjuvant efficacy of liposomes in murine model. Parasite Immunol 2017; 39. [DOI: 10.1111/pim.12492] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Accepted: 09/11/2017] [Indexed: 02/06/2023]
Affiliation(s)
- H. Naseri
- Nanotechnology Research Center; Mashhad University of Medical Sciences; Mashhad Iran
| | - F. Eskandari
- Nanotechnology Research Center; Mashhad University of Medical Sciences; Mashhad Iran
| | - M. R. Jaafari
- Nanotechnology Research Center; Mashhad University of Medical Sciences; Mashhad Iran
- Biotechnology Research Center; Mashhad University of Medical Sciences; Mashhad Iran
- Department of Pharmaceutical Nanotechnology; School of Pharmacy; Mashhad University of Medical Sciences; Mashhad Iran
| | - A. Khamesipour
- Center for Research and Training in Skin Diseases and Leprosy; Tehran University of Medical Sciences; Tehran Iran
| | - A. Abbasi
- Nanotechnology Research Center; Mashhad University of Medical Sciences; Mashhad Iran
| | - A. Badiee
- Nanotechnology Research Center; Mashhad University of Medical Sciences; Mashhad Iran
- Department of Pharmaceutical Nanotechnology; School of Pharmacy; Mashhad University of Medical Sciences; Mashhad Iran
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Heydari AA, Moghadam MB, Eskandari F. An extension of Banerjee and Rahim model in economic and economic statistical designs for multivariate quality characteristics under Burr XII distribution. COMMUN STAT-THEOR M 2016. [DOI: 10.1080/03610926.2016.1140782] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- A. A. Heydari
- Department of Statistics, Allameh Tabataba’i University, Tehran, Iran
| | - M. B. Moghadam
- Department of Statistics, Allameh Tabataba’i University, Tehran, Iran
| | - F. Eskandari
- Department of Statistics, Allameh Tabataba’i University, Tehran, Iran
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Shackelford R, Heldmann M, Eskandari F, Joshi N, Browning J, Maxwell N, Coteligam J. Marked retroperitoneal lymphadenopathy in hairy cell leukemia: a case report. Case Rep Oncol 2013; 6:493-6. [PMID: 24163667 PMCID: PMC3806691 DOI: 10.1159/000355434] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Hairy cell leukemia (HCL) is uncommonly associated with lymphadenopathy, while retroperitoneal lymphadenopathy is extremely uncommon. We report on a patient with a 12-year history of HCL who developed painless jaundice and ascites, accompanied by positional discomfort with persistent nausea. Computed tomography examination revealed 2 large retroperitoneal masses, which at autopsy consisted of HCL with focally intermixed pancreatic and peripancreatic tissue. Lymphadenopathy was not identified above the diaphragm or below the aortic bifurcation. No vasculitis or an unusual HCL histology was identified. As previous reports, our findings suggest that HCL with massive lymphadenopathy has a specific site predilection, but it is not necessarily accompanied by vasculitis or an unusual histology.
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Affiliation(s)
- R.E. Shackelford
- Department of Pathology, LSU Health Shreveport, Shreveport, La., USA
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Cizza G, Mistry S, Nguyen VT, Eskandari F, Martinez P, Torvik S, Reynolds JC, Gold PW, Sinaii N, Csako G. Do premenopausal women with major depression have low bone mineral density? A 36-month prospective study. PLoS One 2012; 7:e40894. [PMID: 22848407 PMCID: PMC3407177 DOI: 10.1371/journal.pone.0040894] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Accepted: 06/18/2012] [Indexed: 01/18/2023] Open
Abstract
Background An inverse relationship between major depressive disorder (MDD) and bone mineral density (BMD) has been suggested, but prospective evaluation in premenopausal women is lacking. Methods Participants of this prospective study were 21 to 45 year-old premenopausal women with MDD (n = 92) and healthy controls (n = 44). We measured BMD at the anteroposterior lumbar spine, femoral neck, total hip, mid-distal radius, trochanter, and Ward's triangle, as well as serum intact parathyroid hormone (iPTH), ionized calcium, plasma adrenocorticotropic hormone (ACTH), serum cortisol, and 24-hour urinary-free cortisol levels at 0, 6, 12, 24, and 36 months. 25-hydroxyvitamin D was measured at baseline. Results At baseline, BMD tended to be lower in women with MDD compared to controls and BMD remained stable over time in both groups. At baseline, 6, 12, and 24 months intact PTH levels were significantly higher in women with MDD vs. controls. At baseline, ionized calcium and 25-hydroxyvitamin D levels were significantly lower in women with MDD compared to controls. At baseline and 12 months, bone-specific alkaline phosphatase, a marker of bone formation, was significantly higher in women with MDD vs. controls. Plasma ACTH was also higher in women with MDD at baseline and 6 months. Serum osteocalcin, urinary N-telopeptide, serum cortisol, and urinary free cortisol levels were not different between the two groups throughout the study. Conclusion Women with MDD tended to have lower BMD than controls over time. Larger and longer studies are necessary to extend these observations with the possibility of prophylactic therapy for osteoporosis. Trial Registration ClinicalTrials.gov NCT 00006180
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Affiliation(s)
- Giovanni Cizza
- Section on Neuroendocrinology of Obesity, National Institutes of Diabetes and Digestive Kidney Diseases (NIDDK), National Institutes of Health, Bethesda, Maryland, United States of America.
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Cizza G, Ronsaville DS, Kleitz H, Eskandari F, Mistry S, Torvik S, Sonbolian N, Reynolds JC, Blackman MR, Gold PW, Martinez PE. Clinical subtypes of depression are associated with specific metabolic parameters and circadian endocrine profiles in women: the power study. PLoS One 2012; 7:e28912. [PMID: 22235252 PMCID: PMC3250402 DOI: 10.1371/journal.pone.0028912] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2011] [Accepted: 11/17/2011] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Major depressive disorder (MDD) has been associated with adverse medical consequences, including cardiovascular disease and osteoporosis. Patients with MDD may be classified as having melancholic, atypical, or undifferentiated features. The goal of the present study was to assess whether these clinical subtypes of depression have different endocrine and metabolic features and consequently, varying medical outcomes. METHODS Premenopausal women, ages 21 to 45 years, with MDD (N = 89) and healthy controls (N = 44) were recruited for a prospective study of bone turnover. Women with MDD were classified as having melancholic (N = 51), atypical (N = 16), or undifferentiated (N = 22) features. Outcome measures included: metabolic parameters, body composition, bone mineral density (BMD), and 24 hourly sampling of plasma adrenocorticotropin (ACTH), cortisol, and leptin. RESULTS Compared with control subjects, women with undifferentiated and atypical features of MDD exhibited greater BMI, waist/hip ratio, and whole body and abdominal fat mass. Women with undifferentiated MDD characteristics also had higher lipid and fasting glucose levels in addition to a greater prevalence of low BMD at the femoral neck compared to controls. Elevated ACTH levels were demonstrated in women with atypical features of depression, whereas higher mean 24-hour leptin levels were observed in the melancholic subgroup. CONCLUSIONS Pre-menopausal women with various features of MDD exhibit metabolic, endocrine, and BMD features that may be associated with different health consequences. TRIAL REGISTRATION ClinicalTrials.gov NCT00006180.
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Affiliation(s)
- Giovanni Cizza
- Section on Neuroendocrinology of Obesity, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, United States of America.
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Cizza G, Nguyen VT, Eskandari F, Duan Z, Wright EC, Reynolds JC, Ahima RS, Blackman MR. Low 24-hour adiponectin and high nocturnal leptin concentrations in a case-control study of community-dwelling premenopausal women with major depressive disorder: the Premenopausal, Osteopenia/Osteoporosis, Women, Alendronate, Depression (POWER) study. J Clin Psychiatry 2010; 71:1079-87. [PMID: 20492842 PMCID: PMC3277206 DOI: 10.4088/jcp.09m05314blu] [Citation(s) in RCA: 56] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2009] [Accepted: 11/17/2009] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Major depressive disorder (MDD) is associated with immune system dysfunction and disruption of multiple circadian systems. Adiponectin is an adipocytokine with anti-inflammatory and antiatherogenic effects. Circulating concentrations are inversely related to adiposity and risks of metabolic syndrome and diabetes mellitus. Our goals were (1) to establish whether premenopausal women with MDD exhibit decreased plasma adiponectin concentrations and/or disruption of circadian adiponectin rhythmicity; (2) to assess whether there is a relationship between adiponectin and MDD; and (3) to explore the temporal relationships among adiponectin, leptin, corticotropin, and cortisol secretion. METHOD We conducted a case-control study of community-dwelling premenopausal women with DSM-IV MDD (n = 23) and age- and body mass index (BMI)-matched control subjects (n = 23). Main outcome measures were circulating concentrations of adiponectin, leptin, corticotropin, and cortisol measured hourly for 24 hours. Subjects were recruited from July 1, 2001, to February 28, 2003. RESULTS Women with MDD had approximately 30% lower mean 24-hour concentration of adiponectin than did control subjects. Adiponectin concentration was inversely related to depression severity and total duration of disease, suggesting a causal link. In contrast, mean nocturnal leptin concentration was higher in the MDD versus control groups. Mean leptin concentration was inversely related to cortisol and adiponectin concentrations, both in subjects with depression and in control subjects. In cross-correlation analyses, the relationship between corticotropin and cortisol concentrations was stronger in women with MDD than in control subjects, a finding consistent with hypothalamic-pituitary-adrenal (HPA) axis activation in MDD. CONCLUSIONS In premenopausal women with MDD, reduced daily adiponectin production may increase the risk of diabetes mellitus, and elevated leptin may contribute to osteoporosis.
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Affiliation(s)
- Giovanni Cizza
- Clinical Endocrine Section, Clinical Endocrinology Branch, National Institute of Diabetes, Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland 20892-1613, USA.
| | - Vi T. Nguyen
- Clinical Endocrine Section, Clinical Endocrinology Branch, National Institute of Diabetes, Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH), Bethesda, Maryland,Pediatric Endocrine Unit, Massachusetts General Hospital, Boston, Massachusetts
| | - Farideh Eskandari
- Section on Neuroendocrine, Immunology and Behavior, Integrative Neural Immune Program, Intramural Research Program, National Institute of Mental Health, NIH, Bethesda, Maryland
| | - Zhigang Duan
- Office of the Director, NIDDK, Bethesda, Maryland
| | | | - James C. Reynolds
- Radiology Department, Warren G. Magnuson Clinical Center, NIH, Bethesda, Maryland
| | - Rexford S. Ahima
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Pennsylvania School of Medicine, Philadelphia, Pensylvania
| | - Marc R. Blackman
- Endocrine Section, National Center for Complementary and Alternative Medicine, NIH, Bethesda, Maryland,Research Service, Veterans Affairs Medical Center, Washington D.C
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Hadaegh F, Khalili D, Fahimfar N, Tohidi M, Eskandari F, Azizi F. Glucose intolerance and risk of cardiovascular disease in Iranian men and women: results of the 7.6-year follow-up of the Tehran Lipid and Glucose Study (TLGS). J Endocrinol Invest 2009; 32:724-30. [PMID: 19574728 DOI: 10.1007/bf03346527] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Despite the high prevalence of diabetes, limited information is available about the impact of impaired glucose regulation on the cardiovascular disease (CVD) risk among Middle East populations. AIMS To determine the risk of CVD in an urban Iranian population according to glucose tolerance status. MATERIALS AND METHODS The study population consisted of 1752 men and 2273 women, aged > or = 40 yr, free of CVD at baseline. Incident CVD was ascertained over a median of 7.6 yr of follow-up. RESULTS A total of 340 CVD events occurred (197 in men and 143 in women). At baseline, there was no difference between newly diagnosed and known diabetes regarding the Prospective Cardiovascular Münster (PROCAM) risk score and prevalence of metabolic syndrome in both genders. Applying the 1997 American Diabetes Association (ADA) criteria, compared with those with normal glucose tolerance, after controlling traditional risk factors, hazard ratios (HR) and 95% confidence intervals (95% CI) for CVD in women with known and newly diagnosed diabetes were 3.30 (2.09-5.21) and 1.93 (1.16-3.21) and the corresponding values for men were 1.90 (1.11-3.25) and 1.69 (1.12-2.54), respectively. Impaired fasting glucose or impaired glucose tolerance was associated with 56% increased risk of CVD in women (HR 1.56, 95% CI 1.00 to 2.45), in the age-adjusted analysis, considering the 2003 ADA criteria. CONCLUSIONS All diabetic subjects, whether newly diagnosed or known cases, should receive intensive primary prevention for CVD regardless of risk factors, in particular females with abnormal glucose regulation.
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Affiliation(s)
- F Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University (M.C.), Yaman street, Velenjak, Tehran, Iran.
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Abstract
C-reactive protein (CRP), an inflammatory marker of cardiovascular risk, is often elevated in major depressive disorder (MDD). The magnitude and consistency of this elevation have not been previously characterized in premenopausal women with MDD. The aim of the study was to prospectively assess plasma CRP levels, body composition, endocrine and metabolic parameters, and depressive status in premenopausal women with MDD (n=77) and controls (n=41), aged 21 to 45. Women were enrolled in a 12-month, controlled study of bone turnover, the P.O.W.E.R. ( Premenopausal, Osteoporosis, Women, Al Endronate, Dep Ression) Study. Blood samples were taken at Baseline, Month 6, and Month 12. Most subjects with MDD were in clinical remission. These women tended to have consistently higher CRP levels than controls over 12 months (p=0.077). BMI was positively related to log[CRP] in women with MDD only. Nine women with MDD had CRP levels greater than 10 mg/l, a value associated with a very high cardiovascular risk. This subset was obese and had significantly higher triglycerides, total cholesterol, LDL-cholesterol, fasting insulin, and HOMA-IR than the rest of women with MDD. The variations in CRP levels over time were high (intra- and inter-individual coefficients of variations of approximately 30-50% and approximately 70-140%, respectively). No control had CRP levels greater than 10 mg/l. Depression was associated with increased plasma CRP in women with MDD. The clinical significance of abnormal plasma CRP for cardiovascular risk needs to be assessed in large prospective studies of women with depression.
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Affiliation(s)
- G Cizza
- Clinical Endocrine Section, Clinical Endocrinology Branch, NIDDK, NIH, DHHS, Bethesda, MD 20892-1613, USA.
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Barikbin B, Givrad S, Yousefi M, Eskandari F. Pimecrolimus 1% cream versus betamethasone 17-valerate 0.1% cream in the treatment of facial discoid lupus erythematosus: a double-blind, randomized pilot study. Clin Exp Dermatol 2009; 34:776-80. [PMID: 19456797 DOI: 10.1111/j.1365-2230.2008.03138.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Discoid lupus erythematosus (DLE) is commonly treated with topical agents, the most important of which are glucocorticosteroids. However, prolonged use of these agents, especially on sensitive areas such as the face, may result in side-effects (e.g. atrophy and telangiectases) by altering collagen synthesis. Therefore, alternative treatments are needed for these patients. AIM To investigate and compare the efficacy of topical pimecrolimus 1% cream and topical betamethasone 17-valerate 0.1% cream on facial lesions of DLE. METHODS This was a randomized double-blind pilot study, performed in outpatient clinics of two major referral hospitals. Ten patients aged 20-53 years with moderate to severe DLE of the face were randomized into two groups for 8 weeks of treatment and 8 weeks of follow-up after treatment. In this double-blind study, one group applied pimecrolimus 1% cream twice daily and the other group applied betamethasone valerate 0.1% cream twice daily to facial lesions. Efficacy end-points included a combined score based on evaluation of erythema, infiltration and presence of scale. RESULTS Efficacy end-points showed significant improvement in both groups. A decrease of 86% and 73% in clinical severity scores was obtained for pimecrolimus and betamethasone, respectively (P = 0.043). There was no significant difference between the two groups in terms of efficacy (P = 0.1). No adverse effect was found at the end of the 8-week trial in any of our patients. CONCLUSIONS The efficacy of pimecrolimus 1% cream is comparable with that of betamethasone valerate 0.1% cream in treating facial DLE.
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Affiliation(s)
- B Barikbin
- Skin Research Centre, Shahid Beheshti University, M.C., Shohada-e Tajrish Hospital, Tehran, Iran.
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12
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Cizza G, Marques AH, Eskandari F, Christie IC, Torvik S, Silverman MN, Phillips TM, Sternberg EM. Elevated neuroimmune biomarkers in sweat patches and plasma of premenopausal women with major depressive disorder in remission: the POWER study. Biol Psychiatry 2008; 64:907-11. [PMID: 18657799 PMCID: PMC2610843 DOI: 10.1016/j.biopsych.2008.05.035] [Citation(s) in RCA: 136] [Impact Index Per Article: 8.5] [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: 10/19/2007] [Revised: 05/19/2008] [Accepted: 05/30/2008] [Indexed: 12/24/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) is inconsistently associated with elevations in proinflammatory cytokines and neuropeptides. We used a skin sweat patch, recently validated in healthy control subjects, and recycling immunoaffinity chromatography to measure neuroimmune biomarkers in patients with MDD mostly in remission. METHODS We collected blood at 8:00 am and applied skin sweat patches for 24 hours in 21- to 45-year-old premenopausal women (n = 19) with MDD (17/19 in remission) and age-matched healthy controls (n = 17) participating in the POWER (Premenopausal, Osteopenia/Osteoporosis, Women, Alendronate, Depression) Study. RESULTS Proinflammatory cytokines, neuropeptide Y, substance P, and calcitonin-gene-related peptide were significantly higher and vasoactive intestinal peptide, a marker of parasympathetic activity, was significantly lower in patients compared to controls, and depressive symptomatology strongly correlated with biomarker levels. All analytes were strongly correlated in the skin sweat patch and plasma in patients (r = .73 to .99; p < .0004). CONCLUSIONS The skin sweat patch allows detection of disrupted patterns of proinflammatory cytokines and neuropeptides in women with MDD in clinical remission, which could predispose to medical consequences such as cardiovascular disease, osteoporosis, and diabetes. This method permits measurement of cytokines in ambulatory settings where blood collection is not feasible.
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Affiliation(s)
| | - Andrea H. Marques
- Section on Neuroendocrine Immunology and Behavior, Integrative Neural Immune Program, NIMH, NIH
| | - Farideh Eskandari
- Section on Neuroendocrine Immunology and Behavior, Integrative Neural Immune Program, NIMH, NIH,Case Western Reserve University, Department of Medicine, Division of Clinical and Molecular Endocrinology, Cleveland, OH
| | - Israel C. Christie
- Cardiovascular Behavioral Medicine Program, Department of Psychiatry, University of Pittsburgh Medical Center
| | | | - Marni N. Silverman
- Section on Neuroendocrine Immunology and Behavior, Integrative Neural Immune Program, NIMH, NIH,Prince of Wales, NCCAM Director’s Fellow, NIH
| | - Terry M. Phillips
- Nanoscale Immunodiagnosis, Laboratory of Bioengineering & Physical Science, NIBIB, NIH
| | - Esther M. Sternberg
- Section on Neuroendocrine Immunology and Behavior, Integrative Neural Immune Program, NIMH, NIH
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Eskandari F, Martinez PE, Torvik S, Phillips TM, Sternberg EM, Mistry S, Ronsaville D, Wesley R, Toomey C, Sebring NG, Reynolds JC, Blackman MR, Calis KA, Gold PW, Cizza G. Low bone mass in premenopausal women with depression. ACTA ACUST UNITED AC 2008; 167:2329-36. [PMID: 18039992 DOI: 10.1001/archinte.167.21.2329] [Citation(s) in RCA: 115] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND An increased prevalence of low bone mineral density (BMD) has been reported in patients with major depressive disorder (MDD), mostly women. METHODS Study recruitment was conducted from July 1, 2001, to February 29, 2003. We report baseline BMD measurements in 89 premenopausal women with MDD and 44 healthy control women enrolled in a prospective study of bone turnover. The BMD was measured by dual-energy x-ray absorptiometry at the spine, hip, and forearm. Mean hourly levels of plasma 24-hour cytokines, 24-hour urinary free cortisol, and catecholamine excretion were measured in a subset of women. We defined MDD according to the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition). RESULTS The prevalence of low BMD, defined as a T score of less than -1, was greater in women with MDD vs controls at the femoral neck (17% vs 2%; P = .02) and total hip (15% vs 2%; P = .03) and tended to be greater at the lumbar spine (20% vs 9%; P = .14). The mean +/- SD BMD, expressed as grams per square centimeters, was lower in women with MDD at the femoral neck (0.849 +/- 0.121 vs 0.866 +/- 0.094; P = .05) and at the lumbar spine (1.024 +/- 0.117 vs 1.043 +/- 0.092; P = .05) and tended to be lower at the radius (0.696 +/- 0.049 vs 0.710 +/- 0.055; P = .07). Women with MDD had increased mean levels of 24-hour proinflammatory cytokines and decreased levels of anti-inflammatory cytokines. CONCLUSIONS Low BMD is more prevalent in premenopausal women with MDD. The BMD deficits are of clinical significance and comparable in magnitude to those resulting from established risk factors for osteoporosis, such as smoking and reduced calcium intake. The possible contribution of immune or inflammatory imbalance to low BMD in premenopausal women with MDD remains to be clarified.
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Affiliation(s)
- Farideh Eskandari
- Department of Medicine, Division of Clinical and Molecular Endocrinology, Case Western Reserve University, Cleveland, Ohio, USA
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Marques-Deak A, Cizza G, Eskandari F, Torvik S, Christie IC, Sternberg EM, Phillips TM. Measurement of cytokines in sweat patches and plasma in healthy women: validation in a controlled study. J Immunol Methods 2006; 315:99-109. [PMID: 16942779 DOI: 10.1016/j.jim.2006.07.011] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2006] [Revised: 07/12/2006] [Accepted: 07/17/2006] [Indexed: 11/25/2022]
Abstract
Cytokines have been detected by ELISA in a variety of body fluids. Recycling immunoaffinity chromatography (RIC) coupled with laser-induced fluorescence detection is a highly sensitive and specific method, which allows simultaneous measurements of many analytes in small volumes of biological fluids. This method has been applied to plasma, cervical secretions and other body fluids, but has not previously been applied to sweat. The aim of this study was to validate the RIC methodology in sweat for measurements of IL-1alpha, IL-1beta, IL-6, TNF-alpha, IL-8 and TGF-beta. Two sweat patches were applied for 24 h on the torso, and blood was collected at one time point during this period in nine healthy women. Cytokines were measured in paired samples of plasma and sweat. Cytokines were detected in sweat in similar concentrations to plasma. Linear regression analysis confirmed that sweat levels of these cytokines accounted for a large percentages of variance in plasma levels: IL-1alpha (R2 = 0.70, p = 0.005), IL-1beta (R2 = 0.79, p = 0.003), IL-6 (R2 = 0.52, p = 0.03), TNF-alpha (R2 = 0.95, p < 0.0001), IL-8 (R2 = 0.81, p = 0.001) and TGF-beta (R2 = 0.94, p = 0.0003). These findings indicate that cytokine levels measured in sweat are informative of circulating levels and that sweat patches combined with RIC represents a viable non-invasive method to measure cytokines in ambulatory settings over time. This method is unobtrusive and requires minimal active compliance on the part of the subjects being studied, without pain or stress. This approach can open a new generation of studies to address the effects of environmental factors on immune responses in a wide range of different settings.
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Affiliation(s)
- Andrea Marques-Deak
- Section on Neuroendocrine Immunology and Behavior Integrative Neural Immune Program, NIMH, NIH, (MSC-9401) Rockville, Maryland 20852, USA
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Eskandari F, Mistry S, Martinez PE, Torvik S, Kotila C, Sebring N, Drinkard BE, Levy C, Reynolds JC, Csako G, Gold PW, Horne M, Cizza G. Younger, premenopausal women with major depressive disorder have more abdominal fat and increased serum levels of prothrombotic factors: implications for greater cardiovascular risk. Metabolism 2005; 54:918-24. [PMID: 15988701 DOI: 10.1016/j.metabol.2005.02.006] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Major depressive disorder (MDD) is one of the most common psychiatric illnesses in the adult population. It is often associated with an increased risk of cardiovascular disease. We measured body fat distribution as well as plasminogen activator inhibitor-1 (PAI-1) concentration and factor VIII (fVIII) activity at 8:00 am and 8:00 pm in 45 premenopausal women with MDD vs 28 healthy controls (age, 37 +/- 6.8 vs 35 +/- 6.5; weight [kg], 75.3 +/- 17.2 vs 67.9 +/- 10.2; mean +/- SD] participating in a prospective study of bone turnover, the POWER Study. At the time of evaluation, women with MDD were mildly depressed and mostly in clinical remission on antidepressants. After adjusting for body weight, women with MDD had greater waist circumference and abdominal fat as well as significantly higher evening (8:00 pm) PAI-1 and fVIII levels than controls. Even when age-, race-, and body mass index-matched subsets were compared, the MDD group continued to exhibit statistically higher PAI-1 and fVIII levels. The observed alterations in body fat distribution (increased abdominal fat) and prothrombotic factors (increased PAI-1 and fVIII) may be in part responsible for the increased risk of cardiovascular disease reported in association with major depression.
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Affiliation(s)
- Farideh Eskandari
- Department of Medicine, Division of Clinical and Molecular Endocrinology, Case Western Reserve University, Cleveland, OH 44106, USA
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Eskandari F. Predictive value of gall bladder scan in management of classic biliary colic in the absence of cholelithiasis or acute inflammation. Am J Surg 2004; 188:821-2; author reply 822. [PMID: 15619506 DOI: 10.1016/j.amjsurg.2004.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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DeRijk RH, Eskandari F, Sternberg EM. Corticosteroid resistance in a subpopulation of multiple sclerosis patients as measured by ex vivo dexamethasone inhibition of LPS induced IL-6 production. J Neuroimmunol 2004; 151:180-8. [PMID: 15145616 DOI: 10.1016/j.jneuroim.2004.02.009] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2003] [Revised: 02/19/2004] [Accepted: 02/20/2004] [Indexed: 11/19/2022]
Abstract
We assessed corticosteroid sensitivity in multiple sclerosis (MS) patients compared to control subjects, using an in vitro assay of dexamethasone (Dex) inhibition of lipopolysaccharide (LPS) stimulated-blood interleukin-6 production. Significantly higher concentrations of dexamethasone were needed to obtain 50%-inhibition (ID(50)) of in vitro LPS stimulated interleukin (IL)-6 production (28.4 x 10(-7) M) in relapsing-remitting MS (RRMS) patients compared to chronic progressive MS (CPMS) patients (6.2 x 10(-7) M) or compared to controls (3.0 x 10(-7) M). We also found a trend towards worsening of clinical status over time with increasing corticosteroid resistance. These data suggest that corticosteroid sensitivity may be a factor in the pathogenesis and could be used for prognosis of MS.
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Affiliation(s)
- Roel H DeRijk
- Section in Neuroendocrine Immunology and Behavior, National Institute of Mental Health, National Institutes of Health, 36 Convent Drive (MSC 4020), Bethesda, MD 20892-4020, USA.
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Eskandari F, Webster JI, Sternberg EM. Neural immune pathways and their connection to inflammatory diseases. Arthritis Res Ther 2003; 5:251-65. [PMID: 14680500 PMCID: PMC333413 DOI: 10.1186/ar1002] [Citation(s) in RCA: 133] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2003] [Revised: 08/08/2003] [Accepted: 08/18/2003] [Indexed: 02/07/2023] Open
Abstract
Inflammation and inflammatory responses are modulated by a bidirectional communication between the neuroendocrine and immune system. Many lines of research have established the numerous routes by which the immune system and the central nervous system (CNS) communicate. The CNS signals the immune system through hormonal pathways, including the hypothalamic-pituitary-adrenal axis and the hormones of the neuroendocrine stress response, and through neuronal pathways, including the autonomic nervous system. The hypothalamic-pituitary-gonadal axis and sex hormones also have an important immunoregulatory role. The immune system signals the CNS through immune mediators and cytokines that can cross the blood-brain barrier, or signal indirectly through the vagus nerve or second messengers. Neuroendocrine regulation of immune function is essential for survival during stress or infection and to modulate immune responses in inflammatory disease. This review discusses neuroimmune interactions and evidence for the role of such neural immune regulation of inflammation, rather than a discussion of the individual inflammatory mediators, in rheumatoid arthritis.
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Affiliation(s)
- Farideh Eskandari
- Section on Neuroendocrine Immunology and Behavior, NIMH/NIH, Bethesda, MD, USA.
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Abstract
Many lines of research have established the numerous routes by which the immune and central nervous systems (CNS) communicate. The CNS signals the immune system via hormonal and neuronal pathways and the immune system signals the CNS through similar routes via immune mediators and cytokines. The primary hormonal pathway by which the CNS regulates the immune system is the hypothalamic-pituitary-adrenal (HPA) axis, through the hormones of the neuroendocrine stress response. The sympathetic nervous system regulates immune system function primarily via adrenergic neurotransmitters released through neuronal routes. Neuroendocrine regulation of immune function is essential for survival during stress or infection and to modulate immune responses in inflammatory disease. Glucocorticoids are the main effector endpoint of the neuroendocrine response system.
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Affiliation(s)
- Farideh Eskandari
- Section on Neuroendocrine Immunology and Behavior, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland 20892, USA
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