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Edwards TM, Hamlin HJ, Freymiller H, Green S, Thurman J, Guillette LJ. Nitrate induces a type 1 diabetic profile in alligator hatchlings. Ecotoxicol Environ Saf 2018; 147:767-775. [PMID: 28942280 DOI: 10.1016/j.ecoenv.2017.09.052] [Citation(s) in RCA: 6] [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] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 08/16/2017] [Accepted: 09/18/2017] [Indexed: 06/07/2023]
Abstract
Type 1 diabetes (T1D) is a chronic autoimmune disease that affects 1 in 300 children by age 18. T1D is caused by inflammation-induced loss of insulin-producing pancreatic beta cells, leading to high blood glucose and a host of downstream complications. Although multiple genes are associated with T1D risk, only 5% of genetically susceptible individuals actually develop clinical disease. Moreover, a growing number of T1D cases occur in geographic clusters and among children with low risk genotypes. These observations suggest that environmental factors contribute to T1D etiology. One potential factor, supported primarily by epidemiological studies, is the presence of nitrate and nitrite in drinking water. To test this hypothesis, female hatchling alligators were exposed to environmentally relevant concentrations of nitrate in their tank water (reference, 10mg/L, or 100mg/L NO3-N) from hatch through 5 weeks or 5 months of age. At each time point, endpoints related to T1D were investigated: plasma levels of glucose, triglycerides, testosterone, estradiol, and thyroxine; pancreas, fat body, and thyroid weights; weight gain or loss; presence of immune cells in the pancreas; and pancreatic beta cell number, assessed by antibody staining of nkx6.1 protein. Internal dosing of nitrate was confirmed by measuring plasma and urine nitrate levels and whole blood methemoglobin. Cluster analysis indicated that high nitrate exposure (most animals exposed to 100mg/L NO3-N and one alligator exposed to 10mg/L NO3-N) induced a profile of endpoints consistent with early T1D that could be detected after 5 weeks and was more strongly present after 5 months. Our study supports epidemiological data correlating elevated nitrate with T1D onset in humans, and highlights nitrate as a possible environmental contributor to the etiology of T1D, possibly through its role as a nitric oxide precursor.
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Affiliation(s)
- Thea M Edwards
- Department of Biology, University of the South, Sewanee, TN, USA; Department of Biology, University of Florida, Gainesville, FL, USA; School of Biological Sciences, Louisiana Tech University, Ruston, LA, USA.
| | - Heather J Hamlin
- School of Marine Sciences, University of Maine, Orono, ME, USA; Department of Biology, University of Florida, Gainesville, FL, USA
| | - Haley Freymiller
- Department of Biology, University of Florida, Gainesville, FL, USA
| | - Stephen Green
- School of Biological Sciences, Louisiana Tech University, Ruston, LA, USA
| | - Jenna Thurman
- Department of Biology, University of Florida, Gainesville, FL, USA
| | - Louis J Guillette
- Department of Biology, University of Florida, Gainesville, FL, USA; Marine Biomedicine & Environmental Sciences, Medical University of South Carolina and Hollings Marine Laboratory, Charleston, SC, USA
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Owosho AA, Tsai CJ, Lee RS, Freymiller H, Kadempour A, Varthis S, Sax AZ, Rosen EB, Yom SK, Randazzo J, Drill E, Riedel E, Patel S, Lee NY, Huryn JM, Estilo CL. The prevalence and risk factors associated with osteoradionecrosis of the jaw in oral and oropharyngeal cancer patients treated with intensity-modulated radiation therapy (IMRT): The Memorial Sloan Kettering Cancer Center experience. Oral Oncol 2016; 64:44-51. [PMID: 28024723 DOI: 10.1016/j.oraloncology.2016.11.015] [Citation(s) in RCA: 133] [Impact Index Per Article: 16.6] [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: 09/19/2016] [Revised: 11/23/2016] [Accepted: 11/26/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To determine the prevalence and correlation of various risk factors [radiation dose, periodontal status, alcohol and smoking] to the development of osteoradionecrosis (ORN). PATIENTS AND METHODS The records of 1023 patients treated with IMRT for oral cavity cancer (OCC) and oropharyngeal cancer (OPC) between 2004 and 2013 were retrospectively reviewed to identify patients who developed ORN. Fisher exact tests were used to analyze patient characteristics between ORN patients with OCC and OPC. Paired Wilcoxon tests were used to compare the dose volumes to the ORN and contralateral non-ORN sites. To evaluate an association between ORN and risk factors, a case-control comparison was performed. One to 2 ORN-free patients were selected to match each ORN patient by gender, tumor site and size. General estimation equations models were used to compare the risk factors in ORN cases and matched controls. RESULTS 44 (4.3%) patients developed ORN during a median follow-up time of 52.5months. In 82% of patients, ORN occurred spontaneously. Patients with OPC are prone to develop ORN earlier compared to patients with OCC (P=0.03). OPC patients received a higher Dmax compared to OCC patients (P=0.01). In the matched case-control analysis the significant risk factors on univariate analysis were poor periodontal status, history of alcohol use and radiation dose (P=0.03, 0.002 and 0.009, respectively) and on multivariate analysis were alcohol use and radiation dose (P=0.004 and 0.026, respectively). CONCLUSION In our study, higher radiation dose, poor periodontal status and alcohol use are significantly related to the risk of developing ORN.
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Affiliation(s)
- Adepitan A Owosho
- Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, United States
| | - C Jillian Tsai
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, United States
| | - Ryan S Lee
- Department of Oral and Maxillofacial Pathology, Radiology, and Medicine, College of Dentistry, New York University, New York, United States
| | - Haley Freymiller
- Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, United States
| | - Arvin Kadempour
- Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, United States
| | - Spyridon Varthis
- Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, United States
| | - Adi Z Sax
- Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, United States
| | - Evan B Rosen
- Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, United States
| | - SaeHee K Yom
- Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, United States
| | - Joseph Randazzo
- Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, United States
| | - Esther Drill
- Department of Biostatistics and Epidemiology, Memorial Sloan Kettering Cancer Center, United States
| | - Elyn Riedel
- Department of Biostatistics and Epidemiology, Memorial Sloan Kettering Cancer Center, United States
| | - Snehal Patel
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, United States
| | - Nancy Y Lee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, United States
| | - Joseph M Huryn
- Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, United States
| | - Cherry L Estilo
- Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, United States.
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