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Kaptoge S, Seshasai SRK, Sun L, Walker M, Bolton T, Spackman S, Ataklte F, Willeit P, Bell S, Burgess S, Pennells L, Altay S, Assmann G, Ben-Shlomo Y, Best LG, Björkelund C, Blazer DG, Brenner H, Brunner EJ, Dagenais GR, Cooper JA, Cooper C, Crespo CJ, Cushman M, D'Agostino RB, Daimon M, Daniels LB, Danker R, Davidson KW, de Jongh RT, Donfrancesco C, Ducimetiere P, Elders PJM, Engström G, Ford I, Gallacher I, Bakker SJL, Goldbourt U, de La Cámara G, Grimsgaard S, Gudnason V, Hansson PO, Imano H, Jukema JW, Kabrhel C, Kauhanen J, Kavousi M, Kiechl S, Knuiman MW, Kromhout D, Krumholz HM, Kuller LH, Laatikainen T, Lowler DA, Meyer HE, Mukamal K, Nietert PJ, Ninomiya T, Nitsch D, Nordestgaard BG, Palmieri L, Price JF, Ridker PM, Sun Q, Rosengren A, Roussel R, Sakurai M, Salomaa V, Schöttker B, Shaw JE, Strandberg TE, Sundström J, Tolonen H, Tverdal A, Verschuren WMM, Völzke H, Wagenknecht L, Wallace RB, Wannamethee SG, Wareham NJ, Wassertheil-Smoller S, Yamagishi K, Yeap BB, Harrison S, Inouye M, Griffin S, Butterworth AS, Wood AM, Thompson SG, Sattar N, Danesh J, Di Angelantonio E, Tipping RW, Russell S, Johansen M, Bancks MP, Mongraw-Chaffin M, Magliano D, Barr ELM, Zimmet PZ, Knuiman MW, Whincup PH, Willeit J, Willeit P, Leitner C, Lawlor DA, Ben-Shlomo Y, Elwood P, Sutherland SE, Hunt KJ, Cushman M, Selmer RM, Haheim LL, Ariansen I, Tybjaer-Hansen A, Frikkle-Schmidt R, Langsted A, Donfrancesco C, Lo Noce C, Balkau B, Bonnet F, Fumeron F, Pablos DL, Ferro CR, Morales TG, Mclachlan S, Guralnik J, Khaw KT, Brenner H, Holleczek B, Stocker H, Nissinen A, Palmieri L, Vartiainen E, Jousilahti P, Harald K, Massaro JM, Pencina M, Lyass A, Susa S, Oizumi T, Kayama T, Chetrit A, Roth J, Orenstein L, Welin L, Svärdsudd K, Lissner L, Hange D, Mehlig K, Salomaa V, Tilvis RS, Dennison E, Cooper C, Westbury L, Norman PE, Almeida OP, Hankey GJ, Hata J, Shibata M, Furuta Y, Bom MT, Rutters F, Muilwijk M, Kraft P, Lindstrom S, Turman C, Kiyama M, Kitamura A, Yamagishi K, Gerber Y, Laatikainen T, Salonen JT, van Schoor LN, van Zutphen EM, Verschuren WMM, Engström G, Melander O, Psaty BM, Blaha M, de Boer IH, Kronmal RA, Sattar N, Rosengren A, Nitsch D, Grandits G, Tverdal A, Shin HC, Albertorio JR, Gillum RF, Hu FB, Cooper JA, Humphries S, Hill- Briggs F, Vrany E, Butler M, Schwartz JE, Kiyama M, Kitamura A, Iso H, Amouyel P, Arveiler D, Ferrieres J, Gansevoort RT, de Boer R, Kieneker L, Crespo CJ, Assmann G, Trompet S, Kearney P, Cantin B, Després JP, Lamarche B, Laughlin G, McEvoy L, Aspelund T, Thorsson B, Sigurdsson G, Tilly M, Ikram MA, Dorr M, Schipf S, Völzke H, Fretts AM, Umans JG, Ali T, Shara N, Davey-Smith G, Can G, Yüksel H, Özkan U, Nakagawa H, Morikawa Y, Ishizaki M, Njølstad I, Wilsgaard T, Mathiesen E, Sundström J, Buring J, Cook N, Arndt V, Rothenbacher D, Manson J, Tinker L, Shipley M, Tabak AG, Kivimaki M, Packard C, Robertson M, Feskens E, Geleijnse M, Kromhout D. Life expectancy associated with different ages at diagnosis of type 2 diabetes in high-income countries: 23 million person-years of observation. Lancet Diabetes Endocrinol 2023; 11:731-742. [PMID: 37708900 PMCID: PMC7615299 DOI: 10.1016/s2213-8587(23)00223-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 07/14/2023] [Accepted: 07/14/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND The prevalence of type 2 diabetes is increasing rapidly, particularly among younger age groups. Estimates suggest that people with diabetes die, on average, 6 years earlier than people without diabetes. We aimed to provide reliable estimates of the associations between age at diagnosis of diabetes and all-cause mortality, cause-specific mortality, and reductions in life expectancy. METHODS For this observational study, we conducted a combined analysis of individual-participant data from 19 high-income countries using two large-scale data sources: the Emerging Risk Factors Collaboration (96 cohorts, median baseline years 1961-2007, median latest follow-up years 1980-2013) and the UK Biobank (median baseline year 2006, median latest follow-up year 2020). We calculated age-adjusted and sex-adjusted hazard ratios (HRs) for all-cause mortality according to age at diagnosis of diabetes using data from 1 515 718 participants, in whom deaths were recorded during 23·1 million person-years of follow-up. We estimated cumulative survival by applying age-specific HRs to age-specific death rates from 2015 for the USA and the EU. FINDINGS For participants with diabetes, we observed a linear dose-response association between earlier age at diagnosis and higher risk of all-cause mortality compared with participants without diabetes. HRs were 2·69 (95% CI 2·43-2·97) when diagnosed at 30-39 years, 2·26 (2·08-2·45) at 40-49 years, 1·84 (1·72-1·97) at 50-59 years, 1·57 (1·47-1·67) at 60-69 years, and 1·39 (1·29-1·51) at 70 years and older. HRs per decade of earlier diagnosis were similar for men and women. Using death rates from the USA, a 50-year-old individual with diabetes died on average 14 years earlier when diagnosed aged 30 years, 10 years earlier when diagnosed aged 40 years, or 6 years earlier when diagnosed aged 50 years than an individual without diabetes. Using EU death rates, the corresponding estimates were 13, 9, or 5 years earlier. INTERPRETATION Every decade of earlier diagnosis of diabetes was associated with about 3-4 years of lower life expectancy, highlighting the need to develop and implement interventions that prevent or delay the onset of diabetes and to intensify the treatment of risk factors among young adults diagnosed with diabetes. FUNDING British Heart Foundation, Medical Research Council, National Institute for Health and Care Research, and Health Data Research UK.
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Lebel T, Cooper JA, Castellano MA, Nuytinck J. Three independent evolutionary events of sequestrate Lactifluus species in Australasia. Fungal Syst Evol 2022; 8:9-25. [PMID: 35005569 PMCID: PMC8687060 DOI: 10.3114/fuse.2021.08.02] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 04/15/2021] [Indexed: 11/15/2022] Open
Abstract
Three Australian species with sequestrate basidiome forms are recorded for the first time in the genus Lactifluus based on nuclear ITS-LSU and morphological data. These species represent three rare independent evolutionary events resulting in sequestrate basidiomes arising from agaricoid species in three different sections in two subgenera. All three species have highly reduced basidiome forms, and no species with intermediate forms have been found. Lactifluus dendriticus is unique in the genus in having highly branched, dendritic terminal elements in the pileipellis. We provide full descriptions of two species: Zelleromyces dendriticus (= Lactifluus dendriticus comb. nov.) in Lactifluus subg. Lactifluus sect. Gerardii, and Lactifluus geoprofluens sp. nov. in Lf. subg. Lactifluus sect. Lactifluus. A reduced description is provided for the third, Lactifluus sp. prov. KV181 in Lf. subg. Pseudogymnocarpi sect. Pseudogymnocarpi, as it is currently known from a single sequence.
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Affiliation(s)
- T Lebel
- Botanic Gardens and State Herbarium of South Australia, Hackney Rd, Adelaide, SA 5000, Australia.,Royal Botanic Gardens Victoria, Birdwood Avenue, South Yarra, Victoria, 3141 Australia.,Mannaki Whenua - Landcare Research, P.O. Box 69040, Lincoln 7640, New Zealand
| | - J A Cooper
- Mannaki Whenua - Landcare Research, P.O. Box 69040, Lincoln 7640, New Zealand
| | - M A Castellano
- USDA Forest Service, Northern Research Station, 3200 Jefferson Way, Corvallis, Oregon, USA
| | - J Nuytinck
- Naturalis Biodiversity Center, Darwinweg 2, 2333 CR Leiden, The Netherlands
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Robinson SA, Cooper JA, Goldstein RL, Polak M, Cruz Rivera PN, Gagnon DR, Samuelson A, Moore S, Kadri R, Richardson CR, Moy ML. A randomised trial of a web-based physical activity self-management intervention in COPD. ERJ Open Res 2021; 7:00158-2021. [PMID: 34476247 PMCID: PMC8405869 DOI: 10.1183/23120541.00158-2021] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 06/15/2021] [Indexed: 11/21/2022] Open
Abstract
Improving exercise capacity is a primary objective in COPD. Declines in exercise capacity result in reduced physical activity and health-related quality of life (HRQoL). Self-management interventions can teach patients skills and behaviours to manage their disease. Technology-mediated interventions have the potential to provide easily accessible support for disease self-management. We evaluated the effectiveness of a web-based self-management intervention, focused on physical activity promotion, on exercise capacity in COPD. This 6-month randomised controlled trial (NCT02099799) enrolled 153 persons with COPD at two US sites (VABoston, n=108; VABirmingham, n=45). Participants were allocated (1:1) to the web-based self-management intervention (physical activity promotion through personalised, progressive step-count goals, feedback, online COPD-related education and social support via an online community) or usual care. The primary outcome was exercise capacity (6-min walk distance (6 MWD)). Secondary outcomes included physical activity (daily steps per day), HRQoL (St. George's Respiratory Questionnaire Total Score), dyspnoea, COPD-related knowledge and social support. Change in step-count goals reflected intervention engagement. Participants' mean age was 69 (sd=7), and mean forced expiratory volume in 1 s % predicted was 61% (sd=21%). Change in 6MWD did not differ between groups. Intervention participants improved their mean daily step counts by 1312 more than those in the usual care group (p<0.001). Groups did not differ on other secondary outcomes. VABirmingham participants were significantly more engaged with the intervention, although site did not modify the effect of the intervention on 6MWD or secondary outcomes. The intervention did not improve exercise capacity but improved physical activity at 6 months. Additional intervention modifications are needed to optimise its COPD self-management capabilities. A web-based self-management intervention improved physical activity but not exercise capacity. There is a need to develop and study accessible self-management interventions for COPD.https://bit.ly/3iT1yvU
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Affiliation(s)
- Stephanie A Robinson
- Center for Healthcare Organization and Implementation Research (CHOIR), Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, USA.,Pulmonary Division, Boston University School of Medicine, Boston, MA, USA
| | - J Allen Cooper
- Birmingham VA Medical Center, Birmingham, AL, USA.,Pulmonary, Allergy and Critical Care Medicine, Dept of Medicine, University of Alabama at Birmingham, AL, USA
| | - Rebekah L Goldstein
- Pulmonary and Critical Care Medicine Section, VA Boston Healthcare System, Boston, MA, USA
| | - Madeline Polak
- Pulmonary and Critical Care Medicine Section, VA Boston Healthcare System, Boston, MA, USA
| | - Paola N Cruz Rivera
- Pulmonary and Critical Care Medicine Section, VA Boston Healthcare System, Boston, MA, USA
| | - David R Gagnon
- Dept of Biostatistics, Boston University School of Public Health, Boston, MA, USA.,Massachusetts Veterans Epidemiology Research and Information Center, Veterans Affairs Boston Healthcare System, Boston, MA, USA
| | | | - Sheila Moore
- Birmingham VA Medical Center, Birmingham, AL, USA
| | - Reema Kadri
- Dept of Family Medicine, University of Michigan, Ann Arbor, MI, USA
| | | | - Marilyn L Moy
- Pulmonary and Critical Care Medicine Section, VA Boston Healthcare System, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
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Murch BJ, Cooper JA, Hodgett TJ, Gara EL, Walker JS, Wood RM. Modelling the effect of first-wave COVID-19 on mental health services. Oper Res Health Care 2021; 30:100311. [PMID: 36466119 PMCID: PMC9701315 DOI: 10.1016/j.orhc.2021.100311] [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] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 05/20/2021] [Accepted: 08/09/2021] [Indexed: 06/17/2023]
Abstract
During the first wave of the COVID-19 pandemic it emerged that the nature and magnitude of demand for mental health services was changing. Considerable increases were expected to follow initial lulls as treatment was sought for new and existing conditions following relaxation of 'lockdown' measures. For this to be managed by the various services that constitute a mental health system, it would be necessary to complement such projections with assessments of capacity, in order to understand the propagation of demand and the value of any consequent mitigations. This paper provides an account of exploratory modelling undertaken within a major UK healthcare system during the first wave of the pandemic, when actionable insights were in short supply and decisions were made under much uncertainty. In understanding the impact on post-lockdown operational performance, the objective was to evaluate the efficacy of two considered interventions against a baseline 'do nothing' scenario. In doing so, a versatile and purpose-built discrete time simulation model was developed, calibrated and used by a multi-disciplinary project working group. The solution, representing a multi-node, multi-server queueing network with reneging, is implemented in open-source software and is freely and publicly available.
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Affiliation(s)
- B J Murch
- Bristol, North Somerset and South Gloucestershire Clinical Commissioning Group, UK National Health Service, South Plaza, Marlborough St, Bristol, BS1 3NX, UK
| | - J A Cooper
- Bristol, North Somerset and South Gloucestershire Clinical Commissioning Group, UK National Health Service, South Plaza, Marlborough St, Bristol, BS1 3NX, UK
- Bristol Medical School, University of Bristol, Beacon House, Queens Rd, BS8 1QU, UK
| | - T J Hodgett
- Bristol, North Somerset and South Gloucestershire Clinical Commissioning Group, UK National Health Service, South Plaza, Marlborough St, Bristol, BS1 3NX, UK
| | - E L Gara
- Bristol, North Somerset and South Gloucestershire Clinical Commissioning Group, UK National Health Service, South Plaza, Marlborough St, Bristol, BS1 3NX, UK
| | - J S Walker
- Research and Development, Avon and Wiltshire Mental Health Partnership, Newbridge Hill, Bath, BA1 3QE, UK
| | - R M Wood
- Bristol, North Somerset and South Gloucestershire Clinical Commissioning Group, UK National Health Service, South Plaza, Marlborough St, Bristol, BS1 3NX, UK
- University of Bath, School of Management, Claverton Down, Bath, BA2 7AY, UK
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5
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Leitao Filho FS, Mattman A, Schellenberg R, Criner GJ, Woodruff P, Lazarus SC, Albert RK, Connett J, Han MK, Gay SE, Martinez FJ, Fuhlbrigge AL, Stoller JK, MacIntyre NR, Casaburi R, Diaz P, Panos RJ, Cooper JA, Bailey WC, LaFon DC, Sciurba FC, Kanner RE, Yusen RD, Au DH, Pike KC, Fan VS, Leung JM, Man SFP, Aaron SD, Reed RM, Sin DD. Serum IgG Levels and Risk of COPD Hospitalization: A Pooled Meta-analysis. Chest 2020; 158:1420-1430. [PMID: 32439504 DOI: 10.1016/j.chest.2020.04.058] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 04/01/2020] [Accepted: 04/10/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Hypogammaglobulinemia (serum IgG levels < 7.0 g/L) has been associated with increased risk of COPD exacerbations but has not yet been shown to predict hospitalizations. RESEARCH QUESTION To determine the relationship between hypogammaglobulinemia and the risk of hospitalization in patients with COPD. STUDY DESIGN AND METHODS Serum IgG levels were measured on baseline samples from four COPD cohorts (n = 2,259): Azithromycin for Prevention of AECOPD (MACRO, n = 976); Simvastatin in the Prevention of AECOPD (STATCOPE, n = 653), Long-Term Oxygen Treatment Trial (LOTT, n = 354), and COPD Activity: Serotonin Transporter, Cytokines and Depression (CASCADE, n = 276). IgG levels were determined by immunonephelometry (MACRO; STATCOPE) or mass spectrometry (LOTT; CASCADE). The effect of hypogammaglobulinemia on COPD hospitalization risk was evaluated using cumulative incidence functions for this outcome and deaths (competing risk). Fine-Gray models were performed to obtain adjusted subdistribution hazard ratios (SHR) related to IgG levels for each study and then combined using a meta-analysis. Rates of COPD hospitalizations per person-year were compared according to IgG status. RESULTS The overall frequency of hypogammaglobulinemia was 28.4%. Higher incidence estimates of COPD hospitalizations were observed among participants with low IgG levels compared with those with normal levels (Gray's test, P < .001); pooled SHR (meta-analysis) was 1.29 (95% CI, 1.06-1.56, P = .01). Among patients with prior COPD admissions (n = 757), the pooled SHR increased to 1.58 (95% CI, 1.20-2.07, P < .01). The risk of COPD admissions, however, was similar between IgG groups in patients with no prior hospitalizations: pooled SHR = 1.15 (95% CI, 0.86-1.52, P =.34). The hypogammaglobulinemia group also showed significantly higher rates of COPD hospitalizations per person-year: 0.48 ± 2.01 vs 0.29 ± 0.83, P < .001. INTERPRETATION Hypogammaglobulinemia is associated with a higher risk of COPD hospital admissions.
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Affiliation(s)
- Fernando Sergio Leitao Filho
- Centre for Heart Lung Innovation, St. Paul's Hospital & Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Andre Mattman
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Robert Schellenberg
- Centre for Heart Lung Innovation, St. Paul's Hospital & Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Gerard J Criner
- Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA
| | - Prescott Woodruff
- Department of Medicine, University of California, San Francisco, San Francisco, CA
| | - Stephen C Lazarus
- Department of Medicine, University of California, San Francisco, San Francisco, CA
| | | | - John Connett
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Meilan K Han
- Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI
| | - Steven E Gay
- Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI
| | - Fernando J Martinez
- Division of Pulmonary and Critical Care Medicine, Weill Cornell Medical College, New York, NY
| | - Anne L Fuhlbrigge
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado School of Medicine, Aurora, CO
| | | | - Neil R MacIntyre
- Department of Medicine, Duke University Medical Center, Durham, NC
| | - Richard Casaburi
- Division of Respiratory and Critical Care Physiology and Medicine, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA
| | - Philip Diaz
- Department of Internal Medicine, Ohio State University, Columbus, OH
| | - Ralph J Panos
- Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH
| | - J Allen Cooper
- Birmingham VA Medical Center, Birmingham, AL; Department of Medicine, University of Alabama Medical School, Birmingham, AL
| | - William C Bailey
- Department of Medicine, University of Alabama Medical School, Birmingham, AL
| | - David C LaFon
- Department of Medicine, University of Alabama Medical School, Birmingham, AL
| | - Frank C Sciurba
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Richard E Kanner
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT
| | - Roger D Yusen
- Divisions of Pulmonary and Critical Care Medicine and General Medical Sciences, Washington University School of Medicine in Saint Louis, Saint Louis, MO
| | - David H Au
- Division of Pulmonary, Critical Care and Sleep Medicine and School of Nursing, University of Washington, Seattle, WA
| | - Kenneth C Pike
- Division of Pulmonary, Critical Care and Sleep Medicine and School of Nursing, University of Washington, Seattle, WA
| | - Vincent S Fan
- Division of Pulmonary, Critical Care and Sleep Medicine and School of Nursing, University of Washington, Seattle, WA; VA Puget Sound Health Care System, Seattle, WA
| | - Janice M Leung
- Centre for Heart Lung Innovation, St. Paul's Hospital & Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Shu-Fan Paul Man
- Centre for Heart Lung Innovation, St. Paul's Hospital & Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Shawn D Aaron
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Robert M Reed
- Department of Medicine, University of Maryland, Baltimore, MD
| | - Don D Sin
- Centre for Heart Lung Innovation, St. Paul's Hospital & Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
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Cooper JA, Church HJ, Wu HY. Cholestane-3β, 5α, 6β-triol: Further insights into the performance of this oxysterol in diagnosis of Niemann-Pick disease type C. Mol Genet Metab 2020; 130:77-86. [PMID: 32178982 DOI: 10.1016/j.ymgme.2020.02.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 02/21/2020] [Accepted: 02/25/2020] [Indexed: 11/20/2022]
Abstract
In recent years the oxysterol species cholestane-3β, 5α, 6β-triol (C-triol) has found application as a diagnostic biomarker for Niemann-Pick disease type C. Other studies have described increased C-triol in patients with Niemann-Pick disease type A/B and milder increases in lysosomal acid lipase deficiency (LALD), whereas they note normal C-triol levels in Smith-Lemli-Opitz syndrome (SLOS) and familial hypercholesterolaemia (FH) patients. Herein, we review data collected in our laboratory during method evaluation along with 5 years of routine analysis and present findings which differ from those reported by other groups with respect to LALD, SLOS and FH in particular, whilst providing further evidence regarding the clinical sensitivity and specificity of this biomarker, which are difficult to accurately assess. All of our Wolman disease (severe LALD) patients have demonstrated gross elevations of C-triol at diagnosis, with reduction to normal levels after induction of enzyme replacement therapy. In diagnostic specimens from SLOS patients we observed very low or undetectable C-triol levels whereas in post-therapeutic SLOS patients demonstrated normalised levels; we also describe a homozygous FH patient in which C-triol is significantly elevated. Upon investigation, we found that C-triol was formed artefactually from cholesterol during our sample preparation, i.e. this is a false positive of analytical origin; at present it is unclear whether similar effects occur during sample preparation in other laboratories. Our data demonstrates clinical sensitivity of 100% during routine application to diagnostic specimens; this is in keeping with other estimates, yet in a small proportion of patients diagnosed prior to C-triol measurement, either by Filipin staining of fibroblasts or molecular genetics, we have observed normal C-triol concentrations. Clinical specificity of C-triol alone is 93.4% and 95.3% when performed in conjunction with lysosomal enzymology. These performance statistics are very similar to those achieved with Filipin staining of cultured fibroblasts in the 5 years preceding introduction of C-triol to routine use in our laboratory. It is increasingly apparent to us that although this analyte is a very useful addition to the diagnostic tools available for NPC, with considerable advantages over more invasive and time-consuming methods, the interpretation of results is complex and should be undertaken only in light of clinical details and results of other analyses including enzymology for lysosomal acid lipase and acid sphingomyelinase.
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Affiliation(s)
- J A Cooper
- Willink Biochemical Genetics Laboratory, Manchester University NHS Foundation Trust, United Kingdom
| | - H J Church
- Willink Biochemical Genetics Laboratory, Manchester University NHS Foundation Trust, United Kingdom
| | - H Y Wu
- Willink Biochemical Genetics Laboratory, Manchester University NHS Foundation Trust, United Kingdom.
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7
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Keller T, Spece LJ, Donovan LM, Udris E, Coggeshall SS, Griffith M, Bryant AD, Casaburi R, Cooper JA, Criner GJ, Diaz PT, Fuhlbrigge AL, Gay SE, Kanner RE, Martinez FJ, Panos RJ, Shade D, Sternberg A, Stibolt T, Stoller JK, Tonascia J, Wise R, Yusen RD, Au DH, Feemster LC. Association of Guideline-Recommended COPD Inhaler Regimens With Mortality, Respiratory Exacerbations, and Quality of Life: A Secondary Analysis of the Long-Term Oxygen Treatment Trial. Chest 2020; 158:529-538. [PMID: 32278779 DOI: 10.1016/j.chest.2020.02.073] [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: 09/04/2019] [Revised: 02/04/2020] [Accepted: 02/23/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Although inhaled therapy reduces exacerbations among patients with COPD, the effectiveness of providing inhaled treatment per risk stratification models remains unclear. RESEARCH QUESTION Are inhaled regimens that align with the 2017 Global Initiative for Chronic Obstructive Lung Disease (GOLD) strategy associated with clinically important outcomes? STUDY DESIGN AND METHODS We conducted secondary analyses of Long-term Oxygen Treatment Trial (LOTT) data. The trial enrolled patients with COPD with moderate resting or exertional hypoxemia between 2009 and 2015. Our exposure was the patient-reported inhaled regimen at enrollment, categorized as either aligning with, undertreating, or potentially overtreating per the 2017 GOLD strategy. Our primary composite outcome was time to death or first hospitalization for COPD. Additional outcomes included individual components of the composite outcome and time to first exacerbation. We generated multivariable Cox proportional hazard models across strata of GOLD-predicted exacerbation risk (high vs low) to estimate between-group hazard ratios for time to event outcomes. We adjusted models a priori for potential confounders, clustered by site. RESULTS The trial enrolled 738 patients (73.4% men; mean age, 68.8 years). Of the patients, 571 (77.4%) were low risk for future exacerbations. Of the patients, 233 (31.6%) reported regimens aligning with GOLD recommendations; most regimens (54.1%) potentially overtreated. During a 2.3-year median follow-up, 332 patients (44.9%) experienced the composite outcome. We found no difference in time to composite outcome or death among patients reporting regimens aligning with recommendations compared with undertreated patients. Among patients at low risk, potential overtreatment was associated with higher exacerbation risk (hazard ratio, 1.42; 95% CI, 1.09-1.87), whereas inhaled corticosteroid treatment was associated with 64% higher risk of pneumonia (incidence rate ratio, 1.64; 95% CI, 1.01-2.66). INTERPRETATION Among patients with COPD with moderate hypoxemia, we found no difference in clinical outcomes between inhaled regimens aligning with the 2017 GOLD strategy compared with those that were undertreated. These findings suggest the need to reevaluate the effectiveness of risk stratification model-based inhaled treatment strategies.
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Affiliation(s)
- Thomas Keller
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Washington, Seattle, WA.
| | - Laura J Spece
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Washington, Seattle, WA; Health Services Research & Development Center of Innovation for Veteran-centered and Value-driven Care, VA Puget Sound Healthcare System, Seattle, WA
| | - Lucas M Donovan
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Washington, Seattle, WA; Health Services Research & Development Center of Innovation for Veteran-centered and Value-driven Care, VA Puget Sound Healthcare System, Seattle, WA
| | - Edmunds Udris
- Health Services Research & Development Center of Innovation for Veteran-centered and Value-driven Care, VA Puget Sound Healthcare System, Seattle, WA
| | - Scott S Coggeshall
- Health Services Research & Development Center of Innovation for Veteran-centered and Value-driven Care, VA Puget Sound Healthcare System, Seattle, WA
| | - Matthew Griffith
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Washington, Seattle, WA; Health Services Research & Development Center of Innovation for Veteran-centered and Value-driven Care, VA Puget Sound Healthcare System, Seattle, WA
| | - Alexander D Bryant
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Washington, Seattle, WA
| | - Richard Casaburi
- Los Angeles Biomedical Research Institute at Harbor - UCLA Medical Center, Torrance, CA
| | - J Allen Cooper
- Birmingham VA Medical Center and the Lung Health Center, University of Alabama Birmingham, Birmingham, AL
| | | | - Philip T Diaz
- 201 Heart Lung Institute, Ohio State University School of Medicine, Columbus, OH
| | | | - Steven E Gay
- University of Michigan School of Medicine, Ann Arbor, MI
| | | | | | - Ralph J Panos
- Cincinnati VA Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH
| | - David Shade
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Alice Sternberg
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Thomas Stibolt
- Kaiser Permanente Center for Health Research, Portland, OR
| | | | - James Tonascia
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Robert Wise
- Johns Hopkins University School of Medicine, Baltimore, MD
| | - Roger D Yusen
- Washington University School of Medicine, Saint Louis, MO
| | - David H Au
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Washington, Seattle, WA; Health Services Research & Development Center of Innovation for Veteran-centered and Value-driven Care, VA Puget Sound Healthcare System, Seattle, WA
| | - Laura C Feemster
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Washington, Seattle, WA; Health Services Research & Development Center of Innovation for Veteran-centered and Value-driven Care, VA Puget Sound Healthcare System, Seattle, WA
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8
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Elmahi E, Sanghvi MM, Jones A, Aye CYL, Lewandowski AJ, Aung N, Cooper JA, Paiva JM, Lukaschuk E, Piechnik SK, Neubauer S, Petersen SE, Leeson P. P2249Does self-reported pregnancy loss identify women at risk of an adverse cardiovascular phenotype in later life? Insights from UK biobank. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Cardiovascular disease (CVD) is more common in women who have had pregnancy complications such as spontaneous pregnancy loss. We used cross-sectional data from the UK Biobank Imaging Enhancement Study to determine whether pregnancy loss is associated with cardiac or vascular remodelling in later life, which might contribute to this increased risk.
Methods
Pregnancy history was reported by women participating in UK Biobank between 2006 and 2010 at age 40–69 years using a self-completed touch-screen questionnaire. Self-reported pregnancy loss was related to cardiovascular measures collected in those women who had participated in the Imaging Enhancement Study up to the end of 2015. Cardiac structure and function were assessed by magnetic resonance (CMR) steady-state free precession imaging at 1.5 Tesla. Three long axes cines (horizontal, vertical and LV outflow tract) and a complete short axis stack were acquired, covering both ventricles. Tagging was used to measure myocardial strain in basal, midventricular and apical short axes views. Carotid intima-media thickness (CIMT) measurements were taken for both common carotid arteries using a CardioHealth Station. Statistical associations with CMR and carotid measures were adjusted for age, BMI and other cardiovascular risk factors.
Results
Data were available on 2660 women of whom 113 were excluded because of pre-existing CVD and 8 had no pregnancy information available. Of the remaining 2539, 466 were nulligravid and 2073 had a history of pregnancies, of whom 622 reported at least one pregnancy loss (92% miscarriages and 8% stillbirths) and 1451 reported no pregnancy loss. No significant differences in cardiac or carotid parameters were evident in women who reported pregnancy loss compared to other groups (Table 1).
CMR cardiac geometry & CIMT measurements Variable Pregnancy History Adjusted Means ± SE Effect Size (%) 95% CI P LVEDV (ml) Pregnancy Loss 122.2±1.0 0 – – No Pregnancy 124.1±1.4 1.58 (−0.83, 4.05) 0.20 Pregnancy (no loss) 122.2±0.8 0.2 (−1.42, 1.48) 0.97 LVESV (ml) Pregnancy Loss 47.8±0.6 0 – – No Pregnancy 48.0±0.8 0.45 (−3.19, 4.22) 0.81 Pregnancy (no loss) 47.3±0.5 −1.01 (−3.19, 1.22) 0.37 VEF (%) Pregnancy Loss 60.6±0.3 0 – – No Pregnancy 61.0±0.4 0.42 (−0.50, 1.35) 0.37 Pregnancy (no loss) 61.0±0.2 0.43 (−0.14, 0.99) 0.14 LVM (g) Pregnancy Loss 70.6±0.6 0 – – No Pregnancy 70.5±0.8 −0.15 (−2.68, 2.44) 0.91 Pregnancy (no loss) 70.4±0.5 −0.26 (−1.81, 1.30) 0.74 CIMT (μm) Pregnancy Loss 633.3±6.5 0 – – No Pregnancy 619.3±8.4 −2.22 (−5.04, 0.68) 0.13 Pregnancy (no loss) 627.1±4.9 −0.99 (−2.75, 0.81) 0.28
Conclusion
Women who self-report pregnancy loss do not have significant differences in cardiac or carotid structure in later life to explain past epidemiological findings of increased cardiovascular risk in this population. This may be because this risk operates through other disease mechanisms or that self-report is not a sufficiently reliable way to identify pregnancy loss, and thereby allocate women into risk groups.
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Affiliation(s)
- E Elmahi
- University of Oxford, Oxford, United Kingdom
| | - M M Sanghvi
- Queen Mary University of London, London, United Kingdom
| | - A Jones
- University of Oxford, Oxford, United Kingdom
| | - C Y L Aye
- University of Oxford, Oxford, United Kingdom
| | | | - N Aung
- University of Oxford, Oxford, United Kingdom
| | - J A Cooper
- University of Oxford, Oxford, United Kingdom
| | - J M Paiva
- University of Oxford, Oxford, United Kingdom
| | - E Lukaschuk
- University of Oxford, Oxford, United Kingdom
| | | | - S Neubauer
- University of Oxford, Oxford, United Kingdom
| | - S E Petersen
- Queen Mary University of London, London, United Kingdom
| | - P Leeson
- University of Oxford, Oxford, United Kingdom
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9
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Sanghvi M, Biasiolli L, Aung N, Cooper JA, Fung K, Lukaschuk E, Paiva JM, Carapella V, Hann E, Rayner JJ, Werys K, Puchta H, Piechnik SK, Neubauer S, Petersen SE. 345The impact of modifiable cardiovascular risk factors on aortic distensibility: insights from the UK Biobank. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez103] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- M Sanghvi
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom of Great Britain & Northern Ireland
| | - L Biasiolli
- University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - N Aung
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom of Great Britain & Northern Ireland
| | - J A Cooper
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom of Great Britain & Northern Ireland
| | - K Fung
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom of Great Britain & Northern Ireland
| | - E Lukaschuk
- University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - J M Paiva
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom of Great Britain & Northern Ireland
| | - V Carapella
- University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - E Hann
- University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - J J Rayner
- University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - K Werys
- University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - H Puchta
- University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - S K Piechnik
- University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - S Neubauer
- University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - S E Petersen
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom of Great Britain & Northern Ireland
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10
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Miller GJ, Stirling Y, Esnouf MP, Heinrich J, van de Loo J, Kienast J, Wu KK, Morrissey JH, Meade TW, Martin JC, Imeson JD, Cooper JA, Finch A. Factor VII-Deficient Substrate Plasmas Depleted of Protein C Raise the Sensitivity of the Factor VII Bio-Assay to Activated Factor VII: an International Study. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1642382] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
SummaryPlasma from healthy individuals, pregnant women and patients on warfarin were distributed to 3 laboratories supporting major cardiovascular surveys (Northwick Park, Muenster and Houston) for assay of factor VII coagulant activity (VIIC) with their own bio-assays. The mean VIIC in 147 samples agreed to within 1% of standard in Northwick Park and Houston, but was 14% of standard lower in Muenster owing to its more potent standard. In samples with an increased VIIC the Northwick Park assay gave a higher result than the other assays owing to its increased responsiveness to activated factor VII (VIIa). Thus when VIIa concentrations were determined directly with a clotting assay which utilises a soluble recombinant tissue factor, the increase in VIIC with increase in VIIa was considerably greater with the Northwick Park assay than the Muenster assay. This feature of the Northwick Park assay was traced to the virtual absence of protein C in its substrate plasma. Factor Va appears rate-limiting for the coagulant expression of VIIa in test plasma. If the thrombotic response to release of tissue factor is determined by the circulating concentration of VIIa, then the Northwick Park factor VII bio-assay may be preferable to other bio-assays currently employed to estimate risk of acute coronary events.
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Affiliation(s)
- G J Miller
- The Medical Research Council Epidemiology and Medical Care Unit, London, England
| | - Y Stirling
- The Medical Research Council Epidemiology and Medical Care Unit, London, England
| | - M P Esnouf
- The Nuffield Department of Clinical Biochemistry, Radcliffe Infirmary, Oxford, England
| | - J Heinrich
- The Institute of Clinical Chemistry and Laboratory Medicine, University of Muenster, Muenster, Germany
| | - J van de Loo
- Department of Internal Medicine, University of Muenster, Muenster, Germany
| | - J Kienast
- Department of Internal Medicine, University of Muenster, Muenster, Germany
| | - K K Wu
- The University of Texas Medical School at Houston, Texas, USA
| | - J H Morrissey
- Oklahoma Medical Research Foundation, Oklahoma City, USA
| | - T W Meade
- The Medical Research Council Epidemiology and Medical Care Unit, London, England
| | - J C Martin
- The Medical Research Council Epidemiology and Medical Care Unit, London, England
| | - J D Imeson
- The Medical Research Council Epidemiology and Medical Care Unit, London, England
| | - J A Cooper
- The Medical Research Council Epidemiology and Medical Care Unit, London, England
| | - A Finch
- The University of Texas Medical School at Houston, Texas, USA
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11
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Miller GJ, Bauer KA, Barzegar S, Foley AJ, Mitchell JP, Cooper JA, Rosenberg RD. The Effects of Quality and Timing of Venepuncture on Markers of Blood Coagulation in Healthy Middle-aged Men. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1653729] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
SummaryEffects of the quality and the time of venepuncture on factor VII coagulant activity (VIIC) and the concentrations of fibrinogen, prothrombin fragment 1 + 2 (F1 + 2) and fibrinopeptide A (FPA) were sought in 2665 men, of whom 2334 were re-examined after about one year. Venepunctures were categorised as satisfactory, not fully satisfactory or unsatisfactory according to pre-defined criteria. Neither the quality nor timing of the venepuncture influenced VIICor fibrinogen concentration. However, at baseline and re-examination F1 + 2and FPA were increased on average by about 9% and 45% respectively when venepunctures were not fully satisfactory, and by about 11% and 100% when unsatisfactory. Plasma collected after 1500 h had slightly but significantly lower levels of F1 + 2and FPA than samples taken earlier, possibly due to circadian rhythm. The results emphasise the need for careful surveillance of the venepuncture procedure and the value of FPA when using F1+ 2as a marker of risk of thrombosis.
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Affiliation(s)
- G J Miller
- The Medical Research Council Epidemiology and Medical Care Unit, London, UK
| | - K A Bauer
- The Molecular Medicine Unit, Beth Israel Hospital, Boston, MA, USA
| | - S Barzegar
- The Molecular Medicine Unit, Beth Israel Hospital, Boston, MA, USA
| | - A J Foley
- The Medical Research Council Epidemiology and Medical Care Unit, London, UK
| | - J P Mitchell
- The Medical Research Council Epidemiology and Medical Care Unit, London, UK
| | - J A Cooper
- The Medical Research Council Epidemiology and Medical Care Unit, London, UK
| | - R D Rosenberg
- The Molecular Medicine Unit, Beth Israel Hospital, Boston, MA, USA
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12
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Connelly JB, Roderick PJ, Cooper JA, Meade TW, Miller GJ. Positive Association Between Self-Reported Fatty Food Consumption and Factor VII Coagulant Activity, a Risk Factor for Coronary Heart Disease, in 4246 Middle-Aged Men. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1649479] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
SummaryRaised levels of factor VII coagulant activity (VIIC) have been reported to increase the incidence of CHD. Preliminary evidence from observational and experimental studies suggests that dietary fat intake is positively associated with VIIC. We explored this further in 4,246 men aged 45–69, who were found to be free of major CHD when screened for a primary prevention trial of antithrombotic medication. All men were asked about their consumption of fatty foods and changes in consumption in the last month.In the 9% of men who reported avoidance of fatty foods in the month before interview, age adjusted VIIC was 7.8% of standard (95% CI 5.1–10.6%) lower than in the remainder. Serum cholesterol and body mass index (BMI) were also significantly lower. The extent to which fat consumed in the past month had deviated from usual intake was significantly and positively related with VIIC, serum cholesterol and BMI. Thus, the VIIC difference between those eating much less fatty food than usual and those eating much more than usual was 11% of standard, with those eating their usual amount having an intermediate level.This study adds to the evidence that dietary fat intake influences VIIC and coagulability. The effect is rapid, so that much of the benefit of dietary fat reduction on thrombogenic risk in CHD is likely to occur within a short time. Thus, the results reinforce the value of a low fat diet, even in individuals with advanced atheroma, in whom dietary intervention has sometimes been considered unlikely to be effective.
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Affiliation(s)
- J B Connelly
- The MRC Epidemiology and Medical Care Unit and British Heart Foundation Cardiovascular Research Group, Wolfson Institute of Preventive Medicine, The Medical College of St. Bartholomew’s Hospital, London, United Kingdom
| | - P J Roderick
- The MRC Epidemiology and Medical Care Unit and British Heart Foundation Cardiovascular Research Group, Wolfson Institute of Preventive Medicine, The Medical College of St. Bartholomew’s Hospital, London, United Kingdom
| | - J A Cooper
- The MRC Epidemiology and Medical Care Unit and British Heart Foundation Cardiovascular Research Group, Wolfson Institute of Preventive Medicine, The Medical College of St. Bartholomew’s Hospital, London, United Kingdom
| | - T W Meade
- The MRC Epidemiology and Medical Care Unit and British Heart Foundation Cardiovascular Research Group, Wolfson Institute of Preventive Medicine, The Medical College of St. Bartholomew’s Hospital, London, United Kingdom
| | - G J Miller
- The MRC Epidemiology and Medical Care Unit and British Heart Foundation Cardiovascular Research Group, Wolfson Institute of Preventive Medicine, The Medical College of St. Bartholomew’s Hospital, London, United Kingdom
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13
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Humphries SE, Cooper JA, Seed M, Capps N, Durrington PN, Jones B, McDowell IFW, Soran H, Neil HAW. Coronary heart disease mortality in treated familial hypercholesterolaemia: Update of the UK Simon Broome FH register. Atherosclerosis 2018; 274:41-46. [PMID: 29751283 PMCID: PMC6013645 DOI: 10.1016/j.atherosclerosis.2018.04.040] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 04/24/2018] [Accepted: 04/27/2018] [Indexed: 01/04/2023]
Abstract
BACKGROUND AND AIMS Patients with familial hypercholesterolaemia (FH) have an elevated risk of coronary heart disease (CHD). Here we compare changes in CHD mortality in patients with heterozygous (FH) pre 1992, before lipid-lowering therapy with statins was used routinely, and in the periods 1992-2008 and 2008-2016. METHODS 1903 Definite (DFH) and 1650 Possible (PFH) patients (51% women) aged 20-79 years, recruited from 21 lipid clinics in the United Kingdom and followed prospectively between 1980 and 2016 for 67,060 person-years. The CHD standardised mortality ratio (SMR) compared to the population in England and Wales was calculated (with 95% Confidence intervals). RESULTS There were 585 deaths, including 252 from CHD. Overall, the observed 2.4-fold excess coronary mortality for treated DFH post-1991 was significantly higher than the 1.78 excess for PFH (35% 95% CI 3%-76%). In patients with DFH and established coronary disease, there was a significant excess coronary mortality in all time periods, but in men it was reduced from a 4.83-fold excess (2.32-8.89) pre-1992 to 4.66 (3.46-6.14) in 1992-2008 and 2.51 (1.01-5.17) post-2008, while in women the corresponding values were 7.23 (2.65-15.73), 4.42 (2.70-6.82) and 6.34 (2.06-14.81). Primary prevention in men with DFH resulted in a progressive reduction in coronary mortality over the three time-periods, with no excess mortality evident post-2008 (0.89 (0.29-2.08)), although in women the excess persisted (post-2008 3.65 (1.75-6.72)). CONCLUSIONS The results confirm the benefit of statin treatment in reducing CHD mortality, but suggest that FH patients with pre-existing CHD and women with FH may not be treated adequately.
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Affiliation(s)
- S E Humphries
- Centre for Cardiovascular Genetics, Institute of Cardiovascular Science, University College London, University Street, London, WC1E 6JJ, UK.
| | - J A Cooper
- Centre for Cardiovascular Genetics, Institute of Cardiovascular Science, University College London, University Street, London, WC1E 6JJ, UK
| | - M Seed
- Department of Cardiology, Imperial College Faculty of Medicine, Charing Cross Campus, University of London, UK
| | - N Capps
- Department of Clinical Biochemistry, The Shrewsbury and Telford Hospital NHS Trust, Princess Royal Hospital, Telford, UK
| | - P N Durrington
- Cardiovascular Research Group, School of Clinical and Laboratory Sciences, University of Manchester, UK
| | - B Jones
- Section of Investigative Medicine, Imperial College London, UK
| | - I F W McDowell
- Department of Medical Biochemistry and Immunology, University Hospital of Wales, Cardiff, UK
| | - H Soran
- Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - H A W Neil
- Wolfson College, University of Oxford, UK
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14
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Duffy S, Marron R, Voelker H, Albert R, Connett J, Bailey W, Casaburi R, Cooper JA, Curtis JL, Dransfield M, Han MK, Make B, Marchetti N, Martinez F, Lazarus S, Niewoehner D, Scanlon PD, Sciurba F, Scharf S, Reed RM, Washko G, Woodruff P, McEvoy C, Aaron S, Sin D, Criner GJ. Effect of beta-blockers on exacerbation rate and lung function in chronic obstructive pulmonary disease (COPD). Respir Res 2017. [PMID: 28629419 PMCID: PMC5477165 DOI: 10.1186/s12931-017-0609-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [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] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Beta-blockers are commonly prescribed for patients with cardiovascular disease. Providers have been wary of treating chronic obstructive pulmonary disease (COPD) patients with beta-blockers due to concern for bronchospasm, but retrospective studies have shown that cardio-selective beta-blockers are safe in COPD and possibly beneficial. However, these benefits may reflect symptom improvements due to the cardiac effects of the medication. The purpose of this study is to evaluate associations between beta-blocker use and both exacerbation rates and longitudinal measures of lung function in two well-characterized COPD cohorts. METHODS We retrospectively analyzed 1219 participants with over 180 days of follow up from the STATCOPE trial, which excluded most cardiac comorbidities, and from the placebo arm of the MACRO trial. Primary endpoints were exacerbation rates per person-year and change in spirometry over time in association with beta blocker use. RESULTS Overall 13.9% (170/1219) of participants reported taking beta-blockers at enrollment. We found no statistically significant differences in exacerbation rates with respect to beta-blocker use regardless of the prevalence of cardiac comorbidities. In the MACRO cohort, patients taking beta-blockers had an exacerbation rate of 1.72/person-year versus a rate of 1.71/person-year in patients not taking beta-blockers. In the STATCOPE cohort, patients taking beta-blockers had an exacerbation rate of 1.14/person-year. Patients without beta-blockers had an exacerbation rate of 1.34/person-year. We found no detrimental effect of beta blockers with respect to change in lung function over time. CONCLUSION We found no evidence that beta-blocker use was unsafe or associated with worse pulmonary outcomes in study participants with moderate to severe COPD.
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Affiliation(s)
- Sean Duffy
- Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA. .,Department of Thoracic Medicine and Surgery, Temple University School of Medicine, 712 Parkinson Pavilion, 3401 North Broad Street, Philadelphia, PA, 19140, USA.
| | - Robert Marron
- Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA
| | | | | | | | - William Bailey
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - Richard Casaburi
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - J Allen Cooper
- University of Alabama at Birmingham, Birmingham, AL, USA
| | | | | | - MeiLan K Han
- University of Michigan Health System, Ann Arbor, MI, USA
| | | | - Nathaniel Marchetti
- Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA
| | - Fernando Martinez
- Weill Cornell Medical College of Cornell University, New York, NY, USA
| | | | | | | | - Frank Sciurba
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | | | | | | | | | | | - Shawn Aaron
- The Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Don Sin
- Providence Heart + Lung Institute, Vancouver, BC, Canada
| | - Gerard J Criner
- Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA
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15
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Cooper JA, Hudgens J. The Two Port Myomectomy: A New Approach to Laparoscopic Myomectomy. J Minim Invasive Gynecol 2016. [DOI: 10.1016/j.jmig.2016.08.414] [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: 11/25/2022]
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16
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Albert RK, Au DH, Blackford AL, Casaburi R, Cooper JA, Criner GJ, Diaz P, Fuhlbrigge AL, Gay SE, Kanner RE, MacIntyre N, Martinez FJ, Panos RJ, Piantadosi S, Sciurba F, Shade D, Stibolt T, Stoller JK, Wise R, Yusen RD, Tonascia J, Sternberg AL, Bailey W. A Randomized Trial of Long-Term Oxygen for COPD with Moderate Desaturation. N Engl J Med 2016; 375:1617-1627. [PMID: 27783918 PMCID: PMC5216457 DOI: 10.1056/nejmoa1604344] [Citation(s) in RCA: 237] [Impact Index Per Article: 29.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Long-term treatment with supplemental oxygen has unknown efficacy in patients with stable chronic obstructive pulmonary disease (COPD) and resting or exercise-induced moderate desaturation. METHODS We originally designed the trial to test whether long-term treatment with supplemental oxygen would result in a longer time to death than no use of supplemental oxygen among patients who had stable COPD with moderate resting desaturation (oxyhemoglobin saturation as measured by pulse oximetry [Spo2], 89 to 93%). After 7 months and the randomization of 34 patients, the trial was redesigned to also include patients who had stable COPD with moderate exercise-induced desaturation (during the 6-minute walk test, Spo2 ≥80% for ≥5 minutes and <90% for ≥10 seconds) and to incorporate the time to the first hospitalization for any cause into the new composite primary outcome. Patients were randomly assigned, in a 1:1 ratio, to receive long-term supplemental oxygen (supplemental-oxygen group) or no long-term supplemental oxygen (no-supplemental-oxygen group). In the supplemental-oxygen group, patients with resting desaturation were prescribed 24-hour oxygen, and those with desaturation only during exercise were prescribed oxygen during exercise and sleep. The trial-group assignment was not masked. RESULTS A total of 738 patients at 42 centers were followed for 1 to 6 years. In a time-to-event analysis, we found no significant difference between the supplemental-oxygen group and the no-supplemental-oxygen group in the time to death or first hospitalization (hazard ratio, 0.94; 95% confidence interval [CI], 0.79 to 1.12; P=0.52), nor in the rates of all hospitalizations (rate ratio, 1.01; 95% CI, 0.91 to 1.13), COPD exacerbations (rate ratio, 1.08; 95% CI, 0.98 to 1.19), and COPD-related hospitalizations (rate ratio, 0.99; 95% CI, 0.83 to 1.17). We found no consistent between-group differences in measures of quality of life, lung function, and the distance walked in 6 minutes. CONCLUSIONS In patients with stable COPD and resting or exercise-induced moderate desaturation, the prescription of long-term supplemental oxygen did not result in a longer time to death or first hospitalization than no long-term supplemental oxygen, nor did it provide sustained benefit with regard to any of the other measured outcomes. (Funded by the National Heart, Lung, and Blood Institute and the Centers for Medicare and Medicaid Services; LOTT ClinicalTrials.gov number, NCT00692198 .).
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17
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Cooper JA, Moss SM, Smith S, Seaman HE, Taylor-Phillips S, Parsons N, Halloran SP. FIT for the future: a case for risk-based colorectal cancer screening using the faecal immunochemical test. Colorectal Dis 2016; 18:650-3. [PMID: 27135192 DOI: 10.1111/codi.13365] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 03/09/2016] [Indexed: 12/12/2022]
Abstract
Worldwide, the guaiac faecal occult blood test (gFOBT) is being replaced with the more accurate faecal immunochemical test (FIT) for colorectal cancer (CRC) screening. From January 2016, the National Screening Committee in the UK has recommended a change from the gFOBT to the FIT following a successful Bowel Cancer Screening Programme pilot study with over 40 000 participants. Although the test has shown improved uptake and the ability to detect significantly more colorectal cancers and advanced adenomas, the higher uptake and test positivity will challenge the capacity of colonoscopy services. One of the main advantages of the FIT is that it provides a quantitative haemoglobin concentration which has been shown to relate to the risk of CRC. Risk scoring systems which combine the FIT concentration with risk factor assessment have been shown to improve the sensitivity of the test. This individualized approach to screening could enable those at greatest risk to be referred for colonoscopy, optimizing resource use and ultimately patient outcomes.
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Affiliation(s)
- J A Cooper
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK.
| | - S M Moss
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - S Smith
- Midlands and North West Bowel Cancer Screening Hub, Hospital of St Cross, University Hospitals Coventry and Warwickshire NHS Trust, Rugby, UK
| | - H E Seaman
- Surrey Research Park, NHS Bowel Cancer Screening Southern Programme Hub, Guildford, Surrey, UK
| | - S Taylor-Phillips
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - N Parsons
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - S P Halloran
- Department of Biochemistry and Physiology, University of Surrey, Guildford, Surrey, UK
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Kalea AZ, Hoteit R, Suvan J, Lovering RC, Palmen J, Cooper JA, Khodiyar VK, Harrington Z, Humphries SE, D'Aiuto F. Upregulation of gingival tissue miR-200b in obese periodontitis subjects. J Dent Res 2015; 94:59S-69S. [PMID: 25630869 DOI: 10.1177/0022034514568197] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Increased local immune and inflammatory responses in obese individuals with periodontitis may explain the aggressive clinical presentation and altered treatment response when compared to that of normal weight subjects. Our goal was to identify any differences in microRNA (miRNA) expression profiles of gingival tissue in periodontitis when obesity is present, which may suggest novel molecular pathways that this miRNA network may affect. Total RNA was extracted from gingival tissue biopsies collected from normal weight and obese individuals with periodontitis; miRNA expression profiling was performed with Affymetrix GeneChip miRNA 3.0 arrays; and results were validated with quantitative reverse transcription polymerase chain reaction (qRT-PCR). In silico identification of previously confirmed miRNA gene targets was conducted through miRTarBase and miRWalk databases, and pathway enrichment analysis identified enriched miRNA gene sets. Expression of selected genes in the same biopsy samples was tested with qRT-PCR. The gingival tissue miRNA profile of obese patients, compared to that of normal weight patients, showed 13 upregulated and 22 downregulated miRNAs, among which miR-200b was validated by qRT-PCR to be significantly increased in obesity. Functional analysis of 51 experimentally validated miR-200b gene targets identified enrichment of genes involved in cell motility, differentiation, DNA binding, response to stimulus, and vasculature development pathways not previously identified in the obesity-specific disease profile. Furthermore, the expression of the miR-200b gene targets ZEB1/2, GATA2, and KDR was confirmed by qRT-PCR as being lower in obese patients with periodontitis versus normal weight patients, suggesting a role of miR-200b in regulation of a set of gene targets and biological pathways relevant to wound healing and angiogenesis. Functional studies to explore the role of miR-200b in the above processes may offer new insights on putative therapeutic targets for this group of patients.
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Affiliation(s)
- A Z Kalea
- Centre for Cardiovascular Genetics, Institute of Cardiovascular Science, University College London, London, UK
| | - R Hoteit
- Centre for Cardiovascular Genetics, Institute of Cardiovascular Science, University College London, London, UK
| | - J Suvan
- Unit of Periodontology, Eastman Dental Institute, University College London, London, UK
| | - R C Lovering
- Centre for Cardiovascular Genetics, Institute of Cardiovascular Science, University College London, London, UK
| | - J Palmen
- Centre for Cardiovascular Genetics, Institute of Cardiovascular Science, University College London, London, UK
| | - J A Cooper
- Centre for Cardiovascular Genetics, Institute of Cardiovascular Science, University College London, London, UK
| | - V K Khodiyar
- Centre for Cardiovascular Genetics, Institute of Cardiovascular Science, University College London, London, UK
| | - Z Harrington
- Peninsula School of Dentistry, Plymouth University, Plymouth, UK
| | - S E Humphries
- Centre for Cardiovascular Genetics, Institute of Cardiovascular Science, University College London, London, UK
| | - F D'Aiuto
- Unit of Periodontology, Eastman Dental Institute, University College London, London, UK
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19
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Ren S, Cooper K, Cooper JA, Smith HT, Shaikh S. A Systematic Review and Network Meta-Analysis of Pharmacological Therapies Used for Patients with Advanced Parkinson's Disease. Value Health 2014; 17:A390. [PMID: 27200898 DOI: 10.1016/j.jval.2014.08.856] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- S Ren
- Sheffield University, Sheffield, UK
| | - K Cooper
- University of Sheffield, Sheffield, UK
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Cooper JA. New species and combinations of some New Zealand agarics belonging to Clitopilus, Lyophyllum, Gerhardtia, Clitocybe, Hydnangium, Mycena, Rhodocollybia and Gerronema. MYCOSPHERE 2014. [DOI: 10.5943/mycosphere/5/2/2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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21
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Pillinger JM, Cooper JA, Harding CJ. Stable free radical from plant litter decomposing in water. J Chem Ecol 2013; 22:1001-11. [PMID: 24227620 DOI: 10.1007/bf02029950] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/1995] [Accepted: 01/06/1996] [Indexed: 11/30/2022]
Abstract
The presence of a stable radical species in both fresh straw and that which had been submerged in aerated water for up to six months has been demonstrated using electron paramagnetic (spin) resonance (EPR or ESR) spectroscopy. A radical signal was associated also with material shown to contain straw lignin markers, which was leached from the rotting straw into surrounding water. Fresh straw treated with strong alkali to remove phenolics did not show a radical signal. The possible effect of a dissolved stable free radical is discussed in relation to the antagonistic effect of rotting straw on algal and cyanobacterial growth in water to which straw has been added as a nuisance algal control agent.
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Affiliation(s)
- J M Pillinger
- Planetary Sciences Research Institute, The Open University, MK7 6AA, Milton Keynes, UK
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22
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Wilson JC, O'Rorke MA, Cooper JA, Murray LJ, Hughes CM, Gormley GJ, Anderson LA. Non-steroidal anti-inflammatory drug use and cervical cancer risk: a case-control study using the Clinical Practice Research Datalink. Cancer Epidemiol 2013; 37:897-904. [PMID: 24042024 DOI: 10.1016/j.canep.2013.08.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [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: 06/05/2013] [Revised: 08/20/2013] [Accepted: 08/21/2013] [Indexed: 01/12/2023]
Abstract
PURPOSE Non-steroidal anti-inflammatory drugs (NSAIDs) have many anticarcinogenic properties via the inhibition of cyclooxygenase 2 (COX-2). Only one study, a cohort study examining risk of all cancers, investigated their role in cervical cancer with inconsistent findings between non-aspirin NSAIDs and aspirin. The aim of this study was to further investigate NSAID/aspirin use and cervical cancer risk. METHODS Using the United Kingdom Clinical Practice Research Datalink, 724 women diagnosed with cervical cancer between 1 January, 1995 and December 2010 were compared to 3479 women (without cervical cancer) matched on year of birth and general practice. Conditional logistic regression analysis adjusted for smoking, sexually transmitted infections, HRT and contraceptive use, was used to calculate odds ratios (OR) and 95% confidence intervals (CI) for cervical cancer risk among users of any oral NSAIDs, non-aspirin NSAIDs and aspirin, as assessed from primary care prescribing data. RESULTS Excluding the year prior to diagnosis, there was no association in adjusted analyses between ever vs. never use of an NSAID (OR 0.92, 95% CI 0.77-1.09), non-aspirin NSAID (OR 0.95, 95% CI 0.80-1.13) or low-dose aspirin (OR 1.07, 0.80-1.44) and cervical cancer risk. In analysis of daily defined doses, there was no association with cervical cancer risk comparing the highest users to non-users of NSAIDs (OR 0.98, 95% CI 0.69-1.39) or non-aspirin NSAIDs (OR 1.00, 95% CI 0.70-1.43) or low-dose aspirin (OR 1.04, 95% CI 0.59-1.81). CONCLUSION This large historical cohort study found no evidence of an association between non-aspirin NSAID or aspirin use and cervical cancer risk.
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Affiliation(s)
- J C Wilson
- Cancer Epidemiology and Health Services Research Group, Centre for Public Health, Queen's University Belfast, UK
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Stevenson JL, Krishnan S, Stoner MA, Goktas Z, Cooper JA. Effects of exercise during the holiday season on changes in body weight, body composition and blood pressure. Eur J Clin Nutr 2013; 67:944-9. [DOI: 10.1038/ejcn.2013.98] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Revised: 04/08/2013] [Accepted: 04/11/2013] [Indexed: 11/09/2022]
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Otto JM, O'Doherty AF, Hennis PJ, Mitchell K, Pate JS, Cooper JA, Grocott MPW, Montgomery HE. Preoperative exercise capacity in adult inflammatory bowel disease sufferers, determined by cardiopulmonary exercise testing. Int J Colorectal Dis 2012; 27:1485-91. [PMID: 22842663 DOI: 10.1007/s00384-012-1533-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/01/2012] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND AIMS Aerobic exercise capacity appears impaired in children with inflammatory bowel disease (IBD). Whether this holds true in adults with IBD is not known. Using cardiopulmonary exercise testing (CPET), we assessed anaerobic threshold (AT) in such patients comparing data with reference values and other elective surgical patients. We also sought to confirm whether the presence of a fistula further reduced AT. METHODS CPET was performed between November 2007 and December 2010 on patients awaiting abdominopelvic surgery. Gender-specific normal reference values were used for comparison. Unadjusted comparison between two groups was made using Mann-Whitney U test and by unpaired t test. Data were adjusted by analysis of covariance, using age and sex as covariates. Differences between patients' observed values and reference values were tested using paired t tests. RESULTS Four hundred and fourteen patients (234 male) were studied (mean ± SD age, 56.6 ± 16.4 years; weight, 74.2 ± 15.6 kg). Adjusted AT values in Crohn's disease (CD) were lower than colorectal cancer (11.4 ± 3.4 vs 13.2 ± 3.5 ml.kg(-1).min(-1), p = 0.03) and for all other colorectal disease groups combined (12.6 ± 3.5 ml.kg(-1).min(-1), p = 0.03). AT of Ulcerative colitis (UC) and CD patients together were reduced compared to population reference values (p < 0.05). CONCLUSION After adjusting for age and sex, CD patients had a reduced AT compared to patients with colorectal cancer and other colorectal disease groups combined. The pathogenesis of this low AT remains to be defined and warrants further investigation.
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Affiliation(s)
- J M Otto
- The Portex Unit, UCL Institute of Child Health, Guilford Street, Archway Campus, N19 5LW, London, England, UK.
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25
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Tang TS, Prior SL, Li KW, Ireland HA, Bain SC, Hurel SJ, Cooper JA, Humphries SE, Stephens JW. Association between the rs1050450 glutathione peroxidase-1 (C > T) gene variant and peripheral neuropathy in two independent samples of subjects with diabetes mellitus. Nutr Metab Cardiovasc Dis 2012; 22:417-425. [PMID: 21185702 DOI: 10.1016/j.numecd.2010.08.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [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] [Received: 02/17/2010] [Revised: 06/02/2010] [Accepted: 08/02/2010] [Indexed: 12/14/2022]
Abstract
Glutathione peroxidase-1 (GPx-1) is an endogenous anti-oxidant enzyme. The T allele of the GPx-1 rs1050450 (C > T) gene variant is associated with reduced enzyme activity. Our aim was to examine the association between this gene variant and peripheral neuropathy in two cross-sectional samples of subjects with diabetes: (i) 773 Caucasian subjects were genotyped from the UCL Diabetes and Cardiovascular disease Study (UDACS) and (ii) 382 Caucasian subjects from the Ealing Diabetes Study (EDS). Peripheral neuropathy status (and oxidised-LDL [Ox-LDL:LDL] and plasma Total Ant-ioxidant Status [TAOS] in UDACS), were analysed in relation to genotype. We observed that: (i) In UDACS, the odds ratio (OR) for peripheral neuropathy in the T allele carriers compared to the CC genotype was 1.61 [1.10-2.28], p = 0.01. This remained significant after adjustment for other risk factors. Ox-LDL:LDL ratio was significantly elevated in T allele carriers (CC vs. CT/TT: 16.3 ± 2.4 v 18.0 ± 2.9 U/mmol LDL, p = 0.02). (ii) In EDS, the OR for peripheral neuropathy in the T allele carriers compared to the CC genotype was 1.95 [1.11-3.42], p = 0.02. This remained significant after adjustment for other risk factors. In conclusion, we observed a significant association between the T allele and peripheral neuropathy and LDL oxidation. This is the first paper to examine the rs1050450 variant in two samples of Caucasian subjects with diabetes. Prospective analysis of the gene variant is required in diabetic and healthy cohorts with measured plasma markers of oxidative stress to investigate the described association further.
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Affiliation(s)
- T S Tang
- Diabetes Research Group, Institute of Life Sciences, Swansea University, Swansea SA2 8PP, UK
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26
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Hawkins KR, Hansen KC, Schoeller DA, Cooper JA. Effect of exercise on the diurnal variation in energy substrate use during a high-fat diet. Eur J Appl Physiol 2012; 112:3775-85. [PMID: 22382668 DOI: 10.1007/s00421-012-2360-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2011] [Accepted: 02/14/2012] [Indexed: 10/28/2022]
Abstract
Aerobic exercise increases 24-h fat oxidation following initiation of a high-fat diet. The objective of this study is to examine the time course of increased fat oxidation under exercise and sedentary conditions. Eighteen healthy subjects completed a randomized crossover design (sedentary and exercise visits) staying for five consecutive days in a metabolic chamber each visit. On day 1, 30% of energy intake was from fat; days 2-5 had 50% of energy as fat. During exercise, subjects rode on a stationary cycle at 45% of VO2max for 1 h in the mornings and evenings. Respiratory gases and urinary nitrogen were collected to calculate macronutrient oxidation and non-protein respiratory exchange ratio (NPRER). This data, collected continuously (24-h periods), were subsequently divided into three time segments: (1) exercise + recovery (1000-1200 hours, 2100-2200 hours), (2) sleep (2300-0645 hours), and (3) wake (all remaining hours). NPRER on exercise versus sedentary visits was lower for the sleep segment (0.77 ± 0.01 01 vs. 0.81 ± 0.01, p < 0.001), higher for the exercise + recovery segment (0.88 ± 0.01 vs. 0.86 ± 0.01, p < 0.001), and was not different for the wake segment. Fat oxidation was significantly higher for exercise versus sedentary treatments during sleep (41 ± 2 vs. 31 ± 2 g), wake (62 ± 3 vs. 51 ± 3 g), and exercise + recovery segments (33 ± 3 vs.16 ± 1 g), but so was fat intake by design (171 ± 8 vs. 128 ± 7 g/d). Although exercise showed greater fat oxidation during all segments, dietary fat intake was also higher. Therefore, based on NPRER, the time of day during which the exercise treatment increased the ratio of fat to carbohydrate oxidation was during sleep.
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Affiliation(s)
- K R Hawkins
- Department of Nutrition, Hospitality, and Retailing, Texas Tech University, P.O. Box 41240, Lubbock, TX 79409, USA
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27
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Talmud PJ, Cooper JA, Gaunt T, Holmes MV, Shah S, Palmen J, Drenos F, Shah T, Kumari M, Kivimaki M, Whittaker J, Lawlor DA, Day IN, Hingorani AD, Casas JP, Humphries SE. Variants of ADRA2A are associated with fasting glucose, blood pressure, body mass index and type 2 diabetes risk: meta-analysis of four prospective studies. Diabetologia 2011; 54:1710-9. [PMID: 21455730 PMCID: PMC3110279 DOI: 10.1007/s00125-011-2108-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2010] [Accepted: 02/08/2011] [Indexed: 11/28/2022]
Abstract
AIMS/HYPOTHESIS We quantified the effect of ADRA2A (encoding α-2 adrenergic receptor) variants on metabolic traits and type 2 diabetes risk, as reported in four studies. METHODS Genotype data for ADRA2A single nucleotide polymorphisms (SNPs) rs553668 and rs10885122 were analysed in >17,000 individuals (1,307 type 2 diabetes cases) with regard to metabolic traits and type 2 diabetes risk. Two studies (n = 9,437), genotyped using the Human Cardiovascular Disease BeadChip, provided 12 additional ADRA2A SNPs. RESULTS Rs553668 was associated with per allele effects on fasting glucose (0.03 mmol/l, p = 0.016) and type 2 diabetes risk (OR 1.17, 95% CI 1.04-1.31; p = 0.01). No significant association was observed with rs10885122. Of the 12 SNPs, several showed associations with metabolic traits. Overall, after variable selection, rs553668 was associated with type 2 diabetes risk (OR 1.38, 95% CI 1.09-1.73; p = 0.007). rs553668 (per allele difference 0.036 mmol/l, 95% CI 0.008-0.065) and rs17186196 (per allele difference 0.066 mmol/l, 95% CI 0.017-0.115) were independently associated with fasting glucose, and rs17186196 with fasting insulin and HOMA of insulin resistance (4.3%, 95% CI 0.6-8.1 and 4.9%, 95% CI 1.0-9.0, respectively, per allele). Per-allele effects of rs491589 on systolic and diastolic blood pressure were 1.19 mmHg (95% CI 0.43-1.95) and 0.61 mmHg (95% CI 0.11-1.10), respectively, and those of rs36022820 on BMI 0.58 kg/m(2) (95% CI 0.15-1.02). CONCLUSIONS/INTERPRETATION Multiple ADRA2A SNPs are associated with metabolic traits, blood pressure and type 2 diabetes risk. The α-2 adrenergic receptor should be revisited as a therapeutic target for reduction of the adverse consequences of metabolic trait disorders and type 2 diabetes.
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Affiliation(s)
- P J Talmud
- Centre for Cardiovascular Genetics, Department of Medicine, University College London, 5 University St, London, WC1E 6JF, UK.
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28
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Smart MC, Dedoussis G, Yiannakouris N, Grisoni ML, Ken-Dror G, Yannakoulia M, Papoutsakis C, Louizou E, Mantzoros CS, Melistas L, Kontogianni MD, Cooper JA, Humphries SE, Talmud PJ. Genetic variation within IL18 is associated with insulin levels, insulin resistance and postprandial measures. Nutr Metab Cardiovasc Dis 2011; 21:476-84. [PMID: 20227263 PMCID: PMC3158674 DOI: 10.1016/j.numecd.2009.12.004] [Citation(s) in RCA: 12] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2009] [Revised: 11/18/2009] [Accepted: 12/10/2009] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS IL-18 expression is up-regulated in atherosclerotic plaques, and higher levels are seen in obese and Type 2 Diabetic individuals. More recently, a possible role for IL-18 in glucose and energy homeostasis has been suggested. METHODS AND RESULTS We investigated variation within the IL18 gene and its association with measures of obesity and the metabolic syndrome. Five IL18 tagging single nucleotide polymorphisms (rs1946519, rs2043055, rs549908, rs360729, rs3882891) were selected and genotyped in the Gene-Diet Attica Investigation on childhood obesity (GENDAI) (age range 10-14 yrs); in young European men in the second European Atherosclerosis Research offspring Study (EARSII), an offspring study (age range 18-28 yrs) and in a group of healthy women from the Greek Obese Women study (GrOW) (age range 18-74 yrs). Six common haplotypes were observed. In GrOW, Hap6 (Frequency-2.6%) was associated with higher insulin levels (p<0.0001), estimates of HOMA(-Insulin Resistance) (p<0.0001) and HOMA(-β-cell) (p<0.0001) compared to the common haplotype Hap1 (Frequency-33.2%). In EARSII, rs2043055 was associated with peak and area under the curve triglycerides (p=0.001 and p=0.002, respectively) after an oral fat tolerance test in 'cases' but not 'controls'. None of the haplotypes were associated with measures of body fatness in any of the studies. CONCLUSION Association of IL18 variation with insulin levels and estimates of insulin resistance were only observed in our adult study, suggesting that the effects of IL-18 are only associated with increasing age. Taken together with the association of IL18 variants with post-prandial measures, this provides support for IL-18 as a metabolic factor.
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Key Words
- interleukin 18
- obesity
- insulin resistance
- single nucleotide polymorphisms
- genetic variants
- haplotypes
- auc, area under the curve
- catameri, catanzaro metabolic risk
- cvd, cardiovascular disease
- ci, confidence intervals
- chd, coronary heart disease
- earsii, european atherosclerosis research case control study
- fdr, false discovery rate
- gendai, gene-diet attica investigation on childhood obesity
- grow, greek obese women
- hwe, hardy–weinberg equilibrium
- homa, homeostasis model assessment
- iipga, innate immunity pga
- ir, insulin resistance
- il-18, interleukin 18
- ld, linkage disequilibrium
- mi, myocardial infarct
- maf, minor allele frequency
- oftt, oral fat tolerance test
- ogtt, oral glucose tolerance test
- quicki, quantitative insulin sensitivity check index
- snp, single nucleotide polymorphism
- tsnps, tagging single nucleotide polymorphisms
- t2d, type 2 diabetes
- utr, untranslated region
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Affiliation(s)
- M C Smart
- Division of Cardiovascular Genetics, British Heart Foundation Laboratories, Department of Medicine, Royal Free and UCL Medical School, London, UK.
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Simmons MM, Spiropoulos J, Webb PR, Spencer YI, Czub S, Mueller R, Davis A, Arnold ME, Marsh S, Hawkins SAC, Cooper JA, Konold T, Wells GAH. Experimental classical bovine spongiform encephalopathy: definition and progression of neural PrP immunolabeling in relation to diagnosis and disease controls. Vet Pathol 2010; 48:948-63. [PMID: 21078883 DOI: 10.1177/0300985810387072] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Tissues from sequential-kill time course studies of bovine spongiform encephalopathy (BSE) were examined to define PrP immunohistochemical labeling forms and map disease-specific labeling over the disease course after oral exposure to the BSE agent at two dose levels. Study was confined to brainstem, spinal cord, and certain peripheral nervous system ganglia-tissues implicated in pathogenesis and diagnosis or disease control strategies. Disease-specific labeling in the brainstem in 39 of 220 test animals showed the forms and patterns observed in natural disease and invariably preceded spongiform changes. A precise temporal pattern of increase in labeling was not apparent, but labeling was generally most widespread in clinical cases, and it always involved neuroanatomic locations in the medulla oblongata. In two cases, sparse labeling was confined to one or more neuroanatomic nuclei of the medulla oblongata. When involved, the spinal cord was affected at all levels, providing no indication of temporal spread within the cord axis or relative to the brainstem. Where minimal PrP labeling occurred in the thoracic spinal cord, it was consistent with initial involvement of general visceral efferent neurons. Labeling of ganglia involved only sensory ganglia and only when PrP was present in the brainstem and spinal cord. These experimental transmissions mimicked the neuropathologic findings in BSE-C field cases, independent of dose of agent or stage of disease. The model supports current diagnostic sampling approaches and control measures for the removal and destruction of nervous system tissues in slaughtered cattle.
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Affiliation(s)
- M M Simmons
- Department of Pathology, Veterinary Laboratories Agency, Addlestone, Surrey, UK.
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Cooper JA, Watras AC, Paton CM, Wegner FH, Adams AK, Schoeller DA. Impact of exercise and dietary fatty acid composition from a high-fat diet on markers of hunger and satiety. Appetite 2010; 56:171-8. [PMID: 21035513 DOI: 10.1016/j.appet.2010.10.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2010] [Revised: 09/14/2010] [Accepted: 10/21/2010] [Indexed: 01/12/2023]
Abstract
To compare the effects of both dietary fatty acid composition and exercise vs. sedentary conditions on circulating levels of hunger and satiety hormones. Eight healthy males were randomized in a 2 × 2 crossover design. The four treatments were 3 days of HF diets (50% of energy) containing high saturated fat (22% of energy) with exercise (SE) or sedentary (SS) conditions, and high monounsaturated fat (30% of energy) with exercise (UE) or sedentary (US) conditions. Cycling exercise was completed at 45% of VO(2)max for 2h daily. On the third HF day, 20 blood samples were drawn over a 24h period for each hormone (leptin, insulin, ghrelin, and peptide YY (PYY)). A visual analog scale (VAS) was completed hourly between 0800 and 2200. Average 24h leptin and insulin levels were lower while 24h PYY was higher during exercise vs. sedentary conditions. FA composition did not differentially affect 24h hormone values. VAS scores for hunger and fullness did not differ between any treatment but did correlate with ghrelin, leptin, and insulin. High saturated or unsaturated fat diets did not differ with respect to markers of hunger or satiety. Exercise decreased 24h leptin and insulin while increasing PYY regardless of FA composition.
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Affiliation(s)
- J A Cooper
- Department of Nutrition, Hospitality, and Retailing, Texas Tech University, PO Box 41240, Lubbock, TX 79409, USA
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Wogman NA, Thomas CW, Cooper JA, Engelmann RJ, Perkins RW. Cosmic ray-produced radionuclides as tracers of atmospheric precipitation processes. Science 2010; 159:189-92. [PMID: 17792356 DOI: 10.1126/science.159.3811.189] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Through recent developments in instrumental analysis it is now possible to measure with good precision the rainwater concentrations of five short-lived radionuclides which are produced by cosmic ray spallation of atmospheric argon. These measurements provide a method for studying the in-cloud nucleation times and aerosol scavenging efficiencies, and promise to provide information onshort-term processes which occur in rain and snow formation.
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Taylor A, Wang D, Patel K, Whittall R, Wood G, Farrer M, Neely RDG, Fairgrieve S, Nair D, Barbir M, Jones JL, Egan S, Everdale R, Lolin Y, Hughes E, Cooper JA, Hadfield SG, Norbury G, Humphries SE. Mutation detection rate and spectrum in familial hypercholesterolaemia patients in the UK pilot cascade project. Clin Genet 2010; 77:572-80. [PMID: 20236128 DOI: 10.1111/j.1399-0004.2009.01356.x] [Citation(s) in RCA: 137] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Cascade testing using DNA-mutation information is now recommended in the UK for patients with familial hypercholesterolaemia (FH). We compared the detection rate and mutation spectrum in FH patients with a clinical diagnosis of definite (DFH) and possible (PFH) FH. Six hundred and thirty-five probands from six UK centres were tested for 18 low-density lipoprotein receptor gene (LDLR) mutations, APOB p.Arg3527Gln and PCSK9 p.Asp374Tyr using a commercial amplification refractory mutation system (ARMS) kit. Samples with no mutation detected were screened in all exons by single strand conformation polymorphism analysis (SSCP)/denaturing high performance liquid chromatography electrophoresis (dHPLC)/direct-sequencing, followed by multiplex ligation-dependent probe amplification (MLPA) to detect deletions and duplications in LDLR.The detection rate was significantly higher in the 190 DFH patients compared to the 394 PFH patients (56.3% and 28.4%, p > 0.00001). Fifty-one patients had inadequate information to determine PFH/DFH status, and in this group the detection rate was similar to the PFH group (25.5%, p = 0.63 vs PFH). Overall, 232 patients had detected mutations (107 different; 6.9% not previously reported). The ARMS kit detected 100 (44%) and the MLPA kit 11 (4.7%). Twenty-eight (12%) of the patients had the APOB p.Arg3527Gln and four (1.7%) had the PCSK9 p.Asp374Tyr mutation. Of the 296 relatives tested from 100 families, a mutation was identified in 56.1%. In 31 patients of Indian/Asian origin 10 mutations (two previously unreported) were identified. The utility of the ARMS kit was confirmed, but sequencing is still required in a comprehensive diagnostic service for FH. Even in subjects with a low clinical suspicion of FH, and in those of Indian origin, mutation testing has an acceptable detection rate.
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Affiliation(s)
- A Taylor
- Great Ormond Street Hospital for Children, London, UK
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Abstract
Abstract
Background
This retrospective analysis of prospectively collected abdominal aortic aneurysm (AAA) screening data aimed to identify predictors of AAA-related events (surgery or death) with a view to better targeting of screening.
Methods
For the interval 1984–2007, data for 1649 subjects with an AAA were collected prospectively as part of the Chichester AAA screening programme. This included serial aortic size measurements, blood pressure, risk factors for arterial disease and concurrent medications. AAA growth rates were adjusted for risk factor confounders using flexible hierarchical modelling. AAA growth distribution was analysed using Silverman's test of multimodality.
Results
Some 1231 subjects met the inclusion criteria of having more than one scan and a surveillance interval of over 3 months. AAA growth showed a bimodal pattern with nearly 50 per cent of all aneurysms never progressing to surgery or rupture. Adjusted annual AAA growth rates of at least 2 mm significantly predicted AAA-related events.
Conclusion
This analysis identified a bimodal growth pattern for AAA, with a significant association between annual AAA growth rate of at least 2 mm and AAA-related events.
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Affiliation(s)
- A R Thompson
- Department of Vascular Surgery, Western Sussex Hospital NHS Trust, Chichester, UK
- Centre for Cardiovascular Genetics, British Heart Foundation Laboratories, University College London, London, UK
| | - J A Cooper
- Centre for Cardiovascular Genetics, British Heart Foundation Laboratories, University College London, London, UK
| | - H A Ashton
- Department of Vascular Surgery, Western Sussex Hospital NHS Trust, Chichester, UK
| | - H Hafez
- Department of Vascular Surgery, Western Sussex Hospital NHS Trust, Chichester, UK
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Jackson D, White I, Kostis JB, Wilson AC, Folsom AR, Wu K, Chambless L, Benderly M, Goldbourt U, Willeit J, Kiechl S, Yarnell JWG, Sweetnam PM, Elwood PC, Cushman M, Psaty BM, Tracy RP, Tybjaerg-Hansen A, Haverkate F, de Maat MPM, Thompson SG, Fowkes FGR, Lee AJ, Smith FB, Salomaa V, Harald K, Rasi V, Vahtera E, Jousilahti P, D'Agostino R, Kannel WB, Wilson PWF, Tofler G, Levy D, Marchioli R, Valagussa F, Rosengren A, Wilhelmsen L, Lappas G, Eriksson H, Cremer P, Nagel D, Curb JD, Rodriguez B, Yano K, Salonen JT, Nyyssönen K, Tuomainen TP, Hedblad B, Engström G, Berglund G, Loewel H, Koenig W, Hense HW, Meade TW, Cooper JA, De Stavola B, Knottenbelt C, Miller GJ, Cooper JA, Bauer KA, Rosenberg RD, Sato S, Kitamura A, Naito Y, Iso H, Salomaa V, Harald K, Rasi V, Vahtera E, Jousilahti P, Palosuo T, Ducimetiere P, Amouyel P, Arveiler D, Evans AE, Ferrieres J, Juhan-Vague I, Bingham A, Schulte H, Assmann G, Cantin B, Lamarche B, Despres JP, Dagenais GR, Tunstall-Pedoe H, Lowe GDO, Woodward M, Ben-Shlomo Y, Davey Smith G, Palmieri V, Yeh JL, Meade TW, Rudnicka A, Brennan P, Knottenbelt C, Cooper JA, Ridker P, Rodeghiero F, Tosetto A, Shepherd J, Lowe GDO, Ford I, Robertson M, Brunner E, Shipley M, Feskens EJM, Di Angelantonio E, Kaptoge S, Lewington S, Lowe GDO, Sarwar N, Thompson SG, Walker M, Watson S, White IR, Wood AM, Danesh J. Systematically missing confounders in individual participant data meta-analysis of observational cohort studies. Stat Med 2009; 28:1218-37. [PMID: 19222087 PMCID: PMC2922684 DOI: 10.1002/sim.3540] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
One difficulty in performing meta-analyses of observational cohort studies is that the availability of confounders may vary between cohorts, so that some cohorts provide fully adjusted analyses while others only provide partially adjusted analyses. Commonly, analyses of the association between an exposure and disease either are restricted to cohorts with full confounder information, or use all cohorts but do not fully adjust for confounding. We propose using a bivariate random-effects meta-analysis model to use information from all available cohorts while still adjusting for all the potential confounders. Our method uses both the fully adjusted and the partially adjusted estimated effects in the cohorts with full confounder information, together with an estimate of their within-cohort correlation. The method is applied to estimate the association between fibrinogen level and coronary heart disease incidence using data from 154 012 participants in 31 cohorts.† Copyright © 2009 John Wiley & Sons, Ltd.
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Petrie Aronin CE, Cooper JA, Sefcik LS, Tholpady SS, Ogle RC, Botchwey EA. Osteogenic differentiation of dura mater stem cells cultured in vitro on three-dimensional porous scaffolds of poly(epsilon-caprolactone) fabricated via co-extrusion and gas foaming. Acta Biomater 2008; 4:1187-97. [PMID: 18434267 PMCID: PMC2654610 DOI: 10.1016/j.actbio.2008.02.029] [Citation(s) in RCA: 41] [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: 10/03/2007] [Revised: 12/31/2007] [Accepted: 02/26/2008] [Indexed: 10/22/2022]
Abstract
A novel scaffold fabrication method utilizing both polymer blend extrusion and gas foaming techniques to control pore size distribution is presented. Seventy-five per cent of all pores produced using polymer blend extrusion alone were less than 50microm. Introducing a gas technique provided better control of pore size distribution, expanding the range from 0-50 to 0-350microm. Varying sintering time, annealing temperature and foaming pressure also helped to reduce the percentage of pore sizes below 50microm. Scaffolds chosen for in vitro cellular studies had a pore size distribution of 0-300microm, average pore size 66+/-17microm, 0.54+/-0.02% porosity and 98% interconnectivity, measured by micro-computed tomography (microCT) analysis. The ability of the scaffolds to support osteogenic differentiation for subsequent cranial defect repair was evaluated by static and dynamic (0.035+/-0.006ms(-1) terminal velocity) cultivation with dura mater stem cells (DSCs). In vitro studies showed minimal increases in proliferation over 28 days in culture in osteogenic media. Alkaline phosphatase expression remained constant throughout the study. Moderate increases in matrix deposition, as assessed by histochemical staining and microCT analysis, occurred at later time points, days 21 and 28. Although constructs cultured dynamically showed greater mineralization than static conditions, these trends were not significant. It remains unclear whether bioreactor culture of DSCs is advantageous for bone tissue engineering applications. However, these studies show that polycaprolactone (PCL) scaffolds alone, without the addition of other co-polymers or ceramics, support long-term attachment and mineralization of DSCs throughout the entire porous scaffold.
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Affiliation(s)
- C E Petrie Aronin
- Department of Biomedical Engineering, University of Virginia, Box 800759, Health System, Charlottesville, VA 22908, USA
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Dorfmeister B, Zeng WW, Dichlberger A, Nilsson SK, Schaap FG, Hubacek JA, Merkel M, Cooper JA, Lookene A, Putt W, Whittall R, Lee PJ, Lins L, Delsaux N, Nierman M, Kuivenhoven JA, Kastelein JJP, Vrablik M, Olivecrona G, Schneider WJ, Heeren J, Humphries SE, Talmud PJ. Effects of six APOA5 variants, identified in patients with severe hypertriglyceridemia, on in vitro lipoprotein lipase activity and receptor binding. Arterioscler Thromb Vasc Biol 2008; 28:1866-71. [PMID: 18635818 DOI: 10.1161/atvbaha.108.172866] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The purpose of this study was to identify rare APOA5 variants in 130 severe hypertriglyceridemic patients by sequencing, and to test their functionality, since no patient recall was possible. METHODS AND RESULTS We studied the impact in vitro on LPL activity and receptor binding of 3 novel heterozygous variants, apoAV-E255G, -G271C, and -H321L, together with the previously reported -G185C, -Q139X, -Q148X, and a novel construct -Delta139 to 147. Using VLDL as a TG-source, compared to wild type, apoAV-G255, -L321 and -C185 showed reduced LPL activation (-25% [P=0.005], -36% [P<0.0001], and -23% [P=0.02]), respectively). ApoAV-C271, -X139, -X148, and Delta139 to 147 had little affect on LPL activity, but apoAV-X139, -X148, and -C271 showed no binding to LDL-family receptors, LR8 or LRP1. Although the G271C proband carried no LPL and APOC2 mutations, the H321L carrier was heterozygous for LPL P207L. The E255G carrier was homozygous for LPL W86G, yet only experienced severe hypertriglyceridemia when pregnant. CONCLUSIONS The in vitro determined function of these apoAV variants only partly explains the high TG levels seen in carriers. Their occurrence in the homozygous state, coinheritance of LPL variants or common APOA5 TG-raising variant in trans, appears to be essential for their phenotypic expression.
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Affiliation(s)
- B Dorfmeister
- Department of Medicine, Division of Cardiovascular Genetics, UCL, London, UK
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Abstract
Many growth factor receptors and retroviral transforming proteins share the property of phosphorylating proteins on tyrosine. Several substrates for both types of protein-tyrosine kinase have been identified. Treatment of quiescent cells with growth factors such as EGF and PDGF, whose receptors have ligand-stimulated protein-tyrosine kinase activities, induces tyrosine phosphorylation of three proteins, p45, p42 and p41. Two phosphorylated forms of p42 are found, the more basic of which is present in some but not all cells transformed by viral protein-tyrosine kinases. p42 is rapidly (as early as 1 min) but transiently (decreased to baseline by 2h) phosphorylated following PGDF or EGF treatment of quiescent fibroblasts. At saturating levels of mitogen the stoichiometry of p42 phosphorylation is greater than 50%. p42 is a highly conserved, rare (0.002% of total cell protein), soluble cytoplasmic protein. IGF I and insulin, whose receptors also have ligand-stimulated protein-tyrosine kinase activity, induce p42 phosphorylation in appropriate cells. In the case of insulin this effect has been observed in cells with large numbers of insulin receptors. p42 is also phosphorylated in response to mitogens whose receptors lack protein-tyrosine kinase activity, for example 12-O-tetradecanoylphorbol-13-acetate (TPA) and thrombin. For TPA there is evidence that this is an indirect effect due to the activation of a protein-serine/threonine kinase. On the basis of the highly conserved nature of this response and its generality, it seems likely that tyrosine phosphorylation of p42 is important for at least early responses to mitogens.
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Miller GJ, Ireland HA, Cooper JA, Bauer KA, Morrissey JH, Humphries SE, Esnouf MP. Relationship between markers of activated coagulation, their correlation with inflammation, and association with coronary heart disease (NPHSII). J Thromb Haemost 2008; 6:259-67. [PMID: 17973650 DOI: 10.1111/j.1538-7836.2008.02819.x] [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] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To determine whether activation of coagulation increases in parallel with inflammation and whether coagulation activation markers (CAMs) are independently associated with coronary heart disease (CHD), in the prospective study, NPHSII. METHODS Surveillance of 2997 men between 50 and 63 years yielded 314 first CHD events during 36507 person-years of observation. The plasma levels of activated factor XII (FXIIa), the peptides released upon activation of factor X (FXpep) and factor IX (FIXpep), activated factor VII (FVIIa), prothrombin fragment 1 + 2 (F1 + 2) and fibrinopeptide A (FpA) served as indices of activity along the coagulation pathway. C reactive protein (CRP) provided a marker of inflammatory activity. RESULTS While borderline or significant correlations were identified for each CAM with inflammation, as determined by CRP levels, these did not reach as high a numerical value as was shown for fibrinogen with CRP. FVIIa and FIXpep possessed independent associations with CHD: a one SD increase in adjusted FIXpep and FVIIa level was associated with a relative hazard of 1.20 (95% CI 1.00-1.43) and 0.70 (CI 0.58-0.86), respectively, using a group including all CHD events, compared with 'no-event'. CONCLUSIONS Inflammation has significant but minimal impact upon CAMs of the extrinsic coagulation pathway. Reduced FVIIa and increased FIXpep levels were found to be significant, independent, predictors of CHD.
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Affiliation(s)
- G J Miller
- MRC Cardiovascular Research Group, Wolfson Institute for Preventive Medicine, London, UK
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Danesh J, Erqou S, Walker M, Thompson SG, Tipping R, Ford C, Pressel S, Walldius G, Jungner I, Folsom AR, Chambless LE, Knuiman M, Whincup PH, Wannamethee SG, Morris RW, Willeit J, Kiechl S, Santer P, Mayr A, Wald N, Ebrahim S, Lawlor DA, Yarnell JWG, Gallacher J, Casiglia E, Tikhonoff V, Nietert PJ, Sutherland SE, Bachman DL, Keil JE, Cushman M, Psaty BM, Tracy RP, Tybjaerg-Hansen A, Nordestgaard BG, Frikke-Schmidt R, Giampaoli S, Palmieri L, Panico S, Vanuzzo D, Pilotto L, Simons L, McCallum J, Friedlander Y, Fowkes FGR, Lee AJ, Smith FB, Taylor J, Guralnik J, Phillips C, Wallace R, Blazer D, Khaw KT, Jansson JH, Donfrancesco C, Salomaa V, Harald K, Jousilahti P, Vartiainen E, Woodward M, D'Agostino RB, Wolf PA, Vasan RS, Pencina MJ, Bladbjerg EM, Jorgensen T, Moller L, Jespersen J, Dankner R, Chetrit A, Lubin F, Rosengren A, Wilhelmsen L, Lappas G, Eriksson H, Bjorkelund C, Cremer P, Nagel D, Tilvis R, Strandberg T, Rodriguez B, Bouter LM, Heine RJ, Dekker JM, Nijpels G, Stehouwer CDA, Rimm E, Pai J, Sato S, Iso H, Kitamura A, Noda H, Goldbourt U, Salomaa V, Salonen JT, Nyyssönen K, Tuomainen TP, Deeg D, Poppelaars JL, Meade T, Cooper J, Hedblad B, Berglund G, Engstrom G, Döring A, Koenig W, Meisinger C, Mraz W, Kuller L, Selmer R, Tverdal A, Nystad W, Gillum R, Mussolino M, Hankinson S, Manson J, De Stavola B, Knottenbelt C, Cooper JA, Bauer KA, Rosenberg RD, Sato S, Naito Y, Holme I, Nakagawa H, Miura H, Ducimetiere P, Jouven X, Crespo C, Garcia-Palmieri M, Amouyel P, Arveiler D, Evans A, Ferrieres J, Schulte H, Assmann G, Shepherd J, Packard C, Sattar N, Cantin B, Lamarche B, Després JP, Dagenais GR, Barrett-Connor E, Wingard D, Bettencourt R, Gudnason V, Aspelund T, Sigurdsson G, Thorsson B, Trevisan M, Witteman J, Kardys I, Breteler M, Hofman A, Tunstall-Pedoe H, Tavendale R, Lowe GDO, Ben-Shlomo Y, Howard BV, Zhang Y, Best L, Umans J, Onat A, Meade TW, Njolstad I, Mathiesen E, Lochen ML, Wilsgaard T, Gaziano JM, Stampfer M, Ridker P, Ulmer H, Diem G, Concin H, Rodeghiero F, Tosetto A, Brunner E, Shipley M, Buring J, Cobbe SM, Ford I, Robertson M, He Y, Ibanez AM, Feskens EJM, Kromhout D, Collins R, Di Angelantonio E, Kaptoge S, Lewington S, Orfei L, Pennells L, Perry P, Ray K, Sarwar N, Scherman M, Thompson A, Watson S, Wensley F, White IR, Wood AM. The Emerging Risk Factors Collaboration: analysis of individual data on lipid, inflammatory and other markers in over 1.1 million participants in 104 prospective studies of cardiovascular diseases. Eur J Epidemiol 2007; 22:839-69. [PMID: 17876711 DOI: 10.1007/s10654-007-9165-7] [Citation(s) in RCA: 132] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2007] [Accepted: 07/02/2007] [Indexed: 01/22/2023]
Abstract
Many long-term prospective studies have reported on associations of cardiovascular diseases with circulating lipid markers and/or inflammatory markers. Studies have not, however, generally been designed to provide reliable estimates under different circumstances and to correct for within-person variability. The Emerging Risk Factors Collaboration has established a central database on over 1.1 million participants from 104 prospective population-based studies, in which subsets have information on lipid and inflammatory markers, other characteristics, as well as major cardiovascular morbidity and cause-specific mortality. Information on repeat measurements on relevant characteristics has been collected in approximately 340,000 participants to enable estimation of and correction for within-person variability. Re-analysis of individual data will yield up to approximately 69,000 incident fatal or nonfatal first ever major cardiovascular outcomes recorded during about 11.7 million person years at risk. The primary analyses will involve age-specific regression models in people without known baseline cardiovascular disease in relation to fatal or nonfatal first ever coronary heart disease outcomes. This initiative will characterize more precisely and in greater detail than has previously been possible the shape and strength of the age- and sex-specific associations of several lipid and inflammatory markers with incident coronary heart disease outcomes (and, secondarily, with other incident cardiovascular outcomes) under a wide range of circumstances. It will, therefore, help to determine to what extent such associations are independent from possible confounding factors and to what extent such markers (separately and in combination) provide incremental predictive value.
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Govers-Riemslag JWP, Smid M, Cooper JA, Bauer KA, Rosenberg RD, Hack CE, Hamulyak K, Spronk HMH, Miller GJ, ten Cate H. The plasma kallikrein-kinin system and risk of cardiovascular disease in men. J Thromb Haemost 2007; 5:1896-903. [PMID: 17723129 DOI: 10.1111/j.1538-7836.2007.02687.x] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.6] [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] [Indexed: 11/30/2022]
Abstract
BACKGROUND The plasma kallikrein-kinin system (PKKS) has been implicated in cardiovascular disease, but activation of the PKKS has not been directly probed in individuals at risk of coronary heart disease (CHD) or stroke. OBJECTIVE To determine the involvement of the PKKS, including factor XI, in cardiovascular disease occurring in a nested case-control study from the Second Northwick Park Heart Study (NPHS-II). METHODS AND RESULTS After a median follow-up of 10.7 years, 287 cases of CHD and stroke had been recorded and 542 age-matched controls were selected. When FXIIa-C1 esterase inhibitor (C1-inhibitor) concentrations were divided into tertiles (lowest tertile as reference), the odds ratios (ORs) at 95% CIs for CHD were 0.52 (0.34-0.80) in the middle tertile and 0.73 (0.49-1.09) in the highest tertile (P = 0.01 for the overall difference; P = 0.01 for CHD and stroke combined). For kallikrein-C1-inhibitor complexes, the ORs for stroke were 0.29 (0.12-0.72) and 0.67 (0.30-1.52) in the middle and high tertiles, respectively (P = 0.02). FXIIa-C1-inhibitor and kallikrein-C1-inhibitor complexes were negatively related to smoking and fibrinogen (P < 0.005). FXIa-inhibitor complexes correlated strongly with FXIIa-inhibitor complexes. CONCLUSIONS Lower levels of inhibitory complexes of the PKKS enzymes and particularly of FXIIa contribute to the risk of CHD and stroke in middle-aged men. This observation supports the involvement of the PKKS in atherothrombosis.
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Affiliation(s)
- J W P Govers-Riemslag
- Laboratory for Clinical Thrombosis and Haemostasis, Department of Internal Medicine and Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
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Abstract
A common polymorphism, rs7566605, 10 kb upstream of the insulin-induced gene 2 transcription start site has been associated with obesity in Caucasian and African-American populations, with the hypothesis that an alteration in gene expression results in elevated plasma triglyceride levels. The goal of this study was to verify the findings in a cohort of 2721 healthy Caucasian men (second Northwick Park Heart Study), and a separate study of 747 type 2 diabetic patients from Caucasian, Afro-Caribbean and Indian groups (University College London Diabetes and Cardiovascular Disease Study). The rs7566605 single-nucleotide polymorphism (SNP) was not related to plasma triglyceride levels in either study, and we found no association with body mass index or obesity in either cohort, despite having the power to detect the previously reported effect. This suggests that, at the least, the true size of the effect on obesity of this SNP is likely to be considerably less than reported previously.
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Affiliation(s)
- A J P Smith
- Department of Medicine, Centre for Cardiovascular Genetics, University College London, London, UK.
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Abstract
Tissue engineering develops organ replacements to overcome the limitations associated with autografts and allografts. The work presented here details the development of biodegradable, porous, three-dimensional polymer-ceramic-sintered microsphere matrices to support bone regeneration. Poly(lactide-co-glycolide)/hydroxyapatite microspheres were formed using solvent evaporation technique. Individual microspheres were placed in a cylindrical mold and sintered at various temperatures. Scaffolds were characterized using scanning electron microscopy, mercury porosimetry, and mechanical testing in compression. After varying the temperature of sintering, a single temperature was selected and the time of sintering was varied. Mechanical testing indicated that as the sintering temperature or time was increased, the elastic modulus, compressive strength, maximum compressive load, and energy at failure significantly increased. Furthermore, increasing the sintering temperature or time resulted in a decreased porosity and the spherical morphology of the microspheres was lost as the microspheres blended together. To more closely mimic the bone marrow cavity observed in native bone tissue, tubular composite-sintered microsphere matrices were formed. These scaffolds demonstrated no statistically significant difference in compressive mechanical properties when compared with cylindrical composite-sintered microsphere matrices of the same dimension. One potential application for these scaffolds is bone regeneration.
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Affiliation(s)
- M D Kofron
- Department of Biomedical Engineering, University of Virginia, PO Box 800759, Charlottesville, Virginia 22908, USA
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Humphries SE, Whittall RA, Hubbart CS, Maplebeck S, Cooper JA, Soutar AK, Naoumova R, Thompson GR, Seed M, Durrington PN, Miller JP, Betteridge DJB, Neil HAW. Genetic causes of familial hypercholesterolaemia in patients in the UK: relation to plasma lipid levels and coronary heart disease risk. J Med Genet 2006; 43:943-9. [PMID: 17142622 PMCID: PMC2563208 DOI: 10.1136/jmg.2006.038356] [Citation(s) in RCA: 199] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIMS To determine the relative frequency of mutations in three different genes (low-density lipoprotein receptor (LDLR), APOB, PCSK9), and to examine their effect in development of coronary heart disease (CHD) in patients with clinically defined definite familial hypercholesterolaemia in UK. PATIENTS AND METHODS 409 patients with familial hypercholesterolaemia patients (158 with CHD) were studied. The LDLR was partially screened by single-strand conformational polymorphism (SSCP) (exons 3, 4, 6-10 and 14) and by using a commercial kit for gross deletions or rearrangements. APOB (p.R3500Q) and PCSK9 (p.D374Y) were detected by specific assays. Coding exons of PCSK9 were screened by SSCP. RESULTS Mutations were detected in 253 (61.9%) PATIENTS 236 (57.7%) carried LDLR, 10 (2.4%) carried APOB p.Q3500 and 7 (1.7%) PCSK9 p.Y374. No additional mutations were identified in PCSK9. After adjusting for age, sex, smoking and systolic blood pressure, compared to those with no detectable mutation, the odds ratio of having CHD in those with an LDLR mutation was 1.84 (95% CI 1.10 to 3.06), for APOB 3.40 (0.71 to 16.36), and for PCSK9 19.96 (1.88 to 211.5; p = 0.001 overall). The high risk in patients carrying LDLR and PCSK9 p.Y374 was partly explained by their higher pretreatment cholesterol levels (LDLR, PCSK9 and no mutation, 10.29 (1.85), 13.12 and 9.85 (1.90) mmol/l, respectively, p = 0.001). The post-statin treatment lipid profile in PCSK9 p.Y374 carriers was worse than in patients with no identified mutation (LDL-C, 6.77 (1.82) mmol/l v 4.19 (1.26) mmol/l, p = 0.001, HDL-C 1.09 (0.27) mmol/l v 1.36 (0.36) mmol/l, p = 0.03). CONCLUSIONS The higher CHD risk in patients carrying PCSK9 p.Y347 or a detected LDLR mutation supports the usefulness of DNA testing in the diagnosis and management of patients with familial hypercholesterolaemia. Mutations in PCSK9 appear uncommon in patients with familial hypercholesterolaemia in UK.
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Stephens JS, Cooper JA, Phelan FR, Dunkers JP. Perfusion flow bioreactor for 3D in situ imaging: Investigating cell/biomaterials interactions. Biotechnol Bioeng 2006; 97:952-61. [PMID: 17149772 DOI: 10.1002/bit.21252] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The capability to image real time cell/material interactions in a three-dimensional (3D) culture environment will aid in the advancement of tissue engineering. This paper describes a perfusion flow bioreactor designed to hold tissue engineering scaffolds and allow for in situ imaging using an upright microscope. The bioreactor can hold a scaffold of desirable thickness for implantation (>2 mm). Coupling 3D culture and perfusion flow leads to the creation of a more biomimetic environment. We examined the ability of the bioreactor to maintain cell viability outside of an incubator environment (temperature and pH stability), investigated the flow features of the system (flow induced shear stress), and determined the image quality in order to perform time-lapsed imaging of two-dimensional (2D) and 3D cell culture. In situ imaging was performed on 2D and 3D, culture samples and cell viability was measured under perfusion flow (2.5 mL/min, 0.016 Pa). The visualization of cell response to their environment, in real time, will help to further elucidate the influences of biomaterial surface features, scaffold architectures, and the influence of flow induced shear on cell response and growth of new tissue.
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Affiliation(s)
- J S Stephens
- Polymers Division, National Institute of Standards and Technology, 100 Bureau Dr, Gaithersburg, Maryland 20899, USA
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Talmud PJ, Cooper JA, Hattori H, Miller IP, Miller GJ, Humphries SE. The apolipoprotein A-V genotype and plasma apolipoprotein A-V and triglyceride levels: prospective risk of type 2 diabetes. Results from the Northwick Park Heart Study II. Diabetologia 2006; 49:2337-40. [PMID: 16917759 DOI: 10.1007/s00125-006-0387-0] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.7] [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] [Received: 05/03/2006] [Accepted: 06/22/2006] [Indexed: 11/30/2022]
Abstract
AIMS/HYPOTHESIS We sought to establish the relationship between plasma apolipoprotein A-V (APOA5, previously known as apoA-V) and triglyceride levels and to determine the impact of the APOA5 genotype on APOA5 levels and development of type 2 diabetes in a 15-year follow-up study of healthy UK men. MATERIALS AND METHODS APOA5 -1131T>C and S19W genotypes were determined in 2,490 men, of whom 145 subsequently developed type 2 diabetes. In a subset of 299 men, we also determined APOA5 levels. RESULTS Plasma APOA5 levels positively correlated with triglycerides (r=0.18, p<0.002) and were not different in men who subsequently developed type 2 diabetes compared with healthy men (p=0.7). Carriers of either APOA5 W19 or -1131C had, as expected, higher plasma triglycerides. However, while W19 carriers had significantly higher APOA5 levels (p=0.0003), APOA5 levels were not associated with -1131T>C (p=0.63), reinforcing the idea that the reported -1131C association with triglycerides levels is due to linkage disequilibrium with variants in the APOC3 gene, and not due to the direct effect on APOA5 levels. Overall no effect of APOA5 -1131T>C or S19W was found on type 2 diabetes risk. CONCLUSIONS/INTERPRETATION In contrast to animal studies, in man, plasma APOA5 positively correlates with plasma triglyceride levels. In prospective analysis, with the caveat that numbers were small, APOA5 genotypes do not appear to have an impact on risk of development of type 2 diabetes.
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Affiliation(s)
- P J Talmud
- Division of Cardiovascular Genetics, Department of Medicine, Royal Free and University College Medical School, 5 University Street, London, WC1E 6JF, UK.
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Ireland H, Konstantoulas CJ, Cooper JA, Hawe E, Humphries SE, Mather H, Goodall AH, Hogwood J, Juhan-Vague I, Yudkin JS, di Minno G, Margaglione M, Hamsten A, Miller GJ, Bauer KA, Kim YT, Stearns-Kurosawa DJ, Kurosawa S. EPCR Ser219Gly: elevated sEPCR, prothrombin F1+2, risk for coronary heart disease, and increased sEPCR shedding in vitro. Atherosclerosis 2006; 183:283-92. [PMID: 15921688 DOI: 10.1016/j.atherosclerosis.2005.02.028] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.6] [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] [Received: 12/22/2004] [Revised: 02/14/2005] [Accepted: 02/21/2005] [Indexed: 11/16/2022]
Abstract
We have progressively analysed three studies of coronary heart disease (CHD) for a variant in EPCR (Ser219Gly). Initially, in a prospective study, NPHSII, while no overall CHD-risk was identified in heterozygotes, homozygotes for 219Gly exhibited a three-fold elevated risk (HR 3.3, CI 1.22-8.96). In diabetics within NPHSII, there was a suggestion that 219Gly+ was associated with elevated CHD-risk (HR 1.89, CI 0.39-9.06) although numbers were small. To further assess the effect of the variant in diabetes, a case-control study of MI, HIFMECH, was used, in which previous analysis had defined a group with metabolic syndrome, by factor analysis. A significant CHD-risk interaction was identified between genotype and the 'metabolic syndrome' factor (interaction p=0.009). To further assess CHD-risk for this variant in type-2 diabetes and to assess the effect of the variant upon thrombin generation and plasma levels of soluble EPCR, a cross-sectional study of type-2 diabetes was used. A significant CHD-risk was identified for European Whites (OR 2.84, CI 1.38-5.85) and Indian Asians in this study (OR 1.6, CI 1.00-2.57) and the frequency of 219Gly was two-fold higher in Indian Asians. Soluble EPCR levels were strongly associated with genotype, with homozygotes for 219Gly having four-fold higher levels (p<0.0001). In vitro studies of EPCR-transfected cells suggested increased basal release of sEPCR from cells expressing the 219Gly EPCR phenotype. Furthermore, in base-line samples from NPHSII and in the diabetic study, a significant increase in prothrombin F1+2 level was observed for 219Gly. The increased CHD-risk and thrombin generation appears to be acting through increased shedding of the Gly allele from the cell surface.
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Affiliation(s)
- H Ireland
- Cardiovascular Genetics, Department Medicine, University College London, 5 University St., London, WC1E 6JF, UK.
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Danesh J, Lewington S, Thompson SG, Lowe GDO, Collins R, Kostis JB, Wilson AC, Folsom AR, Wu K, Benderly M, Goldbourt U, Willeit J, Kiechl S, Yarnell JWG, Sweetnam PM, Elwood PC, Cushman M, Psaty BM, Tracy RP, Tybjaerg-Hansen A, Haverkate F, de Maat MPM, Fowkes FGR, Lee AJ, Smith FB, Salomaa V, Harald K, Rasi R, Vahtera E, Jousilahti P, Pekkanen J, D'Agostino R, Kannel WB, Wilson PWF, Tofler G, Arocha-Piñango CL, Rodriguez-Larralde A, Nagy E, Mijares M, Espinosa R, Rodriquez-Roa E, Ryder E, Diez-Ewald MP, Campos G, Fernandez V, Torres E, Marchioli R, Valagussa F, Rosengren A, Wilhelmsen L, Lappas G, Eriksson H, Cremer P, Nagel D, Curb JD, Rodriguez B, Yano K, Salonen JT, Nyyssönen K, Tuomainen TP, Hedblad B, Lind P, Loewel H, Koenig W, Meade TW, Cooper JA, De Stavola B, Knottenbelt C, Miller GJ, Cooper JA, Bauer KA, Rosenberg RD, Sato S, Kitamura A, Naito Y, Palosuo T, Ducimetiere P, Amouyel P, Arveiler D, Evans AE, Ferrieres J, Juhan-Vague I, Bingham A, Schulte H, Assmann G, Cantin B, Lamarche B, Després JP, Dagenais GR, Tunstall-Pedoe H, Woodward M, Ben-Shlomo Y, Davey Smith G, Palmieri V, Yeh JL, Rudnicka A, Ridker P, Rodeghiero F, Tosetto A, Shepherd J, Ford I, Robertson M, Brunner E, Shipley M, Feskens EJM, Kromhout D, Dickinson A, Ireland B, Juzwishin K, Kaptoge S, Lewington S, Memon A, Sarwar N, Walker M, Wheeler J, White I, Wood A. Plasma fibrinogen level and the risk of major cardiovascular diseases and nonvascular mortality: an individual participant meta-analysis. JAMA 2005; 294:1799-809. [PMID: 16219884 DOI: 10.1001/jama.294.14.1799] [Citation(s) in RCA: 460] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CONTEXT Plasma fibrinogen levels may be associated with the risk of coronary heart disease (CHD) and stroke. OBJECTIVE To assess the relationships of fibrinogen levels with risk of major vascular and with risk of nonvascular outcomes based on individual participant data. DATA SOURCES Relevant studies were identified by computer-assisted searches, hand searches of reference lists, and personal communication with relevant investigators. STUDY SELECTION All identified prospective studies were included with information available on baseline fibrinogen levels and details of subsequent major vascular morbidity and/or cause-specific mortality during at least 1 year of follow-up. Studies were excluded if they recruited participants on the basis of having had a previous history of cardiovascular disease; participants with known preexisting CHD or stroke were excluded. DATA EXTRACTION Individual records were provided on each of 154,211 participants in 31 prospective studies. During 1.38 million person-years of follow-up, there were 6944 first nonfatal myocardial infarctions or stroke events and 13,210 deaths. Cause-specific mortality was generally available. Analyses involved proportional hazards modeling with adjustment for confounding by known cardiovascular risk factors and for regression dilution bias. DATA SYNTHESIS Within each age group considered (40-59, 60-69, and > or =70 years), there was an approximately log-linear association with usual fibrinogen level for the risk of any CHD, any stroke, other vascular (eg, non-CHD, nonstroke) mortality, and nonvascular mortality. There was no evidence of a threshold within the range of usual fibrinogen level studied at any age. The age- and sex- adjusted hazard ratio per 1-g/L increase in usual fibrinogen level for CHD was 2.42 (95% confidence interval [CI], 2.24-2.60); stroke, 2.06 (95% CI, 1.83-2.33); other vascular mortality, 2.76 (95% CI, 2.28-3.35); and nonvascular mortality, 2.03 (95% CI, 1.90-2.18). The hazard ratios for CHD and stroke were reduced to about 1.8 after further adjustment for measured values of several established vascular risk factors. In a subset of 7011 participants with available C-reactive protein values, the findings for CHD were essentially unchanged following additional adjustment for C-reactive protein. The associations of fibrinogen level with CHD or stroke did not differ substantially according to sex, smoking, blood pressure, blood lipid levels, or several features of study design. CONCLUSIONS In this large individual participant meta-analysis, moderately strong associations were found between usual plasma fibrinogen level and the risks of CHD, stroke, other vascular mortality, and nonvascular mortality in a wide range of circumstances in healthy middle-aged adults. Assessment of any causal relevance of elevated fibrinogen levels to disease requires additional research.
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Nagai J, Christensen EI, Morris SM, Willnow TE, Cooper JA, Nielsen R. Mutually dependent localization of megalin and Dab2 in the renal proximal tubule. Am J Physiol Renal Physiol 2005; 289:F569-76. [PMID: 15870384 DOI: 10.1152/ajprenal.00292.2004] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.9] [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] [Indexed: 11/22/2022] Open
Abstract
Disabled-2 (Dab2) is a cytoplasmic adaptor protein that binds to the cytoplasmic tail of the multiligand endocytic receptor megalin, abundantly expressed in renal proximal tubules. Deletion of Dab2 induces a urinary increase in specific plasma proteins such as vitamin D binding protein and retinol binding protein (Morris SM, Tallquist MD, Rock CO, and Cooper JA. EMBO J 21: 1555-1564, 2002). However, the subcellular localization of Dab2 in the renal proximal tubule and its function have not been fully elucidated yet. Here, we report the characterization of Dab2 in the renal proximal tubule. Immunohistocytochemistry revealed colocalization with megalin in coated pits and vesicles but not in dense apical tubules and the brush border. Kidney-specific megalin knockout almost abolished Dab2 staining, indicating that Dab2 subcellular localization requires megalin in the proximal tubule. Reciprocally, knockout of Dab2 led to a redistribution of megalin from endosomes to microvilli. In addition, there was an overall decrease in levels of megalin protein observed by immunoblotting but no decrease in clathrin or alpha-adaptin protein levels or in megalin mRNA. In rat yolk sac epithelial BN16 cells, Dab2 was present apically and colocalized with megalin. Introduction of anti-Dab2 antibody into BN16 cells decreased the internalization of 125I-labeled receptor-associated protein, substantiating the role of Dab2 in megalin-mediated endocytosis. The present study shows that Dab2 is localized in the apical endocytic apparatus of the renal proximal tubule and that this localization requires megalin. Furthermore, the study suggests that the urinary loss of megalin ligands observed in Dab2 knockout mice is caused by suboptimal trafficking of megalin, leading to decreased megalin levels.
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Affiliation(s)
- J Nagai
- Cell Biology, Institute of Anatomy, Univ. of Aarhus, University Park, Bldg. 234, DK-8000 Aarhus C, Denmark
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Abstract
The merozoite is the invasive form of the asexual stage of Plasmodium species. At least two polymorphic glycoproteins have been found on its surface in the human malaria parasite Plasmodium falciparum. The best-characterized of these is known as merozoite surface antigen-1 (MSA1) (185-200 kDa) (Ref. 1). Similar molecules are found in other malaria species. The other merozoite surface antigen, MSA2 (35-48 kDa) (Ref. 2), is distinct from MSA1 but is equally polymorphic. In this review, Juan Cooper condenses the body of structural information on MSA1 known to date. A database compiled from MSA1 sequences from several species used together with sequence comparisons and predicted secondary structure reveals interesting features of this molecule.
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Affiliation(s)
- J A Cooper
- Zentrum für Molekulare Biologie, Universität Heidelberg, Im Neuenheimer Feld 282, 6900 Heidelberg, Germany
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