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Taneri PE, Wehrli F, Roa-Díaz ZM, Itodo OA, Salvador D, Raeisi-Dehkordi H, Bally L, Minder B, Kiefte-de Jong JC, Laine JE, Bano A, Glisic M, Muka T. Association Between Ultra-Processed Food Intake and All-Cause Mortality: A Systematic Review and Meta-Analysis. Am J Epidemiol 2022; 191:1323-1335. [PMID: 35231930 DOI: 10.1093/aje/kwac039] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 02/07/2022] [Accepted: 02/25/2022] [Indexed: 01/26/2023] Open
Abstract
Consumption of ultra-processed foods (UPF) has increased worldwide during the last decades because they are hyperpalatable, cheap, and ready-to-consume products. However, uncertainty exists about their impact on health. We conducted a systematic review and meta-analysis evaluating the association of UPF consumption with all-cause mortality risk. Five bibliographic databases were searched for relevant studies. Random effects models were used to calculate pooled relative risks (RRs) and 95% confidence intervals (CIs). Of 6,951 unique citations, 40 unique prospective cohort studies comprising 5,750,133 individuals were included; publication dates ranged from 1984 to 2021. Compared with low consumption, highest consumption of UPF (RR = 1.29, 95% CI: 1.17, 1.42), sugar-sweetened beverages (RR = 1.11, 95% CI, 1.04, 1.18), artificially sweetened beverages (RR = 1.14, 95% CI, 1.05, 1.22), and processed meat/red meat (RR = 1.15, 95% CI, 1.10, 1.21) were significantly associated with increased risk of mortality. However, breakfast cereals were associated with a lower mortality risk (RR = 0.85, 95% CI, 0.79, 0.92). This meta-analysis suggests that high consumption of UPF, sugar-sweetened beverages, artificially sweetened beverages, processed meat, and processed red meat might increase all-cause mortality, while breakfast cereals might decrease it. Future studies are needed to address lack of standardized methods in UPF categorization.
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Laine JE. War in Europe: health implications of environmental nuclear disaster amidst war. Eur J Epidemiol 2022; 37:221-225. [PMID: 35426580 DOI: 10.1007/s10654-022-00862-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 03/12/2022] [Indexed: 11/03/2022]
Abstract
Recent incidents at nuclear facilities in Ukraine related to the attacks from Russian forces highlight the fragility of nuclear power plants and other nuclear facilities in war and the very real potential for another environmental nuclear disaster and associated health risks in Europe. Nuclear catastrophes from war can occur from radioactive materials released from war threatened nuclear power plants and other nuclear facilities in war zones, in addition to the direct threat from the deployment of nuclear weaponry and can result in immediate and long-term health impacts. Despite historical nuclear catastrophic events, including the Chernobyl nuclear power plant accident and atomic bombings of Hiroshima and Nagasaki, and that for more than a century epidemiologists have studied the consequences of radiation exposures, there are still major unanswered questions regarding radiation risks and human health. Epidemiologists will need to continue to quantify the health effects from exposure to environmental radiation, including background radiation, and are able to contribute to conversations about reliance on nuclear energy and alternative energy futures. As a society we are compelled to rethink our ties to nuclear energy, especially with the potential of increasing reliance on nuclear power amid oil and gas crisis and considering climate change, nuclear warfare, including nuclear weapon testing, and the fragility of humanity and health to even low doses of radiation from these and other natural and unnatural sources.
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Affiliation(s)
- Jessica E Laine
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland. .,MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom.
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Guo X, Franco OH, Laine JE. Accelerated ageing in the COVID-19 pandemic: A dilemma for healthy ageing. Maturitas 2021; 157:68-69. [PMID: 35067379 PMCID: PMC8711135 DOI: 10.1016/j.maturitas.2021.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 12/18/2021] [Indexed: 11/20/2022]
Affiliation(s)
- Xiaolei Guo
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Oscar H Franco
- University of Bern, Institute of Social and Preventive Medicine, Bern, Switzerland
| | - Jessica E Laine
- University of Bern, Institute of Social and Preventive Medicine, Bern, Switzerland; School of Public Health, MRC Centre for Environmental and Biostatistics, Imperial College London, London, United Kingdom.
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Laine JE, Huybrechts I, Gunter MJ, Ferrari P, Weiderpass E, Tsilidis K, Aune D, Schulze MB, Bergmann M, Temme EHM, Boer JMA, Agnoli C, Ericson U, Stubbendorff A, Ibsen DB, Dahm CC, Deschasaux M, Touvier M, Kesse-Guyot E, Sánchez Pérez MJ, Rodríguez Barranco M, Tong TYN, Papier K, Knuppel A, Boutron-Ruault MC, Mancini F, Severi G, Srour B, Kühn T, Masala G, Agudo A, Skeie G, Rylander C, Sandanger TM, Riboli E, Vineis P. Co-benefits from sustainable dietary shifts for population and environmental health: an assessment from a large European cohort study. Lancet Planet Health 2021; 5:e786-e796. [PMID: 34688354 PMCID: PMC8581185 DOI: 10.1016/s2542-5196(21)00250-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 07/08/2021] [Accepted: 08/20/2021] [Indexed: 05/26/2023]
Abstract
BACKGROUND Unhealthy diets, the rise of non-communicable diseases, and the declining health of the planet are highly intertwined, where food production and consumption are major drivers of increases in greenhouse gas emissions, substantial land use, and adverse health such as cancer and mortality. To assess the potential co-benefits from shifting to more sustainable diets, we aimed to investigate the associations of dietary greenhouse gas emissions and land use with all-cause and cause-specific mortality and cancer incidence rates. METHODS Using data from 443 991 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) study, a multicentre prospective cohort, we estimated associations between dietary contributions to greenhouse gas emissions and land use and all-cause and cause-specific mortality and incident cancers using Cox proportional hazards regression models. The main exposures were modelled as quartiles. Co-benefits, encompassing the potential effects of alternative diets on all-cause mortality and cancer and potential reductions in greenhouse gas emissions and land use, were estimated with counterfactual attributable fraction intervention models, simulating potential effects of dietary shifts based on the EAT-Lancet reference diet. FINDINGS In the pooled analysis, there was an association between levels of dietary greenhouse gas emissions and all-cause mortality (adjusted hazard ratio [HR] 1·13 [95% CI 1·10-1·16]) and between land use and all-cause mortality (1·18 [1·15-1·21]) when comparing the fourth quartile to the first quartile. Similar associations were observed for cause-specific mortality. Associations were also observed between all-cause cancer incidence rates and greenhouse gas emissions, when comparing the fourth quartile to the first quartile (adjusted HR 1·11 [95% CI 1·09-1·14]) and between all-cause cancer incidence rates and land use (1·13 [1·10-1·15]); however, estimates differed by cancer type. Through counterfactual attributable fraction modelling of shifts in levels of adherence to the EAT-Lancet diet, we estimated that up to 19-63% of deaths and up to 10-39% of cancers could be prevented, in a 20-year risk period, by different levels of adherence to the EAT-Lancet reference diet. Additionally, switching from lower adherence to the EAT-Lancet reference diet to higher adherence could potentially reduce food-associated greenhouse gas emissions up to 50% and land use up to 62%. INTERPRETATION Our results indicate that shifts towards universally sustainable diets could lead to co-benefits, such as minimising diet-related greenhouse gas emissions and land use, reducing the environmental footprint, aiding in climate change mitigation, and improving population health. FUNDING European Commission (DG-SANCO), the International Agency for Research on Cancer (IARC), MRC Early Career Fellowship (MR/M501669/1).
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Affiliation(s)
- Jessica E Laine
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK; Institute for Social and Preventive Medicine, University of Bern, Bern, Switzerland; Department of Epidemiology and Biostatistics, Faculty of Medicine, School of Public Health, Imperial College London, London, UK.
| | | | - Marc J Gunter
- International Agency for Research on Cancer, Lyon, France
| | - Pietro Ferrari
- International Agency for Research on Cancer, Lyon, France
| | | | - Kostas Tsilidis
- Department of Epidemiology and Biostatistics, Faculty of Medicine, School of Public Health, Imperial College London, London, UK
| | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, Faculty of Medicine, School of Public Health, Imperial College London, London, UK; Department of Nutrition, Bjørknes University College, Oslo, Norway; Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Ullevål, Oslo, Norway
| | - Matthias B Schulze
- Institute of Nutritional Sciences, University of Potsdam, Nuthetal, Germany
| | - Manuela Bergmann
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Elisabeth H M Temme
- Centre for Nutrition, Prevention and Health Services National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Jolanda M A Boer
- Centre for Nutrition, Prevention and Health Services National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Claudia Agnoli
- Epidemiology and Prevention Unit Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Ulrika Ericson
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | | | - Daniel B Ibsen
- Research Unit for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | | | - Mélanie Deschasaux
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Mathilde Touvier
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Maria-Jose Sánchez Pérez
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
| | - Miguel Rodríguez Barranco
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
| | - Tammy Y N Tong
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Keren Papier
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Anika Knuppel
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - Francesca Mancini
- CESP, Faculté de médecine, Université Paris-Saclay, UVSQ, INSERM, 94805, Villejuif, France
| | - Gianluca Severi
- CESP, Faculté de médecine, Université Paris-Saclay, UVSQ, INSERM, 94805, Villejuif, France; Gustave Roussy, F-94805, Villejuif, France; Department of Statistics, Computer Science and Applications "G. Parenti", University of Florence, Florence, Italy
| | - Bernard Srour
- Division of Cancer Epidemiology, German Cancer Rsearch Center Heidelberg, Heidelberg, Germany
| | - Tilman Kühn
- Division of Cancer Epidemiology, German Cancer Rsearch Center Heidelberg, Heidelberg, Germany
| | - Giovanna Masala
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network - ISPRO, Florence, Italy
| | - Antonio Agudo
- Unit of Nutrition and Cancer, Catalan Institute of Oncology - ICO, Nutrition and Cancer Group, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Guri Skeie
- Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Charlotta Rylander
- Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Torkjel M Sandanger
- Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, Faculty of Medicine, School of Public Health, Imperial College London, London, UK
| | - Paolo Vineis
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK; Department of Epidemiology and Biostatistics, Faculty of Medicine, School of Public Health, Imperial College London, London, UK; Italian Institute of Technology, Genova, Italy
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Roa-Díaz ZM, Raguindin PF, Bano A, Laine JE, Muka T, Glisic M. Menopause and cardiometabolic diseases: What we (don't) know and why it matters. Maturitas 2021; 152:48-56. [PMID: 34674807 DOI: 10.1016/j.maturitas.2021.06.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 06/20/2021] [Accepted: 06/26/2021] [Indexed: 01/11/2023]
Abstract
This narrative review discusses the current understanding, knowledge gaps and challenges in expanding our knowledge of the association between menopause and the reproductive aging process and cardiometabolic disease (CMD) in women, with a focus on type 2 diabetes and cardiovascular disease. The physiological changes that occur at different stages of the reproductive life span, as well as type of menopause and timing, are factors widely associated with CMD risk; however, the underlying mechanisms remain either unclear or insufficiently studied. Decreased ovarian estrogen production and relative androgen excess around menopause onset are the most studied factors linking menopause and cardiometabolic health; nevertheless, the evidence is not persuasive and other hypotheses might explain the changes in CMD risk during menopausal transition. In this context, hormone therapy has been widely adopted in the treatment and prevention of CMD, although uncertainty regarding its cardiometabolic effects has raised the need to optimize therapeutic modalities. Mechanisms such as the "iron overload theory" and new "omics" platforms could provide new insights into potential pathways underlying the association between menopause and cardiometabolic health, such as the DNA damage response. Although it has been widely reported that environmental and lifestyle factors affect both menopause and cardiometabolic health, there is little evidence on the role of these exposures in menopause-associated CMD risk.
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Affiliation(s)
- Zayne M Roa-Díaz
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland; Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Peter Francis Raguindin
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland; Graduate School for Health Sciences, University of Bern, Bern, Switzerland; Swiss Paraplegic Research, Nottwil, Switzerland
| | - Arjola Bano
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland; Department of Cardiology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Jessica E Laine
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Taulant Muka
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Marija Glisic
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland; Swiss Paraplegic Research, Nottwil, Switzerland.
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Bernhard SM, Tuleja A, Laine JE, Haupt F, Häberli D, Hügel U, Rössler J, Schindewolf M, Baumgartner I. Clinical presentation of simple and combined or syndromic arteriovenous malformations. J Vasc Surg Venous Lymphat Disord 2021; 10:705-712. [PMID: 34649003 DOI: 10.1016/j.jvsv.2021.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 10/03/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Arteriovenous malformations of the lower extremities (AVMLE) can present as simple or complex combined or syndromic forms (eg, Parkes Weber Syndrome). We aimed to characterize the differences in clinical presentation and natural history of these potentially life- and limb-threatening congenital vascular malformations. METHODS We conducted a retrospective analysis of a consecutive series of patients with AVMLE who presented to a tertiary referral center in Switzerland between 2008 and 2018. Clinical baseline characteristics, D-dimer level, and course were summarized and differences between simple, non-syndromic and combined or syndromic AVMLE determined. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression models. RESULTS Overall, 506 patients were prospectively enrolled in the Bernese Congenital Vascular Malformation Registry, 31 (6%) with AVMLE. There were 16 women and 15 men, with a mean age of 18 years at first diagnosis (range, 1 month to 72 years). Simple AVMLE was present in 22 (71%) and combined or syndromic AVMLE with limb overgrowth in 9 patients (29%), respectively. Common symptoms and signs were pain (n = 25; 81%), swelling (n = 21; 68%), and soft tissue hypertrophy (n = 13; 42%). Among combined or syndromic patients, three patients died from wound infection with sepsis or disseminated intravascular coagulation with bleeding complications (intracranial hemorrhage and bleeding from extensive leg ulcers). Combined or syndromic patients presented more often with bleeding (67% vs 5%; P < .001), malformation-related infection (44% vs 5%; P = .017) and leg length difference (56% vs 14%; P = .049). D-dimer levels were elevated (mean, 17,256 μg/L; range, 1557-80,000 μg/L) and angiographic appearance showed complex, mixed type of AVMs, including interstitial type IV, in all patients with combined or syndromic AVMLE. CONCLUSIONS Patients with congenital simple AVMLE most often present with benign clinical features and rarely with complications related to hemodynamic changes. Patients with combined or syndromic AVMLE often face serious outcomes dominated by complications other than direct high-flow-related heart failure.
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Affiliation(s)
- Sarah M Bernhard
- Division of Angiology, Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Aleksandra Tuleja
- Division of Angiology, Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Jessica E Laine
- Division of Angiology, Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Fabian Haupt
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Dario Häberli
- Division of Angiology, Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Ulrike Hügel
- Division of Angiology, Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Jochen Rössler
- Pediatric Hematology/Oncology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Marc Schindewolf
- Division of Angiology, Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Iris Baumgartner
- Division of Angiology, Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
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Bernhard SM, Adam L, Atef H, Häberli D, Bramer WM, Minder B, Döring Y, Laine JE, Muka T, Rössler J, Baumgartner I. A systematic review of the safety and efficacy of currently used treatment modalities in the treatment of patients with PIK3CA-related overgrowth spectrum. J Vasc Surg Venous Lymphat Disord 2021; 10:527-538.e2. [PMID: 34358672 DOI: 10.1016/j.jvsv.2021.07.008] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 07/22/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND PIK3CA (activating mutations of the p110α subunit of phosphatidylinositol 3-kinases)-related overgrowth spectrums (PROS) include a variety of clinical presentations that are associated with hypertrophy of different parts of the body. We performed a systematic literature review to assess the current treatment options and their efficacy and safety for PROS. METHODS A literature search was performed in Embase, MEDLINE (Ovid), Web of Science Core Collection, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, and Google Scholar to retrieve studies on the treatment of hypertrophy in PROS. Randomized controlled trials, cohort studies, and case series with ≥10 patients were included in the present review. The titles, abstracts, and full text were assessed by two reviewers independently. The risk of bias was assessed using the Newcastle-Ottawa scale. RESULTS We included 16 studies of the treatment of hypertrophy in PROS patients, 13 (81.3%) from clinical retrospective studies and 3 (13.7%) from prospective cohort studies. The risk of bias grade was low for 2, medium for 12, and high for 2 studies. Of the 16 studies, 13 reported on surgical treatment and 3 reported pharmacologic treatment using phosphatidylinositol-3-kinase (PI3K)/mammalian target of rapamycin (mTOR) pathway inhibitors in PROS patients. In 3 studies, PROS was defined by a mutation in the PIK3CA gene, and 13 studies relied on a clinical definition of PROS. Surgical therapy was beneficial for a specific subgroup of PROS (macrodactyly). However, little has been reported concerning surgery and the potential benefits for other PROS entities. The reported side effects after surgical therapy were mostly prolonged wound healing or scarring. PI3K/mTOR pathway inhibition was beneficial in patients with PROS by reducing hypertrophy and systemic symptoms. The adverse effects reported included infection, changes in blood count, liver enzymes, and metabolic measures. CONCLUSIONS Surgery is a locally limited treatment option for specific types of PROS. A promising treatment option for PROS is pharmacologic PIK3CA inhibition. However, the level of evidence on the treatment of overgrowth in PROS patients is limited.
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Affiliation(s)
- Sarah M Bernhard
- Division of Angiology, Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Luise Adam
- Division of Angiology, Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Institute of Primary Health Care, University of Bern, Bern, Switzerland
| | - Hady Atef
- Faculty of Physical therapy, Cairo University, Cairo, Egypt; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Dario Häberli
- Division of Angiology, Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Wichor M Bramer
- Medical Library, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Beatrice Minder
- Public Health and Primary Care Library, University Library of Bern, University of Bern, Bern, Switzerland
| | - Yvonne Döring
- Division of Angiology, Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Institute for Cardiovascular Prevention, Ludwig-Maximilians-University, Munich, Germany; German Center for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany
| | - Jessica E Laine
- Division of Angiology, Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Taulant Muka
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Jochen Rössler
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Iris Baumgartner
- Division of Angiology, Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
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Laine JE, Baltar VT, Stringhini S, Gandini M, Chadeau-Hyam M, Kivimaki M, Severi G, Perduca V, Hodge AM, Dugué PA, Giles GG, Milne RL, Barros H, Sacerdote C, Krogh V, Panico S, Tumino R, Goldberg M, Zins M, Delpierre C, Vineis P. Reducing socio-economic inequalities in all-cause mortality: a counterfactual mediation approach. Int J Epidemiol 2021; 49:497-510. [PMID: 31855265 PMCID: PMC7266549 DOI: 10.1093/ije/dyz248] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 11/27/2019] [Indexed: 12/05/2022] Open
Abstract
Background Socio-economic inequalities in mortality are well established, yet the contribution of intermediate risk factors that may underlie these relationships remains unclear. We evaluated the role of multiple modifiable intermediate risk factors underlying socio-economic-associated mortality and quantified the potential impact of reducing early all-cause mortality by hypothetically altering socio-economic risk factors. Methods Data were from seven cohort studies participating in the LIFEPATH Consortium (total n = 179 090). Using both socio-economic position (SEP) (based on occupation) and education, we estimated the natural direct effect on all-cause mortality and the natural indirect effect via the joint mediating role of smoking, alcohol intake, dietary patterns, physical activity, body mass index, hypertension, diabetes and coronary artery disease. Hazard ratios (HRs) were estimated, using counterfactual natural effect models under different hypothetical actions of either lower or higher SEP or education. Results Lower SEP and education were associated with an increase in all-cause mortality within an average follow-up time of 17.5 years. Mortality was reduced via modelled hypothetical actions of increasing SEP or education. Through higher education, the HR was 0.85 [95% confidence interval (CI) 0.84, 0.86] for women and 0.71 (95% CI 0.70, 0.74) for men, compared with lower education. In addition, 34% and 38% of the effect was jointly mediated for women and men, respectively. The benefits from altering SEP were slightly more modest. Conclusions These observational findings support policies to reduce mortality both through improving socio-economic circumstances and increasing education, and by altering intermediaries, such as lifestyle behaviours and morbidities.
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Affiliation(s)
- Jessica E Laine
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
| | - Valéria T Baltar
- Department of Epidemiology and Biostatistics, Instituto de Saúde Coletiva, Universidade Federal Fluminense, Rio de Janeiro, Brazil
| | - Silvia Stringhini
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Martina Gandini
- Epidemiology Unit, ASL TO3 Piedmont Region, Grugliasco, Italy
| | - Marc Chadeau-Hyam
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
| | - Mika Kivimaki
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Gianluca Severi
- Centre de Recherche en Épidémiologie et Santé des Populations (CESP, UMR Inserm 1018) Facultés de Medicine, Université Paris-Saclay, Université Paris-Sud, Saint-Aubin, France
| | - Vittorio Perduca
- Centre de Recherche en Épidémiologie et Santé des Populations (CESP, UMR Inserm 1018) Facultés de Medicine, Université Paris-Saclay, Université Paris-Sud, Saint-Aubin, France
| | - Allison M Hodge
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Australia.,Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Pierre-Antoine Dugué
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Australia.,Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, Australia.,Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia
| | - Graham G Giles
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Australia.,Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Roger L Milne
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Australia.,Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, Australia.,Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia
| | - Henrique Barros
- Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, AO Citta' della Salute e della Scienza-University of Turin and Center for Cancer Prevention, Turin, Italy
| | - Vittorio Krogh
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Salvatore Panico
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Rosario Tumino
- Provincial Healthcare Company (ASP) Ragusa, Vittoria, Italy
| | - Marcel Goldberg
- Population-based Epidemiological Cohorts Unit, INSERM UMS 11, Villejuif, France
| | - Marie Zins
- Population-based Epidemiological Cohorts Unit, INSERM UMS 11, Villejuif, France
| | - Cyrille Delpierre
- LEASP, UMR 1027, Inserm-Université Toulouse III Paul Sabatier, Toulouse, France
| | | | - Paolo Vineis
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
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9
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Laine JE, Bodinier B, Robinson O, Plusquin M, Scalbert A, Keski-Rahkonen P, Robinot N, Vermeulen R, Pizzi C, Asta F, Nawrot T, Gulliver J, Chatzi L, Kogevinas M, Nieuwenhuijsen M, Sunyer J, Vrijheid M, Chadeau-Hyam M, Vineis P. Prenatal Exposure to Multiple Air Pollutants, Mediating Molecular Mechanisms, and Shifts in Birthweight. Environ Sci Technol 2020; 54:14502-14513. [PMID: 33124810 DOI: 10.1021/acs.est.0c02657] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Mechanisms underlying adverse birth and later in life health effects from exposure to air pollution during the prenatal period have not been not fully elucidated, especially in the context of mixtures. We assessed the effects of prenatal exposure to mixtures of air pollutants of particulate matter (PM), PM2.5, PM10, nitrogen oxides, NO2, NOx, ultrafine particles (UFP), and oxidative potential (OP) of PM2.5 on infant birthweight in four European birth cohorts and the mechanistic underpinnings through cross-omics of metabolites and inflammatory proteins. The association between mixtures of air pollutants and birthweight z-scores (standardized for gestational age) was assessed for three different mixture models, using Bayesian machine kernel regression (BKMR). We determined the direct effect for PM2.5, PM10, NO2, and mediation by cross-omic signatures (identified using sparse partial least-squares regression) using causal mediation BKMR models. There was a negative association with birthweight z-scores and exposure to mixtures of air pollutants, where up to -0.21 or approximately a 96 g decrease in birthweight, comparing the 75th percentile to the median level of exposure to the air pollutant mixture could occur. Shifts in birthweight z-scores from prenatal exposure to PM2.5, PM10, and NO2 were mediated by molecular mechanisms, represented by cross-omics scores. Interleukin-17 and epidermal growth factor were identified as important inflammatory responses underlyingair pollution-associated shifts in birthweight. Our results signify that by identifying mechanisms through which mixtures of air pollutants operate, the causality of air pollution-associated shifts in birthweight is better supported, substantiating the need for reducing exposure in vulnerable populations.
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Affiliation(s)
- Jessica E Laine
- Department of Epidemiology and Biostatistics, MRC Centre for Environment and Health, Imperial College London, London SW7 2BU, United Kingdom
| | - Barbara Bodinier
- Department of Epidemiology and Biostatistics, MRC Centre for Environment and Health, Imperial College London, London SW7 2BU, United Kingdom
| | - Oliver Robinson
- Department of Epidemiology and Biostatistics, MRC Centre for Environment and Health, Imperial College London, London SW7 2BU, United Kingdom
| | - Michelle Plusquin
- Center for Environmental Sciences, Hasselt University, Hasselt 3500, Belgium
| | - Augustin Scalbert
- Nutrition and Metabolism Section, Biomarkers Group, International Agency for Research on Cancer (IARC), Lyon 69372, France
| | - Pekka Keski-Rahkonen
- Nutrition and Metabolism Section, Biomarkers Group, International Agency for Research on Cancer (IARC), Lyon 69372, France
| | - Nivonirina Robinot
- Nutrition and Metabolism Section, Biomarkers Group, International Agency for Research on Cancer (IARC), Lyon 69372, France
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Environmental Epidemiology Division, Utrecht University, Utrecht 3584 CS, Netherlands
| | - Costanza Pizzi
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte, Turin 10126, Italy
| | - Federica Asta
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome 00147, Italy
| | - Tim Nawrot
- Center for Environmental Sciences, Hasselt University, Hasselt 3500, Belgium
- Department of Public Health, Environment and Health Unit, Leuven University (KU Leuven), Leuven 3000, Belgium
| | - John Gulliver
- Centre for Environmental Health and Sustainability & School of Geography, Geology and the Environment, University of Leicester, Leicester LE1 7RH, United Kingdom
| | - Leda Chatzi
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion 700 13, Crete, Greece
| | - Manolis Kogevinas
- ISGlobal, Barcelona Institute for Global Health, Barcelona 08003, Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid 28029, Spain
- Universitat Pompeu Fabra (UPF), Barcelona 08002, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona 08003, Spain
| | | | - Jordi Sunyer
- ISGlobal, Barcelona Institute for Global Health, Barcelona 08003, Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid 28029, Spain
- Universitat Pompeu Fabra (UPF), Barcelona 08002, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona 08003, Spain
| | - Martine Vrijheid
- ISGlobal, Barcelona Institute for Global Health, Barcelona 08003, Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid 28029, Spain
- Universitat Pompeu Fabra (UPF), Barcelona 08002, Spain
| | - Marc Chadeau-Hyam
- Department of Epidemiology and Biostatistics, MRC Centre for Environment and Health, Imperial College London, London SW7 2BU, United Kingdom
| | - Paolo Vineis
- Department of Epidemiology and Biostatistics, MRC Centre for Environment and Health, Imperial College London, London SW7 2BU, United Kingdom
- Italian Institute of Technology, Genova 16163, Italy
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10
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Mancini FR, Laine JE, Tarallo S, Vlaanderen J, Vermeulen R, van Nunen E, Hoek G, Probst-Hensch N, Imboden M, Jeong A, Gulliver J, Chadeau-Hyam M, Nieuwenhuijsen M, de Kok TM, Piepers J, Krauskopf J, Kleinjans JCS, Vineis P, Naccarati A. microRNA expression profiles and personal monitoring of exposure to particulate matter. Environ Pollut 2020; 263:114392. [PMID: 32276129 DOI: 10.1016/j.envpol.2020.114392] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 02/10/2020] [Accepted: 03/14/2020] [Indexed: 06/11/2023]
Abstract
An increasing number of findings from epidemiological studies support associations between exposure to air pollution and the onset of several diseases, including pulmonary, cardiovascular and neurodegenerative diseases, and malignancies. However, intermediate, and potentially mediating, biological mechanisms associated with exposure to air pollutants are largely unknown. Previous studies on the human exposome have shown that the expression of certain circulating microRNAs (miRNAs), regulators of gene expression, are altered upon exposure to traffic-related air pollutants. In the present study, we investigated the relationship between particulate matter (PM) smaller than 2.5 μm (PM2.5), PM2.5 absorbance (as a proxy of black carbon and soot), and ultrafine-particles (UFP, smaller than 0.1 μm), measured in healthy volunteers by 24 h personal monitoring (PEM) sessions and global expression levels of peripheral blood miRNAs. The PEM sessions were conducted in four European countries, namely Switzerland (Basel), United Kingdom (Norwich), Italy (Turin), and The Netherlands (Utrecht). miRNAs expression levels were analysed using microarray technology on blood samples from 143 participants. Seven miRNAs, hsa-miR-24-3p, hsa-miR-4454, hsa-miR-4763-3p, hsa-miR-425-5p, hsa-let-7d-5p, hsa-miR-502-5p, and hsa-miR-505-3p were significantly (FDR corrected) expressed in association with PM2.5 personal exposure, while no significant association was found between miRNA expression and the other pollutants. The results obtained from this investigation suggest that personal exposure to PM2.5 is associated with miRNA expression levels, showing the potential for these circulating miRNAs as novel biomarkers for air pollution health risk assessment.
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Affiliation(s)
- Francesca Romana Mancini
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif, France; Gustave Roussy, F-94805, Villejuif, France
| | - Jessica E Laine
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
| | - Sonia Tarallo
- Italian Institute for Genomic Medicine (IIGM), c/o IRCCS Candiolo, 10060 Candiolo, Turin, Italy
| | - Jelle Vlaanderen
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, 3584 CM Utrecht, the Netherlands
| | - Roel Vermeulen
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom; Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, 3584 CM Utrecht, the Netherlands
| | - Erik van Nunen
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, 3584 CM Utrecht, the Netherlands
| | - Gerard Hoek
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, 3584 CM Utrecht, the Netherlands
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health (TPH) Institute, Basel, Switzerland; University of Basel, Switzerland
| | - Medea Imboden
- Swiss Tropical and Public Health (TPH) Institute, Basel, Switzerland; University of Basel, Switzerland
| | - Ayoung Jeong
- Swiss Tropical and Public Health (TPH) Institute, Basel, Switzerland; University of Basel, Switzerland
| | - John Gulliver
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom; University of Leicester, Leicester, United Kingdom
| | - Marc Chadeau-Hyam
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
| | - Mark Nieuwenhuijsen
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Department of Experimental and Health Sciences, Pompeu Fabra University (UPF), Barcelona, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Barcelona, Spain
| | - Theo M de Kok
- Department of Toxicogenomics, Maastricht University, Maastricht, the Netherlands
| | - Jolanda Piepers
- Department of Toxicogenomics, Maastricht University, Maastricht, the Netherlands
| | - Julian Krauskopf
- Department of Toxicogenomics, Maastricht University, Maastricht, the Netherlands
| | - Jos C S Kleinjans
- Department of Toxicogenomics, Maastricht University, Maastricht, the Netherlands
| | - Paolo Vineis
- Italian Institute for Genomic Medicine (IIGM), c/o IRCCS Candiolo, 10060 Candiolo, Turin, Italy; Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
| | - Alessio Naccarati
- Italian Institute for Genomic Medicine (IIGM), c/o IRCCS Candiolo, 10060 Candiolo, Turin, Italy.
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11
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Laine JE, Baltar VT, Stringhini S, Gandini M, Chadeau-Hyam M, Kivimaki M, Severi G, Perduca V, Hodge AM, Dugué PA, Giles GG, Milne RL, Barros H, Sacerdote C, Krogh V, Panico S, Tumino R, Goldberg M, Zins M, Delpierre C, Vineis P. Corrigendum to: Reducing socio-economic inequalities in all-cause mortality: a counterfactual mediation approach. Int J Epidemiol 2020; 49:707. [PMID: 32048712 PMCID: PMC7266540 DOI: 10.1093/ije/dyaa008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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12
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Laine JE, Ilievski V, Richardson DB, Herring AH, Stýblo M, Rubio-Andrade M, Garcia-Vargas G, Gamble MV, Fry RC. Correction to: Maternal one carbon metabolism and arsenic methylation in a pregnancy cohort in Mexico. J Expo Sci Environ Epidemiol 2019; 29:732. [PMID: 31171829 DOI: 10.1038/s41370-019-0147-0] [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] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
A correction to this paper has been published and can be accessed via link at the top of the paper.
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Affiliation(s)
- Jessica E Laine
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA.
| | - Vesna Ilievski
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - David B Richardson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Amy H Herring
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
- Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Miroslav Stýblo
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Marisela Rubio-Andrade
- Facultad de Medicina, Universidad Juarez del Estado de Durango, Gómez Palacio, Durango, Mexico
| | - Gonzalo Garcia-Vargas
- Facultad de Medicina, Universidad Juarez del Estado de Durango, Gómez Palacio, Durango, Mexico
| | - Mary V Gamble
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Rebecca C Fry
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
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13
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Laine JE, Ilievski V, Richardson DB, Herring AH, Stýblo M, Rubio-Andrade M, Garcia-Vargas G, Gamble MV, Fry RC. Maternal one carbon metabolism and arsenic methylation in a pregnancy cohort in Mexico. J Expo Sci Environ Epidemiol 2018; 28:505-514. [PMID: 30068932 PMCID: PMC6531675 DOI: 10.1038/s41370-018-0041-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 08/18/2017] [Accepted: 09/06/2017] [Indexed: 05/04/2023]
Abstract
The prenatal period represents a critical window of susceptibility to inorganic arsenic (iAs) exposure from contaminated drinking water. Ingested iAs undergoes hepatic methylation generating mono and di-methyl arsenicals (MMAs and DMAs, respectively), a process that facilitates urinary arsenic (As) elimination. Differences in pregnant women's metabolism of As as indicated by greater proportions of MMAs and smaller proportions of DMAs in urine are a risk factor for adverse birth outcomes. One carbon metabolism (OCM), the nutritionally-regulated pathway essential for supplying methyl groups, plays a role in As metabolism and is understudied during the prenatal period. In this cross-sectional study from the Biomarkers of Exposure to ARsenic (BEAR) pregnancy cohort in Gómez Palacio, Mexico, we assessed the relationships among OCM indicators (e.g. maternal serum B12, folate, and homocysteine (Hcys)), and levels of iAs and its metabolites in maternal urine and in neonatal cord serum. The prevalence of folate sufficiency (folate levels > 9 nmol/L) in the cohort was high 99%, and hyperhomocysteinemia (Hcys levels > 10.4 μmol/L) was low (8%). However, 74% of the women displayed a deficiency in B12 (serum levels < 148 pmol/L). Association analyses identified that infants born to mothers in the lowest tertile of serum folate had significantly higher mean levels of %MMA in cord serum relative to folate replete women. In addition, elevated maternal Hcys was associated with total As in maternal urine and cord serum as well as cord serum %MMAs. The results from this study indicate that maternal OCM status may influence the distribution of As metabolites in cord serum.
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Affiliation(s)
- Jessica E Laine
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA.
| | - Vesna Ilievski
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - David B Richardson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Amy H Herring
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
- Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Miroslav Stýblo
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Marisela Rubio-Andrade
- Facultad de Medicina, Universidad Juarez del Estado de Durango, Gómez Palacio, Durango, Mexico
| | - Gonzalo Garcia-Vargas
- Facultad de Medicina, Universidad Juarez del Estado de Durango, Gómez Palacio, Durango, Mexico
| | - Mary V Gamble
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Rebecca C Fry
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
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14
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Laine JE, Ilievski V, Richardson DB, Herring AH, Stýblo M, Rubio-Andrade M, Garcia-Vargas G, Gamble MV, Fry RC. Maternal one carbon metabolism and arsenic methylation in a pregnancy cohort in Mexico. J Expo Sci Environ Epidemiol 2018. [PMID: 30068932 DOI: 10.1038/s41370-41018-40041-41371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
The prenatal period represents a critical window of susceptibility to inorganic arsenic (iAs) exposure from contaminated drinking water. Ingested iAs undergoes hepatic methylation generating mono and di-methyl arsenicals (MMAs and DMAs, respectively), a process that facilitates urinary arsenic (As) elimination. Differences in pregnant women's metabolism of As as indicated by greater proportions of MMAs and smaller proportions of DMAs in urine are a risk factor for adverse birth outcomes. One carbon metabolism (OCM), the nutritionally-regulated pathway essential for supplying methyl groups, plays a role in As metabolism and is understudied during the prenatal period. In this cross-sectional study from the Biomarkers of Exposure to ARsenic (BEAR) pregnancy cohort in Gómez Palacio, Mexico, we assessed the relationships among OCM indicators (e.g. maternal serum B12, folate, and homocysteine (Hcys)), and levels of iAs and its metabolites in maternal urine and in neonatal cord serum. The prevalence of folate sufficiency (folate levels > 9 nmol/L) in the cohort was high 99%, and hyperhomocysteinemia (Hcys levels > 10.4 μmol/L) was low (8%). However, 74% of the women displayed a deficiency in B12 (serum levels < 148 pmol/L). Association analyses identified that infants born to mothers in the lowest tertile of serum folate had significantly higher mean levels of %MMA in cord serum relative to folate replete women. In addition, elevated maternal Hcys was associated with total As in maternal urine and cord serum as well as cord serum %MMAs. The results from this study indicate that maternal OCM status may influence the distribution of As metabolites in cord serum.
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Affiliation(s)
- Jessica E Laine
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA.
| | - Vesna Ilievski
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - David B Richardson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Amy H Herring
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
- Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Miroslav Stýblo
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Marisela Rubio-Andrade
- Facultad de Medicina, Universidad Juarez del Estado de Durango, Gómez Palacio, Durango, Mexico
| | - Gonzalo Garcia-Vargas
- Facultad de Medicina, Universidad Juarez del Estado de Durango, Gómez Palacio, Durango, Mexico
| | - Mary V Gamble
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Rebecca C Fry
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
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15
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Abstract
BACKGROUND Prenatal exposure to inorganic arsenic (iAs) is associated with dysregulated fetal gene and protein expression. Potential biological mechanisms that underlie these changes include, but are not limited to, changes to the epigenome. OBJECTIVE The aim of the present study was to identify whether the expression of key genes, proteins, or both and their associated biological pathways are perturbed by compiling datasets from studies on prenatal arsenic exposure. METHODS We compiled datasets from 12 studies that analyzed the relationship between prenatal iAs exposure and changes to the fetal epigenome (5-methyl cytosine), transcriptome (mRNA expression), and/or proteome (protein expression). FINDINGS Across the 12 studies, a set of 845 unique genes was identified and found to enrich for their role in biological pathways, including the peroxisome proliferator-activated receptor, nuclear factor of kappa light polypeptide gene enhancer in B-cells inhibitor, and the glucocorticoid receptor. Tumor necrosis factor was identified as a putative cellular regulator underlying most (n = 277) of the identified iAs-associated gene or protein expression changes. CONCLUSIONS The identification of the common set of genes across numerous human cohorts suggests a conserved biological response to prenatal arsenic exposure. The genes/proteins and their associated pathways may be useful in future mechanistic investigations of iAs associated diseases.
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Affiliation(s)
- Jessica E Laine
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC.
| | - Rebecca C Fry
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
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16
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Laine JE, Bailey KA, Olshan AF, Smeester L, Drobná Z, Stýblo M, Douillet C, García-Vargas G, Rubio-Andrade M, Pathmasiri W, McRitchie S, Sumner SJ, Fry RC. Neonatal Metabolomic Profiles Related to Prenatal Arsenic Exposure. Environ Sci Technol 2017; 51:625-633. [PMID: 27997141 PMCID: PMC5460981 DOI: 10.1021/acs.est.6b04374] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Prenatal inorganic arsenic (iAs) exposure is associated with health effects evident at birth and later in life. An understanding of the relationship between prenatal iAs exposure and alterations in the neonatal metabolome could reveal critical molecular modifications, potentially underpinning disease etiologies. In this study, nuclear magnetic resonance (NMR) spectroscopy-based metabolomic analysis was used to identify metabolites in neonate cord serum associated with prenatal iAs exposure in participants from the Biomarkers of Exposure to ARsenic (BEAR) pregnancy cohort, in Gómez Palacio, Mexico. Through multivariable linear regression, ten cord serum metabolites were identified as significantly associated with total urinary iAs and/or iAs metabolites, measured as %iAs, %monomethylated arsenicals (MMAs), and %dimethylated arsenicals (DMAs). A total of 17 metabolites were identified as significantly associated with total iAs and/or iAs metabolites in cord serum. These metabolites are indicative of changes in important biochemical pathways such as vitamin metabolism, the citric acid (TCA) cycle, and amino acid metabolism. These data highlight that maternal biotransformation of iAs and neonatal levels of iAs and its metabolites are associated with differences in neonate cord metabolomic profiles. The results demonstrate the potential utility of metabolites as biomarkers/indicators of in utero environmental exposure.
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Affiliation(s)
- Jessica E. Laine
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina 27599, United States
| | - Kathryn A. Bailey
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina 27599, United States
| | - Andrew F. Olshan
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina 27599, United States
| | - Lisa Smeester
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina 27599, United States
| | - Zuzana Drobná
- Department of Biological Sciences, College of Sciences, North Carolina State University, Raleigh, North Carolina 27695, United States
| | - Miroslav Stýblo
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina 27599, United States
| | - Christelle Douillet
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina 27599, United States
| | - Gonzalo García-Vargas
- Facultad de Medicina, Universidad Juarez del Estado de Durango, Gómez Palacio, Durango 35050, Mexico
| | - Marisela Rubio-Andrade
- Facultad de Medicina, Universidad Juarez del Estado de Durango, Gómez Palacio, Durango 35050, Mexico
| | - Wimal Pathmasiri
- RTI International, Research Triangle Park, North Carolina 27709, United States
| | - Susan McRitchie
- RTI International, Research Triangle Park, North Carolina 27709, United States
| | - Susan J. Sumner
- RTI International, Research Triangle Park, North Carolina 27709, United States
| | - Rebecca C. Fry
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina 27599, United States
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17
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Laine JE, Bailey KA, Rubio-Andrade M, Olshan AF, Smeester L, Drobná Z, Herring AH, Stýblo M, García-Vargas GG, Fry RC. Maternal arsenic exposure, arsenic methylation efficiency, and birth outcomes in the Biomarkers of Exposure to ARsenic (BEAR) pregnancy cohort in Mexico. Environ Health Perspect 2015; 123:186-92. [PMID: 25325819 PMCID: PMC4314242 DOI: 10.1289/ehp.1307476] [Citation(s) in RCA: 110] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 10/15/2014] [Indexed: 05/19/2023]
Abstract
BACKGROUND Exposure to inorganic arsenic (iAs) from drinking water is a global public health problem, yet much remains unknown about the extent of exposure in susceptible populations. OBJECTIVES We aimed to establish the Biomarkers of Exposure to ARsenic (BEAR) prospective pregnancy cohort in Gómez Palacio, Mexico, to better understand the effects of iAs exposure on pregnant women and their children. METHODS Two hundred pregnant women were recruited for this study. Concentrations of iAs in drinking water (DW-iAs) and maternal urinary concentrations of iAs and its monomethylated and dimethylated metabolites (MMAs and DMAs, respectively) were determined. Birth outcomes were analyzed for their relationship to DW-iAs and to the concentrations and proportions of maternal urinary arsenicals. RESULTS DW-iAs for the study subjects ranged from < 0.5 to 236 μg As/L. More than half of the women (53%) had DW-iAs that exceeded the World Health Organization's recommended guideline of 10 μg As/L. DW-iAs was significantly associated with the sum of the urinary arsenicals (U-tAs). Maternal urinary concentrations of MMAs were negatively associated with newborn birth weight and gestational age. Maternal urinary concentrations of iAs were associated with lower mean gestational age and newborn length. CONCLUSIONS Biomonitoring results demonstrate that pregnant women in Gómez Palacio are exposed to potentially harmful levels of DW-iAs. The data support a relationship between iAs metabolism in pregnant women and adverse birth outcomes. The results underscore the risks associated with iAs exposure in vulnerable populations.
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Affiliation(s)
- Jessica E Laine
- Department of Epidemiology, and Department of Environmental Sciences and Engineering, University of North Carolina at Chapel Hill, Gillings School of Public Heath, Chapel Hill, North Carolina, USA
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Rager JE, Bailey KA, Smeester L, Miller SK, Parker JS, Laine JE, Drobná Z, Currier J, Douillet C, Olshan AF, Rubio-Andrade M, Stýblo M, García-Vargas G, Fry RC. Prenatal arsenic exposure and the epigenome: altered microRNAs associated with innate and adaptive immune signaling in newborn cord blood. Environ Mol Mutagen 2014; 55:196-208. [PMID: 24327377 PMCID: PMC4023469 DOI: 10.1002/em.21842] [Citation(s) in RCA: 136] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Revised: 11/22/2013] [Accepted: 11/25/2013] [Indexed: 05/17/2023]
Abstract
The Biomarkers of Exposure to ARsenic (BEAR) pregnancy cohort in Gómez Palacio, Mexico was recently established to better understand the impacts of prenatal exposure to inorganic arsenic (iAs). In this study, we examined a subset (n = 40) of newborn cord blood samples for microRNA (miRNA) expression changes associated with in utero arsenic exposure. Levels of iAs in maternal drinking water (DW-iAs) and maternal urine were assessed. Levels of DW-iAs ranged from below detectable values to 236 µg/L (mean = 51.7 µg/L). Total arsenic in maternal urine (U-tAs) was defined as the sum of iAs and its monomethylated and dimethylated metabolites (MMAs and DMAs, respectively) and ranged from 6.2 to 319.7 µg/L (mean = 64.5 µg/L). Genome-wide miRNA expression analysis of cord blood revealed 12 miRNAs with increasing expression associated with U-tAs. Transcriptional targets of the miRNAs were computationally predicted and subsequently assessed using transcriptional profiling. Pathway analysis demonstrated that the U-tAs-associated miRNAs are involved in signaling pathways related to known health outcomes of iAs exposure including cancer and diabetes mellitus. Immune response-related mRNAs were also identified with decreased expression levels associated with U-tAs, and predicted to be mediated in part by the arsenic-responsive miRNAs. Results of this study highlight miRNAs as novel responders to prenatal arsenic exposure that may contribute to associated immune response perturbations.
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Affiliation(s)
- Julia E. Rager
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Kathryn A. Bailey
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Lisa Smeester
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Sloane K. Miller
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Joel S. Parker
- Department of Genetics, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Jessica E. Laine
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Zuzana Drobná
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Jenna Currier
- Curriculum in Toxicology, University of North Carolina, Chapel Hill, NC, United States of America
| | - Christelle Douillet
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Andrew F. Olshan
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Marisela Rubio-Andrade
- Facultad de Medicina, Universidad Juárez del Estado de Durango, Gómez Palacio, Durango, Mexico
| | - Miroslav Stýblo
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Gonzalo García-Vargas
- Facultad de Medicina, Universidad Juárez del Estado de Durango, Gómez Palacio, Durango, Mexico
| | - Rebecca C. Fry
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America
- Curriculum in Toxicology, University of North Carolina, Chapel Hill, NC, United States of America
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Sanders AP, Smeester L, Rojas D, DeBussycher T, Wu MC, Wright FA, Zhou YH, Laine JE, Rager JE, Swamy GK, Ashley-Koch A, Lynn Miranda M, Fry RC. Cadmium exposure and the epigenome: Exposure-associated patterns of DNA methylation in leukocytes from mother-baby pairs. Epigenetics 2013; 9:212-21. [PMID: 24169490 DOI: 10.4161/epi.26798] [Citation(s) in RCA: 120] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Cadmium (Cd) is prevalent in the environment yet understudied as a developmental toxicant. Cd partially crosses the placental barrier from mother to fetus and is linked to detrimental effects in newborns. Here we examine the relationship between levels of Cd during pregnancy and 5-methylcytosine (5mC) levels in leukocyte DNA collected from 17 mother-newborn pairs. The methylation of cytosines is an epigenetic mechanism known to impact transcriptional signaling and influence health endpoints. A methylated cytosine-guanine (CpG) island recovery assay was used to assess over 4.6 million sites spanning 16,421 CpG islands. Exposure to Cd was classified for each mother-newborn pair according to maternal blood levels and compared with levels of cotinine. Subsets of genes were identified that showed altered DNA methylation levels in their promoter regions in fetal DNA associated with levels of Cd (n = 61), cotinine (n = 366), or both (n = 30). Likewise, in maternal DNA, differentially methylated genes were identified that were associated with Cd (n = 92) or cotinine (n = 134) levels. While the gene sets were largely distinct between maternal and fetal DNA, functional similarities at the biological pathway level were identified including an enrichment of genes that encode for proteins that control transcriptional regulation and apoptosis. Furthermore, conserved DNA motifs with sequence similarity to specific transcription factor binding sites were identified within the CpG islands of the gene sets. This study provides evidence for distinct patterns of DNA methylation or "footprints" in fetal and maternal DNA associated with exposure to Cd.
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Affiliation(s)
- Alison P Sanders
- Department of Environmental Sciences and Engineering; Gillings School of Global Public Health; University of North Carolina; Chapel Hill, NC USA
| | - Lisa Smeester
- Department of Environmental Sciences and Engineering; Gillings School of Global Public Health; University of North Carolina; Chapel Hill, NC USA
| | - Daniel Rojas
- Curriculum in Toxicology; School of Medicine; University of North Carolina; Chapel Hill, NC USA
| | - Tristan DeBussycher
- Center for Bioinformatics; University of North Carolina; Chapel Hill, NC USA
| | - Michael C Wu
- Department of Biostatistics; Gillings School of Global Public Health; University of North Carolina; Chapel Hill, NC USA
| | - Fred A Wright
- Department of Biostatistics; Gillings School of Global Public Health; University of North Carolina; Chapel Hill, NC USA
| | - Yi-Hui Zhou
- Department of Biostatistics; Gillings School of Global Public Health; University of North Carolina; Chapel Hill, NC USA
| | - Jessica E Laine
- Department of Epidemiology; Gillings School of Global Public Health; University of North Carolina; Chapel Hill, NC USA
| | - Julia E Rager
- Department of Environmental Sciences and Engineering; Gillings School of Global Public Health; University of North Carolina; Chapel Hill, NC USA
| | - Geeta K Swamy
- Department of Obstetrics and Gynecology; Duke University; Durham, NC USA
| | | | - Marie Lynn Miranda
- School of Natural Resources and Environment; Department of Pediatrics; University of Michigan; Ann Arbor, MI USA
| | - Rebecca C Fry
- Department of Environmental Sciences and Engineering; Gillings School of Global Public Health; University of North Carolina; Chapel Hill, NC USA; Curriculum in Toxicology; School of Medicine; University of North Carolina; Chapel Hill, NC USA
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Abstract
Acetaminophen is a widely used analgesic antipyretic agent. When used at low doses, it is a safe drug, but at higher doses it can cause acute hepatic necrosis in humans and experimental animals. The key mechanism in the hepatotoxicity is cytochrome P450 (CYP)-catalysed formation of the reactive metabolite, N-acetyl-p-benzoquinone imine (NAPQI) that is capable of binding to cellular macromolecules and in that way an LC/MS liquid chromatography/mass spectrometry (LC/MS) method was developed to measure NAPQI formation by trapping it to reduced glutathione. This method was used to determine the bioactivation of acetaminophen at two concentrations: 50 microM therapeutic and 1 mM toxic by using nine human recombinant CYP enzymes: CYP1A1, CYP1A2, CYP2A6, CYP2B6, CYP2C9, CYP2C19, CYP2D6, CYP2E1, and CYP3A4; and with different microsomes from experimental animals. At the toxic concentration the formation of NAPQI-glutathione was highest with CYP3A4 followed by CYP2E1, CYP1A2, and CYP2D6. At the therapeutic concentration, CYP3A4 had also the highest bioactivation capacity. In a comparison of the enzyme kinetics, CYP3A4 was the most efficient CYP with the lowest K(m) value 130 microM (95% confidence interval = 63-210 microM). Dexamethasone-induced rat liver microsomes had the most effective bioactivation capacity at therapeutic and toxic acetaminophen concentrations. This study suggests that CYP3A4 is the major CYP enzyme form catalysing acetaminophen oxidation to NAPQI in human liver.
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Affiliation(s)
- J E Laine
- Pharmacology and Toxicology, University of Kuopio, Kuopio, Finland.
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