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Petersen J, Freedman J, Ford L, Gawthrop M, Simons H, Edelstein M, Plunkett J, Balogun K, Mandal S, Patel D. Changes to country-specific hepatitis A travel vaccination recommendation for UK travellers in 2017-responding to a vaccine shortage in the national context. Public Health 2018; 168:150-156. [PMID: 30442468 DOI: 10.1016/j.puhe.2018.09.017] [Citation(s) in RCA: 2] [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: 12/07/2017] [Revised: 08/29/2018] [Accepted: 09/06/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVES A routine review of hepatitis A travel vaccination recommendations was brought forward in June 2017 due to hepatitis A vaccine shortages and a concurrent outbreak in men who have sex with men (MSM). There were three objectives: first, to document the review process for changing the recommendations for the UK travellers in June 2017. Second, to study the impact of these changes on prescribing in general practice in 2017 compared with the previous 5 years. Third, to study any changes in hepatitis A notifications in June-October 2017 compared with the previous 5 years. STUDY DESIGN This is an observational study. METHODS Travel vaccination recommendations for countries with either low-risk (<20%) or high-risk (>90%) status according to child hepatitis A seroprevalence were not changed. A total of 67 intermediate-risk countries with existing recommendations for most travellers and with new data on rural sanitation levels were shortlisted for the analysis. Data on child hepatitis A seroprevalence, country income status, access to sanitation in rural areas and traveller volumes were obtained. Information about the vaccine supply was obtained from Public Health England. Changes to the existing classification were made through expert consensus, based on countries' hepatitis A seroprevalence, sanitation levels, level of income, volume of travel and hepatitis A traveller cases. Data on the number of combined and monovalent hepatitis A-containing vaccines prescribed in England, 2012-2017, were obtained from the National Health Service Business Service Authorities. The number of monthly prescriptions for January-September 2017 was compared with the mean number of prescriptions for the same month in the previous 5 years (t-test, α = 5%, df = 4). The number of hepatitis A cases notified in June-October 2017 not related to the MSM outbreak was compared with the number of notifications in the same months in previous years. RESULTS A total of 36 countries were downgraded based on good access (80+% of population) to sanitation in rural areas and the intermediate-risk status in terms of child hepatitis A seroprevalence. For these countries, vaccination would only be recommended to travellers staying long term, visiting friends and relatives or staying in areas without good sanitation. There was a significant decline in hepatitis A vaccine prescriptions in June-September 2017, and there was no increase in the number of notifications. CONCLUSIONS Hepatitis A vaccination recommendations for travel were revised in 2017 following a systematic approach to maintain continuity of supply after a hepatitis A vaccine shortage and increased hepatitis A vaccine demand related to a large outbreak. Improved access to good sanitation in rural areas and low seroprevalence estimates among children have led to 36 countries to no longer require vaccination for most travellers. These changes do not seem to have impacted on hepatitis A notifications in England, although further research will be needed to quantify the impact more precisely.
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Affiliation(s)
- J Petersen
- National Travel Health Network and Centre (NaTHNaC), University College London Hospital NHS Foundation Trust, London, UK.
| | - J Freedman
- Travel and Migrant Health, Public Health England, London, UK
| | - L Ford
- National Travel Health Network and Centre (NaTHNaC), Liverpool School of Tropical Medicine, Liverpool, UK
| | - M Gawthrop
- National Travel Health Network and Centre (NaTHNaC), University College London Hospital NHS Foundation Trust, London, UK
| | - H Simons
- National Travel Health Network and Centre (NaTHNaC), Liverpool School of Tropical Medicine, Liverpool, UK
| | - M Edelstein
- Immunisation, Hepatitis and Blood Safety Department, National Infection Service, Public Health England, London, UK
| | - J Plunkett
- Immunisation, Hepatitis and Blood Safety Department, National Infection Service, Public Health England, London, UK
| | - K Balogun
- Immunisation, Hepatitis and Blood Safety Department, National Infection Service, Public Health England, London, UK
| | - S Mandal
- Immunisation, Hepatitis and Blood Safety Department, National Infection Service, Public Health England, London, UK
| | - D Patel
- National Travel Health Network and Centre (NaTHNaC), University College London Hospital NHS Foundation Trust, London, UK
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Chun S, Plunkett J, Teramo K, Muglia LJ, Fay JC. Fine-mapping an association of FSHR with preterm birth in a Finnish population. PLoS One 2013; 8:e78032. [PMID: 24205076 PMCID: PMC3812121 DOI: 10.1371/journal.pone.0078032] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Accepted: 09/09/2013] [Indexed: 12/18/2022] Open
Abstract
Preterm birth is a complex disorder defined by gestations of less than 37 weeks. While preterm birth is estimated to have a significant genetic component, relative few genes have been associated with preterm birth. Polymorphism in one such gene, follicle-stimulating hormone receptor (FSHR), has been associated with preterm birth in Finnish and African American mothers but not other populations. To refine the genetic association of FSHR with preterm birth we conducted a fine-mapping study at the FSHR locus in a Finnish cohort. We sequenced a total of 44 kb, including protein-coding and conserved non-coding regions, in 127 preterm and 135 term mothers. Overall, we identified 288 single nucleotide variants and 65 insertion/deletions of 1-2 bp across all subjects. While no common SNPs in protein-coding regions were associated with preterm birth, including one previously associated with timing of fertilization, multiple SNPs spanning the first and second intron showed the strongest associations. Analysis of the associated SNPs revealed that they form both a protective (OR = 0.50, 95% CI = 0.25-0.93) as well as a risk (OR = 1.89, 95% CI = 1.08-3.39) haplotype with independent effects. In these haplotypes, two SNPs, rs12052281 and rs72822025, were predicted to disrupt ZEB1 and ELF3 transcription factor binding sites, respectively. Our results show that multiple haplotypes at FSHR are associated with preterm birth and we discuss the frequency and structure of these haplotypes outside of the Finnish population as a potential explanation for the absence of FSHR associations in some populations.
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Affiliation(s)
- Sung Chun
- Computational and Systems Biology Program, Washington University, St. Louis, Missouri, United States of America
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Kim J, Stirling KJ, Cooper ME, Ascoli M, Momany AM, McDonald EL, Ryckman KK, Rhea L, Schaa KL, Cosentino V, Gadow E, Saleme C, Shi M, Hallman M, Plunkett J, Teramo KA, Muglia LJ, Feenstra B, Geller F, Boyd HA, Melbye M, Marazita ML, Dagle JM, Murray JC. Sequence variants in oxytocin pathway genes and preterm birth: a candidate gene association study. BMC Med Genet 2013; 14:77. [PMID: 23889750 PMCID: PMC3737028 DOI: 10.1186/1471-2350-14-77] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Accepted: 07/18/2013] [Indexed: 11/10/2022]
Abstract
Background Preterm birth (PTB) is a complex disorder associated with significant neonatal mortality and morbidity and long-term adverse health consequences. Multiple lines of evidence suggest that genetic factors play an important role in its etiology. This study was designed to identify genetic variation associated with PTB in oxytocin pathway genes whose role in parturition is well known. Methods To identify common genetic variants predisposing to PTB, we genotyped 16 single nucleotide polymorphisms (SNPs) in the oxytocin (OXT), oxytocin receptor (OXTR), and leucyl/cystinyl aminopeptidase (LNPEP) genes in 651 case infants from the U.S. and one or both of their parents. In addition, we examined the role of rare genetic variation in susceptibility to PTB by conducting direct sequence analysis of OXTR in 1394 cases and 1112 controls from the U.S., Argentina, Denmark, and Finland. This study was further extended to maternal triads (maternal grandparents-mother of a case infant, N=309). We also performed in vitro analysis of selected rare OXTR missense variants to evaluate their functional importance. Results Maternal genetic effect analysis of the SNP genotype data revealed four SNPs in LNPEP that show significant association with prematurity. In our case–control sequence analysis, we detected fourteen coding variants in exon 3 of OXTR, all but four of which were found in cases only. Of the fourteen variants, three were previously unreported novel rare variants. When the sequence data from the maternal triads were analyzed using the transmission disequilibrium test, two common missense SNPs (rs4686302 and rs237902) in OXTR showed suggestive association for three gestational age subgroups. In vitro functional assays showed a significant difference in ligand binding between wild-type and two mutant receptors. Conclusions Our study suggests an association between maternal common polymorphisms in LNPEP and susceptibility to PTB. Maternal OXTR missense SNPs rs4686302 and rs237902 may have gestational age-dependent effects on prematurity. Most of the OXTR rare variants identified do not appear to significantly contribute to the risk of PTB, but those shown to affect receptor function in our in vitro study warrant further investigation. Future studies with larger sample sizes are needed to confirm the findings of this study.
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Affiliation(s)
- Jinsil Kim
- Department of Anatomy and Cell Biology, University of Iowa, Iowa City, IA 52242, USA
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Karjalainen MK, Huusko JM, Ulvila J, Sotkasiira J, Luukkonen A, Teramo K, Plunkett J, Anttila V, Palotie A, Haataja R, Muglia LJ, Hallman M. A potential novel spontaneous preterm birth gene, AR, identified by linkage and association analysis of X chromosomal markers. PLoS One 2012; 7:e51378. [PMID: 23227263 PMCID: PMC3515491 DOI: 10.1371/journal.pone.0051378] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [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: 08/08/2012] [Accepted: 11/07/2012] [Indexed: 11/20/2022] Open
Abstract
Preterm birth is the major cause of neonatal mortality and morbidity. In many cases, it has severe life-long consequences for the health and neurological development of the newborn child. More than 50% of all preterm births are spontaneous, and currently there is no effective prevention. Several studies suggest that genetic factors play a role in spontaneous preterm birth (SPTB). However, its genetic background is insufficiently characterized. The aim of the present study was to perform a linkage analysis of X chromosomal markers in SPTB in large northern Finnish families with recurrent SPTBs. We found a significant linkage signal (HLOD = 3.72) on chromosome locus Xq13.1 when the studied phenotype was being born preterm. There were no significant linkage signals when the studied phenotype was giving preterm deliveries. Two functional candidate genes, those encoding the androgen receptor (AR) and the interleukin-2 receptor gamma subunit (IL2RG), located near this locus were analyzed as candidates for SPTB in subsequent case-control association analyses. Nine single-nucleotide polymorphisms (SNPs) within these genes and an AR exon-1 CAG repeat, which was previously demonstrated to be functionally significant, were analyzed in mothers with preterm delivery (n = 272) and their offspring (n = 269), and in mothers with exclusively term deliveries (n = 201) and their offspring (n = 199), all originating from northern Finland. A replication study population consisting of individuals born preterm (n = 111) and term (n = 197) from southern Finland was also analyzed. Long AR CAG repeats (≥26) were overrepresented and short repeats (≤19) underrepresented in individuals born preterm compared to those born at term. Thus, our linkage and association results emphasize the role of the fetal genome in genetic predisposition to SPTB and implicate AR as a potential novel fetal susceptibility gene for SPTB.
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Affiliation(s)
- Minna K Karjalainen
- Department of Pediatrics, Institute of Clinical Medicine, University of Oulu, Oulu, Finland
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DeFranco E, Jacobs T, Plunkett J, Chaudhari B, Huettner P, Muglia L. Placental pathologic aberrations in cases of familial idiopathic spontaneous preterm birth. Placenta 2011; 32:386-90. [DOI: 10.1016/j.placenta.2011.02.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2010] [Revised: 02/01/2011] [Accepted: 02/28/2011] [Indexed: 11/26/2022]
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Plunkett J, Doniger S, Orabona G, Morgan T, Haataja R, Hallman M, Puttonen H, Menon R, Kuczynski E, Norwitz E, Snegovskikh V, Palotie A, Peltonen L, Fellman V, DeFranco EA, Chaudhari BP, McGregor TL, McElroy JJ, Oetjens MT, Teramo K, Borecki I, Fay J, Muglia L. An evolutionary genomic approach to identify genes involved in human birth timing. PLoS Genet 2011; 7:e1001365. [PMID: 21533219 PMCID: PMC3077368 DOI: 10.1371/journal.pgen.1001365] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2010] [Accepted: 03/07/2011] [Indexed: 01/06/2023] Open
Abstract
Coordination of fetal maturation with birth timing is essential for mammalian reproduction. In humans, preterm birth is a disorder of profound global health significance. The signals initiating parturition in humans have remained elusive, due to divergence in physiological mechanisms between humans and model organisms typically studied. Because of relatively large human head size and narrow birth canal cross-sectional area compared to other primates, we hypothesized that genes involved in parturition would display accelerated evolution along the human and/or higher primate phylogenetic lineages to decrease the length of gestation and promote delivery of a smaller fetus that transits the birth canal more readily. Further, we tested whether current variation in such accelerated genes contributes to preterm birth risk. Evidence from allometric scaling of gestational age suggests human gestation has been shortened relative to other primates. Consistent with our hypothesis, many genes involved in reproduction show human acceleration in their coding or adjacent noncoding regions. We screened >8,400 SNPs in 150 human accelerated genes in 165 Finnish preterm and 163 control mothers for association with preterm birth. In this cohort, the most significant association was in FSHR, and 8 of the 10 most significant SNPs were in this gene. Further evidence for association of a linkage disequilibrium block of SNPs in FSHR, rs11686474, rs11680730, rs12473870, and rs1247381 was found in African Americans. By considering human acceleration, we identified a novel gene that may be associated with preterm birth, FSHR. We anticipate other human accelerated genes will similarly be associated with preterm birth risk and elucidate essential pathways for human parturition. The control of birth timing in humans is the greatest unresolved question in reproductive biology, and preterm birth is the most important medical issue in maternal and child health. To begin to address this critical problem, we test the hypothesis that genes accelerated in their rate of evolution in humans, as compared with other primates and mammals, are involved in birth timing. We first show that human gestational length has been altered relative to other non-human primates and mammals. Using allometric scaling, we demonstrate that human gestation is shorter than predicted based upon gestational length in other mammalian species. Next, we show that genes with rate acceleration in humans—in coding or regulatory regions—are plausible candidates to be involved in birth timing. Finally, we find that polymorphisms in the human accelerated gene (FSHR), not before implicated in the timing for birth, may alter risk for human preterm birth. Our understanding of pathways for birth timing in humans is limited, yet its elucidation remains one of the most important issues in biology and medicine. The evolutionary genetic approach that we apply should be applicable to many human disorders and assist other investigators studying preterm birth.
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Affiliation(s)
- Jevon Plunkett
- Department of Pediatrics, Vanderbilt University School of Medicine and Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee, United States of America
- Human and Statistic Genetics Program, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Scott Doniger
- Computational Biology Program, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Guilherme Orabona
- Department of Pediatrics, Vanderbilt University School of Medicine and Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee, United States of America
- Center for Human Genetics Research, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Thomas Morgan
- Department of Pediatrics, Vanderbilt University School of Medicine and Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee, United States of America
- Center for Human Genetics Research, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Ritva Haataja
- Institute of Clinical Medicine, Department of Pediatrics, University of Oulu, Oulu, Finland
| | - Mikko Hallman
- Institute of Clinical Medicine, Department of Pediatrics, University of Oulu, Oulu, Finland
| | - Hilkka Puttonen
- Departments of Obstetrics and Gynecology, University of Helsinki, Helsinki, Finland
| | - Ramkumar Menon
- The Perinatal Research Center, Nashville, Tennessee, United States of America
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Edward Kuczynski
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Errol Norwitz
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Victoria Snegovskikh
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Aarno Palotie
- Finnish Institute of Molecular Medicine, University of Helsinki, Helsinki, Finland
- The Broad Institute of MIT and Harvard, Cambridge, Massachusetts, United States of America
- Wellcome Trust Sanger Institute, Cambridge, United Kingdom
| | - Leena Peltonen
- Finnish Institute of Molecular Medicine, University of Helsinki, Helsinki, Finland
- The Broad Institute of MIT and Harvard, Cambridge, Massachusetts, United States of America
- Wellcome Trust Sanger Institute, Cambridge, United Kingdom
| | - Vineta Fellman
- Department of Pediatrics, Lund University, Lund, Sweden
- Department of Pediatrics, University of Helsinki, Helsinki, Finland
| | - Emily A. DeFranco
- Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States of America
| | - Bimal P. Chaudhari
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Tracy L. McGregor
- Department of Pediatrics, Vanderbilt University School of Medicine and Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee, United States of America
| | - Jude J. McElroy
- Department of Pediatrics, Vanderbilt University School of Medicine and Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee, United States of America
- Center for Human Genetics Research, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Matthew T. Oetjens
- Center for Human Genetics Research, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Kari Teramo
- Departments of Obstetrics and Gynecology, University of Helsinki, Helsinki, Finland
| | - Ingrid Borecki
- Division of Statistical Genomics, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Justin Fay
- Department of Genetics and Center for Genome Sciences, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Louis Muglia
- Department of Pediatrics, Vanderbilt University School of Medicine and Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee, United States of America
- Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
- Vanderbilt Kennedy Center for Human Development, Vanderbilt University, Nashville, Tennessee, United States of America
- * E-mail:
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Haataja R, Karjalainen MK, Luukkonen A, Teramo K, Puttonen H, Ojaniemi M, Varilo T, Chaudhari BP, Plunkett J, Murray JC, McCarroll SA, Peltonen L, Muglia LJ, Palotie A, Hallman M. Mapping a new spontaneous preterm birth susceptibility gene, IGF1R, using linkage, haplotype sharing, and association analysis. PLoS Genet 2011; 7:e1001293. [PMID: 21304894 PMCID: PMC3033387 DOI: 10.1371/journal.pgen.1001293] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2010] [Accepted: 01/05/2011] [Indexed: 11/19/2022] Open
Abstract
Preterm birth is the major cause of neonatal death and serious morbidity. Most preterm births are due to spontaneous onset of labor without a known cause or effective prevention. Both maternal and fetal genomes influence the predisposition to spontaneous preterm birth (SPTB), but the susceptibility loci remain to be defined. We utilized a combination of unique population structures, family-based linkage analysis, and subsequent case-control association to identify a susceptibility haplotype for SPTB. Clinically well-characterized SPTB families from northern Finland, a subisolate founded by a relatively small founder population that has subsequently experienced a number of bottlenecks, were selected for the initial discovery sample. Genome-wide linkage analysis using a high-density single-nucleotide polymorphism (SNP) array in seven large northern Finnish non-consanginous families identified a locus on 15q26.3 (HLOD 4.68). This region contains the IGF1R gene, which encodes the type 1 insulin-like growth factor receptor IGF-1R. Haplotype segregation analysis revealed that a 55 kb 12-SNP core segment within the IGF1R gene was shared identical-by-state (IBS) in five families. A follow-up case-control study in an independent sample representing the more general Finnish population showed an association of a 6-SNP IGF1R haplotype with SPTB in the fetuses, providing further evidence for IGF1R as a SPTB predisposition gene (frequency in cases versus controls 0.11 versus 0.05, P = 0.001, odds ratio 2.3). This study demonstrates the identification of a predisposing, low-frequency haplotype in a multifactorial trait using a well-characterized population and a combination of family and case-control designs. Our findings support the identification of the novel susceptibility gene IGF1R for predisposition by the fetal genome to being born preterm.
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Affiliation(s)
- Ritva Haataja
- Department of Pediatrics, Institute of Clinical Medicine, University of Oulu, Oulu, Finland
| | - Minna K. Karjalainen
- Department of Pediatrics, Institute of Clinical Medicine, University of Oulu, Oulu, Finland
- * E-mail:
| | - Aino Luukkonen
- Department of Pediatrics, Institute of Clinical Medicine, University of Oulu, Oulu, Finland
| | - Kari Teramo
- Department of Obstetrics and Gynecology, University Central Hospital, Helsinki, Finland
| | - Hilkka Puttonen
- Department of Obstetrics and Gynecology, University Central Hospital, Helsinki, Finland
| | - Marja Ojaniemi
- Department of Pediatrics, Institute of Clinical Medicine, University of Oulu, Oulu, Finland
| | - Teppo Varilo
- Department of Medical Genetics, Haartman Institute, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
- National Institute for Health and Welfare (THL), Helsinki, Finland
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Bimal P. Chaudhari
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Jevon Plunkett
- Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
- Human and Statistics Genetics Program, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Jeffrey C. Murray
- Department of Pediatrics, University of Iowa, Iowa City, Iowa, United States of America
| | - Steven A. McCarroll
- Department of Genetics, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Leena Peltonen
- Department of Medical Genetics, Haartman Institute, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
- National Institute for Health and Welfare (THL), Helsinki, Finland
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- The Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, Massachusetts, United States of America
- Wellcome Trust Sanger Institute, Cambridge, United Kingdom
| | - Louis J. Muglia
- Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Aarno Palotie
- Department of Medical Genetics, Haartman Institute, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- The Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, Massachusetts, United States of America
- Wellcome Trust Sanger Institute, Cambridge, United Kingdom
| | - Mikko Hallman
- Department of Pediatrics, Institute of Clinical Medicine, University of Oulu, Oulu, Finland
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Plunkett J, Doniger S, Morgan T, Haataja R, Hallman M, Puttonen H, Menon R, Kuczynski E, Norwitz E, Snegovskikh V, Palotie A, Peltonen L, Fellman V, DeFranco EA, Chaudhari BP, Oates J, Boutaud O, McGregor TL, McElroy JJ, Teramo K, Borecki I, Fay JC, Muglia LJ. Primate-specific evolution of noncoding element insertion into PLA2G4C and human preterm birth. BMC Med Genomics 2010; 3:62. [PMID: 21184677 PMCID: PMC3017005 DOI: 10.1186/1755-8794-3-62] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2010] [Accepted: 12/24/2010] [Indexed: 11/17/2022] Open
Abstract
Background The onset of birth in humans, like other apes, differs from non-primate mammals in its endocrine physiology. We hypothesize that higher primate-specific gene evolution may lead to these differences and target genes involved in human preterm birth, an area of global health significance. Methods We performed a comparative genomics screen of highly conserved noncoding elements and identified PLA2G4C, a phospholipase A isoform involved in prostaglandin biosynthesis as human accelerated. To examine whether this gene demonstrating primate-specific evolution was associated with birth timing, we genotyped and analyzed 8 common single nucleotide polymorphisms (SNPs) in PLA2G4C in US Hispanic (n = 73 preterm, 292 control), US White (n = 147 preterm, 157 control) and US Black (n = 79 preterm, 166 control) mothers. Results Detailed structural and phylogenic analysis of PLA2G4C suggested a short genomic element within the gene duplicated from a paralogous highly conserved element on chromosome 1 specifically in primates. SNPs rs8110925 and rs2307276 in US Hispanics and rs11564620 in US Whites were significant after correcting for multiple tests (p < 0.006). Additionally, rs11564620 (Thr360Pro) was associated with increased metabolite levels of the prostaglandin thromboxane in healthy individuals (p = 0.02), suggesting this variant may affect PLA2G4C activity. Conclusions Our findings suggest that variation in PLA2G4C may influence preterm birth risk by increasing levels of prostaglandins, which are known to regulate labor.
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Affiliation(s)
- Jevon Plunkett
- Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
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Defranco E, Shen T, Wangler M, Kistka Z, Palomar L, Stormo A, Plunkett J, Huettner P, Muglia L. 498: Placental pathology findings in cases of familial spontaneous preterm birth. Am J Obstet Gynecol 2009. [DOI: 10.1016/j.ajog.2009.10.664] [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: 10/20/2022]
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Daw EW, Plunkett J, Feitosa M, Gao X, Van Brunt A, Ma D, Czajkowski J, Province MA, Borecki I. A framework for analyzing both linkage and association: an analysis of Genetic Analysis Workshop 16 simulated data. BMC Proc 2009; 3 Suppl 7:S98. [PMID: 20018095 PMCID: PMC2796002 DOI: 10.1186/1753-6561-3-s7-s98] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Plunkett J, Feitosa MF, Trusgnich M, Wangler MF, Palomar L, Kistka ZAF, DeFranco EA, Shen TT, Stormo AE, Puttonen H, Hallman M, Haataja R, Luukkonen A, Fellman V, Peltonen L, Palotie A, Daw EW, An P, Teramo K, Borecki I, Muglia LJ. Mother's genome or maternally-inherited genes acting in the fetus influence gestational age in familial preterm birth. Hum Hered 2009; 68:209-19. [PMID: 19521103 PMCID: PMC2869074 DOI: 10.1159/000224641] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2008] [Accepted: 02/26/2009] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE While multiple lines of evidence suggest the importance of genetic contributors to risk of preterm birth, the nature of the genetic component has not been identified. We perform segregation analyses to identify the best fitting genetic model for gestational age, a quantitative proxy for preterm birth. METHODS Because either mother or infant can be considered the proband from a preterm delivery and there is evidence to suggest that genetic factors in either one or both may influence the trait, we performed segregation analysis for gestational age either attributed to the infant (infant's gestational age), or the mother (by averaging the gestational ages at which her children were delivered), using 96 multiplex preterm families. RESULTS These data lend further support to a genetic component contributing to birth timing since sporadic (i.e. no familial resemblance) and nontransmission (i.e. environmental factors alone contribute to gestational age) models are strongly rejected. Analyses of gestational age attributed to the infant support a model in which mother's genome and/or maternally-inherited genes acting in the fetus are largely responsible for birth timing, with a smaller contribution from the paternally-inherited alleles in the fetal genome. CONCLUSION Our findings suggest that genetic influences on birth timing are important and likely complex.
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Affiliation(s)
- Jevon Plunkett
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Miss., USA
- Center for Preterm Birth Research, Washington University School of Medicine, St. Louis, Miss., USA
- Human and Statistical Genetics Program, Washington University School of Medicine, St. Louis, Miss., USA
| | - Mary F. Feitosa
- Division of Statistical Genomics, Washington University School of Medicine, St. Louis, Miss., USA
| | - Michelle Trusgnich
- Division of Biostatistics, Washington University School of Medicine, St. Louis, Miss., USA
| | - Michael F. Wangler
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Miss., USA
- Center for Preterm Birth Research, Washington University School of Medicine, St. Louis, Miss., USA
| | - Lisanne Palomar
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Miss., USA
- Center for Preterm Birth Research, Washington University School of Medicine, St. Louis, Miss., USA
| | - Zachary A.-F. Kistka
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Miss., USA
- Center for Preterm Birth Research, Washington University School of Medicine, St. Louis, Miss., USA
| | - Emily A. DeFranco
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Miss., USA
- Center for Preterm Birth Research, Washington University School of Medicine, St. Louis, Miss., USA
| | - Tammy T. Shen
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Miss., USA
- Center for Preterm Birth Research, Washington University School of Medicine, St. Louis, Miss., USA
| | - Adrienne E.D. Stormo
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Miss., USA
- Center for Preterm Birth Research, Washington University School of Medicine, St. Louis, Miss., USA
| | - Hilkka Puttonen
- Department of Obstetrics and Gynecology, University of Helsinki, Helsinki, Finland
| | - Mikko Hallman
- Department of Pediatrics, University of Oulu, Oulu, Finland
| | - Ritva Haataja
- Department of Pediatrics, University of Oulu, Oulu, Finland
| | - Aino Luukkonen
- Department of Pediatrics, University of Oulu, Oulu, Finland
| | - Vineta Fellman
- Department of Pediatrics, University of Helsinki, Helsinki, Finland
- Department of Pediatrics, Lund University, Lund, Sweden
| | - Leena Peltonen
- Biomedicum Helsinki Research Program in Molecular Medicine, University of Helsinki, Helsinki, Finland
- Department of Clinical Chemistry, Helsinki University Central Hospital, Helsinki, Finland
- Department of Molecular Medicine, National Public Health Institute, Helsinki, Finland
- The Broad Institute of MIT and Harvard, Cambridge, Mass., USA
- Wellcome Trust Sanger Institute, Cambridge, UK
| | - Aarno Palotie
- Biomedicum Helsinki Research Program in Molecular Medicine, University of Helsinki, Helsinki, Finland
- The Finnish Genome Center, University of Helsinki, Helsinki, Finland
- Department of Pediatrics, University of Oulu, Oulu, Finland
- The Broad Institute of MIT and Harvard, Cambridge, Mass., USA
- Wellcome Trust Sanger Institute, Cambridge, UK
| | - E. Warwick Daw
- Division of Statistical Genomics, Washington University School of Medicine, St. Louis, Miss., USA
| | - Ping An
- Division of Statistical Genomics, Washington University School of Medicine, St. Louis, Miss., USA
| | - Kari Teramo
- Department of Obstetrics and Gynecology, University of Helsinki, Helsinki, Finland
| | - Ingrid Borecki
- Division of Statistical Genomics, Washington University School of Medicine, St. Louis, Miss., USA
- Center for Preterm Birth Research, Washington University School of Medicine, St. Louis, Miss., USA
- Human and Statistical Genetics Program, Washington University School of Medicine, St. Louis, Miss., USA
| | - Louis J. Muglia
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Miss., USA
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Miss., USA
- Center for Preterm Birth Research, Washington University School of Medicine, St. Louis, Miss., USA
- Human and Statistical Genetics Program, Washington University School of Medicine, St. Louis, Miss., USA
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Chaudhari BP, Plunkett J, Ratajczak CK, Shen TT, DeFranco EA, Muglia LJ. The genetics of birth timing: insights into a fundamental component of human development. Clin Genet 2009; 74:493-501. [PMID: 19037974 DOI: 10.1111/j.1399-0004.2008.01124.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The timing of birth necessitates the coupling of fetal maturation with the onset of parturition, and occurs at characteristic, but divergent gestations between mammals. Preterm birth in humans is an important but poorly understood outcome of pregnancy that uncouples fetal maturation and birth timing. The etiology of preterm birth is complex, involving environmental and genetic factors whose underlying molecular and cellular pathogenic mechanisms remain poorly understood. Animal models, although limited by differences with human physiology, have been crucial in exploring the role of various genetic pathways in mammalian birth timing. Studies in humans of both familial aggregation and racial disparities in preterm birth have contributed to the understanding that preterm birth is heritable. A significant portion of this heritability is due to polygenic causes with few true Mendelian disorders contributing to preterm birth. Thus far, studies of the human genetics of preterm birth using a candidate gene approach have met with limited success. Emerging research efforts using unbiased methods may yield promising results if concerns about study design can be adequately addressed. The findings from this frontier of research may have direct implications for the allocation of public health and clinical resources as well as spur the development of more effective therapeutics.
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Affiliation(s)
- B P Chaudhari
- Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri 63110, USA
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13
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Plunkett J, Borecki I, Morgan T, Stamilio D, Muglia LJ. Population-based estimate of sibling risk for preterm birth, preterm premature rupture of membranes, placental abruption and pre-eclampsia. BMC Genet 2008; 9:44. [PMID: 18611258 PMCID: PMC2483292 DOI: 10.1186/1471-2156-9-44] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2007] [Accepted: 07/08/2008] [Indexed: 11/16/2022] Open
Abstract
Background Adverse pregnancy outcomes, such as preterm birth, preeclampsia and placental abruption, are common, with acute and long-term complications for both the mother and infant. Etiologies underlying such adverse outcomes are not well understood. As maternal and fetal genetic factors may influence these outcomes, we estimated the magnitude of familial aggregation as one index of possible heritable contributions. Using the Missouri Department of Health's maternally-linked birth certificate database, we performed a retrospective population-based cohort study of births (1989–1997), designating an individual born from an affected pregnancy as the proband for each outcome studied. We estimated the increased risk to siblings compared to the population risk, using the sibling risk ratio, λs, and sibling-sibling odds ratio (sib-sib OR), for the adverse pregnancy outcomes of preterm birth, preterm premature rupture of membranes (PPROM), placental abruption, and pre-eclampsia. Results Risk to siblings of an affected individual was elevated above the population prevalence of a given disorder, as indicated by λS (λS (95% CI): 4.3 (4.0–4.6), 8.2 (6.5–9.9), 4.0 (2.6–5.3), and 4.5 (4.4–4.8), for preterm birth, PPROM, placental abruption, and pre-eclampsia, respectively). Risk to siblings of an affected individual was similarly elevated above that of siblings of unaffected individuals, as indicated by the sib-sib OR (sib-sib OR adjusted for known risk factors (95% CI): 4.2 (3.9–4.5), 9.6 (7.6–12.2), 3.8 (2.6–5.5), 8.1 (7.5–8.8) for preterm birth, PPROM, placental abruption, and pre-eclampsia, respectively). Conclusion These results suggest that the adverse pregnancy outcomes of preterm birth, PPROM, placental abruption, and pre-eclampsia aggregate in families, which may be explained in part by genetics.
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Affiliation(s)
- Jevon Plunkett
- Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri 63110, USA.
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Abstract
Infants born before term (<37 weeks) have an increased risk of neonatal mortality as well as other health problems. The increasing rate of preterm birth in recent decades, despite improvements in health care, creates an impetus to better understand and prevent this disorder. Preterm birth likely depends on a number of interacting factors, including genetic, epigenetic, and environmental risk factors. Genetic studies may identify markers, which more accurately predict preterm birth than currently known risk factors, or novel proteins and/or pathways involved in the disorder. This review summarizes epidemiological and genetic studies to date, emphasizing the complexity of genetic influences on birth timing. While several candidate genes have been reportedly associated with the disorder, inconsistency across studies has been problematic. More systematic and unbiased genetic approaches are needed for future studies to examine the genetic etiology of human birth timing thoroughly.
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Affiliation(s)
- Jevon Plunkett
- Department of Pediatrics, Center for Preterm Birth Research, and Human and Statistical Genetics Program, Washington University School of Medicine, St. Louis, Missouri, USA
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15
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Plunkett J, Muglia L. 648: Sibling risk for adverse pregnancy outcomes. Am J Obstet Gynecol 2007. [DOI: 10.1016/j.ajog.2007.10.675] [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: 10/22/2022]
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16
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Dick DM, Wang JC, Plunkett J, Aliev F, Hinrichs A, Bertelsen S, Budde JP, Goldstein EL, Kaplan D, Edenberg HJ, Nurnberger J, Hesselbrock V, Schuckit M, Kuperman S, Tischfield J, Porjesz B, Begleiter H, Bierut LJ, Goate A. Family-Based Association Analyses of Alcohol Dependence Phenotypes Across DRD2 and Neighboring Gene ANKK1. Alcohol Clin Exp Res 2007; 31:1645-53. [PMID: 17850642 DOI: 10.1111/j.1530-0277.2007.00470.x] [Citation(s) in RCA: 96] [Impact Index Per Article: 5.6] [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: 11/29/2022]
Abstract
BACKGROUND There is an extensive and inconsistent literature on the association of the dopamine D2 receptor gene (DRD2) with alcohol dependence. Conflicting results have been attributed to differences in the severity of the alcohol dependence phenotype across studies, failure to exclude related disorders from comparison groups, and artifacts of population-stratification. Recently the genetic polymorphism most widely analyzed in DRD2, Taq1A, has been discovered to reside in a neighboring gene, ankyrin repeat and kinase domain containing 1 (ANKK1), located 10 kb downstream from DRD2. METHODS To more carefully characterize evidence for association across this region, we genotyped 26 single nucleotide polymorphisms (SNPs) spanning DRD2 and ANKK1 in a sample of 219 Caucasian families (n = 1,923) from the Collaborative Study on the Genetics of Alcoholism (COGA), making this the most extensive analysis to date of association between this region and alcohol dependence. We used family-based analyses robust to population-stratification, and we made use of rich phenotypic data to analyze alcohol dependence and subtypes hypothesized in the literature to be more directly influenced by DRD2. RESULTS We found that the evidence for association is strongest in the 5' linkage disequilibrium block of ANKK1 (that does not contain Taq1A), with weak evidence of association with a small number of SNPs in DRD2. The association in ANKK1 is strongest among the subsets of alcoholics with medical complications and with antisocial personality disorder. CONCLUSIONS More extensive genotyping across DRD2 and ANKK1 suggests that the association with alcohol dependence observed in this region may be due to genetic variants in the ANKK1 gene. ANKK1 is involved in signal transduction pathways and is a plausible biological candidate for involvement in addictive disorders.
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17
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Dick DM, Plunkett J, Hamlin D, Nurnberger J, Kuperman S, Schuckit M, Hesselbrock V, Edenberg H, Bierut L. Association analyses of the serotonin transporter gene with lifetime depression and alcohol dependence in the Collaborative Study on the Genetics of Alcoholism (COGA) sample. Psychiatr Genet 2007; 17:35-8. [PMID: 17167343 DOI: 10.1097/ypg.0b013e328011188b] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.2] [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: 12/27/2022]
Abstract
The objective of this study was to analyze association of the serotonin transporter gene 5-HTTLPR polymorphism on lifetime depression and alcohol dependence in the Collaborative Study on the Genetics of Alcoholism sample. We conducted family-based association analyses in 1913 Caucasians genotyped for the 5-HTTLPR polymorphism. We found evidence for association of the short allele with depression, but no evidence of association with alcohol dependence. On the basis of the evidence that the effect of this polymorphism may be moderated by stressful life events, we classified individuals for the presence and/or absence of stress, as defined by unemployment, relationship problems, or poor health. The evidence for the association with lifetime depression was limited to the group of individuals who had experienced stress, paralleling the direction of effects originally reported by Caspi and colleagues. No evidence was found for the association with alcohol dependence in either the stress or the no-stress groups.
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Affiliation(s)
- Danielle M Dick
- Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri 63110, USA.
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18
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Dick DM, Plunkett J, Wetherill LF, Xuei X, Goate A, Hesselbrock V, Schuckit M, Crowe R, Edenberg HJ, Foroud T. Association between GABRA1 and drinking behaviors in the collaborative study on the genetics of alcoholism sample. Alcohol Clin Exp Res 2006; 30:1101-10. [PMID: 16792556 DOI: 10.1111/j.1530-0277.2006.00136.x] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.2] [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: 11/27/2022]
Abstract
BACKGROUND A wealth of literature supports the role of gamma-aminobutyric acid (GABA) in neurobiological pathways contributing to alcohol dependence and related phenotypes. Animal studies have consistently tied rodent homologs of the GABAA receptor genes on human chromosome 5q to alcohol-related behaviors; however, human studies have produced mixed results. Family-based association analyses previously conducted in the Collaborative Study on the Genetics of Alcoholism (COGA) sample yielded no evidence of association with Diagnostic and Statistical Manual of Mental Disorder-fourth edition (DSM-IV) alcohol dependence and these genes. As a follow-up to that study, we examined several alcohol-related behaviors in the COGA sample as follows: (1) a broader definition of alcohol dependence, including DSM-III-R symptoms and Feighner criteria (referred to as COGA alcohol dependence); (2) withdrawal; (3) history of alcohol-induced blackouts; (4) level of response to alcohol; (5) age of onset of regular drinking; and (6) age at first drunkenness. METHODS Family-based association tests were conducted, using multiple single-nucleotide polymorphisms (SNPs) in each of the 4 GABAA receptor genes on chromosome 5q. RESULTS In GABRA1, we found evidence of association with several of the drinking behavior phenotypes, including COGA alcohol dependence, history of blackouts, age at first drunkenness, and level of response to alcohol. We did not find consistent evidence of association with the remaining genes and any of the phenotypes. CONCLUSIONS We found evidence for association between GABRA1 and COGA alcohol dependence, history of blackouts, age at first drunkenness, and level of response to alcohol. These analyses suggest that efforts to characterize genetic contributions to alcohol dependence may benefit by examining alcohol-related behaviors in addition to clinical alcohol dependence diagnoses.
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Affiliation(s)
- Danielle M Dick
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
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19
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Geddes JF, Plunkett J. The evidence base for shaken baby syndrome. West J Med 2004. [DOI: 10.1136/bmj.328.7451.1317] [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: 11/04/2022]
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Abstract
Physicians disagree on several issues regarding head injury in infants and children, including the potential lethality of a short-distance fall, a lucid interval in an ultimately fatal head injury, and the specificity of retinal hemorrhage for inflicted trauma. There is scant objective evidence to resolve these questions, and more information is needed. The objective of this study was to determine whether there are witnessed or investigated fatal short-distance falls that were concluded to be accidental. The author reviewed the January 1, 1988 through June 30, 1999 United States Consumer Product Safety Commission database for head injury associated with the use of playground equipment. The author obtained and reviewed the primary source data (hospital and emergency medical services' records, law enforcement reports, and coroner or medical examiner records) for all fatalities involving a fall. The results revealed 18 fall-related head injury fatalities in the database. The youngest child was 12 months old, the oldest 13 years. The falls were from 0.6 to 3 meters (2-10 feet). A noncaretaker witnessed 12 of the 18, and 12 had a lucid interval. Four of the six children in whom funduscopic examination was documented in the medical record had bilateral retinal hemorrhage. The author concludes that an infant or child may suffer a fatal head injury from a fall of less than 3 meters (10 feet). The injury may be associated with a lucid interval and bilateral retinal hemorrhage.
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Affiliation(s)
- J Plunkett
- Department of Pathology, Regina Medical Center, Hastings, MN 55033, USA.
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Abstract
Surface modulation is part of normal bone growth. However, the radiologic appearance of physiologically growing bone in infancy may resemble changes secondary to trauma. This case report reviews bone remodeling in the postnatal infant and describes its unique radiologic and pathologic characteristics, allowing normal to be differentiated from healing and repair.
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Affiliation(s)
- J Plunkett
- Department of Pathology, Regina Medical Center, Hastings, Minnesota 55033, USA
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23
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Plunkett J. Clarity on the diagnosis line. Ann Diagn Pathol 2000; 4:134. [PMID: 10841632 DOI: 10.1016/s1092-9134(00)90022-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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24
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Plunkett J. Recognizing abusive head trauma in children. JAMA 1999; 282:1421-2. [PMID: 10535427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
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Abstract
Ruptured aneurysms of the cerebrovasculature in infancy and early childhood, except for "giant" aneurysms and arteriovenous malformations, are rare. Seizures, loss of consciousness, and apnea are the usual presenting signs in infancy; symptoms such as headache or visual disturbances and signs such as cranial nerve compression or meningeal irritation commonly found in older children or adults are absent in infants. However, the morphologic findings (i.e., subarachnoid and retinal hemorrhage, and occasionally subdural hemorrhage) may be mistaken for inflicted trauma, especially if the aneurysm is not identified. Sudden death caused by rupture of a cerebral aneurysm has not been previously described in an infant. This report outlines the investigation and autopsy findings in a 7-month-old infant who died unexpectedly as a result of rupture of a complex basilar artery aneurysm.
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Affiliation(s)
- J Plunkett
- Regina Medical Center, Hastings, Minnesota 55033, USA
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26
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Abstract
Ruptured aneurysms of the cerebrovasculature in infancy and early childhood, except for "giant" aneurysms and arteriovenous malformations, are rare. Seizures, loss of consciousness, and apnea are the usual presenting signs in infancy; symptoms such as headache or visual disturbances and signs such as cranial nerve compression or meningeal irritation commonly found in older children or adults are absent in infants. However, the morphologic findings (i.e., subarachnoid and retinal hemorrhage, and occasionally subdural hemorrhage) may be mistaken for inflicted trauma, especially if the aneurysm is not identified. Sudden death caused by rupture of a cerebral aneurysm has not been previously described in an infant. This report outlines the investigation and autopsy findings in a 7-month-old infant who died unexpectedly as a result of rupture of a complex basilar artery aneurysm.
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Affiliation(s)
- J Plunkett
- Regina Medical Center, Hastings, Minnesota 55033, USA
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27
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Abstract
Subdural hemorrhage, retinal hemorrhage, and cerebral edema have been considered diagnostic for a "shaken infant" since the syndrome was described almost 30 years ago. However, the specificity of these findings has been disputed by defense witnesses in recent U.S. criminal prosecutions. This review examines the scientific basis for the shaken baby syndrome.
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Affiliation(s)
- J Plunkett
- Regina Medical Center, and Minnesota Regional Coroner's Office, Hastings 55033, USA
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28
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Plunkett J, Thomas LC. Coroner and medical examiner systems. JAMA 1998; 280:325. [PMID: 9686545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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30
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Plunkett J. Serum tests for diagnosis of iron deficiency. Am J Clin Pathol 1990; 94:524-5. [PMID: 2220678 DOI: 10.1093/ajcp/94.4.524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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31
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Plunkett J. Sudden death and myocardial infarction in Minnesota. N Engl J Med 1984; 310:1187-8. [PMID: 6709015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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32
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Dwyer AJ, Prewitt JM, Ecker JG, Plunkett J. Use of the hazard rate to schedule follow-up exams efficiently. An optimization approach to patient management. Med Decis Making 1983; 3:229-44. [PMID: 6633190 DOI: 10.1177/0272989x8300300211] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The problem of surveillance for metastasis in a cancer patient is modeled as an allocation problem. The hazard rate of metastasis appearing determines the efficient scheduling of follow-up exams. An optimal schedule of follow-up exams is shown to be dependent on the hazard rate, K, and D. K relates the cost of testing to the benefit of early detection. It diminishes as benefit increases or cost diminishes. D is the time by which a metastasis' detection by testing precedes its clinical presentation. Hence it is a direct measure of the effectiveness of testing. The optimal testing frequency = (hazard rate/2K)1/2. Testing may be stopped when the hazard rate drops below 2K/D2. Tests need never be routinely scheduled if the intervals between tests exceed D in length.
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Dwyer AJ, Glaubiger DL, Ecker JG, Doppman JL, Prewitt JM, Plunkett J. The radiographic follow-up of patients with Ewing sarcoma: a demonstration of a general method. Radiology 1982; 145:327-31. [PMID: 7134429 DOI: 10.1148/radiology.145.2.7134429] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
An analysis of the patterns of detectable tumor recurrence using the concepts of hazard rate, predictive value, and cumulative probability was undertaken to assess the appearance of metastases in Ewing sarcoma. This study comprises 107 patients who were seen between 1964 and 1977. The distribution of the sites of metastases indicates that repeated examinations of both lungs and bones are necessary for the effective surveillance of both truncal and extremity primary lesions. The hazard rates for metastases suggest that these serial examinations should be concentrated early in the follow-up period for truncal primaries and more uniformly distributed for extremity primaries. The method used is general and is applicable to any disease for which the surveillance for recurrence or a complication is of major concern. The results of the analysis may be used in the selection and scheduling of follow-up examinations for patients with Ewing sarcoma, and in advising the patient of the prognosis for continued remission.
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Stein IM, Plunkett J, Troy M. Comparison of techniques for examining long-term ECG recordings. Med Instrum 1980; 14:69-72. [PMID: 6153451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The Holter superimposition method was compared with the Argus/H computer system and the Stein/Peterson frozen display technique in the analysis of 94 long-term ambulatory ECG recordings using technical staff experienced with each analysis procedure. The use of the Holter superimposition method resulted in a failure of detection of 33-66 percent of ventricular and supraventricular arrhythmias as compared to the two other computer-based playback systems. The Argus/H system and the frozen display method of Stein and Peterson were comparable with respect to ventricular arrhythmia detection, but the frozen display method was superior to the Argus/H system with respect to the detection of supraventricular arrhythmias.
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