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Súkeníková L, Mallone A, Schreiner B, Ripellino P, Nilsson J, Stoffel M, Ulbrich SE, Sallusto F, Latorre D. Autoreactive T cells target peripheral nerves in Guillain-Barré syndrome. Nature 2024; 626:160-168. [PMID: 38233524 PMCID: PMC10830418 DOI: 10.1038/s41586-023-06916-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 11/30/2023] [Indexed: 01/19/2024]
Abstract
Guillain-Barré syndrome (GBS) is a rare heterogenous disorder of the peripheral nervous system, which is usually triggered by a preceding infection, and causes a potentially life-threatening progressive muscle weakness1. Although GBS is considered an autoimmune disease, the mechanisms that underlie its distinct clinical subtypes remain largely unknown. Here, by combining in vitro T cell screening, single-cell RNA sequencing and T cell receptor (TCR) sequencing, we identify autoreactive memory CD4+ cells, that show a cytotoxic T helper 1 (TH1)-like phenotype, and rare CD8+ T cells that target myelin antigens of the peripheral nerves in patients with the demyelinating disease variant. We characterized more than 1,000 autoreactive single T cell clones, which revealed a polyclonal TCR repertoire, short CDR3β lengths, preferential HLA-DR restrictions and recognition of immunodominant epitopes. We found that autoreactive TCRβ clonotypes were expanded in the blood of the same patient at distinct disease stages and, notably, that they were shared in the blood and the cerebrospinal fluid across different patients with GBS, but not in control individuals. Finally, we identified myelin-reactive T cells in the nerve biopsy from one patient, which indicates that these cells contribute directly to disease pathophysiology. Collectively, our data provide clear evidence of autoreactive T cell immunity in a subset of patients with GBS, and open new perspectives in the field of inflammatory peripheral neuropathies, with potential impact for biomedical applications.
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Affiliation(s)
- L Súkeníková
- Institute of Microbiology, ETH Zurich, Zurich, Switzerland
| | - A Mallone
- Institute of Microbiology, ETH Zurich, Zurich, Switzerland
| | - B Schreiner
- Department of Neurology, University Hospital Zurich, Zurich, Switzerland
- Institute of Experimental Immunology, University of Zurich, Zurich, Switzerland
| | - P Ripellino
- Department of Neurology, Neurocenter of Southern Switzerland EOC, Lugano, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - J Nilsson
- Department of Immunology, University Hospital Zurich, Zurich, Switzerland
| | - M Stoffel
- Institute of Molecular Health Sciences, ETH Zurich, Zurich, Switzerland
- Medical Faculty, University of Zurich, Zurich, Switzerland
| | - S E Ulbrich
- Animal Physiology, Institute of Agricultural Sciences, ETH Zurich, Zurich, Switzerland
| | - F Sallusto
- Institute of Microbiology, ETH Zurich, Zurich, Switzerland
- Institute for Research in Biomedicine, Università della Svizzera Italiana, Bellinzona, Switzerland
| | - D Latorre
- Institute of Microbiology, ETH Zurich, Zurich, Switzerland.
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2
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Thalén NB, Barzadd MM, Lundqvist M, Rodhe J, Andersson M, Bidkhori G, Possner D, Su C, Nilsson J, Eisenhut P, Malm M, Karlsson A, Vestin J, Forsberg J, Nordling E, Mardinoglu A, Volk AL, Sandegren A, Rockberg J. Tuning of CHO secretional machinery improve activity of secreted therapeutic sulfatase 150-fold. Metab Eng 2024; 81:157-166. [PMID: 38081506 DOI: 10.1016/j.ymben.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 10/12/2023] [Accepted: 12/01/2023] [Indexed: 12/18/2023]
Abstract
Rare diseases are, despite their name, collectively common and millions of people are affected daily of conditions where treatment often is unavailable. Sulfatases are a large family of activating enzymes related to several of these diseases. Heritable genetic variations in sulfatases may lead to impaired activity and a reduced macromolecular breakdown within the lysosome, with several severe and lethal conditions as a consequence. While therapeutic options are scarce, treatment for some sulfatase deficiencies by recombinant enzyme replacement are available. The recombinant production of such sulfatases suffers greatly from both low product activity and yield, further limiting accessibility for patient groups. To mitigate the low product activity, we have investigated cellular properties through computational evaluation of cultures with varying media conditions and comparison of two CHO clones with different levels of one active sulfatase variant. Transcriptome analysis identified 18 genes in secretory pathways correlating with increased sulfatase production. Experimental validation by upregulation of a set of three key genes improved the specific enzymatic activity at varying degree up to 150-fold in another sulfatase variant, broadcasting general production benefits. We also identified a correlation between product mRNA levels and sulfatase activity that generated an increase in sulfatase activity when expressed with a weaker promoter. Furthermore, we suggest that our proposed workflow for resolving bottlenecks in cellular machineries, to be useful for improvements of cell factories for other biologics as well.
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Affiliation(s)
- Niklas Berndt Thalén
- Dept. of Protein science, KTH - Royal Institute of Technology, Stockholm, SE-106 91, Sweden
| | - Mona Moradi Barzadd
- Dept. of Protein science, KTH - Royal Institute of Technology, Stockholm, SE-106 91, Sweden
| | - Magnus Lundqvist
- Dept. of Protein science, KTH - Royal Institute of Technology, Stockholm, SE-106 91, Sweden
| | | | | | - Gholamreza Bidkhori
- Science for Life Laboratory, KTH - Royal Institute of Technology, Solna, 171 65, Sweden; AIVIVO Ltd. Unit 25, Bio-innovation centre, Cambridge Science park, Cambridge, UK
| | | | - Chao Su
- SOBI AB, Tomtebodavägen 23A, Stockholm, Sweden
| | | | - Peter Eisenhut
- ACIB - Austrian Centre of Industrial Biotechnology, Krenngasse 37, 8010 Graz, Austria; BOKU - University of Natural Resources and Life Sciences, Department of Biotechnology, Vienna, 1190, Austria
| | - Magdalena Malm
- Dept. of Protein science, KTH - Royal Institute of Technology, Stockholm, SE-106 91, Sweden
| | - Alice Karlsson
- Dept. of Protein science, KTH - Royal Institute of Technology, Stockholm, SE-106 91, Sweden
| | | | | | | | - Adil Mardinoglu
- Science for Life Laboratory, KTH - Royal Institute of Technology, Solna, 171 65, Sweden
| | - Anna-Luisa Volk
- Dept. of Protein science, KTH - Royal Institute of Technology, Stockholm, SE-106 91, Sweden
| | | | - Johan Rockberg
- Dept. of Protein science, KTH - Royal Institute of Technology, Stockholm, SE-106 91, Sweden.
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Sah V, Karlsson J, Bucher V, Olofsson Bagge R, Ny L, Nilsson L, Nilsson J. Using patient-derived xenografts as sources of 3D tumor sphere cultures to study autologous tumor-infiltrating lymphocytes in metastatic uveal melanoma. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)00922-4] [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: 11/15/2022]
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Schiopu A, Svedlund S, Yndigegn T, Varma V, Ongstad EL, Collen A, George RT, Wang X, Goncalves I, Nilsson J, Gan LM. Elevated soluble lectin-like oxidised low-density lipoprotein receptor-1 (sLOX-1) associated with increased risk for heart failure and MACE after an acute coronary event. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background/Introduction
The lectin-like oxidised low-density lipoprotein receptor (LOX-1) is involved in atherosclerotic plaque inflammation and vulnerability. Plasma levels of soluble LOX-1 (sLOX-1) have previously been associated with increased risk for recurrent coronary events and mortality in patients with acute coronary syndrome (ACS).
Purpose
To assess the association of sLOX-1 with the development of heart failure (HF) post-ACS.
Methods
We measured sLOX-1 in 524 patients with ACS within 24 hours after the acute event. A subgroup of 97 of these patients completed a follow-up echocardiogram after one year. The incidence of HF-related hospitalisation and recurrent major adverse cardiovascular events (MACE), defined as recurrent ACS or cardiovascular death, was followed for a mean period of two years. In a separate cohort of 363 patients with ACS and percutaneous coronary intervention (PCI), we studied the correlations between sLOX-1, coronary flow reserve, left ventricular systolic function and systemic inflammation at two follow-up visits within four weeks and 16 weeks post-ACS, respectively.
Results
Baseline sLOX-1 was positively associated with the risk of HF and MACE, independently of traditional cardiovascular risk factors, revascularisation and medication. The hazard ratios and 95% confidence intervals were 1.57 (1.10–2.23), p=0.012 for HF and 1.36 (1.08–1.71), p=0.009 for MACE per standard deviation baseline sLOX-1 increase. Elevated sLOX-1 was also negatively associated with lower-left ventricular ejection fraction at one year (r=−0.263, p=0.009). In the second ACS cohort, we found that plasma sLOX-1 measured at the two follow-up visits was negatively associated with coronary flow reserve and left ventricular systolic function, and positively correlated with biomarkers of systemic inflammation and cardiac overload.
Conclusion
Elevated sLOX-1 is associated with the development of HF and recurrent cardiovascular events in patients with ACS. Although this association study cannot confirm causality, the results suggest LOX-1 as a potential biomarker and treatment target in patients with ACS.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): • Swedish Research Council • The Swedish Heart and Lung foundation• Swedish Foundation for Strategic Research Dnr IRC15-0067 • Marianne and Marcus Wallenberg Foundation • Bundy Academy at Lund University
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Affiliation(s)
- A Schiopu
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - S Svedlund
- Department of Clinical Physiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - T Yndigegn
- Department of Cardiology, Skåne University Hospital, Lund, Sweden
| | - V Varma
- Translational Science and Experimental Medicine, Research and Early Development, CVRM, AstraZeneca, Gaithersburg, MD, United States of America
| | - E L Ongstad
- Bioscience Cardiovascular, Research and Early Development, CVRM, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, United States of America
| | - A Collen
- Projects, Research and Early Development, CVRM, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - R T George
- Early Clinical Development, Research and Early Development, CVRM, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, United States of America
| | - X Wang
- Translational Science and Experimental Medicine, Research and Early Development, CVRM, AstraZeneca, Gaithersburg, MD, United States of America
| | - I Goncalves
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - J Nilsson
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - L M Gan
- Early Clinical Development, Research and Early Development, CVRM, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
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Holm Nielsen S, Edsfeldt A, Tengryd C, Gustafsson H, Shore AC, Natali A, Khan F, Genovese F, Bengtsson E, Karsdal M, Leeming DJ, Nilsson J, Goncalves I. The novel collagen matrikine, endotrophin, is associated with mortality and cardiovascular events in patients with atherosclerosis. J Intern Med 2021; 290:179-189. [PMID: 33951242 PMCID: PMC8359970 DOI: 10.1111/joim.13253] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 11/27/2020] [Accepted: 12/08/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Rupture of atherosclerotic plaques is the major cause of acute cardiovascular events. The biomarker PRO-C6 measuring Endotrophin, a matrikine of collagen type VI, may provide valuable information detecting subjects in need of intensified strategies for secondary prevention. OBJECTIVE In this study, we evaluate endotrophin in human atherosclerotic plaques and circulating levels of PRO-C6 in patients with atherosclerosis, to determine the predictive potential of the biomarker. METHODS Sections from the stenotic human carotid plaques were stained with the PRO-C6 antibody. PRO-C6 was measured in serum of patients enrolled in the Carotid Plaque Imagining Project (CPIP) (discovery cohort, n = 577) and the innovative medicines initiative surrogate markers for micro- and macrovascular hard end-points for innovative diabetes tools (IMI-SUMMIT, validation cohort, n = 1,378). Median follow-up was 43 months. Kaplan-Meier curves and log-rank tests were performed in the discovery cohort. Cox proportional hazard regression analysis (HR with 95% CI) was used in the discovery cohort and binary logistic regression (OR with 95% CI) in the validation cohort. RESULTS PRO-C6 was localized in the core and shoulder of the atherosclerotic plaque. In the discovery cohort, PRO-C6 independently predicted future cardiovascular events (HR 1.089 [95% CI 1.019 -1.164], p = 0.01), cardiovascular death (HR 1.118 [95% CI 1.008 -1.241], p = 0.04) and all-cause death (HR 1.087 [95% CI 1.008 -1.172], p = 0.03). In the validation cohort, PRO-C6 predicted future cardiovascular events (OR 1.063 [95% CI 1.011 -1.117], p = 0.017). CONCLUSION PRO-C6 is present in the atherosclerotic plaque and associated with future cardiovascular events, cardiovascular death and all-cause mortality in two large prospective cohorts.
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Affiliation(s)
- S Holm Nielsen
- Nordic Bioscience, Herlev, Denmark.,Department of Biomedicine and Biotechnology, Technical University of Denmark, Lyngby, Denmark
| | - A Edsfeldt
- Department of Cardiology, Skåne University Hospital, Malmö, Sweden.,Department of Clinical Sciences, Lund University, Malmö, Sweden.,Wallenberg Center for Molecular Medicine, Lund University, Malmö, Sweden
| | - C Tengryd
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - H Gustafsson
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - A C Shore
- Diabetes and Vascular Medicine, University of Exeter, Medical School, National Institute for Health Research Exeter Clinical Research Facility, Exeter, UK
| | - A Natali
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - F Khan
- Division of Molecular and Clinical medicine, University of Dundee, Dundee, UK
| | | | - E Bengtsson
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | | | | | - J Nilsson
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - I Goncalves
- Department of Cardiology, Skåne University Hospital, Malmö, Sweden.,Department of Clinical Sciences, Lund University, Malmö, Sweden
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Folkedal O, Utskot SO, Nilsson J. Thermal delousing in anaesthetised small Atlantic salmon (Salmo salar) post-smolts: A case study showing the viability of anaesthesia prior to delousing for improved welfare during treatment for salmon lice. Anim Welf 2021. [DOI: 10.7120/09627286.30.2.117] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Delousing treatment for salmon sea lice (Lepeophtheirus salmonis) is considered a significant welfare concern in farming of Atlantic salmon ( Salmo salar), where both industry and legislative bodies prompt for better methods. Currently, the most common method is thermal
delousing, where fish are crowded, pumped into a vessel and exposed to ∼28–34°C for ∼30 s. Physical collisions occurring as a result of a loss of behavioural control lead to acute stress. Crowding triggers vigorous escape behaviour as salmon respond not only to treatment
but also to being channeled to and from the treatment zone. A sequence of events considered to cause mortality and poor welfare. The present case study was motivated by an urgent need for delousing in groups of small salmon post-smolts in experimental research. For this purpose, a simple,
small-scale system for thermal delousing was constructed, including anaesthesia to alleviate behavioural responses. The anaesthetised fish showed little behavioural response to thermal treatment, strong appetite within hours, and negligible mortality. The described method is regarded as a
welfare-friendly alternative to industrial delousing in smaller fish groups, for example, in experimental research. We would encourage detailed research aimed towards gaining a deeper under-standing of the welfare effects of anaesthesia prior to treatment for delousing.
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Ringdal M, Bergbom I, Nilsson J, Karlsson V. Older patients' recovery following intensive care: A follow-up study with the RAIN questionnaire. Intensive Crit Care Nurs 2021; 65:103038. [PMID: 33775549 DOI: 10.1016/j.iccn.2021.103038] [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: 06/30/2020] [Revised: 02/10/2021] [Accepted: 02/18/2021] [Indexed: 12/12/2022]
Abstract
The aim was to investigate older patient recovery (65 years+) up to two years following discharge from an intensive care unit (ICU) using the Recovery After Intensive Care (RAIN) instrument and to correlate RAIN with the Hospital Anxiety and Depression Scale (HAD). METHODS An explorative and descriptive longitudinal design was used. Eighty-two patients answered RAIN and HAD at least twice following discharge. Demographic and clinical data were collected from patient records. RESULTS Recovery after the ICU was relatively stable and good for older patients at the four data collection points. There was little variation on the RAIN subscales over time. The greatest recovery improvement was found in existential ruminations from 2 to 24 months. A patient that could look forward and those with supportive relatives had the highest scores at all four measurements. Having lower financial situation was correlated to poorer recovery and was significant at 24 months. The RAIN and HAD instruments showed significant correlations, except for the revaluation of life subscale, which is not an aspect in HAD. CONCLUSION The RAIN instrument shows to be a good measurement for all dimensions of recovery, including existential dimensions, which are not covered by any other instrument.
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Affiliation(s)
- M Ringdal
- Institute of Health and Care Sciences at Sahlgrenska Academy, University of Gothenburg, Kungälvs Hospital, Sweden.
| | - I Bergbom
- Institute of Health and Care Sciences at Sahlgrenska Academy, University of Gothenburg, Sweden, Professor Emerita, Honorary Doctor at Åbo Academy, Åbo, Finland
| | - J Nilsson
- Institute of Health and Care Sciences at Sahlgrenska Academy, University of Gothenburg, Sweden
| | - V Karlsson
- Department of Health Science, University West, Trollhättan, Sweden
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Nilsson J, Winfree K, Molife C, Bhattacharyya D, D'Yachova Y, Wang X, Malmenäs M, Taipale K. P10.04 A Budget Impact Analysis for Treatment with Ramucirumab Plus Erlotinib in Metastatic EGFR-Mutated NSCLC in the US. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.493] [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: 10/21/2022]
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Shami A, Edsfeldt A, Shore A, Natali A, Khan F, Nilsson J, Lutgens E, Goncalves I. CD40 levels in plasma are associated with cardiovascular disease and in carotid plaques with a vulnerable plaque phenotype and remodelling. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3782] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and purpose
CD40 and CD40 ligand (CD40L) are costimulatory molecules and members of the TNF receptor superfamily well known for their involvement in inflammatory and autoimmune diseases. This study uses two large human cohorts – the SUrrogate markers for Micro- and Macro-vascular hard endpoints for Innovative diabetes Tools (SUMMIT) and the Carotid Plaque Imaging Project (CPIP) – to explore the potential of plasma or intra-plaque expression of CD40 and CD40L as biomarkers and to locally affect plaque stability.
Methods
Proximity Extension Assay (PEA) technique was used to measure soluble CD40 and CD40L (sCD40 and sCD40L) in plasma from 1437 subjects from the SUMMIT cohort, the majority of which (80%) with pre-existing cardiovascular disease, and in atherosclerotic plaque homogenates from 199 subjects of the CPIP cohort undergoing carotid endarterectomy. The Mann-Whitney U test was used to compare groups and Spearman's rank correlation/the Chi-square test was used to assess correlations. Multiple comparisons were corrected for using the Holm-Šídák test. A logistic regression model was used to test for associations with future cardiovascular events and mortality.
Results
In the SUMMIT cohort both plasma CD40 and CD40L levels were elevated in individuals with a history of stroke (p=0.000030 and p=0.020, respectively), while sCD40 levels also were higher in individuals with a prior acute myocardial infarction (p=0.016). Plasma levels of sCD40 correlated with carotid plaque burden (as measured by ultrasound imaging, r=0.355, p<1x10–16) and were associated with future cardiovascular events over a three year-follow up period (p=0.02, hazard ratio 1.3, 95% C.I: 1.042–1.625).
sCD40 and sCD40L were associated with a plaque phenotype characterized by the strong presence of features both of vulnerability such as high content oxidized low-density lipoprotein (LDL; r=0.236, p=0.004 and r=0.259, p=0.0037, respectively) and pro-inflammatory cytokines (e.g. tumour necrosis factor-α: p=3.1x10–7 and p=0.0006, respectively) and low calcium content (r=−0.208, p=0.012 and r=0.268, p=0.00034, respectively).
Conclusion
High plasma CD40 and CD40L levels are associated with symptomatic cardiovascular disease. Plasma CD40 levels correlate with the severity of carotid atherosclerosis and are associated with an increased risk for future cardiovascular events. Additionally, intra-plaque levels are associated with a vulnerable plaque phenotype. Our findings thus support the value of sCD40 and sCD40L both as biomarkers and therapeutic targets for cardiovascular disease.
Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): The Swedish Heart and Lung Foundation (1) and the Swedish Research Council (2)
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Affiliation(s)
- A Shami
- Lund University, Dept. of Clinical Sciences Malmö, Malmo, Sweden
| | - A Edsfeldt
- Lund University, Dept. of Clinical Sciences Malmö and Dept. of Cardiology, Skane University Hospital, Malmo, Sweden
| | - A.C Shore
- University of Exeter, Diabetes and Vascular Medicine, Exeter, United Kingdom
| | - A Natali
- University of Pisa, Department of Clinical and Experimental Medicine, Pisa, Italy
| | - F Khan
- University of Dundee, Division of Molecular and Clinical medicine, Dundee, United Kingdom
| | - J Nilsson
- Lund University, Dept. of Clinical Sciences Malmö, Malmo, Sweden
| | - E Lutgens
- Amsterdam UMC, Dept. of Medical Biochemistry, Amsterdam, Netherlands (The)
| | - I Goncalves
- Lund University, Dept. of Clinical Sciences Malmö and Dept. of Cardiology, Skane University Hospital, Malmo, Sweden
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Holm Nielsen S, Shami A, Jonasson L, Swahn E, Auf Dem Keller U, Genovese F, Karsdal M, Grufman H, Yndigegn T, Schiopu A, Nilsson J, Edsfeldt A, Alfredsson J, Goncalves I. Collagen remodeling markers show differentiated expression in patients with ST- and non-ST elevation myocardial infarction. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Following acute myocardial infarction (MI), the left ventricle undergoes molecular and extracellular matrix (ECM) changes. The ECM is a dynamic structure with a potential role in cardiac remodeling post-MI. Collagens are the major components of both cardiac and arterial ECM.
Purpose
We evaluated circulating levels of type I, IV and VI collagen fragments in two cohorts of patients with acute MI to investigate collagen turnover post-MI. The cohorts were Malmö AMI in elderly (MAMI-Y) and Assessing Platelet Activity in Coronary Heart Disease (APACHE).
Methods
Serum was collected from 190 patients from the discovery cohort (MAMI-Y: mean age 74, SD 10.8) at four timepoints: admission when MI, after 3–6 days, 6 weeks, 12 months; citrate plasma was collected from 142 patients from the validation cohort (APACHE: mean age 65, SD 11.6) at four timepoints: hospitalization, 3 days, 7–9 days, 6 months. The biomarkers of matrix metalloproteinase (MMP)-mediated degradation of type I collagen (C1M), MMP-mediated degradation of type IV collagen (C4M) and formation of type VI collagen (PRO-C6) were measured at all timepoints (immunosorbent assays). Differences in the markers at the different timepoints were calculated using repeated measures ANOVA.
Results
Circulating levels of the formation biomarker PRO-C6 significantly increased from baseline and remained high at all three following timepoints in both MAMI-Y and APACHE studies (all p<0.001). In contrast, the degradation biomarkers C1M and C4M showed a similar pattern of an initial increase 3 days post-MI followed by a decrease over time, with C1M in MAMI-Y and both C1M and C4M in APACHE having returned to baseline level by the final timepoint. Circulating baseline levels of PRO-C6 correlated with age (r=0.397, p<0.0001 in MAMI-Y, r=0.427, p<0.0001 in APACHE). Categorizing the subjects into ST elevation MI (STEMI; MAMI-Y: N=67, APACHE: N=71) or non-ST elevation MI (NSTEMI; MAMI-Y: N=130, APACHE: N=52) revealed that a correlation with age remained in both subgroups (r=0.443, p<0.0001 and r=0.325, p<0.0001, respectively, in MAMI-Y, and r=0.516, p<0.0001 and r=0.316, p=0.023, respectively, in APACHE). Moreover, PRO-C6 was elevated in STEMI patients that had previously experienced an MI in both cohorts (MAMI-Y: p=0.017, APACHE: p=0.016). C1M and C4M levels were not different in patients with prior MI in any of the cohorts. No association was found between any biomarker and gender or diabetes. Echocardiography showed a correlation between baseline levels of C1M and ejection fraction (r=0.228, p=0.023) in the whole MAMI-Y cohort and among NSTEMI, but not among STEMI, subjects (r=0.337, p=0.004).
Conclusions
We observed changes in circulating fragments reflecting collagen turnover in the acute phase post-MI, more pronounced in STEMI patients. This may indicate that STEMI patients have more active collagen remodeling than NSTEMI patients and may have more altered left ventricle function and remodeling.
Funding Acknowledgement
Type of funding source: Other. Main funding source(s): This work was supported by the Danish Research Foundation “den danske forskningsfond”, the Innovation foundation (Innovationsfonden), Swedish Research Council, Swedish Heart and Lung Foundation, Swedish Society for Medical Research, Swedish Society of Medicine, the Crafoord Foundation, the Åke Wiberg foundation and the Stroke foundation.
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Affiliation(s)
- S Holm Nielsen
- Nordic Bioscience, Biomarkers and Research, Herlev, Denmark
| | - A Shami
- Lund University, Clinical Sciences Malmö, Malmö, Sweden
| | - L Jonasson
- Linkoping University, Cardiology, University Hospital and Health, Medicine and Caring Sciences, Linkoping, Sweden
| | - E Swahn
- Linkoping University, Cardiology, University Hospital and Health, Medicine and Caring Sciences, Linkoping, Sweden
| | - U Auf Dem Keller
- Technical University of Denmark, Biomedicine and Biotechnology, Lyngby, Denmark
| | - F Genovese
- Nordic Bioscience, Biomarkers and Research, Herlev, Denmark
| | - M Karsdal
- Nordic Bioscience, Biomarkers and Research, Herlev, Denmark
| | - H Grufman
- Lund University, Clinical Sciences Malmö, Malmö, Sweden
| | - T Yndigegn
- Lund University, Clinical Sciences Malmö and Department of Cardiology, Malmö, Sweden
| | - A Schiopu
- Lund University, Clinical Sciences Malmö, Malmö, Sweden
| | - J Nilsson
- Lund University, Clinical Sciences Malmö, Malmö, Sweden
| | - A Edsfeldt
- Lund University, Clinical Sciences Malmö and Department of Cardiology, Malmö, Sweden
| | - J Alfredsson
- Linkoping University, Cardiology, University Hospital and Health, Medicine and Caring Sciences, Linkoping, Sweden
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Grauen Larsen H, Sjogren M, Engstrom G, Nilsson P, Orho-Melander M, Nilsson J, Melander O, Schiopu A. The Gly82Ser polymorphism in the receptor for advanced glycation end products is associated with increased risk for coronary events in the general population. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background/Introduction
Activation of the receptor for advanced glycation end products (RAGE) by AGEs and various immune mediators has pro-inflammatory and pro-atherogenic effects. RAGE also exists in a soluble form, sRAGE, that acts as a decoy receptor for RAGE ligands. Low plasma sRAGE has previously been found to be associated with a higher risk for major adverse coronary events (MACE) in the population.
Purpose
The purpose of our study was to examine the causality of the association, by exploring whether genetic variants that influence sRAGE are associated with atherosclerosis progression and incident MACE and mortality in the population.
Methods
We performed a genome-wide association study (GWAS) in 4192 individuals from a randomly selected subgroup of a population-based cohort. Subsequently, we explored the associations between the identified single nucleotide polymorphims (SNPs) associated with plasma sRAGE levels, baseline intima media thickness (IMT) and IMT progression in the common carotid artery during a median follow-up of 16.5 years. Further, we analyzed the prospective relationships between the sRAGE-associated SNPs, incident MACE and mortality in the entire population-based cohort of 29245 individuals. The median follow-up time from baseline was 21.2 years for MACE and 21.6 years for total mortality (time to event or end of follow-up).
Results
We found the minor alleles of two single nucleotide polymorphisms (SNPs), rs2070600 and rs204993, to be independently associated with lower plasma sRAGE. While rs204993 is a silent intronic mutation, rs2070600 is known to cause a Gly82Ser polymorphism in the ligand binding domain, enhancing RAGE propensity for activation. In Cox regression analyses, we found an association between the minor T (vs. C) allele of rs2070600 and increased risk for first-time MACE [HR 1.12 (1.02–1.23); P=0.023]. The association was independent of traditional cardiovascular risk factors, blood pressure-lowering medication and lipid-lowering medication at baseline. rs204993 was not associated with MACE. Neither SNP was associated with carotid IMT at baseline or with IMT progression. We did not identify any relationships with total mortality.
Conclusions
We demonstrate for the first time an independent link between a genetic RAGE determinant and the risk for MACE in the population. Despite both identified SNPs being associated with lower sRAGE levels, only the functional rs2070600 mutation was associated with MACE, suggesting that the link is probably due to the enhancement of RAGE function rather than to the sRAGE lowering effect.
Funding Acknowledgement
Type of funding source: Public Institution(s). Main funding source(s): This study was supported by grants from the Swedish Research Council and the Swedish Heart and Lung foundation.
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Affiliation(s)
- H Grauen Larsen
- Lund University, Department of Clinical Sciences Malmö, Malmo, Sweden
| | - M Sjogren
- Lund University, Department of Clinical Sciences Malmö, Malmo, Sweden
| | - G Engstrom
- Lund University, Department of Clinical Sciences Malmö, Malmo, Sweden
| | - P.M Nilsson
- Lund University, Department of Clinical Sciences Malmö, Malmo, Sweden
| | - M Orho-Melander
- Lund University, Department of Clinical Sciences Malmö, Malmo, Sweden
| | - J Nilsson
- Lund University, Department of Clinical Sciences Malmö, Malmo, Sweden
| | - O Melander
- Lund University, Department of Clinical Sciences Malmö, Malmo, Sweden
| | - A Schiopu
- Lund University, Department of Clinical Sciences Malmö, Malmo, Sweden
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Tanaka E, Inoue E, Shoji A, Nilsson J, Papagiannopoulos C, Devender D, Anazawa Y, Yoshizawa Y, Harigai M. AB1199 COST-EFFECTIVENESS OF EARLY INITIATION OF ABATACEPT ON JAPANESE RHEUMATOID ARTHRITIS PATIENTS BASED ON THE AMPLE STUDY, USING IORRA REAL WORLD DATA. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Rheumatoid arthritis (RA) is a chronic inflammatory disorder leading to disability and reduced quality of life. Effective treatment with biologic disease-modifying antirheumatic drugs (bDMARD) poses a significant economic burden. The abatacept (ABT) versus adalimumab comparison in biologic-naive RA subjects with background methotrexate (AMPLE) trial1was a head-to-head randomized study.Objectives:To assess the cost-effectiveness (CE) of early initiation of ABT on Japanese RA patients with data from the IORRA database (ID).2Methods:A model based on the AMPLE study was used to estimate the CE of ABT 1stversus ABT 2ndlines in a cohort of 1000 patients based on responses on ACR20/50/70, HAQ-DI, CDAI and SDAI estimated from the real-clinical data of the ID. Unit costs for direct medical costs of adverse events (AEs), proportions of patients with concomitant medications or outpatient/inpatient visits; doses and duration of concomitant medications were taken from the JMDC claims database.3Uncertainty was assessed in sensitivity analyses (SA) where cost parameters were tested on their ±30% levels. Results were compared between subgroups using cut-offs of 65-years of age and 1.5 of HAQ, or 5-years of treatment duration. The study used a Japanese healthcare payers’ perspective over a 2-year time horizon.Results:Incremental costs were all in favor of ABT 2ndline with 137 MJPY (1.1 M€, 120 JPY=1 €), 6 MJPY (0.05 M€), 41 MJPY (0.3 M€), 8 MJPY (0.07 M€) and 2.2 MJPY (0.02 M€) for bDMARDs, concomitant medication, AEs, serious AE, and hospitalizations due to infections, respectively. In total, the incremental costs were expected to be 195 MJPY (1.6 M€) higher for ABT as 1stline treatment, but the cost per responding patient and per patient in remission favored ABT 1stline across most response outcomes (Table 1).Table 1.Total costs per responder and patient in remission per 2-yearDifference in cost per health gain(ABT first line - ABT second line)Cost per responding patient (kJPY)ACR20-2,927 (-24 k€)ACR50-6,406 (-53 k€)ACR70-10,822 (-90 k€)HAQ-DI-5,120 (-43 k€)Cost per patient in remission (kJPY)DAS28828 (7 k€)CDAI-7,019 (-58 k€)SDAI-5,584 (-47 k€)ABT=abatacept; ACR20/50/70= 20/50/70% improvement of the American college of rheumatology criteria; HAQ-DI=health assessment questionnaire disability index; DAS28=disease activity score; CDAI=clinical disease activity index; SDAI=simplified disease activity indexSA showed that the cost for bDMARDs drives the difference in healthcare costs between the cohorts (-685 MJPY to 1,074 MJPY). For sub-groups of patients ≥65 years, <65 years, HAQ≥1.5, HAQ <1.5, treatment duration ≥5 years, <5 years the total 2-yearly costs per responder (SDAI remission) were 106 kJPY (0.9 k€), 321 kJPY (2.7 k€), 1,353 kJPY (11.3 k€), 106 kJPY (0.9 k€), 231 kJPY (1.9 k€) and 178 kJPY (1.5 k€) lower for ABT 1stline, respectively.Conclusion:Savings per responding patient are expected if ABT are prescribed as 1stline versus 2ndor 3rdline treatment, irrespective of age, disease duration and functional impairment level.References:[1]Sokolove J MS et al.,Anna rheum dis.2015;74(Suppl 2)[2]IORRA cohort database, Tokyo Women’s Medical University, Tokyo, Japan[3]JMDC claims database, Tokyo, JapanDisclosure of Interests:Eiichi Tanaka Consultant of: ET has received lecture fees or consulting fees from Abbvie, Asahi Kasei pharma co., Bristol Myers Squibb, Chugai Pharmaceutical, Daiichi Sankyo Co., Eisai Pharmaceutical, Janssen Pharmaceutical K.K., Nippon Kayaku, Pfizer, Takeda Pharmaceutical, Taisho Toyama Pharmaceutical Co., and UCB Pharma., Speakers bureau: ET has received lecture fees or consulting fees from Abbvie, Asahi Kasei pharma co., Bristol Myers Squibb, Chugai Pharmaceutical, Daiichi Sankyo Co., Eisai Pharmaceutical, Janssen Pharmaceutical K.K., Nippon Kayaku, Pfizer, Takeda Pharmaceutical, Taisho Toyama Pharmaceutical Co., and UCB Pharma., Eisuke Inoue Speakers bureau: EI has received speaker fee from Bristol-Meyers, Pfizer, Merck serono., Ayako Shoji Consultant of: To conduct this work, Jonas Nilsson Consultant of: To conduct this study, Christos Papagiannopoulos Consultant of: To conduct this study, Dhanda Devender Shareholder of: BMS, Employee of: BMS, Yoshio Anazawa Shareholder of: BMS, Employee of: BMS, Yuri Yoshizawa Shareholder of: BMS, Employee of: BMS, masayoshi harigai Grant/research support from: AbbVie Japan GK, Ayumi Pharmaceutical Co., Bristol Myers Squibb Co., Ltd., Eisai Co., Ltd., Mitsubishi Tanabe Pharma Co., Nippon Kayaku Co., Ltd., and Teijin Pharma Ltd. MH has received speaker’s fee from AbbVie Japan GK, Ayumi Pharmaceutical Co., Boehringer Ingelheim Japan, Inc., Bristol Myers Squibb Co., Ltd., Chugai Pharmaceutical Co., Ltd., Eisai Co., Ltd., Eli Lilly Japan K.K., GlaxoSmithKline K.K., Kissei Pharmaceutical Co., Ltd., Oxford Immuotec, Pfizer Japan Inc., and Teijin Pharma Ltd. MH is a consultant for AbbVie, Boehringer-ingelheim, Kissei Pharmaceutical Co., Ltd. and Teijin Pharma.
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Holm Nielsen S, Jonasson L, Kalogeropoulos K, Karsdal MA, Reese-Petersen AL, Auf dem Keller U, Genovese F, Nilsson J, Goncalves I. Exploring the role of extracellular matrix proteins to develop biomarkers of plaque vulnerability and outcome. J Intern Med 2020; 287:493-513. [PMID: 32012358 DOI: 10.1111/joim.13034] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 11/04/2019] [Accepted: 01/13/2020] [Indexed: 12/14/2022]
Abstract
Cardiovascular disease (CVD) is the most common cause of death in industrialized countries. One underlying cause is atherosclerosis, which is a systemic disease characterized by plaques of retained lipids, inflammatory cells, apoptotic cells, calcium and extracellular matrix (ECM) proteins in the arterial wall. The biologic composition of an atherosclerotic plaque determines whether the plaque is more or less vulnerable, that is prone to rupture or erosion. Here, the ECM and tissue repair play an important role in plaque stability, vulnerability and progression. This review will focus on ECM remodelling in atherosclerotic plaques, with focus on how ECM biomarkers might predict plaque vulnerability and outcome.
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Affiliation(s)
- S Holm Nielsen
- From the, Biomarkers and Research, Nordic Bioscience, Herlev, Denmark.,Department of Biotechnology and Biomedicine, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - L Jonasson
- Department of Medical and Health Sciences, Division of Cardiovascular Medicine, Linköping University, Linköping, Sweden
| | - K Kalogeropoulos
- Department of Biotechnology and Biomedicine, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - M A Karsdal
- From the, Biomarkers and Research, Nordic Bioscience, Herlev, Denmark
| | | | - U Auf dem Keller
- Department of Biotechnology and Biomedicine, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - F Genovese
- From the, Biomarkers and Research, Nordic Bioscience, Herlev, Denmark
| | - J Nilsson
- Experimental Cardiovascular Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - I Goncalves
- Experimental Cardiovascular Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.,Department of Cardiology, Skåne University Hospital, Malmö, Sweden
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Esmaily S, Dellgren G, Bobbio E, Nilsson J, Rådegran G, Braun O, Gjesdal G, Löfman I, Melin M, Karason K. Patient Outcomes after Heart Transplantation in Sweden between 1988 and 2017: Continuous Improvement in Survival. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.626] [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: 11/26/2022] Open
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Braun O, Brambatti M, Shah P, Cipriani M, Veenis J, Bui Q, Hong K, de Heyning C, Perna E, Timmermans P, Cikes M, Gjesdal G, Partida C, Potena L, Masetti M, Loforte A, Jakus N, Nilsson J, De Bock D, Minto J, Brugts J, Sterken C, Van den Bossche K, Rega F, Sing R, Russo C, Pretorius V, Klein L, Frigerio M, Adler E, Ammirati E. ICD Therapy Confers No Survival Advantage in a Global LVAD Population: Insights from the Trans-Atlantic Registry on VAD and Transplant (TRAViATA). J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.783] [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: 11/29/2022] Open
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16
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Zar G, Vihinen M, Nilsson J. Identify New Genetic Variants on Chromosome 6 Associated with Mortality after Heart Transplantation. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.015] [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: 11/24/2022] Open
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17
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Grauen Larsen H, Nilsson PM, Nilsson J, Engstrom G, Melander O, Orho-Melander M, Schiopu A. P5510High plasma sRAGE is associated with slower carotid intima media thickness progression and lower risk for first-time coronary events and mortality. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background/Introduction
The receptor for advanced glycation end products (RAGE) and the extracellular matrix metalloproteinase inducer (EMMPRIN) are immune receptors for pro-inflammatory mediators. These receptors can also be found in a soluble form in the circulation. Soluble RAGE (sRAGE) has shown atheroprotective properties in animal studies, by acting as a decoy receptor for its ligands. Whether sEMMPRIN has similar roles is unknown.
Purpose
The purpose of our study was to investigate the associations between sRAGE and sEMMPRIN in plasma and the progression of vascular disease, incident coronary events and mortality in the general population.
Methods
We measured baseline sRAGE and sEMMPRIN in 4612 cardiovascular disease-free middle aged individuals from a population-based cohort. Measurements of intima media thickness (IMT) in the common carotid artery were performed at inclusion and after a median of 16.5 years. Incident major adverse coronary events (MACE) and mortality were recorded during a follow-up period of 21 years.
Results
sRAGE was negatively correlated with the progression of carotid IMT, independently of traditional cardiovascular risk factors, kidney function and hsCRP. Additionally, sRAGE was associated with decreased risk for MACE [HR=0.91 (0.83–0.99); p=0.031] and total mortality [HR=0.92 (0.87–0.99); p=0.017] in multivariate Cox regression analyses. We found no correlations between EMMPRIN, IMT progression or prognosis.
Conclusion
We show that individuals with high levels of circulating sRAGE have a slower rate of carotid artery disease progression, and a lower risk for coronary events and mortality. These findings support further research into the potential atheroprotective properties of sRAGE.
Acknowledgement/Funding
This study was supported by grants from the Swedish Research Council, Marianne and Marcus Wallenberg Foundation, Swedish Heart and Lung Foundation
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Affiliation(s)
- H Grauen Larsen
- Lund University, Institution for clinical science, Malmö, Malmo, Sweden
| | - P M Nilsson
- Lund University, Institution for clinical science, Malmö, Malmo, Sweden
| | - J Nilsson
- Lund University, Institution for clinical science, Malmö, Malmo, Sweden
| | - G Engstrom
- Lund University, Institution for clinical science, Malmö, Malmo, Sweden
| | - O Melander
- Lund University, Institution for clinical science, Malmö, Malmo, Sweden
| | - M Orho-Melander
- Lund University, Institution for clinical science, Malmö, Malmo, Sweden
| | - A Schiopu
- Lund University, Institution for clinical science, Malmö, Malmo, Sweden
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18
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Fernandez C, Rysa J, Nilsson J, Engstrom G, Orho-Melander M, Ruskoaho H, Melander O. 5949Interleukin-6 and growth differentiation factor-15 in hypertensive heart failure. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Hypertension is the leading cause for the development of heart failure (HF). Increased hemodynamic load, including mechanical stretch and neurohumoral factors, is able to trigger hypertrophic growth of cardiac myocytes. Although hypertensive HF is prevalent, there is no useful biomarker to identify HF due to chronic hypertension.
Aims
To identify plasma markers associated with incidence of hypertensive HF.
Methods
Circulating levels of 149 proteins were measured by proximity extension assay at baseline examination in 4469 individuals from the Malmö Diet and Cancer study. Protein levels were compared to stretch-activated gene expression changes in cultured neonatal rat ventricular myocytes (NRVM) in response to 1, 4, 12, 24 or 48 hours of cyclic mechanical stretch. Association between plasma proteins level and HF incidence and hypertension was studied using respectively Cox proportional hazards model and binary logistic regressions.
Results
After Bonferroni correction, 44 circulating proteins were significantly differentially expressed in individuals who developed HF during follow-up versus controls (P<3.4E-4). Out of these, 5 proteins (Interleukin-6 (IL-6), Growth Differentiation Factor-15 (GDF15), Interleukin-1 Receptor-Like-1 (ST2), Plasminogen Activator Urokinase Receptor (U-PAR), Transforming Growth Factor-α (TGF-α)), corresponding mRNA levels were upregulated by mechanical stretch in NRVM at all time points (P<0.05). Similar upregulation for the 5 proteins was shown in hypertensive versus normotensive individuals (P≤8.05E-4). In a model with all 5 proteins entered simultaneously, GDF15 and IL-6 were predictive of incident HF after adjustment for age, sex and NT-BNP levels (205 events; hazard ratio [HR] per SD increment of protein: HR=1.29, CI=1.05–1.58, P=0.013 and HR=1.16, CI=1.02–1.33, P=0.028). Using the same model, IL-6 but not GDF15 associated with hypertension (Odds ratio [OR] per SD increment of IL-6: OR=1.18, CI=1.09–1.27, P=3.3E-5). In hypertensive individuals GDF15 and IL-6 were individually predictive of future HF after adjustment for age, sex, NT-BNP levels, smoking, BMI and diabetes (183 events; HR=1.36, CI=1.16–1.60, P=1.64E-4 and HR=1.21, CI=1.05–1.40, P=0.008). Furthermore, in these hypertensive individuals, GDF15 and IL-6 were predictive of HF in a model with IL-6, GDF15, ST2 and TGF-α entered simultaneously after adjustment for age, sex and NT-BNP levels (176 events; HR=1.36, CI=1.13–1.64, P=0.001 and HR=1.16, CI=1.01–1.34, P=0.041).
Conclusions
Circulating levels of IL-6 and GDF15 might be used as NT-BNP independent biomarkers for HF development in hypertensive patients.
Acknowledgement/Funding
Påhlsson, Crafoord, Lundström, Åke Wiberg, Royal Physiographic Society and the Swedish Foundation for Strategic Research for IRC15-0067
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Affiliation(s)
| | - J Rysa
- University of Eastern Finland, Kuopio, Finland
| | | | | | | | - H Ruskoaho
- University of Helsinki, Helsinki, Finland
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Goncalves I, Tengryd C, Nielsen SH, Genovese F, Bengtsson E, Karsdal M, Leeming DJ, Nilsson J, Edsfeldt A. 3046High levels of MMP-cleaved mimecan is associated to carotid plaque stability and less future cardiovascular events. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
The clinical consequences of atherosclerosis, myocardial infarction and stroke are the most common causes of death globally. Mimecan, a small leucine rich-repeat proteoglycan (SLRP), is cleaved by matrix metalloproteinases (MMPs) and known to be involved in collagen fibrillogenesis and angiogenesis. Circulating levels of MMP-cleaved mimecan (cMIM) has previously been identified as a marker of extracellular matrix remodelling in ApoE−/− knockout mice. The role of mimecan and its degradation in human atherosclerotic plaques has not been explored.
Purpose
We explored whether full-length mimecan and cleaved mimecan (cMIM) are associated to plaque composition and evaluated if they can predict future cardiovascular events.
Methods
Two hundred and eighteen human atherosclerotic plaques were stained for mimecan using immunohistochemistry. cMIM was measured in 202 plaque tissue homogenates using a competitive ELISA assay. Histological components (α-actin, CD68 and glycophorin A) were assessed using immunohistochemistry, neutral lipids were measured using Oil Red O and visible areas of calcium deposits were quantified. Matrix metalloproteinases (MMP-1, -2, -3, -9, -10 and -12), tissue inhibitors of matrix metalloproteinases (TIMP-1 and -2) were analysed in plaque tissue homogenates using ELISA assays and a proximity extension assay. ECM components (glycosaminoglycans, collagen and elastin) were detected with colorimetric assays and the TGF-β1, β2 and β3 were measured by a multiplex assay. Cardiovascular events were registered using national registers, patient records and telephone calls during a follow-up period of 59 months IQR (34–73).
Results
Mimecan was expressed in human atherosclerotic plaques. The expression correlated positively with neutral lipids and intraplaque hemorrhage and inversely with α-actin. In contrast cMIM correlated with α-actin and inversely with neutral lipids. cMIM correlated also with stabilizing extracellular matrix proteins elastin, collagen as well as TGF-β1, β2 and β3. Mimecan correlated to MMP-9 and cMIM correlated to MMP-2 and TIMP-2. Patient with high levels of cMIM had a lower risk of future cardiovascular events which remained significant after adjusting for risk factors (age, gender, diabetes and symptoms) in a multivariate Cox regression
Conclusion(s)
Mimecan was associated with vulnerable plaque features, whereas cMIM was related to stable plaque features. Low levels of cMIM predicted future cardiovascular events, independently of known risk factors. Taken together this suggests a possible role for mimecan and its cleavage in atherosclerosis that needs to be further explored.
Acknowledgement/Funding
Danish Research Foundation, Swedish Research Council, Swedish Heart and Lung Foundation, Skåne University Hospital and more.
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Affiliation(s)
- I Goncalves
- Lund University, Clinical Sciences Malmö and Department of Cardiology, Malmö, Sweden
| | - C Tengryd
- Lund University, Clinical Sciences Malmö, Malmö, Sweden
| | - S H Nielsen
- Nordic Bioscience, Biomarkers & Research, Technical University Denmark, Biotechnology & Biomedicine, Herlev and Kgs. Lyngby, Denmark
| | - F Genovese
- Nordic Bioscience, Biomarkers and Research, Herlev, Denmark
| | - E Bengtsson
- Lund University, Clinical Sciences Malmö, Malmö, Sweden
| | - M Karsdal
- Nordic Bioscience, Biomarkers and Research, Herlev, Denmark
| | - D J Leeming
- Nordic Bioscience, Biomarkers and Research, Herlev, Denmark
| | - J Nilsson
- Lund University, Clinical Sciences Malmö, Malmö, Sweden
| | - A Edsfeldt
- Lund University, Clinical Sciences Malmö and Department of Cardiology, Malmö, Sweden
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Holm Nielsen S, Goncalves I, Shore A, Natali A, Khan F, Genovese F, Karsdal M, Nilsson J. 3043Endotrophin, a fragment of collagen type VI, is correlated to IMT and associated with cardiovascular events in patients with atherosclerosis and diabetes: the IMI-SUMMIT cohort. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background/Introduction
Patients with micro- and macrovascular diseases, including atherosclerosis, have increased risk of cardiovascular events and early mortality. The atherosclerotic disease is characterised by accumulation of lipids, cells and proteins in the arterial wall, which includes remodelling of the extracellular matrix (ECM). Collagen type VI (COL6) is known to be over-expressed in patients with atherosclerosis. The biomarker PRO-C6, known as endotrophin, is a COL6 fragment that reflects formation of collagen type VI, and possess pro-inflammatory and pro-fibrotic activities.
Purpose
We explored whether increased endotrophin levels, measured by PRO-C6, were associated with intima-media thickness (IMT) and mortality in the IMI-SUMMIT cohort.
Methods
Circulating protein levels of PRO-C6 were measured in EDTA plasma from 1500 patients enrolled at four European University Hospitals, using an enzyme-linked immunosorbent assay. Follow-up data were available up to three years after sample collection. Associations between PRO-C6 and incidence of cardiovascular (CV) events and all-cause mortality were assessed by Kaplan-Meier curves and Cox proportional hazard regression analyses. Pearson correlation was performed to explore the association of PRO-C6, IMT and clinical variables. Known confounders defined by the Framingham Heart study (age, gender and diabetes) were included in the Cox proportional hazard regression analysis.
Results
Plasma PRO-C6 was significantly correlated with IMT in both the common carotid artery and the carotid bulb (r=0.09, p=0.002 and r=0.11, p=0.0003, respectively), HbA1c (r=0.11, p<0.0001) and C-reactive protein (r=0.14, p<0.0001). A total of 145 patients suffered from fatal or non-fatal cardiovascular events during the three-year follow-up period. Patients in the highest PRO-C6 tertile had a two-fold increased risk of experiencing a CV event during follow-up (p=0.002), independently of age, presence of CVD at baseline, type 2 diabetes, smoking and statin treatment in a regression model.
Conclusion
The present findings demonstrate that circulating levels of PRO-C6 are associated with atherosclerosis severity and increased incidence of cardiovascular events. Since PRO-C6 detects the signaling molecule endotrophin, the results may indicate that endotrophin is not only a biomarker of atherosclerotic disease, but may have a role in promoting disease progression.
Acknowledgement/Funding
This work was supported by the Danish Research Foundation, The Danish innovation foundation and the IMI-SUMMIT participants
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Affiliation(s)
| | - I Goncalves
- Lund University, Department of clinical Sciences, Malmo, Sweden
| | - A Shore
- University of Exeter, Diabetes and Vascular Medicine, Exeter, United Kingdom
| | - A Natali
- University of Pisa, Department of Clinical and Experimental Medicine, Pisa, Italy
| | - F Khan
- University of Dundee, Division of Systems Medicine, Dundee, United Kingdom
| | | | | | - J Nilsson
- Skane University Hospital, Department of cardiology, Malmo, Sweden
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Moustakis C, Chan M, Kim J, Nilsson J, Bergman A, Bichay T, Cilla S, Deodato F, Doro R, Eich H, Fau P, Fong M, Haverkamp U, Heinze S, Köhn J, de Klerck E, Lambrecht U, Masi L, Mayville A, Morganti A, Milder M, Rades D, Ramm U, Ryu S, Soltys S, Tazeh Maha FE, Toom WD, Wang L, Blanck O. A Multi-Platform Treatment Planning Benchmark Study for Spinal Radiosurgery. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.810] [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: 10/26/2022]
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Shami A, Atzler D, Bosmans L, van Tiel C, Winkels H, Meiler S, Lacy M, Buerger C, Megens R, Nitz K, Riccardi C, Daemen M, de Winther M, Nilsson J, Weber C, Gerdes N, Goncalves I, Lutgens E. Glucocorticoid-Induced Tumor Necrosis Factor Receptor Family-Related Protein (Gitr) Drives Atherosclerosis In Mice And Is Associated With An Unstable Plaque Phenotype And Cerebrovascular Events In Humans. Atherosclerosis 2019. [DOI: 10.1016/j.atherosclerosis.2019.06.025] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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23
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Mattisson IY, Nilsson J, Fredrikson GN, Wigren M. Immunomodulation With An Apob-100 Peptide Vaccine Elicits A Protective Response By Inhibiting Atherosclerotic Progression In Murine Systemic Lupus Erythematous With Hypoercholesterolemia. Atherosclerosis 2019. [DOI: 10.1016/j.atherosclerosis.2019.06.219] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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24
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Aizawa K, Casanova F, Mawson D, Gooding K, Strain W, Gates P, Östling G, Khan F, Colhoun H, Palombo C, Parker K, Nilsson J, Shore A, Hughes A. ALTERED CENTRAL HAEMODYNAMIC PARAMETERS DERIVED FROM RESERVOIR PRESSURE ANALYSIS. J Hypertens 2019. [DOI: 10.1097/01.hjh.0000573860.40388.fe] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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25
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Berndtsson R, Becker P, Persson A, Aspegren H, Haghighatafshar S, Jönsson K, Larsson R, Mobini S, Mottaghi M, Nilsson J, Nordström J, Pilesjö P, Scholz M, Sternudd C, Sörensen J, Tussupova K. Drivers of changing urban flood risk: A framework for action. J Environ Manage 2019; 240:47-56. [PMID: 30928794 DOI: 10.1016/j.jenvman.2019.03.094] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 03/12/2019] [Accepted: 03/19/2019] [Indexed: 06/09/2023]
Abstract
This study focuses on drivers for changing urban flood risk. We suggest a framework for guiding climate change adaptation action concerning flood risk and manageability in cities. The identified key drivers of changing flood hazard and vulnerability are used to provide an overview of each driver's impact on flood risk and manageability at the city level. We find that identified drivers for urban flood risk can be grouped in three different priority areas with different time horizon. The first group has high impact but is manageable at city level. Typical drivers in this group are related to the physical environment such as decreasing permeability and unresponsive engineering. The second group of drivers is represented by public awareness and individual willingness to participate and urbanization and urban sprawl. These drivers may be important and are manageable for the cities and they involve both short-term and long-term measures. The third group of drivers is related to policy and long-term changes. This group is represented by economic growth and increasing values at risk, climate change, and increasing complexity of society. They have all high impact but low manageability. Managing these drivers needs to be done in a longer time perspective, e.g., by developing long-term policies and exchange of ideas.
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Affiliation(s)
- R Berndtsson
- Water Resources Engineering, Lund University, SE-221 00, Lund, Sweden; Center for Middle Eastern Studies, Lund University, SE-221 00, Lund, Sweden.
| | - P Becker
- Risk Management and Societal Safety, Lund University, SE-221 00, Lund, Sweden; Unit for Environmental Sciences and Management, North-West University, Potchefstroom, 2520, South Africa
| | - A Persson
- GIS Centre/Physical Geography and Ecosystem Science, Lund University, SE-221 00, Lund, Sweden
| | - H Aspegren
- Water and Environmental Engineering, Lund University, SE-221 00, Lund, Sweden; VA SYD, SE-211 20 Malmö, Sweden
| | - S Haghighatafshar
- Water and Environmental Engineering, Lund University, SE-221 00, Lund, Sweden
| | - K Jönsson
- Water and Environmental Engineering, Lund University, SE-221 00, Lund, Sweden
| | - R Larsson
- Water Resources Engineering, Lund University, SE-221 00, Lund, Sweden
| | - S Mobini
- Water Resources Engineering, Lund University, SE-221 00, Lund, Sweden
| | - M Mottaghi
- Water and Environmental Engineering, Lund University, SE-221 00, Lund, Sweden; VA SYD, SE-211 20 Malmö, Sweden; Architecture and Built Environment, Lund University, SE-221 00, Lund, Sweden
| | - J Nilsson
- Faculty of Culture and Society, Malmö University, SE-205 06, Malmö, Sweden
| | - J Nordström
- AgriFood, Economics Centre, Lund University, SE-220 07, Lund, Sweden
| | - P Pilesjö
- Center for Middle Eastern Studies, Lund University, SE-221 00, Lund, Sweden; GIS Centre/Physical Geography and Ecosystem Science, Lund University, SE-221 00, Lund, Sweden
| | - M Scholz
- Water Resources Engineering, Lund University, SE-221 00, Lund, Sweden; Department of Civil Engineering Science, University of Johannesburg, PO Box 524, Johannesburg, South Africa; Directorate of Civil Engineering, University of Salford, Greater Manchester, M5 4WT, United Kingdom
| | - C Sternudd
- Architecture and Built Environment, Lund University, SE-221 00, Lund, Sweden
| | - J Sörensen
- Water Resources Engineering, Lund University, SE-221 00, Lund, Sweden
| | - K Tussupova
- Water Resources Engineering, Lund University, SE-221 00, Lund, Sweden; Center for Middle Eastern Studies, Lund University, SE-221 00, Lund, Sweden; Center for Transfer of Technology, Karaganda State Medical University, 100004, Karaganda, Kazakhstan
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26
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Edvardsson A, Kügele M, Alkner S, Enmark M, Nilsson J, Kristensen I, Kjellén E, Engelholm S, Ceberg S. Comparative treatment planning study for mediastinal Hodgkin's lymphoma: impact on normal tissue dose using deep inspiration breath hold proton and photon therapy. Acta Oncol 2019; 58:95-104. [PMID: 30280626 DOI: 10.1080/0284186x.2018.1512153] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Late effects induced by radiotherapy (RT) are of great concern for mediastinal Hodgkin's lymphoma (HL) patients and it is therefore important to reduce normal tissue dose. The aim of this study was to investigate the impact on the normal tissue dose and target coverage, using various combinations of intensity modulated proton therapy (IMPT), volumetric modulated arc therapy (VMAT) and 3-dimensional conformal RT (3D-CRT), planned in both deep inspiration breath hold (DIBH) and free breathing (FB). MATERIAL AND METHODS Eighteen patients were enrolled in this study and planned with involved site RT. Two computed tomography images were acquired for each patient, one during DIBH and one during FB. Six treatment plans were created for each patient; 3D-CRT in FB, 3D-CRT in DIBH, VMAT in FB, VMAT in DIBH, IMPT in FB and IMPT in DIBH. Dosimetric impact on the heart, left anterior descending (LAD) coronary artery, lungs, female breasts, target coverage, and also conformity index and integral dose (ID), was compared between the different treatment techniques. RESULTS The use of DIBH significantly reduced the lung dose for all three treatment techniques, however, no significant difference in the dose to the female breasts was observed. Regarding the heart and LAD doses, large individual variations were observed. For VMAT, the mean heart and LAD doses were significantly reduced using DIBH, but no significant difference was observed for 3D-CRT and IMPT. Both IMPT and VMAT resulted in improved target coverage and more conform dose distributions compared to 3D-CRT. IMPT generally showed the lowest organs at risk (OAR) doses and significantly reduced the ID compared to both 3D-CRT and VMAT. CONCLUSIONS The majority of patients benefited from treatment in DIBH, however, the impact on the normal tissue dose was highly individual and therefore comparative treatment planning is encouraged. The lowest OAR doses were generally observed for IMPT in combination with DIBH.
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Affiliation(s)
- Anneli Edvardsson
- Department of Medical Radiation Physics, Clinical Sciences, Lund University, Lund, Sweden
| | - Malin Kügele
- Department of Medical Radiation Physics, Clinical Sciences, Lund University, Lund, Sweden
- Department of Hematology, Oncology and Radiation Physics, Skane University Hospital, Lund, Sweden
| | - Sara Alkner
- Department of Hematology, Oncology and Radiation Physics, Skane University Hospital, Lund, Sweden
| | - Marika Enmark
- Department of Hematology, Oncology and Radiation Physics, Skane University Hospital, Lund, Sweden
| | - Joakim Nilsson
- Department of Hematology, Oncology and Radiation Physics, Skane University Hospital, Lund, Sweden
| | - Ingrid Kristensen
- Department of Hematology, Oncology and Radiation Physics, Skane University Hospital, Lund, Sweden
| | - Elisabeth Kjellén
- Department of Hematology, Oncology and Radiation Physics, Skane University Hospital, Lund, Sweden
| | - Silke Engelholm
- Department of Hematology, Oncology and Radiation Physics, Skane University Hospital, Lund, Sweden
| | - Sofie Ceberg
- Department of Medical Radiation Physics, Clinical Sciences, Lund University, Lund, Sweden
- Department of Hematology, Oncology and Radiation Physics, Skane University Hospital, Lund, Sweden
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27
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Holm Nielsen S, Tengryd C, Edsfeldt A, Brix S, Genovese F, Bengtsson E, Karsdal M, Leeming DJ, Nilsson J, Goncalves I. A biomarker of collagen type I degradation is associated with cardiovascular events and mortality in patients with atherosclerosis. J Intern Med 2019; 285:118-123. [PMID: 30156050 DOI: 10.1111/joim.12819] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Atherosclerosis is characterized by accumulation of lipids, cells and extracellular matrix (ECM) proteins in the arterial wall. Collagen type I (COL1), a component of the arterial ECM, is cleaved by matrix metalloproteinases (MMPs) and known to be remodelled in atherosclerosis. We explored whether the MMP-mediated COL1 biomarker, C1M, was associated with cardiovascular events, cardiovascular mortality and all-cause mortality in a large prospective cohort of patients with known atherosclerosis. METHODS Serum from 787 patients who underwent a carotid endarterectomy was included. Circulating levels of C1M were measured in serum. A total of 473 patients were followed for 6 years after surgery. Associations between C1M and incidence of cardiovascular events, cardiovascular mortality and all-cause mortality were assessed by Kaplan-Meier curves and Cox regression analysis. RESULTS A total of 101 (21.4%) patients suffered from nonfatal cardiovascular events during the follow-up period, and 64 (13.5%) patients died. Of these, 39 (60.9%) died from cardiovascular diseases. Patients with C1M levels above the median were significantly associated with cardiovascular events, cardiovascular mortality and all-cause mortality (P < 0.001, P = 0.004 and P < 0.001, respectively). C1M was included in the final model for prediction of cardiovascular events (HR 2.15, 95% CI 1.40-3.32, P = 0.001), cardiovascular mortality (HR 2.20, 95% CI 1.07-4.51, P = 0.031) and all-cause mortality (HR 2.98 95% CI 1.67-5.33, P = < 0.001). CONCLUSIONS In patients with atherosclerotic carotid lesions, high levels of C1M predicted cardiovascular events, cardiovascular mortality and all-cause mortality. These findings emphasize the importance of remodelling mechanisms in atherosclerosis that are now becoming more and more explored.
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Affiliation(s)
- S Holm Nielsen
- Nordic Bioscience, Herlev, Denmark.,Technical University of Denmark, Kgs. Lyngby, Denmark
| | - C Tengryd
- Experimental Cardiovascular Research Unit, Lund University, Malmö, Sweden
| | - A Edsfeldt
- Experimental Cardiovascular Research Unit, Lund University, Malmö, Sweden.,Department of Cardiology, Skåne University Hospital, Malmö, Sweden
| | - S Brix
- Technical University of Denmark, Kgs. Lyngby, Denmark
| | | | - E Bengtsson
- Experimental Cardiovascular Research Unit, Lund University, Malmö, Sweden
| | | | | | - J Nilsson
- Experimental Cardiovascular Research Unit, Lund University, Malmö, Sweden
| | - I Goncalves
- Experimental Cardiovascular Research Unit, Lund University, Malmö, Sweden.,Department of Cardiology, Skåne University Hospital, Malmö, Sweden
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28
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Lagerstedt JO, Dalla-Riva J, Marinkovic G, Del Giudice R, Engelbertsen D, Burlin J, Petrlova J, Lindahl M, Bernfur K, Melander O, Nilsson J, Schiopu A. Anti-ApoA-I IgG antibodies are not associated with carotid artery disease progression and first-time cardiovascular events in middle-aged individuals. J Intern Med 2019; 285:49-58. [PMID: 30028049 DOI: 10.1111/joim.12817] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE IgG antibodies against apolipoprotein A-I (ApoA-I) have been found to be elevated in subjects from the general population with clinically manifest cardiovascular disease and in myocardial infarction patients with an adverse prognosis. Here, we investigated whether these antibodies are prospectively associated with carotid artery disease progression and with the risk for first-time cardiovascular events in individuals with no previous history of cardiovascular disease. APPROACH AND RESULTS We selected 383 subjects from the cardiovascular cohort of Malmö Diet and Cancer study who suffered a coronary event during a median follow-up period of 15.4 (10.3-16.4) years and 395 age- and sex-matched controls. None of the study participants had a previous history of coronary artery disease or stroke. Anti-ApoA-I IgG were measured by ELISA in serum samples collected at baseline. Intima-media thickness (IMT) was measured in the common carotid artery and in the carotid bifurcation at baseline and after 15.9 (±1.5) years. We found no associations between anti-ApoA-I IgG and carotid artery IMT at baseline or with IMT progression during follow-up. In Cox proportional hazards analyses adjusted for traditional cardiovascular risk factors, the hazard ratio (HR 95%CI) for the primary outcome, incident coronary events, was 0.97 (0.75-1.25), P = 0.782, in subjects with anti-ApoA-I IgG within the highest tertile compared with the lowest tertile. Similarly, we did not find any associations with the secondary outcome, incident first-time stroke. CONCLUSIONS Serum autoantibodies against ApoA-I do not correlate with disease progression and adverse events in cardiovascular disease-free individuals from the general population.
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Affiliation(s)
- J O Lagerstedt
- Medical Protein Science Unit, Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - J Dalla-Riva
- Medical Protein Science Unit, Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - G Marinkovic
- Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - R Del Giudice
- Medical Protein Science Unit, Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - D Engelbertsen
- Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - J Burlin
- Medical Protein Science Unit, Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - J Petrlova
- Medical Protein Science Unit, Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - M Lindahl
- Medical Protein Science Unit, Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - K Bernfur
- Department of Biochemistry and Structural Biology, Lund University, Lund, Sweden
| | - O Melander
- Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - J Nilsson
- Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - A Schiopu
- Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.,Department of Cardiology, Skåne University Hospital Malmö, Malmö, Sweden
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29
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Fernandez C, Rysä J, Almgren P, Nilsson J, Engström G, Orho-Melander M, Ruskoaho H, Melander O. Plasma levels of the proprotein convertase furin and incidence of diabetes and mortality. J Intern Med 2018; 284:377-387. [PMID: 29888466 PMCID: PMC6175079 DOI: 10.1111/joim.12783] [Citation(s) in RCA: 112] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Diabetes mellitus is linked to premature mortality of virtually all causes. Furin is a proprotein convertase broadly involved in the maintenance of cellular homeostasis; however, little is known about its role in the development of diabetes mellitus and risk of premature mortality. OBJECTIVES To test if fasting plasma concentration of furin is associated with the development of diabetes mellitus and mortality. METHODS Overnight fasted plasma furin levels were measured at baseline examination in 4678 individuals from the population-based prospective Malmö Diet and Cancer Study. We studied the relation of plasma furin levels with metabolic and hemodynamic traits. We used multivariable Cox proportional hazards models to investigate the association between baseline plasma furin levels and incidence of diabetes mellitus and mortality during 21.3-21.7 years follow-up. RESULTS An association was observed between quartiles of furin concentration at baseline and body mass index, blood pressure and plasma concentration of glucose, insulin, LDL and HDL cholesterol (|0.11| ≤ β ≤ |0.31|, P < 0.001). Plasma furin (hazard ratio [HR] per one standard deviation increment of furin) was predictive of future diabetes mellitus (727 events; HR = 1.24, CI = 1.14-1.36, P < 0.001) after adjustment for age, sex, body mass index, systolic and diastolic blood pressure, use of antihypertensive treatment, alcohol intake and fasting plasma level of glucose, insulin and lipoproteins cholesterol. Furin was also independently related to the risk of all-cause mortality (1229 events; HR = 1.12, CI = 1.05-1.19, P = 0.001) after full multivariable adjustment. CONCLUSION Individuals with high plasma furin concentration have a pronounced dysmetabolic phenotype and elevated risk of diabetes mellitus and premature mortality.
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Affiliation(s)
- C Fernandez
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - J Rysä
- Faculty of Health Sciences, School of Pharmacy, University of Eastern Finland, Kuopio, Finland
| | - P Almgren
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - J Nilsson
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - G Engström
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - M Orho-Melander
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - H Ruskoaho
- Division of Pharmacology and Pharmacotherapy, Drug Research Program, University of Helsinki, Helsinki, Finland
| | - O Melander
- Department of Clinical Sciences, Lund University, Malmö, Sweden
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30
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Burbank J, Kelly B, Nilsson J, Power M. Tests of size and growth effects on Arctic charr (Salvelinus alpinus) otolith δ 18 O and δ 13 C values. Rapid Commun Mass Spectrom 2018; 32:1557-1564. [PMID: 29874707 DOI: 10.1002/rcm.8198] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Revised: 05/29/2018] [Accepted: 05/30/2018] [Indexed: 06/08/2023]
Abstract
RATIONALE Otolith δ18 O and δ13 C values have been used extensively to reconstruct thermal and diet histories. Researchers have suggested that individual growth rate and size may have an effect on otolith isotope ratios and subsequently confound otolith-based thermal and diet reconstructions. As few explicit tests of the effect on fish in freshwater environments exist, here we determine experimentally the potential for related growth rate and size effects on otolith δ18 O and δ13 C values. METHODS Fifty Arctic charr were raised in identical conditions for two years after which their otoliths were removed and analyzed for their δ18 O and δ13 C values. The potential effects of final length and the Thermal Growth Coefficient (TGC) on otolith isotope ratios were tested using correlation and regression analysis to determine if significant effects were present and to quantify effects when present. RESULTS The analyses indicated that TGC and size had significant and similar positive non-linear relationships with δ13 C values and explained 35% and 42% of the variability, respectively. Conversely, both TGC and size were found to have no significant correlation with otolith δ18 O values. There was no significant correlation between δ18 O and δ13 C values. CONCLUSIONS The investigation indicated the presence of linked growth rate and size effects on otolith δ13 C values, the nature of which requires further study. Otolith δ18 O values were unaffected by individual growth rate and size, confirming the applicability of these values to thermal reconstructions of fish habitat.
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Affiliation(s)
- J Burbank
- Department of Biology, University of Waterloo, 200 University Ave. West, Waterloo, ON, Canada, N2L 3G1
| | - B Kelly
- World Wildlife Fund Canada, 5251 Duke Street, Duke Tower, Suite 1202, Halifax, NS, Canada, B3J 1P3
| | - J Nilsson
- Wildlife, Fish, and Environmental Studies, Swedish University of Agricultural Sciences, SE-901 83, Umeå, Sweden
| | - M Power
- Department of Biology, University of Waterloo, 200 University Ave. West, Waterloo, ON, Canada, N2L 3G1
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Goncalves I, Holm Nielsen S, Tengryd C, Brix S, Edsfeldt A, Genovese F, Bengtsson E, Karsdal M, Julie Leeming D, Nilsson J. 4982Markers of basement membrane remodelling are associated with higher mortality in patients with advanced carotid atherosclerosis. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.4982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- I Goncalves
- Lund University, Clinical Sciences Malmö and Department of Cardiology, Malmö, Sweden
| | - S Holm Nielsen
- Technical University of Denmark / Nordic Bioscience, Disease Systems Immunology, Department of Biotechnology and Biomedicine / Biomarkers and Research, Kgs. Lyngby/Herlev, Denmark
| | - C Tengryd
- Lund University, Clinical Sciences Malmö, Malmö, Sweden
| | - S Brix
- Technical University of Denmark, Disease Systems Immunology, Department of Biotechnology and Biomedicine, Kgs. Lyngby, Denmark
| | - A Edsfeldt
- Lund University, Clinical Sciences Malmö and Department of Cardiology, Malmö, Sweden
| | - F Genovese
- Nordic Bioscience, Biomarkers and Research, Herlev, Denmark
| | - E Bengtsson
- Lund University, Clinical Sciences Malmö, Malmö, Sweden
| | - M Karsdal
- Nordic Bioscience, Biomarkers and Research, Herlev, Denmark
| | | | - J Nilsson
- Lund University, Clinical Sciences Malmö, Malmö, Sweden
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32
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Holm Nielsen S, Tengryd C, Brix S, Genovese F, Bengtsson E, Karsdal M, Lynge Reese-Pedersen A, Leeming DJ, Edsfeldt A, Nilsson J, Goncalves I. 4984A marker of collagen type I degradation is associated with cardiovascular events and mortality in patients with known atherosclerosis. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.4984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - C Tengryd
- Lund University, Department of clinical Sciences, Malmo, Sweden
| | - S Brix
- Technical University of Denmark, Department of Biotechnology and Biomedicine, Kgs. Lyngby, Denmark
| | | | - E Bengtsson
- Lund University, Department of clinical Sciences, Malmo, Sweden
| | | | | | | | - A Edsfeldt
- Lund University, Department of clinical Sciences, Malmo, Sweden
| | - J Nilsson
- Lund University, Department of clinical Sciences, Malmo, Sweden
| | - I Goncalves
- Skane University Hospital, Department of cardiology, Malmo, Sweden
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Schiopu A, Marinkovic G, DeCamp L, Winkler L, Nilsson J, Jovinge S. The S100A8/A9 alarmin stimulates myeloid cell response and promotes cardiac repair after myocardial infarction. Atherosclerosis 2018. [DOI: 10.1016/j.atherosclerosis.2018.06.906] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Even G, Kiss M, Laschet J, Ozvar Kozma M, Simon T, Wigren M, Gaston A, Procopio E, Le Borgne-Moynnier M, Nilsson J, Kuiper J, Nicoletti A, Binder C, Caligiuri G. Vaccination with Prevenar® boosts the production of anti-phosphorylcholine antibodies and protects APOE knockout mice from atherosclerosis. Atherosclerosis 2018. [DOI: 10.1016/j.atherosclerosis.2018.06.903] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Heijl C, Kahn F, Edsfeldt A, Hoglund P, Nilsson J, Goncalves I. P1637Carotid plaque morphology is similar in patients with reduced and normal renal function. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- C Heijl
- Lund University, Department of Cardiology, Lund, Sweden
| | - F Kahn
- Lund University, Division of Infection Medicine, Department of Clinical Sciences, Lund, Sweden
| | - A Edsfeldt
- Lund University, Experimental Cardiovascular Research Unit, Department of Clinical Sciences, Malmö, Sweden
| | - P Hoglund
- Lund University, Division of Clinical Chemistry and Pharmacology, Department of Clinical Sciences, Lund, Sweden
| | - J Nilsson
- Lund University, Experimental Cardiovascular Research Unit, Department of Clinical Sciences, Malmö, Sweden
| | - I Goncalves
- Lund University, Experimental Cardiovascular Research Unit, Department of Clinical Sciences, Malmö, Sweden
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Hsiung S, Knutsson A, van der Have O, Larsson J, Vallejo J, Dunér P, Heinonen S, Jönsson-Rylander AC, Bengtsson E, Nilsson J, Hultgårdh-Nilsson A. Hyperglycemia does not affect tissue repair in mouse models of arterial lesions with different morphologies. Atherosclerosis 2018. [DOI: 10.1016/j.atherosclerosis.2018.06.135] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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37
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Knutsson A, Hsiung S, Roxå A, Andersson E, Rattik S, Rauch U, Larsson J, Nilsson J, Hultgårdh-Nilsson A. IL-22 deficiency reduces progression of advanced atherosclerotic carotid plaques in apoe deficient mice. Atherosclerosis 2018. [DOI: 10.1016/j.atherosclerosis.2018.06.121] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Moustakis C, Chan MKH, Kim J, Nilsson J, Bergman A, Bichay TJ, Palazon Cano I, Cilla S, Deodato F, Doro R, Dunst J, Eich HT, Fau P, Fong M, Haverkamp U, Heinze S, Hildebrandt G, Imhoff D, de Klerck E, Köhn J, Lambrecht U, Loutfi-Krauss B, Ebrahimi F, Masi L, Mayville AH, Mestrovic A, Milder M, Morganti AG, Rades D, Ramm U, Rödel C, Siebert FA, den Toom W, Wang L, Wurster S, Schweikard A, Soltys SG, Ryu S, Blanck O. Treatment planning for spinal radiosurgery : A competitive multiplatform benchmark challenge. Strahlenther Onkol 2018; 194:843-854. [PMID: 29802435 DOI: 10.1007/s00066-018-1314-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [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: 01/16/2018] [Accepted: 05/08/2018] [Indexed: 12/20/2022]
Abstract
PURPOSE To investigate the quality of treatment plans of spinal radiosurgery derived from different planning and delivery systems. The comparisons include robotic delivery and intensity modulated arc therapy (IMAT) approaches. Multiple centers with equal systems were used to reduce a bias based on individual's planning abilities. The study used a series of three complex spine lesions to maximize the difference in plan quality among the various approaches. METHODS Internationally recognized experts in the field of treatment planning and spinal radiosurgery from 12 centers with various treatment planning systems participated. For a complex spinal lesion, the results were compared against a previously published benchmark plan derived for CyberKnife radiosurgery (CKRS) using circular cones only. For two additional cases, one with multiple small lesions infiltrating three vertebrae and a single vertebra lesion treated with integrated boost, the results were compared against a benchmark plan generated using a best practice guideline for CKRS. All plans were rated based on a previously established ranking system. RESULTS All 12 centers could reach equality (n = 4) or outperform (n = 8) the benchmark plan. For the multiple lesions and the single vertebra lesion plan only 5 and 3 of the 12 centers, respectively, reached equality or outperformed the best practice benchmark plan. However, the absolute differences in target and critical structure dosimetry were small and strongly planner-dependent rather than system-dependent. Overall, gantry-based IMAT with simple planning techniques (two coplanar arcs) produced faster treatments and significantly outperformed static gantry intensity modulated radiation therapy (IMRT) and multileaf collimator (MLC) or non-MLC CKRS treatment plan quality regardless of the system (mean rank out of 4 was 1.2 vs. 3.1, p = 0.002). CONCLUSIONS High plan quality for complex spinal radiosurgery was achieved among all systems and all participating centers in this planning challenge. This study concludes that simple IMAT techniques can generate significantly better plan quality compared to previous established CKRS benchmarks.
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Affiliation(s)
- Christos Moustakis
- Department of Radiation Oncology, University Hospital Münster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Germany.
| | - Mark K H Chan
- Department of Radiation Oncology, University Clinic Schleswig-Holstein, Kiel, Germany
| | - Jinkoo Kim
- Department of Radiation Oncology, Stony Brook University Hospital, Stony Brook, NY, USA
| | - Joakim Nilsson
- Department of Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden
| | - Alanah Bergman
- Vancouver Cancer Centre, Department of Medical Physics, BC Cancer Agency, Vancouver, BC, Canada
| | - Tewfik J Bichay
- Lacks Cancer Center, Department of Radiation Oncology, Mercy Health Saint Mary's, Grand Rapids, MI, USA.,Wayne State University School of Medicine, Detroit, MI, USA
| | | | - Savino Cilla
- Fondazione di Ricerca e Cura "Giovanni Paolo II", Medical Physics Unit, Catholic University of Sacred Heart, Campobasso, Italy
| | - Francesco Deodato
- Fondazione di Ricerca e Cura "Giovanni Paolo II", Radiation Oncology Unit, Catholic University of Sacred Heart, Campobasso, Italy
| | - Raffaela Doro
- Department of Medical Physics and Radiation Oncology, IFCA, Firenze, Italy
| | - Jürgen Dunst
- Department of Radiation Oncology, University Clinic Schleswig-Holstein, Kiel, Germany.,Department of Radiation Oncology, University Clinic Copenhagen, Copenhagen, Denmark
| | - Hans Theodor Eich
- Department of Radiation Oncology, University Hospital Münster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Germany
| | - Pierre Fau
- University of Aix Marseille, Marseille, France.,Physics Department, Institut Paoli Calmettes, Marseille, France
| | - Ming Fong
- Vancouver Cancer Centre, Department of Radiation Therapy, BC Cancer Agency, Vancouver, BC, Canada
| | - Uwe Haverkamp
- Department of Radiation Oncology, University Hospital Münster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Germany
| | - Simon Heinze
- Department of Radiation Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Guido Hildebrandt
- Department of Radiation Oncology, University Medicine Rostock, Rostock, Germany
| | - Detlef Imhoff
- Department of Radiation Oncology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Erik de Klerck
- Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Janett Köhn
- Department of Radiation Oncology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Ulrike Lambrecht
- Department of Radiation Oncology, University Clinic Erlangen, Erlangen, Germany
| | - Britta Loutfi-Krauss
- Department of Radiation Oncology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Fatemeh Ebrahimi
- Department of Radiation Oncology, University Hospital Münster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Germany
| | - Laura Masi
- Department of Medical Physics and Radiation Oncology, IFCA, Firenze, Italy
| | - Alan H Mayville
- Lacks Cancer Center, Department of Radiation Oncology, Mercy Health Saint Mary's, Grand Rapids, MI, USA
| | - Ante Mestrovic
- Vancouver Cancer Centre, Department of Medical Physics, BC Cancer Agency, Vancouver, BC, Canada
| | - Maaike Milder
- Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Alessio G Morganti
- Radiation Oncology Department, DIMES University of Bologna-S. Orsola Malpighi Hospital, Bologna, Italy
| | - Dirk Rades
- Department of Radiation Oncology, University Clinic Schleswig-Holstein, Lübeck, Germany
| | - Ulla Ramm
- Department of Radiation Oncology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Claus Rödel
- Department of Radiation Oncology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Frank-Andre Siebert
- Department of Radiation Oncology, University Clinic Schleswig-Holstein, Kiel, Germany
| | - Wilhelm den Toom
- Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Lei Wang
- Department of Radiation Oncology, Stanford University, Stanford, CA, USA
| | - Stefan Wurster
- Saphir Radiosurgery Center, Northern Germany and Frankfurt, Güstrow, Germany.,Department of Radiation Oncology, University Medicine Greifswald, Greifswald, Germany
| | - Achim Schweikard
- Institute for Robotic and Cognitive Systems, University of Lübeck, Lübeck, Germany
| | - Scott G Soltys
- Department of Radiation Oncology, Stanford University, Stanford, CA, USA
| | - Samuel Ryu
- Department of Radiation Oncology, Stony Brook University Hospital, Stony Brook, NY, USA
| | - Oliver Blanck
- Department of Radiation Oncology, University Clinic Schleswig-Holstein, Kiel, Germany.,Saphir Radiosurgery Center, Northern Germany and Frankfurt, Güstrow, Germany
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Jernryd V, Wohlfahrt J, Ede J, Smith G, Haugen Lofman I, Andersson B, Nilsson J. Recipient Age and Acute Cellular Rejection - Implications for Targeted Surveillance After Heart Transplantation. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.835] [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: 10/17/2022] Open
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Brambatti M, Braun O, Ammirati E, Shah P, Klein L, Perna E, Van De Heyning C, Cikes M, Gjesdal G, Gernhofer Y, Minto J, Jakus N, Russo C, Kassemos M, Partida C, Quan B, Milicic D, Cipriani M, Bogar L, De Bock D, Pretorius V, Nilsson J, Frigerio M, Adler E. Implantation Strategies and Outcomes of Patients Treated with Left Ventricular Assist Devices Awaiting for Heart Transplant in Europe and United States: Data from the TransAtlantic Registry on VAD and Transplant (TRAVIATA). J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.741] [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: 10/17/2022] Open
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41
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Medved D, Nugets P, Ohlsson M, Höglund P, Andersson B, Nilsson J. Using Deep Neural Networks to Simulate Heart Allocation Policies. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.417] [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: 11/28/2022] Open
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Adamo S, Nilsson J, Krebs A, Steiner U, Cozzio A, French LE, Kolios AGA. Successful treatment of SAPHO syndrome with apremilast. Br J Dermatol 2018; 179:959-962. [PMID: 29034454 DOI: 10.1111/bjd.16071] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2017] [Indexed: 01/02/2023]
Abstract
SAPHO (synovitis, acne, pustulosis, hyperostosis and osteitis) syndrome is a rare disease with inflammatory osteoarticular and skin involvement. The pathogenesis of SAPHO syndrome remains unclear, but evidence suggests it may be an autoinflammatory disease triggered upon exposure to infectious agents in genetically predisposed individuals. Induction of the interleukin (IL)-23/T helper 17 axis in addition to neutrophil activation seem to play a key role, and therapies targeting these immunological pathways, including tumour necrosis factor (TNF) inhibitors, ustekinumab, secukinumab and the IL-1 inhibitor anakinra, are potential treatment options that need further investigation. Here we report a case of a 24-year-old woman with SAPHO syndrome who presented at our clinic with palmoplantar pustulosis and sternoclavicular joint involvement. Previous treatments with topical steroids and keratolytics combined with nonsteroidal anti-inflammatory drugs, intravenous methylprednisolone, methotrexate and sulfasalazine had all failed to improve symptoms. Therapy with etanercept was not tolerated, and because of a previous demyelinating peripheral neuropathy, further treatment with TNF inhibitors was avoided. We initiated ustekinumab 45 mg, which improved skin manifestations but not joint pain. Dose escalation to 90 mg initially improved joint pain, but the dose had to be reduced to 45 mg again because of increased infections. During subsequent 45-mg ustekinumab treatment, joint pain exacerbated so we switched to adalimumab which caused an exacerbation of the disease, so we switched to secukinumab, which improved skin and joint symptoms significantly but was associated with a pustular hypersensitivity reaction. Finally, we began treatment with apremilast, a pan-cytokine approach, resulting in stabilization of the skin and joint symptoms without side-effects. To our knowledge, this is the first case report of apremilast as a treatment for SAPHO syndrome.
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Affiliation(s)
| | | | | | | | - A Cozzio
- Department of Dermatology, University Hospital, Zurich, Switzerland
| | - L E French
- Department of Dermatology, Venerology and Allergology, Kantonsspital, St. Gallen, Switzerland
| | - A G A Kolios
- Department of Immunology.,Department of Dermatology, Venerology and Allergology, Kantonsspital, St. Gallen, Switzerland
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Kolios AGA, Hafner J, Luder C, Guenova E, Kerl K, Kempf W, Nilsson J, French LE, Cozzio A. Comparison of pyoderma gangrenosum and Martorell hypertensive ischaemic leg ulcer in a Swiss cohort. Br J Dermatol 2018; 178:e125-e126. [PMID: 28832960 DOI: 10.1111/bjd.15901] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- A G A Kolios
- Department of Dermatology, Zürich University Hospital, Zürich, Switzerland.,Department of Immunology, Zürich University Hospital, Zürich, Switzerland
| | - J Hafner
- Department of Dermatology, Zürich University Hospital, Zürich, Switzerland
| | - C Luder
- Department of Dermatology, Zürich University Hospital, Zürich, Switzerland
| | - E Guenova
- Department of Dermatology, Zürich University Hospital, Zürich, Switzerland.,Department of Dermatology, Venerology and Allergology, Kantonsspital St Gallen, St Gallen, Switzerland
| | - K Kerl
- Department of Dermatology, Zürich University Hospital, Zürich, Switzerland
| | - W Kempf
- Department of Dermatology, Zürich University Hospital, Zürich, Switzerland.,Kempf und Pfaltz Histologische Diagnostik, Zürich, Switzerland
| | - J Nilsson
- Department of Immunology, Zürich University Hospital, Zürich, Switzerland
| | - L E French
- Department of Dermatology, Zürich University Hospital, Zürich, Switzerland
| | - A Cozzio
- Department of Dermatology, Venerology and Allergology, Kantonsspital St Gallen, St Gallen, Switzerland
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Stien LH, Nilsson J, Bui S, Fosseidengen JE, Kristiansen TS, Øverli Ø, Folkedal O. Consistent melanophore spot patterns allow long-term individual recognition of Atlantic salmon Salmo salar. J Fish Biol 2017; 91:1699-1712. [PMID: 29094766 DOI: 10.1111/jfb.13491] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 09/22/2017] [Indexed: 06/07/2023]
Abstract
The present study shows that permanent melanophore spot patterns in Atlantic salmon Salmo salar make it possible to use images of the operculum to keep track of individual fish over extended periods of their life history. Post-smolt S. salar (n = 246) were initially photographed at an average mass of 98 g and again 10 months later after rearing in a sea cage, at an average mass of 3088 g. Spots that were present initially remained and were the most overt (largest) 10 months later, while new and less overt spots had developed. Visual recognition of spot size and position showed that fish with at least four initial spots were relatively easy to identify, while identifying fish with less than four spots could be challenging. An automatic image analysis method was developed and shows potential for fast match processing of large numbers of fish. The current findings promote visual recognition of opercular spots as a welfare-friendly alternative to tagging in experiments involving salmonid fishes.
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Affiliation(s)
- L H Stien
- Institute of Marine Research (IMR), Austevoll Research Station, 5392, Storebø, Norway
| | - J Nilsson
- Institute of Marine Research (IMR), Austevoll Research Station, 5392, Storebø, Norway
| | - S Bui
- Institute of Marine Research (IMR), Austevoll Research Station, 5392, Storebø, Norway
| | - J E Fosseidengen
- Institute of Marine Research (IMR), Austevoll Research Station, 5392, Storebø, Norway
| | - T S Kristiansen
- Institute of Marine Research (IMR), Austevoll Research Station, 5392, Storebø, Norway
| | - Ø Øverli
- Department of Food Safety and Infection Biology, Faculty of Veterinary Medicine and Biosciences, Norwegian University of Life Sciences, P.O. Box 8146 Dep, N-0033, Oslo, Norway
| | - O Folkedal
- Institute of Marine Research (IMR), Austevoll Research Station, 5392, Storebø, Norway
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46
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Vallejo J, Dunér P, Fredrikson GN, Nilsson J, Bengtsson E. Autoantibodies against aldehyde-modified collagen type IV are associated with risk of development of myocardial infarction. J Intern Med 2017; 282:496-507. [PMID: 28944562 DOI: 10.1111/joim.12659] [Citation(s) in RCA: 5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Oxidation of LDL particles entrapped in the extracellular matrix of the arterial wall is a key factor in the development of atherosclerosis. Lipid oxidation products, such as malondialdehyde (MDA), react with surrounding extracellular matrix proteins and cause modifications that are recognized by the immune system. MDA modification of collagen type IV is increased in carotid lesions from symptomatic patients and correlates with autoantibodies against MDA-modified collagen type IV in plasma. OBJECTIVE The aim of this study was to determine whether autoantibodies against MDA-modified collagen type IV predict risk of development of myocardial infarction (MI). METHODS Plasma levels of MDA-modified collagen type IV IgM and IgG antibodies were analysed by enzyme-linked immunosorbent assay in 385 subjects with incident MI during 13 years of follow-up and 410 age- and sex-matched controls in the Malmö Diet and Cancer study. RESULTS MDA-modified collagen type IV IgG levels were higher in cases with incident MI than in controls. Subjects in the highest tertile of MDA-modified collagen type IV IgG had an increased risk of MI (hazard ratio 1.56, 95% confidence interval 1.22-2.00, P for trend 0.0004). This association remained significant after adjusting for factors included in the Framingham risk score and diabetes. High levels of MDA-collagen type IV IgG were associated with increased carotid intima-media thickness and elevated plasma levels of matrix metalloproteinase 10 and 12. CONCLUSIONS Immune responses against MDA-modified collagen type IV are associated with more severe carotid disease and increased risk of MI. These immune responses may reflect LDL oxidation in the artery wall, but could also affect the atherosclerotic disease process.
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Affiliation(s)
- J Vallejo
- Department of Clinical Sciences Malmö, Skåne University Hospital, Lund University, Malmö, Sweden
| | - P Dunér
- Department of Clinical Sciences Malmö, Skåne University Hospital, Lund University, Malmö, Sweden
| | - G N Fredrikson
- Department of Clinical Sciences Malmö, Skåne University Hospital, Lund University, Malmö, Sweden
| | - J Nilsson
- Department of Clinical Sciences Malmö, Skåne University Hospital, Lund University, Malmö, Sweden
| | - E Bengtsson
- Department of Clinical Sciences Malmö, Skåne University Hospital, Lund University, Malmö, Sweden
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Björkbacka H, Yao Mattisson I, Wigren M, Melander O, Fredrikson GN, Bengtsson E, Gonçalves I, Almgren P, Lagerstedt JO, Orho-Melander M, Engström G, Nilsson J. Plasma stem cell factor levels are associated with risk of cardiovascular disease and death. J Intern Med 2017; 282:508-521. [PMID: 28842933 DOI: 10.1111/joim.12675] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Stem cell factor (SCF) is a key growth factor for several types of stem and progenitor cells. There is experimental evidence that such cells are of importance for maintaining the integrity of the cardiovascular system. We investigated the association between circulating levels of SCF and risk for development of cardiovascular events and death. METHODS SCF was analysed by the proximity extension assay technique in plasma from 4742 subjects participating in the Malmö Diet and Cancer Study. Cardiovascular events and death were monitored through national registers with a mean follow-up time of 19.2 years. RESULTS Subjects with high baseline levels of SCF had lower cardiovascular (n = 340) and all-cause mortality (n = 1159) as well as a lower risk of heart failure (n = 177), stroke (n = 318) and myocardial infarction (n = 452). Smoking, diabetes and high alcohol consumption were associated with lower levels of SCF. Single nucleotide polymorphisms in the gene region encoding PDX1 C-terminal inhibiting factor 1 (PCIF1) and matrix metalloproteinase-9 were associated with plasma SCF levels. The highest SCF quartile remained independently associated with a lower risk of a lower risk of cardiovascular [hazard ratio and 95% confidence interval 0.59 (0.43-0.81)] and all-cause mortality [0.68 (0.57-0.81)], heart failure [0.50 (0.31-0.80)] and stroke [0.66 (0.47-0.92)], but not with MI [0.96 (0.72-1.27)] as compared with the lowest quartile when adjusting for traditional cardiovascular risk factors in Cox proportional hazard regression models. CONCLUSIONS This prospective population-based study demonstrates that subjects with high levels of SCF have a lower risk of cardiovascular events and death. The findings provide clinical support for a protective role of SCF in maintaining cardiovascular integrity.
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Affiliation(s)
- H Björkbacka
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - I Yao Mattisson
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - M Wigren
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - O Melander
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - G N Fredrikson
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - E Bengtsson
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - I Gonçalves
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.,Department of Cardiology - Coronary diseases, Skåne University Hospital, Malmö, Sweden
| | - P Almgren
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - J O Lagerstedt
- Department of Experimental Medical Science, Lund University, Malmö, Sweden
| | - M Orho-Melander
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - G Engström
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - J Nilsson
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
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Armuand G, Wettergren L, Nilsson J, Rodriguez-Wallberg K, Lampic C. Threatened fertility: A longitudinal study exploring experiences of fertility and having children after cancer treatment. Eur J Cancer Care (Engl) 2017; 27:e12798. [DOI: 10.1111/ecc.12798] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2017] [Indexed: 01/15/2023]
Affiliation(s)
- G. Armuand
- Department of Neurobiology; Care Sciences and Society (NVS); H1, Division of Nursing; Karolinska Institutet; Huddinge Sweden
- Department of Clinical and Experimental Medicine; Faculty of Health Sciences; Linköping University; Linköping Sweden
| | - L. Wettergren
- Department of Neurobiology; Care Sciences and Society (NVS); H1, Division of Nursing; Karolinska Institutet; Huddinge Sweden
| | - J. Nilsson
- Department of Neurobiology; Care Sciences and Society (NVS); H1, Division of Nursing; Karolinska Institutet; Huddinge Sweden
| | - K. Rodriguez-Wallberg
- Department of Oncology - Pathology; Karolinska Institutet; Karolinska University Hospital Solna; Stockholm Sweden
- Reproductive Medicine Karolinska; Karolinska University Hospital Huddinge; Huddinge Sweden
| | - C. Lampic
- Department of Neurobiology; Care Sciences and Society (NVS); H1, Division of Nursing; Karolinska Institutet; Huddinge Sweden
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Nilsson J, Berglund A, Bergström S, Bergqvist M, Lambe M. P1.06-002 The Role of Comorbidity in the Management and Prognosis in Nonsmall Cell Lung Cancer: A Population-Based Study. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.896] [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: 10/18/2022]
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50
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Armuand G, Nilsson J, Rodriguez‐Wallberg K, Malmros J, Arvidson J, Lampic C, Wettergren L. Physicians' self-reported practice behaviour regarding fertility-related discussions in paediatric oncology in Sweden. Psychooncology 2017; 26:1684-1690. [PMID: 28734133 PMCID: PMC5656910 DOI: 10.1002/pon.4507] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 07/17/2017] [Accepted: 07/18/2017] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The aim of this study was to investigate practice behaviours of Swedish physicians with regard to discussing the impact of cancer treatment on fertility with paediatric oncology patients and their parents, and to identify factors associated with such discussions. METHODS A cross-sectional survey study was conducted targeting all physicians in Sweden working in paediatric oncology care settings. Participants responded to a questionnaire measuring practice behaviour, attitudes, barriers, and confidence in knowledge. Multivariable logistic regression was used to determine factors associated with seldom discussing fertility. RESULTS More than half of the physicians routinely talked with their patients/parents about the treatment's potential impact on fertility (male patients: 62%; female patients: 57%; P = 0.570). Factors associated with less frequently discussing fertility with patients/parents were working at a non-university hospital (male patients: OR 11.49, CI 1.98-66.67; female patients: OR 33.18, CI 4.06-271.07), concerns that the topic would cause worry (male patients: OR 8.23, CI 1.48-45.89; female patients: OR 12.38, CI 1.90-80.70), and perceiving the parents as anxious (male patients: OR 7.18, CI 1.20-42.85; female patients: OR 11.65, CI 1.32-103.17). CONCLUSIONS Based on our findings, we recommend structured training in how to communicate about fertility issues in stressful situations, which in turn might increase fertility-related discussions in paediatric oncology.
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Affiliation(s)
- G.M. Armuand
- Department of Neurobiology, Care Sciences and SocietyKarolinska InstitutetStockholmSweden
| | - J. Nilsson
- Department of Neurobiology, Care Sciences and SocietyKarolinska InstitutetStockholmSweden
| | - K.A. Rodriguez‐Wallberg
- Department of Oncology‐PathologyKarolinska InstitutetStockholmSweden
- Reproductive MedicineKarolinska University HospitalStockholmSweden
| | - J. Malmros
- Paediatric Oncology Unit, Astrid Lindgren Children's HospitalKarolinska University HospitalStockholmSweden
- Department of Women's and Children's HealthKarolinska InstitutetStockholmSweden
| | - J. Arvidson
- Department of Women's and Children's HealthUppsala UniversityUppsalaSweden
| | - C. Lampic
- Department of Neurobiology, Care Sciences and SocietyKarolinska InstitutetStockholmSweden
| | - L. Wettergren
- Department of Neurobiology, Care Sciences and SocietyKarolinska InstitutetStockholmSweden
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