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Kjerulff B, Dowsett J, Jacobsen RL, Gladov J, Larsen MH, Lundgaard AT, Banasik K, Westergaard D, Mikkelsen S, Dinh KM, Hindhede L, Kaspersen KA, Schwinn M, Juul A, Poulsen B, Lindegaard B, Pedersen CB, Sabel CE, Bundgaard H, Nielsen HS, Møller JA, Boldsen JK, Burgdorf KS, Kessing LV, Handgaard LJ, Thørner LW, Didriksen M, Nyegaard M, Grarup N, Ødum N, Johansson PI, Jennum P, Frikke-Schmidt R, Berger SS, Brunak S, Jacobsen S, Hansen TF, Lundquist TK, Hansen T, Sørensen TL, Sigsgaard T, Nielsen KR, Bruun MT, Hjalgrim H, Ullum H, Rostgaard K, Sørensen E, Pedersen OB, Ostrowski SR, Erikstrup C. Lifestyle and demographic associations with 47 inflammatory and vascular stress biomarkers in 9876 blood donors. Commun Med (Lond) 2024; 4:50. [PMID: 38493237 PMCID: PMC10944541 DOI: 10.1038/s43856-024-00474-2] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 03/04/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND The emerging use of biomarkers in research and tailored care introduces a need for information about the association between biomarkers and basic demographics and lifestyle factors revealing expectable concentrations in healthy individuals while considering general demographic differences. METHODS A selection of 47 biomarkers, including markers of inflammation and vascular stress, were measured in plasma samples from 9876 Danish Blood Donor Study participants. Using regression models, we examined the association between biomarkers and sex, age, Body Mass Index (BMI), and smoking. RESULTS Here we show that concentrations of inflammation and vascular stress biomarkers generally increase with higher age, BMI, and smoking. Sex-specific effects are observed for multiple biomarkers. CONCLUSION This study provides comprehensive information on concentrations of 47 plasma biomarkers in healthy individuals. The study emphasizes that knowledge about biomarker concentrations in healthy individuals is critical for improved understanding of disease pathology and for tailored care and decision support tools.
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Affiliation(s)
- Bertram Kjerulff
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark.
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
- BERTHA Big Data Centre for Environment and Health, Aarhus University, Aarhus, Denmark.
| | - Joseph Dowsett
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Rikke Louise Jacobsen
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Josephine Gladov
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- BERTHA Big Data Centre for Environment and Health, Aarhus University, Aarhus, Denmark
| | - Margit Hørup Larsen
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Agnete Troen Lundgaard
- Translational Disease Systems Biology, Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Karina Banasik
- Translational Disease Systems Biology, Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - David Westergaard
- Translational Disease Systems Biology, Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Susan Mikkelsen
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Khoa Manh Dinh
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Lotte Hindhede
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Kathrine Agergård Kaspersen
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
- BERTHA Big Data Centre for Environment and Health, Aarhus University, Aarhus, Denmark
| | - Michael Schwinn
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Anders Juul
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Betina Poulsen
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Birgitte Lindegaard
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Pulmonary and Infectious Diseases, Copenhagen University Hospital-North Zealand, Hillerød, Denmark
| | - Carsten Bøcker Pedersen
- BERTHA Big Data Centre for Environment and Health, Aarhus University, Aarhus, Denmark
- National Centre for Register-based Research, Aarhus BSS, Aarhus University, Aarhus, Denmark
| | - Clive Eric Sabel
- BERTHA Big Data Centre for Environment and Health, Aarhus University, Aarhus, Denmark
- Department of Public Health, Aarhus University, DK-8000, Aarhus, Denmark
- School of Geography, Earth and Environmental Sciences, University of Plymouth, Plymouth, PL4 8AA, UK
| | - Henning Bundgaard
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Henriette Svarre Nielsen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Recurrent Pregnancy Loss Unit, Capital Region, Copenhagen University Hospitals, Hvidovre and Rigshospitalet, Copenhagen, Denmark
- Department of Obstetrics and Gynecology, Copenhagen University Hospital, Hvidovre, Denmark
| | - Janne Amstrup Møller
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Jens Kjærgaard Boldsen
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
- BERTHA Big Data Centre for Environment and Health, Aarhus University, Aarhus, Denmark
| | - Kristoffer Sølvsten Burgdorf
- Translational Disease Systems Biology, Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Lars Vedel Kessing
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Center Copenhagen, Copenhagen, Denmark
| | - Linda Jenny Handgaard
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Lise Wegner Thørner
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Maria Didriksen
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Mette Nyegaard
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Niels Grarup
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Niels Ødum
- LEO Foundation Skin Immunology Research Center, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Pär I Johansson
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Obstetrics and Gynecology, Copenhagen University Hospital, Hvidovre, Denmark
| | - Poul Jennum
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Rigshospitalet, Copenhagen, Denmark
| | - Ruth Frikke-Schmidt
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Biochemistry, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - Sanne Schou Berger
- Centre for Diagnostics, DTU Health Technology, Technical University of Denmark, 2800, Kgs. Lyngby, Denmark
| | - Søren Brunak
- Translational Disease Systems Biology, Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Søren Jacobsen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Copenhagen Lupus and Vasculitis Clinic, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen, Denmark
| | - Thomas Folkmann Hansen
- Translational Disease Systems Biology, Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Danish Headache Center and Danish Multiple Sclerosis Center, Copenhagen University Hospital, Rigshospitalet Glostrup, Glostrup, Denmark
| | - Tine Kirkeskov Lundquist
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Torben Hansen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Torben Lykke Sørensen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Clinical Eye Research Division, Department of Ophthalmology, Zealand University, Hospital, Roskilde, Denmark
| | - Torben Sigsgaard
- BERTHA Big Data Centre for Environment and Health, Aarhus University, Aarhus, Denmark
- Department of Public Health, Aarhus University, DK-8000, Aarhus, Denmark
| | - Kaspar René Nielsen
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
| | - Mie Topholm Bruun
- Department of Clinical Immunology, Odense University Hospital, Odense, Denmark
| | - Henrik Hjalgrim
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
- Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark
- Department of Hematology, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Klaus Rostgaard
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
- Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark
| | - Erik Sørensen
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Ole Birger Pedersen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Immunology, Zealand University Hospital, Køge, Denmark
| | - Sisse Rye Ostrowski
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- BERTHA Big Data Centre for Environment and Health, Aarhus University, Aarhus, Denmark
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Kjerulff B, Thisted Horsdal H, Kaspersen K, Mikkelsen S, Manh Dinh K, Hørup Larsen M, Rye Ostrowski S, Ullum H, Sørensen E, Birger Pedersen O, Topholm Bruun M, René Nielsen K, Brandt J, Geels C, Frohn LM, Christensen JH, Sigsgaard T, Eric Sabel C, Bøcker Pedersen C, Erikstrup C. Medium term moderate to low-level air pollution exposure is associated with higher C-reactive protein among healthy Danish blood donors. Environ Res 2023; 233:116426. [PMID: 37336432 DOI: 10.1016/j.envres.2023.116426] [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] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 05/10/2023] [Accepted: 06/13/2023] [Indexed: 06/21/2023]
Abstract
Air pollution is a significant contributor to the global burden of disease with a plethora of associated health effects such as pulmonary and systemic inflammation. C-reactive protein (CRP) is associated with a wide range of diseases and is associated with several exposures. Studies on the effect of air pollution exposure on CRP levels in low to moderate pollution settings have shown inconsistent results. In this cross-sectional study high sensitivity CRP measurements on 18,463 Danish blood donors were linked to modelled air pollution data for NOx, NO2, O3, CO, SO2, NH3, mineral dust, black carbon, organic carbon, sea salt, secondary inorganic aerosols and its components, primary PM2.5, secondary organic aerosols, total PM2.5, and total PM10 at their residential address over the previous month. Associations were analysed using ordered logistic regression with CRP quartile as individuals outcome and air pollution exposure as scaled deciles. Analyses were adjusted for health related and socioeconomic covariates using health questionnaires and Danish register data. Exposure to different air pollution components was generally associated with higher CRP (odds ratio estimates ranging from 1.11 to 1.67), while exposure to a few air pollution components was associated with lower CRP. For example, exposure to NO2 increased the odds of high CRP 1.32-fold (95%CI 1.16-1.49), while exposure to NH3 decreased the odds of high CRP 0.81-fold (95%CI 0.73-0.89). This large study among healthy individuals found air pollution exposure to be associated with increased levels of CRP even in a setting with low to moderate air pollution levels.
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Affiliation(s)
- Bertram Kjerulff
- Department of Clinical Immunology, Aarhus University Hospital, DK-8200, Aarhus N, Denmark; Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, Denmark; Department of Clinical Medicine, Aarhus University, Denmark.
| | - Henriette Thisted Horsdal
- Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, Denmark; National Centre for Register-based Research, Aarhus BSS, Aarhus University, DK-8210, Aarhus V, Denmark
| | - Kathrine Kaspersen
- Department of Clinical Immunology, Aarhus University Hospital, DK-8200, Aarhus N, Denmark; Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, Denmark
| | - Susan Mikkelsen
- Department of Clinical Immunology, Aarhus University Hospital, DK-8200, Aarhus N, Denmark; Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, Denmark
| | - Khoa Manh Dinh
- Department of Clinical Immunology, Aarhus University Hospital, DK-8200, Aarhus N, Denmark
| | - Margit Hørup Larsen
- Dept. of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Sisse Rye Ostrowski
- Dept. of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, Copenhagen University, Denmark
| | | | - Erik Sørensen
- Dept. of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Ole Birger Pedersen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Copenhagen University, Denmark; Dept. of Clinical Immunology, Zealand University Hospital, Køge, Denmark
| | | | | | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, DK-4000, Roskilde, Denmark; IClimate - Interdisciplinary Centre for Climate Change, Aarhus University, DK-4000, Denmark
| | - Camilla Geels
- Department of Environmental Science, Aarhus University, DK-4000, Roskilde, Denmark; IClimate - Interdisciplinary Centre for Climate Change, Aarhus University, DK-4000, Denmark
| | - Lise M Frohn
- Department of Environmental Science, Aarhus University, DK-4000, Roskilde, Denmark; IClimate - Interdisciplinary Centre for Climate Change, Aarhus University, DK-4000, Denmark
| | - Jesper H Christensen
- Department of Environmental Science, Aarhus University, DK-4000, Roskilde, Denmark; IClimate - Interdisciplinary Centre for Climate Change, Aarhus University, DK-4000, Denmark
| | - Torben Sigsgaard
- Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, Denmark; Department of Public Health, Aarhus University, DK-8000, Aarhus, Denmark
| | - Clive Eric Sabel
- Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, Denmark; Department of Public Health, Aarhus University, DK-8000, Aarhus, Denmark
| | - Carsten Bøcker Pedersen
- Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, Denmark; National Centre for Register-based Research, Aarhus BSS, Aarhus University, DK-8210, Aarhus V, Denmark
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, DK-8200, Aarhus N, Denmark; Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, Denmark; Department of Clinical Medicine, Aarhus University, Denmark
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Lindsø Andersen P, Villumsen B, Saunte DML, Burgdorf KS, Didriksen M, Ostrowski SR, Thørner LW, Erikstrup C, Dinh KM, Nielsen KR, Brodersen T, Bruun MT, Banasik K, Hansen TF, Pedersen OB, Jemec GB. Symptoms of attention deficit hyperactivity disorder are associated with Hidradenitis suppurativa in Danish blood donors. Arch Dermatol Res 2023; 315:1989-1994. [PMID: 36867221 DOI: 10.1007/s00403-023-02570-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 01/31/2023] [Accepted: 02/07/2023] [Indexed: 03/04/2023]
Abstract
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease associated with psychiatric comorbidity. Attention deficit hyperactivity disorder (ADHD) is a mental disorder associated with systemic and skin inflammation such as psoriasis and atopic dermatitis. Whether HS symptoms are associated with ADHD symptoms remains unexplored. Thus, the aim of this study was to explore the possible association between HS and ADHD. Participants in the Danish Blood Donor Study (DBDS) were included in this cross-sectional study during 2015-2017. The participants provided questionnaire data on screening items of HS, ADHD symptoms (ASRS-score), and depressive symptoms, smoking and body mass index (BMI). A logistic regression with HS symptoms as a binary outcome predicted by ADHD adjusted for age, sex, smoking, BMI, and depression was conducted to investigate the association between HS and ADHD. A total of 52,909 Danish blood donors were included in the study. Of these were 1004/52,909 (1.9%) considered participants with HS. Of the participants with HS, 74/996 (7.4%) screened positive of ADHD symptoms, while only 1786/51,129 (3.5%) of the participants without HS screened positive of ADHD. Adjusted for confounders, ADHD was positively associated with HS, odds ratio 1.85 (95% confidence interval: 1.43-2.37). Psychiatric comorbidity of HS is not limited to depression and anxiety. This study shows a positive association between HS and ADHD. Further research on the biological mechanisms behind this association is warranted.
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Affiliation(s)
- Pernille Lindsø Andersen
- Department of Dermatology, Zealand University Hospital Roskilde, Sygehusvej 5, 4000, Roskilde, Denmark.
- Department of Clinical Immunology, Zealand University Hospital, Køge, Denmark.
| | | | - Ditte Marie Lindhardt Saunte
- Department of Dermatology, Zealand University Hospital Roskilde, Sygehusvej 5, 4000, Roskilde, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
| | | | - Maria Didriksen
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Sisse Rye Ostrowski
- Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Lise Wegner Thørner
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Khoa Manh Dinh
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Kaspar René Nielsen
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
| | - Thorsten Brodersen
- Department of Clinical Immunology, Zealand University Hospital, Køge, Denmark
| | - Mie Topholm Bruun
- Deparment of Clinical Immunology, Odense University Hospital, Odense, Denmark
| | - Karina Banasik
- The Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Folkmann Hansen
- The Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Neurology, Danish Headache Center, Copenhagen University Hospital, Glostrup, Denmark
| | - Ole Birger Pedersen
- Department of Clinical Immunology, Zealand University Hospital, Køge, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
| | - Gregor Borut Jemec
- Department of Dermatology, Zealand University Hospital Roskilde, Sygehusvej 5, 4000, Roskilde, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
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4
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Chalmer MA, Kogelman LJA, Ullum H, Sørensen E, Didriksen M, Mikkelsen S, Dinh KM, Brodersen T, Nielsen KR, Bruun MT, Banasik K, Brunak S, Erikstrup C, Pedersen OB, Ostrowski SR, Olesen J, Hansen TF. Population-Based Characterization of Menstrual Migraine and Proposed Diagnostic Criteria. JAMA Netw Open 2023; 6:e2313235. [PMID: 37184838 DOI: 10.1001/jamanetworkopen.2023.13235] [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: 05/16/2023] Open
Abstract
Importance There is a need for better recognition and more extensive research into menstrual migraine (MM) in the general population, and a revision of the diagnostic criteria for MM is warranted to move the field forward. Increased understanding of MM is crucial for improving clinical care, diagnosis, and therapy for MM. Objectives To assess the clinical characteristics of MM, including severity and treatment response, and to propose new diagnostic criteria for pure MM and menstrually related migraine. Design, Setting, and Participants This is a case-control study of Danish individuals with migraine. All individuals completed a 105-item validated diagnostic migraine questionnaire, sent via the Danish electronic mailing system (e-Boks) between May and August 2020, allowing diagnosis of pure MM and menstrually related migraine by the International Classification of Headache Disorders, Third Edition (ICHD-3). Data analysis was performed from September 2021 to November 2022. Exposure Diagnosis of migraine. Main Outcomes and Measures Clinical characteristics of women with MM and women with nonmenstrual migraine (non-MM) were compared using the ICHD-3 diagnostic criteria. A simulation of the risk of randomly misclassifying MM was based on number of migraine attacks during 3 menstrual cycles (3 × 28 days), and simulation analyses were performed using 100 000 permutations of random migraine attacks in migraine patients. Results A total of 12 618 individuals, including 9184 women, with migraine participated in the study. Among the women with migraine, the prevalence of MM was 16.6% (1532 women), and the prevalence of non-MM was 45.9% (4216 women). The mean (SD) age was 38.7 (8.7) years for women with MM and 37.0 (9.2) years for women with non-MM. Of the 1532 women with MM, 410 (26.8%) fulfilled ICHD-3 diagnostic criteria for pure MM, 1037 (67.7%) fulfilled ICHD-3 diagnostic criteria for menstrually related migraine, and 152 (9.9%) fulfilled proposed diagnostic criteria for rare pure MM. MM was associated with a higher frequency of migraine-accompanying symptoms (odds ratio [OR], 1.98; 95% CI, 1.71-2.29), more frequent (OR, 7.21; 95% CI, 5.77-9.03) and more severe (OR, 1.17; 95% CI, 1.13-1.21) migraine attacks, lower frequency of nonmigraine headache (OR, 0.31; 95% CI, 0.18-0.49), an overall greater response to treatment with triptans (OR, 1.66; 95% CI, 1.24-2.24), better improvement of migraine attacks during late pregnancy (OR, 5.10; 95% CI, 2.17-14.00), and faster reappearance of migraine attacks post partum (OR, 3.19; 95% CI, 2.40-4.25). Hormonal contraceptive-related MM was associated with a higher prevalence of migraine without aura than migraine related to spontaneous menstruation (OR, 1.82; 95% CI, 1.62-2.06). Otherwise, no differences between hormonal and spontaneous MM were observed. The risk of random diagnostic misclassification of ICHD-3 menstrually related migraine in women with high frequency episodic migraine was 43%. This risk was reduced to 3% when applying the proposed criteria for menstrually related migraine. Conclusions and Relevance In this case-control study, MM in the general population had clinical characteristics that were quantitively different from those of non-MM. Detailed descriptive data and suggested improved diagnostic criteria for pure MM and menstrually related migraine were provided.
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Affiliation(s)
- Mona Ameri Chalmer
- Department of Neurology, Danish Headache Center, Copenhagen University Hospital, Glostrup, Denmark
| | - Lisette J A Kogelman
- Department of Neurology, Danish Headache Center, Copenhagen University Hospital, Glostrup, Denmark
| | | | - Erik Sørensen
- Department of Clinical Immunology, Centre of Diagnostic Investigation, Rigshospitalet, Copenhagen, Denmark
| | - Maria Didriksen
- Department of Clinical Immunology, Centre of Diagnostic Investigation, Rigshospitalet, Copenhagen, Denmark
| | - Susan Mikkelsen
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Khoa Manh Dinh
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Thorsten Brodersen
- Department of Clinical Immunology, Zealand University Hospital, Køge, Denmark
| | - Kaspar R Nielsen
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
| | - Mie Topholm Bruun
- Department of Clinical Immunology, Odense University Hospital, Odense, Denmark
| | - Karina Banasik
- Novo Nordisk Foundation Center for Protein Research, University of Copenhagen, Copenhagen, Denmark
| | - Søren Brunak
- Novo Nordisk Foundation Center for Protein Research, University of Copenhagen, Copenhagen, Denmark
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Ole Birger Pedersen
- Department of Clinical Immunology, Zealand University Hospital, Køge, Denmark
| | - Sisse Rye Ostrowski
- Department of Clinical Immunology, Centre of Diagnostic Investigation, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Jes Olesen
- Department of Neurology, Danish Headache Center, Copenhagen University Hospital, Glostrup, Denmark
| | - Thomas Folkmann Hansen
- Department of Neurology, Danish Headache Center, Copenhagen University Hospital, Glostrup, Denmark
- Novo Nordisk Foundation Center for Protein Research, University of Copenhagen, Copenhagen, Denmark
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Nudel R, Christensen RV, Kalnak N, Schwinn M, Banasik K, Dinh KM, Erikstrup C, Pedersen OB, Burgdorf KS, Ullum H, Ostrowski SR, Hansen TF, Werge T. Developmental language disorder - a comprehensive study of more than 46,000 individuals. Psychiatry Res 2023; 323:115171. [PMID: 36963307 DOI: 10.1016/j.psychres.2023.115171] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 10/25/2022] [Revised: 02/16/2023] [Accepted: 03/14/2023] [Indexed: 03/26/2023]
Abstract
Developmental language disorder (DLD) is characterized by enduring low language abilities with a significant functional impact, in the absence of biomedical conditions in which language impairment is part of a complex of impairments. There is a lack of awareness of DLD even among healthcare professionals. Here we estimated the prevalence of DLD and its links to reading and learning difficulties and physical and mental health in the Danish Blood Donor Study (N = 46,547), where DLD-related information is based on questionnaires (self-report). We compared the questionnaire-derived DLD status with the relevant language-related diagnoses from hospital registers. We also investigated the genetic architecture of DLD in a subset of the cohort (N = 18,380). DLD was significantly associated with reading and learning difficulties and poorer mental and physical health. DLD prevalence was 3.36%-3.70% based on questionnaires, compared with 0.04% in hospital registers. Our genetic analyses identified one genome-wide significant locus, but not a significant heritability estimate. Our study shows that DLD has health-related implications that may last into adulthood, and that DLD may be undiagnosed in general healthcare. Furthermore, DLD is likely more genetically heterogeneous than narrower developmental language phenotypes. Our results emphasize the need to raise awareness of DLD and consider criteria for molecular studies of DLD to reduce case heterogeneity.
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Affiliation(s)
- Ron Nudel
- CORE - Copenhagen Research Centre for Mental Health, Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark; iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark.
| | - Rikke Vang Christensen
- Department of Nordic Studies and Linguistics, University of Copenhagen, Emil Holms Kanal 2, Copenhagen 2300, Denmark.
| | - Nelli Kalnak
- Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden; Department of Speech-Language Pathology, Helsingborg Hospital, Helsingborg, Sweden.
| | - Michael Schwinn
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Karina Banasik
- Novo Nordisk foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Khoa Manh Dinh
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Ole Birger Pedersen
- Department of Immunology, Næstved Hospital, Næstved, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kristoffer Sølvsten Burgdorf
- Department of Immunology, Rigshospitalet, Copenhagen, Denmark; Translational Disease Systems Biology, Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Sisse Rye Ostrowski
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Folkmann Hansen
- Novo Nordisk foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Danish Headache Center, Rigshospitalet Glostrup, Glostrup, Denmark
| | - Thomas Werge
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Mental Health Centre Sct. Hans, Mental Health Services Copenhagen, Institute of Biological Psychiatry, Roskilde, Denmark
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6
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Chalmer MA, Kogelman LJA, Callesen I, Christensen CG, Techlo TR, Møller PL, Davidsson OB, Olofsson IA, Schwinn M, Mikkelsen S, Dinh KM, Nielsen K, Topholm M, Erikstrup C, Ostrowski SR, Pedersen OB, Hjalgrim H, Banasik K, Burgdorf KS, Nyegaard M, Olesen J, Hansen TF. Sex differences in clinical characteristics of migraine and its burden: A population-based study. Eur J Neurol 2023; 30:1774-1784. [PMID: 36905094 DOI: 10.1111/ene.15778] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 03/01/2023] [Accepted: 03/03/2023] [Indexed: 03/12/2023]
Abstract
BACKGROUND Understanding migraine in a sex-specific manner is crucial for improving clinical care, diagnosis, and therapy for both females and males. Here, we provide data on sex differences in the presentation of migraine in a large European-based population cohort, which is representative of the general population. METHODS We performed a population-based study of 62,672 Danish blood donors (both present and previous donors), of whom 12,658 had migraine. All participants completed a 105-item diagnostic migraine questionnaire send via electronic mailing system (e-Boks) between May 2020 and August 2020. The questionnaire allowed for correct diagnosis of migraine according to the International Classification of Headache Disorders third edition. RESULTS The migraine questionnaire was in-cohort validated and had a positive predictive value of 97% for any migraine, a specificity of 93%, and a sensitivity of 93%. There were 9,184 females (mean age=45.1) and 3,434 males (mean age=48.0). The three-months prevalence of migraine without aura was 11% in females and 3.59% in males. The three-months prevalence of migraine with aura was 1.72% in females and 1.58% in males. In females, the age-related three-months prevalence of migraine without aura increased markedly during the childbearing age. In males, both migraine with- and without aura showed less age variation. Females had a higher frequency of migraine attacks (OR=1.22), but a lower frequency of non-migraine headaches (OR=0.35). Females also had a greater intensity of pain, more unilateral and pulsatile pain, and exacerbation by physical activity (OR=1.40-1.49) as well as more associated symptoms (OR=1.26-1.98). Females carried 79% of the total migraine disease burden, which was almost exclusively driven by migraine without aura (77%), while there was no sex difference in the disease burden of migraine with aura. CONCLUSION Females have more severe disease, resulting in a much higher migraine disease burden than indicated by prevalence alone.
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Affiliation(s)
- Mona Ameri Chalmer
- Department of Neurology, Danish Headache Center, Copenhagen University Hospital, Glostrup, Denmark
| | - Lisette J A Kogelman
- Department of Neurology, Danish Headache Center, Copenhagen University Hospital, Glostrup, Denmark
| | - Ida Callesen
- Department of Neurology, Danish Headache Center, Copenhagen University Hospital, Glostrup, Denmark
| | | | - Tanya Ramdal Techlo
- Department of Neurology, Danish Headache Center, Copenhagen University Hospital, Glostrup, Denmark
| | - Peter L Møller
- Department of Biomedicine, Aarhus University, Hoegh-Guldbergs Gade 10, Aarhus, Denmark
| | - Olafur B Davidsson
- Department of Neurology, Danish Headache Center, Copenhagen University Hospital, Glostrup, Denmark
| | - Isa A Olofsson
- Department of Neurology, Danish Headache Center, Copenhagen University Hospital, Glostrup, Denmark
| | - Michael Schwinn
- Department of Clinical Immunology, Centre of Diagnostic Investigation, Rigshospitalet
| | - Susan Mikkelsen
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Khoa Manh Dinh
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Kaspar Nielsen
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
| | - Mie Topholm
- Department of Clinical Immunology, Odense University Hospital, Odense, Denmark
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Sisse Rye Ostrowski
- Department of Clinical Immunology, Centre of Diagnostic Investigation, Rigshospitalet.,Department of Clinical Medicine, University of Copenhagen
| | - Ole Birger Pedersen
- Department of Clinical Immunology, Zealand University Hospital, Køge, Denmark
| | | | - Henrik Hjalgrim
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.,Department of Hematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Karina Banasik
- Novo Nordic Foundation Center for Protein Research, Copenhagen University, Copenhagen, Denmark
| | - Kristoffer S Burgdorf
- Novo Nordic Foundation Center for Protein Research, Copenhagen University, Copenhagen, Denmark
| | - Mette Nyegaard
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
| | - Jes Olesen
- Department of Neurology, Danish Headache Center, Copenhagen University Hospital, Glostrup, Denmark
| | - Thomas Folkmann Hansen
- Department of Neurology, Danish Headache Center, Copenhagen University Hospital, Glostrup, Denmark.,Novo Nordic Foundation Center for Protein Research, Copenhagen University, Copenhagen, Denmark
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7
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Henkel C, Styrkársdóttir U, Thorleifsson G, Stefánsdóttir L, Björnsdóttir G, Banasik K, Brunak S, Erikstrup C, Dinh KM, Hansen TF, Nielsen KR, Bruun MT, Dowsett J, Brodersen T, Thorgeirsson TE, Gromov K, Boesen MP, Ullum H, Ostrowski SR, Pedersen OB, Stefánsson K, Troelsen A. Genome-wide association meta-analysis of knee and hip osteoarthritis uncovers genetic differences between patients treated with joint replacement and patients without joint replacement. Ann Rheum Dis 2023; 82:384-392. [PMID: 36376028 DOI: 10.1136/ard-2022-223199] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 10/25/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Osteoarthritis is a common and severe, multifactorial disease with a well-established genetic component. However, little is known about how genetics affect disease progression, and thereby the need for joint placement. Therefore, we aimed to investigate whether the genetic associations of knee and hip osteoarthritis differ between patients treated with joint replacement and patients without joint replacement. METHODS We included knee and hip osteoarthritis cases along with healthy controls, altogether counting >700 000 individuals. The cases were divided into two groups based on joint replacement status (surgical vs non-surgical) and included in four genome-wide association meta-analyses: surgical knee osteoarthritis (N = 22 525), non-surgical knee osteoarthritis (N = 38 626), surgical hip osteoarthritis (N = 20 221) and non-surgical hip osteoarthritis (N = 17 847). In addition, we tested for genetic correlation between the osteoarthritis groups and the pain phenotypes intervertebral disc disorder, dorsalgia, fibromyalgia, migraine and joint pain. RESULTS We identified 52 sequence variants associated with knee osteoarthritis (surgical: 17, non-surgical: 3) or hip osteoarthritis (surgical: 34, non-surgical: 1). For the surgical phenotypes, we identified 10 novel variants, including genes involved in autophagy (rs2447606 in ATG7) and mechanotransduction (rs202127176 in PIEZO1). One variant, rs13107325 in SLC39A8, associated more strongly with non-surgical knee osteoarthritis than surgical knee osteoarthritis. For all other variants, significance and effect sizes were higher for the surgical phenotypes. In contrast, genetic correlations with pain phenotypes tended to be stronger in the non-surgical groups. CONCLUSIONS Our results indicate differences in genetic associations between knee and hip osteoarthritis depending on joint replacement status.
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Affiliation(s)
- Cecilie Henkel
- Clinical Orthopaedic Research Hvidovre (CORH), Department of Orthopaedic Surgery, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | | | | | | | | | - Karina Banasik
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Søren Brunak
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Khoa Manh Dinh
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Thomas Folkmann Hansen
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Glostrup, Denmark
| | - Kaspar René Nielsen
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
| | - Mie Topholm Bruun
- Department of Clinical Immunology, Odense University Hospital, Odense, Denmark
| | - Joseph Dowsett
- Department of Clinical Immunology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Thorsten Brodersen
- Department of Clinical Immunology, Zealand University Hospital Køge, Køge, Denmark
| | | | | | - Kirill Gromov
- Clinical Orthopaedic Research Hvidovre (CORH), Department of Orthopaedic Surgery, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.,Clinical Academic Group: Research OsteoArthritis Denmark (CAG ROAD), Greater Copenhagen Health Science Partners, Copenhagen, Denmark
| | - Mikael Ploug Boesen
- Clinical Academic Group: Research OsteoArthritis Denmark (CAG ROAD), Greater Copenhagen Health Science Partners, Copenhagen, Denmark.,Department of Radiology, Bispebjerg Hospital, Copenhagen, Denmark
| | | | - Sisse Rye Ostrowski
- Department of Clinical Immunology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ole Birger Pedersen
- Department of Clinical Immunology, Zealand University Hospital Køge, Køge, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Anders Troelsen
- Clinical Orthopaedic Research Hvidovre (CORH), Department of Orthopaedic Surgery, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.,Clinical Academic Group: Research OsteoArthritis Denmark (CAG ROAD), Greater Copenhagen Health Science Partners, Copenhagen, Denmark
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8
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Lindsø Andersen P, Jemec GBE, Erikstrup C, Didriksen M, Dinh KM, Mikkelsen S, Bruun MT, Hjalgrim H, Hansen TF, Sækmose SG, Ostrowski SR, Pedersen OB, Saunte DM. Two Novel Human Leukocyte Antigen Alleles Are Associated with Decreased Risk of Onychomycosis in a Large Cohort of Danish Blood Donors. Skin Appendage Disord 2023. [DOI: 10.1159/000529092] [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: 02/17/2023] Open
Abstract
<b><i>Introduction:</i></b> Antigen presentation and antimicrobial immune responses involve the human leukocyte antigen (HLA) system. Onychomycosis is primarily caused by dermatophytes and affects around 5.5% of the population worldwide. Yet, only limited data exist on the associations between the HLA system and onychomycosis. Thus, the objective of the study was to investigate if there is an association between HLA alleles and onychomycosis. <b><i>Methods:</i></b> Participants in the Danish Blood Donor Study were defined as cases of onychomycosis and controls based on antifungal prescriptions in the national prescription registry. Associations were investigated using logistic regressions adjusted for confounders and were Bonferroni corrected for multiple tests. <b><i>Results:</i></b> A total of 3,665 participants were considered onychomycosis cases, and 24,144 participants were considered controls. We found two protective HLA alleles of onychomycosis: DQB1*06:04, odds ratios (OR) 0.80 (95% confidence interval (CI) 0.71–0.90), and DRB1*13:02, OR 0.79 (95% CI: 0.71–0.89). <b><i>Conclusion:</i></b> The finding of two novel protective alleles of onychomycosis indicates that certain HLA alleles have certain antigen presentation properties affecting the risk of fungal infection. These findings may provide the basis for future research identifying immunologically relevant antigens of fungi causing onychomycosis, which could ultimately lead to targets of new drugs with antifungal effects.
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9
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Lindsø Andersen P, Jemec GB, Erikstrup C, Didriksen M, Dinh KM, Mikkelsen S, Sørensen E, Nielsen KR, Bruun MT, Hjalgrim H, Hansen TF, Sækmose SG, Ostrowski SR, Saunte DML, Pedersen OB. Human leukocyte antigen system associations in Malassezia-related skin diseases. Arch Dermatol Res 2022; 315:895-902. [PMID: 36394635 DOI: 10.1007/s00403-022-02454-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 10/10/2022] [Accepted: 10/31/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND The human leukocyte antigen system (HLA) is divided into two classes involved in antigen presentation: class I presenting intracellular antigens and class II presenting extracellular antigens. While susceptibility to infections is correlated with the HLA system, data on associations between HLA genotypes and Malassezia-related skin diseases (MRSD) are lacking. Thus, the objective of this study was to investigate associations between HLA alleles and MRSD. MATERIALS AND METHODS Participants in The Danish Blood Donor Study (2010-2018) provided questionnaire data on life style, anthropometric measures, and registry data on filled prescriptions. Genotyping was done using Illumina Infinium Global Screening Array, and HLA alleles were imputed using the HIBAG algorithm. Cases and controls were defined using filled prescriptions on topical ketoconazole 2% as a proxy of MRSD. Logistic regressions assessed associations between HLA alleles and MRSD adjusted for confounders and Bonferroni corrected for multiple tests. RESULTS A total of 9455 participants were considered MRSD cases and 24,144 participants as controls. We identified four risk alleles B*57:01, OR 1.19 (95% CI: 1.09-1.31), C*01:02, OR 1.19 (95% CI: 1.08-1.32), C*06:02, OR 1.14 (95% CI: 1.08-1.22), and DRB1*01:01, OR 1.10 (95% CI: 1.04-1.17), and two protective alleles, DQB1*02:01, OR 0.89 (95% CI: 0.85-0.94), and DRB1*03:01, OR 0.89 (95% CI: 0.85-0.94). CONCLUSION Five novel associations between HLA alleles and MRSD were identified in our cohort, and one previous association was confirmed. Future studies should assess the correlation between Malassezia antigens and antigen-binding properties of the associated HLA alleles.
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Affiliation(s)
- P Lindsø Andersen
- Department of Dermatology, Zealand University Hospital Roskilde, Sygehusvej 5, 4000, Roskilde, Denmark.
- Department of Clinical Immunology, Zealand University Hospital, Køge, Denmark.
| | - G B Jemec
- Department of Dermatology, Zealand University Hospital Roskilde, Sygehusvej 5, 4000, Roskilde, Denmark
- Department of Clinical Medicine, Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark
| | - C Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - M Didriksen
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - K M Dinh
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Microbiology, Aarhus University Hospital, Aarhus, Denmark
| | - S Mikkelsen
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - E Sørensen
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - K R Nielsen
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
| | - M T Bruun
- Department of Clinical Immunology, Odense University Hospital, Odense, Denmark
| | - H Hjalgrim
- Department of Clinical Medicine, Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark
- Department of Epidemiology Research, Statens Serum Institute, Copenhagen, Denmark
- Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Haematology, Rigshospitalet, Copenhagen, Denmark
| | - T F Hansen
- Department of Neurology, Danish Headache Center, Copenhagen University Hospital, Glostrup, Denmark
- The Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - S G Sækmose
- Department of Clinical Immunology, Zealand University Hospital, Køge, Denmark
| | - S R Ostrowski
- Department of Clinical Medicine, Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - D M L Saunte
- Department of Dermatology, Zealand University Hospital Roskilde, Sygehusvej 5, 4000, Roskilde, Denmark
- Department of Clinical Medicine, Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark
| | - O B Pedersen
- Department of Clinical Immunology, Zealand University Hospital, Køge, Denmark
- Department of Clinical Medicine, Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark
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10
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Erikstrup C, Laksafoss AD, Gladov J, Kaspersen KA, Mikkelsen S, Hindhede L, Boldsen JK, Jørgensen SW, Ethelberg S, Holm DK, Bruun MT, Nissen J, Schwinn M, Brodersen T, Mikkelsen C, Sækmose SG, Sørensen E, Harritshøj LH, Aagaard B, Dinh KM, Busch MP, Jørgensen CS, Krause TG, Ullum H, Ostrowski SR, Espenhain L, Pedersen OBV. Seroprevalence and infection fatality rate of the SARS-CoV-2 Omicron variant in Denmark: A nationwide serosurveillance study. Lancet Reg Health Eur 2022; 21:100479. [PMID: 35959415 PMCID: PMC9355516 DOI: 10.1016/j.lanepe.2022.100479] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Introduction of the Omicron variant caused a steep rise in SARS-CoV-2 infections despite high vaccination coverage in the Danish population. We used blood donor serosurveillance to estimate the percentage of recently infected residents in the similarly aged background population with no known comorbidity. Methods To detect SARS-CoV-2 antibodies induced due to recent infection, and not vaccination, we assessed anti-nucleocapsid (anti-N) immunoglobulin G (IgG) in blood donor samples. Individual level data on SARS-CoV-2 RT-PCR results and vaccination status were available. Anti-N IgG was measured fortnightly from January 18 to April 3, 2022. Samples from November 2021 were analysed to assess seroprevalence before introduction of the Omicron variant in Denmark. Findings A total of 43 088 donations from 35 309 Danish blood donors aged 17–72 years were screened. In November 2021, 1·2% (103/8 701) of donors had detectable anti-N IgG antibodies. Adjusting for test sensitivity (estimates ranging from 74%–81%) and November seroprevalence, we estimate that 66% (95% confidence intervals (CI): 63%–70%) of the healthy, similarly aged Danish population had been infected between November 1, 2021, and March 15, 2022. One third of infections were not captured by SARS-CoV-2 RT-PCR testing. The infection fatality rate (IFR) was 6·2 (CI: 5·1–7·5) per 100 000 infections. Interpretation Screening for anti-N IgG and linkage to national registers allowed us to detect recent infections and accurately assess assay sensitivity in vaccinated or previously infected individuals during the Omicron outbreak. The IFR was lower than during previous waves. Funding The Danish Ministry of Health.
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Affiliation(s)
- Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, DK-8200 Aarhus N, Denmark
- Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, DK-8000 Aarhus C, Denmark
- Department of Clinical Medicine, Aarhus University, DK-8000 Aarhus C, Denmark
- Corresponding author at: Department of Clinical Immunology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark.
| | - Anna Damkjær Laksafoss
- Epidemiological Infectious Disease Preparedness, Statens Serum Institut, DK-2300 Copenhagen S, Denmark
| | - Josephine Gladov
- Department of Clinical Immunology, Aarhus University Hospital, DK-8200 Aarhus N, Denmark
| | - Kathrine Agergård Kaspersen
- Department of Clinical Immunology, Aarhus University Hospital, DK-8200 Aarhus N, Denmark
- Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, DK-8000 Aarhus C, Denmark
| | - Susan Mikkelsen
- Department of Clinical Immunology, Aarhus University Hospital, DK-8200 Aarhus N, Denmark
| | - Lotte Hindhede
- Department of Clinical Immunology, Aarhus University Hospital, DK-8200 Aarhus N, Denmark
| | - Jens Kjærgaard Boldsen
- Department of Clinical Immunology, Aarhus University Hospital, DK-8200 Aarhus N, Denmark
- Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, DK-8000 Aarhus C, Denmark
| | | | - Steen Ethelberg
- Epidemiological Infectious Disease Preparedness, Statens Serum Institut, DK-2300 Copenhagen S, Denmark
| | - Dorte Kinggaard Holm
- Department of Clinical Immunology, Odense University Hospital, DK-5000 Odense, Denmark
| | - Mie Topholm Bruun
- Department of Clinical Immunology, Odense University Hospital, DK-5000 Odense, Denmark
| | - Janna Nissen
- Department of Clinical Immunology, Copenhagen University Hospital, DK-2100 Copenhagen Ø, Denmark
| | - Michael Schwinn
- Department of Clinical Immunology, Copenhagen University Hospital, DK-2100 Copenhagen Ø, Denmark
| | - Thorsten Brodersen
- Department of Clinical Immunology, Zealand University Hospital, DK-4700 Naestved, Denmark
| | - Christina Mikkelsen
- Department of Clinical Immunology, Copenhagen University Hospital, DK-2100 Copenhagen Ø, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health, Copenhagen University, DK-2200 Copenhagen Ø, Denmark
| | - Susanne Gjørup Sækmose
- Department of Clinical Immunology, Zealand University Hospital, DK-4700 Naestved, Denmark
| | - Erik Sørensen
- Department of Clinical Immunology, Copenhagen University Hospital, DK-2100 Copenhagen Ø, Denmark
| | - Lene Holm Harritshøj
- Department of Clinical Immunology, Copenhagen University Hospital, DK-2100 Copenhagen Ø, Denmark
| | - Bitten Aagaard
- Department of Clinical Immunology, Aalborg University Hospital, DK-9000 Aalborg, Denmark
| | - Khoa Manh Dinh
- Department of Clinical Immunology, Aarhus University Hospital, DK-8200 Aarhus N, Denmark
| | - Michael P. Busch
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, USA
- Vitalant Research Institute, San Francisco, CA, USA
| | - Charlotte Sværke Jørgensen
- Department of Virus and Microbiological Special Diagnostics, Statens Serum Institut, DK-2300 Copenhagen S, Denmark
| | - Tyra Grove Krause
- Epidemiological Infectious Disease Preparedness, Statens Serum Institut, DK-2300 Copenhagen S, Denmark
| | - Henrik Ullum
- Epidemiological Infectious Disease Preparedness, Statens Serum Institut, DK-2300 Copenhagen S, Denmark
| | - Sisse Rye Ostrowski
- Department of Clinical Immunology, Copenhagen University Hospital, DK-2100 Copenhagen Ø, Denmark
- Department of Clinical Medicine, University of Copenhagen, DK-2200 Copenhagen Ø, Denmark
| | - Laura Espenhain
- Epidemiological Infectious Disease Preparedness, Statens Serum Institut, DK-2300 Copenhagen S, Denmark
| | - Ole Birger Vesterager Pedersen
- Department of Clinical Immunology, Zealand University Hospital, DK-4700 Naestved, Denmark
- Department of Clinical Medicine, University of Copenhagen, DK-2200 Copenhagen Ø, Denmark
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11
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Kjaersgaard Andersen R, Loft IC, Hansen T, Hjalgrim H, Rostgaard K, Banasik K, Bruun M, Nielsen K, Dinh KM, Sørensen E, Burgdorff K, Erikstrup C, Ullum H, Saunte DM, Pedersen OB, Jemec GBE. Incidence and remission rates of self-reported hidradenitis suppurativa - A prospective cohort study conducted in Danish blood donors. J Eur Acad Dermatol Venereol 2021; 36:717-725. [PMID: 34862994 DOI: 10.1111/jdv.17857] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 11/10/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND A large discrepancy between physician-diagnosed and self-reported Hidradenitis suppurativa (HS) exists. Knowledge regarding incidence and remission rates of self-reported HS is missing, but may help bridge the gap in understanding between these two phenotypes. OBJECTIVES To determine the incidence and remission rates of self-reported HS, and to what degree these are affected by sex, smoking and BMI. METHODS A prospective cohort of 23 930 Danish blood donors. Information on self-reported HS, symptom-localisation, sex, age, BMI and smoking status was collected at baseline and study termination. Self-reported HS fulfilled clinical obligatory diagnostic criteria. Cox proportional hazards regression analyses were conducted for both incidence and remission rates providing a hazard ratio (HR) of risk for each variable in the regression. RESULTS Incidence rate of self-reported HS was 10.8/1000 person-years (95% confidence interval (CI): 9.9-11.7), decreasing as a function of numbers of areas affected. Female BMI points above 25 (HR = 1.11, 95% CI: 1.09-1.13), male BMI points above 25 (HR = 1.07, 95% CI: 1.04-1.11), active smoking (HR = 1.72, 95% CI: 1.15-2.57), male sex (HR = 0.55, 95% CI: 0.45-0.67) and years of age above 25 (HR = 0.97, 95% CI: 0.96-0.97) were all statistically associated with the development of self-reported HS. Remission rate of self-reported HS was 256.7/1000 person-years (95% CI: 223.9-292.6), decreasing as a function of numbers of affected areas. Symptoms in ≥3 areas (HR = 0.54, 95% CI: 0.34-0.85), active smoking (HR = 0.49, 95% CI: 0.32-0.76) and female weight loss (every percentage drop in BMI: HR = 1.07, 95% CI: 1.05-1.11) all significantly affected the remission rate. CONCLUSIONS Both incidence and remission rates of self-reported HS are high, indicating that many with self-reported HS are unlikely to be diagnosed, as they to a higher degree experience mild transient HS symptoms.
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Affiliation(s)
| | - I C Loft
- Department of Clinical Immunology, Zealand University Hospital, Naestved, Denmark
| | - T Hansen
- Danish Headache Center, Department of Neurology, Glostrup Research Institute, Rigshospitalet Glostrup, Glostrup, Denmark
| | - H Hjalgrim
- Department of Epidemiology Research, Centre for Cancer Research, Danish Cancer Society, Statens Serum Institut, Copenhagen, Denmark
| | - K Rostgaard
- Department of Epidemiology Research, Centre for Cancer Research, Danish Cancer Society, Statens Serum Institut, Copenhagen, Denmark
| | - K Banasik
- The Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - M Bruun
- Department of Clinical Immunology, Odense University Hospital, Odense, Denmark
| | - K Nielsen
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
| | - K M Dinh
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - E Sørensen
- Statens Serum Institute, Copenhagen, Denmark
| | - K Burgdorff
- Statens Serum Institute, Copenhagen, Denmark
| | - C Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - H Ullum
- Statens Serum Institute, Copenhagen, Denmark
| | - D M Saunte
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
| | - O B Pedersen
- Department of Clinical Immunology, Zealand University Hospital, Naestved, Denmark
| | - G B E Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
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12
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Dowsett J, Didriksen M, Larsen MH, Dinh KM, Kaspersen KA, Mikkelsen S, Thørner LW, Sørensen E, Erikstrup C, Pedersen OB, Eugen-Olsen J, Banasik K, Ostrowski SR. Investigating the inflammation marker neutrophil-to-lymphocyte ratio in Danish blood donors with restless legs syndrome. PLoS One 2021; 16:e0259681. [PMID: 34767616 PMCID: PMC8589184 DOI: 10.1371/journal.pone.0259681] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 10/24/2021] [Indexed: 11/18/2022] Open
Abstract
Background Restless Legs Syndrome (RLS) is a neurological sensorimotor disorder that occurs in the evening and night, thereby impacting quality of sleep in sufferers. The pathophysiology of RLS is poorly understood but inflammation has been proposed as possibly being involved. The neutrophil-to-lymphocyte ratio (NLR) can be used as an inflammation marker but results from small studies have been inconclusive in determining whether NLR is associated with RLS. We aimed to assess whether an association between NLR and RLS exists in a large cohort of healthy individuals. Methods Neutrophils and lymphocytes were measured in blood samples of 13,055 individuals from the Danish Blood Donor Study, all of whom completed the validated Cambridge-Hopkins RLS-questionnaire for RLS assessment. Results In the sample, 661 individuals were determined as current RLS cases (5.1%). A higher proportion of individuals with RLS were females (62.5% vs 47.5%; P<0.001) and RLS cases were older than controls (P<0.001), but no differences in body mass index (BMI), smoking or alcohol consumption were found between the two groups. An increased NLR was observed in RLS cases compared to controls (median NLR: 1.80 vs 1.72; P = 0.033). In an unadjusted logistic regression model, increased NLR was associated with RLS (OR = 1.10 per NLR unit increase [95%CI:1.01–1.20]; P = 0.032); however, the association was not significant in multivariate models adjusting for sex and age (P = 0.094) or sex, age, alcohol consumption, smoking status and BMI (P = 0.107). Conclusion We found no association between RLS and NLR among Danish blood donors after adjusting for sex, age, alcohol consumption, smoking status and BMI. Further studies are needed to determine whether inflammation is a risk factor for RLS.
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Affiliation(s)
- Joseph Dowsett
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- * E-mail:
| | - Maria Didriksen
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Margit Hørup Larsen
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Khoa Manh Dinh
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Kathrine Agergård Kaspersen
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
- Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, Roskilde, Denmark
| | - Susan Mikkelsen
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Lise Wegner Thørner
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Erik Sørensen
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Jesper Eugen-Olsen
- Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
| | - Karina Banasik
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Sisse Rye Ostrowski
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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13
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Mikkelsen S, Boldsen JK, Møller BK, Dinh KM, Rostgaard K, Petersen MS, Kaspersen KA, Pedersen OB, Thørner LW, Handgaard LJ, Ostrowski SR, Sigsgaard T, Erikstrup C. Atopic respiratory diseases and IgE sensitization are associated with leukocyte subset concentrations in 14,440 blood donors. Clin Chim Acta 2021; 520:139-146. [PMID: 34118238 DOI: 10.1016/j.cca.2021.06.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 06/07/2021] [Accepted: 06/07/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND AIMS Allergic rhinitis (AR), allergic conjunctivitis (AC), and asthma are characterized by activation of the immune system. The aim of this study was to explore the long-term association between AR, AC, asthma, and specific immunoglobulin E (IgE) and blood platelet and leukocyte differential counts. MATERIAL AND METHODS In the Danish Blood Donor Study, 14,440 participants from Central Denmark Region had platelet and leukocyte differential counts available and completed a questionnaire regarding AR, AC, and asthma. Of these participants, 8485 were tested for IgE to inhalation allergens. RESULTS The prevalence of AR, AC, asthma, and IgE sensitization was 19%, 15%, 9%, and 29%, respectively. AR, AC, asthma, wheeze, and IgE sensitization was associated with increased blood eosinophil concentration even in IgE sensitized participants who did not report any allergy or asthma. The strongest associations were observed for participants with current disease. We found no differences in eosinophil concentration between months without symptoms and months with symptoms of AR and asthma. CONCLUSION AR, AC, asthma, wheezing, and IgE sensitization to inhalation allergens are associated with increased eosinophil concentration. This may reflect a persistent inflammation even in periods without symptomatic disease.
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Affiliation(s)
- Susan Mikkelsen
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark.
| | - Jens Kjærgaard Boldsen
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark; Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, DK-4000 Roskilde, Denmark
| | - Bjarne Kuno Møller
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Khoa Manh Dinh
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Klaus Rostgaard
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | | | - Kathrine Agergård Kaspersen
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark; Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, DK-4000 Roskilde, Denmark
| | - Ole Birger Pedersen
- Department of Clinical Immunology, Zealand University Hospital, Køge, Denmark
| | - Lise Wegner Thørner
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Linda Jenny Handgaard
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Sisse Rye Ostrowski
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Torben Sigsgaard
- Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, DK-4000 Roskilde, Denmark; Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark; Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, DK-4000 Roskilde, Denmark
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14
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Mikkelsen S, Dinh KM, Boldsen JK, Pedersen OB, Holst GJ, Petersen MS, Kaspersen KA, Møller BK, Nielsen KR, Paarup HM, Rostgaard K, Hjalgrim H, Sørensen E, Handgaard LJ, Hansen TF, Banasik K, Burgdorf KS, Ullum H, Sigsgaard T, Erikstrup C. Combinations of self-reported rhinitis, conjunctivitis, and asthma predicts IgE sensitization in more than 25,000 Danes. Clin Transl Allergy 2021; 11:e12013. [PMID: 33900050 PMCID: PMC8099331 DOI: 10.1002/clt2.12013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/12/2021] [Accepted: 02/17/2021] [Indexed: 12/01/2022] Open
Abstract
Background Allergic rhinitis (AR), allergic conjunctivitis (AC), and asthma composing multiple phenotypes and improved understanding of these phenotypes and their respective risk factors are needed. Objectives The objective of this study was to define the prevalence of AR, AC, and asthma and their association with allergen‐specific immunoglobulin E (sIgE) sensitization in a large cohort of blood donors and identify risk factors. Methods From the nationwide population‐based Danish Blood Donor Study, 52,976 participants completed an electronic questionnaire including AR, AC, asthma, allergic predisposition, and childhood residence. Of these, 25,257 were additionally tested for sIgE to inhalation allergens (Phadiatop). Results The prevalence of sIgE sensitization, AR, AC, and asthma was 30%, 19%, 15%, and 9%, respectively. The youngest birth cohorts had the highest prevalence of sIgE sensitization and symptoms of asthma, AR, and AC, and for asthma, they apparently experienced symptoms at an earlier age. The sIgE sensitization was positively associated with male sex. The sIgE seroprevalence was higher in participants with both AR and AC (ARC) than in participants with either AR or AC. Allergic predisposition and sIgE sensitization increased the risk of the diseases, while farm upbringing was associated with reduced prevalence of ARC, however, only in sIgE sensitized participants. Conclusion Birth year, childhood residence, sIgE sensitization, and allergic predisposition were associated with asthma, AR, and AC prevalence. Individuals with self‐reported ARC represent a primarily sIgE‐positive phenotype, while those with either AR or AC represent more diverse phenotypes.
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Affiliation(s)
- Susan Mikkelsen
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Khoa Manh Dinh
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Jens Kjaergaard Boldsen
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark.,Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, Roskilde, Denmark
| | - Ole Birger Pedersen
- Department of Clinical Immunology, Zealand University Hospital, Køge, Denmark
| | - Gitte Juel Holst
- The Danish Clinical Quality Program-National Clinical Registries (RKKP), Central Denmark Region, Aarhus, Denmark
| | | | - Kathrine Agergård Kaspersen
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark.,Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, Roskilde, Denmark
| | - Bjarne Kuno Møller
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Kaspar Rene Nielsen
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
| | | | - Klaus Rostgaard
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Henrik Hjalgrim
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Erik Sørensen
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Linda Jenny Handgaard
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Thomas Folkmann Hansen
- Department of Neurology, Danish Headache Center, Copenhagen University Hospital, Glostrup, Denmark.,Faculty of Health and Medical Sciences, Novo Nordisk Foundation Center for Protein Research, University of Copenhagen, Copenhagen, Denmark
| | - Karina Banasik
- Faculty of Health and Medical Sciences, Novo Nordisk Foundation Center for Protein Research, University of Copenhagen, Copenhagen, Denmark
| | | | - Henrik Ullum
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark.,Statens Serum Institut, Copenhagen, Denmark
| | - Torben Sigsgaard
- Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, Roskilde, Denmark.,Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark.,Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, Roskilde, Denmark
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15
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Erikstrup C, Hother CE, Pedersen OBV, Mølbak K, Skov RL, Holm DK, Sækmose SG, Nilsson AC, Brooks PT, Boldsen JK, Mikkelsen C, Gybel-Brask M, Sørensen E, Dinh KM, Mikkelsen S, Møller BK, Haunstrup T, Harritshøj L, Jensen BA, Hjalgrim H, Lillevang ST, Ullum H. Estimation of SARS-CoV-2 Infection Fatality Rate by Real-time Antibody Screening of Blood Donors. Clin Infect Dis 2021; 72:249-253. [PMID: 33501969 PMCID: PMC7337681 DOI: 10.1093/cid/ciaa849] [Citation(s) in RCA: 95] [Impact Index Per Article: 31.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 06/19/2020] [Indexed: 01/17/2023] Open
Abstract
Background The pandemic due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has tremendous consequences for our societies. Knowledge of the seroprevalence of SARS-CoV-2 is needed to accurately monitor the spread of the epidemic and to calculate the infection fatality rate (IFR). These measures may help the authorities make informed decisions and adjust the current societal interventions. The objective was to perform nationwide real-time seroprevalence surveying among blood donors as a tool to estimate previous SARS-CoV-2 infections and the population-based IFR. Methods Danish blood donors aged 17–69 years giving blood 6 April to 3 May were tested for SARS-CoV-2 immunoglobulin M and G antibodies using a commercial lateral flow test. Antibody status was compared between geographical areas, and an estimate of the IFR was calculated. Seroprevalence was adjusted for assay sensitivity and specificity taking the uncertainties of the test validation into account when reporting the 95% confidence intervals (CIs). Results The first 20 640 blood donors were tested, and a combined adjusted seroprevalence of 1.9% (95% CI, .8–2.3) was calculated. The seroprevalence differed across areas. Using available data on fatalities and population numbers, a combined IFR in patients <70 years is estimated at 89 per 100 000 (95% CI, 72–211) infections. Conclusions The IFR was estimated to be slightly lower than previously reported from other countries not using seroprevalence data. The IFR is likely severalfold lower than the current estimate. We have initiated real-time nationwide anti–SARS-CoV-2 seroprevalence surveying of blood donations as a tool in monitoring the epidemic.
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Affiliation(s)
- Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine Aarhus University, Aarhus, Denmark
| | | | | | - Kåre Mølbak
- Infection Control, Statens Serum Institut, Copenhagen, Denmark
| | - Robert Leo Skov
- Infection Control, Statens Serum Institut, Copenhagen, Denmark
| | | | | | | | | | - Jens Kjærgaard Boldsen
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine Aarhus University, Aarhus, Denmark
| | - Christina Mikkelsen
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark.,Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mikkel Gybel-Brask
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Erik Sørensen
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Khoa Manh Dinh
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine Aarhus University, Aarhus, Denmark
| | - Susan Mikkelsen
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine Aarhus University, Aarhus, Denmark
| | - Bjarne Kuno Møller
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine Aarhus University, Aarhus, Denmark
| | - Thure Haunstrup
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
| | - Lene Harritshøj
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Henrik Hjalgrim
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | | | - Henrik Ullum
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark
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16
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Erikstrup C, Hother CE, Pedersen OBV, Mølbak K, Skov RL, Holm DK, Sækmose SG, Nilsson AC, Brooks PT, Boldsen JK, Mikkelsen C, Gybel-Brask M, Sørensen E, Dinh KM, Mikkelsen S, Møller BK, Haunstrup T, Harritshøj L, Jensen BA, Hjalgrim H, Lillevang ST, Ullum H. Estimation of SARS-CoV-2 Infection Fatality Rate by Real-time Antibody Screening of Blood Donors. Clin Infect Dis 2021. [PMID: 33501969 DOI: 10.1101/2020.04.24.20075291] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND The pandemic due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has tremendous consequences for our societies. Knowledge of the seroprevalence of SARS-CoV-2 is needed to accurately monitor the spread of the epidemic and to calculate the infection fatality rate (IFR). These measures may help the authorities make informed decisions and adjust the current societal interventions. The objective was to perform nationwide real-time seroprevalence surveying among blood donors as a tool to estimate previous SARS-CoV-2 infections and the population-based IFR. METHODS Danish blood donors aged 17-69 years giving blood 6 April to 3 May were tested for SARS-CoV-2 immunoglobulin M and G antibodies using a commercial lateral flow test. Antibody status was compared between geographical areas, and an estimate of the IFR was calculated. Seroprevalence was adjusted for assay sensitivity and specificity taking the uncertainties of the test validation into account when reporting the 95% confidence intervals (CIs). RESULTS The first 20 640 blood donors were tested, and a combined adjusted seroprevalence of 1.9% (95% CI, .8-2.3) was calculated. The seroprevalence differed across areas. Using available data on fatalities and population numbers, a combined IFR in patients <70 years is estimated at 89 per 100 000 (95% CI, 72-211) infections. CONCLUSIONS The IFR was estimated to be slightly lower than previously reported from other countries not using seroprevalence data. The IFR is likely severalfold lower than the current estimate. We have initiated real-time nationwide anti-SARS-CoV-2 seroprevalence surveying of blood donations as a tool in monitoring the epidemic.
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Affiliation(s)
- Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine Aarhus University, Aarhus, Denmark
| | | | | | - Kåre Mølbak
- Infection Control, Statens Serum Institut, Copenhagen, Denmark
| | - Robert Leo Skov
- Infection Control, Statens Serum Institut, Copenhagen, Denmark
| | | | | | | | | | - Jens Kjærgaard Boldsen
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine Aarhus University, Aarhus, Denmark
| | - Christina Mikkelsen
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mikkel Gybel-Brask
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Erik Sørensen
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Khoa Manh Dinh
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine Aarhus University, Aarhus, Denmark
| | - Susan Mikkelsen
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine Aarhus University, Aarhus, Denmark
| | - Bjarne Kuno Møller
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine Aarhus University, Aarhus, Denmark
| | - Thure Haunstrup
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
| | - Lene Harritshøj
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Henrik Hjalgrim
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | | | - Henrik Ullum
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark
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17
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Lindsø Andersen P, Kjaersgaard Andersen R, Jemec GBE, Ullum H, Erikstrup C, Nielsen KR, Bruun MT, Hjalgrim H, Sørensen E, Burgdorf KS, Dinh KM, Banasik K, Hansen T, Saunte DM, Pedersen OB. Superficial fungal infections and patients with hidradenitis suppurativa: a study under the Danish Blood Donor Study. Clin Exp Dermatol 2020; 46:571-573. [PMID: 33006774 DOI: 10.1111/ced.14468] [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] [Subscribe] [Scholar Register] [Accepted: 09/26/2020] [Indexed: 11/30/2022]
Affiliation(s)
- P Lindsø Andersen
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark.,Department of Clinical Immunology, Zealand University Hospital, Naestved, Denmark
| | | | - G B E Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark.,Department of Clinical Medicine, Health Sciences Faculty, University of Copenhagen, Copenhagen, Denmark
| | - H Ullum
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - C Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - K R Nielsen
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
| | - M T Bruun
- Department of Clinical Immunology, Odense University Hospital, Odense, Denmark
| | - H Hjalgrim
- Department of Epidemiology Research, Statens Serum Institute, Copenhagen, Denmark
| | - E Sørensen
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - K S Burgdorf
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - K M Dinh
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - K Banasik
- The Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - T Hansen
- Danish Headache Center, Department of Neurology, Glostrup Research Institute, Rigshospitalet Glostrup, Glostrup, Denmark
| | - D M Saunte
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark.,Department of Clinical Medicine, Health Sciences Faculty, University of Copenhagen, Copenhagen, Denmark
| | - O B Pedersen
- Department of Clinical Immunology, Zealand University Hospital, Naestved, Denmark
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18
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Pedersen OB, Nissen J, Dinh KM, Schwinn M, Kaspersen KA, Boldsen JK, Didriksen M, Dowsett J, Sørensen E, Thørner LW, Larsen MAH, Grum-Schwensen B, Sækmose S, Paulsen IW, Frisk NLS, Brodersen T, Vestergaard LS, Rostgaard K, Mølbak K, Skov RL, Erikstrup C, Ullum H, Hjalgrim H. SARS-CoV-2 infection fatality rate among elderly retired Danish blood donors - A cross-sectional study. Clin Infect Dis 2020; 73:e2962-e2969. [PMID: 33103182 PMCID: PMC7665387 DOI: 10.1093/cid/ciaa1627] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 10/21/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Despite the vast majority of individuals succumbing to infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are elderly, infection fatality rate (IFR) estimates for the age group 70 years older are still scarce. To this end we assessed SARS-CoV-2 seroprevalence among retired blood donors and combined it with national COVID-19 survey data to provide reliable population-based IFR estimates for this age group. METHODS We identified 60,926 retired blood donors age 70 years or older in the rosters of three region-wide Danish blood banks and invited them to fill in a questionnaire on COVID-19 related symptoms and behaviours. Among 24,861 (40.8%) responders, we invited a random sample of 3,200 individuals for blood testing. Overall, 1,201 (37.5%) individuals were tested for SARS-CoV-2 antibodies (Wantai) and compared to 1,110 active blood donors age 17-69 years. Seroprevalence 95% confidence intervals (CI) were adjusted for assay sensitivity and specificity. RESULTS Among retired (age 70 years or older) and active (age 17-69 years) blood donors, adjusted seroprevalences were 1.4% (95% CI: 0.3%-2.5%) and 2.5% (95% CI: 1.3%-3.8%), respectively. Using available population data on COVID-19 related fatalities, IFRs for patients age 70 years or older and for 17-69 years were estimated at 5.4% (95% CI: 2.7%-6.4%) and 0.083% (95% CI: 0.054%-0.18%), respectively. Only 52.4% of SARS-CoV-2 seropositive retired blood donors reported having been sick since the start of the pandemic. CONCLUSION COVID-19 IFR in the age group above 69 years is estimated to be 65 times as high as the IFR for people age 18-69 years.
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Affiliation(s)
- Ole Birger Pedersen
- Department of Clinical Immunology, Zealand University Hospital, Køge, Denmark.,Department of Clinical Medicine, Copenhagen University, Copenhagen
| | - Janna Nissen
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Khoa Manh Dinh
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Michael Schwinn
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark
| | | | | | - Maria Didriksen
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Joseph Dowsett
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Erik Sørensen
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Lise Wegner Thørner
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark
| | | | | | - Susanne Sækmose
- Department of Clinical Immunology, Zealand University Hospital, Køge, Denmark
| | | | | | - Thorsten Brodersen
- Department of Clinical Immunology, Zealand University Hospital, Køge, Denmark
| | | | - Klaus Rostgaard
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Kåre Mølbak
- Infection Disease Preparedness, Statens Serum Institut, Copenhagen, Denmark
| | - Robert Leo Skov
- Infection Disease Preparedness, Statens Serum Institut, Copenhagen, Denmark
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Henrik Ullum
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, Copenhagen University, Copenhagen
| | - Henrik Hjalgrim
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.,Department of Haematology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Medicine, Copenhagen University, Copenhagen
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19
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Dinh KM, Erikstrup LT, Andersen RK, Andersen PS, Mikkelsen S, Kjerulff BD, Burgdorf KS, Hansen TF, Nielsen KR, Hjalgrim H, Jemec GB, Ullum H, Erikstrup C, Pedersen OB. Cross-sectional study identifies lower risk of Staphylococcus aureus nasal colonization in Danish blood donors with hidradenitis suppurativa symptoms. Br J Dermatol 2020; 183:387-389. [PMID: 32078163 DOI: 10.1111/bjd.18962] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- K M Dinh
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - L T Erikstrup
- Department of Clinical Microbiology, Aarhus University Hospital, Aarhus, Denmark
| | - R K Andersen
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
| | - P S Andersen
- Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark.,Department of Veterinary and Animal Sciences, University of Copenhagen, Copenhagen, Denmark
| | - S Mikkelsen
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - B D Kjerulff
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - K S Burgdorf
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - T F Hansen
- Danish Headache Center, Rigshospitalet Glostrup, Glostrup, Denmark
| | - K R Nielsen
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
| | - H Hjalgrim
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.,Department of Hematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - G B Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
| | - H Ullum
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - C Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - O B Pedersen
- Department of Clinical Immunology, Naestved Hospital, Naestved, Denmark
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20
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Erikstrup LT, Dinh KM, Andersen PS, Skov RL, Kaspersen KA, Nielsen KR, Ellermann-Eriksen S, Erikstrup C. Cohort description: The Danish Blood Donor Staphylococcus aureus Carriage Study. Clin Epidemiol 2019; 11:885-900. [PMID: 31572018 PMCID: PMC6757111 DOI: 10.2147/clep.s218637] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 08/20/2019] [Indexed: 12/15/2022] Open
Abstract
Purpose Staphylococcus aureus carriage poses an increased risk of S. aureus infection. The aim of this study was to investigate the colonization of S. aureus among healthy individuals and to establish a prospective cohort and biobank for research in the health consequences of colonization. Population and methods The Danish Blood Donor S. aureus Carriage Study (DBDSaCS) was established in 2014. So far, a total of 6082 healthy participants have been included with nasal swabs and repeated swabs are performed at subsequent donations. Samples from the first 2217 participants were cultured using a two-step method to evaluate the effect of using enrichment broth. Furthermore, 262 participants were sampled from both the nares and the throat. All participants completed a questionnaire with self-reported health, anthropometric measurements, current smoking status, and physical activity. Plasma samples, nasal swab transport media, and S. aureus isolates were stored. Results The prevalence of S. aureus nasal colonization was 41%. The prevalence of colonization was higher in men (46%) than women (34%), lower for smokers, and decreased with increasing age (<25 years: 44% vs >55 years: 35%). In participants swabbed from the nose and throat, the prevalence of S. aureus colonization after enrichment was 55% with significantly higher prevalence in the throat (45%) than in the nose (40%). The use of an enrichment broth increased the proportion of S. aureus colonization. Conclusion We describe a large and growing cohort of healthy individuals established to investigate predictors for S. aureus carriage and the health consequences of carriage. Multiple projects using data from DBDSaCS linked with Danish health registers, biomarkers, and genetic markers are ongoing. Results will be published in the coming years.
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Affiliation(s)
| | - Khoa Manh Dinh
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Paal Skytt Andersen
- Bacteria, Parasites and Fungi, Statens Serum Institute, Copenhagen, Denmark.,Department Veterinary and Animal Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Robert Leo Skov
- Bacteria, Parasites and Fungi, Statens Serum Institute, Copenhagen, Denmark
| | | | - Kaspar René Nielsen
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
| | | | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
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21
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Kaspersen KA, Dinh KM, Mikkelsen S, Petersen MS, Erikstrup LT, Pedersen OB, Sørensen E, Hjalgrim H, Rigas A, Nielsen KR, Ullum H, Erikstrup C. Oral iron supplementation is not associated with short-term risk of infections: results from the Danish Blood Donor Study. Transfusion 2019; 59:2030-2038. [PMID: 30828821 DOI: 10.1111/trf.15221] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 02/08/2019] [Accepted: 02/08/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND Blood donors are at increased risk of developing iron deficiency, and several studies have recommended iron supplementation for this group. The aim of this study was to investigate the effect of oral iron supplementation on risk of infections among healthy blood donors. STUDY DESIGN AND METHODS We included 82,062 participants from the Danish Blood Donor Study who completed a questionnaire on health-related items including use of oral iron supplementation. Infection outcomes were ascertained by using ICD-10 codes in the Danish National Patient Register and Anatomical Therapeutic Chemical codes in the Danish Prescription Register. Multivariable Cox proportional hazards analysis was used as the statistical model. Risk estimates are presented as crude hazard ratios (HRs) with 95% confidence intervals (CIs). RESULTS During 19,978 person-years of observation, 6983 donors redeemed at least one prescription of antimicrobials. Similarly, during 19,829 person-years of observation, 242 donors were treated for infection at a hospital. Use of oral iron supplementation was not associated with redeemed prescriptions of antimicrobials in any strata: premenopausal women-HR 1.00, 95% CI 0.91-1.10; postmenopausal women-HR 1.07, 95% CI 0.87-1.32; and men-HR 1.01, 95% CI 0.84-1.21. In addition, use of oral iron supplementation was not associated with risk of hospital-based treatment for infection. CONCLUSION In a large cohort of blood donors, use of oral iron supplementation was not associated with subsequent short-term risk of infection. These findings are important to help understanding the safety of using oral iron supplementation among blood donors and the general population.
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Affiliation(s)
| | - Khoa Manh Dinh
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Susan Mikkelsen
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | | | | | | | - Erik Sørensen
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Henrik Hjalgrim
- Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.,Department of Hematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Andreas Rigas
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Kaspar Rene Nielsen
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
| | - Henrik Ullum
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
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Abstract
As the use of fecal microbiota transplantation (FMT) has gained momentum, an increasing need for continuous access to healthy feces donors has developed. Blood donors constitute a healthy subset of the general population and may serve as an appropriate group for recruitment. In this study, we investigated the suitability of blood donors as feces donors. In a prospective cohort study, we recruited blood donors onsite at a public Danish blood bank. Following their consent, the blood donors underwent a stepwise screening process: First, blood donors completed an electronic pre-screening questionnaire to rule out predisposing risk factors. Second, eligible blood donors had blood and fecal samples examined. Of 155 blood donors asked to participate, 137 (88%) completed the electronic pre-screening questionnaire, 16 declined, and 2 were excluded. Of the 137 donors who completed the questionnaire, 79 (58%) were excluded mainly due to having an allergy, being overweight, or presenting gastrointestinal complaints. Among the remaining 58 (37%) donors, complete blood and feces screenings were obtained from 46 (79%). Of these 46 donors, 15 (33%) were excluded primarily due to abnormal blood results or the presence of apathogenic intestinal parasites. Overall, 31 (20%; 95% confidence interval 14-27%) of the 155 blood donors qualified as feces donors. In conclusion, blood donors constitute a suitable and motivated population for a continuous recruitment of voluntary feces donors. We found that a stepwise recruitment procedure was feasible and that 20% of the blood donors were eligible for feces donation.
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Affiliation(s)
- Simon Mark Dahl Jørgensen
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark,CONTACT Simon Mark Dahl Jørgensen Department of Hepatology and Gastroenterology, Aarhus University Hospital, Noerrebrogade 44, Building 7, DK-8000 Aarhus C, Denmark
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Khoa Manh Dinh
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Lars Erik Lemming
- Department of Clinical Microbiology, Aarhus University Hospital, Aarhus, Denmark
| | - Jens Frederik Dahlerup
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
| | - Christian Lodberg Hvas
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
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Kotzé SR, Pedersen OB, Petersen MS, Sørensen E, Manh Dinh K, Agergård Kaspersen K, Rigas AS, Hjalgrim H, Rostgaard K, Edgren G, Ullum H, Erikstrup C. Deferral for low hemoglobin is not associated with increased risk of infection in Danish blood donors. Transfusion 2016; 57:571-577. [PMID: 27900795 DOI: 10.1111/trf.13931] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Revised: 09/15/2016] [Accepted: 10/03/2016] [Indexed: 12/30/2022]
Abstract
BACKGROUND Low hemoglobin (Hb) is associated with poor general health and adverse outcomes in a wide range of diseases. However, a link between Hb levels and the risk of infection among healthy individuals has yet to be investigated. STUDY DESIGN AND METHODS Using data from the Scandinavian Donations and Transfusions database, 497,390 donors were followed after 5,458,499 donations in health registers. With 1,339,362 person-years of follow-up, Andersen-Gill Cox regression was used to study the association of Hb levels below deferral thresholds, very low Hb levels (in the lowest 0.1 percentile), and declining Hb levels with the risk of infection as measured by hospital or outpatient contact for infection and filling of prescription for antimicrobials, respectively, within 3 months of donation. Analyses were stratified by sex, menopausal status, and frequency of donation. RESULTS Hb levels below deferral thresholds were not associated with a risk of hospital contact for infection among premenopausal women (hazard ratio [HR], 1.04; 95% confidence interval [CI], 0.95-1.14), postmenopausal women (HR, 0.77; 95% CI, 0.54-1.11), or men (HR, 0.97; 95% CI, 0.81-1.16), nor was there any association with hospital contact for very low Hb levels or patterns of declining Hb levels. However, subthreshold Hb levels were associated with a reduced risk of antimicrobial prescriptions among premenopausal women (HR, 0.92; 95% CI, 0.91-0.93), postmenopausal women (HR, 0.93; 95% CI, 0.89-0.97), and men (HR, 0.91; 95% CI, 0.88-0.94). CONCLUSIONS Neither Hb levels below deferral thresholds nor very low or declining Hb levels were associated with an increased risk of infection. This is reassuring, because blood donation can lead to lower Hb levels.
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Affiliation(s)
- Sebastian R Kotzé
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Ole B Pedersen
- Department of Clinical Immunology, Naestved Hospital, Naestved, Denmark
| | - Mikkel S Petersen
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Erik Sørensen
- Department of Clinical Immunology, Copenhagen University Hospital
| | - Khoa Manh Dinh
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Andreas S Rigas
- Department of Clinical Immunology, Copenhagen University Hospital
| | - Henrik Hjalgrim
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Klaus Rostgaard
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Gustaf Edgren
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet.,Hematology Centre, Karolinska University Hospital, Stockholm, Sweden
| | - Henrik Ullum
- Department of Clinical Immunology, Copenhagen University Hospital
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
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Kaspersen KA, Dinh KM, Erikstrup LT, Burgdorf KS, Pedersen OB, Sørensen E, Petersen MS, Hjalgrim H, Rostgaard K, Nielsen KR, Ullum H, Erikstrup C. Low-Grade Inflammation Is Associated with Susceptibility to Infection in Healthy Men: Results from the Danish Blood Donor Study (DBDS). PLoS One 2016; 11:e0164220. [PMID: 27701463 PMCID: PMC5049789 DOI: 10.1371/journal.pone.0164220] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Accepted: 09/21/2016] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION The aim of this study was to examine whether low-grade inflammation (LGI) is associated with a subsequently increased risk of infection. METHODS We included 15,754 healthy participants from the Danish Blood Donor Study, who completed a questionnaire on health-related items. LGI was defined as a C-reactive protein level between 3 and 10 mg/L. Infections were identified by ICD-10 codes in the Danish National Patient Register and ATC-codes in the Danish Prescription Register. Multivariable Cox proportional hazard analysis was used as the statistical model. RESULTS During 53,302 person-years of observation, 571 participants were hospitalized for infection. Similarly, during 26,125 person-years of observation, 7,276 participants filled a prescription of antimicrobials. LGI was associated with increased risk of hospital-based treatment for infection only among men (hazard ratio = 1.60, 95% confidence interval (CI): 1.10-2.34) and specifically infections were abscesses and infections of the skin and subcutaneous tissue. Similarly, LGI was associated with the overall use of antimicrobials among men, and particularly with phenoxymethylpenicillin and broad-spectrum antimicrobials for treatment of urinary tract infections. The difference between men and women was not statistically significant. CONCLUSIONS In a large cohort of healthy individuals, LGI was associated with an increased risk of infection among healthy male blood donors.
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Affiliation(s)
| | - Khoa Manh Dinh
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | | | | | | | - Erik Sørensen
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen S, Denmark
| | | | - Henrik Hjalgrim
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen S, Denmark
| | - Klaus Rostgaard
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen S, Denmark
| | - Kaspar Rene Nielsen
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
| | - Henrik Ullum
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen S, Denmark
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
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