1
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Taki MH, Lee KE, Gangnon R, Gern JE, Lemanske RF, Jackson DJ, Singh AM. Atopic dermatitis phenotype affects expression of atopic diseases despite similar mononuclear cell cytokine response. J Allergy Clin Immunol 2024:S0091-6749(24)00231-8. [PMID: 38438085 DOI: 10.1016/j.jaci.2024.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 01/08/2024] [Accepted: 02/12/2024] [Indexed: 03/06/2024]
Abstract
BACKGROUND The atopic march refers to the coexpression and progression of atopic diseases in childhood, often beginning with atopic dermatitis (AD), although children may not progress through each atopic disease. OBJECTIVE We hypothesized that future atopic disease expression is modified by AD phenotype and that these differences result from underlying dysregulation of cytokine signaling. METHODS Children (n = 285) were enrolled into the Childhood Origins of Asthma (COAST) birth cohort and followed prospectively. Rates of AD, food allergy, allergic rhinitis, and asthma were assessed longitudinally from birth to 18 years of age. Associations between AD phenotype and food allergy, allergic rhinitis, asthma, allergic sensitization, exhaled nitric oxide, and lung function were determined. Peripheral blood mononuclear cell responses (IL-5, IL-10, IL-13, IFN-γ) to dust mite, phytohemagglutinin, Staphylococcus aureus Cowan I, and tetanus toxoid were compared among AD phenotypes. RESULTS AD at year 1 was associated with an increased risk of food allergy (P = .004). Both persistent and late-onset AD were associated with an increased risk of asthma (P < .001), rhinitis (P < .001), elevated total IgE (P < .001), percentage of aeroallergens with detectable IgE (P < .001), and elevated exhaled nitric oxide (P = .002). Longitudinal analyses did not reveal consistent differences in peripheral blood mononuclear cell responses among dermatitis phenotypes. CONCLUSION AD phenotype is associated with differential expression of other atopic diseases. Our findings suggest that peripheral blood cytokine dysregulation is not a mechanism underlying this process, and immune dysregulation may be mediated at mucosal surfaces or in secondary lymphoid organs.
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Affiliation(s)
- Mohamed H Taki
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wis; Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Kristine E Lee
- Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Ronald Gangnon
- Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - James E Gern
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wis; Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Robert F Lemanske
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wis; Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Daniel J Jackson
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wis.
| | - Anne Marie Singh
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wis.
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Brownell J, Lee KE, Chasman D, Gangnon R, Bendixsen CG, Barnes K, Grindle K, Pappas T, Bochkov YA, Dresen A, Hou C, Haslam DB, Seroogy CM, Ong IM, Gern JE. Farm animal exposure, respiratory illnesses, and nasal cell gene expression. J Allergy Clin Immunol 2024:S0091-6749(24)00122-2. [PMID: 38309597 DOI: 10.1016/j.jaci.2024.01.019] [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: 05/16/2023] [Revised: 01/19/2024] [Accepted: 01/26/2024] [Indexed: 02/05/2024]
Abstract
BACKGROUND Farm exposures in early life reduce the risks for childhood allergic diseases and asthma. There is less information about how farm exposures relate to respiratory illnesses and mucosal immune development. OBJECTIVE We hypothesized that children raised in farm environments have a lower incidence of respiratory illnesses over the first 2 years of life than nonfarm children. We also analyzed whether farm exposures or respiratory illnesses were related to patterns of nasal cell gene expression. METHODS The Wisconsin Infant Study Cohort included farm (n = 156) and nonfarm (n = 155) families with children followed to age 2 years. Parents reported prenatal farm and other environmental exposures. Illness frequency and severity were assessed using illness diaries and periodic surveys. Nasopharyngeal cell gene expression in a subset of 64 children at age 2 years was compared to farm exposure and respiratory illness history. RESULTS Farm versus nonfarm children had nominally lower rates of respiratory illnesses (rate ratio 0.82 [95% CI, 0.69, 0.97]) with a stepwise reduction in illness rates in children exposed to 0, 1, or ≥2 animal species, but these trends were nonsignificant in a multivariable model. Farm exposures and preceding respiratory illnesses were positively related to nasal cell gene signatures for mononuclear cells and innate and antimicrobial responses. CONCLUSIONS Maternal and infant exposure to farms and farm animals was associated with nonsignificant trends for reduced respiratory illnesses. Nasal cell gene expression in a subset of children suggests that farm exposures and respiratory illnesses in early life are associated with distinct patterns of mucosal immune expression.
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Affiliation(s)
- Joshua Brownell
- Department of Pediatrics, University of Wisconsin-Madison, Madison, Wis
| | - Kristine E Lee
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, Wis
| | - Deborah Chasman
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, Wis; Department of Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, Wis
| | - Ronald Gangnon
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, Wis
| | - Casper G Bendixsen
- National Farm Medicine Center, Marshfield Clinic Research Institute, Marshfield, Wis
| | - Katherine Barnes
- National Farm Medicine Center, Marshfield Clinic Research Institute, Marshfield, Wis
| | - Kristine Grindle
- Department of Pediatrics, University of Wisconsin-Madison, Madison, Wis
| | - Tressa Pappas
- Department of Pediatrics, University of Wisconsin-Madison, Madison, Wis
| | - Yury A Bochkov
- Department of Pediatrics, University of Wisconsin-Madison, Madison, Wis
| | - Amy Dresen
- Department of Pediatrics, University of Wisconsin-Madison, Madison, Wis
| | - Christine Hou
- Department of Statistics, University of Wisconsin-Madison, Madison
| | - David B Haslam
- Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio
| | | | - Irene M Ong
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, Wis; Department of Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, Wis
| | - James E Gern
- Department of Pediatrics, University of Wisconsin-Madison, Madison, Wis.
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McIntyre A, Lee KE, Patel GB, Mathur SK, Singh AM. Food allergy symptoms in adults and children using the Food Allergy Research & Education Patient Registry. J Allergy Clin Immunol Pract 2024; 12:249-251.e1. [PMID: 37778628 DOI: 10.1016/j.jaip.2023.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 09/06/2023] [Accepted: 09/18/2023] [Indexed: 10/03/2023]
Affiliation(s)
- Amanda McIntyre
- Division of Allergy, Pulmonary, and Critical Care, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Kristine E Lee
- Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Gayatri B Patel
- Division of Allergy and Immunology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Ill
| | - Sameer K Mathur
- Division of Allergy, Pulmonary, and Critical Care, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wis; Department of Medicine, William S. Middleton Veterans Hospital, Madison, Wis
| | - Anne Marie Singh
- Division of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wis.
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Laurenzo SA, Townsend EA, Lane Starr NM, Wollet LJ, Castro M, Jarjour NN, Sorkness CA, Lee KE, Denlinger LC. Development and Dynamic Responsiveness of the Acute Asthma Exacerbation Survey in Patients With Moderate to Severe Disease. J Allergy Clin Immunol Pract 2023; 11:3425-3434.e4. [PMID: 37453571 PMCID: PMC11000541 DOI: 10.1016/j.jaip.2023.07.007] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 07/03/2023] [Accepted: 07/06/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND The recall periods and response scales of existing surveys of asthma control are poorly suited for studying acute exacerbations. OBJECTIVE To develop an instrument able to predict exacerbations after the onset of acute symptoms and with a recall window sufficiently short to study recovery. METHODS We developed the six-item Acute Asthma Exacerbation Survey (AAES). Data were collected at baseline, acute, and recovery visits within an established longitudinal protocol for participants with severe asthma. Participants scheduled acute study visits at the first sign of a cold. Nasal lavage samples and lung function measurements were also collected. The AAES data were analyzed using Cronbach α, Spearman correlations, and Kruskal-Wallace methods. We used logistic regression for predictors of bursts of oral corticosteroids (OCS). RESULTS Of 130 participants studied at baseline, 52 returned for an acute visit. The AAES scores were elevated at the acute visit and returned to baseline after recovery independently of respiratory virus detection. Cronbach α for the AAES was 0.853, 0.822, and 0.889 at the three respective visits. Compared with participants not needing burst OCS, those with exacerbations had higher acute AAES scores (16 [13.5-18] vs 11.5 [8.2-14], median [interquartile range]; P = .017) and a larger reduction from baseline in lung function. For each 3-point increase in AAES scores, the odds ratio for burst OCS use was 1.64 (95% CI, 1.04-2.57; P = .030). CONCLUSIONS The AAES is internally consistent and dynamically responsive during acute asthma exacerbations. Additional validation studies are warranted to support future trials and aid in clinical decision-making.
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Affiliation(s)
- Scott A Laurenzo
- Division of Allergy, Pulmonary, and Critical Care, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Elizabeth A Townsend
- Division of Allergy, Pulmonary, and Critical Care, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wis; Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Nicole M Lane Starr
- Division of Allergy, Pulmonary, and Critical Care, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Lori J Wollet
- Division of Allergy, Pulmonary, and Critical Care, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Mario Castro
- Department of Internal Medicine, University of Kansas-Kansas City, Kansas City, Kan
| | - Nizar N Jarjour
- Division of Allergy, Pulmonary, and Critical Care, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Christine A Sorkness
- Division of Allergy, Pulmonary, and Critical Care, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wis; Pharmacy Practice and Translational Research Division, University of Wisconsin School of Pharmacy, Madison, Wis
| | - Kristine E Lee
- Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Loren C Denlinger
- Division of Allergy, Pulmonary, and Critical Care, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wis.
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5
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Carey KJ, Hotvedt P, Mummy DG, Lee KE, Denlinger LC, Schiebler ML, Sorkness RL, Jarjour NN, Hatt CR, Galban CJ, Fain SB. Comparison of hyperpolarized 3He-MRI, CT based parametric response mapping, and mucus scores in asthmatics. Front Physiol 2023; 14:1178339. [PMID: 37593238 PMCID: PMC10431597 DOI: 10.3389/fphys.2023.1178339] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 07/17/2023] [Indexed: 08/19/2023] Open
Abstract
Purpose: The purpose of this study was to anatomically correlate ventilation defects with regions of air trapping by whole lung, lung lobe, and airway segment in the context of airway mucus plugging in asthma. Methods: A total of 34 asthmatics [13M:21F, 13 mild/moderate, median age (range) of 49.5 (36.8-53.3) years and 21 severe, 56.1 (47.1-62.6) years] and 4 healthy subjects [1M:3F, 38.5 (26.6-52.2) years] underwent HP 3He MRI and CT imaging. HP 3He MRI was assessed for ventilation defects using a semi-automated k-means clustering algorithm. Inspiratory and expiratory CTs were analyzed using parametric response mapping (PRM) to quantify markers of emphysema and functional small airways disease (fSAD). Segmental and lobar lung masks were obtained from CT and registered to HP 3He MRI in order to localize ventilation defect percent (VDP), at the lobar and segmental level, to regions of fSAD and mucus plugging. Spearman's correlation was utilized to compare biomarkers on a global and lobar level, and a multivariate analysis was conducted to predict segmental fSAD given segmental VDP (sVDP) and mucus score as variables in order to further understand the functional relationships between regional measures of obstruction. Results: On a global level, fSAD was correlated with whole lung VDP (r = 0.65, p < 0.001), mucus score (r = 0.55, p < 0.01), and moderately correlated (-0.60 ≤ r ≤ -0.56, p < 0.001) to percent predicted (%p) FEV1, FEF25-75 and FEV1/FVC, and more weakly correlated to FVC%p (-0.38 ≤ r ≤ -0.35, p < 0.001) as expected from previous work. On a regional level, lobar VDP, mucus scores, and fSAD were also moderately correlated (r from 0.45-0.66, p < 0.01). For segmental colocalization, the model of best fit was a piecewise quadratic model, which suggests that sVDP may be increasing due to local airway obstruction that does not manifest as fSAD until more extensive disease is present. sVDP was more sensitive to the presence of a mucus plugs overall, but the prediction of fSAD using multivariate regression showed an interaction in the presence of a mucus plugs when sVDP was between 4% and 10% (p < 0.001). Conclusion: This multi-modality study in asthma confirmed that areas of ventilation defects are spatially correlated with air trapping at the level of the airway segment and suggests VDP and fSAD are sensitive to specific sources of airway obstruction in asthma, including mucus plugs.
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Affiliation(s)
- Katherine J. Carey
- Department of Medical Physics, University of Wisconsin—Madison, Madison, WI, United States
- Department of Radiology, University of Wisconsin—Madison, Madison, WI, United States
- Imbio LLC, Minneapolis, MN, United States
| | - Peter Hotvedt
- Department of Nuclear Engineering, University of Michigan—Ann Arbor, Ann Arbor, MI, United States
| | - David G. Mummy
- Center for In Vivo Microscopy, Department of Radiology, Duke University, Durham, NC, United States
- Center for In Vivo Microscopy, Duke University, Durham, NC, United States
| | - Kristine E. Lee
- Department of Biostatistics, University of Wisconsin—Madison, Madison, WI, United States
| | - Loren C. Denlinger
- Division of Allergy, Pulmonary, and Critical Care Medicine, University of Wisconsin—Madison, Madison, WI, United States
| | - Mark L. Schiebler
- Department of Radiology, University of Wisconsin—Madison, Madison, WI, United States
| | - Ronald L. Sorkness
- School of Pharmacy, University of Wisconsin—Madison, Madison, WI, United States
| | - Nizar N. Jarjour
- Division of Allergy, Pulmonary, and Critical Care Medicine, University of Wisconsin—Madison, Madison, WI, United States
| | - Charles R. Hatt
- Imbio LLC, Minneapolis, MN, United States
- Department of Radiology, University of Michigan, Ann Arbor, MI, United States
| | - Craig J. Galban
- Department of Radiology, University of Michigan, Ann Arbor, MI, United States
| | - Sean B. Fain
- Department of Radiology, University of Iowa, Iowa City, IA, United States
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Hahn AD, Carey KJ, Barton GP, Torres LA, Kammerman J, Cadman RV, Lee KE, Schiebler ML, Sandbo N, Fain SB. Functional xenon-129 magnetic resonance imaging response to antifibrotic treatment in idiopathic pulmonary fibrosis. ERJ Open Res 2023; 9:00080-2023. [PMID: 37377660 PMCID: PMC10291299 DOI: 10.1183/23120541.00080-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 04/06/2023] [Indexed: 06/29/2023] Open
Abstract
A measure of regional gas exchange on HP 129Xe MRI was able to detect apparent improvements in IPF patients treated with antifibrotic medication after 1 year, while no such improvements were found in patients treated with conventional therapies https://bit.ly/3ZXipzD.
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Affiliation(s)
- Andrew D. Hahn
- Department of Medical Physics, UW-Madison, Madison, WI, USA
- Department of Radiology, University of Iowa, Iowa City, IA, USA
| | - Katie J. Carey
- Department of Medical Physics, UW-Madison, Madison, WI, USA
| | - Gregory P. Barton
- Department of Medical Physics, UW-Madison, Madison, WI, USA
- Department of Medicine, UT Southwestern Medical Center, Dallas, TX, USA
| | - Luis A. Torres
- Department of Medical Physics, UW-Madison, Madison, WI, USA
| | - Jeff Kammerman
- Department of Medical Physics, UW-Madison, Madison, WI, USA
| | - Robert V. Cadman
- Department of Medical Physics, UW-Madison, Madison, WI, USA
- Department of Medicine, UW-Madison, Madison, WI, USA
| | - Kristine E. Lee
- Department of Biostatistics and Medical Informatics, UW-Madison, Madison, WI, USA
| | | | - Nathan Sandbo
- Department of Medicine, UW-Madison, Madison, WI, USA
| | - Sean B. Fain
- Department of Medical Physics, UW-Madison, Madison, WI, USA
- Department of Radiology, University of Iowa, Iowa City, IA, USA
- Department of Medicine, UW-Madison, Madison, WI, USA
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Tattersall MC, Lee KE, Tsuchiya N, Osman F, Korcarz CE, Hansen KM, Peters MC, Fahy JV, Longhurst CA, Dunican E, Wentzel SE, Leader JK, Israel E, Levy BD, Castro M, Erzurum SC, Lempel J, Moore WC, Bleecker ER, Phillips BR, Mauger DT, Hoffman EA, Fain SB, Reeder SB, Sorkness RL, Jarjour NN, Denlinger LC, Schiebler ML. Skeletal Muscle Adiposity and Lung Function Trajectory in the Severe Asthma Research Program. Am J Respir Crit Care Med 2023; 207:475-484. [PMID: 36194556 PMCID: PMC9940151 DOI: 10.1164/rccm.202203-0597oc] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 10/04/2022] [Indexed: 01/05/2023] Open
Abstract
Rationale: Extrapulmonary manifestations of asthma, including fatty infiltration in tissues, may reflect systemic inflammation and influence lung function and disease severity. Objectives: To determine if skeletal muscle adiposity predicts lung function trajectory in asthma. Methods: Adult SARP III (Severe Asthma Research Program III) participants with baseline computed tomography imaging and longitudinal postbronchodilator FEV1% predicted (median follow-up 5 years [1,132 person-years]) were evaluated. The mean of left and right paraspinous muscle density (PSMD) at the 12th thoracic vertebral body was calculated (Hounsfield units [HU]). Lower PSMD reflects higher muscle adiposity. We derived PSMD reference ranges from healthy control subjects without asthma. A linear multivariable mixed-effects model was constructed to evaluate associations of baseline PSMD and lung function trajectory stratified by sex. Measurements and Main Results: Participants included 219 with asthma (67% women; mean [SD] body mass index, 32.3 [8.8] kg/m2) and 37 control subjects (51% women; mean [SD] body mass index, 26.3 [4.7] kg/m2). Participants with asthma had lower adjusted PSMD than control subjects (42.2 vs. 55.8 HU; P < 0.001). In adjusted models, PSMD predicted lung function trajectory in women with asthma (β = -0.47 Δ slope per 10-HU decrease; P = 0.03) but not men (β = 0.11 Δ slope per 10-HU decrease; P = 0.77). The highest PSMD tertile predicted a 2.9% improvement whereas the lowest tertile predicted a 1.8% decline in FEV1% predicted among women with asthma over 5 years. Conclusions: Participants with asthma have lower PSMD, reflecting greater muscle fat infiltration. Baseline PSMD predicted lung function decline among women with asthma but not men. These data support an important role of metabolic dysfunction in lung function decline.
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Affiliation(s)
| | | | - Nanae Tsuchiya
- Division of Cardiothoracic Imaging, Department of Radiology, School of Medicine and Public Health, University of Wisconsin–Madison, Madison, Wisconsin
- Department of Radiology, School of Medicine, University of the Ryukyus, Nishihara, Japan
| | | | | | | | - Michael C. Peters
- Division of Pulmonary and Critical Care, Department of Medicine, University of California, San Francisco, San Francisco, California
| | - John V. Fahy
- Division of Pulmonary and Critical Care, Department of Medicine, University of California, San Francisco, San Francisco, California
| | | | - Eleanor Dunican
- Department of Medicine, School of Medicine, University College Dublin, Dublin, Ireland
- St. Vincent’s Hospital Elm Park, Dublin, Ireland
| | - Sally E. Wentzel
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, and
| | - Joseph K. Leader
- Department of Radiology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Elliot Israel
- Division of Pulmonary and Critical Care and
- Division of Allergy and Immunology, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | | | - Mario Castro
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Kansas Medical Center, Kansas City, Kansas
| | | | - Jason Lempel
- Department of Radiology, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Wendy C. Moore
- Section of Pulmonary, Critical Care, Allergy and Immunologic Diseases, Department of Internal Medicine, School of Medicine, Wake Forest University, Winston-Salem, North Carolina
| | - Eugene R. Bleecker
- Division of Genetics and
- Division of Pharmacokinetics, Department of Medicine, College of Medicine, University of Arizona, Tucson, Arizona
| | - Brenda R. Phillips
- Department of Public Health Sciences, College of Medicine, Pennsylvania State University, Hershey, Pennsylvania; and
| | - David T. Mauger
- Department of Public Health Sciences, College of Medicine, Pennsylvania State University, Hershey, Pennsylvania; and
| | - Eric A. Hoffman
- Department of Biomedical Engineering
- Department of Radiology, and
- Department of Medicine, Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | | | | | | | - Nizar N. Jarjour
- Division of Pulmonary Medicine and Critical Care
- Department of Medicine
| | | | - Mark L. Schiebler
- Division of Cardiothoracic Imaging, Department of Radiology, School of Medicine and Public Health, University of Wisconsin–Madison, Madison, Wisconsin
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8
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Hahn AD, Carey KJ, Barton GP, Torres LA, Kammerman J, Cadman RV, Lee KE, Schiebler ML, Sandbo N, Fain SB. Hyperpolarized 129Xe MR Spectroscopy in the Lung Shows 1-year Reduced Function in Idiopathic Pulmonary Fibrosis. Radiology 2022; 305:688-696. [PMID: 35880982 PMCID: PMC9713448 DOI: 10.1148/radiol.211433] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 04/29/2022] [Accepted: 05/12/2022] [Indexed: 11/11/2022]
Abstract
Background Idiopathic pulmonary fibrosis (IPF) is a temporally and spatially heterogeneous lung disease. Identifying whether IPF in a patient is progressive or stable is crucial for treatment regimens. Purpose To assess the role of hyperpolarized (HP) xenon 129 (129Xe) MRI measures of ventilation and gas transfer in IPF generally and as an early signature of future IPF progression. Materials and Methods In a prospective study, healthy volunteers and participants with IPF were consecutively recruited between December 2015 and August 2019 and underwent baseline HP 129Xe MRI and chest CT. Participants with IPF were followed up with forced vital capacity percent predicted (FVC%p), diffusing capacity of the lungs for carbon monoxide percent predicted (DLco%p), and clinical outcome at 1 year. IPF progression was defined as reduction in FVC%p by at least 10%, reduction in DLco%p by at least 15%, or admission to hospice care. CT and MRI were spatially coregistered and a measure of pulmonary gas transfer (red blood cell [RBC]-to-barrier ratio) and high-ventilation percentage of lung volume were compared across groups and across fibrotic versus normal-appearing regions at CT by using Wilcoxon signed rank tests. Results Sixteen healthy volunteers (mean age, 57 years ± 14 [SD]; 10 women) and 22 participants with IPF (mean age, 71 years ± 9; 15 men) were evaluated, as follows: nine IPF progressors (mean age, 72 years ± 7; five women) and 13 nonprogressors (mean age, 70 years ± 10; 11 men). Reduction of high-ventilation percent (13% ± 6.1 vs 8.2% ± 5.9; P = .03) and RBC-to-barrier ratio (0.26 ± 0.06 vs 0.20 ± 0.06; P = .03) at baseline were associated with progression of IPF. Participants with progressive disease had reduced RBC-to-barrier ratio in structurally normal-appearing lung at CT (0.21 ± 0.07 vs 0.28 ± 0.05; P = .01) but not in fibrotic regions of the lung (0.15 ± 0.09 vs 0.14 ± 0.04; P = .62) relative to the nonprogressive group. Conclusion In this preliminary study, functional measures of gas transfer and ventilation measured with xenon 129 MRI and the extent of fibrotic structure at CT were associated with idiopathic pulmonary fibrosis disease progression. Differences in gas transfer were found in regions of nonfibrotic lung. © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Gleeson and Fraser in this issue.
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Affiliation(s)
- Andrew D. Hahn
- From the Departments of Medical Physics (A.D.H., K.J.C., G.P.B.,
L.A.T., J.K., R.V.C., S.B.F.), Medicine (R.V.C., N.S.), Biostatistics and
Medical Informatics (K.E.L.), and Radiology (M.L.S.), University of
Wisconsin–Madison, 1111 Highland Ave, Room 1005, Madison, WI 53705;
Department of Medicine, University of Texas Southwestern Medical Center, Dallas,
Tex (G.P.B.); and Department of Radiology, University of Iowa, Iowa City, Iowa
(A.D.H., S.B.F.)
| | - Katie J. Carey
- From the Departments of Medical Physics (A.D.H., K.J.C., G.P.B.,
L.A.T., J.K., R.V.C., S.B.F.), Medicine (R.V.C., N.S.), Biostatistics and
Medical Informatics (K.E.L.), and Radiology (M.L.S.), University of
Wisconsin–Madison, 1111 Highland Ave, Room 1005, Madison, WI 53705;
Department of Medicine, University of Texas Southwestern Medical Center, Dallas,
Tex (G.P.B.); and Department of Radiology, University of Iowa, Iowa City, Iowa
(A.D.H., S.B.F.)
| | - Gregory P. Barton
- From the Departments of Medical Physics (A.D.H., K.J.C., G.P.B.,
L.A.T., J.K., R.V.C., S.B.F.), Medicine (R.V.C., N.S.), Biostatistics and
Medical Informatics (K.E.L.), and Radiology (M.L.S.), University of
Wisconsin–Madison, 1111 Highland Ave, Room 1005, Madison, WI 53705;
Department of Medicine, University of Texas Southwestern Medical Center, Dallas,
Tex (G.P.B.); and Department of Radiology, University of Iowa, Iowa City, Iowa
(A.D.H., S.B.F.)
| | - Luis A. Torres
- From the Departments of Medical Physics (A.D.H., K.J.C., G.P.B.,
L.A.T., J.K., R.V.C., S.B.F.), Medicine (R.V.C., N.S.), Biostatistics and
Medical Informatics (K.E.L.), and Radiology (M.L.S.), University of
Wisconsin–Madison, 1111 Highland Ave, Room 1005, Madison, WI 53705;
Department of Medicine, University of Texas Southwestern Medical Center, Dallas,
Tex (G.P.B.); and Department of Radiology, University of Iowa, Iowa City, Iowa
(A.D.H., S.B.F.)
| | - Jeff Kammerman
- From the Departments of Medical Physics (A.D.H., K.J.C., G.P.B.,
L.A.T., J.K., R.V.C., S.B.F.), Medicine (R.V.C., N.S.), Biostatistics and
Medical Informatics (K.E.L.), and Radiology (M.L.S.), University of
Wisconsin–Madison, 1111 Highland Ave, Room 1005, Madison, WI 53705;
Department of Medicine, University of Texas Southwestern Medical Center, Dallas,
Tex (G.P.B.); and Department of Radiology, University of Iowa, Iowa City, Iowa
(A.D.H., S.B.F.)
| | - Robert V. Cadman
- From the Departments of Medical Physics (A.D.H., K.J.C., G.P.B.,
L.A.T., J.K., R.V.C., S.B.F.), Medicine (R.V.C., N.S.), Biostatistics and
Medical Informatics (K.E.L.), and Radiology (M.L.S.), University of
Wisconsin–Madison, 1111 Highland Ave, Room 1005, Madison, WI 53705;
Department of Medicine, University of Texas Southwestern Medical Center, Dallas,
Tex (G.P.B.); and Department of Radiology, University of Iowa, Iowa City, Iowa
(A.D.H., S.B.F.)
| | - Kristine E. Lee
- From the Departments of Medical Physics (A.D.H., K.J.C., G.P.B.,
L.A.T., J.K., R.V.C., S.B.F.), Medicine (R.V.C., N.S.), Biostatistics and
Medical Informatics (K.E.L.), and Radiology (M.L.S.), University of
Wisconsin–Madison, 1111 Highland Ave, Room 1005, Madison, WI 53705;
Department of Medicine, University of Texas Southwestern Medical Center, Dallas,
Tex (G.P.B.); and Department of Radiology, University of Iowa, Iowa City, Iowa
(A.D.H., S.B.F.)
| | - Mark L. Schiebler
- From the Departments of Medical Physics (A.D.H., K.J.C., G.P.B.,
L.A.T., J.K., R.V.C., S.B.F.), Medicine (R.V.C., N.S.), Biostatistics and
Medical Informatics (K.E.L.), and Radiology (M.L.S.), University of
Wisconsin–Madison, 1111 Highland Ave, Room 1005, Madison, WI 53705;
Department of Medicine, University of Texas Southwestern Medical Center, Dallas,
Tex (G.P.B.); and Department of Radiology, University of Iowa, Iowa City, Iowa
(A.D.H., S.B.F.)
| | - Nathan Sandbo
- From the Departments of Medical Physics (A.D.H., K.J.C., G.P.B.,
L.A.T., J.K., R.V.C., S.B.F.), Medicine (R.V.C., N.S.), Biostatistics and
Medical Informatics (K.E.L.), and Radiology (M.L.S.), University of
Wisconsin–Madison, 1111 Highland Ave, Room 1005, Madison, WI 53705;
Department of Medicine, University of Texas Southwestern Medical Center, Dallas,
Tex (G.P.B.); and Department of Radiology, University of Iowa, Iowa City, Iowa
(A.D.H., S.B.F.)
| | - Sean B. Fain
- From the Departments of Medical Physics (A.D.H., K.J.C., G.P.B.,
L.A.T., J.K., R.V.C., S.B.F.), Medicine (R.V.C., N.S.), Biostatistics and
Medical Informatics (K.E.L.), and Radiology (M.L.S.), University of
Wisconsin–Madison, 1111 Highland Ave, Room 1005, Madison, WI 53705;
Department of Medicine, University of Texas Southwestern Medical Center, Dallas,
Tex (G.P.B.); and Department of Radiology, University of Iowa, Iowa City, Iowa
(A.D.H., S.B.F.)
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9
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Torres LA, Lee KE, Barton GP, Hahn AD, Sandbo N, Schiebler ML, Fain SB. Dynamic contrast enhanced MRI for the evaluation of lung perfusion in idiopathic pulmonary fibrosis. Eur Respir J 2022; 60:13993003.02058-2021. [PMID: 35273033 PMCID: PMC10015995 DOI: 10.1183/13993003.02058-2021] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 02/24/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND The objective of this work was to apply quantitative and semiquantitative dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) methods to evaluate lung perfusion in idiopathic pulmonary fibrosis (IPF). METHODS In this prospective trial 41 subjects, including healthy control and IPF subjects, were studied using DCE-MRI at baseline. IPF subjects were then followed for 1 year; progressive IPF (IPFprog) subjects were distinguished from stable IPF (IPFstable) subjects based on a decline in percent predicted forced vital capacity (FVC % pred) or diffusing capacity of the lung for carbon monoxide (D LCO % pred) measured during follow-up visits. 35 out of 41 subjects were retained for final baseline analysis (control: n=15; IPFstable: n=14; IPFprog: n=6). Seven measures and their coefficients of variation (CV) were derived using temporally resolved DCE-MRI. Two sets of global and regional comparisons were made: control versus IPF groups and control versus IPFstable versus IPFprog groups, using linear regression analysis. Each measure was compared with FVC % pred, D LCO % pred and the lung clearance index (LCI % pred) using a Spearman rank correlation. RESULTS DCE-MRI identified regional perfusion differences between control and IPF subjects using first moment transit time (FMTT), contrast uptake slope and pulmonary blood flow (PBF) (p≤0.05), while global averages did not. FMTT was shorter for IPFprog compared with both IPFstable (p=0.004) and control groups (p=0.023). Correlations were observed between PBF CV and D LCO % pred (rs= -0.48, p=0.022) and LCI % pred (rs= +0.47, p=0.015). Significant group differences were detected in age (p<0.001), D LCO % pred (p<0.001), FVC % pred (p=0.001) and LCI % pred (p=0.007). CONCLUSIONS Global analysis obscures regional changes in pulmonary haemodynamics in IPF using DCE-MRI in IPF. Decreased FMTT may be a candidate marker for IPF progression.
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Affiliation(s)
- Luis A Torres
- Dept of Medical Physics, School of Medicine and Public Health, University of Wisconsin - Madison, Madison, WI, USA
| | - Kristine E Lee
- Dept of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin - Madison, Madison, WI, USA
| | - Gregory P Barton
- Dept of Medical Physics, School of Medicine and Public Health, University of Wisconsin - Madison, Madison, WI, USA
| | - Andrew D Hahn
- Dept of Medical Physics, School of Medicine and Public Health, University of Wisconsin - Madison, Madison, WI, USA
| | - Nathan Sandbo
- Dept of Medicine, School of Medicine and Public Health, University of Wisconsin - Madison, Madison, WI, USA
| | - Mark L Schiebler
- Dept of Medicine, School of Medicine and Public Health, University of Wisconsin - Madison, Madison, WI, USA.,Dept of Radiology, School of Medicine and Public Health, University of Wisconsin - Madison, Madison, WI, USA
| | - Sean B Fain
- Dept of Medical Physics, School of Medicine and Public Health, University of Wisconsin - Madison, Madison, WI, USA .,Dept of Radiology, School of Medicine and Public Health, University of Wisconsin - Madison, Madison, WI, USA.,Dept of Biomedical Engineering, College of Engineering, University of Wisconsin - Madison, Madison, WI, USA.,Dept of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
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10
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Goswamy V, Lee KE, McKernan EM, Fichtinger PS, Mathur SK, Viswanathan RK. Omalizumab for Treatment of Idiopathic Angioedema. Ann Allergy Asthma Immunol 2022; 129:605-611.e1. [PMID: 35914662 DOI: 10.1016/j.anai.2022.07.017] [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] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 07/10/2022] [Accepted: 07/19/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Omalizumab has been shown to improve outcomes in patients with chronic spontaneous urticaria (CSU). Idiopathic angioedema (IAE) is increasingly being recognized as a condition with similar underlying mechanisms as CSU and a form of CSU. We hypothesized that add-on therapy with omalizumab would benefit patients with uncontrolled IAE. OBJECTIVE To study the safety and efficacy of omalizumab for the treatment of IAE in adults. METHODS We conducted a randomized, placebo-controlled trial to study the efficacy of omalizumab in adults with two or more episodes of angioedema (AE) in the past 6 months for which no clinical or laboratory cause of AE could be found. Ten patients were randomized on a 1:1 basis to receive omalizumab 300 mg SQ or placebo every 4 weeks for 24 weeks with a 12 week follow up period. The primary endpoint was the change in the Angioedema Activity Score (AAS). Secondary endpoints included the Angioedema Quality of Life Questionnaire (AE-QoL), the Visual Analog Scale (VAS) and the number of angioedema episodes per month. RESULTS We observed improvement in the AAS score (-2.93 ln odds; 95% confidence interval (CI) -4.84, -1.02; p = 0.003), VAS (-3.49 ln odds; 95% CI -6.58, -0.40; p = 0.03), AE-QoL (-9.43 score; 95% CI -17.63, -1.24; p = 0.028) and number of angioedema episodes per month (-1.93 ln count; 95% CI -3.23, -0.63; p = 0.005) in patients that received omalizumab vs placebo. CONCLUSION This study provides preliminary prospective evidence that omalizumab improves outcomes in patients with IAE.
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Affiliation(s)
- Vinay Goswamy
- Division of Allergy, Pulmonary and Critical Care, Department of Medicine, University of Wisconsin School of Medicine and Public Health.
| | - Kristine E Lee
- Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health
| | - Elizabeth M McKernan
- Division of Allergy, Pulmonary and Critical Care, Department of Medicine, University of Wisconsin School of Medicine and Public Health
| | - Paul S Fichtinger
- Division of Allergy, Pulmonary and Critical Care, Department of Medicine, University of Wisconsin School of Medicine and Public Health
| | - Sameer K Mathur
- Division of Allergy, Pulmonary and Critical Care, Department of Medicine, University of Wisconsin School of Medicine and Public Health
| | - Ravi K Viswanathan
- Division of Allergy, Pulmonary and Critical Care, Department of Medicine, University of Wisconsin School of Medicine and Public Health
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11
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Jeong MJ, Lee KE, Chae YK, Nam OH, Lee HS, Choi SC. Correlations between skeletal maturity and dental calcification stages in Korean children. Eur J Paediatr Dent 2022; 23:101-105. [PMID: 35722843 DOI: 10.23804/ejpd.2022.23.02.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
AIM To evaluate the relationship between dental calcification and skeletal maturity and to identify the tooth with the highest correlation with skeletal maturity index in Korean children. MATERIALS For 447 children (205 boys and 242 girls) aged between 5 and 13 years, hand-wrist and lateral cephalometric radiographs were taken to assess skeletal maturity by Fishman's skeletal maturity indicators (SMI) and Baccetti's cervical vertebrae maturation (CVM) stages. Dental panoramic radiographs were taken to assess dental maturity of the permanent mandibular canine, first and second premolar, and second molar using the method devised by Dermirjian. CONCLUSION Dental calcification stages determined by panoramic radiographs can be clinically used as useful indices to predict skeletal maturity in Korean children.
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Affiliation(s)
- M J Jeong
- Department of Pediatric Dentistry, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - K E Lee
- Department of Pediatric Dentistry, Kyung Hee University Dental Hospital, Seoul, Republic of Korea
| | - Y K Chae
- Department of Pediatric Dentistry, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - O H Nam
- Department of Pediatric Dentistry, Kyung Hee University Dental Hospital, Seoul, Republic of Korea
| | - H S Lee
- Department of Pediatric Dentistry, Kyung Hee University Dental Hospital, Seoul, Republic of Korea
| | - S C Choi
- Department of Pediatric Dentistry, Kyung Hee University Dental Hospital, Seoul, Republic of Korea
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12
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Yang BR, Cha SH, Lee KE, Kim JW, Lee J, Shin KH. Effect of dipeptidyl peptidase IV inhibitors, thiazolidinedione, and sulfonylurea on osteoporosis in patients with type 2 diabetes: population-based cohort study. Osteoporos Int 2021; 32:1705-1712. [PMID: 33594487 DOI: 10.1007/s00198-020-05801-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 12/15/2020] [Indexed: 12/01/2022]
Abstract
UNLABELLED The population-based cohort study used the Korean National Health Insurance claims database to evaluate the effect of anti-diabetic drugs on osteoporosis. The use of DPP-IV inhibitors does not increase the risk of osteoporosis compared with the use of sulfonylureas in patients with type 2 diabetes mellitus, while a weak association was found between thiazolidinediones and increased risk of osteoporosis. PURPOSE The current study aimed to evaluate the effect of dipeptidyl peptidase IV inhibitors (DPP-IVi), thiazolidinedione (TZD), and sulfonylurea (SU) on osteoporosis in patients with type 2 diabetes. METHODS A population-based cohort study was conducted in the Republic of Korea using the Korean National Health Insurance claims database. Data from 2012 to 2017 for patients of 50-99 years of age who were prescribed DPP-IVi, TZD, or SU during 2013-2015 were extracted from the database. Based on pre-defined criteria, a total of 381,404 patients were analyzed after inverse probability of treatment weighting. The association between the study drugs and osteoporosis was estimated using Cox proportional hazards models. Data of 220,166 patients who were prescribed DPP-IVi, 18,630 who were prescribed TZD, and 142,608 patients who were prescribed SU were set. RESULTS In the multivariate-adjusted analysis, the hazard ratio (HR) of osteoporosis in the DPP-IVi group was not significantly different from that of the SU group (HR: 0.97; 95% confidence interval (CI) 0.94-1.00), whereas the HR of osteoporosis in the TZD group was higher (HR: 1.13; 95% CI 1.06-1.20). In the subgroup analysis, the HRs of osteoporosis were higher with pioglitazone (HR: 1.14; 95% CI 1.06-1.23) in the TZD group and with glibenclamides (HR: 1.39; 95% CI 1.09-1.77) in the SU group, whereas drugs with lower HR in the DPP-IVi group were saxagliptin (HR: 0.93; 95% CI 0.87-0.99) and sitagliptin (HR: 0.93; 95% CI 0.89-0.97). CONCLUSION DPP-IV inhibitors do not increase the risk of osteoporosis compared with sulfonylureas in patients with type 2 diabetes mellitus, while a weak association was found between thiazolidinediones and increased risk of osteoporosis.
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Affiliation(s)
- B R Yang
- College of Pharmacy, Chungnam National University, Daejeon, Republic of Korea
| | - S H Cha
- Department of Statistics, College of Natural Sciences, Kyungpook National University, Daegu, Republic of Korea
| | - K E Lee
- Department of Statistics, College of Natural Sciences, Kyungpook National University, Daegu, Republic of Korea
| | - J W Kim
- Department of Family Medicine, Daegu Health College Hospital, Daegu, Republic of Korea
| | - J Lee
- College of Pharmacy, Research Institute of Pharmaceutical Sciences, Kyungpook National University, 80 Daehak-ro, Buk-gu, Daegu, 41566, Republic of Korea
| | - K-H Shin
- College of Pharmacy, Research Institute of Pharmaceutical Sciences, Kyungpook National University, 80 Daehak-ro, Buk-gu, Daegu, 41566, Republic of Korea.
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13
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Bartig KA, Lee KE, Mosher DF, Mathur SK, Johansson MW. Platelet association with leukocytes in active eosinophilic esophagitis. PLoS One 2021; 16:e0250521. [PMID: 33891621 PMCID: PMC8064567 DOI: 10.1371/journal.pone.0250521] [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: 12/28/2020] [Accepted: 04/07/2021] [Indexed: 12/27/2022] Open
Abstract
We previously demonstrated that the percentage of blood eosinophils that are associated with platelets and thus positive for CD41 (integrin αIIb-subunit) correlates with and predicts peak eosinophil count (PEC) in biopsies of eosinophilic esophagitis (EoE) patients after treatment. Thus, flow cytometric determination of CD41+ eosinophils is a potential measure of EoE disease activity. Determinants of association of platelets with eosinophils and other leukocytes in EoE are largely unknown. The objectives of this study were to test the hypotheses that platelets associate with blood leukocytes other than eosinophils in EoE and that such associations also predict EoE activity. Whole blood flow cytometry was performed on samples from 25 subjects before and after two months of standard of care EoE treatment. CD41 positivity of cells within gates for eosinophils, neutrophils, monocytes, lymphocytes, and natural killer cells was compared. We found that percent CD41+ neutrophils, monocytes, and eosinophils correlated with one another such that principal component analysis of the five cell types identified “myeloid” and “lymphoid” factors. Percent CD41+ neutrophils or monocytes, or the myeloid factor, like CD41+ eosinophils, correlated with PEC after treatment, and CD41+ neutrophils or the myeloid factor predicted PEC < 6/high power field after treatment, albeit with lower area under the curve than for CD41+ eosinophils. We conclude that the processes driving platelets to associate with eosinophils in EoE also drive association of platelets with neutrophils and monocytes and that association of platelets with all three cell types is related to disease activity. Clinicaltrials.gov identifier: NCT02775045.
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Affiliation(s)
- Kelly A. Bartig
- Department of Biomolecular Chemistry, University of Wisconsin, Madison, Wisconsin, United States of America
| | - Kristine E. Lee
- Department of Biostatistics and Medical Informatics, University of Wisconsin, Madison, Wisconsin, United States of America
| | - Deane F. Mosher
- Department of Biomolecular Chemistry, University of Wisconsin, Madison, Wisconsin, United States of America
- Department of Medicine, University of Wisconsin, Madison, Wisconsin, United States of America
- Morgridge Institute for Research, Madison, Wisconsin, United States of America
| | - Sameer K. Mathur
- Department of Medicine, University of Wisconsin, Madison, Wisconsin, United States of America
| | - Mats W. Johansson
- Department of Biomolecular Chemistry, University of Wisconsin, Madison, Wisconsin, United States of America
- Department of Medicine, University of Wisconsin, Madison, Wisconsin, United States of America
- Morgridge Institute for Research, Madison, Wisconsin, United States of America
- * E-mail:
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14
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Choi T, Devries M, Bacharier LB, Busse W, Camargo CA, Cohen R, Demuri GP, Evans MD, Fitzpatrick AM, Gergen PJ, Grindle K, Gruchalla R, Hartert T, Hasegawa K, Khurana Hershey GK, Holt P, Homil K, Jartti T, Kattan M, Kercsmar C, Kim H, Laing IA, LeBeau P, Lee KE, Le Souëf PN, Liu A, Mauger DT, Ober C, Pappas T, Patel SJ, Phipatanakul W, Pongracic J, Seroogy C, Sly PD, Tisler C, Wald ER, Wood R, Gangnon R, Jackson DJ, Lemanske RF, Gern JE, Bochkov YA. Enhanced Neutralizing Antibody Responses to Rhinovirus C and Age-Dependent Patterns of Infection. Am J Respir Crit Care Med 2021; 203:822-830. [PMID: 33357024 PMCID: PMC8017585 DOI: 10.1164/rccm.202010-3753oc] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 12/23/2020] [Indexed: 01/10/2023] Open
Abstract
Rationale: Rhinovirus (RV) C can cause asymptomatic infection and respiratory illnesses ranging from the common cold to severe wheezing.Objectives: To identify how age and other individual-level factors are associated with susceptibility to RV-C illnesses.Methods: Longitudinal data from the COAST (Childhood Origins of Asthma) birth cohort study were analyzed to determine relationships between age and RV-C infections. Neutralizing antibodies specific for RV-A and RV-C (three types each) were determined using a novel PCR-based assay. Data were pooled from 14 study cohorts in the United States, Finland, and Australia, and mixed-effects logistic regression was used to identify factors related to the proportion of RV-C versus RV-A detection.Measurements and Main Results: In COAST, RV-A and RV-C infections were similarly common in infancy, whereas RV-C was detected much less often than RV-A during both respiratory illnesses and scheduled surveillance visits (P < 0.001, χ2) in older children. The prevalence of neutralizing antibodies to RV-A or RV-C types was low (5-27%) at the age of 2 years, but by the age of 16 years, RV-C seropositivity was more prevalent (78% vs. 18% for RV-A; P < 0.0001). In the pooled analysis, the RV-C to RV-A detection ratio during illnesses was significantly related to age (P < 0.0001), CDHR3 genotype (P < 0.05), and wheezing illnesses (P < 0.05). Furthermore, certain RV types (e.g., C2, C11, A78, and A12) were consistently more virulent and prevalent over time.Conclusions: Knowledge of prevalent RV types, antibody responses, and populations at risk based on age and genetics may guide the development of vaccines or other novel therapies against this important respiratory pathogen.
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Affiliation(s)
- Timothy Choi
- University of Wisconsin-Madison, Madison, Wisconsin
| | - Mark Devries
- University of Wisconsin-Madison, Madison, Wisconsin
| | | | | | | | | | | | | | - Anne M Fitzpatrick
- Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Peter J Gergen
- National Institute of Allergy and Infectious Disease, National Institutes of Health, Rockville, Maryland
| | | | | | | | | | | | - Patrick Holt
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | | | - Tuomas Jartti
- University of Turku, Turku, Finland
- Universities of Oulu, Oulu, Finland
| | | | | | - Haejin Kim
- Henry Ford Health Systems, Detroit, Michigan
| | - Ingrid A Laing
- University of Western Australia, Perth, Western Australia, Australia
| | | | | | - Peter N Le Souëf
- University of Western Australia, Perth, Western Australia, Australia
| | - Andrew Liu
- University of Colorado, Denver, Colorado
| | | | | | | | | | | | | | | | - Peter D Sly
- Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia; and
| | | | - Ellen R Wald
- University of Wisconsin-Madison, Madison, Wisconsin
| | - Robert Wood
- Johns Hopkins University, Baltimore, Maryland
| | | | | | | | - James E Gern
- University of Wisconsin-Madison, Madison, Wisconsin
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15
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Lane Starr NM, Evans MD, Lee KE, Gern JE, Denlinger LC. Ensemble Analysis Identifies Nasal 15-Keto-PGE2 as a Predictor of Recovery in Experimental Rhinovirus Colds. J Infect Dis 2021; 224:839-849. [PMID: 33681993 DOI: 10.1093/infdis/jiab015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 01/24/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Symptom intensity during a common cold is highly variable, particularly after the illness peaks, contributing to delay in recovery. Rhinoviruses frequently cause colds and, during acute infections, generate leukotriene B4 and prostaglandin E2 (PGE2). PGE2 is known to initiate oxylipin class switching and resolution of acute inflammation. Thus, we hypothesized that during acute rhinovirus colds, oxylipins with pro-resolving capabilities reduce symptom severity and speed recovery. METHODS Four groups of healthy volunteers were inoculated with placebo or 3 different doses of rhinovirus A16. Participants kept daily records of symptoms and contributed serial nasal lavage fluid samples. We collected semi-quantitative mass spectrometry data for 71 oxylipins in these acute samples from all participants. An ensemble analysis approach was used to further reduce this dataset. RESULTS Levels of 15-keto-PGE2 at day 3 of the cold were consistently among the top candidates in these models of recovery symptoms. 15-keto-PGE2 was the only oxylipin with an interaction between inoculum dose and time. Acute 15-keto-PGE2 levels were inversely associated with symptoms during cold recovery in a multivariable analysis (P = .0043). CONCLUSIONS These findings show that high 15-keto-PGE2 levels during the acute cold are associated with fewer symptoms during recovery.
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Affiliation(s)
- Nicole M Lane Starr
- Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Michael D Evans
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Kristine E Lee
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - James E Gern
- Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Allergy and Immunology, Department of Pediatrics, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Loren C Denlinger
- Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
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16
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Nusinovici S, Sabanayagam C, Lee KE, Zhang L, Cheung CY, Tai ES, Tan GSW, Cheng CY, Klein BEK, Wong TY. Retinal microvascular signs and risk of diabetic kidney disease in asian and white populations. Sci Rep 2021; 11:4898. [PMID: 33649427 PMCID: PMC7921402 DOI: 10.1038/s41598-021-84464-7] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 02/11/2021] [Indexed: 12/19/2022] Open
Abstract
The objective was to examine prospectively the association between retinal microvascular signs and development of diabetic kidney disease (DKD) in Asian and White populations. We analysed two population-based cohorts, composing of 1,221 Asians (SEED) and 703 White (WESDR) adults with diabetes. Retinal microvascular signs at baseline included vascular caliber (arteriolar—CRAE, and venular—CRVE) and diabetic retinopathy (DR). Incident cases of DKD were identified after ~ 6-year. Incident cases were defined based on eGFR in SEED and proteinuria or history of renal dialysis in WESDR. The incidence of DKD were 11.8% in SEED and 14.0% in WESDR. Wider CRAE in SEED (OR = 1.58 [1.02, 2.45]) and wider CRVE (OR = 1.69 [1.02, 2.80)) in WESDR were associated with increased risk of DKD. Presence of DR was associated with an increased risk of DKD in both cohorts (SEED: OR = 1.91 [1.21, 3.01] in SEED, WESDR: OR = 1.99 [1.18, 3.35]). Adding DR and retinal vascular calibers in the model beyond traditional risk factors led to an improvement of predictive performance of DKD risk between 1.1 and 2.4%; and improved classification (NRI 3 between 9%). Microvascular changes in the retina are longitudinally associated with risk of DKD.
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Affiliation(s)
- Simon Nusinovici
- Singapore Eye Research Institute, Singapore National Eye Centre, 11 Third Hospital Avenue, Singapore, 168751, Singapore
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute, Singapore National Eye Centre, 11 Third Hospital Avenue, Singapore, 168751, Singapore.,Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Kristine E Lee
- Department of Ophthalmology and Visual Sciences, University of Wisconsin Medical School, Madison, WI, USA.,Department of Biostatistics and Medical Informatics, University of Wisconsin Medical School, Madison, WI, USA
| | - Liang Zhang
- Singapore Eye Research Institute, Singapore National Eye Centre, 11 Third Hospital Avenue, Singapore, 168751, Singapore
| | - Carol Y Cheung
- Singapore Eye Research Institute, Singapore National Eye Centre, 11 Third Hospital Avenue, Singapore, 168751, Singapore.,Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - E Shyong Tai
- Department of Medicine, National University Health System, National University of Singapore, Singapore, Singapore
| | - Gavin S W Tan
- Singapore Eye Research Institute, Singapore National Eye Centre, 11 Third Hospital Avenue, Singapore, 168751, Singapore.,Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Ching Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, 11 Third Hospital Avenue, Singapore, 168751, Singapore
| | - Barbara E K Klein
- Department of Ophthalmology and Visual Sciences, University of Wisconsin Medical School, Madison, WI, USA
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, 11 Third Hospital Avenue, Singapore, 168751, Singapore. .,Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore.
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17
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Seo MY, Nam DH, Kong DS, Lee SH, Noh Y, Jung YG, Kim HY, Chung SK, Lee KE, Hong SD. Extended approach or usage of nasoseptal flap is a risk factor for olfactory dysfunction after endoscopic anterior skullbase surgery: results from 928 patients in a single tertiary center. Rhinology 2020; 58:574-580. [PMID: 32662778 DOI: 10.4193/rhin20.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The aim of this study was to compare olfactory function change in patients who underwent endoscopic skull-base surgery. METHODOLOGY A total of 928 patients were included in this retrospective study. Olfactory function was measured using the non- validated Likert scale (0â€"100), the Cross-Cultural Smell Identification Test (CC-SIT) and the butanol threshold test (BTT). Patients were divided into two groups: an endoscopic trans-sellar approach group (ETA, n = 768) and an extended endoscopic endonasal approach group (EEEA, n = 160). The ETA group was sub-divided into Nasoseptal flap (NSF) and no NSF groups. RESULTS Non-validated olfactory function significantly worsened in the EEEA and ETA-NSF groups compared with that in the ETA- no NSF group for at least 6 months post-operatively. Validated olfactory impairment (BTT and CC-SIT) was also significantly worse in the EEEA and NSF groups compared with that in the ETA-no NSF group 3 months post-operatively. Additionally, the degrees of non-validated and validated olfactory deterioration were not significantly different between the EEEA and ETA-NSF groups. We also found that CC-SIT score changes were significantly impaired in tuberculum sellae meningioma patients than in craniopharyn- gioma patients. CONCLUSIONS We conclude that NSF was the key factor that led to olfactory impairment after endoscopic skull-base surgery.
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Affiliation(s)
- M Y Seo
- Department of Otorhinolaryngology - Head and Neck Surgery, Korea University College of Medicine, Korea University Ansan Hospital, Ansan, South Korea; Department of Otorhinolaryngology - Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - D-H Nam
- Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - D-S Kong
- Department of Otorhinolaryngology - Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - S H Lee
- Department of Otorhinolaryngology - Head and Neck Surgery, Korea University College of Medicine, Korea University Ansan Hospital, Ansan, South Korea
| | - Y Noh
- Department of Otorhinolaryngology - Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Y G Jung
- Department of Otorhinolaryngology - Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - H Y Kim
- Department of Otorhinolaryngology - Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - S-K Chung
- Department of Otorhinolaryngology - Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - K E Lee
- Department of Otorhinolaryngology - Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - S D Hong
- Department of Otorhinolaryngology - Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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18
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Johansson MW, Grill BM, Barretto KT, Favour MC, Schira HM, Swanson CM, Lee KE, Sorkness RL, Mosher DF, Denlinger LC, Jarjour NN. Plasma P-Selectin Is Inversely Associated with Lung Function and Corticosteroid Responsiveness in Asthma. Int Arch Allergy Immunol 2020; 181:879-887. [PMID: 32777786 DOI: 10.1159/000509600] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 06/14/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Severe asthma has multiple phenotypes for which biomarkers are still being defined. Plasma P-selectin reports endothelial and/or platelet activation. OBJECTIVE To determine if P-selectin is associated with features of asthma in a longitudinal study. METHODS Plasmas from 70 adult patients enrolled in the Severe Asthma Research Program (SARP) III at the University of Wisconsin-Madison were analyzed for concentration of P-selectin at several points over the course of 3 years, namely, at baseline (BPS), after intramuscular triamcinolone acetonide (TA) injection, and at 36 months after baseline. Thirty-four participants also came in during acute exacerbation and 6 weeks after exacerbation. RESULTS BPS correlated inversely with forced expiratory volume in 1 s (FEV1) and with residual volume/total lung capacity, an indicator of air trapping. BPS was inversely associated with FEV1 change after TA, by regression analysis. FEV1 did not change significantly after TA if BPS was above the median, whereas patients with BPS below the median had significantly increased FEV1 after TA. BPS was higher in and predicted assignment to SARP phenotype cluster 5 ("severe fixed-airflow asthma"). P-selectin was modestly but significantly increased at exacerbation but returned to baseline within 3 years. CONCLUSIONS High BPS is associated with airway obstruction, air trapping, the "severe fixed-airflow" cluster, and lack of FEV1 improvement in response to TA injection. P-selectin concentration, which is a stable trait with only modest elevation during exacerbation, may be a useful biomarker for a severe asthma pheno- or endotype characterized by low pulmonary function and lack of corticosteroid responsiveness.
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Affiliation(s)
- Mats W Johansson
- Department of Biomolecular Chemistry, University of Wisconsin, Madison, Wisconsin, USA,
| | - Brandon M Grill
- Department of Biomolecular Chemistry, University of Wisconsin, Madison, Wisconsin, USA
| | - Karina T Barretto
- Department of Biomolecular Chemistry, University of Wisconsin, Madison, Wisconsin, USA
| | - Molly C Favour
- Department of Biomolecular Chemistry, University of Wisconsin, Madison, Wisconsin, USA
| | - Hazel M Schira
- Department of Biomolecular Chemistry, University of Wisconsin, Madison, Wisconsin, USA
| | - Calvin M Swanson
- Department of Biomolecular Chemistry, University of Wisconsin, Madison, Wisconsin, USA
| | - Kristine E Lee
- Department of Biostatistics and Medical Informatics, University of Wisconsin, Madison, Wisconsin, USA
| | - Ronald L Sorkness
- School of Pharmacy, University of Wisconsin, Madison, Wisconsin, USA
| | - Deane F Mosher
- Department of Biomolecular Chemistry, University of Wisconsin, Madison, Wisconsin, USA.,Department of Medicine, University of Wisconsin, Madison, Wisconsin, USA
| | - Loren C Denlinger
- Department of Medicine, University of Wisconsin, Madison, Wisconsin, USA
| | - Nizar N Jarjour
- Department of Medicine, University of Wisconsin, Madison, Wisconsin, USA
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19
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Steiman CA, Evans MD, Lee KE, Lasarev MR, Gangnon RE, Olson BF, Barnes KL, Bendixsen CG, Seroogy CM, Gern JE. Patterns of farm exposure are associated with reduced incidence of atopic dermatitis in early life. J Allergy Clin Immunol 2020; 146:1379-1386.e6. [PMID: 32650021 DOI: 10.1016/j.jaci.2020.06.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 06/14/2020] [Accepted: 06/22/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND Farm exposures may reduce the risk of atopic dermatitis (AD) in children, but this is controversial and US data are limited. OBJECTIVE This study was conducted to identify patterns of farm exposure in Wisconsin family farms that modify AD incidence and prevalence in early childhood. METHODS Environmental exposures, health history, and clinical outcomes were prospectively recorded for 111 farm families and 129 non-farm families enrolled in the Wisconsin Infant Study Cohort birth cohort study. Exposures from the prenatal and early postnatal (2-month) visits were evaluated together with parental report of AD diagnosis by a health care provider through age 24 months. Latent class analysis was performed with prenatal and early postnatal farm-exposure variables to assign farm children to 3 classes. RESULTS Overall, children of farm families had reduced AD incidence (P = .03). Within farm families, exposures including poultry (3% vs 28%; P = .003), pig (4% vs 25%; P = .04), feed grain (13% vs 34%; P = .02), and number of animal species were inversely associated with AD incidence. Among the latent class groups, children in families with diverse or more intense farm exposures (classes A and B) had reduced AD incidence, whereas low-exposure (class C) infants had AD incidence similar to that in nonfarm children. CONCLUSIONS Infants in Wisconsin farm families had reduced AD incidence, and patterns of farm exposures further defined AD risk. These findings suggest that exposure to diverse farm animals, feed, and bedding during the prenatal period and in early infancy reduce the risk of early-onset AD, a phenotype associated with multiple other atopic diseases.
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Affiliation(s)
- Cheryl A Steiman
- University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Michael D Evans
- University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Kristine E Lee
- University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Michael R Lasarev
- University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Ronald E Gangnon
- University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Brent F Olson
- Marshfield Clinic Research Institute, National Farm Medicine Center, Marshfield, Wis
| | - Kathrine L Barnes
- Marshfield Clinic Research Institute, National Farm Medicine Center, Marshfield, Wis
| | - Casper G Bendixsen
- Marshfield Clinic Research Institute, National Farm Medicine Center, Marshfield, Wis
| | | | - James E Gern
- University of Wisconsin School of Medicine and Public Health, Madison, Wis.
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20
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Johansson MW, McKernan EM, Fichtinger PS, Angulo EL, Bagley JL, Lee KE, Evans MD, Lomeli LD, Mosher DF, Cook SM, Gaumnitz EA, Mathur SK. α IIb-Integrin (CD41) associated with blood eosinophils is a potential biomarker for disease activity in eosinophilic esophagitis. J Allergy Clin Immunol 2020; 145:1699-1701. [PMID: 32004525 DOI: 10.1016/j.jaci.2020.01.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 01/17/2020] [Accepted: 01/21/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Mats W Johansson
- Department of Biomolecular Chemistry, University of Wisconsin, Madison, Wis.
| | | | | | - Evelyn L Angulo
- Department of Medicine, University of Wisconsin, Madison, Wis
| | | | - Kristine E Lee
- Department of Biostatistics and Medical Informatics, University of Wisconsin, Madison, Wis
| | - Michael D Evans
- Department of Biostatistics and Medical Informatics, University of Wisconsin, Madison, Wis
| | - Luis D Lomeli
- Department of Medicine, University of Wisconsin, Madison, Wis
| | - Deane F Mosher
- Department of Biomolecular Chemistry, University of Wisconsin, Madison, Wis; Department of Medicine, University of Wisconsin, Madison, Wis
| | - Shelly M Cook
- Department of Pathology and Laboratory Medicine, University of Wisconsin, Madison, Wis
| | - Eric A Gaumnitz
- Department of Medicine, University of Wisconsin, Madison, Wis
| | - Sameer K Mathur
- Department of Medicine, University of Wisconsin, Madison, Wis
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21
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Salem RM, Todd JN, Sandholm N, Cole JB, Chen WM, Andrews D, Pezzolesi MG, McKeigue PM, Hiraki LT, Qiu C, Nair V, Di Liao C, Cao JJ, Valo E, Onengut-Gumuscu S, Smiles AM, McGurnaghan SJ, Haukka JK, Harjutsalo V, Brennan EP, van Zuydam N, Ahlqvist E, Doyle R, Ahluwalia TS, Lajer M, Hughes MF, Park J, Skupien J, Spiliopoulou A, Liu A, Menon R, Boustany-Kari CM, Kang HM, Nelson RG, Klein R, Klein BE, Lee KE, Gao X, Mauer M, Maestroni S, Caramori ML, de Boer IH, Miller RG, Guo J, Boright AP, Tregouet D, Gyorgy B, Snell-Bergeon JK, Maahs DM, Bull SB, Canty AJ, Palmer CNA, Stechemesser L, Paulweber B, Weitgasser R, Sokolovska J, Rovīte V, Pīrāgs V, Prakapiene E, Radzeviciene L, Verkauskiene R, Panduru NM, Groop LC, McCarthy MI, Gu HF, Möllsten A, Falhammar H, Brismar K, Martin F, Rossing P, Costacou T, Zerbini G, Marre M, Hadjadj S, McKnight AJ, Forsblom C, McKay G, Godson C, Maxwell AP, Kretzler M, Susztak K, Colhoun HM, Krolewski A, Paterson AD, Groop PH, Rich SS, Hirschhorn JN, Florez JC. Genome-Wide Association Study of Diabetic Kidney Disease Highlights Biology Involved in Glomerular Basement Membrane Collagen. J Am Soc Nephrol 2019; 30:2000-2016. [PMID: 31537649 DOI: 10.1681/asn.2019030218] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [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: 03/01/2019] [Accepted: 07/08/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Although diabetic kidney disease demonstrates both familial clustering and single nucleotide polymorphism heritability, the specific genetic factors influencing risk remain largely unknown. METHODS To identify genetic variants predisposing to diabetic kidney disease, we performed genome-wide association study (GWAS) analyses. Through collaboration with the Diabetes Nephropathy Collaborative Research Initiative, we assembled a large collection of type 1 diabetes cohorts with harmonized diabetic kidney disease phenotypes. We used a spectrum of ten diabetic kidney disease definitions based on albuminuria and renal function. RESULTS Our GWAS meta-analysis included association results for up to 19,406 individuals of European descent with type 1 diabetes. We identified 16 genome-wide significant risk loci. The variant with the strongest association (rs55703767) is a common missense mutation in the collagen type IV alpha 3 chain (COL4A3) gene, which encodes a major structural component of the glomerular basement membrane (GBM). Mutations in COL4A3 are implicated in heritable nephropathies, including the progressive inherited nephropathy Alport syndrome. The rs55703767 minor allele (Asp326Tyr) is protective against several definitions of diabetic kidney disease, including albuminuria and ESKD, and demonstrated a significant association with GBM width; protective allele carriers had thinner GBM before any signs of kidney disease, and its effect was dependent on glycemia. Three other loci are in or near genes with known or suggestive involvement in this condition (BMP7) or renal biology (COLEC11 and DDR1). CONCLUSIONS The 16 diabetic kidney disease-associated loci may provide novel insights into the pathogenesis of this condition and help identify potential biologic targets for prevention and treatment.
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Affiliation(s)
- Rany M Salem
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California
| | - Jennifer N Todd
- Division of Endocrinology, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts.,Programs in Metabolism and Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts.,Center for Genomic Medicine and
| | - Niina Sandholm
- Folkhälsan Research Center, Folkhälsan Institute of Genetics, Helsinki, Finland.,Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Research Program for Clinical and Molecular Metabolism, Faculty of Medicine and
| | - Joanne B Cole
- Division of Endocrinology, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts.,Programs in Metabolism and Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts.,Center for Genomic Medicine and
| | - Wei-Min Chen
- Center for Public Health Genomics, School of Medicine, University of Virginia, Charlottesville, Virginia
| | - Darrell Andrews
- Diabetes Complications Research Centre, Conway Institute, School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
| | - Marcus G Pezzolesi
- Division of Nephrology and Hypertension, Diabetes and Metabolism Center, University of Utah, Salt Lake City, Utah
| | - Paul M McKeigue
- Usher Institute of Population Health Sciences and Informatics and
| | - Linda T Hiraki
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Chengxiang Qiu
- Departments of Medicine and Genetics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Viji Nair
- Division of Nephrology, Department of Internal Medicine and
| | - Chen Di Liao
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jing Jing Cao
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Erkka Valo
- Folkhälsan Research Center, Folkhälsan Institute of Genetics, Helsinki, Finland.,Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Research Program for Clinical and Molecular Metabolism, Faculty of Medicine and
| | - Suna Onengut-Gumuscu
- Center for Public Health Genomics, School of Medicine, University of Virginia, Charlottesville, Virginia
| | | | - Stuart J McGurnaghan
- Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Jani K Haukka
- Folkhälsan Research Center, Folkhälsan Institute of Genetics, Helsinki, Finland.,Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Research Program for Clinical and Molecular Metabolism, Faculty of Medicine and
| | - Valma Harjutsalo
- Folkhälsan Research Center, Folkhälsan Institute of Genetics, Helsinki, Finland.,Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Research Program for Clinical and Molecular Metabolism, Faculty of Medicine and.,The Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Eoin P Brennan
- Diabetes Complications Research Centre, Conway Institute, School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
| | - Natalie van Zuydam
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK.,Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Emma Ahlqvist
- Department of Genomics, Diabetes and Endocrinology, Lund University Diabetes Centre, Malmö, Sweden
| | - Ross Doyle
- Diabetes Complications Research Centre, Conway Institute, School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
| | | | - Maria Lajer
- Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Maria F Hughes
- Diabetes Complications Research Centre, Conway Institute, School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
| | - Jihwan Park
- Departments of Medicine and Genetics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jan Skupien
- Joslin Diabetes Center, Boston, Massachusetts
| | | | | | - Rajasree Menon
- Division of Nephrology, Department of Internal Medicine and.,Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, Michigan
| | | | - Hyun M Kang
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, Michigan.,Center for Statistical Genetics, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Robert G Nelson
- Chronic Kidney Disease Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona
| | - Ronald Klein
- University of Wisconsin-Madison, Madison, Wisconsin
| | | | | | - Xiaoyu Gao
- The George Washington University, Washington, DC
| | | | - Silvia Maestroni
- Complications of Diabetes Unit, Division of Immunology, Transplantation and Infectious Diseases, Diabetes Research Institute, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | | | | | - Rachel G Miller
- University of Pittsburgh Public Health, Pittsburgh, Pennsylvania
| | - Jingchuan Guo
- University of Pittsburgh Public Health, Pittsburgh, Pennsylvania
| | | | - David Tregouet
- INSERM UMR_S 1166, Sorbonne Université, UPMC Univ Paris 06, Paris, France.,ICAN Institute for Cardiometabolism and Nutrition, Paris, France
| | - Beata Gyorgy
- INSERM UMR_S 1166, Sorbonne Université, UPMC Univ Paris 06, Paris, France.,ICAN Institute for Cardiometabolism and Nutrition, Paris, France
| | | | - David M Maahs
- Department of Pediatrics-Endocrinology, Stanford University, Stanford, California
| | - Shelley B Bull
- The Lunenfeld-Tanenbaum Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Angelo J Canty
- Department of Mathematics and Statistics, McMaster University, Hamilton, Ontario, Canada
| | - Colin N A Palmer
- Pat Macpherson Centre for Pharmacogenetics and Pharmacogenomics, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK
| | - Lars Stechemesser
- First Department of Medicine, Paracelsus Medical University, Salzburg, Austria
| | - Bernhard Paulweber
- First Department of Medicine, Paracelsus Medical University, Salzburg, Austria
| | - Raimund Weitgasser
- First Department of Medicine, Paracelsus Medical University, Salzburg, Austria.,Department of Medicine, Diakonissen-Wehrle Hospital, Salzburg, Austria
| | | | - Vita Rovīte
- Latvian Biomedical Research and Study Centre, Riga, Latvia
| | - Valdis Pīrāgs
- University of Latvia, Riga, Latvia.,Pauls Stradins University Hospital, Riga, Latvia
| | | | - Lina Radzeviciene
- Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Rasa Verkauskiene
- Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Nicolae Mircea Panduru
- Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,2nd Clinical Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Leif C Groop
- Department of Genomics, Diabetes and Endocrinology, Lund University Diabetes Centre, Malmö, Sweden.,Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Mark I McCarthy
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK.,Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.,Oxford NIHR Biomedical Research Centre, Oxford University Hospitals Trust, Oxford, UK.,Genentech, 1 DNA Way, South San Francisco, California
| | - Harvest F Gu
- Department of Clinical Science, Intervention and Technology and.,School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Anna Möllsten
- Division of Pediatrics, Department of Clinical Sciences, Umeå University, Umeå, Sweden
| | - Henrik Falhammar
- Department of Molecular Medicine and Surgery, Rolf Luft Center for Diabetes Research and Endocrinology, Karolinska Institutet, Stockholm, Sweden.,Department of Endocrinology, Diabetes and Metabolism, Karolinska University Hospital, Stockholm, Sweden
| | - Kerstin Brismar
- Department of Molecular Medicine and Surgery, Rolf Luft Center for Diabetes Research and Endocrinology, Karolinska Institutet, Stockholm, Sweden.,Department of Endocrinology, Diabetes and Metabolism, Karolinska University Hospital, Stockholm, Sweden
| | - Finian Martin
- Diabetes Complications Research Centre, Conway Institute, School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
| | - Peter Rossing
- Steno Diabetes Center Copenhagen, Gentofte, Denmark.,University of Copenhagen, Copenhagen, Denmark
| | - Tina Costacou
- University of Pittsburgh Public Health, Pittsburgh, Pennsylvania
| | - Gianpaolo Zerbini
- Complications of Diabetes Unit, Division of Immunology, Transplantation and Infectious Diseases, Diabetes Research Institute, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Michel Marre
- Department of Diabetology, Endocrinology and Nutrition, Bichat Hospital, DHU FIRE, Assistance Publique-Hôpitaux de Paris, Paris, France.,UFR de Médecine, Paris Diderot University, Sorbonne Paris Cité, Paris, France.,INSERM UMRS 1138, Cordeliers Research Center, Paris, France.,Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
| | - Samy Hadjadj
- Department of Endocrinology and Diabetology, Centre Hospitalier Universitaire de Poitiers, Poitiers, France.,INSERM CIC 1402, Poitiers, France.,L'institut du thorax, INSERM, CNRS, CHU Nantes, Nantes, France
| | - Amy J McKnight
- Centre for Public Health, Queens University of Belfast, Northern Ireland, UK
| | - Carol Forsblom
- Folkhälsan Research Center, Folkhälsan Institute of Genetics, Helsinki, Finland.,Research Program for Clinical and Molecular Metabolism, Faculty of Medicine and.,Research Program for Clinical and Molecular Metabolism, Faculty of Medicine and
| | - Gareth McKay
- Centre for Public Health, Queens University of Belfast, Northern Ireland, UK
| | - Catherine Godson
- Diabetes Complications Research Centre, Conway Institute, School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
| | - A Peter Maxwell
- Centre for Public Health, Queens University of Belfast, Northern Ireland, UK
| | - Matthias Kretzler
- Division of Nephrology, Department of Internal Medicine and.,Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, Michigan
| | - Katalin Susztak
- Departments of Medicine and Genetics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Helen M Colhoun
- Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | | | | | - Per-Henrik Groop
- Folkhälsan Research Center, Folkhälsan Institute of Genetics, Helsinki, Finland.,Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Research Program for Clinical and Molecular Metabolism, Faculty of Medicine and.,Department of Diabetes, Central Clinical School, Monash University, Melbourne, Victoria, Australia; and
| | - Stephen S Rich
- Center for Public Health Genomics, School of Medicine, University of Virginia, Charlottesville, Virginia
| | - Joel N Hirschhorn
- Division of Endocrinology, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts.,Programs in Metabolism and Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts
| | - Jose C Florez
- Programs in Metabolism and Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts; .,Center for Genomic Medicine and.,Diabetes Unit, Massachusetts General Hospital, Boston, Massachusetts.,Department of Medicine, Harvard Medical School, Boston, Massachusetts
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22
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Klein BEK, Horak KML, Meuer SM, Mosher AE, Ewen AF, Danforth LG, Lee KE, Klein R. Retinal vessel diameters confound the relationship of pregnancy to retinopathy and infant outcomes in T1D. J Diabetes Complications 2019; 33:530-534. [PMID: 31213351 DOI: 10.1016/j.jdiacomp.2019.05.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 05/02/2019] [Accepted: 05/15/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To determine whether: 1) retinal vessel diameters in pregnant and non-pregnant women with type 1 diabetes (T1D) alter the relationship of pregnancy to severity of diabetic retinopathy (DR); and 2) retinal vessel diameters in early pregnancy alter the relationship of severity of DR in the mother to severe adverse outcome in the infant. METHODS Two cohorts of women with T1D, one composed of pregnant women and the other of non-pregnant women of child-bearing age, were recruited in Wisconsin. Baseline examinations (including retinal photography and collection of diabetes-related characteristics) were conducted, with follow-up approximately one year later. Retinal images were graded according to the modified Airlie House classification protocol, and retinal vessel diameters were measured from digitized images. The latter were included in analyses as central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE). RESULTS In multivariate models: 1) Pregnancy was significantly associated with both incidence (OR = 4.43, CI = 1.42-13.79) and progression (OR = 2.62, CI = 1.52-4.51) of DR. Neither CRAE nor CRVE were significant, but their addition modestly altered the associations of pregnancy to worsening DR; 2) Baseline retinopathy (OR = 1.28, CI = 1.05-1.57) was associated with severe adverse outcome in the infant. This association was unchanged by adjustment for retinal vessel diameters. CONCLUSIONS Pregnancy is associated with worsening DR in women with T1D. DR severity in early pregnancy is associated with severe adverse outcome in the infant. The retinal vessel diameters CRAE and CRVE were not associated with these outcomes but were modest confounders of the association of pregnancy to worsening DR.
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Affiliation(s)
- Barbara E K Klein
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States of America.
| | - Kayla M L Horak
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States of America
| | - Stacy M Meuer
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States of America
| | - Anne E Mosher
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States of America
| | - Andrew F Ewen
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States of America
| | - Lorraine G Danforth
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States of America
| | - Kristine E Lee
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States of America
| | - Ronald Klein
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States of America
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Klein BEK, Lee KE, Maynard JD, Johnson CA, Danforth L, Klein R. Skin Intrinsic Fluorescence and Selected Measures of Visual Function and aging in Older Adults. Ophthalmic Epidemiol 2019; 26:264-269. [PMID: 31030599 DOI: 10.1080/09286586.2019.1604977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: Functional, structural and metabolic decline in many systems and in combination contribute to biologic aging and may be manifest as increased risk of morbid events such as neuropathy, albuminuria, and coronary artery disease or mortality. A biologic marker of aging may be a useful tool in identifying persons at increased risk of morbidity or mortality. We have measured skin intrinsic fluorescence (SIF) in a group of older adults to determine whether this easily determined measure could serve as such a biomarker. Methods: Survivors of a population based study of older adults in a moderate sized Midwestern town. Of the 1181 persons participating, 939 had measures of skin intrinsic fluorescence (SIF) and at least one functional or diagnostic characteristic at the most recent examination. Characteristics such as blood pressure, forced expiratory volume, vision, time to walk a standard course and medical history and their associations with SIF measures were examined. Mortality after the last examination with respect to SIF was also investigated. There were 118 deaths among those who participated in this phase of the study. All analyses pertinent to these findings were adjusted for age. Results: SIF measures were significantly associated with low contrast sensitivity, more errors on frequency doubling technology testing (loss of peripheral vision), self-reported poor vision, slow gait, poor forced expiratory volume, and self-reported poor health. SIF was also associated with increased risk of death. All of these analyses were adjusted for age. Conclusions: Skin intrinsic fluorescence provides easily obtained markers of age-related functional outcomes, suggesting SIF measurements may be useful to identify persons who may benefit from more frequent medical scrutiny to decrease morbidity and mortality.
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Affiliation(s)
- Barbara E K Klein
- a Department of Ophthalmology and Visual Sciences , University of Wisconsin School of Medicine and Public Health , Madison , Wisconsin
| | - Kristine E Lee
- a Department of Ophthalmology and Visual Sciences , University of Wisconsin School of Medicine and Public Health , Madison , Wisconsin
| | - John D Maynard
- b Medical Device and Diagnostics Consulting , Albuquerque , New Mexico , USA
| | - Chris A Johnson
- c University of Iowa Hospitals and Clinics , Iowa City , Iowa , USA.,d Ophthalmology and Visual Sciences , University of Iowa , Iowa City , Iowa , USA
| | - Lorraine Danforth
- a Department of Ophthalmology and Visual Sciences , University of Wisconsin School of Medicine and Public Health , Madison , Wisconsin
| | - Ronald Klein
- a Department of Ophthalmology and Visual Sciences , University of Wisconsin School of Medicine and Public Health , Madison , Wisconsin
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Bomotti S, Lau B, Klein BEK, Lee KE, Klein R, Duggal P, Klein AP. Refraction and Change in Refraction Over a 20-Year Period in the Beaver Dam Eye Study. Invest Ophthalmol Vis Sci 2019; 59:4518-4524. [PMID: 30208419 PMCID: PMC6133235 DOI: 10.1167/iovs.18-23914] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Purpose Hyperopic shifts in refraction have been consistently reported in adults over 40, followed by myopic shifts after age 70. Although potential factors underlying these changes in refraction in older adults have been investigated previously, the studies were restricted by the limited longitudinal data available. The authors of this study sought to better characterize the long-term trajectory of refraction in older adults using 20 years of prospective data. Methods The impact of cohort effects on refraction over 20 years was examined. Generalized estimating equations were used to evaluate the etiologic factors underlying refraction and changes in refraction measured over a 20-year period (1988–2010) among adults over age 40 from the Beaver Dam Eye Study. Results Only individuals with nuclear cataract experienced a myopic shift in refraction, showing a 0.25 diopter (D) decrease (95% confidence interval [CI]: −0.44 D to −0.07 D) over a five-year period. Individuals with mild and moderate nuclear sclerosis showed varying degrees of hyperopic shifts over five years (0.22 D: 95% CI: 0.20 D–0.25 D; 0.23 D: 95% CI: 0.20 D–0.27 D, respectively). Conclusions Nuclear cataract is the primary contributor to the myopic shift among older individuals. Birth cohort effects on baseline refraction but not change in refraction were observed.
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Affiliation(s)
- Samantha Bomotti
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States
| | - Bryan Lau
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States
| | - Barbara E K Klein
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States
| | - Kristine E Lee
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States
| | - Ronald Klein
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States
| | - Priya Duggal
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States
| | - Alison P Klein
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States.,Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Johns Hopkins University, Baltimore, Maryland, United States.,Department of Pathology, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States
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25
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Tan AG, Kifley A, Holliday EG, Klein BEK, Iyengar SK, Lee KE, Jun GR, Cumming RG, Zhao W, Wong TY, Cheng CY, Mitchell P, Wang JJ. Aldose Reductase Polymorphisms, Fasting Blood Glucose, and Age-Related Cortical Cataract. Invest Ophthalmol Vis Sci 2019; 59:4755-4762. [PMID: 30267098 DOI: 10.1167/iovs.18-24353] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To determine whether there is an association between polymorphisms of the AKR1B1 gene and cortical cataract in the presence of hyperglycemia. Methods In the second cross section of the Blue Mountains Eye Study (BMES), 3508 participants (2334 at 5-year follow-up and 1174 newly recruited participants) were examined during 1997 to 2000. Cataract was graded from lens photographs using the Wisconsin Cataract Grading System. Fasting blood glucose (FBG) was measured. Continuous imputed dosages of minor alleles of 17 AKR1B1 single nucleotide polymorphisms (SNPs) were assessed for associations with prevalent cortical cataract. Gene-environment interactions between SNPs and FBG were examined. Odds ratios (OR) and 95% confidence intervals (CI) for prevalent cortical cataract were estimated using logistic regression adjusting for age, sex, smoking, hypertension, education, and myopia. A P value of 0.005 was considered statistically significant after correction for 10 independent tests. Replication of significant associations found in the BMES sample was conducted in the Singapore Epidemiology of Eye Diseases (SEED) study (n = 10,033). Results No polymorphism was associated with prevalent cortical cataract. A significant interaction was observed between rs9640883 and FBG (Pinteraction = 0.004), with increased cortical cataract prevalence associated with rs9640883 minor allele dosage in those with FBG >6.0 mM (strata-specific OR 1.72, 95% CI 1.09-2.72). No similar association was found in participants with normal FBG (OR 0.85, 95% CI 0.69-1.04). This interaction was not evident in the SEED study. Conclusions The identified interaction between rs9640883 and FBG in relation to cortical cataract was not replicated but may warrant further investigation.
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Affiliation(s)
- Ava Grace Tan
- Centre for Vision Research, Department of Ophthalmology, The Westmead Institute for Medical Research, The University of Sydney, Westmead Hospital, Westmead, New South Wales, Australia
| | - Annette Kifley
- Centre for Vision Research, Department of Ophthalmology, The Westmead Institute for Medical Research, The University of Sydney, Westmead Hospital, Westmead, New South Wales, Australia
| | - Elizabeth G Holliday
- Centre for Clinical Epidemiology and Biostatistics, and School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Barbara E K Klein
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States
| | - Sudha K Iyengar
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, United States.,Department of Ophthalmology and Visual Sciences, Case Western Reserve University and University Hospitals Eye Institute, Cleveland, Ohio, United States.,Department of Genetics and Genome Sciences, Case Western Reserve University, Cleveland, Ohio, United States
| | - Kristine E Lee
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States
| | - Gyungah R Jun
- Biomedical Genetics Section, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, United States
| | - Robert G Cumming
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Wanting Zhao
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Ophthalmology and Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Ophthalmology and Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Ophthalmology and Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore
| | - Paul Mitchell
- Centre for Vision Research, Department of Ophthalmology, The Westmead Institute for Medical Research, The University of Sydney, Westmead Hospital, Westmead, New South Wales, Australia
| | - Jie Jin Wang
- Centre for Vision Research, Department of Ophthalmology, The Westmead Institute for Medical Research, The University of Sydney, Westmead Hospital, Westmead, New South Wales, Australia.,Health Services and Systems Research, Duke-NUS Medical School, Singapore
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Sivakumaran TA, Igo RP, Kidd JM, Itsara A, Kopplin LJ, Chen W, Hagstrom SA, Peachey NS, Francis PJ, Klein ML, Chew EY, Ramprasad VL, Tay WT, Mitchell P, Seielstad M, Stambolian DE, Edwards AO, Lee KE, Leontiev DV, Jun G, Wang Y, Tian L, Qiu F, Henning AK, LaFramboise T, Sen P, Aarthi M, George R, Raman R, Das MK, Vijaya L, Kumaramanickavel G, Wong TY, Swaroop A, Abecasis GR, Klein R, Klein BEK, Nickerson DA, Eichler EE, Iyengar SK. Correction: A 32 kb Critical Region Excluding Y402H in CFH Mediates Risk for Age-Related Macular Degeneration. PLoS One 2018; 13:e0209943. [PMID: 30571798 PMCID: PMC6301675 DOI: 10.1371/journal.pone.0209943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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27
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Klein R, Lee KE, Tsai MY, Cruickshanks KJ, Gangnon RE, Klein BEK. Oxidized Low-density Lipoprotein and the Incidence of Age-related Macular Degeneration. Ophthalmology 2018; 126:752-758. [PMID: 30572074 DOI: 10.1016/j.ophtha.2018.12.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 11/26/2018] [Accepted: 12/11/2018] [Indexed: 01/25/2023] Open
Abstract
PURPOSE To examine the relationship between serum oxidized low-density lipoprotein (ox-LDL) cholesterol and the incidence of age-related macular degeneration (AMD) over a 25-year period in a sample of persons from the population-based Beaver Dam Eye Study (BDES). DESIGN Observational prospective cohort study. PARTICIPANTS A total of 4972 people from the BDES (aged 43-84 years and living in Beaver Dam, Wisconsin in 1988) seen during at least 1 of 6 examination phases at approximately 5-year intervals between 1988 and 2016. METHODS A 50% random sample of participants (N = 2468) was selected for ox-LDL measurements. Stored frozen specimens from every examination phase were processed using an enzyme-linked immunosorbent assay from a single batch. All available intervals were included for a person, resulting in 6586 person-visits. MAIN OUTCOME MEASURES Age-related macular degeneration was assessed using the Wisconsin Age-related Maculopathy Grading System, and severity was defined using a 5-step severity scale. The severity of the worse eye at each examination was used for analyses. A multi-state Markov (MSM) model was fit to simultaneously assess the ox-LDL relationship to all AMD transitions, including incidence of any AMD, incidence of late AMD, and worsening and improvement of AMD over the 25 years of the study. RESULTS The mean (standard deviation) level of ox-LDL was 75.3 (23.1) U/L at the baseline examination. When adjusting for age, sex, ARMS2 and CFH risk alleles, and examination phase, the ox-LDL at the beginning of a period was not statistically significantly associated with the incidence of any AMD (hazard ratio per 10 U/L ox-LDL was 1.03, 95% confidence interval 0.98,1.09). Furthermore, ox-LDL was not associated with worsening anywhere along the AMD severity scale, nor with incidence of late AMD. The lack of relationships of ox-LDL to the incidence of any AMD or worsening of AMD remained after adjustment for history of statin use, smoking status, body mass index, and history of cardiovascular disease (data not shown). CONCLUSIONS Our findings do not provide evidence for statistically significant relationships between ox-LDL and AMD disease development or worsening of AMD.
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Affiliation(s)
- Ronald Klein
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin.
| | - Kristine E Lee
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin
| | - Michael Y Tsai
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota
| | - Karen J Cruickshanks
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin; Department of Population Health Sciences, University of Wisconsin-Madison, Madison, Wisconsin
| | - Ronald E Gangnon
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, Wisconsin
| | - Barbara E K Klein
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin
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Rhodes K, Hall K, Lee KE, Razzaghi H, Breindl M. Correct cell- and differentiation-specific expression of a murine alpha 1 (I) collagen minigene in vitro differentiating embryonal carcinoma cells. Gene Expr 2018; 6:35-44. [PMID: 8931990 PMCID: PMC6148262] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
An in vitro differentiation system utilizing retinoic acid (RA) treatment of pluripotent murine P19 embryonal carcinoma (EC) cells, which can be induced to differentiate into various cell types, was optimized for maximal induction of alpha 1 type I collagen (Col1a1) gene expression. Differentiation was associated with apoptotic death of the majority of cells, indicating that this in vitro system faithfully mimics the in vivo differentiation process. Col1a1 mRNA became detectable by RNase protection assay after 3 days of RA treatment and, after 6 days, reached a level comparable to that in NIH 3T3 fibroblasts. After induction of differentiation the Col1a1 gene remained transcriptionally active for extended periods of time even in the absence of RA. A minigene version of the murine Col1a1 gene was constructed that contains all of the so far known Col1a1 regulatory elements. This construct exhibited the correct expression pattern in stable transfection experiments: it was expressed in fibroblasts, but not in undifferentiated P19 EC cells, and it was transcriptionally activated after induction of differentiation. This experimental system should be a useful tool for dissecting the molecular mechanisms involved in the developmental activation and stage- and tissue-specific expression of the murine Col1a1 gene.
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Affiliation(s)
- K Rhodes
- Department of Biology and Molecular Biology Institute, San Diego University, CA 92182, USA
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Vergara C, Bomotti SM, Valencia C, Klein BEK, Lee KE, Klein R, Klein AP, Duggal P. Association analysis of exome variants and refraction, axial length, and corneal curvature in a European-American population. Hum Mutat 2018; 39:1973-1979. [PMID: 30157304 DOI: 10.1002/humu.23628] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 08/24/2018] [Accepted: 08/25/2018] [Indexed: 12/16/2022]
Abstract
Refractive errors, myopia, and hyperopia are common visual disorders greatly affecting older individuals. Refraction is determined by genetic factors but only a small percentage of its variation has been explained. We performed a genetic association analysis with three ocular phenotypes: spherical equivalent (a continous measure of refraction), axial length, and corneal curvature in 1,871 European-Americans from the Beaver Dam Eye Study. Individuals were genotyped on the Illumina exome array and imputed to the Haplotype Reference Consortium reference panel. After increasing the number of analyzed variants in targeted protein-coding regions 10-fold via imputation, we confirmed associations for two previously known loci with corneal curvature (chr4q12, rs2114039; g.55092626T > C, β = -0.03 (95% confidence interval [CI]): -0.06, -0.01, P value = 0.01) and spherical equivalent (chr15q14, rs634990; g.35006073T > C, β = -0.27, 95% CI: -0.45, -0.09, P value = 3.79 × 10-3 ). Despite increased single nucleotide polymorphism (SNP) density, we did not detect any novel significant variants after correction for multiple comparisons. In summary, we confirmed two previous loci associated with corneal curvature and spherical equivalent in a European-American population highlighting the potential biological role of those regions in these traits.
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Affiliation(s)
- Candelaria Vergara
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Samantha M Bomotti
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Cristian Valencia
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Barbara E K Klein
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Kristine E Lee
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Ronald Klein
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Alison P Klein
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland.,Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Priya Duggal
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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30
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Klein BEK, Horak KL, Lee KE, Meuer SM, Abramoff MD, Soliman EZ, Rechek M, Klein R. Neural dysfunction and retinopathy in persons with type 1 diabetes. Ophthalmic Epidemiol 2018; 25:373-378. [PMID: 29985712 DOI: 10.1080/09286586.2018.1489971] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To determine associations of microvascular and neuropathic complications of diabetes cross-sectionally and longitudinally in persons with long-term type 1 diabetes (T1D). RESEARCH DESIGN AND METHODS Persons receiving care for T1D in South Central Wisconsin were identified in 1979-1980 and examined approximately every 5 years. Associations between neuropathic and microvascular complications were examined at most prior visits, when information on several neuropathic complications was collected. Temporal relationships were examined by modeling incidence between examinations across the visits. RESULTS Adjusting for duration of diabetes, glycated hemoglobin, and systolic blood pressure, the following were cross-sectionally associated with prevalent PDR (proliferative diabetic retinopathy): the presence of sensory neuropathy (SN) as reported at each Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR) examination (odds ratio (OR) = 2.76, confidence interval (CI) = 1.71, 4.48) and the heartrate variability measures RMSD (square root of the mean of squared differences of successive RR intervals) (OR = 0.24, CI = 0.16, 0.37) and SDNN (standard deviation of successive RR intervals) (OR = 0.26, CI = 0.17, 0.39). Findings were similar for prevalent ME (macular edema) as assessed from spectral-domain optical coherence tomography (SD-OCT). The presence of PDR (OR = 2.13, CI = 1.63, 2.78) and ME (OR = 2.36, CI = 1.66, 3.34) were both significantly associated with incident WESDR SN. WESDR SN was associated with incident PDR (OR = 1.53, CI = 1.09, 2.15) but not incident ME (OR = 1.31, CI = 0.92, 1.87). CONCLUSIONS Sensory neuropathy and heartrate variability were significantly associated with prevalent PDR and ME in people with long-term T1D. PDR and ME were significantly associated with incident sensory neuropathy, and sensory neuropathy was significantly associated with incident PDR. Studies using earliest detectable markers of microvascular and neurologic abnormalities are needed to determine which of the two systems 'fails' first. Such information might suggest a temporal sequence of diabetes complications.
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Affiliation(s)
- Barbara E K Klein
- a Ophthalmology & Visual Sciences , University of Wisconsin-Madison , Madison , WI , USA
| | - Kayla L Horak
- a Ophthalmology & Visual Sciences , University of Wisconsin-Madison , Madison , WI , USA
| | - Kristine E Lee
- a Ophthalmology & Visual Sciences , University of Wisconsin-Madison , Madison , WI , USA
| | - Stacy M Meuer
- a Ophthalmology & Visual Sciences , University of Wisconsin-Madison , Madison , WI , USA
| | - Michael D Abramoff
- b Electrical and Computer Engineering , University of Iowa , Iowa City , IA , USA.,c Biomedical Engineering , University of Iowa , Iowa City , IA , USA
| | - Elsayed Z Soliman
- d Epidemiology & Prevention EpiCare , Wake Forest University , Winston-Salem , NC , USA
| | - Mary Rechek
- a Ophthalmology & Visual Sciences , University of Wisconsin-Madison , Madison , WI , USA
| | - Ronald Klein
- a Ophthalmology & Visual Sciences , University of Wisconsin-Madison , Madison , WI , USA
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Klein R, Lee KE, Danforth L, Tsai MY, Gangnon RE, Meuer SE, Wong TY, Cheung CY, Klein BEK. The Relationship of Retinal Vessel Geometric Characteristics to the Incidence and Progression of Diabetic Retinopathy. Ophthalmology 2018; 125:1784-1792. [PMID: 29779685 DOI: 10.1016/j.ophtha.2018.04.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 04/16/2018] [Accepted: 04/17/2018] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To examine the relationships of retinal vessel geometric characteristics (RVGCs) to the incidence and progression of diabetic retinopathy (DR). DESIGN Observational, prospective cohort study. PARTICIPANTS Nine hundred ninety-six persons with type 1 diabetes mellitus (T1DM) and 1370 persons with type 2 diabetes mellitus (T2DM) seen at a baseline examination who were eligible for follow-up examinations at subsequent 5-year intervals. A total of 3846 person-interval data from these follow-up examinations are the basis for the analyses. METHODS Diabetic retinopathy and macular edema were assessed by grading of 30° stereoscopic color fundus photographs. Retinal vessel geometric characteristics were assessed using the Singapore I Vessel Assessment program from a digitized copy of 1 of the field 1 fundus photographs obtained at baseline and follow-up. MAIN OUTCOME MEASURES The 5-year incidence of any DR, progression of DR, and incidence of proliferative diabetic retinopathy (PDR) and clinically significant macular edema (CSME) in right eyes. RESULTS Incident DR occurred in 45%, progression in 32%, PDR in 10%, and CSME in 5%. While adjusting for glycated hemoglobin, duration of diabetes, and other factors, retinal arteriolar simple tortuosity was associated significantly with the incidence of any DR (odds ratio [OR], 1.17; 95% confidence interval [CI], 1.01-1.35). Retinal venular branching angle was associated significantly with progression of DR (OR, 1.18; 95% CI, 1.03-1.36), retinal venular curvature tortuosity was associated significantly with the incidence of PDR (OR, 1.15; 95% CI, 1.01-1.30), and retinal venular branching angle (OR, 1.41; 95% CI, 1.10-1.82) was associated significantly with the incidence of CSME. There were no significant associations of other RVGCs with any of the DR outcomes in the full multivariate model. Inclusion of all possible RVGCs did not improve the predictive value of the models that already included retinal vessel diameter and baseline DR severity level. CONCLUSIONS Retinal vessel geometric characteristics of the retinal venules were associated with progression of DR; however, most of the RVGCs measured from digitized fundus photographs added little to the assessment of risk of incidence and progression of DR when other risk factors were considered in T1DM and T2DM.
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Affiliation(s)
- Ronald Klein
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin.
| | - Kristine E Lee
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin
| | - Lorraine Danforth
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin
| | - Michael Y Tsai
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, United States
| | - Ronald E Gangnon
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, Wisconsin
| | - Stacy E Meuer
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin
| | - Tien Y Wong
- Department of Ophthalmology & Visual Sciences, Duke-NUS Medical School, Singapore, Republic of Singapore
| | - Carol Y Cheung
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Barbara E K Klein
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin
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Kim YS, Kim MN, Lee KE, Hong JY, Oh MS, Kim SY, Kim KW, Sohn MH. Activated leucocyte cell adhesion molecule (ALCAM/CD166) regulates T cell responses in a murine model of food allergy. Clin Exp Immunol 2018; 192:151-164. [PMID: 29363753 DOI: 10.1111/cei.13104] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2018] [Indexed: 12/14/2022] Open
Abstract
Food allergy is a major public health problem. Studies have shown that long-term interactions between activated leucocyte cell adhesion molecule (ALCAM/CD166) on the surface of antigen-presenting cells, and CD6, a co-stimulatory molecule, influence immune responses. However, there are currently no studies on the functions of ALCAM in food allergy. Therefore, we aimed to identify the functions of ALCAM in ovalbumin (OVA)-induced food allergy using ALCAM-deficient mice. Wild-type (WT) and ALCAM-deficient (ALCAM-/- ) mice were sensitized intraperitoneally and with orally fed OVA. The mice were killed, and parameters related to food allergy and T helper type 2 (Th2) immune responses were analysed. ALCAM serum levels increased and mRNA expression decreased in OVA-challenged WT mice. Serum immunoglobulin (Ig)E levels, Th2 cytokine mRNA and histological injuries were higher in OVA-challenged WT mice than in control mice, and these were attenuated in ALCAM-/- mice. T cell proliferation of total cells, CD3+ CD4+ T cells and activated T cells in immune tissues were diminished in OVA-challenged ALCAM-/- mice. Proliferation of co-cultured T cells and dendritic cells (DCs) was decreased by the anti-CD6 antibody. In addition, WT mice sensitized by adoptive transfer of OVA-pulsed ALCAM-/- BM-derived DCs showed reduced immune responses. Lastly, serum ALCAM levels were higher in children with food allergy than in control subjects. In this study, serum levels of ALCAM were elevated in food allergy-induced WT mice and children with food allergy. Moreover, immune responses and T cell activation were attenuated in OVA-challenged ALCAM-/- mice. These results indicate that ALCAM regulates food allergy by affecting T cell activation.
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Affiliation(s)
- Y S Kim
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - M N Kim
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - K E Lee
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - J Y Hong
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - M S Oh
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - S Y Kim
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - K W Kim
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - M H Sohn
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
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Kim J, Lee Y, Won CW, Lee KE, Chon D. Nutritional Status and Frailty in Community-Dwelling Older Korean Adults: The Korean Frailty and Aging Cohort Study. J Nutr Health Aging 2018; 22:774-778. [PMID: 30080218 DOI: 10.1007/s12603-018-1005-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [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: 10/18/2022]
Abstract
OBJECTIVES To examine the association between nutritional status and frailty in older adults. DESIGN Cross-sectional study. SETTING Community-dwelling older adults were recruited from 10 study sites in South Korea. PARTICIPANTS 1473 volunteers aged 70-84 years without severe cognitive impairment and who participated in the Korean Frailty and Aging Cohort Study (KFACS) conducted in 2016. MEASUREMENTS Nutritional status was measured using the Mini Nutritional Assessment Short Form (MNA-SF). Frailty was assessed with the Fried's frailty index. The relationship between nutritional status and frailty was examined using the multinomial regression analysis, adjusting for covariates. RESULTS Of the respondents 14.3% had poor nutrition (0.8% with malnutrition, 13.5% at risk of malnutrition). There were 10.7% who were frail, with 48.5% being prefrail, and 40.8% robust. Poor nutrition was related to a significantly increased risk of being prefrail (odds ratio [OR]: 1.59, 95% confidence interval [CI]: 1.09-2.32) and frail (OR: 3.30, 95% CI: 1.96-5.54). CONCLUSION Poor nutritional status is strongly associated with frailty in older adults. More research to understand the interdependency between nutritional status and frailty may lead to better management of the two geriatric conditions.
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Affiliation(s)
- J Kim
- Yunhwan Lee, Department of Preventive Medicine and Public Health, Ajou University School of Medicine, 164 World cup-ro, Youngtong-gu, Suwon 16499, Republic of Korea. Tel: +82 31 219 5085; Fax: +82 31 219 5084; E-mail:
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Lee KE. Considerations When Temporal Order Is Not Clear. JAMA Ophthalmol 2018; 136:74-75. [DOI: 10.1001/jamaophthalmol.2017.5212] [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] [Indexed: 11/14/2022]
Affiliation(s)
- Kristine E. Lee
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison
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Joachim N, Kifley A, Colijn JM, Lee KE, Buitendijk GHS, Klein BEK, Myers C, Meuer SM, Tan AG, Flood V, Schoufour JD, Franco OH, Holliday EG, Attia J, Liew G, Iyengar SK, de Jong PTVM, Hofman A, Vingerling JR, Mitchell P, Klein R, Klaver CCW, Wang JJ. Joint Contribution of Genetic Susceptibility and Modifiable Factors to the Progression of Age-Related Macular Degeneration over 10 Years: The Three Continent AMD Consortium Report. Ophthalmol Retina 2017; 2:684-693. [PMID: 31047378 DOI: 10.1016/j.oret.2017.10.019] [Citation(s) in RCA: 10] [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: 05/17/2017] [Revised: 10/31/2017] [Accepted: 10/31/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE To assess joint effects of genetic and modifiable factors on the 10-year progression of age-related macular degeneration (AMD). DESIGN Individual and pooled data analyses of 2 population-based cohorts. PARTICIPANTS Blue Mountains Eye Study (BMES) and Rotterdam Study (RS) participants (n = 835). METHODS Participants of the BMES and RS were followed up over 10 years or more. At baseline and follow-up visits, interviews using questionnaires and eye examinations with retinal photography were performed. Age-related macular degeneration was assessed by trained photographic graders and verified by retinal specialists. Genetic susceptibility to AMD meant carrying 2 or more risk alleles of the CFH or ARMS2 SNPs, or both (rs1061170 and rs10490924), relative to 0 or 1 risk allele. Discrete logistic regression models were used to investigate the joint associations of genetic susceptibility and either smoking, fish consumption, dietary intake of lutein-zeaxanthin, or combined environmental risk scores from the 3 modifiable factors with the risk of AMD progression. Odds ratios (ORs) with 95% confidence intervals (CIs) and synergy indexes are reported. MAIN OUTCOME MEASURE Ten-year progression of AMD, categorized as any (≥1 step) or 2-step (≥2 steps) progression on the Three Continent AMD Consortium 5-step severity scale. RESULTS Older age, the presence of AMD genetic susceptibility, and baseline AMD status were associated strongly with AMD progression (P < 0.0001). In analyses of pooled data, each additional score from the combined environmental risk scores was associated with an increased risk of 2-step progression over 10 years (OR, 1.26; 95% CI, 1.02-1.56). The copresence of AMD genetic susceptibility and combined risk score of 3 or more was associated with a substantially higher risk of 2-step progression compared with the presence of either factor alone. There was a significant synergistic effect (OR, 4.14; 95% CI, 1.07-15.95) and interaction (P = 0.025) between genetic susceptibility and environmental risk score of 3 or more. CONCLUSIONS Among persons with AMD genetic susceptibility and pre-existing early AMD lesions, presenting with high environmental risk scores from 3 modifiable factors (smoking, infrequent consumption of fish, low lutein-zeaxanthin intake) were associated with an increased risk of 2-step progression over 10 years.
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Affiliation(s)
- Nichole Joachim
- Centre for Vision Research, Westmead Institute for Medical Research, University of Sydney, Sydney, Australia
| | - Annette Kifley
- Centre for Vision Research, Westmead Institute for Medical Research, University of Sydney, Sydney, Australia
| | - Johanna Maria Colijn
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Kristine E Lee
- Department of Ophthalmology & Visual Sciences, University of Wisconsin Medical School, Madison, Wisconsin
| | - Gabriëlle H S Buitendijk
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Barbara E K Klein
- Department of Ophthalmology & Visual Sciences, University of Wisconsin Medical School, Madison, Wisconsin
| | - Chelsea Myers
- Department of Ophthalmology & Visual Sciences, University of Wisconsin Medical School, Madison, Wisconsin
| | - Stacy M Meuer
- Department of Ophthalmology & Visual Sciences, University of Wisconsin Medical School, Madison, Wisconsin
| | - Ava G Tan
- Centre for Vision Research, Westmead Institute for Medical Research, University of Sydney, Sydney, Australia
| | - Victoria Flood
- Faculty of Health Sciences, University of Sydney, Sydney, Australia; Western Sydney Local Health District, Westmead, Australia
| | - Josje D Schoufour
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Oscar H Franco
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Elizabeth G Holliday
- Centre for Clinical Epidemiology and Biostatistics and School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
| | - John Attia
- Centre for Clinical Epidemiology and Biostatistics and School of Medicine and Public Health, University of Newcastle, Newcastle, Australia; Department of Medicine, John Hunter Hospital and Hunter Medical Research Institute, Newcastle, Australia
| | - Gerald Liew
- Centre for Vision Research, Westmead Institute for Medical Research, University of Sydney, Sydney, Australia
| | - Sudha K Iyengar
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio
| | - Paulus T V M de Jong
- Netherlands Institute of Neurosciences, Institute of the Royal Netherlands Academy of Arts and Sciences, Department of Ophthalmology, Academic Medical Centre, Amsterdam, and Leiden University Medical Centre, Leiden, The Netherlands
| | - Albert Hofman
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands; Netherlands Consortium for Healthy Aging, Netherlands Genomics Initiative, The Hague, The Netherlands
| | - Johannes R Vingerling
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Ophthalmology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Paul Mitchell
- Centre for Vision Research, Westmead Institute for Medical Research, University of Sydney, Sydney, Australia
| | - Ronald Klein
- Department of Ophthalmology & Visual Sciences, University of Wisconsin Medical School, Madison, Wisconsin
| | - Caroline C W Klaver
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Jie Jin Wang
- Centre for Vision Research, Westmead Institute for Medical Research, University of Sydney, Sydney, Australia; Office of Clinical Sciences and Academic Medicine Research Institute, Duke-NUS, Singapore, Republic of Singapore.
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Sol IS, Kim YH, Park YA, Lee KE, Hong JY, Kim MN, Kim YS, Oh MS, Yoon SH, Kim MJ, Kim KW, Sohn MH, Kim KE. Relationship between sputum clusterin levels and childhood asthma. Clin Exp Allergy 2017; 46:688-95. [PMID: 26661728 DOI: 10.1111/cea.12686] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Revised: 11/27/2015] [Accepted: 12/05/2015] [Indexed: 12/25/2022]
Abstract
BACKGROUND Clusterin is a sensitive cellular biosensor of oxidative stress and has been studied as a biomarker for inflammation-associated diseases. Clusterin levels in childhood asthma have not been evaluated. OBJECTIVES (1) To evaluate sputum clusterin levels in children with asthma compared to a control group. (2) To assess the relationships between sputum clusterin levels and airway inflammation, pulmonary function, and bronchial hyperresponsiveness. METHODS This study included 170 children aged 5-18 years with stable asthma (n = 91), asthma exacerbation (n = 29), or no asthma (healthy controls; n = 50). Induced sputum, pulmonary function, and methacholine challenge tests were performed. Stable asthma was classified into two groups according to the severity. Clusterin levels in sputum were measured using an enzyme-linked immunosorbent assay. RESULTS Children with stable asthma had a higher clusterin level than healthy controls [4540 (3872-5651) pg/mL vs. 3857 (1054-4369) pg/mL, P < 0.001]. The clusterin level was also more elevated in eosinophil-dominant sputum than in non-eosinophilic sputum in stable asthma [5094 (4243-6257) pg/mL vs. 4110 (1871-4839) pg/mL, P = 0.0017]. Clusterin levels were associated with asthma severity. Paradoxically, clusterin levels were lower during asthma exacerbation than in stable asthma [1838 (350-4790] pg/mL vs. 4540 (3872-5651) pg/mL, P < 0.001]. Clusterin levels were strongly correlated with the methacholine concentration that caused a 20% decrease in the forced expiratory volume in 1 s (r = -0.617, P < 0.001); there was no significant correlation between clusterin levels and other pulmonary function parameters. CONCLUSIONS AND CLINICAL RELEVANCE Clusterin levels were altered in children with stable asthma and asthma exacerbation because of its antioxidant and anti-inflammatory effects. Clusterin may be a marker that reflects airway inflammation and severity of symptoms, and it can be used in the assessment and management of childhood asthma.
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Affiliation(s)
- I S Sol
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - Y H Kim
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - Y A Park
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - K E Lee
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - J Y Hong
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - M N Kim
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - Y S Kim
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - M S Oh
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - S H Yoon
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - M J Kim
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - K W Kim
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - M H Sohn
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - K E Kim
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
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Klein R, Lee KE, Maynard JD, Meuer SM, Gangnon RE, Klein BEK. Skin Intrinsic Fluorescence and Age-Related Macular Degeneration: The Beaver Dam Eye Study. Invest Ophthalmol Vis Sci 2017; 58:6328-6333. [PMID: 29242907 PMCID: PMC5742994 DOI: 10.1167/iovs.17-22382] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To determine if skin intrinsic fluorescence (SIF), a noninvasive measure of advanced glycation endproducts and oxidative stress in skin is associated with AMD. Methods SIF was measured with the SCOUT DS skin fluorescence spectrometer in a cross-sectional cohort study of 969 persons aged 68 to 102 years from the 1181 who participated in the 25-year follow-up examination in the Beaver Dam Eye Study (BDES) in 2014 to 2016. The SCOUT DS skin fluorescence spectrometer uses five light-emitting diodes, centered at 375 nm to 456 nm. AMD was assessed by grading of digital color 45° stereoscopic fundus photographs of the macula using the Wisconsin Age-Related Maculopathy grading scheme. Analyses included logistic regression with generalized estimating equations to account for correlation between the eyes of a person. Results There were data for 1827 eyes for analyses. Early AMD was present in 22% and late AMD in 4% of the eyes. While adjusting for age, sex, smoking status, and history of cardiovascular disease, there were no significant associations of any SIF measure with any AMD or exudative AMD. SIF01 (odds ratio per 1 SD difference on the log scale, 95% confidence interval) (1.66, 1.00-2.74, P = 0.05) and SIF03 (1.81, 1.16-2.81, P = 0.008) were associated with geographic atrophy. Conclusions There was a suggestive relationship of two SIF measures, SIF01 and SIF03, using different correction factors from the excitation centered at 375 nm, with the prevalence of geographic atrophy in the BDES. Longitudinal follow-up is indicated to assess a temporal relationship.
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Affiliation(s)
- Ronald Klein
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States
| | - Kristine E Lee
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States
| | - John D Maynard
- Medical Device and Diagnostics Consulting, Albuquerque, New Mexico, United States
| | - Stacy M Meuer
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States
| | - Ronald E Gangnon
- Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States.,Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States
| | - Barbara E K Klein
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States
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Loomis SJ, Klein AP, Lee KE, Chen F, Bomotti S, Truitt B, Iyengar SK, Klein R, Klein BEK, Duggal P. Exome Array Analysis of Nuclear Lens Opacity. Ophthalmic Epidemiol 2017; 25:215-219. [PMID: 29182452 DOI: 10.1080/09286586.2017.1406122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE Nuclear cataract is the most common subtype of age-related cataract, the leading cause of blindness worldwide. It results from advanced nuclear sclerosis, or opacity in the center of the optic lens, and is affected by both genetic and environmental risk factors, including smoking. We sought to understand the genetic factors associated with nuclear sclerosis through interrogation of rare and low frequency coding variants using exome array data. METHODS We analyzed Illumina Human Exome Array data for 1,488 participants of European ancestry in the Beaver Dam Eye Study who were without cataract surgery for association with nuclear sclerosis grade, controlling for age and sex. We performed single-variant regression analysis for 32,138 variants with minor allele frequency (MAF) ≥0.003. In addition, gene-based analysis of 11,844 genes containing at least two variants with MAF < 0.05 was performed using a gene-based unified burden and non-burden sequence kernel association test (SKAT-O). Additionally, both single-variant and gene-based analyses were analyzed stratified by smoking status. RESULTS No single-variant test was statistically significant after Bonferroni correction (p < 1.6 × 10-6; top single nucleotide polymorphism (SNP): rs144458991, p = 2.83 × 10-5). Gene-based tests were suggestively associated with the gene RNF149 overall (p = 8.29 × 10-6) and among never smokers (N = 790, p = 2.67 × 10-6). CONCLUSIONS This study did not find a significant genetic association with nuclear sclerosis, the possible association with the RNF149 gene highlights a potential candidate gene for future studies that aim to understand the genetic architecture of nuclear sclerosis.
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Affiliation(s)
- Stephanie J Loomis
- a Department of Epidemiology , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA
| | - Alison P Klein
- a Department of Epidemiology , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA.,b Department of Oncology , Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins , Baltimore , MD , USA.,c Department of Pathology , Johns Hopkins School of Medicine , Baltimore , MD , USA
| | - Kristine E Lee
- d Department of Ophthalmology and Visual Sciences , University of Wisconsin School of Medicine and Public Health , Madison , WN , USA
| | - Fei Chen
- a Department of Epidemiology , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA
| | - Samantha Bomotti
- a Department of Epidemiology , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA
| | - Barbara Truitt
- e Department of Epidemiology and Biostatistics , Case Western Reserve University , Cleveland , OH , USA
| | - Sudha K Iyengar
- e Department of Epidemiology and Biostatistics , Case Western Reserve University , Cleveland , OH , USA
| | - Ronald Klein
- d Department of Ophthalmology and Visual Sciences , University of Wisconsin School of Medicine and Public Health , Madison , WN , USA
| | - Barbara E K Klein
- d Department of Ophthalmology and Visual Sciences , University of Wisconsin School of Medicine and Public Health , Madison , WN , USA
| | - Priya Duggal
- a Department of Epidemiology , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA
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Klein R, Horak K, Lee KE, Danforth L, Cruickshanks KJ, Tsai MY, Gangnon RE, Klein BEK. The Relationship of Serum Soluble Receptor for Advanced Glycation End Products (sRAGE) and Carboxymethyl Lysine (CML) to the Incidence of Diabetic Nephropathy in Persons With Type 1 Diabetes. Diabetes Care 2017; 40. [PMID: 28630056 PMCID: PMC5566284 DOI: 10.2337/dc17-0421] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Ronald Klein
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Kayla Horak
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Kristine E Lee
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Lorraine Danforth
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Karen J Cruickshanks
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI.,Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Michael Y Tsai
- Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, MN
| | - Ronald E Gangnon
- Department of Biostatistics & Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Barbara E K Klein
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI
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Kiire CA, Horak K, Lee KE, Klein BEK, Klein R. The period effect in the prevalence of proliferative diabetic retinopathy, gross proteinuria, and peripheral neuropathy in type 1 diabetes: A longitudinal cohort study. PLoS One 2017; 12:e0174979. [PMID: 28362881 PMCID: PMC5376304 DOI: 10.1371/journal.pone.0174979] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [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: 12/19/2016] [Accepted: 03/19/2017] [Indexed: 11/20/2022] Open
Abstract
Aims To investigate whether, for a specific duration of type 1 diabetes, there is a significant change in the prevalence of proliferative diabetic retinopathy, gross proteinuria and peripheral neuropathy in those more recently diagnosed with diabetes (a period effect), in the Wisconsin Epidemiologic Study of Diabetic Retinopathy. Where present, to determine how common risk factors for diabetic complications might be associated with it, and what might be driving it. Materials and methods Longitudinal cohort study with seven examination phases between 1980 and 2014. Multivariate logistic regression models and ordinal parameterization were used to test for and evaluate any period effect. Results There is a period effect in the prevalence of gross proteinuria and peripheral neuropathy (decreasing), as seen with proliferative diabetic retinopathy (p < 0.001). Adjusting for changing levels of common risk factors attenuates the period effect, particularly for proliferative diabetic retinopathy. For gross proteinuria and peripheral neuropathy, however there is a persistent period effect in spite of adjusting for the major risk factors. Conclusions There are period effects in the prevalence of proliferative diabetic retinopathy, gross proteinuria and peripheral neuropathy that cannot be fully explained by changes in common risk factors for complications of type 1 diabetes in this cohort. The role of other potential confounders warrants further exploration.
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Affiliation(s)
- Christine A. Kiire
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States of America
- * E-mail:
| | - Kayla Horak
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States of America
| | - Kristine E. Lee
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States of America
| | - Barbara E. K. Klein
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States of America
| | - Ronald Klein
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States of America
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Klein BEK, Horak KL, Maynard JD, Lee KE, Klein R. Association of Skin Intrinsic Fluorescence with Retinal Microvascular Complications of Long Term Type 1 Diabetes in the Wisconsin Epidemiologic Study of Diabetic Retinopathy. Ophthalmic Epidemiol 2017; 24:211-216. [PMID: 28287861 DOI: 10.1080/09286586.2016.1269934] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE To determine the association between skin intrinsic fluorescence (SIF), a noninvasive measure of advanced glycation endproducts and oxidative stress in skin, and retinal microvascular complications of long duration type 1 diabetes, proliferative diabetic retinopathy (PDR) and macular edema. METHODS A cross-sectional cohort study of persons with type 1 diabetes in the Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR) who participated in a 32-year follow-up examination in 2012-2014. Subjects underwent a physical examination, answered a health questionnaire, and had fundus photographs taken. SIF was measured on the underside of the left forearm near the elbow with the SCOUT DS® skin fluorescence spectrometer. Two representative SIF measures were used for these analyses: SIF01 excited by an LED centered at 375 nm with correction factors Kx = 0.6 and Km = 0.2 and SIF15 excited by an LED centered at 456 nm with correction factors Kx = 0.4 and Km = 0.9. RESULTS The 414 participants had mean diabetes duration of 42.2 years (standard deviation 6.8 years, range 32.9-67.9 years). PDR was statistically significantly associated (p < 0.05) with both SIF measures in multivariate models including other relevant factors (odds ratio [OR] = 1.17 for SIF01 and 1.20 for SIF15). CONCLUSION Skin intrinsic fluorescence measures are independently associated with PDR in the WESDR. Incidence information is needed to evaluate whether there is a causal relationship.
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Affiliation(s)
- Barbara E K Klein
- a Department of Ophthalmology and Visual Sciences , University of Wisconsin School of Medicine and Public Health , Madison , WI , USA
| | - Kayla L Horak
- a Department of Ophthalmology and Visual Sciences , University of Wisconsin School of Medicine and Public Health , Madison , WI , USA
| | - John D Maynard
- b Medical Device and Diagnostics Consulting , Albuquerque , NM , USA
| | - Kristine E Lee
- a Department of Ophthalmology and Visual Sciences , University of Wisconsin School of Medicine and Public Health , Madison , WI , USA
| | - Ronald Klein
- a Department of Ophthalmology and Visual Sciences , University of Wisconsin School of Medicine and Public Health , Madison , WI , USA
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Park DJ, Kang JH, Lee JW, Lee KE, Kim TJ, Park YW, Lee JS, Choi YD, Lee SS. Risk factors to predict the development of chronic kidney disease in patients with lupus nephritis. Lupus 2017; 26:1139-1148. [DOI: 10.1177/0961203317694257] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Objectives We analyzed the clinical follow-up results of 88 lupus nephritis patients to find prognostic factors for the development of chronic kidney disease in ethnically homogeneous Korean patients with biopsy-proven lupus nephritis. Methods Sociodemographic, clinical, laboratory, and treatment-related data at the time of kidney biopsy and during follow-up were obtained. Renal biopsy specimens were reclassified according to the International Society of Pathology/Renal Pathology Society classification, separately, by two renal pathologists blinded to the previous classification. Univariate and multivariate analyses were performed using the Cox proportional hazard regression model to identify independent risk factors for chronic kidney disease in lupus nephritis patients. Results Eighteen of 88 patients (20.5%) developed chronic kidney disease during a mean follow-up of 47.6 months (range: 12–96 months). Patients who developed chronic kidney disease were older at onset of lupus nephritis, had less education, and were more likely to have hypertension; they had lower serum albumin levels, lower platelet levels, higher serum creatinine levels, lower estimated glomerular filtration rate, higher chronicity index, and lower frequency of anti-ribosomal P antibodies, and they were less likely to be in complete remission in the first year. In stepwise multivariable analyses, hypertension, lower glomerular filtration rate, and failure to achieve complete remission in the first year of treatment were significant predictors of the development of chronic kidney disease in lupus nephritis patients. Conclusions These findings suggest that patients with hypertension and decreased kidney function at the onset of lupus nephritis and showing a poor response to immunosuppressive drugs in the first year should be monitored carefully and managed aggressively to avoid deterioration of kidney function.
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Affiliation(s)
- D J Park
- Division of Rheumatology, Chonnam National University Medical School & Hospital, Gwangju, Republic of Korea
| | - J H Kang
- Division of Rheumatology, Chonnam National University Medical School & Hospital, Gwangju, Republic of Korea
| | - J W Lee
- Division of Rheumatology, Chonnam National University Medical School & Hospital, Gwangju, Republic of Korea
| | - K E Lee
- Division of Rheumatology, Chonnam National University Medical School & Hospital, Gwangju, Republic of Korea
| | - T J Kim
- Division of Rheumatology, Chonnam National University Medical School & Hospital, Gwangju, Republic of Korea
| | - Y W Park
- Division of Rheumatology, Chonnam National University Medical School & Hospital, Gwangju, Republic of Korea
| | - J S Lee
- Department of Pathology, Chonnam National University Hospital & Medical School, Gwangju, Republic of Korea
| | - Y D Choi
- Department of Pathology, Chonnam National University Hospital & Medical School, Gwangju, Republic of Korea
| | - S S Lee
- Division of Rheumatology, Chonnam National University Medical School & Hospital, Gwangju, Republic of Korea
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O'Neal WT, Lee KE, Soliman EZ, Klein R, Klein BEK. Predictors of electrocardiographic abnormalities in type 1 Diabetes: the Wisconsin Epidemiologic Study of Diabetic Retinopathy. J Endocrinol Invest 2017; 40:313-318. [PMID: 27766550 PMCID: PMC5475256 DOI: 10.1007/s40618-016-0564-z] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 10/11/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE To determine the incidence and determinants of developing abnormalities on the 12-lead electrocardiogram (ECG) in persons with type 1 diabetes. METHODS We evaluated the distribution of ECG abnormalities and risk factors for developing new abnormalities in 266 (mean age = 44 years ± 9.0; 50 % female) people with type 1 diabetes from the Wisconsin Epidemiologic Study of Diabetic Retinopathy. This analysis included participants with complete ECG data from study visit 5 (2000-2001) and follow-up ECGs from study visit 7 (2012-2014). ECG abnormalities were classified as major and minor according to Minnesota Code Classification. RESULTS At baseline, 94 (35 %) participants had at least one ECG abnormality, including 13 major ECG abnormalities. At follow-up, 117 (44 %) participants developed at least one new ECG abnormality, including 35 new major ECG abnormalities. In a multivariable logistic regression model, older age (per 5-year increase: OR = 1.31, 95 % CI = 1.08, 1.60) was associated with the development of at least one new ECG abnormality, while serum HDL cholesterol (per 10-unit increase: OR = 0.98, 95 % CI = 0.96, 1.00) was protective against developing new ECG abnormalities. CONCLUSIONS The development of new ECG abnormalities is common in type 1 diabetes. Older age and HDL cholesterol are independent risk factors for developing new ECG abnormalities. Further research is needed to determine whether routine ECG screening is indicated in people with type 1 diabetes to identify those with underlying subclinical coronary heart disease.
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Affiliation(s)
- Wesley T O'Neal
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, 101 Woodruff Circle, Woodruff Memorial Building, Atlanta, GA, 30322, USA.
| | - Kristine E Lee
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Elsayed Z Soliman
- Epidemiological Cardiology Research Center, Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Department of Internal Medicine, Section on Cardiovascular Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Ronald Klein
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Barbara E K Klein
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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Joachim N, Colijn JM, Kifley A, Lee KE, Buitendijk GHS, Klein BEK, Myers CE, Meuer SM, Tan AG, Holliday EG, Attia J, Liew G, Iyengar SK, de Jong PTVM, Hofman A, Vingerling JR, Mitchell P, Klaver CCW, Klein R, Wang JJ. Five-year progression of unilateral age-related macular degeneration to bilateral involvement: the Three Continent AMD Consortium report. Br J Ophthalmol 2017; 101:1185-1192. [PMID: 28108569 DOI: 10.1136/bjophthalmol-2016-309729] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 12/14/2016] [Accepted: 12/26/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE To assess the 5-year progression from unilateral to bilateral age-related macular degeneration (AMD) and associated risk factors. DESIGN Pooled data analyses of three prospective population-based cohorts, the Blue Mountains Eye Study, Beaver Dam Eye Study and Rotterdam Study. METHODS Retinal photography and interview with comprehensive questionnaires were conducted at each visit of three studies. AMD was assessed following the modified Wisconsin AMD grading protocol. Progression to bilateral any (early and late) or late AMD was assessed among participants with unilateral involvement only. Factors associated with the progression were assessed using logistic regression models while simultaneously adjusting for other significant risk factors. RESULTS In any 5-year duration, 19-28% of unilateral any AMD cases became bilateral and 27-68% of unilateral late AMD became bilateral. Factors associated with the progression to bilateral involvement of any AMD were age (per year increase, adjusted OR 1.07), carrying risk alleles of the complement factor H and age-related maculopathy susceptibility 2 genes (compared with none, OR 1.76 for 1 risk allele and OR 3.34 for 2+ risk alleles), smoking (compared with non-smokers, OR 1.64 for past and OR 1.67 for current smokers), and the presence of large drusen area or retinal pigmentary abnormalities in the first eye. CONCLUSION One in four to one in five unilateral any AMD cases, and up to one in two unilateral late AMD cases, progressed to bilateral in 5 years. Known AMD risk factors, including smoking, are significantly associated with the progression to bilateral involvement.
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Affiliation(s)
- Nichole Joachim
- Centre for Vision Research, The Westmead Institute for Medical Research, University of Sydney, Sydney, New South Wales, Australia
| | - Johanna Maria Colijn
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Annette Kifley
- Centre for Vision Research, The Westmead Institute for Medical Research, University of Sydney, Sydney, New South Wales, Australia
| | - Kristine E Lee
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Wisconsin, USA
| | - Gabriëlle H S Buitendijk
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Barbara E K Klein
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Wisconsin, USA
| | - Chelsea E Myers
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Wisconsin, USA
| | - Stacy M Meuer
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Wisconsin, USA
| | - Ava G Tan
- Centre for Vision Research, The Westmead Institute for Medical Research, University of Sydney, Sydney, New South Wales, Australia
| | - Elizabeth G Holliday
- Centre for Clinical Epidemiology and Biostatistics, and School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - John Attia
- Centre for Clinical Epidemiology and Biostatistics, and School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia.,Department of Medicine, John Hunter Hospital and Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Gerald Liew
- Centre for Vision Research, The Westmead Institute for Medical Research, University of Sydney, Sydney, New South Wales, Australia
| | - Sudha K Iyengar
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio, USA
| | - Paulus T V M de Jong
- Netherlands Institute of Neuroscience of the Royal Netherlands Academy of Arts and Sciences (KNAW), Departments of Ophthalmology AMC, Amsterdam and LUMC, Leiden, The Netherlands
| | - Albert Hofman
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands.,Netherlands Consortium for Healthy Aging, Netherlands Genomics Initiative, The Hague, The Netherlands
| | - Johannes R Vingerling
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Paul Mitchell
- Centre for Vision Research, The Westmead Institute for Medical Research, University of Sydney, Sydney, New South Wales, Australia
| | - Caroline C W Klaver
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands.,Centre for Vision Research, The Westmead Institute for Medical Research, University of Sydney, Sydney, New South Wales, Australia
| | - Ronald Klein
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Wisconsin, USA
| | - Jie Jin Wang
- Centre for Vision Research, The Westmead Institute for Medical Research, University of Sydney, Sydney, New South Wales, Australia
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Klein BEK, Johnson CA, Meuer SM, Lee K, Wahle A, Lee KE, Kulkarni A, Sonka M, Abràmoff MD, Klein R. Nerve Fiber Layer Thickness and Characteristics Associated with Glaucoma in Community Living Older Adults: Prelude to a Screening Trial? Ophthalmic Epidemiol 2016; 24:104-110. [PMID: 28032805 DOI: 10.1080/09286586.2016.1258082] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE To examine the associations of nerve fiber layer (NFL) thickness with other ocular characteristics in older adults. METHODS Participants in the Beaver Dam Eye Study (2008-2010) underwent spectral domain optical coherence tomography (SD-OCT) scans of the optic nerve head, imaging of optic discs, frequency doubling technology (FDT) perimetry, measurement of intraocular pressure (IOP), and an interview concerning their history of glaucoma and use of drops to lower eye pressure. Self-reported histories of glaucoma and the use of drops to lower eye pressure were obtained at follow-up examinations (2014-2016). RESULTS NFL thickness measured on OCTs varied by location around the optic nerve. Age was associated with mean NFL thickness. Mean NFL was thinnest in eyes with larger cup/disc (C/D) ratios. Horizontal hemifield defects or other optic nerve-field defects were associated with thinner NFL. NFL in persons who reported taking eye drops for high intraocular pressure was thinner compared to those not taking drops. After accounting for the presence of high intraocular pressure, large C/D ratios or hemifield defects, eyes with thinner NFL in the arcades were more likely (OR = 2.3 for 30 micron thinner NFL, p = 0.04) to have incident glaucoma at examination 5 years later. CONCLUSION Retinal NFL thickness was associated with a new history of self-reported glaucoma 5 years later. A trial testing the usefulness of NFL as part of a screening battery for predicting glaucoma in those previously undiagnosed might lead to improved case finding and, ultimately, to diminishing the risk of visual field loss.
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Affiliation(s)
- Barbara E K Klein
- a Department of Ophthalmology and Visual Sciences , University of Wisconsin School of Medicine and Public Health , Madison , WI , USA
| | - Chris A Johnson
- b University of Iowa Hospitals and Clinics , Iowa City , IA , USA.,c Department of Ophthalmology and Visual Sciences , University of Iowa , Iowa City , IA , USA
| | - Stacy M Meuer
- a Department of Ophthalmology and Visual Sciences , University of Wisconsin School of Medicine and Public Health , Madison , WI , USA
| | - Kyungmoo Lee
- d Electrical and Computer Engineering, University of Iowa , Iowa City , IA , USA.,e Iowa Institute for Biomedical Imaging, University of Iowa , Iowa City , IA , USA
| | - Andreas Wahle
- d Electrical and Computer Engineering, University of Iowa , Iowa City , IA , USA.,e Iowa Institute for Biomedical Imaging, University of Iowa , Iowa City , IA , USA
| | - Kristine E Lee
- a Department of Ophthalmology and Visual Sciences , University of Wisconsin School of Medicine and Public Health , Madison , WI , USA
| | - Amruta Kulkarni
- a Department of Ophthalmology and Visual Sciences , University of Wisconsin School of Medicine and Public Health , Madison , WI , USA
| | - Milan Sonka
- c Department of Ophthalmology and Visual Sciences , University of Iowa , Iowa City , IA , USA.,d Electrical and Computer Engineering, University of Iowa , Iowa City , IA , USA.,e Iowa Institute for Biomedical Imaging, University of Iowa , Iowa City , IA , USA
| | - Michael D Abràmoff
- d Electrical and Computer Engineering, University of Iowa , Iowa City , IA , USA.,f Biomedical Engineering, University of Iowa , Iowa City , IA , USA.,g VA Medical Center , Iowa City , IA , USA
| | - Ronald Klein
- a Department of Ophthalmology and Visual Sciences , University of Wisconsin School of Medicine and Public Health , Madison , WI , USA
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Kim MN, Lee KE, Hong JY, Kim KW, Kim KE, Sohn MH, Park JW. IgE cross-reactivity of peanut with walnut and soybean in children with food allergy. Allergol Immunopathol (Madr) 2016; 44:524-530. [PMID: 27726958 DOI: 10.1016/j.aller.2016.04.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 04/11/2016] [Accepted: 04/27/2016] [Indexed: 01/09/2023]
Abstract
BACKGROUND Peanut allergies are common and can be life-threating for sensitised individuals. Peanut allergens share significant amino acid homology with those of other legumes and tree nuts, but their cross-reactivity still remains unclear. OBJECTIVE We sought to determine the clinical significance of the cross-reactivity of peanut allergens with those of walnut and soybean. METHODS Pooled sera from eight subjects with both peanut and walnut specific IgE were investigated in an inhibition test. After the sera were incubated with either peanut or walnut protein extracts, the quantity of IgE antibodies against the peanut and walnut was measured using an immunoCAP test. Likewise, pooled sera from 18 subjects with both peanut and soybean specific IgE antibodies were incubated with either peanut or soybean protein extracts and evaluated with a peanut and soybean immunoCAP test. SDS-PAGE and immunoblotting were also performed with peanut, walnut and soybean protein extracts and relevant sera. RESULTS Peanut specific IgE was inhibited up to 20% and 26% by walnut and soybean protein extracts, respectively. In reverse, walnut and soybean specific IgE were inhibited up to 21% and 23% by peanut protein extracts, respectively. In the immunoblot analysis, pooled serum from the subjects with peanut specific IgE antibodies reacted with walnut protein extracts significantly. CONCLUSION Although the clinical significance of the cross-reactivity of peanut specific IgE with walnut and soybean protein extracts has not been established, we believe that individuals who are allergic to peanuts need to be cautious about consuming walnuts and soybeans.
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Affiliation(s)
- M N Kim
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - K E Lee
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - J Y Hong
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - K W Kim
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - K-E Kim
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - M H Sohn
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - J W Park
- Department of Internal Medicine, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
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Ryan CM, Klein BEK, Lee KE, Cruickshanks KJ, Klein R. Associations between recent severe hypoglycemia, retinal vessel diameters, and cognition in adults with type 1 diabetes. J Diabetes Complications 2016; 30:1513-1518. [PMID: 27601058 PMCID: PMC5050129 DOI: 10.1016/j.jdiacomp.2016.08.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2016] [Accepted: 08/09/2016] [Indexed: 01/21/2023]
Abstract
AIMS Mild cognitive dysfunction has been identified in children and adults with type 1 diabetes, but most studies have failed to find a relationship between severe hypoglycemia and cognition, despite reports of such associations in older adults with type 2 diabetes. Focusing on older adults with type 1 diabetes, we examined the associations between cognitive performance and recent episodes of severe hypoglycemia, retinal vessel diameters and the presence of micro- and macrovascular complications. METHODS Cognitive functioning was assessed in 244 participants enrolled in the Wisconsin Epidemiologic Study of Diabetic Retinopathy. The mean (SD; range) age at assessment in 2012-14 was 55.2 (8.3; 37-82) years and the mean (SD) duration of diabetes was 41.1 (5.6) years. Three cognitive domains were assessed in this cross-sectional study: mental efficiency and executive function, nonverbal memory, and verbal memory. RESULTS Multivariate modeling demonstrated that although age and/or education are most strongly associated with performance on measures of mental efficiency, three diabetes-related variables were also associated with poorer test scores: an episode of severe hypoglycemia in the past year (β=-0.360 [95% CI, -0.672, -0.047]), retinal arteriolar and venular diameters (β=0.140 [95% CI, 0.062, 0.219]; β=-0.127 [95% CI -0.207, -0.047]), and carotid artery plaque (β=-0.372 [95% CI -0.741, -0.003]). In addition, recent severe hypoglycemia was associated with poorer nonverbal memory (β=-0.522 [95% CI, -0.849, -0.194]). CONCLUSIONS For middle-aged and older adults with long-duration type 1 diabetes, poorer cognition was associated with a recent episode of severe hypoglycemia as well as with the presence of micro- and/or macrovascular conditions. Given the increasing numbers of aging adults with type 1 diabetes, future longitudinal studies are needed to identify causality and to determine whether diabetes management techniques that reduce the onset or severity of vascular complications and hypoglycemia can also reduce the risk of cognitive dysfunction in this population.
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Affiliation(s)
- Christopher M Ryan
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.
| | - Barbara E K Klein
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
| | - Kristine E Lee
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
| | - Karen J Cruickshanks
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States; Department of Population Health Sciences, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
| | - Ronald Klein
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
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Chen F, Duggal P, Klein BEK, Lee KE, Truitt B, Klein R, Iyengar SK, Klein AP. Variation in PTCHD2, CRISP3, NAP1L4, FSCB, and AP3B2 associated with spherical equivalent. Mol Vis 2016; 22:783-96. [PMID: 27440996 DOI: pmid/27440996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 07/12/2016] [Indexed: 11/10/2022] Open
Abstract
PURPOSE Ocular refraction is measured in spherical equivalent as the power of the external lens required to focus images on the retina. Myopia (nearsightedness) and hyperopia (farsightedness) are the most common refractive errors, and the leading causes of visual impairment and blindness in the world. The goal of this study is to identify rare and low-frequency variants that influence spherical equivalent. METHODS We conducted variant-level and gene-level quantitative trait association analyses for mean spherical equivalent, using data from 1,560 individuals in the Beaver Dam Eye Study. Genotyping was conducted using the Illumina exome array. We analyzed 34,976 single nucleotide variants and 11,571 autosomal genes across the genome, using single-variant tests as well as gene-based tests. RESULTS Spherical equivalent was significantly associated with five genes in gene-based analysis: PTCHD2 at 1p36.22 (p = 3.6 × 10(-7)), CRISP3 at 6p12.3 (p = 4.3 × 10(-6)), NAP1L4 at 11p15.5 (p = 3.6 × 10(-6)), FSCB at 14q21.2 (p = 1.5 × 10(-7)), and AP3B2 at 15q25.2 (p = 1.6 × 10(-7)). The variant-based tests identified evidence suggestive of association with two novel variants in linkage disequilibrium (pairwise r(2) = 0.80) in the TCTE1 gene region at 6p21.1 (rs2297336, minor allele frequency (MAF) = 14.1%, β = -0.62 p = 3.7 × 10(-6); rs324146, MAF = 16.9%, β = -0.55, p = 1.4 × 10(-5)). In addition to these novel findings, we successfully replicated a previously reported association with rs634990 near GJD2 at 15q14 (MAF = 47%, β = -0.29, p=1.8 × 10(-3)). We also found evidence of association with spherical equivalent on 2q37.1 in PRSS56 at rs1550094 (MAF = 31%, β = -0.33, p = 1.7 × 10(-3)), a region previously associated with myopia. CONCLUSIONS We identified several novel candidate genes that may play a role in the control of spherical equivalent. However, further studies are needed to replicate these findings. In addition, our results contribute to the increasing evidence that variation in the GJD2 and PRSS56 genes influence the development of refractive errors. Identifying that variation in these genes is associated with spherical equivalent may provide further insight into the etiology of myopia and consequent vision loss.
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Affiliation(s)
- Fei Chen
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Priya Duggal
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Barbara E K Klein
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Kristine E Lee
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Barbara Truitt
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH
| | - Ronald Klein
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Sudha K Iyengar
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH
| | - Alison P Klein
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD
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Lee JW, Park DJ, Kang JH, Choi SE, Yim YR, Kim JE, Lee KE, Wen L, Kim TJ, Park YW, Sung YK, Lee SS. The rate of and risk factors for frequent hospitalization in systemic lupus erythematosus: results from the Korean lupus network registry. Lupus 2016; 25:1412-1419. [PMID: 27000153 DOI: 10.1177/0961203316640916] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives The survival rate of patients with systemic lupus erythematosus has improved in the last few decades, but the rate of hospitalization and health care costs for these patients remain higher than in the general population. Thus, we evaluated the rate of hospitalization and associated risk factors in an inception cohort of Korean patients with lupus. Methods Of the 507 patients with systemic lupus erythematosus enrolled in the KORean lupus NETwork, we investigated an inception cohort consisting of 196 patients with systemic lupus erythematosus presenting within 6 months of diagnosis based on the American College of Rheumatology classification criteria. We evaluated the causes of hospitalization, demographic characteristics, and laboratory and clinical data at the time of systemic lupus erythematosus diagnosis of hospitalized patients and during a follow-up period. We calculated the hospitalization rate as the number of total hospitalizations divided by the disease duration, and defined "frequent hospitalization" as hospitalization more than once per year. Results Of the 196 patients, 117 (59.6%) were admitted to hospital a total of 257 times during the 8-year follow-up period. Moreover, 22 (11.2%) patients were hospitalized frequently. The most common reasons for hospitalization included disease flares, infection, and pregnancy-related morbidity. In the univariate regression analysis, malar rash, arthritis, pericarditis, renal involvement, fever, systemic lupus erythematosus disease activity index > 12, hemoglobin level < 10 mg/dl, albumin level < 3.5 mg/dl, and anti-Sjögren's syndrome A positivity were associated with frequent hospitalization. Finally, multivariate analysis showed that arthritis, pericarditis, and anti-Sjögren's syndrome A antibody positivity at the time of diagnosis were risk factors for frequent hospitalization. Conclusions Our results showed that frequent hospitalization occurred in 11.2% of hospitalized patients and arthritis, pericarditis, and anti-Sjögren's syndrome A antibody positivity at the time of diagnosis were risk factors for frequent hospitalization.
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Affiliation(s)
- J W Lee
- 1 Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - D J Park
- 1 Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - J H Kang
- 1 Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - S E Choi
- 1 Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Y R Yim
- 1 Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - J E Kim
- 1 Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - K E Lee
- 1 Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - L Wen
- 1 Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - T J Kim
- 1 Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Y W Park
- 1 Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Y K Sung
- 2 Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Republic of Korea
| | - S S Lee
- 1 Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
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Howard KP, Chandler CS, Huang Y, Klein BEK, Lee KE, Meuer SM, Danis RP, Danforth LG, Gangnon RE, Klein R. Variability in Spectral-Domain Optical Coherence Tomography over 4 Weeks by Age. Ophthalmic Epidemiol 2016; 23:193-201. [PMID: 27128499 DOI: 10.3109/09286586.2015.1119285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE To quantify variation in spectral-domain optical coherence tomography (SD-OCT) measures of total retinal thickness (top of inner limiting membrane to top of retinal pigment epithelium, RPE) and RPE thickness measures over a 4-week period and by age. METHODS A total of 76 volunteers aged 40-85 years were seen at three visits over 4 weeks. Two Topcon SD-OCT scans were taken at each visit. Following grid re-centration, total retinal and RPE thickness were determined in nine subfields. Multilevel modeling was used to quantify variance between scans and by age. RESULTS In the central circle, mean total retinal thickness was 237.9 µm (standard deviation, SD, 23.5 µm) and RPE thickness was 46.0 µm (SD 5.3 µm). Intraclass correlation coefficient in the central circle was 0.988 for total retinal thickness and 0.714 for RPE thickness. Pairwise measures taken within 4 weeks were strongly correlated (p > 0.95). Within-subject variation of total retinal thickness increased significantly with age. Subjects in the oldest age group had significantly increased among- and within-subject variability in measures of RPE thickness. CONCLUSIONS Correlation between retinal thickness measures was very high (>0.95) over a period of 4 weeks with small changes likely due to variation in measurement. Increasing variability in total retinal and RPE thickness measures with age suggest that the use of more and/or higher quality images to calculate mean thickness to reduce variability may benefit the study of these measures in older persons. This may also impact sample size calculations for future studies of SD-OCT measures in older adults.
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Affiliation(s)
- Kerri P Howard
- a Department of Ophthalmology and Visual Sciences , University of Wisconsin School of Medicine and Public Health , Madison , WI , USA
| | - Charles S Chandler
- a Department of Ophthalmology and Visual Sciences , University of Wisconsin School of Medicine and Public Health , Madison , WI , USA
| | - Yijun Huang
- a Department of Ophthalmology and Visual Sciences , University of Wisconsin School of Medicine and Public Health , Madison , WI , USA
| | - Barbara E K Klein
- a Department of Ophthalmology and Visual Sciences , University of Wisconsin School of Medicine and Public Health , Madison , WI , USA
| | - Kristine E Lee
- a Department of Ophthalmology and Visual Sciences , University of Wisconsin School of Medicine and Public Health , Madison , WI , USA
| | - Stacy M Meuer
- a Department of Ophthalmology and Visual Sciences , University of Wisconsin School of Medicine and Public Health , Madison , WI , USA
| | - Ronald P Danis
- a Department of Ophthalmology and Visual Sciences , University of Wisconsin School of Medicine and Public Health , Madison , WI , USA
| | - Lorraine G Danforth
- a Department of Ophthalmology and Visual Sciences , University of Wisconsin School of Medicine and Public Health , Madison , WI , USA
| | - Ronald E Gangnon
- b Department of Population Health Sciences , University of Wisconsin School of Medicine and Public Health , Madison , WI , USA
| | - Ronald Klein
- a Department of Ophthalmology and Visual Sciences , University of Wisconsin School of Medicine and Public Health , Madison , WI , USA
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