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Thu AM, Phyo AP, Pateekhum C, Rae JD, Landier J, Parker DM, Delmas G, Watthanaworawit W, McLean ARD, Arya A, Reyes A, Li X, Miotto O, Soe K, Ashley EA, Dondorp A, White NJ, Day NP, Anderson TJC, Imwong M, Nosten F, Smithuis F. Molecular markers of artemisinin resistance during falciparum malaria elimination in Eastern Myanmar. Malar J 2024; 23:138. [PMID: 38720269 PMCID: PMC11078751 DOI: 10.1186/s12936-024-04955-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 04/06/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Artemisinin resistance in Plasmodium falciparum threatens global malaria elimination efforts. To contain and then eliminate artemisinin resistance in Eastern Myanmar a network of community-based malaria posts was instituted and targeted mass drug administration (MDA) with dihydroartemisinin-piperaquine (three rounds at monthly intervals) was conducted. The prevalence of artemisinin resistance during the elimination campaign (2013-2019) was characterized. METHODS Throughout the six-year campaign Plasmodium falciparum positive blood samples from symptomatic patients and from cross-sectional surveys were genotyped for mutations in kelch-13-a molecular marker of artemisinin resistance. RESULT The program resulted in near elimination of falciparum malaria. Of 5162 P. falciparum positive blood samples genotyped, 3281 (63.6%) had K13 mutations. The prevalence of K13 mutations was 73.9% in 2013 and 64.4% in 2019. Overall, there was a small but significant decline in the proportion of K13 mutants (p < 0.001). In the MDA villages there was no significant change in the K13 proportions before and after MDA. The distribution of different K13 mutations changed substantially; F446I and P441L mutations increased in both MDA and non-MDA villages, while most other K13 mutations decreased. The proportion of C580Y mutations fell from 9.2% (43/467) before MDA to 2.3% (19/813) after MDA (p < 0.001). Similar changes occurred in the 487 villages where MDA was not conducted. CONCLUSION The malaria elimination program in Kayin state, eastern Myanmar, led to a substantial reduction in falciparum malaria. Despite the intense use of artemisinin-based combination therapies, both in treatment and MDA, this did not select for artemisinin resistance.
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Affiliation(s)
- Aung Myint Thu
- Shoklo Malaria Research Unit (SMRU), Faculty of Tropical Medicine, Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University Mae Sot, Bangkok, Thailand
| | - Aung Pyae Phyo
- Shoklo Malaria Research Unit (SMRU), Faculty of Tropical Medicine, Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University Mae Sot, Bangkok, Thailand.
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7BN, UK.
| | - Chanapat Pateekhum
- Shoklo Malaria Research Unit (SMRU), Faculty of Tropical Medicine, Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University Mae Sot, Bangkok, Thailand
| | - Jade D Rae
- Shoklo Malaria Research Unit (SMRU), Faculty of Tropical Medicine, Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University Mae Sot, Bangkok, Thailand
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, P. O. Box 10400, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7BN, UK
| | - Jordi Landier
- IRD, Aix Marseille Univ, INSERM, SESSTIM, Aix Marseille Institute of Public Health, ISSPAM, Marseille, France
| | - Daniel M Parker
- Department of Population Health and Disease Prevention, Department of Epidemiology & Biostatistics, University of California, Irvine, CE, 92617, USA
| | - Gilles Delmas
- Shoklo Malaria Research Unit (SMRU), Faculty of Tropical Medicine, Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University Mae Sot, Bangkok, Thailand
| | - Wanitda Watthanaworawit
- Shoklo Malaria Research Unit (SMRU), Faculty of Tropical Medicine, Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University Mae Sot, Bangkok, Thailand
| | - Alistair R D McLean
- Medical Action Myanmar, Yangon, Myanmar
- Myanmar Oxford Clinical Research Unit (MOCRU), Yangon, Myanmar
| | - Ann Arya
- Disease Intervention and Prevention Program, Texas Biomedical Research Institute, P. O. Box 760549, San Antonio, TX, USA
| | - Ann Reyes
- Disease Intervention and Prevention Program, Texas Biomedical Research Institute, P. O. Box 760549, San Antonio, TX, USA
| | - Xue Li
- Disease Intervention and Prevention Program, Texas Biomedical Research Institute, P. O. Box 760549, San Antonio, TX, USA
| | - Olivo Miotto
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, P. O. Box 10400, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7BN, UK
| | - Kyaw Soe
- Medical Action Myanmar, Yangon, Myanmar
- Myanmar Oxford Clinical Research Unit (MOCRU), Yangon, Myanmar
| | - Elizabeth A Ashley
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7BN, UK
- Microbiology Laboratory, Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Mahosot Hospital, Vientiane, Lao PDR
| | - Arjen Dondorp
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, P. O. Box 10400, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7BN, UK
| | - Nicholas J White
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, P. O. Box 10400, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7BN, UK
| | - Nicholas P Day
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, P. O. Box 10400, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7BN, UK
| | - Tim J C Anderson
- Disease Intervention and Prevention Program, Texas Biomedical Research Institute, P. O. Box 760549, San Antonio, TX, USA
| | - Mallika Imwong
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, P. O. Box 10400, Bangkok, Thailand
- Department of Molecular Tropical Medicine and Genetics, Mahidol University, P. O. Box 10400, Bangkok, Thailand
| | - Francois Nosten
- Shoklo Malaria Research Unit (SMRU), Faculty of Tropical Medicine, Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University Mae Sot, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7BN, UK
| | - Frank Smithuis
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, P. O. Box 10400, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7BN, UK
- Medical Action Myanmar, Yangon, Myanmar
- Myanmar Oxford Clinical Research Unit (MOCRU), Yangon, Myanmar
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2
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Roseberry K, Le-Niculescu H, Levey DF, Bhagar R, Soe K, Rogers J, Palkowitz S, Pina N, Anastasiadis WA, Gill SS, Kurian SM, Shekhar A, Niculescu AB. Towards precision medicine for anxiety disorders: objective assessment, risk prediction, pharmacogenomics, and repurposed drugs. Mol Psychiatry 2023; 28:2894-2912. [PMID: 36878964 PMCID: PMC10615756 DOI: 10.1038/s41380-023-01998-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 01/29/2023] [Accepted: 02/10/2023] [Indexed: 03/08/2023]
Abstract
Anxiety disorders are increasingly prevalent, affect people's ability to do things, and decrease quality of life. Due to lack of objective tests, they are underdiagnosed and sub-optimally treated, resulting in adverse life events and/or addictions. We endeavored to discover blood biomarkers for anxiety, using a four-step approach. First, we used a longitudinal within-subject design in individuals with psychiatric disorders to discover blood gene expression changes between self-reported low anxiety and high anxiety states. Second, we prioritized the list of candidate biomarkers with a Convergent Functional Genomics approach using other evidence in the field. Third, we validated our top biomarkers from discovery and prioritization in an independent cohort of psychiatric subjects with clinically severe anxiety. Fourth, we tested these candidate biomarkers for clinical utility, i.e. ability to predict anxiety severity state, and future clinical worsening (hospitalizations with anxiety as a contributory cause), in another independent cohort of psychiatric subjects. We showed increased accuracy of individual biomarkers with a personalized approach, by gender and diagnosis, particularly in women. The biomarkers with the best overall evidence were GAD1, NTRK3, ADRA2A, FZD10, GRK4, and SLC6A4. Finally, we identified which of our biomarkers are targets of existing drugs (such as a valproate, omega-3 fatty acids, fluoxetine, lithium, sertraline, benzodiazepines, and ketamine), and thus can be used to match patients to medications and measure response to treatment. We also used our biomarker gene expression signature to identify drugs that could be repurposed for treating anxiety, such as estradiol, pirenperone, loperamide, and disopyramide. Given the detrimental impact of untreated anxiety, the current lack of objective measures to guide treatment, and the addiction potential of existing benzodiazepines-based anxiety medications, there is a urgent need for more precise and personalized approaches like the one we developed.
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Affiliation(s)
- K Roseberry
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - H Le-Niculescu
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
- Stark Neuroscience Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA
| | - D F Levey
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
- Yale School of Medicine, New Haven, CT, USA
| | - R Bhagar
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - K Soe
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
- Cincinnati Children's Hospital, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - J Rogers
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - S Palkowitz
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
- Indianapolis VA Medical Center, Indianapolis, IN, USA
| | - N Pina
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
- Indianapolis VA Medical Center, Indianapolis, IN, USA
| | - W A Anastasiadis
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
- Indianapolis VA Medical Center, Indianapolis, IN, USA
| | - S S Gill
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - S M Kurian
- Scripps Health and Department of Molecular Medicine, Scripps Research, La Jolla, CA, USA
| | - A Shekhar
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
- Office of the Dean, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - A B Niculescu
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA.
- Stark Neuroscience Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA.
- Indianapolis VA Medical Center, Indianapolis, IN, USA.
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3
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Mulpuri N, Bryant A, Shahin D, Soe K. The Hemoglobin Wayne Variant and Association With Falsely Elevated HbA 1c. JCEM Case Rep 2023; 1:luad043. [PMID: 37908573 PMCID: PMC10580435 DOI: 10.1210/jcemcr/luad043] [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] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Indexed: 11/02/2023]
Abstract
The objective of this work is to explain the effect of the clinically silent hemoglobinopathy hemoglobin Wayne (Hb Wayne) variant on glycated hemoglobin A1c (HbA1c) assay. This variant can result in falsely high HbA1c values among euglycemic individuals without diabetes mellitus (DM). We discuss 3 patients who were diagnosed with type 2 DM based on spuriously high HbA1c values due to the presence of Hb Wayne. All 3 patients were found to have elevated HbA1c values that did not correlate with other glycemic parameters such as capillary blood sugar, 2-hour oral glucose tolerance test, and fructosamine levels. Hemoglobin electrophoresis revealed that each patient had a rare hemoglobinopathy called Hb Wayne variant. These patients were reassured that they did not have DM and were able to avoid unnecessary treatment. These cases emphasize the importance of clinical judgment in recognizing the limitations and caveats of the HbA1c test. It is always necessary to investigate further any discordance between HbA1c values and the clinical picture or other glycemic parameters.
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Affiliation(s)
- Neha Mulpuri
- UT Southwestern Medical Center, Department of Internal Medicine, Dallas, TX 75390, USA
| | - Ananda Bryant
- VA North Texas Health Care System, Division of Endocrinology, Dallas, TX 75216, USA
| | - Daryoush Shahin
- VA North Texas Health Care System, Division of Endocrinology, Dallas, TX 75216, USA
| | - Kyaw Soe
- UT Southwestern Medical Center, Department of Internal Medicine, Dallas, TX 75390, USA
- VA North Texas Health Care System, Division of Endocrinology, Dallas, TX 75216, USA
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4
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Shah MS, Lee C, Guo L, Bryant A, Ragunton JM, Caldwell L, Xu L, Onodera T, Gordillo R, Scherer PE, Soe K. PMON280 Effect of Gender Affirming Hormone Therapy (GAHT) on Adipose Tissue Morphology and Metabolism in Transgender Individuals. J Endocr Soc 2022. [DOI: 10.1210/jendso/bvac150.1457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Abstract
Background
Circulating sex hormones exert unique effects on metabolism, leading to sexual dimorphism in white adipose tissue distribution and function. The gender affirming hormone therapy (GAHT) or cross-sex hormone therapy (CSHT) for transgender patients lower the endogenous sex hormones while raising the opposite sex hormones. Sex hormones are known to have a significant impact on white adipose tissue and metabolism. However, long-term metabolic changes with GAHT in transgender individuals have not been studied, nor are the underlying mechanisms properly elucidated.
Hypothesis
We test the hypothesis that GAHT will result in sexual dimorphic changes in morphology and function of white adipose tissue according to the type of sex hormones used and the native sex of the patients.
Aim 1
To study the effect of cross-sex hormones on clinical parameters such as blood pressure, weight, waist-hip circumference ratio, serum lipids, insulin sensitivity
Aim 2
To study the changes in human subcutaneous white adipose tissue (SWAT) distribution and expansion with GAHT
Aim 3
To study changes in circulating metabolites and adipokines, and pro-inflammatory and pro-fibrotic gene expression in SWAT with GAHT.
Methodology
31 hormone-naive patients (19 Male-to-Female; MtF and 12 Female-to-Male; FtM) were enrolled in the longitudinal study and followed up for 3 years. Clinical parameters and blood samples were gathered at baseline and at 6 month intervals. DXA scans and fat biopsies (peri-umbilical SWAT) were performed at baseline and at 1 year intervals.
Results
The results presented here compare baseline and at 1 year of GAHT. There was an increase in total cholesterol in the MtF group. HOMA-IR, total fat mass and visceral fat mass increased in MtF group, while they decreased in the FtM group. In MtF group, lean mass and bone mineral content (BMC) decreased at 1 year, but no change was observed in the FtM group. On histological assessment, fat cell size increased in MtF group, while it decreased in the FtM group.
Conclusion
In MtF transgender patients, androgen deprivation and estrogen treatment resulted in reduced insulin sensitivity together with a rise in total cholesterol possibly via a decrease in lean mass and adipose tissue expansion through significant adipocyte hypertrophy. In FtM transgender patients, testosterone treatment caused improved insulin sensitivity possibly via a decrease in total and visceral fat mass. The greatest strengths of our project include its longitudinal nature over 3 years to capture long-term effects in the same patients as well as deeper mechanistic insights into the underlying metabolite, adipokine and gene expression changes. The limitations of our study include the small sample size with heterogeneity of study population in terms of demographics and lifestyles.
Presentation: Monday, June 13, 2022 12:30 p.m. - 2:30 p.m.
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5
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Htun MW, Shibata Y, Soe K, Koji T. Nuclear Expression of Pygo2 Correlates with Poorly Differentiated State Involving c-Myc, PCNA and Bcl9 in Myanmar Hepatocellular Carcinoma. Acta Histochem Cytochem 2021; 54:195-206. [PMID: 35023882 PMCID: PMC8727843 DOI: 10.1267/ahc.21-00090] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 12/03/2021] [Indexed: 01/10/2023] Open
Abstract
In Myanmar, hepatocellular carcinoma (HCC) is commonly seen in young adult and associated with poor prognosis, while the molecular mechanisms that characterize HCC in Myanmar are unknown. As co-activation of Wnt/β-catenin signaling and c-Myc (Myc) are reported to associate with malignancy of HCC, we immunohistochemically investigated the expression of Pygo2 and Bcl9, the co-activators of the Wnt/β-catenin signaling, Myc and PCNA in 60 cases of Myanmar HCC. Pygo2 expression was confirmed by in situ hybridization. The signal intensity was measured by image analyzer and then statistically analyzed. As a result, the expression of Pygo2 was significantly higher in HCC compared to normal liver tissue and the nuclear signal was the most intense in poorly differentiated HCC. Cytoplasmic Bcl9 was expressed in the normal liver tissue but decreased in HCC with the progression of histopathological grade. Myc was significantly higher in poorly differentiated HCC, whereas PCNA labeling index increased with the progression of histopathological grade. Nuclear Pygo2 showed strong correlation with nuclear Myc (P < 0.01) and PCNA (P < 0.001), and inversely correlated with cytoplasmic Bcl9 (P < 0.01). Our results suggested Wnt/β-catenin and Myc signaling is commonly activated in Myanmar HCC and that the correlative upregulation of nuclear Pygo2 and Myc characterizes the malignant features of HCC in Myanmar.
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Affiliation(s)
- Myo Win Htun
- Department of Histology and Cell Biology, Nagasaki University Graduate School of Biomedical Sciences
| | - Yasuaki Shibata
- Department of Histology and Cell Biology, Nagasaki University Graduate School of Biomedical Sciences
| | | | - Takehiko Koji
- Office for Research Initiative and Development, Nagasaki University
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6
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Warrell CE, Phyo AP, Win MM, McLean ARD, Watthanaworawit W, Swe MMM, Soe K, Lin HN, Aung YY, Ko CK, Waing CZ, Linn KS, Aung YPW, Aung NM, Tun NN, Dance DAB, Smithuis FM, Ashley EA. Observational study of adult respiratory infections in primary care clinics in Myanmar: understanding the burden of melioidosis, tuberculosis and other infections not covered by empirical treatment regimes. Trans R Soc Trop Med Hyg 2021; 115:914-921. [PMID: 33681986 PMCID: PMC8326957 DOI: 10.1093/trstmh/trab024] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 01/22/2021] [Accepted: 02/09/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Lower respiratory infections constitute a major disease burden worldwide. Treatment is usually empiric and targeted towards typical bacterial pathogens. Understanding the prevalence of pathogens not covered by empirical treatment is important to improve diagnostic and treatment algorithms. METHODS A prospective observational study in peri-urban communities of Yangon, Myanmar was conducted between July 2018 and April 2019. Sputum specimens of 299 adults presenting with fever and productive cough were tested for Mycobacterium tuberculosis (microscopy and GeneXpert MTB/RIF [Mycobacterium tuberculosis/resistance to rifampicin]) and Burkholderia pseudomallei (Active Melioidosis Detect Lateral Flow Assay and culture). Nasopharyngeal swabs underwent respiratory virus (influenza A, B, respiratory syncytial virus) polymerase chain reaction testing. RESULTS Among 299 patients, 32% (95% confidence interval [CI] 26 to 37) were diagnosed with tuberculosis (TB), including 9 rifampicin-resistant cases. TB patients presented with a longer duration of fever (median 14 d) and productive cough (median 30 d) than non-TB patients (median fever duration 6 d, cough 7 d). One case of melioidosis pneumonia was detected by rapid test and confirmed by culture. Respiratory viruses were detected in 16% (95% CI 12 to 21) of patients. CONCLUSIONS TB was very common in this population, suggesting that microscopy and GeneXpert MTB/RIF on all sputum samples should be routinely included in diagnostic algorithms for fever and cough. Melioidosis was uncommon in this population.
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Affiliation(s)
- Clare E Warrell
- Myanmar Oxford Clinical Research Unit, Yangon, Myanmar.,Medical Action Myanmar, Yangon, Myanmar
| | | | - Mo Mo Win
- Department of Medical Research, Myanmar
| | - Alistair R D McLean
- Myanmar Oxford Clinical Research Unit, Yangon, Myanmar.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Wanitda Watthanaworawit
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
| | | | - Kyaw Soe
- Myanmar Oxford Clinical Research Unit, Yangon, Myanmar
| | - Htet Naing Lin
- Myanmar Oxford Clinical Research Unit, Yangon, Myanmar.,Medical Action Myanmar, Yangon, Myanmar
| | | | | | | | | | | | - Ne Myo Aung
- Department of Medicine, Insein General Hospital, Min Gyi Road, Insein Township, Yangon, Myanmar.,Department of Medicine, University of Medicine 2, Khaymar Thi Road, North Okkalapa Township, Yangon, Myanmar
| | - Ni Ni Tun
- Myanmar Oxford Clinical Research Unit, Yangon, Myanmar.,Medical Action Myanmar, Yangon, Myanmar
| | - David A B Dance
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.,Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao People's Democratic Republic.,Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Frank M Smithuis
- Myanmar Oxford Clinical Research Unit, Yangon, Myanmar.,Medical Action Myanmar, Yangon, Myanmar
| | - Elizabeth A Ashley
- Myanmar Oxford Clinical Research Unit, Yangon, Myanmar.,Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao People's Democratic Republic.,Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
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7
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McLean ARD, Indrasuta C, Khant ZS, Phyo AK, Maung SM, Heaton J, Aung H, Aung Y, Soe K, Swe MMM, von Seidlein L, Tun NN, Tun KM, Day NPJ, Ashley EA, Hlaing T, Kyaw TT, Dondorp AM, Imwong M, White NJ, Smithuis FM. Mass drug administration for the acceleration of malaria elimination in a region of Myanmar with artemisinin-resistant falciparum malaria: a cluster-randomised trial. Lancet Infect Dis 2021; 21:1579-1589. [PMID: 34147154 PMCID: PMC7614510 DOI: 10.1016/s1473-3099(20)30997-x] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 11/18/2020] [Accepted: 12/17/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND To contain multidrug-resistant Plasmodium falciparum, malaria elimination in the Greater Mekong subregion needs to be accelerated while current antimalarials remain effective. We evaluated the safety, effectiveness, and potential resistance selection of dihydroartemisinin-piperaquine mass drug administration (MDA) in a region with artemisinin resistance in Myanmar. METHODS We did a cluster-randomised controlled trial in rural community clusters in Kayin (Karen) state in southeast Myanmar. Malaria prevalence was assessed using ultrasensitive quantitative PCR (uPCR) in villages that were operationally suitable for MDA (villages with community willingness, no other malaria control campaigns, and a population of 50-1200). Villages were eligible to participate if the prevalence of malaria (all species) in adults was greater than 30% or P falciparum prevalence was greater than 10% (or both). Contiguous villages were combined into clusters. Eligible clusters were paired based on P falciparum prevalence (estimates within 10%) and proximity. Community health workers provided routine malaria case management and distributed long-lasting insecticidal bed-nets (LLINs) in all clusters. Randomisation of clusters (1:1) to the MDA intervention group or control group was by public coin-flip. Group allocations were not concealed. Three MDA rounds (3 days of supervised dihydroartemisinin-piperaquine [target total dose 7 mg/kg dihydroartemisinin and 55 mg/kg piperaquine] and single low-dose primaquine [target dose 0·25 mg base per kg]) were delivered to intervention clusters. Parasitaemia prevalence was assessed at 3, 5, 10, 15, 21, 27, and 33 months. The primary outcomes were P falciparum prevalence at months 3 and 10. All clusters were included in the primary analysis. Adverse events were monitored from the first MDA dose until 1 month after the final dose, or until resolution of any adverse event occurring during follow-up. This trial is registered with ClinicalTrials.gov, NCT01872702. FINDINGS Baseline uPCR malaria surveys were done in January, 2015, in 43 villages that were operationally suitable for MDA (2671 individuals). 18 villages met the eligibility criteria. Three villages in close proximity were combined into one cluster because a border between them could not be defined. This gave a total of 16 clusters in eight pairs. In the intervention clusters, MDA was delivered from March 4 to March 17, from March 30 to April 10, and from April 27 to May 10, 2015. The weighted mean absolute difference in P falciparum prevalence in the MDA group relative to the control group was -10·6% (95% CI -15·1 to -6·1; p=0·0008) at month 3 and -4·5% (-10·9 to 1·9; p=0·14) at month 10. At month 3, the weighted P falciparum prevalence was 1·4% (0·6 to 3·6; 12 of 747) in the MDA group and 10·6% (7·0 to 15·6; 56 of 485) in the control group. Corresponding prevalences at month 10 were 3·2% (1·5 to 6·8; 34 of 1013) and 5·8% (2·5 to 12·9; 33 of 515). Adverse events were reported for 151 (3·6%) of 4173 treated individuals. The most common adverse events were dizziness (n=109) and rash or itching (n=20). No treatment-related deaths occurred. INTERPRETATION In this low-transmission setting, the substantial reduction in P falciparum prevalence resulting from support of community case management was accelerated by MDA. In addition to supporting community health worker case management and LLIN distribution, malaria elimination programmes should consider using MDA to reduce P falciparum prevalence rapidly in foci of higher transmission. FUNDING The Global Fund to Fight AIDS, Tuberculosis and Malaria.
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Affiliation(s)
- Alistair R D McLean
- Medical Action Myanmar, Yangon, Myanmar; Myanmar Oxford Clinical Research Unit, Yangon, Myanmar; Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | | | | | | | | | | | - Hein Aung
- Medical Action Myanmar, Yangon, Myanmar
| | - Ye Aung
- Medical Action Myanmar, Yangon, Myanmar
| | - Kyaw Soe
- Myanmar Oxford Clinical Research Unit, Yangon, Myanmar
| | | | - Lorenz von Seidlein
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Ni Ni Tun
- Medical Action Myanmar, Yangon, Myanmar; Myanmar Oxford Clinical Research Unit, Yangon, Myanmar
| | - Kyaw Myo Tun
- Department of Preventive and Social Medicine, Defence Services Medical Academy, Yangon, Myanmar
| | - Nicholas P J Day
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Elizabeth A Ashley
- Myanmar Oxford Clinical Research Unit, Yangon, Myanmar; Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Thaung Hlaing
- Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Thar Tun Kyaw
- Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Arjen M Dondorp
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Mallika Imwong
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Nicholas J White
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Frank M Smithuis
- Medical Action Myanmar, Yangon, Myanmar; Myanmar Oxford Clinical Research Unit, Yangon, Myanmar; Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.
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8
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Aung H, Soe K, Smithuis FF, Lamb T, Aung MW, Smithuis FM. Case Report: Children with Severe Nutritional Rickets in the Naga Region in Northwest Myanmar, on the border with India. Am J Trop Med Hyg 2021; 105:217-221. [PMID: 34097648 PMCID: PMC8274785 DOI: 10.4269/ajtmh.20-1431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 03/30/2021] [Indexed: 11/07/2022] Open
Abstract
Rickets is an often-neglected, painful, and disabling childhood condition of impaired bone mineralization. In this case series we describe a cluster of 29 children with severe, painful bone deformities who live in the very remote region of Nagaland in northwest Myanmar. Children were found to have low 25-hydroxyvitamin D, elevated parathyroid hormone, and elevated alkaline phosphatase levels, consistent with nutritional rickets secondary to vitamin D deficiency, calcium deficiency, or a combination of the two. After treatment with vitamin D3 and calcium carbonate, significant improvement was seen in symptoms, biochemistry, and radiography. This is the first report of nutritional rickets in Myanmar in more than 120 years. Vitamin D and calcium supplementation, and food fortification for pregnant women and young children may be required to prevent this potentially devastating disease.
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Affiliation(s)
- Hein Aung
- 1Medical Action Myanmar, Yangon, Myanmar
| | - Kyaw Soe
- 2Myanmar Oxford Clinical Research Unit, Yangon, Myanmar
| | - Frank F Smithuis
- 3Department of Radiology, Amsterdam UMC Imaging Center, Amsterdam, The Netherlands
| | - Thomas Lamb
- 2Myanmar Oxford Clinical Research Unit, Yangon, Myanmar
| | - Moe Wint Aung
- 4Department of Endocrinology, Yangon General Hospital, Yangon, Myanmar
| | - Frank M Smithuis
- 1Medical Action Myanmar, Yangon, Myanmar.,2Myanmar Oxford Clinical Research Unit, Yangon, Myanmar
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9
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Holland-Deguire C, Rabalais A, Soe K, Anderson E, Shivakumar G. Transitioning from the Battlefield: A Theoretical Model for the Development of Posttraumatic Stress Disorder (PTSD) in Gender Diverse Veterans. JVS 2021. [DOI: 10.21061/jvs.v7i1.245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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10
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Swe MMM, Win MM, Cohen J, Phyo AP, Lin HN, Soe K, Amorncha P, Wah TT, Win KKN, Ling C, Parker DM, Dance DAB, Ashley EA, Smithuis F. Geographical distribution of Burkholderia pseudomallei in soil in Myanmar. PLoS Negl Trop Dis 2021; 15:e0009372. [PMID: 34029325 PMCID: PMC8143414 DOI: 10.1371/journal.pntd.0009372] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 04/07/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Burkholderia pseudomallei is a Gram-negative bacterium found in soil and water in many tropical countries. It causes melioidosis, a potentially fatal infection first described in 1911 in Myanmar. Melioidosis is a common cause of sepsis and death in South and South-east Asia, but it is rarely diagnosed in Myanmar. We conducted a nationwide soil study to identify areas where B. pseudomallei is present. METHODOLOGY/PRINCIPAL FINDINGS We collected soil samples from 387 locations in all 15 states and regions of Myanmar between September 2017 and June 2019. At each site, three samples were taken at each of three different depths (30, 60 and 90 cm) and were cultured for B. pseudomallei separately, along with a pooled sample from each site (i.e. 10 cultures per site). We used a negative binomial regression model to assess associations between isolation of B. pseudomallei and environmental factors (season, soil depth, soil type, land use and climate zones). B. pseudomallei was isolated in 7 of 15 states and regions. Of the 387 sites, 31 (8%) had one or more positive samples and of the 3,870 samples cultured, 103 (2.7%) tested positive for B. pseudomallei. B. pseudomallei was isolated more frequently during the monsoon season [RR-2.28 (95% CI: 0.70-7.38)] and less in the hot dry season [RR-0.70 (95% CI: 0.19-2.56)] compared to the cool dry season, and in the tropical monsoon climate zone [RR-2.26; 95% CI (0.21-6.21)] compared to the tropical dry winter climate zone. However, these associations were not statistically significant. B. pseudomallei was detected at all three depths and from various soil types (clay, silt and sand). Isolation was higher in agricultural land (2.2%), pasture land (8.5%) and disused land (5.8%) than in residential land (0.4%), but these differences were also not significant. CONCLUSION/SIGNIFICANCE This study confirms a widespread distribution of B. pseudomallei in Myanmar. Clinical studies should follow to obtain a better picture of the burden of melioidosis in Myanmar.
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Affiliation(s)
- Myo Maung Maung Swe
- Myanmar Oxford Clinical Research Unit, Yangon, Myanmar
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom
| | - Mo Mo Win
- Department of Medical Research, Ministry of Health and Sports, Yangon, Myanmar
| | - Joshua Cohen
- Myanmar Oxford Clinical Research Unit, Yangon, Myanmar
| | | | | | - Kyaw Soe
- Myanmar Oxford Clinical Research Unit, Yangon, Myanmar
| | - Premjit Amorncha
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University Bangkok, Thailand
| | - Thin Thin Wah
- Department of Medical Research, Ministry of Health and Sports, Yangon, Myanmar
| | - Kyi Kyi Nyein Win
- Department of Medical Research, Ministry of Health and Sports, Yangon, Myanmar
| | - Clare Ling
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom
- Shoklo Malaria Research Unit (SMRU), Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
| | - Daniel M. Parker
- Department of Population Health and Disease Prevention Program in Public Health, University of California, Irvine, CA, United States of America
| | - David A. B. Dance
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Vientiane, Lao People’s Democratic Republic
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Elizabeth A. Ashley
- Myanmar Oxford Clinical Research Unit, Yangon, Myanmar
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Vientiane, Lao People’s Democratic Republic
| | - Frank Smithuis
- Myanmar Oxford Clinical Research Unit, Yangon, Myanmar
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom
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11
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Elders PND, Swe MMM, Phyo AP, McLean ARD, Lin HN, Soe K, Htay WYA, Tanganuchitcharnchai A, Hla TK, Tun NN, Nwe TT, Moe MM, Thein WM, Zaw NN, Kyaw WM, Linn H, Htwe YY, Smithuis FM, Blacksell SD, Ashley EA. Serological evidence indicates widespread distribution of rickettsioses in Myanmar. Int J Infect Dis 2020; 103:494-501. [PMID: 33310022 PMCID: PMC7862081 DOI: 10.1016/j.ijid.2020.12.013] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 12/04/2020] [Accepted: 12/07/2020] [Indexed: 11/26/2022] Open
Abstract
Diagnosis of rickettsial infections is difficult in low-resource settings; this leads to delays in receiving appropriate treatment. Before this study, the distribution of rickettsioses in Myanmar was not known. This serosurvey shows that rickettsioses are widespread in Myanmar. Particularly high prevalence of scrub typhus was found in central and northern regions.
Background Little research has been published on the prevalence of rickettsial infections in Myanmar. This study determined the seroprevalence of immunoglobulin G (IgG) antibodies to rickettsial species in different regions of Myanmar. Methods Seven hundred leftover blood samples from patients of all ages in primary care clinics and hospitals in seven regions of Myanmar were collected. Samples were screened for scrub typhus group (STG), typhus group (TG) and spotted fever group (SFG) IgG antibodies using enzyme-linked immunosorbent assays (ELISA). Immunofluorescence assays were performed for the same rickettsial groups to confirm seropositivity if ELISA optical density ≥0.5. Results Overall IgG seroprevalence was 19% [95% confidence interval (CI) 16–22%] for STG, 5% (95% CI 3–7%) for TG and 3% (95% CI: 2–5%) for SFG. The seroprevalence of STG was particularly high in northern and central Myanmar (59% and 19–33%, respectively). Increasing age was associated with higher odds of STG and TG seropositivity [per 10-year increase, adjusted odds ratio estimate 1.68 (p < 0.01) and 1.24 (p = 0.03), respectively]. Conclusion Rickettsial infections are widespread in Myanmar, with particularly high seroprevalence of STG IgG antibodies in central and northern regions. Healthcare workers should consider rickettsial infections as common causes of fever in Myanmar.
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Affiliation(s)
| | | | | | - Alistair R D McLean
- Myanmar Oxford Clinical Research Unit, Yangon, Myanmar; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | | | - Kyaw Soe
- Myanmar Oxford Clinical Research Unit, Yangon, Myanmar
| | | | - Ampai Tanganuchitcharnchai
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Thel K Hla
- Myanmar Oxford Clinical Research Unit, Yangon, Myanmar; Medical Action Myanmar, Yangon, Myanmar
| | - Ni Ni Tun
- Medical Action Myanmar, Yangon, Myanmar
| | - Thin Thin Nwe
- Magway General Hospital and University of Medicine, Magway, Myanmar; University of Medicine 2, Yangon, Myanmar
| | - Myat Myat Moe
- Magway General Hospital and University of Medicine, Magway, Myanmar
| | - Win May Thein
- Mandalay General Hospital and University of Medicine, Mandalay, Myanmar
| | - Ni Ni Zaw
- Mandalay General Hospital and University of Medicine, Mandalay, Myanmar
| | | | - Htun Linn
- Monywa General Hospital, Monywa, Myanmar
| | | | - Frank M Smithuis
- Myanmar Oxford Clinical Research Unit, Yangon, Myanmar; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom; Medical Action Myanmar, Yangon, Myanmar
| | - Stuart D Blacksell
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Elizabeth A Ashley
- Myanmar Oxford Clinical Research Unit, Yangon, Myanmar; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom; Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao Democratic People's Republic.
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12
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Irwig MS, Fleseriu M, Jonklaas J, Tritos NA, Yuen KCJ, Correa R, Elhomsy G, Garla V, Jasim S, Soe K, Baldeweg SE, Boguszewski CL, Bancos I. OFF-LABEL USE AND MISUSE OF TESTOSTERONE, GROWTH HORMONE, THYROID HORMONE, AND ADRENAL SUPPLEMENTS: RISKS AND COSTS OF A GROWING PROBLEM. Endocr Pract 2020; 26:340-353. [PMID: 32163313 DOI: 10.4158/ps-2019-0540] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Over the past few decades, there has been an unprecedented rise in off-label use and misuse of testosterone, growth hormone, thyroid hormone, and adrenal supplements. Testosterone therapy is often promoted to men for the treatment of low energy, lower libido, erectile dysfunction, and other symptoms. Growth hormone is used in attempts to improve athletic performance in athletes and to attenuate aging in older adults. Thyroid hormone and/or thyroid supplements or boosters are taken to treat fatigue, obesity, depression, cognitive impairment, impaired physical performance, and infertility. Adrenal supplements are used to treat common nonspecific symptoms due to "adrenal fatigue," an entity that has not been recognized as a legitimate medical diagnosis. Several factors have contributed to the surge in off-label use and misuse of these hormones and supplements: direct-to-consumer advertising, websites claiming to provide legitimate medical information, and for-profit facilities promoting therapies for men's health and anti-aging. The off-label use and misuse of hormones and supplements in individuals without an established endocrine diagnosis carries known and unknown risks. For example, the risks of growth hormone abuse in athletes and older adults are unknown due to a paucity of studies and because those who abuse this hormone often take supraphysiologic doses in sporadic intervals. In addition to the health risks, off-label use of these hormones and supplements generates billions of dollars of unnecessary costs to patients and to the overall health-care system. It is important that patients honestly disclose to their providers off-label hormone use, as it may affect their health and treatment plan. General medical practitioners and adult endocrinologists should be able to begin a discussion with their patients regarding the unfavorable balance between the risks and benefits associated with off-label use of testosterone, growth hormone, thyroid hormone, and adrenal supplements. Abbreviations: DHEA = dehydroepiandrosterone; FDA = U.S. Food and Drug Administration; GH = growth hormone; IGF-1 = insulin-like growth factor 1; LT3 = L-triiodothyronine; LT4 = levothyroxine; T3 = total triiodothyronine; T4 = thyroxine; TSH = thyroid-stimulating hormone.
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13
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An S, Soe K, Akamatsu M, Hishikawa Y, Koji T. Correction to: Accelerated proliferation of hepatocytes in rats with iron overload after partial hepatectomy. Histochem Cell Biol 2020; 153:287-288. [PMID: 32206867 DOI: 10.1007/s00418-020-01865-x] [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] [Indexed: 11/30/2022]
Abstract
The figure shown below is the correct version. We apologize for the mistake.
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Affiliation(s)
- Shucai An
- Department of Histology and Cell Biology, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4, Sakamoto, Nagasaki, 852-8523, Japan
- Department of General Surgery, First Affiliated Hospital, Medical College of Jiamusi University, 234 Dexiang, Jiamusi, 154007, Heilonjiang, China
| | - Kyaw Soe
- Department of Histology and Cell Biology, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4, Sakamoto, Nagasaki, 852-8523, Japan
- Chemical Toxicology Research Division, Department of Medical Research (Lower Myanmar), National Poison Control Centre, No. 5, Ziwaka Road, Yangon, 11191, Myanmar
| | - Maki Akamatsu
- Department of Histology and Cell Biology, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4, Sakamoto, Nagasaki, 852-8523, Japan
| | - Yoshitaka Hishikawa
- Department of Histology and Cell Biology, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4, Sakamoto, Nagasaki, 852-8523, Japan
- Division of Histochemistry and Cell Biology, Department of Anatomy, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan
| | - Takehiko Koji
- Department of Histology and Cell Biology, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4, Sakamoto, Nagasaki, 852-8523, Japan.
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14
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Soe K, Beard H, Neumann D, Trim PJ, Duplock S, Snel MF, Hopwood JJ, Hemsley KM. Early disease course is unaltered in mucopolysaccharidosis type IIIA (MPS IIIA) mice lacking α-synuclein. Neuropathol Appl Neurobiol 2019; 45:715-731. [PMID: 30907009 DOI: 10.1111/nan.12548] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 03/19/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Sanfilippo syndrome (mucopolysaccharidosis type IIIA; MPS IIIA) is an inherited paediatric-onset neurodegenerative disorder caused by the lysosomal deficiency of sulphamidase with subsequent accumulation of heparan sulphate. The pathological mechanisms responsible for clinical disease are unknown; however, intraneuronal accumulation of aggregation-prone proteins such as α-synuclein, phosphorylated tau and amyloid precursor protein suggests inefficient intracellular trafficking and lysosomal degradation. AIM To investigate the contribution the accumulating α-synuclein plays in early symptom emergence that is, impaired cognition, reduced anxiety and motor deficits, first detectable between 3-5 months of age. METHODS We have crossed congenic MPS IIIA mice with α-synuclein-deficient (Sncatm1Rosl /J) mice and evaluated phenotype and brain disease lesions. RESULTS In a battery of behavioural tests performed on mice aged 12-22 weeks, we were unable to differentiate α-synuclein-deficient MPS IIIA mice from those with one or both copies of the α-synuclein gene; all three affected genotypes were significantly impaired in test performance when compared to wild-type littermates. Histological studies revealed that the rate, location and nature of deposition of other proteinaceous lesions, the disruption to endolysosomal protein expression and the inflammatory response seen in the brain of α-synuclein-deficient MPS IIIA mice reflected that seen in MPS IIIA mice homo- or heterozygous for α-synuclein. CONCLUSION Deletion and/or deficiency of α-synuclein does not influence clinical and neuropathological disease progression in murine MPS IIIA, demonstrating that in and of itself, this protein does not initiate the cognitive and motor symptoms that occur in the first 5 months of life in MPS IIIA mice.
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Affiliation(s)
- K Soe
- Hopwood Centre for Neurobiology (HCN), South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia.,Department of Paediatrics, University of Adelaide, Adelaide, SA, Australia
| | - H Beard
- Hopwood Centre for Neurobiology (HCN), South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia
| | - D Neumann
- Hopwood Centre for Neurobiology (HCN), South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia
| | - P J Trim
- Hopwood Centre for Neurobiology (HCN), South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia.,Department of Paediatrics, University of Adelaide, Adelaide, SA, Australia
| | - S Duplock
- Hopwood Centre for Neurobiology (HCN), South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia
| | - M F Snel
- Hopwood Centre for Neurobiology (HCN), South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia.,Department of Paediatrics, University of Adelaide, Adelaide, SA, Australia
| | - J J Hopwood
- Hopwood Centre for Neurobiology (HCN), South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia.,Department of Paediatrics, University of Adelaide, Adelaide, SA, Australia
| | - K M Hemsley
- Hopwood Centre for Neurobiology (HCN), South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia.,Department of Paediatrics, University of Adelaide, Adelaide, SA, Australia
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15
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Soe MT, Shibata Y, Win Htun M, Abe K, Soe K, Win Than N, Lwin T, Phone Kyaw M, Koji T. Immunohistochemical Mapping of Bcl9 Using Two Antibodies that Recognize Different Epitopes Is Useful to Characterize Juvenile Development of Hepatocellular Carcinoma in Myanmar. Acta Histochem Cytochem 2019; 52:9-17. [PMID: 30923411 PMCID: PMC6434316 DOI: 10.1267/ahc.18045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 12/13/2018] [Indexed: 01/10/2023] Open
Abstract
B-cell lymphoma 9 (Bcl9) is the core component of Wnt/β-catenin signaling and overexpressed in nuclei of various tumors, including hepatocellular carcinoma (HCC). However, the extent of Bcl9 expression relative to HCC differentiation stage and its functional aspects are poorly understood. In this study, we examined the expression pattern of Bcl9 immunohistochemically, using two anti-Bcl9 antibodies; one was a conventional polyclonal-antibody (anti-Bcl9ABC) against amino acid no.800-900 of human-Bcl9, while the other (anti-Bcl9BIO) was against amino acid no.50-200, covering Pygopus-binding sites of Bcl9. Immunohistochemistry using anti-Bcl9BIO demonstrated distinctive staining in the cytoplasm, while the anti-Bcl9ABC signal was detected in both cytoplasm and nuclei of HCC cells, reflecting different states of Bcl9 function because Pygopus-binding to Bcl9 is essential to exert its function together with β-catenin in nucleus. Quantitative analysis revealed a significantly higher immunohistochemical-score by anti-Bcl9BIO in normal liver comparing various differentiation grades of HCC (P < 0.004), whereas no significant difference was noted with anti-Bcl9ABC. Interestingly, immunohistochemical-score of anti-Bcl9BIO in patients aged < 40 years was significantly lower than that of ≥ 40 years group (P < 0.01). The results indicated that anti-Bcl9BIO detected cytoplasmic Bcl9, which does not bind to Pygopus suggesting it could be a useful indicator for development of HCC in young Myanmar patients.
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Affiliation(s)
- Myat Thu Soe
- Department of Histology and Cell Biology, Nagasaki University Graduate School of Biomedical Sciences
| | - Yasuaki Shibata
- Department of Histology and Cell Biology, Nagasaki University Graduate School of Biomedical Sciences
| | - Myo Win Htun
- Department of Histology and Cell Biology, Nagasaki University Graduate School of Biomedical Sciences
| | - Kuniko Abe
- Department of Pathology, Japanese Red Cross Nagasaki Atomic Bomb Hospital
| | | | - Nay Win Than
- Department of Hepatobiliary and Pancreatic Surgery, Yangon Specialty Hospital
| | - Thann Lwin
- Department of Hepatobiliary and Pancreatic Surgery, Yangon Specialty Hospital
| | | | - Takehiko Koji
- Department of Histology and Cell Biology, Nagasaki University Graduate School of Biomedical Sciences
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16
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Dungan K, Craven TE, Soe K, Wright JT, Basile J, Haley WE, Kressin NR, Rani U, Tamariz L, Whittle J, Wiggers A, Osei K. Influence of metabolic syndrome and race on the relationship between intensive blood pressure control and cardiovascular outcomes in the SPRINT cohort. Diabetes Obes Metab 2018; 20:629-637. [PMID: 29024310 PMCID: PMC5812782 DOI: 10.1111/dom.13127] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 09/22/2017] [Accepted: 10/09/2017] [Indexed: 01/06/2023]
Abstract
AIMS To determine whether baseline metabolic syndrome (MetS) modifies the effect of intensive blood pressure control on cardiovascular (CV) outcomes, and whether the effects varied by race/ethnicity. METHODS We performed post hoc analyses among non-Hispanic black, non-hispanic white and Hispanic participants, with and without MetS, in the Systolic Blood Pressure Intervention Trial (SPRINT), who were randomized to a systolic blood pressure (SBP) target of <120 mm Hg (intensive group, N = 4544) or an SBP target of <140 mm Hg (standard group, N = 4553). The median follow-up was 3.26 years. The primary outcome was the composite of the first occurrence of myocardial infarction, stroke, heart failure, non-myocardial infarction acute coronary syndrome or CV death. RESULTS Overall, 3521/9097 participants (38.7%) met the criteria for MetS at baseline. Baseline characteristics were similar in the two SBP target groups within each MetS subgroup, except body mass index was slightly higher in the standard arm of the MetS subgroup (33.3 ± 5.6 vs 33.0 ± 5.3 kg/m2 ; P < .01), but were similar across treatment arms in the non-MetS subgroup. The hazard ratio for the primary outcome was similarly reduced in participants with or without baseline MetS: 0.75 (95% confidence interval [CI] 0.57, 0.96) and 0.71 (95% CI 0.57, 0.87), respectively (adjusted P value for treatment by subgroup interaction = .98). Similarly, there was no evidence of treatment × MetS subgroup interaction for all-cause mortality (adjusted interaction P value = .98). The findings were also similar across race/ethnic subgroups. CONCLUSIONS In this analysis the CV benefit of intensive SBP control did not differ among participants by baseline MetS status, regardless of race/ethnicity.
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Affiliation(s)
- Kathleen Dungan
- Division of Endocrinology, Diabetes and Metabolism, Ohio State University, Columbus, Ohio
| | - Timothy E Craven
- Department of Biostatistics, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Kyaw Soe
- Division of Endocrinology, UT Southwestern Medical Center, Dallas, Texas
- Division of Population Health and Computational Medicine, University of Miami and Geriatric Research and Education Clinical Center, Miami
| | - Jackson T Wright
- Division of Nephrology and Hypertension, Clinical Hypertension Program, University Hospitals Case Medical Center, Cleveland, Ohio
| | - Jan Basile
- Division of General Internal Medicine, Seinsheimer Cardiovascular Health Program, Medical University of South Carolina, Charleston, South Carolina
| | - William E Haley
- Division of Nephrology and Hypertension, Mayo Clinic, Jacksonville, Florida
| | - Nancy R Kressin
- VA Boston Healthcare System; Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Uzma Rani
- Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt Medical Center, Nashville, Tennessee
| | - Leonardo Tamariz
- Division of Population Health and Computational Medicine, University of Miami and Geriatric Research and Education Clinical Center, Miami, Florida
| | - Jeff Whittle
- Division of Primary Care, Clement J Zablocki VA Medical Center, Milwaukee, Wisconsin
| | - Alan Wiggers
- Department of Primary Care, Ohio University Heritage College of Osteopathic Medicine, Cleveland campus, Cleveland, Ohio
| | - Kwame Osei
- Division of Endocrinology, Diabetes and Metabolism, Ohio State University, Columbus, Ohio
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17
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Rogers AJ, Xia K, Soe K, Sexias A, Sogade F, Hutchinson B, Vieira D, McFarlane SI, Jean-Louis G. Obstructive Sleep Apnea among Players in the National Football League: A Scoping Review. ACTA ACUST UNITED AC 2017; 6. [PMID: 29984115 PMCID: PMC6035001 DOI: 10.4172/2167-0277.1000278] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Objective Obstructive sleep apnea (OSA) is a common sleep-disordered breathing condition that has emerged as a significant public health problem given its increased prevalence over the past decade. The high prevalence of obesity and large waist circumference among NFL players are two risk factors that might contribute to the high susceptibility of football players to develop OSA. National Football League linemen might be particularly vulnerable since they tend to have a higher body mass index. In this scoping review, we aim to bring attention to the limited research regarding OSA among National Football League players and highlight the negative consequences of OSA in an attempt to increase awareness of the urgent need for further research in this area. Methods Search terms associated with obstructive sleep apnea and football were used to examine Google Scholar, EMBASE, CINAHL, PubMed, ProQuest, and Web of Science Plus for relevant studies. All relevant studies were included and documented. Results Findings included (n=4) studies of interest. All 4 studies revealed a near or slightly above 50% prevalence of OSA in the investigated cohorts (mostly retired NFL linemen). Most participants in the study (active NFL players) showed symptoms associated with a sleep-disorder breathing condition (snoring). Conclusion OSA requires more attention from the research and medical community. As suggested by results in the 4 studies included in this paper, OSA and associated symptoms are prevalent in the NFL population. Further research is required to investigate the extent of OSA and OSA risk in this population. There is an urgent need to conduct OSA risk surveillance in the athletic community.
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Affiliation(s)
- April J Rogers
- Center for Healthful Behavior Change (CHBC), Division of Health and Behavior, Department of Population Health, New York University Medical Center, New York, NY 10016, USA.,Department of Health Service Administration, St. John's University, Queens, NY 11439, USA
| | - Kevin Xia
- Department of Medicine, Jersey Shore University Medical Center, Neptune, NJ 07753, USA
| | - Kyaw Soe
- Department of Medicine, Jersey Shore University Medical Center, Neptune, NJ 07753, USA
| | - Azizi Sexias
- Center for Healthful Behavior Change (CHBC), Division of Health and Behavior, Department of Population Health, New York University Medical Center, New York, NY 10016, USA
| | - Felix Sogade
- Department of Cardiology, Health Service of Central Georgia, Macon, Georgia 31201, USA
| | | | - Dorice Vieira
- Center for Healthful Behavior Change (CHBC), Division of Health and Behavior, Department of Population Health, New York University Medical Center, New York, NY 10016, USA
| | - Samy I McFarlane
- Department of Medicine, Division of Endocrinology, State University of New York, Downstate Medical Center, Brooklyn, NY 11203, USA
| | - Girardin Jean-Louis
- Center for Healthful Behavior Change (CHBC), Division of Health and Behavior, Department of Population Health, New York University Medical Center, New York, NY 10016, USA
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Nayak P, Soe K, Natwa M, Sachak T, Jin M, Lehman NL, Nabhan F. Incidental hypermetabolic PET positive lesions in thyroid and pituitary glands in a patient with lung cancer: A case of two uncommon findings in a single patient. Journal of Clinical and Translational Endocrinology: Case Reports 2016. [DOI: 10.1016/j.jecr.2016.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Harrold L, Reed G, John A, Barr C, Saunders K, Soe K, Magner R, Greenberg J, Kremer J. THU0060 The Relationship between Adherence To A Treat-To-Target Approach for Clinical Care of US Patients with Rheumatoid Arthritis and Achievement of Low Disease Activity. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Soe K, Dungan KM. Subcutaneous liraglutide reduces weight and improves metabolic control in obese participants. Evid Based Med 2015; 20:203. [PMID: 26385492 DOI: 10.1136/ebmed-2015-110273] [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] [Indexed: 06/05/2023]
Affiliation(s)
- Kyaw Soe
- The Ohio State University, Columbus, Ohio, USA
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Kenney MC, Chwa M, Atilano SR, Pavlis JM, Falatoonzadeh P, Ramirez C, Malik D, Hsu T, Woo G, Soe K, Nesburn AB, Boyer DS, Kuppermann BD, Jazwinski SM, Miceli MV, Wallace DC, Udar N. Mitochondrial DNA variants mediate energy production and expression levels for CFH, C3 and EFEMP1 genes: implications for age-related macular degeneration. PLoS One 2013; 8:e54339. [PMID: 23365660 PMCID: PMC3554762 DOI: 10.1371/journal.pone.0054339] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [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: 10/01/2012] [Accepted: 12/10/2012] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Mitochondrial dysfunction is associated with the development and progression of age-related macular degeneration (AMD). Recent studies using populations from the United States and Australia have demonstrated that AMD is associated with mitochondrial (mt) DNA haplogroups (as defined by combinations of mtDNA polymorphisms) that represent Northern European Caucasians. The aim of this study was to use the cytoplasmic hybrid (cybrid) model to investigate the molecular and biological functional consequences that occur when comparing the mtDNA H haplogroup (protective for AMD) versus J haplogroup (high risk for AMD). METHODOLOGY/PRINCIPAL FINDINGS Cybrids were created by introducing mitochondria from individuals with either H or J haplogroups into a human retinal epithelial cell line (ARPE-19) that was devoid of mitochondrial DNA (Rho0). In cybrid lines, all of the cells carry the same nuclear genes but vary in mtDNA content. The J cybrids had significantly lower levels of ATP and reactive oxygen/nitrogen species production, but increased lactate levels and rates of growth. Q-PCR analyses showed J cybrids had decreased expressions for CFH, C3, and EFEMP1 genes, high risk genes for AMD, and higher expression for MYO7A, a gene associated with retinal degeneration in Usher type IB syndrome. The H and J cybrids also have comparatively altered expression of nuclear genes involved in pathways for cell signaling, inflammation, and metabolism. CONCLUSION/SIGNIFICANCE Our findings demonstrate that mtDNA haplogroup variants mediate not only energy production and cell growth, but also cell signaling for major molecular pathways. These data support the hypothesis that mtDNA variants play important roles in numerous cellular functions and disease processes, including AMD.
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Affiliation(s)
- M Cristina Kenney
- Gavin Herbert Eye Institute, University of California Irvine, Irvine, California, United States of America.
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Kenney MC, Hertzog D, Chak G, Atilano SR, Khatibi N, Soe K, Nobe A, Yang E, Chwa M, Zhu F, Memarzadeh M, King J, Langberg J, Small K, Nesburn AB, Boyer DS, Udar N. Mitochondrial DNA haplogroups confer differences in risk for age-related macular degeneration: a case control study. BMC Med Genet 2013; 14:4. [PMID: 23302509 PMCID: PMC3566905 DOI: 10.1186/1471-2350-14-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Accepted: 12/17/2012] [Indexed: 12/21/2022]
Abstract
BACKGROUND Age-related macular degeneration (AMD) is the leading cause of vision loss in elderly, Caucasian populations. There is strong evidence that mitochondrial dysfunction and oxidative stress play a role in the cell death found in AMD retinas. The purpose of this study was to examine the association of the Caucasian mitochondrial JTU haplogroup cluster with AMD. We also assessed for gender bias and additive risk with known high risk nuclear gene SNPs, ARMS2/LOC387715 (G > T; Ala69Ser, rs10490924) and CFH (T > C; Try402His, rs1061170). METHODS Total DNA was isolated from 162 AMD subjects and 164 age-matched control subjects located in Los Angeles, California, USA. Polymerase chain reaction (PCR) and restriction enzyme digestion were used to identify the J, U, T, and H mitochondrial haplogroups and the ARMS2-rs10490924 and CFH-rs1061170 SNPs. PCR amplified products were sequenced to verify the nucleotide substitutions for the haplogroups and ARMS2 gene. RESULTS The JTU haplogroup cluster occurred in 34% (55/162) of AMD subjects versus 15% (24/164) of normal (OR = 2.99; p = 0.0001). This association was slightly greater in males (OR = 3.98, p = 0.005) than the female population (OR = 3.02, p = 0.001). Assuming a dominant effect, the risk alleles for the ARMS2 (rs10490924; p = 0.00001) and CFH (rs1061170; p = 0.027) SNPs were significantly associated with total AMD populations. We found there was no additive risk for the ARMS2 (rs10490924) or CFH (rs1061170) SNPs on the JTU haplogroup background. CONCLUSIONS There is a strong association of the JTU haplogroup cluster with AMD. In our Southern California population, the ARMS2 (rs10490924) and CFH (rs1061170) genes were significantly but independently associated with AMD. SNPs defining the JTU mitochondrial haplogroup cluster may change the retinal bioenergetics and play a significant role in the pathogenesis of AMD.
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Affiliation(s)
- M Cristina Kenney
- Gavin Herbert Eye Institute, Univeresity of California Irvine, Hewitt Hall, Room 2028, 843 Health Science Rd, Irvine, CA 92697, USA.
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An S, Soe K, Akamatsu M, Hishikawa Y, Koji T. Accelerated proliferation of hepatocytes in rats with iron overload after partial hepatectomy. Histochem Cell Biol 2012; 138:773-86. [PMID: 22825839 DOI: 10.1007/s00418-012-0994-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2012] [Indexed: 12/25/2022]
Abstract
Although iron overload is implicated in hepatocarcinogenesis, the precise mechanism was not known yet. In the present study, we investigated the effect of iron overload upon the induction of hepatocyte proliferation after 70% partial hepatectomy (PH) in rats fed with rat chow with 3% carbonyl iron for 3 months. In normal-diet rats, the increase in Ki-67 labeling index (LI) commenced at 24 h post-PH and the LIs of proliferating cell nuclear antigen (PCNA) incorporated 5-bromo-2'-deoxyuridine (BrdU) and phospho-histone H3 reached maximum values at 36 and 48 h after PH, respectively. In iron-overload rats, the above parameters occurred 12 h earlier compared to that of normal-diet rats, shortening the G0-G1 transition. Interestingly, nuclear staining for metallothionein (MT), which is essential for hepatocyte proliferation, was noted even at 0 h in iron-overload rats, while MT expression occurred at 6 h in the normal rats. Moreover, nuclear factor kappa B (NF-κB) expression, which is an essential early event leading to liver regeneration, was detected in Kupffer cells at 0 h in iron-overload rats. These results may indicate that overloaded iron, maybe through the induction of MT and NF-κB, may keep liver as a state ready to regenerate in response to PH, by bypassing signal transduction cascades involved in the initiation of liver regeneration.
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Affiliation(s)
- Shucai An
- Department of Histology and Cell Biology, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4, Sakamoto, Nagasaki, 852-8523, Japan
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McFarlane SI, McCullough PA, Sowers JR, Soe K, Chen SC, Li S, Vassalotti JA, Stevens LA, Salifu MO, Kurella Tamura M, Bomback AS, Norris KC, Collins AJ, Bakris GL, Whaley-Connell AT. Comparison of the CKD Epidemiology Collaboration (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) study equations: prevalence of and risk factors for diabetes mellitus in CKD in the Kidney Early Evaluation Program (KEEP). Am J Kidney Dis 2011; 57:S24-31. [PMID: 21338847 PMCID: PMC3237700 DOI: 10.1053/j.ajkd.2010.11.009] [Citation(s) in RCA: 24] [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: 08/30/2010] [Accepted: 11/08/2010] [Indexed: 11/11/2022]
Abstract
BACKGROUND Diabetes is a leading cause of chronic kidney disease (CKD). Whether reclassification of CKD stages based on glomerular filtration rate estimated using the CKD Epidemiology Collaboration (CKD-EPI) equation versus the Modification of Diet in Renal Disease (MDRD) Study equation modifies estimates of prevalent risk factors across stages is unknown. METHODS This is a cross-sectional analysis of data from the Kidney Early Evaluation Program (KEEP), a community-based health screening program targeting individuals 18 years and older with diabetes, hypertension, or a family history of diabetes, hypertension, or kidney disease. Of 109,055 participants, 68.2% were women and 31.8% were African American. Mean age was 55.3 ± 0.05 years. Clinical, demographic, and laboratory data were collected from August 2000 through December 2009. Glomerular filtration rate was estimated using the CKD-EPI and MDRD Study equations. RESULTS CKD was present in 25.6% and 23.5% of the study population using the MDRD Study and CKD-EPI equations, respectively. Diabetes was present in 42.4% and 43.8% of participants with CKD, respectively. Prevalent risk factors for diabetes included obesity (body mass index >30 kg/m(2)), 44.0%; hypertension, 80.5%; cardiovascular disease, 23.2%; family history of diabetes, 55.9%; and dyslipidemia, 43.0%. In a logistic regression model after adjusting for age and other risk factors, odds for diabetes increased significantly compared with no CKD with each CKD stage based on the CKD-EPI equation and similarly with stages based on the MDRD Study equation. Using a CKD-EPI-adjusted model, ORs were: stage 1, 2.08 (95% CI, 1.90-2.27); stage 2, 1.86 (95% CI, 1.72-2.02); stage 3, 1.23 (95% CI, 1.17-1.30); stage 4, 1.69 (95% CI, 1.42-2.03); and stage 5, 2.46 (95% CI, 1.46-4.14). CONCLUSIONS Using the CKD-EPI equation led to a lower prevalence of CKD but to similar diabetes prevalence rates associated with CKD across all stages compared with the MDRD Study equation. Diabetes and other CKD risk factor prevalence was increased compared with the non-CKD population.
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Affiliation(s)
- Samy I McFarlane
- Division of Endocrinology, SUNY-Downstate and Kings County Hospital Centers, Brooklyn, NY 11203, USA.
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Soe K, Alam A, Philip C, Ruiz E, Ramkissoon K, McFarlane SI. Cardiovascular risk reduction via increasing HDL cholesterol: the promise of the dal-OUTCOMES Trial. Curr Diab Rep 2011; 11:4-6. [PMID: 21069482 DOI: 10.1007/s11892-010-0165-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Kyaw Soe
- Division of Endocrinology, College of Medicine, SUNY-Downstate/Kings County Hospital Center, Brooklyn, NY 11203, USA
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Soe K, Hishikawa Y, Fukuzawa Y, Win N, Yin KS, Win KM, Myint AA, Koji T. Possible correlation between iron deposition and enhanced proliferating activity in hepatitis C virus-positive hepatocellular carcinoma in Myanmar (Burma). J Gastroenterol 2007; 42:225-35. [PMID: 17380281 DOI: 10.1007/s00535-006-1993-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2006] [Accepted: 12/04/2006] [Indexed: 02/04/2023]
Abstract
BACKGROUND The aim of this study was to survey the effect of deposited iron on the cell kinetics of hepatitis C virus (HCV)-positive hepatocellular carcinoma (HCC) in Myanmar (Burmese) patients. METHODS Formalin-fixed and paraffin-embedded liver tissues from 34 Myanmar patients with HCC were used. To detect iron deposition, Prussian blue staining was performed. Cell proliferation and apoptosis were assessed by Ki-67 staining and by the terminal deoxynucleotidyl transferase (TdT)-mediated dUTP-biotin nick end labeling (TUNEL) assay, respectively. HCV RNA was detected by in situ hybridization, and HCV protein, Fas and Fas ligand (FasL) were localized by immunohistochemistry. To identify the subtype of lymphocytes, CD8 was used as a surface marker. RESULTS Iron deposition was found in 43% of the HCC cases, and was heavier in moderately differentiated HCC than in well-differentiated HCC. The Ki-67 labeling index (LI) in cancer cells was higher in Prussian blue-positive-HCC than in -negative HCC (3.8 +/- 2.2 vs 1.5 +/- 1.7, mean +/- SD; P=0.0067), whereas there was no significant difference between these groups in TUNEL LI. HCV protein was localized in cancer cells, and was found in 89% of the patients. In addition, Fas was expressed in HCC cells, and FasL was localized in HCC cells as well as in infiltrating CD8+ T lymphocytes. The frequency of apoptosis of HCC cells was correlated significantly with the population density of infiltrating CD8+ T lymphocytes. CONCLUSIONS Our results indicated that, in Myanmar patients with HCC, iron deposition might accelerate hepatocarcinogenesis, by promoting cancer cell proliferation, without affecting the Fas/FasL apoptotic system.
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Affiliation(s)
- Kyaw Soe
- Department of Histology and Cell Biology, Unit of Basic Medical Science, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
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Lwin M, Lin H, Linn N, Kyaw MP, Ohn M, Maung NS, Soe K, Oo T. The use of personal protective measures in control of malaria in a defined community. Southeast Asian J Trop Med Public Health 1997; 28:254-8. [PMID: 9444002] [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: 02/05/2023]
Abstract
Malaria is one of the main health problems in the non-immune immigrant workers and army personnel of the malaria endemic areas in Myanmar. Due to changes in the vector bionomics and multiresistant strains of P. falciparum, chemoprophylaxis alone is not an effective means of control of malaria in them. So it is envisaged that the combined used of personal protective measures (deltamethrin impregnated bed-nets, scalves and hand-bands) and the chemoprophylaxis will be an effective means of control of malaria in the define group of people. The study also intended to find out the side effects of the deltamethrin and feasibility and acceptability of methods by the users. The study was conducted in Theini Township, Northern Shan State, from March to November 1993. The study population consisted of all ages of both sexes 554 and 440 persons in the test and control groups respectively. At the initial phase of the study, malaria infected persons from both the groups were treated. The experimental group received personal protective measures with impregnation of bed-nets using 25 mg ai/m2 of deltamethrin at 4 monthly intervals and the scarves and hand-bands at twice the concentration of the insecticides at monthly intervals. Chemoprophylaxis was given to both the groups at weekly intervals using age adjusted dosage of Pyrixine tablet (sulfadoxine-pyrimethamine). The parasitological, entomological, and epidemiological indices were collected at two month intervals in both the groups. The study clearly showed the impact of personal protective measures and chemoprophylaxis on malaria infection in the studied subjects. During the study period, the out patient malaria cases of the test group was 6% to 11.2% and that of the control group was 12% to 21.6% in Theini Hospital. The reinfection rate of the test group (0.9 to 4.7%) was also significantly lower than the control group (6.1 to 14.3%) from July to November. Acceptance of the treated bed-nets, scarves and hand-bands was high and good compliance was found in the follow up. The results of the study clearly showed that malaria can be controlled effectively in the defined group of persons for a malaria transmission season by using chemoprophylaxis and personal protective measures.
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Affiliation(s)
- M Lwin
- Disease Control Unit, Department of Health, Ministry of Defence, Yangon, Myanmar
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