1
|
Barletta F, Gandaglia G, Robesti D, Bianchi L, Zattoni F, Dal Moro F, Reitano G, Rajwa P, Hübner N, Shariat S, Kesch C, Darr C, Fendler W, Gomez-Rivas J, Moreno-Sierra J, Ibañez L, Marra G, Guo H, Zhuang J, Amparore D, Checcucci E, Porpiglia F, Picchio M, Montorsi F, Briganti A. Identifying the optimal candidates for a super-extended staging pelvic lymph-node dissection in prostate cancer patients treated in the PET-PSMA era. Results from a multi-institutional series. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00700-5] [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: 02/12/2023]
|
2
|
Cárcel-Márquez J, Muiño E, Gallego-Fabrega C, Cullell N, Lledós M, Llucià-Carol L, Sobrino T, Campos F, Castillo J, Freijo M, Arenillas JF, Obach V, Álvarez-Sabín J, Molina CA, Ribó M, Jiménez-Conde J, Roquer J, Muñoz-Narbona L, Lopez-Cancio E, Millán M, Diaz-Navarro R, Vives-Bauza C, Serrano-Heras G, Segura T, Ibañez L, Heitsch L, Delgado P, Dhar R, Krupinski J, Delgado-Mederos R, Prats-Sánchez L, Camps-Renom P, Blay N, Sumoy L, de Cid R, Montaner J, Cruchaga C, Lee JM, Martí-Fàbregas J, Férnandez-Cadenas I. A Polygenic Risk Score Based on a Cardioembolic Stroke Multitrait Analysis Improves a Clinical Prediction Model for This Stroke Subtype. Front Cardiovasc Med 2022; 9:940696. [PMID: 35872910 PMCID: PMC9304625 DOI: 10.3389/fcvm.2022.940696] [Citation(s) in RCA: 6] [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] [Received: 05/10/2022] [Accepted: 06/06/2022] [Indexed: 11/13/2022] Open
Abstract
Background Occult atrial fibrillation (AF) is one of the major causes of embolic stroke of undetermined source (ESUS). Knowing the underlying etiology of an ESUS will reduce stroke recurrence and/or unnecessary use of anticoagulants. Understanding cardioembolic strokes (CES), whose main cause is AF, will provide tools to select patients who would benefit from anticoagulants among those with ESUS or AF. We aimed to discover novel loci associated with CES and create a polygenetic risk score (PRS) for a more efficient CES risk stratification. Methods Multitrait analysis of GWAS (MTAG) was performed with MEGASTROKE-CES cohort (n = 362,661) and AF cohort (n = 1,030,836). We considered significant variants and replicated those variants with MTAG p-value < 5 × 10−8 influencing both traits (GWAS-pairwise) with a p-value < 0.05 in the original GWAS and in an independent cohort (n = 9,105). The PRS was created with PRSice-2 and evaluated in the independent cohort. Results We found and replicated eleven loci associated with CES. Eight were novel loci. Seven of them had been previously associated with AF, namely, CAV1, ESR2, GORAB, IGF1R, NEURL1, WIPF1, and ZEB2. KIAA1755 locus had never been associated with CES/AF, leading its index variant to a missense change (R1045W). The PRS generated has been significantly associated with CES improving discrimination and patient reclassification of a model with age, sex, and hypertension. Conclusion The loci found significantly associated with CES in the MTAG, together with the creation of a PRS that improves the predictive clinical models of CES, might help guide future clinical trials of anticoagulant therapy in patients with ESUS or AF.
Collapse
Affiliation(s)
- Jara Cárcel-Márquez
- Stroke Pharmacogenomics and Genetics Group, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Elena Muiño
- Stroke Pharmacogenomics and Genetics Group, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
| | - Cristina Gallego-Fabrega
- Stroke Pharmacogenomics and Genetics Group, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
- Stroke Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Natalia Cullell
- Stroke Pharmacogenomics and Genetics Group, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
- Stroke Pharmacogenomics and Genetics Laboratory, Fundación Docència i Recerca Mútua Terrassa, Hospital Mútua Terrassa, Terrassa, Spain
| | - Miquel Lledós
- Stroke Pharmacogenomics and Genetics Group, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
| | - Laia Llucià-Carol
- Stroke Pharmacogenomics and Genetics Group, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
- Department de Genética i de Microbiologia, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - Tomás Sobrino
- Clinical Neurosciences Research Laboratory, Hospital Clínico Universitario de Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Francisco Campos
- Clinical Neurosciences Research Laboratory, Hospital Clínico Universitario de Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - José Castillo
- Clinical Neurosciences Research Laboratory, Hospital Clínico Universitario de Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Marimar Freijo
- Department of Neurology, Biocruces-Bizkaia Health Research Institute, Bilbao, Spain
| | | | - Victor Obach
- Department of Neurology, Hospital Clínic de Barcelona, IDIBAPS, Barcelona, Spain
| | - José Álvarez-Sabín
- Stroke Unit, Department of Neurology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Carlos A. Molina
- Stroke Unit, Department of Neurology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Marc Ribó
- Stroke Unit, Department of Neurology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Jordi Jiménez-Conde
- Department of Neurology, IMIM-Hospital del Mar; Neurovascular Research Group, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Universitat Autònoma de Barcelona/DCEXS-Universitat Pompeu Fabra, Barcelona, Spain
| | - Jaume Roquer
- Department of Neurology, IMIM-Hospital del Mar; Neurovascular Research Group, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Universitat Autònoma de Barcelona/DCEXS-Universitat Pompeu Fabra, Barcelona, Spain
| | - Lucia Muñoz-Narbona
- Department of Neurosciences, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Elena Lopez-Cancio
- Department of Neurology, University Hospital Central de Asturias (HUCA).Oviedo, Spain
| | - Mònica Millán
- Department of Neurosciences, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Rosa Diaz-Navarro
- Department of Neurology, Son Espases University Hospital, Illes Balears Health Research Institute (IdISBa), Palma, Spain
| | - Cristòfol Vives-Bauza
- Department of Neurology, Son Espases University Hospital, Illes Balears Health Research Institute (IdISBa), Palma, Spain
| | | | - Tomás Segura
- Department of Neurology, University Hospital of Albacete, Albacete, Spain
| | - Laura Ibañez
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, MO, United States
| | - Laura Heitsch
- Department of Emergency Medicine, Washington University School of Medicine, Saint Louis, MO, United States
- Department of Neurology, Washington University School of Medicine, Saint Louis, MO, United States
| | - Pilar Delgado
- Neurovascular Research Laboratory, Vall d'Hebron Institute of Research, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Rajat Dhar
- Department of Neurology, Washington University School of Medicine, Saint Louis, MO, United States
| | - Jerzy Krupinski
- Neurology Service, Hospital Universitari Mútua Terrassa, Terrassa, Spain
| | - Raquel Delgado-Mederos
- Stroke Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Luis Prats-Sánchez
- Stroke Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Pol Camps-Renom
- Stroke Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Natalia Blay
- GenomesForLife-GCAT Lab, Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
| | - Lauro Sumoy
- High Content Genomics and Bioinformatics Unit, Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
| | - Rafael de Cid
- GenomesForLife-GCAT Lab, Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
| | - Joan Montaner
- Institute de Biomedicine of Seville, IBiS/Hospital Universitario Virgen del Rocío/CSIC/University of Seville and Department of Neurology, Hospital Universitario Virgen Macarena, Seville, Spain
| | - Carlos Cruchaga
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, MO, United States
- Neurogenomics and Informatics Center at Washington University in St. Louis, Saint Louis, MO, United States
| | - Jin-Moo Lee
- Department of Neurology, Washington University School of Medicine, Saint Louis, MO, United States
| | - Joan Martí-Fàbregas
- Stroke Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Israel Férnandez-Cadenas
- Stroke Pharmacogenomics and Genetics Group, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
- *Correspondence: Israel Férnandez-Cadenas
| |
Collapse
|
3
|
Camacho-Arteaga LF, Gardarsdottir H, Ibañez L, Souverein PC, van Dijk L, Hek K, Vidal X, Ballarín E, Sabaté M. Indications related to antidepressant prescribing in the Nivel-PCD database and the SIDIAP database. J Affect Disord 2022; 303:131-137. [PMID: 35134393 DOI: 10.1016/j.jad.2022.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/31/2022] [Accepted: 02/03/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Antidepressant drug consumption has increased, mainly in the elderly. This trend could be explained by the use for indications other than depression. We aimed to describe the indications related to antidepressant drug new users in two primary care settings. METHODS A longitudinal study of new antidepressant users aged ≥65 was conducted, with data from the Nivel-PCD (The Netherlands) and SIDIAP (Catalonia) databases (2010-2015). As a proxy for indication, diagnoses registered around the 3 months of antidepressant prescribing were collected. Indications were classified in seven categories and an additional one of non-selected indications. The percentage and incidence calculated over the total population registered was described. RESULTS A total of 16,537 and 199,168 new antidepressant users were identified in the Nivel-PCD and SIDIAP databases, respectively (women aged 65-69 were the most prevalent). Depression was the most frequent indication (24.0% and 31.3%), followed by anxiety (12.5% and 19.5%) and sleep disorders (10.2% and 26.4%). Tricyclic antidepressants were the most commonly prescribed in Nivel-PCD (48.7%), mainly associated with neuropathic pain, and selective serotonin reuptake inhibitor antidepressants in SIDIAP (63.1%), associated with depression. The non-selected indications category showed an upward trend in the Nivel-PCD database while in the SIDIAP database it decreased. LIMITATIONS It is not mandatory for physicians to register a diagnosis with each prescription. CONCLUSIONS Depression was the most common prescribing indication in The Netherlands and Spain, followed by anxiety and sleep disorders. The most commonly prescribed antidepressant differed between the countries and is likely explained by differences in local guidelines.
Collapse
Affiliation(s)
- L F Camacho-Arteaga
- Department of Pharmacology, Therapeutics and Toxicology, Autonomous University of Barcelona, Spain; Clinical Pharmacology Department, Vall d'Hebron University Hospital, Passeig Vall d'Hebron 119-129, Barcelona 08035, Spain; Clinical Pharmacology, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Spain
| | - H Gardarsdottir
- Division of Pharmacoepidemiology and Clinical Pharmacology, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, the Netherland; Department of Clinical Pharmacy, University Medical Center Utrecht, Utrecht, the Netherland; Department of Pharmaceutical Sciences, University of Iceland, Reykjavik, Iceland
| | - L Ibañez
- Department of Pharmacology, Therapeutics and Toxicology, Autonomous University of Barcelona, Spain; Clinical Pharmacology Department, Vall d'Hebron University Hospital, Passeig Vall d'Hebron 119-129, Barcelona 08035, Spain; Clinical Pharmacology, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Spain; Catalan Institute of Pharmacology Foundation, Spain
| | - P C Souverein
- Division of Pharmacoepidemiology and Clinical Pharmacology, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, the Netherland
| | - L van Dijk
- Nivel, Netherlands Institute for Health Services Research, Utrecht, the Netherland
| | - K Hek
- Nivel, Netherlands Institute for Health Services Research, Utrecht, the Netherland; Department of PharmacoTherapy, Epidemiology and Economics (PTEE), Faculty of Science and Engineering, University of Groningen, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, the Netherlands
| | - X Vidal
- Department of Pharmacology, Therapeutics and Toxicology, Autonomous University of Barcelona, Spain; Clinical Pharmacology Department, Vall d'Hebron University Hospital, Passeig Vall d'Hebron 119-129, Barcelona 08035, Spain; Clinical Pharmacology, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Spain; Catalan Institute of Pharmacology Foundation, Spain
| | - E Ballarín
- Department of Pharmacology, Therapeutics and Toxicology, Autonomous University of Barcelona, Spain; Clinical Pharmacology, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Spain; Catalan Institute of Pharmacology Foundation, Spain
| | - M Sabaté
- Department of Pharmacology, Therapeutics and Toxicology, Autonomous University of Barcelona, Spain; Clinical Pharmacology Department, Vall d'Hebron University Hospital, Passeig Vall d'Hebron 119-129, Barcelona 08035, Spain; Clinical Pharmacology, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Spain; Catalan Institute of Pharmacology Foundation, Spain.
| |
Collapse
|
4
|
Carrera C, Cárcel-Márquez J, Cullell N, Torres-Águila N, Muiño E, Castillo J, Sobrino T, Campos F, Rodríguez-Castro E, Llucià-Carol L, Millán M, Muñoz-Narbona L, López-Cancio E, Bustamante A, Ribó M, Álvarez-Sabín J, Jiménez-Conde J, Roquer J, Giralt-Steinhauer E, Soriano-Tárraga C, Mola-Caminal M, Vives-Bauza C, Navarro RD, Tur S, Obach V, Arenillas JF, Segura T, Serrano-Heras G, Martí-Fàbregas J, Delgado-Mederos R, Freijo-Guerrero MM, Moniche F, Cabezas JA, Castellanos M, Gallego-Fabrega C, González-Sanchez J, Krupinsky J, Strbian D, Tatlisumak T, Thijs V, Lemmens R, Slowik A, Pera J, Kittner S, Cole J, Heitsch L, Ibañez L, Cruchaga C, Lee JM, Montaner J, Fernández-Cadenas I. Single nucleotide variations in ZBTB46 are associated with post-thrombolytic parenchymal haematoma. Brain 2021; 144:2416-2426. [PMID: 33723576 PMCID: PMC8418348 DOI: 10.1093/brain/awab090] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 08/24/2020] [Revised: 02/12/2021] [Accepted: 02/25/2021] [Indexed: 12/13/2022] Open
Abstract
Haemorrhagic transformation is a complication of recombinant tissue-plasminogen activator treatment. The most severe form, parenchymal haematoma, can result in neurological deterioration, disability, and death. Our objective was to identify single nucleotide variations associated with a risk of parenchymal haematoma following thrombolytic therapy in patients with acute ischaemic stroke. A fixed-effect genome-wide meta-analysis was performed combining two-stage genome-wide association studies (n = 1904). The discovery stage (three cohorts) comprised 1324 ischaemic stroke individuals, 5.4% of whom had a parenchymal haematoma. Genetic variants yielding a P-value < 0.05 1 × 10-5 were analysed in the validation stage (six cohorts), formed by 580 ischaemic stroke patients with 12.1% haemorrhagic events. All participants received recombinant tissue-plasminogen activator; cases were parenchymal haematoma type 1 or 2 as defined by the European Cooperative Acute Stroke Study (ECASS) criteria. Genome-wide significant findings (P < 5 × 10-8) were characterized by in silico functional annotation, gene expression, and DNA regulatory elements. We analysed 7 989 272 single nucleotide polymorphisms and identified a genome-wide association locus on chromosome 20 in the discovery cohort; functional annotation indicated that the ZBTB46 gene was driving the association for chromosome 20. The top single nucleotide polymorphism was rs76484331 in the ZBTB46 gene [P = 2.49 × 10-8; odds ratio (OR): 11.21; 95% confidence interval (CI): 4.82-26.55]. In the replication cohort (n = 580), the rs76484331 polymorphism was associated with parenchymal haematoma (P = 0.01), and the overall association after meta-analysis increased (P = 1.61 × 10-8; OR: 5.84; 95% CI: 3.16-10.76). ZBTB46 codes the zinc finger and BTB domain-containing protein 46 that acts as a transcription factor. In silico studies indicated that ZBTB46 is expressed in brain tissue by neurons and endothelial cells. Moreover, rs76484331 interacts with the promoter sites located at 20q13. In conclusion, we identified single nucleotide variants in the ZBTB46 gene associated with a higher risk of parenchymal haematoma following recombinant tissue-plasminogen activator treatment.
Collapse
Affiliation(s)
- Caty Carrera
- Neurovascular Research Laboratory, VHIR, Universitat Autònoma de Barcelona, Barcelona 08035, Spain
- Stroke Pharmacogenomics and Genetics, IIB-Sant Pau, Barcelona 08025, Spain
| | | | - Natalia Cullell
- Stroke Pharmacogenomics and Genetics, IIB-Sant Pau, Barcelona 08025, Spain
- Stroke Pharmacogenomics and Genetics, Fundació Docència i Recerca Mútua Terrassa, Terrassa 08221, Spain
| | - Nuria Torres-Águila
- Stroke Pharmacogenomics and Genetics, IIB-Sant Pau, Barcelona 08025, Spain
- Stroke Pharmacogenomics and Genetics, Fundació Docència i Recerca Mútua Terrassa, Terrassa 08221, Spain
| | - Elena Muiño
- Stroke Pharmacogenomics and Genetics, IIB-Sant Pau, Barcelona 08025, Spain
| | - José Castillo
- Clinical Neurosciences Research Laboratory, IDIS, Santiago de Compostela, 15706, Spain
| | - Tomás Sobrino
- Clinical Neurosciences Research Laboratory, IDIS, Santiago de Compostela, 15706, Spain
| | - Francisco Campos
- Clinical Neurosciences Research Laboratory, IDIS, Santiago de Compostela, 15706, Spain
| | | | - Laia Llucià-Carol
- Stroke Pharmacogenomics and Genetics, IIB-Sant Pau, Barcelona 08025, Spain
| | - Mònica Millán
- Department of Neuroscience, HUGTP, Badalona 08916, Spain
| | | | | | - Alejandro Bustamante
- Neurovascular Research Laboratory, VHIR, Universitat Autònoma de Barcelona, Barcelona 08035, Spain
| | - Marc Ribó
- Stroke Unit, HUVH, Barcelona 08035, Spain
| | | | - Jordi Jiménez-Conde
- Department of Neurology, Neurovascular Research Group, IMIM-Hospital del Mar, Barcelona 08003, Spain
| | - Jaume Roquer
- Department of Neurology, Neurovascular Research Group, IMIM-Hospital del Mar, Barcelona 08003, Spain
| | - Eva Giralt-Steinhauer
- Department of Neurology, Neurovascular Research Group, IMIM-Hospital del Mar, Barcelona 08003, Spain
| | - Carolina Soriano-Tárraga
- Department of Neurology, Neurovascular Research Group, IMIM-Hospital del Mar, Barcelona 08003, Spain
| | - Marina Mola-Caminal
- Department of Neurology, Neurovascular Research Group, IMIM-Hospital del Mar, Barcelona 08003, Spain
| | | | | | - Silvia Tur
- Department of Neurology, HUSE, Mallorca 07120, Spain
| | - Victor Obach
- Department of Neurology, Hospital Clínic i Provincial de Barcelona, Barcelona 08036, Spain
| | - Juan Francisco Arenillas
- Department of Neurology, Hospital Clínico Universitario, University of Valladolid, Valladolid 47003, Spain
| | - Tomás Segura
- Department of Neurology, CHUA, Albacete 02006, Spain
| | | | - Joan Martí-Fàbregas
- Department of Neurology, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona 08025, Spain
| | - Raquel Delgado-Mederos
- Department of Neurology, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona 08025, Spain
| | - M Mar Freijo-Guerrero
- Neurovascular Unit, Biocruces Bizkaia Health Research Institute, Bilbao 48903, Spain
| | - Francisco Moniche
- Department of Neurology, Virgen del Rocío, IBIS, Seville 41023, Spain
| | | | | | - Cristina Gallego-Fabrega
- Stroke Pharmacogenomics and Genetics, IIB-Sant Pau, Barcelona 08025, Spain
- Stroke Pharmacogenomics and Genetics, Fundació Docència i Recerca Mútua Terrassa, Terrassa 08221, Spain
| | - Jonathan González-Sanchez
- Stroke Pharmacogenomics and Genetics, Fundació Docència i Recerca Mútua Terrassa, Terrassa 08221, Spain
- School of Healthcare Science, Manchester Metropolitan University, Manchester M15 6BH, UK
| | - Jurek Krupinsky
- School of Healthcare Science, Manchester Metropolitan University, Manchester M15 6BH, UK
- Neurology Unit, Hospital Universitari Mútua Terrassa, Terrassa 08221, Spain
| | - Daniel Strbian
- Department of Neurology, Helsinki University Hospital, Helsinki FI-00029, Finland
| | - Turgut Tatlisumak
- Sahlgrenska Academy at University of Gothenburg and Sahlgrenska University Hospital, Gothenburg 41345, Sweden
| | - Vincent Thijs
- Stroke Division, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg, VIC 3072, Australia
- Department of Neurology, Austin Health, Heidelberg, VIC 3072, Australia
| | - Robin Lemmens
- Department of Neurology, University Hospitals Leuven, Campus Gasthuisberg, Leuven 3000, Belgium
| | - Agnieszka Slowik
- Department of Neurology, Jagiellonian University Medical College, Kraków 31-007, Poland
| | - Johanna Pera
- Department of Neurology, Jagiellonian University Medical College, Kraków 31-007, Poland
| | - Steven Kittner
- Department of Neurology, University of Maryland School of Medicine and Baltimore, Baltimore, MD 21201-1559, USA
| | - John Cole
- Department of Neurology, University of Maryland School of Medicine and Baltimore, Baltimore, MD 21201-1559, USA
| | - Laura Heitsch
- Division of Emergency Medicine, Washington University School of Medicine, St. Louis, MO 63110-1010, USA
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110-1010, USA
| | - Laura Ibañez
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110-1010, USA
| | - Carlos Cruchaga
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110-1010, USA
| | - Jin-Moo Lee
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110-1010, USA
| | - Joan Montaner
- Neurovascular Research Laboratory, VHIR, Universitat Autònoma de Barcelona, Barcelona 08035, Spain
- Department of Neurology, Virgen del Rocío, IBIS, Seville 41023, Spain
| | | |
Collapse
|
5
|
Muiño E, Cárcel-Márquez J, Carrera C, Llucià-Carol L, Gallego-Fabrega C, Cullell N, Lledós M, Castillo J, Sobrino T, Campos F, Rodríguez-Castro E, Millán M, Muñoz-Narbona L, Bustamante A, López-Cancio E, Ribó M, Álvarez-Sabín J, Jiménez-Conde J, Roquer J, Giralt-Steinhauer E, Soriano-Tárraga C, Vives-Bauza C, Navarro RD, Tur S, Obach V, Arenillas JF, Segura T, Serrano-Heras G, Martí-Fàbregas J, Delgado-Mederos R, Camps-Renom P, Prats-Sánchez L, Guisado D, Guasch M, Marin R, Martínez-Domeño A, Freijo-Guerrero MDM, Moniche F, Cabezas JA, Castellanos M, Krupinsky J, Strbian D, Tatlisumak T, Thijs V, Lemmens R, Slowik A, Pera J, Heitsch L, Ibañez L, Cruchaga C, Dhar R, Lee JM, Montaner J, Fernández-Cadenas I. RP11-362K2.2:RP11-767I20.1 Genetic Variation Is Associated with Post-Reperfusion Therapy Parenchymal Hematoma. A GWAS Meta-Analysis. J Clin Med 2021; 10:jcm10143137. [PMID: 34300314 PMCID: PMC8305811 DOI: 10.3390/jcm10143137] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/05/2021] [Accepted: 07/14/2021] [Indexed: 12/12/2022] Open
Abstract
Stroke is one of the most common causes of death and disability. Reperfusion therapies are the only treatment available during the acute phase of stroke. Due to recent clinical trials, these therapies may increase their frequency of use by extending the time-window administration, which may lead to an increase in complications such as hemorrhagic transformation, with parenchymal hematoma (PH) being the more severe subtype, associated with higher mortality and disability rates. Our aim was to find genetic risk factors associated with PH, as that could provide molecular targets/pathways for their prevention/treatment and study its genetic correlations to find traits sharing genetic background. We performed a GWAS and meta-analysis, following standard quality controls and association analysis (fastGWAS), adjusting age, NIHSS, and principal components. FUMA was used to annotate, prioritize, visualize, and interpret the meta-analysis results. The total number of patients in the meta-analysis was 2034 (216 cases and 1818 controls). We found rs79770152 having a genome-wide significant association (beta 0.09, p-value 3.90 × 10−8) located in the RP11-362K2.2:RP11-767I20.1 gene and a suggestive variant (rs13297983: beta 0.07, p-value 6.10 × 10−8) located in PCSK5 associated with PH occurrence. The genetic correlation showed a shared genetic background of PH with Alzheimer’s disease and white matter hyperintensities. In addition, genes containing the ten most significant associations have been related to aggregated amyloid-β, tau protein, white matter microstructure, inflammation, and matrix metalloproteinases.
Collapse
Affiliation(s)
- Elena Muiño
- Stroke Pharmacogenomics and Genetics Group, Institut de Recerca de l’Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain; (E.M.); (J.C.-M.); (L.L.-C.); (C.G.-F.); (N.C.); (M.L.)
| | - Jara Cárcel-Márquez
- Stroke Pharmacogenomics and Genetics Group, Institut de Recerca de l’Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain; (E.M.); (J.C.-M.); (L.L.-C.); (C.G.-F.); (N.C.); (M.L.)
| | - Caty Carrera
- Neurovascular Research Laboratory, Vall d’Hebron Institut de Recerca, Universitat Autònoma de Barcelona, 08025 Barcelona, Spain;
| | - Laia Llucià-Carol
- Stroke Pharmacogenomics and Genetics Group, Institut de Recerca de l’Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain; (E.M.); (J.C.-M.); (L.L.-C.); (C.G.-F.); (N.C.); (M.L.)
| | - Cristina Gallego-Fabrega
- Stroke Pharmacogenomics and Genetics Group, Institut de Recerca de l’Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain; (E.M.); (J.C.-M.); (L.L.-C.); (C.G.-F.); (N.C.); (M.L.)
- Department of Neurology, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, 08025 Barcelona, Spain; (J.M.-F.); (R.D.-M.); (P.C.-R.); (L.P.-S.); (D.G.); (M.G.); (R.M.); (A.M.-D.)
| | - Natalia Cullell
- Stroke Pharmacogenomics and Genetics Group, Institut de Recerca de l’Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain; (E.M.); (J.C.-M.); (L.L.-C.); (C.G.-F.); (N.C.); (M.L.)
- Stroke Pharmacogenomics and Genetics, Fundació MútuaTerrassa per la Docència i la Recerca, 08221 Terrassa, Spain
| | - Miquel Lledós
- Stroke Pharmacogenomics and Genetics Group, Institut de Recerca de l’Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain; (E.M.); (J.C.-M.); (L.L.-C.); (C.G.-F.); (N.C.); (M.L.)
| | - José Castillo
- Clinical Neurosciences Research Laboratories, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (J.C.); (T.S.); (F.C.)
| | - Tomás Sobrino
- Clinical Neurosciences Research Laboratories, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (J.C.); (T.S.); (F.C.)
| | - Francisco Campos
- Clinical Neurosciences Research Laboratories, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (J.C.); (T.S.); (F.C.)
| | - Emilio Rodríguez-Castro
- Department of Neurology, Hospital Clínico Universitario de Santiago, 15706 Santiago de Compostela, Spain;
| | - Mònica Millán
- Department of Neuroscience, Hospital Germans Trias i Pujol, 08025 Badalona, Spain; (M.M.); (L.M.-N.); (A.B.)
| | - Lucía Muñoz-Narbona
- Department of Neuroscience, Hospital Germans Trias i Pujol, 08025 Badalona, Spain; (M.M.); (L.M.-N.); (A.B.)
| | - Alejandro Bustamante
- Department of Neuroscience, Hospital Germans Trias i Pujol, 08025 Badalona, Spain; (M.M.); (L.M.-N.); (A.B.)
| | - Elena López-Cancio
- Stroke Unit, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain;
| | - Marc Ribó
- Stroke Unit, Hospital Universitario Valle de Hebrón, 08025 Barcelona, Spain;
| | - José Álvarez-Sabín
- Department of Neurology, Hospital Universitario Valle de Hebrón, Universidad Autónoma de Barcelona, 08025 Barcelona, Spain;
| | - Jordi Jiménez-Conde
- Department of Neurology, Neurovascular Research Group, Instituto de Investigaciones Médicas Hospital del Mar-Hospital del Mar, 08025 Barcelona, Spain; (J.J.-C.); (J.R.); (E.G.-S.); (C.S.-T.)
| | - Jaume Roquer
- Department of Neurology, Neurovascular Research Group, Instituto de Investigaciones Médicas Hospital del Mar-Hospital del Mar, 08025 Barcelona, Spain; (J.J.-C.); (J.R.); (E.G.-S.); (C.S.-T.)
| | - Eva Giralt-Steinhauer
- Department of Neurology, Neurovascular Research Group, Instituto de Investigaciones Médicas Hospital del Mar-Hospital del Mar, 08025 Barcelona, Spain; (J.J.-C.); (J.R.); (E.G.-S.); (C.S.-T.)
| | - Carolina Soriano-Tárraga
- Department of Neurology, Neurovascular Research Group, Instituto de Investigaciones Médicas Hospital del Mar-Hospital del Mar, 08025 Barcelona, Spain; (J.J.-C.); (J.R.); (E.G.-S.); (C.S.-T.)
| | - Cristófol Vives-Bauza
- Neurobiology Laboratory, Instituto de Investigación Sanitaria de Palma, 07120 Mallorca, Spain;
| | - Rosa Díaz Navarro
- Department of Neurology, Hospital Universitari Son Espases, 07120 Mallorca, Spain; (R.D.N.); (S.T.)
| | - Silvia Tur
- Department of Neurology, Hospital Universitari Son Espases, 07120 Mallorca, Spain; (R.D.N.); (S.T.)
| | - Victor Obach
- Department of Neurology, Hospital Clínic i Provincial de Barcelona, 08025 Barcelona, Spain;
| | - Juan F. Arenillas
- Department of Neurology, Hospital Clínico Universitario, University of Valladolid, 47003 Valladolid, Spain;
| | - Tomás Segura
- Department of Neurology, Complejo Hospitalario Universitario de Albacete, 02006 Albacete, Spain;
| | - Gemma Serrano-Heras
- Experimental Research Unit, Complejo Hospitalario Universitario de Albacete, 02006 Albacete, Spain;
| | - Joan Martí-Fàbregas
- Department of Neurology, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, 08025 Barcelona, Spain; (J.M.-F.); (R.D.-M.); (P.C.-R.); (L.P.-S.); (D.G.); (M.G.); (R.M.); (A.M.-D.)
| | - Raquel Delgado-Mederos
- Department of Neurology, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, 08025 Barcelona, Spain; (J.M.-F.); (R.D.-M.); (P.C.-R.); (L.P.-S.); (D.G.); (M.G.); (R.M.); (A.M.-D.)
| | - Pol Camps-Renom
- Department of Neurology, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, 08025 Barcelona, Spain; (J.M.-F.); (R.D.-M.); (P.C.-R.); (L.P.-S.); (D.G.); (M.G.); (R.M.); (A.M.-D.)
| | - Luis Prats-Sánchez
- Department of Neurology, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, 08025 Barcelona, Spain; (J.M.-F.); (R.D.-M.); (P.C.-R.); (L.P.-S.); (D.G.); (M.G.); (R.M.); (A.M.-D.)
| | - Daniel Guisado
- Department of Neurology, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, 08025 Barcelona, Spain; (J.M.-F.); (R.D.-M.); (P.C.-R.); (L.P.-S.); (D.G.); (M.G.); (R.M.); (A.M.-D.)
| | - Marina Guasch
- Department of Neurology, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, 08025 Barcelona, Spain; (J.M.-F.); (R.D.-M.); (P.C.-R.); (L.P.-S.); (D.G.); (M.G.); (R.M.); (A.M.-D.)
| | - Rebeca Marin
- Department of Neurology, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, 08025 Barcelona, Spain; (J.M.-F.); (R.D.-M.); (P.C.-R.); (L.P.-S.); (D.G.); (M.G.); (R.M.); (A.M.-D.)
| | - Alejandro Martínez-Domeño
- Department of Neurology, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, 08025 Barcelona, Spain; (J.M.-F.); (R.D.-M.); (P.C.-R.); (L.P.-S.); (D.G.); (M.G.); (R.M.); (A.M.-D.)
| | | | - Francisco Moniche
- Department of Neurology, Virgen del Rocío, Instituto de Biomedicina de Sevilla, 41013 Seville, Spain; (F.M.); (J.A.C.); (J.M.)
| | - Juan Antonio Cabezas
- Department of Neurology, Virgen del Rocío, Instituto de Biomedicina de Sevilla, 41013 Seville, Spain; (F.M.); (J.A.C.); (J.M.)
| | - Mar Castellanos
- Department of Neurology, Complejo Hospitalario Universitario A Coruña, 15006 A Coruña, Spain;
| | - Jerzy Krupinsky
- School of Healthcare Science, Manchester Metropolitan University, Manchester M15 6BH, UK;
- Neurology Unit, Hospital Universitari Mútua Terrassa, 08221 Terrassa, Spain
| | - Daniel Strbian
- Department of Neurology, Helsinki University Hospital, FI-00029 Helsinki, Finland;
| | - Turgut Tatlisumak
- Department of Clinical Neuroscience, Institute of Neurosciences and Physiology, Sahlgrenska Academy at University of Gothenburg, 41345 Gothenburg, Sweden;
- Department of Neurology, Sahlgrenska University Hospital, 41345 Gothenburg, Sweden
| | - Vincent Thijs
- Stroke Division, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg VIC 3072, Australia;
- Department of Neurology, Austin Health, Heidelberg VIC 3072, Australia
| | - Robin Lemmens
- Department of Neurology, University Hospitals Leuven, Campus Gasthuisberg, 3000 Leuven, Belgium;
| | - Agnieszka Slowik
- Department of Neurology, Jagiellonian University Medical College, 31-007 Kraków, Poland; (A.S.); (J.P.)
| | - Joanna Pera
- Department of Neurology, Jagiellonian University Medical College, 31-007 Kraków, Poland; (A.S.); (J.P.)
| | - Laura Heitsch
- Division of Emergency Medicine, Washington University School of Medicine, St. Louis, MO 63110-1010, USA;
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110-1010, USA; (R.D.); (J.-M.L.)
| | - Laura Ibañez
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110-1010, USA; (L.I.); (C.C.)
| | - Carlos Cruchaga
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110-1010, USA; (L.I.); (C.C.)
| | - Rajat Dhar
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110-1010, USA; (R.D.); (J.-M.L.)
| | - Jin-Moo Lee
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110-1010, USA; (R.D.); (J.-M.L.)
| | - Joan Montaner
- Department of Neurology, Virgen del Rocío, Instituto de Biomedicina de Sevilla, 41013 Seville, Spain; (F.M.); (J.A.C.); (J.M.)
| | - Israel Fernández-Cadenas
- Stroke Pharmacogenomics and Genetics Group, Institut de Recerca de l’Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain; (E.M.); (J.C.-M.); (L.L.-C.); (C.G.-F.); (N.C.); (M.L.)
- Correspondence:
| | | | | |
Collapse
|
6
|
Cárcel-Márquez J, Cullell N, Muiño E, Gallego-Fabrega C, Lledós M, Ibañez L, Krupinski J, Montaner J, Cruchaga C, Lee JM, Gill D, Paré G, Mola-Caminal M, Roquer J, Jimenez-Conde J, Martí-Fàbregas J, Fernandez-Cadenas I. Causal Effect of MMP-1 (Matrix Metalloproteinase-1), MMP-8, and MMP-12 Levels on Ischemic Stroke: A Mendelian Randomization Study. Stroke 2021; 52:e316-e320. [PMID: 33902302 DOI: 10.1161/strokeaha.120.033041] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
[Figure: see text].
Collapse
Affiliation(s)
- Jara Cárcel-Márquez
- Stroke Pharmacogenomics and Genetics Laboratory, Sant Pau Research Institute, Barcelona, Spain (J.C.-M., N.C., E.M., C.G.-F., M.L., I.F.-C.).,Department of Medicine, Universitat Autònoma de Barcelona, Spain (J.C.-M.)
| | - Natalia Cullell
- Stroke Pharmacogenomics and Genetics Laboratory, Sant Pau Research Institute, Barcelona, Spain (J.C.-M., N.C., E.M., C.G.-F., M.L., I.F.-C.).,Stroke Pharmacogenomics and Genetics Laboratory, Fundación Docència I Recerca Mútua Terrassa, Hospital Mútua de Terrassa, Spain (N.C., C.G.-F., J.K., I.F.-C.)
| | - Elena Muiño
- Stroke Pharmacogenomics and Genetics Laboratory, Sant Pau Research Institute, Barcelona, Spain (J.C.-M., N.C., E.M., C.G.-F., M.L., I.F.-C.)
| | - Cristina Gallego-Fabrega
- Stroke Pharmacogenomics and Genetics Laboratory, Sant Pau Research Institute, Barcelona, Spain (J.C.-M., N.C., E.M., C.G.-F., M.L., I.F.-C.).,Stroke Pharmacogenomics and Genetics Laboratory, Fundación Docència I Recerca Mútua Terrassa, Hospital Mútua de Terrassa, Spain (N.C., C.G.-F., J.K., I.F.-C.)
| | - Miquel Lledós
- Stroke Pharmacogenomics and Genetics Laboratory, Sant Pau Research Institute, Barcelona, Spain (J.C.-M., N.C., E.M., C.G.-F., M.L., I.F.-C.)
| | - Laura Ibañez
- Department of Psychiatry (L.I., C.C.), Washington University School of Medicine, Saint Louis, MO
| | - Jerzy Krupinski
- Stroke Pharmacogenomics and Genetics Laboratory, Fundación Docència I Recerca Mútua Terrassa, Hospital Mútua de Terrassa, Spain (N.C., C.G.-F., J.K., I.F.-C.)
| | - Joan Montaner
- Institute de Biomedicine of Seville, IBiS/Hospital Universitario Virgen del Rocío/CSIC/University of Seville, Department of Neurology, Hospital Universitario Virgen Macarena, Spain (J.M.)
| | - Carlos Cruchaga
- Department of Psychiatry (L.I., C.C.), Washington University School of Medicine, Saint Louis, MO
| | - Jin-Moo Lee
- Department of Neurology (J.-M.L.), Washington University School of Medicine, Saint Louis, MO
| | - Dipender Gill
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, United Kingdom (D.G.)
| | | | - Marina Mola-Caminal
- Department of Neurology, IMIM-Hospital del Mar, Neurovascular Research Group, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain (M.M.-C., J.R., J.J.-C.)
| | - Jaume Roquer
- Department of Neurology, IMIM-Hospital del Mar, Neurovascular Research Group, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain (M.M.-C., J.R., J.J.-C.)
| | - Jordi Jimenez-Conde
- Department of Neurology, IMIM-Hospital del Mar, Neurovascular Research Group, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain (M.M.-C., J.R., J.J.-C.)
| | - Joan Martí-Fàbregas
- Stroke Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain (J.M.-F.)
| | - Israel Fernandez-Cadenas
- Stroke Pharmacogenomics and Genetics Laboratory, Sant Pau Research Institute, Barcelona, Spain (J.C.-M., N.C., E.M., C.G.-F., M.L., I.F.-C.).,Stroke Pharmacogenomics and Genetics Laboratory, Fundación Docència I Recerca Mútua Terrassa, Hospital Mútua de Terrassa, Spain (N.C., C.G.-F., J.K., I.F.-C.)
| |
Collapse
|
7
|
Diez-Fairen M, Houle G, Ortega-Cubero S, Bandres-Ciga S, Alvarez I, Carcel M, Ibañez L, Fernandez MV, Budde JP, Trotta JR, Tonda R, Chong JX, Bamshad MJ, Nickerson DA, Aguilar M, Tartari JP, Gironell A, García-Martín E, Agundez JA, Alonso-Navarro H, Jimenez-Jimenez FJ, Fernandez M, Valldeoriola F, Marti MJ, Tolosa E, Coria F, Pastor MA, Vilariño-Güell C, Rajput A, Dion PA, Cruchaga C, Rouleau GA, Pastor P. Exome-wide rare variant analysis in familial essential tremor. Parkinsonism Relat Disord 2020; 82:109-116. [PMID: 33279834 DOI: 10.1016/j.parkreldis.2020.11.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 10/08/2020] [Accepted: 11/21/2020] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Essential tremor (ET) is one of the most common movement disorders. Despite its high prevalence and heritability, its genetic etiology remains elusive with only a few susceptibility genes identified and poorly replicated. Our aim was to find novel candidate genes involved in ET predisposition through whole exome sequencing. METHODS We studied eight multigenerational families (N = 40 individuals) with an autosomal-dominant inheritance using a comprehensive strategy combining whole exome sequencing followed by case-control association testing of prioritized variants in a separate cohort comprising 521 ET cases and 596 controls. We further performed gene-based burden analyses in an additional dataset comprising 789 ET patients and 770 healthy individuals to investigate whether there was an enrichment of rare deleterious variants within our candidate genes. RESULTS Fifteen variants co-segregated with disease status in at least one of the families, among which rs749875462 in CCDC183, rs535864157 in MMP10 and rs114285050 in GPR151 showed a nominal association with ET. However, we found no significant enrichment of rare variants within these genes in cases compared with controls. Interestingly, MMP10 protein is involved in the inflammatory response to neuronal damage and has been previously associated with other neurological disorders. CONCLUSIONS We prioritized a set of promising genes, especially MMP10, for further genetic and functional studies in ET. Our study suggests that rare deleterious coding variants that markedly increase susceptibility to ET are likely to be found in many genes. Future studies are needed to replicate and further infer biological mechanisms and potential disease causality for our identified genes.
Collapse
Affiliation(s)
- Monica Diez-Fairen
- Fundació Docència i Recerca MútuaTerrassa, Movement Disorders Unit, Department of Neurology, University Hospital Mútua Terrassa, Terrassa, Barcelona, Spain
| | - Gabrielle Houle
- Department of Human Genetics, McGill University, Montréal, Quebec, Canada; Montreal Neurological Institute, McGill University, Montréal, Quebec, Canada
| | - Sara Ortega-Cubero
- Department of Neurology and Neurosurgery, Hospital Universitario de Burgos, Burgos, Spain
| | - Sara Bandres-Ciga
- Molecular Genetics Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA; Instituto de Investigación Biosanitaria de Granada (ibs. GRANADA), Granada, Spain
| | - Ignacio Alvarez
- Fundació Docència i Recerca MútuaTerrassa, Movement Disorders Unit, Department of Neurology, University Hospital Mútua Terrassa, Terrassa, Barcelona, Spain
| | - Maria Carcel
- Fundació Docència i Recerca MútuaTerrassa, Movement Disorders Unit, Department of Neurology, University Hospital Mútua Terrassa, Terrassa, Barcelona, Spain
| | - Laura Ibañez
- NeuroGenomics and Informatics, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Maria Victoria Fernandez
- NeuroGenomics and Informatics, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - John P Budde
- NeuroGenomics and Informatics, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Jean-Rémi Trotta
- Centre Nacional d'Anàlisis Genòmic (CNAG-CRG), Center for Genomic Regulation, Barcelona Institute of Science and Technology (BIST), Barcelona, Spain & Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Raúl Tonda
- Centre Nacional d'Anàlisis Genòmic (CNAG-CRG), Center for Genomic Regulation, Barcelona Institute of Science and Technology (BIST), Barcelona, Spain & Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Jessica X Chong
- Division of Genetic Medicine, Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Michael J Bamshad
- Division of Genetic Medicine, Department of Pediatrics, University of Washington, Seattle, WA, USA; Seattle Children's Hospital, Seattle, WA, 98105, USA; Department of Genome Sciences, University of Washington, Seattle, WA, USA
| | | | | | - Miquel Aguilar
- Fundació Docència i Recerca MútuaTerrassa, Movement Disorders Unit, Department of Neurology, University Hospital Mútua Terrassa, Terrassa, Barcelona, Spain
| | - Juan P Tartari
- Fundació Docència i Recerca MútuaTerrassa, Movement Disorders Unit, Department of Neurology, University Hospital Mútua Terrassa, Terrassa, Barcelona, Spain
| | - Alexandre Gironell
- Movement Disorders Unit, Neurology Department, Hospital de Sant Pau and Sant Pau Biomedical Research Institute, Barcelona, 08026, Spain
| | - Elena García-Martín
- University Institute of Molecular Pathology Biomarkers, UNEx. ARADyAL Instituto de Salud Carlos III, Cáceres, Spain
| | - Jose Ag Agundez
- University Institute of Molecular Pathology Biomarkers, UNEx. ARADyAL Instituto de Salud Carlos III, Cáceres, Spain
| | | | | | - Manel Fernandez
- María de Maeztu Unit of Excellence, Institute of Neurosciences, University of Barcelona, MDM-2017-0729, Ministry of Science, Innovation and Universities, Spain; Parkinson's Disease & Movement Disorders Unit, Department of Neurology, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - Francesc Valldeoriola
- Parkinson's Disease & Movement Disorders Unit, Department of Neurology, Hospital Clínic, IDIBAPS, Barcelona, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Barcelona, Spain
| | - Maria Jose Marti
- Parkinson's Disease & Movement Disorders Unit, Department of Neurology, Hospital Clínic, IDIBAPS, Barcelona, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Barcelona, Spain
| | - Eduard Tolosa
- Parkinson's Disease & Movement Disorders Unit, Department of Neurology, Hospital Clínic, IDIBAPS, Barcelona, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Barcelona, Spain
| | - Francisco Coria
- Clinic for Nervous Disorders, Service of Neurology, Son Espases University Hospital, Palma de Mallorca, Spain
| | - Maria A Pastor
- Department of Neurology, Clínica Universidad de Navarra, Pamplona, Spain
| | - Carles Vilariño-Güell
- Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada
| | - Alex Rajput
- Saskatchewan Movement Disorders Program, University of Saskatchewan/Saskatchewan Health Authority, Saskatoon, Saskatchewan, Canada
| | - Patrick A Dion
- Department of Human Genetics, McGill University, Montréal, Quebec, Canada; Department of Neurology and Neurosurgery, McGill University, Montréal, H3A 2B4, Quebec, Canada
| | - Carlos Cruchaga
- NeuroGenomics and Informatics, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Guy A Rouleau
- Montreal Neurological Institute, McGill University, Montréal, Quebec, Canada; Department of Neurology and Neurosurgery, McGill University, Montréal, H3A 2B4, Quebec, Canada
| | - Pau Pastor
- Fundació Docència i Recerca MútuaTerrassa, Movement Disorders Unit, Department of Neurology, University Hospital Mútua Terrassa, Terrassa, Barcelona, Spain.
| |
Collapse
|
8
|
Faura J, Bustamante A, Penalba A, Giralt D, Simats A, Martínez-Sáez E, Alcolea D, Fortea J, Lleó A, Teunissen CE, van der Flier WM, Ibañez L, Harari O, Cruchaga C, Hernández-Guillamón M, Delgado P, Montaner J. CCL23: A Chemokine Associated with Progression from Mild Cognitive Impairment to Alzheimer's Disease. J Alzheimers Dis 2020; 73:1585-1595. [PMID: 31958084 PMCID: PMC8010612 DOI: 10.3233/jad-190753] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
CCL23 is a chemokine implicated in inflammation and host defense responses. It has been recently associated with acquired brain damage and stroke outcomes. In this study, we reported the role of CCL23 in Alzheimer's disease (AD). We evaluated the levels of CCL23 in 659 individuals: cognitively normal, mild cognitive impaired (MCI), and AD patients. Two cross-sectional (study 1, n = 53; study 2, n = 200) and two longitudinal (study 3, n = 74; study 4, n = 332) studies were analyzed separately. CCL23 levels in the blood and/or cerebrospinal fluid (CSF) of each study were measured by immunoassays. Globally, our results suggest a predictive role of CCL23 protein levels both in the plasma in study 3 (hazard ratio (HR) = 2.5 (confidence interval (CI) 95% : 1.2-5.3), p = 0.02) and in the CSF in study 4 (HR = 3.05 (CI 95% : 1.02-5), p = 0.04) in cases of MCI that progress to AD. Moreover, we observed that the APOEɛ4 allele was associated with higher levels of CCL23 in study 2 (470.33 pg/mL (interquartile range (IQR): 303.33-597.76) versus 377.94 pg/mL (IQR: 267.16-529.19), p = 0.01) (APOE genotypes were available in studies 2 and 4). Together, these findings support the role of CCL23 in neuroinflammation in the early stages of AD, suggesting that CCL23 might be a candidate blood biomarker for MCI to AD progression.
Collapse
Affiliation(s)
- Júlia Faura
- Neurovascular Research Laboratory. Vall d’Hebron Institut de Recerca (VHIR) – Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Alejandro Bustamante
- Neurovascular Research Laboratory. Vall d’Hebron Institut de Recerca (VHIR) – Universitat Autònoma de Barcelona, Barcelona, Spain
- Neurology Department, Hospital Universitari Vall d’Hebron, Barcelona, Spain
| | - Anna Penalba
- Neurovascular Research Laboratory. Vall d’Hebron Institut de Recerca (VHIR) – Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Dolors Giralt
- Neurovascular Research Laboratory. Vall d’Hebron Institut de Recerca (VHIR) – Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Alba Simats
- Neurovascular Research Laboratory. Vall d’Hebron Institut de Recerca (VHIR) – Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Elena Martínez-Sáez
- Neuropathology Unit, Department of Pathology, Hospital Universitari Vall d’Hebron, Barcelona, Spain
| | - Daniel Alcolea
- Sant Pau Memory Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau - Biomedical Research Institute Sant Pau - Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas. CIBERNED, Spain
| | - Juan Fortea
- Sant Pau Memory Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau - Biomedical Research Institute Sant Pau - Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas. CIBERNED, Spain
| | - Alberto Lleó
- Sant Pau Memory Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau - Biomedical Research Institute Sant Pau - Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas. CIBERNED, Spain
| | - Charlotte E. Teunissen
- Department of Clinical Chemistry, Neurochemistry Laboratory and Biobank, VU University Medical Center, Amsterdam, The Netherlands
| | - Wiesje M. van der Flier
- Alzheimer Center & Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, P.O. Box 7057, 1007MB, Amsterdam, The Netherlands
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Laura Ibañez
- Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Ave. B8134, St. Louis, MO 63110, USA
- Hope Center for Neurological Disorders. Washington University School of Medicine, 660 S. Euclid Ave. B8111, St. Louis, MO 63110, USA
| | - Oscar Harari
- Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Ave. B8134, St. Louis, MO 63110, USA
- Hope Center for Neurological Disorders. Washington University School of Medicine, 660 S. Euclid Ave. B8111, St. Louis, MO 63110, USA
| | - Carlos Cruchaga
- Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Ave. B8134, St. Louis, MO 63110, USA
- Hope Center for Neurological Disorders. Washington University School of Medicine, 660 S. Euclid Ave. B8111, St. Louis, MO 63110, USA
| | - Mar Hernández-Guillamón
- Neurovascular Research Laboratory. Vall d’Hebron Institut de Recerca (VHIR) – Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Pilar Delgado
- Neurovascular Research Laboratory. Vall d’Hebron Institut de Recerca (VHIR) – Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Joan Montaner
- Neurovascular Research Laboratory. Vall d’Hebron Institut de Recerca (VHIR) – Universitat Autònoma de Barcelona, Barcelona, Spain
| |
Collapse
|
9
|
Torres-Aguila NP, Carrera C, Giese AK, Cullell N, Muiño E, Cárcel-Márquez J, Gallego-Fabrega C, González-Sánchez J, Del Mar Freijo M, Álvarez-Sabín J, Molina C, Ribó M, Jimenez-Conde J, Roquer J, Sobrino T, Campos F, Castillo J, Muñoz-Narbona L, Lopez-Cancio E, Dàvalos A, Diaz-Navarro R, Tur S, Vives-Bauza C, Serrano-Heras G, Segura T, Krupinski J, Delgado-Mederos R, Martí-Fàbregas J, Heitsch L, Ibañez L, Cruchaga C, Rost NS, Montaner J, Lee JM, Fernandez-Cadenas I. Genome-Wide Association Study of White Blood Cell Counts in Patients With Ischemic Stroke. Stroke 2019; 50:3618-3621. [PMID: 31587654 DOI: 10.1161/strokeaha.119.026593] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background and Purpose- Immune cells play a key role in the first 24h poststroke (acute phase), being associated with stroke outcome. We aimed to find genetic risk factors associated with leukocyte counts during the acute phase of stroke. Methods- Ischemic stroke patients with leukocyte counts data during the first 24h were included. Genome-wide association study and gene expression studies were performed. Results- Our genome-wide association study, which included 2064 (Discovery) and 407 (Replication) patients, revealed a new locus (14q24.3) associated with leukocyte counts. After Joint analysis (n=2471) 5 more polymorphisms reached genome-wide significance (P<5×10-8). The 14q24.3 locus was associated with acute stroke outcome (rs112809786, P=0.036) and with ACOT1 and PTGR2 gene expression. Previous polymorphisms associated with leukocyte counts in general-population did not show any significance in our study. Conclusions- We have found the first locus associated with leukocyte counts in ischemic stroke, also associated with acute outcome. Genetic analysis of acute endophenotypes could be useful to find the genetic factors associated with stroke outcome. Our findings suggested a different modulation of immune cells in stroke compared with healthy conditions.
Collapse
Affiliation(s)
- Nuria P Torres-Aguila
- From the Stroke Pharmacogenomics and Genetics Laboratory, Hospital de la Santa Creu i Sant Pau Research Institute, Barcelona Spain (N.P.T.-A., E.M., J.C.-M., C.G.-F., J.G.-S., I.F.-C.).,Neurovascular Research Laboratory, Vall d'Hebron Research Institute, Barcelona, Spain (N.P.T.-A., C.C., J.M.)
| | - Caty Carrera
- Neurovascular Research Laboratory, Vall d'Hebron Research Institute, Barcelona, Spain (N.P.T.-A., C.C., J.M.)
| | - Anne-Katrine Giese
- Neurology Department, Massachusetts General Hospital, Boston (A.-K.G., N.S.R.)
| | - Natalia Cullell
- Stroke Pharmacogenomics and Genetics Laboratory, Fundació Mútua Terrasa, Hospital Universitari Mútua Terrassa, Spain (N.C., C.G.-F., J.G.-S.)
| | - Elena Muiño
- From the Stroke Pharmacogenomics and Genetics Laboratory, Hospital de la Santa Creu i Sant Pau Research Institute, Barcelona Spain (N.P.T.-A., E.M., J.C.-M., C.G.-F., J.G.-S., I.F.-C.)
| | - Jara Cárcel-Márquez
- From the Stroke Pharmacogenomics and Genetics Laboratory, Hospital de la Santa Creu i Sant Pau Research Institute, Barcelona Spain (N.P.T.-A., E.M., J.C.-M., C.G.-F., J.G.-S., I.F.-C.)
| | - Cristina Gallego-Fabrega
- From the Stroke Pharmacogenomics and Genetics Laboratory, Hospital de la Santa Creu i Sant Pau Research Institute, Barcelona Spain (N.P.T.-A., E.M., J.C.-M., C.G.-F., J.G.-S., I.F.-C.).,Stroke Pharmacogenomics and Genetics Laboratory, Fundació Mútua Terrasa, Hospital Universitari Mútua Terrassa, Spain (N.C., C.G.-F., J.G.-S.)
| | - Jonathan González-Sánchez
- From the Stroke Pharmacogenomics and Genetics Laboratory, Hospital de la Santa Creu i Sant Pau Research Institute, Barcelona Spain (N.P.T.-A., E.M., J.C.-M., C.G.-F., J.G.-S., I.F.-C.).,Stroke Pharmacogenomics and Genetics Laboratory, Fundació Mútua Terrasa, Hospital Universitari Mútua Terrassa, Spain (N.C., C.G.-F., J.G.-S.).,School of Healthcare Science, Manchester Metropolitan University, Manchester, United Kingdom (J.G.-S., J.K.)
| | | | - José Álvarez-Sabín
- Stroke Unit, Neurology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain (J.Á.-S., C.M., M.R.)
| | - Carlos Molina
- Stroke Unit, Neurology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain (J.Á.-S., C.M., M.R.)
| | - Marc Ribó
- Stroke Unit, Neurology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain (J.Á.-S., C.M., M.R.)
| | - Jordi Jimenez-Conde
- Neurology Department, Institut Hospital del Mar d'Investigacions Mèdiques-Hospital del Mar Barcelona, Spain (J.J.-C., J.R.).,Neurovascular Research Group, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain (J.J.-C., J.R.).,Universitat Autónoma de Barcelona/Departamento de Ciencias Experimentales y de la Salud, Universitat Pompeu Fabra, Barcelona, Spain (J.J.-C., J.R.)
| | - Jaume Roquer
- Neurology Department, Institut Hospital del Mar d'Investigacions Mèdiques-Hospital del Mar Barcelona, Spain (J.J.-C., J.R.).,Neurovascular Research Group, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain (J.J.-C., J.R.).,Universitat Autónoma de Barcelona/Departamento de Ciencias Experimentales y de la Salud, Universitat Pompeu Fabra, Barcelona, Spain (J.J.-C., J.R.)
| | - Tomás Sobrino
- Clinical Neurosciences Research Laboratory, Instituto de Investigación Sanitaria de Santiago de Compostela, Santiago de Compostela, Spain (T.S., F.C., J.C.)
| | - Francisco Campos
- Clinical Neurosciences Research Laboratory, Instituto de Investigación Sanitaria de Santiago de Compostela, Santiago de Compostela, Spain (T.S., F.C., J.C.)
| | - José Castillo
- Clinical Neurosciences Research Laboratory, Instituto de Investigación Sanitaria de Santiago de Compostela, Santiago de Compostela, Spain (T.S., F.C., J.C.)
| | - Lucia Muñoz-Narbona
- Neurosciences Department, Hospital Germans Trias I Pujol-Universitat Autónoma de Barcelona, Barcelona, Spain (L.M.-N., A.D.)
| | - Elena Lopez-Cancio
- Stroke Unit, Hospital Universitario Central de Asturias, Oviedo, Spain (E.L.-C.)
| | - Antoni Dàvalos
- Neurosciences Department, Hospital Germans Trias I Pujol-Universitat Autónoma de Barcelona, Barcelona, Spain (L.M.-N., A.D.)
| | - Rosa Diaz-Navarro
- Neuroscience Laboratory, Fundació Institut d'Investigació Sanitària Illes Balears, Mallorca, Spain (R.D.-N., S.T., C.V.-B.)
| | - Silvia Tur
- Neuroscience Laboratory, Fundació Institut d'Investigació Sanitària Illes Balears, Mallorca, Spain (R.D.-N., S.T., C.V.-B.)
| | - Cristòfol Vives-Bauza
- Neuroscience Laboratory, Fundació Institut d'Investigació Sanitària Illes Balears, Mallorca, Spain (R.D.-N., S.T., C.V.-B.)
| | - Gemma Serrano-Heras
- Neurology Department, University Hospital of Albacete, Spain (G.S.-H., T.S.)
| | - Tomás Segura
- Neurology Department, University Hospital of Albacete, Spain (G.S.-H., T.S.)
| | - Jerzy Krupinski
- School of Healthcare Science, Manchester Metropolitan University, Manchester, United Kingdom (J.G.-S., J.K.).,Neurology Service, Hospital Universitari Mútua Terrassa, Spain (J.K.)
| | - Raquel Delgado-Mederos
- Stroke Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain (R.D.-M., J.M.-F.)
| | - Joan Martí-Fàbregas
- Stroke Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain (R.D.-M., J.M.-F.)
| | - Laura Heitsch
- Emergency Medicine (L.H.), Washington University School of Medicine, Saint Louis, MO.,Neurology Department (L.H., J.-M.L.), Washington University School of Medicine, Saint Louis, MO
| | - Laura Ibañez
- Psychiatry Department (L.I., C.C.), Washington University School of Medicine, Saint Louis, MO
| | - Carlos Cruchaga
- Psychiatry Department (L.I., C.C.), Washington University School of Medicine, Saint Louis, MO
| | - Natalia S Rost
- Neurology Department, Massachusetts General Hospital, Boston (A.-K.G., N.S.R.)
| | - Joan Montaner
- Neurovascular Research Laboratory, Vall d'Hebron Research Institute, Barcelona, Spain (N.P.T.-A., C.C., J.M.).,Stroke Research Program, Instituto de Biomedicina de Sevilla/Hospital Universitario Virgen del Rocío/Consejo Superior de Investigaciones Científicas/University of Seville (J.M.).,Department of Neurology, Hospital Universitario Virgen Macarena, Seville, Spain (J.M.)
| | - Jin-Moo Lee
- Neurology Department (L.H., J.-M.L.), Washington University School of Medicine, Saint Louis, MO
| | - Israel Fernandez-Cadenas
- From the Stroke Pharmacogenomics and Genetics Laboratory, Hospital de la Santa Creu i Sant Pau Research Institute, Barcelona Spain (N.P.T.-A., E.M., J.C.-M., C.G.-F., J.G.-S., I.F.-C.)
| |
Collapse
|
10
|
Torres-Aguila NP, Carrera C, Muiño E, Cullell N, Cárcel-Márquez J, Gallego-Fabrega C, González-Sánchez J, Bustamante A, Delgado P, Ibañez L, Heitsch L, Krupinski J, Montaner J, Martí-Fàbregas J, Cruchaga C, Lee JM, Fernandez-Cadenas I. Clinical Variables and Genetic Risk Factors Associated with the Acute Outcome of Ischemic Stroke: A Systematic Review. J Stroke 2019; 21:276-289. [PMID: 31590472 PMCID: PMC6780022 DOI: 10.5853/jos.2019.01522] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 08/28/2019] [Indexed: 12/19/2022] Open
Abstract
Stroke is a complex disease and one of the main causes of morbidity and mortality among the adult population. A huge variety of factors is known to influence patient outcome, including demographic variables, comorbidities or genetics. In this review, we expound what is known about the influence of clinical variables and related genetic risk factors on ischemic stroke outcome, focusing on acute and subacute outcome (within 24 to 48 hours after stroke and until day 10, respectively), as they are the first indicators of stroke damage. We searched the PubMed data base for articles that investigated the interaction between clinical variables or genetic factors and acute or subacute stroke outcome. A total of 61 studies were finally included in this review. Regarding the data collected, the variables consistently associated with acute stroke outcome are: glucose levels, blood pressure, presence of atrial fibrillation, prior statin treatment, stroke severity, type of acute treatment performed, severe neurological complications, leukocyte levels, and genetic risk factors. Further research and international efforts are required in this field, which should include genome-wide association studies.
Collapse
Affiliation(s)
- Nuria P Torres-Aguila
- Stroke Pharmacogenomics and Genetics Laboratory, Sant Pau Research Institute, Barcelona, Spain.,Neurovascular Research Laboratory, Vall d'Hebron Research Institute (VHIR), Autonomous University of Barcelona, Barcelona, Spain
| | - Caty Carrera
- Stroke Pharmacogenomics and Genetics Laboratory, Sant Pau Research Institute, Barcelona, Spain.,Neurovascular Research Laboratory, Vall d'Hebron Research Institute (VHIR), Autonomous University of Barcelona, Barcelona, Spain
| | - Elena Muiño
- Stroke Pharmacogenomics and Genetics Laboratory, Sant Pau Research Institute, Barcelona, Spain
| | - Natalia Cullell
- Stroke Pharmacogenomics and Genetics Laboratory, Mutua Terrasa Foundation of Teaching and Research, Mutua Terrassa Hospital, Terrassa, Spain
| | - Jara Cárcel-Márquez
- Stroke Pharmacogenomics and Genetics Laboratory, Sant Pau Research Institute, Barcelona, Spain
| | - Cristina Gallego-Fabrega
- Stroke Pharmacogenomics and Genetics Laboratory, Sant Pau Research Institute, Barcelona, Spain.,Stroke Pharmacogenomics and Genetics Laboratory, Mutua Terrasa Foundation of Teaching and Research, Mutua Terrassa Hospital, Terrassa, Spain
| | - Jonathan González-Sánchez
- Stroke Pharmacogenomics and Genetics Laboratory, Sant Pau Research Institute, Barcelona, Spain.,Stroke Pharmacogenomics and Genetics Laboratory, Mutua Terrasa Foundation of Teaching and Research, Mutua Terrassa Hospital, Terrassa, Spain.,Health Care Science Department, The Manchester Metropolitan University of All Saints, Manchester, UK
| | - Alejandro Bustamante
- Neurovascular Research Laboratory, Vall d'Hebron Research Institute (VHIR), Autonomous University of Barcelona, Barcelona, Spain
| | - Pilar Delgado
- Neurovascular Research Laboratory, Vall d'Hebron Research Institute (VHIR), Autonomous University of Barcelona, Barcelona, Spain
| | - Laura Ibañez
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Laura Heitsch
- Division of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, USA.,Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Jerzy Krupinski
- Stroke Pharmacogenomics and Genetics Laboratory, Mutua Terrasa Foundation of Teaching and Research, Mutua Terrassa Hospital, Terrassa, Spain.,Health Care Science Department, The Manchester Metropolitan University of All Saints, Manchester, UK
| | - Joan Montaner
- Department of Neurology, Virgin Rocío and Macarena Hospitals, Institute of Biomedicine of Seville (IBiS), Seville, Spain
| | - Joan Martí-Fàbregas
- Stroke Unit, Department of Neurology, Saint Cross and Saint Pau Hospital, Barcelona, Spain
| | - Carlos Cruchaga
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Jin-Moo Lee
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | | | -
- Stroke Pharmacogenomics and Genetics Laboratory, Sant Pau Research Institute, Barcelona, Spain
| |
Collapse
|
11
|
Carrera C, Cullell N, Torres-Águila N, Muiño E, Bustamante A, Dávalos A, López-Cancio E, Ribó M, Molina CA, Giralt-Steinhauer E, Soriano-Tárraga C, Mola-Caminal M, Jiménez-Conde J, Roquer J, Vives-Bauza C, Navarro RD, Obach V, Arenillas JF, Segura T, Serrano-Heras G, Martí-Fàbregas J, Freijo M, Cabezas JA, Tatlisumak T, Heitsch L, Ibañez L, Cruchaga C, Lee JM, Strbian D, Montaner J, Fernández-Cadenas I. Validation of a clinical-genetics score to predict hemorrhagic transformations after rtPA. Neurology 2019; 93:e851-e863. [PMID: 31366724 DOI: 10.1212/wnl.0000000000007997] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 04/02/2019] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE To validate the Genot-PA score, a clinical-genetic logistic regression score that stratifies the thrombolytic therapy safety, in a new cohort of patients with stroke. METHODS We enrolled 1,482 recombinant tissue plasminogen activator (rtPA)-treated patients with stroke in Spain and Finland from 2003 to 2016. Cohorts were analyzed on the basis of ethnicity and therapy: Spanish patients treated with IV rtPA within 4.5 hours of onset (cohort A and B) or rtPA in combination with mechanical thrombectomy within 6 hours of onset (cohort C) and Finnish participants treated with IV rtPA within 4.5 hours of onset (cohort D). The Genot-PA score was calculated, and hemorrhagic transformation (HT) and parenchymal hematoma (PH) risks were determined for each score stratum. RESULTS Genot-PA score was tested in 1,324 (cohort A, n = 726; B, n = 334; C, n = 54; and D, n = 210) patients who had enough information to complete the score. Of these, 213 (16.1%) participants developed HT and 85 (6.4%) developed PH. In cohorts A, B, and D, HT occurrence was predicted by the score (p = 2.02 × 10-6, p = 0.023, p = 0.033); PH prediction was associated in cohorts A through C (p = 0.012, p = 0.034, p = 5.32 × 10-4). Increased frequency of PH events from the lowest to the highest risk group was found (cohort A 4%-15.7%, cohort B 1.5%-18.2%, cohort C 0%-100%). The best odds ratio for PH prediction in the highest-risk group was obtained in cohort A (odds ratio 5.16, 95% confidence interval 1.46-18.08, p = 0.009). CONCLUSION The Genot-PA score predicts HT in patients with stroke treated with IV rtPA. Moreover, in an exploratory study, the score was associated with PH risk in mechanical thrombectomy-treated patients.
Collapse
Affiliation(s)
- Caty Carrera
- From the Neurovascular Research Laboratory (C.C., A.B.), Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; Stroke Pharmacogenomics and Genetics (N.C., N.-T.A.) and Stroke Genomics and Genetics (E.M.), Fundació Docència i Recerca Mútua Terrassa; Department of Neuroscience (A.D.), Hospital Germans Trias i Pujol; Stroke Unit (E.L.-C.), Hospital Universitario Central de Asturias; Stroke Unit (M.R., C.A.M.), Hospital Universitari Vall d'Hebron; Stroke Unit, Hospital Universitari Vall d'Hebron; Department of Neurology (E.G.-S., C.S.-T., M.M.-C., J.J.-C., J.R.), Neurovascular Research Group, IMIM-Hospital del Mar; Neurobiology Laboratory (C.V.-B.), Institut d'Investigacio Sanitaria de Palma; Department of Neurology (R.D.N.), Hospital Universitari Son Espases; Department of Neurology (V.O.), Hospital Clínic i Provincial de Barcelona; Department of Neurology (J.F.A.), Hospital Clínico Universitario, University of Valladolid; Department of Neurology (T.S.) and Experimental Research Unit (G.S.-H.), Hospital Universitario de Albacete; Department of Neurology (J.M.-F.), Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau; Department of Neurology (M.F.), Hospital de Basurto; Department of Neurology (J.A.C.), Virgen del Rocío & Macarena Hospitals, IBIS, Spain; Department of Clinical Neuroscience/Neurology (T.T.), Sahlgrenska Academy at University of Gothenburg and Sahlgrenska University Hospital, Sweden; Division of Emergency Medicine (L.H.), Department of Psychiatry (L.I., C.C.), and Department of Neurology (J.-M.L.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (D.S.), Helsinki University Hospital, Finland; Department of Neurology (J.M.), Virgen del Rocío & Macarena Hospitals, IBIS. Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; and Stroke Pharmacogenomics and Genetics (I.F.-C.), Fundació Docència i Recerca Mútua Terrassa, Hospital Universitari Mútua de Terrassa, Stroke Pharmacogenomics and Genetics, IIB-Sant Pau, Spain
| | - Natalia Cullell
- From the Neurovascular Research Laboratory (C.C., A.B.), Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; Stroke Pharmacogenomics and Genetics (N.C., N.-T.A.) and Stroke Genomics and Genetics (E.M.), Fundació Docència i Recerca Mútua Terrassa; Department of Neuroscience (A.D.), Hospital Germans Trias i Pujol; Stroke Unit (E.L.-C.), Hospital Universitario Central de Asturias; Stroke Unit (M.R., C.A.M.), Hospital Universitari Vall d'Hebron; Stroke Unit, Hospital Universitari Vall d'Hebron; Department of Neurology (E.G.-S., C.S.-T., M.M.-C., J.J.-C., J.R.), Neurovascular Research Group, IMIM-Hospital del Mar; Neurobiology Laboratory (C.V.-B.), Institut d'Investigacio Sanitaria de Palma; Department of Neurology (R.D.N.), Hospital Universitari Son Espases; Department of Neurology (V.O.), Hospital Clínic i Provincial de Barcelona; Department of Neurology (J.F.A.), Hospital Clínico Universitario, University of Valladolid; Department of Neurology (T.S.) and Experimental Research Unit (G.S.-H.), Hospital Universitario de Albacete; Department of Neurology (J.M.-F.), Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau; Department of Neurology (M.F.), Hospital de Basurto; Department of Neurology (J.A.C.), Virgen del Rocío & Macarena Hospitals, IBIS, Spain; Department of Clinical Neuroscience/Neurology (T.T.), Sahlgrenska Academy at University of Gothenburg and Sahlgrenska University Hospital, Sweden; Division of Emergency Medicine (L.H.), Department of Psychiatry (L.I., C.C.), and Department of Neurology (J.-M.L.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (D.S.), Helsinki University Hospital, Finland; Department of Neurology (J.M.), Virgen del Rocío & Macarena Hospitals, IBIS. Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; and Stroke Pharmacogenomics and Genetics (I.F.-C.), Fundació Docència i Recerca Mútua Terrassa, Hospital Universitari Mútua de Terrassa, Stroke Pharmacogenomics and Genetics, IIB-Sant Pau, Spain
| | - Nuria Torres-Águila
- From the Neurovascular Research Laboratory (C.C., A.B.), Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; Stroke Pharmacogenomics and Genetics (N.C., N.-T.A.) and Stroke Genomics and Genetics (E.M.), Fundació Docència i Recerca Mútua Terrassa; Department of Neuroscience (A.D.), Hospital Germans Trias i Pujol; Stroke Unit (E.L.-C.), Hospital Universitario Central de Asturias; Stroke Unit (M.R., C.A.M.), Hospital Universitari Vall d'Hebron; Stroke Unit, Hospital Universitari Vall d'Hebron; Department of Neurology (E.G.-S., C.S.-T., M.M.-C., J.J.-C., J.R.), Neurovascular Research Group, IMIM-Hospital del Mar; Neurobiology Laboratory (C.V.-B.), Institut d'Investigacio Sanitaria de Palma; Department of Neurology (R.D.N.), Hospital Universitari Son Espases; Department of Neurology (V.O.), Hospital Clínic i Provincial de Barcelona; Department of Neurology (J.F.A.), Hospital Clínico Universitario, University of Valladolid; Department of Neurology (T.S.) and Experimental Research Unit (G.S.-H.), Hospital Universitario de Albacete; Department of Neurology (J.M.-F.), Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau; Department of Neurology (M.F.), Hospital de Basurto; Department of Neurology (J.A.C.), Virgen del Rocío & Macarena Hospitals, IBIS, Spain; Department of Clinical Neuroscience/Neurology (T.T.), Sahlgrenska Academy at University of Gothenburg and Sahlgrenska University Hospital, Sweden; Division of Emergency Medicine (L.H.), Department of Psychiatry (L.I., C.C.), and Department of Neurology (J.-M.L.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (D.S.), Helsinki University Hospital, Finland; Department of Neurology (J.M.), Virgen del Rocío & Macarena Hospitals, IBIS. Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; and Stroke Pharmacogenomics and Genetics (I.F.-C.), Fundació Docència i Recerca Mútua Terrassa, Hospital Universitari Mútua de Terrassa, Stroke Pharmacogenomics and Genetics, IIB-Sant Pau, Spain
| | - Elena Muiño
- From the Neurovascular Research Laboratory (C.C., A.B.), Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; Stroke Pharmacogenomics and Genetics (N.C., N.-T.A.) and Stroke Genomics and Genetics (E.M.), Fundació Docència i Recerca Mútua Terrassa; Department of Neuroscience (A.D.), Hospital Germans Trias i Pujol; Stroke Unit (E.L.-C.), Hospital Universitario Central de Asturias; Stroke Unit (M.R., C.A.M.), Hospital Universitari Vall d'Hebron; Stroke Unit, Hospital Universitari Vall d'Hebron; Department of Neurology (E.G.-S., C.S.-T., M.M.-C., J.J.-C., J.R.), Neurovascular Research Group, IMIM-Hospital del Mar; Neurobiology Laboratory (C.V.-B.), Institut d'Investigacio Sanitaria de Palma; Department of Neurology (R.D.N.), Hospital Universitari Son Espases; Department of Neurology (V.O.), Hospital Clínic i Provincial de Barcelona; Department of Neurology (J.F.A.), Hospital Clínico Universitario, University of Valladolid; Department of Neurology (T.S.) and Experimental Research Unit (G.S.-H.), Hospital Universitario de Albacete; Department of Neurology (J.M.-F.), Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau; Department of Neurology (M.F.), Hospital de Basurto; Department of Neurology (J.A.C.), Virgen del Rocío & Macarena Hospitals, IBIS, Spain; Department of Clinical Neuroscience/Neurology (T.T.), Sahlgrenska Academy at University of Gothenburg and Sahlgrenska University Hospital, Sweden; Division of Emergency Medicine (L.H.), Department of Psychiatry (L.I., C.C.), and Department of Neurology (J.-M.L.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (D.S.), Helsinki University Hospital, Finland; Department of Neurology (J.M.), Virgen del Rocío & Macarena Hospitals, IBIS. Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; and Stroke Pharmacogenomics and Genetics (I.F.-C.), Fundació Docència i Recerca Mútua Terrassa, Hospital Universitari Mútua de Terrassa, Stroke Pharmacogenomics and Genetics, IIB-Sant Pau, Spain
| | - Alejandro Bustamante
- From the Neurovascular Research Laboratory (C.C., A.B.), Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; Stroke Pharmacogenomics and Genetics (N.C., N.-T.A.) and Stroke Genomics and Genetics (E.M.), Fundació Docència i Recerca Mútua Terrassa; Department of Neuroscience (A.D.), Hospital Germans Trias i Pujol; Stroke Unit (E.L.-C.), Hospital Universitario Central de Asturias; Stroke Unit (M.R., C.A.M.), Hospital Universitari Vall d'Hebron; Stroke Unit, Hospital Universitari Vall d'Hebron; Department of Neurology (E.G.-S., C.S.-T., M.M.-C., J.J.-C., J.R.), Neurovascular Research Group, IMIM-Hospital del Mar; Neurobiology Laboratory (C.V.-B.), Institut d'Investigacio Sanitaria de Palma; Department of Neurology (R.D.N.), Hospital Universitari Son Espases; Department of Neurology (V.O.), Hospital Clínic i Provincial de Barcelona; Department of Neurology (J.F.A.), Hospital Clínico Universitario, University of Valladolid; Department of Neurology (T.S.) and Experimental Research Unit (G.S.-H.), Hospital Universitario de Albacete; Department of Neurology (J.M.-F.), Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau; Department of Neurology (M.F.), Hospital de Basurto; Department of Neurology (J.A.C.), Virgen del Rocío & Macarena Hospitals, IBIS, Spain; Department of Clinical Neuroscience/Neurology (T.T.), Sahlgrenska Academy at University of Gothenburg and Sahlgrenska University Hospital, Sweden; Division of Emergency Medicine (L.H.), Department of Psychiatry (L.I., C.C.), and Department of Neurology (J.-M.L.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (D.S.), Helsinki University Hospital, Finland; Department of Neurology (J.M.), Virgen del Rocío & Macarena Hospitals, IBIS. Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; and Stroke Pharmacogenomics and Genetics (I.F.-C.), Fundació Docència i Recerca Mútua Terrassa, Hospital Universitari Mútua de Terrassa, Stroke Pharmacogenomics and Genetics, IIB-Sant Pau, Spain
| | - Antonio Dávalos
- From the Neurovascular Research Laboratory (C.C., A.B.), Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; Stroke Pharmacogenomics and Genetics (N.C., N.-T.A.) and Stroke Genomics and Genetics (E.M.), Fundació Docència i Recerca Mútua Terrassa; Department of Neuroscience (A.D.), Hospital Germans Trias i Pujol; Stroke Unit (E.L.-C.), Hospital Universitario Central de Asturias; Stroke Unit (M.R., C.A.M.), Hospital Universitari Vall d'Hebron; Stroke Unit, Hospital Universitari Vall d'Hebron; Department of Neurology (E.G.-S., C.S.-T., M.M.-C., J.J.-C., J.R.), Neurovascular Research Group, IMIM-Hospital del Mar; Neurobiology Laboratory (C.V.-B.), Institut d'Investigacio Sanitaria de Palma; Department of Neurology (R.D.N.), Hospital Universitari Son Espases; Department of Neurology (V.O.), Hospital Clínic i Provincial de Barcelona; Department of Neurology (J.F.A.), Hospital Clínico Universitario, University of Valladolid; Department of Neurology (T.S.) and Experimental Research Unit (G.S.-H.), Hospital Universitario de Albacete; Department of Neurology (J.M.-F.), Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau; Department of Neurology (M.F.), Hospital de Basurto; Department of Neurology (J.A.C.), Virgen del Rocío & Macarena Hospitals, IBIS, Spain; Department of Clinical Neuroscience/Neurology (T.T.), Sahlgrenska Academy at University of Gothenburg and Sahlgrenska University Hospital, Sweden; Division of Emergency Medicine (L.H.), Department of Psychiatry (L.I., C.C.), and Department of Neurology (J.-M.L.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (D.S.), Helsinki University Hospital, Finland; Department of Neurology (J.M.), Virgen del Rocío & Macarena Hospitals, IBIS. Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; and Stroke Pharmacogenomics and Genetics (I.F.-C.), Fundació Docència i Recerca Mútua Terrassa, Hospital Universitari Mútua de Terrassa, Stroke Pharmacogenomics and Genetics, IIB-Sant Pau, Spain
| | - Elena López-Cancio
- From the Neurovascular Research Laboratory (C.C., A.B.), Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; Stroke Pharmacogenomics and Genetics (N.C., N.-T.A.) and Stroke Genomics and Genetics (E.M.), Fundació Docència i Recerca Mútua Terrassa; Department of Neuroscience (A.D.), Hospital Germans Trias i Pujol; Stroke Unit (E.L.-C.), Hospital Universitario Central de Asturias; Stroke Unit (M.R., C.A.M.), Hospital Universitari Vall d'Hebron; Stroke Unit, Hospital Universitari Vall d'Hebron; Department of Neurology (E.G.-S., C.S.-T., M.M.-C., J.J.-C., J.R.), Neurovascular Research Group, IMIM-Hospital del Mar; Neurobiology Laboratory (C.V.-B.), Institut d'Investigacio Sanitaria de Palma; Department of Neurology (R.D.N.), Hospital Universitari Son Espases; Department of Neurology (V.O.), Hospital Clínic i Provincial de Barcelona; Department of Neurology (J.F.A.), Hospital Clínico Universitario, University of Valladolid; Department of Neurology (T.S.) and Experimental Research Unit (G.S.-H.), Hospital Universitario de Albacete; Department of Neurology (J.M.-F.), Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau; Department of Neurology (M.F.), Hospital de Basurto; Department of Neurology (J.A.C.), Virgen del Rocío & Macarena Hospitals, IBIS, Spain; Department of Clinical Neuroscience/Neurology (T.T.), Sahlgrenska Academy at University of Gothenburg and Sahlgrenska University Hospital, Sweden; Division of Emergency Medicine (L.H.), Department of Psychiatry (L.I., C.C.), and Department of Neurology (J.-M.L.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (D.S.), Helsinki University Hospital, Finland; Department of Neurology (J.M.), Virgen del Rocío & Macarena Hospitals, IBIS. Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; and Stroke Pharmacogenomics and Genetics (I.F.-C.), Fundació Docència i Recerca Mútua Terrassa, Hospital Universitari Mútua de Terrassa, Stroke Pharmacogenomics and Genetics, IIB-Sant Pau, Spain
| | - Marc Ribó
- From the Neurovascular Research Laboratory (C.C., A.B.), Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; Stroke Pharmacogenomics and Genetics (N.C., N.-T.A.) and Stroke Genomics and Genetics (E.M.), Fundació Docència i Recerca Mútua Terrassa; Department of Neuroscience (A.D.), Hospital Germans Trias i Pujol; Stroke Unit (E.L.-C.), Hospital Universitario Central de Asturias; Stroke Unit (M.R., C.A.M.), Hospital Universitari Vall d'Hebron; Stroke Unit, Hospital Universitari Vall d'Hebron; Department of Neurology (E.G.-S., C.S.-T., M.M.-C., J.J.-C., J.R.), Neurovascular Research Group, IMIM-Hospital del Mar; Neurobiology Laboratory (C.V.-B.), Institut d'Investigacio Sanitaria de Palma; Department of Neurology (R.D.N.), Hospital Universitari Son Espases; Department of Neurology (V.O.), Hospital Clínic i Provincial de Barcelona; Department of Neurology (J.F.A.), Hospital Clínico Universitario, University of Valladolid; Department of Neurology (T.S.) and Experimental Research Unit (G.S.-H.), Hospital Universitario de Albacete; Department of Neurology (J.M.-F.), Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau; Department of Neurology (M.F.), Hospital de Basurto; Department of Neurology (J.A.C.), Virgen del Rocío & Macarena Hospitals, IBIS, Spain; Department of Clinical Neuroscience/Neurology (T.T.), Sahlgrenska Academy at University of Gothenburg and Sahlgrenska University Hospital, Sweden; Division of Emergency Medicine (L.H.), Department of Psychiatry (L.I., C.C.), and Department of Neurology (J.-M.L.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (D.S.), Helsinki University Hospital, Finland; Department of Neurology (J.M.), Virgen del Rocío & Macarena Hospitals, IBIS. Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; and Stroke Pharmacogenomics and Genetics (I.F.-C.), Fundació Docència i Recerca Mútua Terrassa, Hospital Universitari Mútua de Terrassa, Stroke Pharmacogenomics and Genetics, IIB-Sant Pau, Spain
| | - Carlos A Molina
- From the Neurovascular Research Laboratory (C.C., A.B.), Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; Stroke Pharmacogenomics and Genetics (N.C., N.-T.A.) and Stroke Genomics and Genetics (E.M.), Fundació Docència i Recerca Mútua Terrassa; Department of Neuroscience (A.D.), Hospital Germans Trias i Pujol; Stroke Unit (E.L.-C.), Hospital Universitario Central de Asturias; Stroke Unit (M.R., C.A.M.), Hospital Universitari Vall d'Hebron; Stroke Unit, Hospital Universitari Vall d'Hebron; Department of Neurology (E.G.-S., C.S.-T., M.M.-C., J.J.-C., J.R.), Neurovascular Research Group, IMIM-Hospital del Mar; Neurobiology Laboratory (C.V.-B.), Institut d'Investigacio Sanitaria de Palma; Department of Neurology (R.D.N.), Hospital Universitari Son Espases; Department of Neurology (V.O.), Hospital Clínic i Provincial de Barcelona; Department of Neurology (J.F.A.), Hospital Clínico Universitario, University of Valladolid; Department of Neurology (T.S.) and Experimental Research Unit (G.S.-H.), Hospital Universitario de Albacete; Department of Neurology (J.M.-F.), Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau; Department of Neurology (M.F.), Hospital de Basurto; Department of Neurology (J.A.C.), Virgen del Rocío & Macarena Hospitals, IBIS, Spain; Department of Clinical Neuroscience/Neurology (T.T.), Sahlgrenska Academy at University of Gothenburg and Sahlgrenska University Hospital, Sweden; Division of Emergency Medicine (L.H.), Department of Psychiatry (L.I., C.C.), and Department of Neurology (J.-M.L.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (D.S.), Helsinki University Hospital, Finland; Department of Neurology (J.M.), Virgen del Rocío & Macarena Hospitals, IBIS. Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; and Stroke Pharmacogenomics and Genetics (I.F.-C.), Fundació Docència i Recerca Mútua Terrassa, Hospital Universitari Mútua de Terrassa, Stroke Pharmacogenomics and Genetics, IIB-Sant Pau, Spain
| | - Eva Giralt-Steinhauer
- From the Neurovascular Research Laboratory (C.C., A.B.), Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; Stroke Pharmacogenomics and Genetics (N.C., N.-T.A.) and Stroke Genomics and Genetics (E.M.), Fundació Docència i Recerca Mútua Terrassa; Department of Neuroscience (A.D.), Hospital Germans Trias i Pujol; Stroke Unit (E.L.-C.), Hospital Universitario Central de Asturias; Stroke Unit (M.R., C.A.M.), Hospital Universitari Vall d'Hebron; Stroke Unit, Hospital Universitari Vall d'Hebron; Department of Neurology (E.G.-S., C.S.-T., M.M.-C., J.J.-C., J.R.), Neurovascular Research Group, IMIM-Hospital del Mar; Neurobiology Laboratory (C.V.-B.), Institut d'Investigacio Sanitaria de Palma; Department of Neurology (R.D.N.), Hospital Universitari Son Espases; Department of Neurology (V.O.), Hospital Clínic i Provincial de Barcelona; Department of Neurology (J.F.A.), Hospital Clínico Universitario, University of Valladolid; Department of Neurology (T.S.) and Experimental Research Unit (G.S.-H.), Hospital Universitario de Albacete; Department of Neurology (J.M.-F.), Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau; Department of Neurology (M.F.), Hospital de Basurto; Department of Neurology (J.A.C.), Virgen del Rocío & Macarena Hospitals, IBIS, Spain; Department of Clinical Neuroscience/Neurology (T.T.), Sahlgrenska Academy at University of Gothenburg and Sahlgrenska University Hospital, Sweden; Division of Emergency Medicine (L.H.), Department of Psychiatry (L.I., C.C.), and Department of Neurology (J.-M.L.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (D.S.), Helsinki University Hospital, Finland; Department of Neurology (J.M.), Virgen del Rocío & Macarena Hospitals, IBIS. Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; and Stroke Pharmacogenomics and Genetics (I.F.-C.), Fundació Docència i Recerca Mútua Terrassa, Hospital Universitari Mútua de Terrassa, Stroke Pharmacogenomics and Genetics, IIB-Sant Pau, Spain
| | - Carolina Soriano-Tárraga
- From the Neurovascular Research Laboratory (C.C., A.B.), Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; Stroke Pharmacogenomics and Genetics (N.C., N.-T.A.) and Stroke Genomics and Genetics (E.M.), Fundació Docència i Recerca Mútua Terrassa; Department of Neuroscience (A.D.), Hospital Germans Trias i Pujol; Stroke Unit (E.L.-C.), Hospital Universitario Central de Asturias; Stroke Unit (M.R., C.A.M.), Hospital Universitari Vall d'Hebron; Stroke Unit, Hospital Universitari Vall d'Hebron; Department of Neurology (E.G.-S., C.S.-T., M.M.-C., J.J.-C., J.R.), Neurovascular Research Group, IMIM-Hospital del Mar; Neurobiology Laboratory (C.V.-B.), Institut d'Investigacio Sanitaria de Palma; Department of Neurology (R.D.N.), Hospital Universitari Son Espases; Department of Neurology (V.O.), Hospital Clínic i Provincial de Barcelona; Department of Neurology (J.F.A.), Hospital Clínico Universitario, University of Valladolid; Department of Neurology (T.S.) and Experimental Research Unit (G.S.-H.), Hospital Universitario de Albacete; Department of Neurology (J.M.-F.), Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau; Department of Neurology (M.F.), Hospital de Basurto; Department of Neurology (J.A.C.), Virgen del Rocío & Macarena Hospitals, IBIS, Spain; Department of Clinical Neuroscience/Neurology (T.T.), Sahlgrenska Academy at University of Gothenburg and Sahlgrenska University Hospital, Sweden; Division of Emergency Medicine (L.H.), Department of Psychiatry (L.I., C.C.), and Department of Neurology (J.-M.L.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (D.S.), Helsinki University Hospital, Finland; Department of Neurology (J.M.), Virgen del Rocío & Macarena Hospitals, IBIS. Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; and Stroke Pharmacogenomics and Genetics (I.F.-C.), Fundació Docència i Recerca Mútua Terrassa, Hospital Universitari Mútua de Terrassa, Stroke Pharmacogenomics and Genetics, IIB-Sant Pau, Spain
| | - Marina Mola-Caminal
- From the Neurovascular Research Laboratory (C.C., A.B.), Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; Stroke Pharmacogenomics and Genetics (N.C., N.-T.A.) and Stroke Genomics and Genetics (E.M.), Fundació Docència i Recerca Mútua Terrassa; Department of Neuroscience (A.D.), Hospital Germans Trias i Pujol; Stroke Unit (E.L.-C.), Hospital Universitario Central de Asturias; Stroke Unit (M.R., C.A.M.), Hospital Universitari Vall d'Hebron; Stroke Unit, Hospital Universitari Vall d'Hebron; Department of Neurology (E.G.-S., C.S.-T., M.M.-C., J.J.-C., J.R.), Neurovascular Research Group, IMIM-Hospital del Mar; Neurobiology Laboratory (C.V.-B.), Institut d'Investigacio Sanitaria de Palma; Department of Neurology (R.D.N.), Hospital Universitari Son Espases; Department of Neurology (V.O.), Hospital Clínic i Provincial de Barcelona; Department of Neurology (J.F.A.), Hospital Clínico Universitario, University of Valladolid; Department of Neurology (T.S.) and Experimental Research Unit (G.S.-H.), Hospital Universitario de Albacete; Department of Neurology (J.M.-F.), Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau; Department of Neurology (M.F.), Hospital de Basurto; Department of Neurology (J.A.C.), Virgen del Rocío & Macarena Hospitals, IBIS, Spain; Department of Clinical Neuroscience/Neurology (T.T.), Sahlgrenska Academy at University of Gothenburg and Sahlgrenska University Hospital, Sweden; Division of Emergency Medicine (L.H.), Department of Psychiatry (L.I., C.C.), and Department of Neurology (J.-M.L.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (D.S.), Helsinki University Hospital, Finland; Department of Neurology (J.M.), Virgen del Rocío & Macarena Hospitals, IBIS. Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; and Stroke Pharmacogenomics and Genetics (I.F.-C.), Fundació Docència i Recerca Mútua Terrassa, Hospital Universitari Mútua de Terrassa, Stroke Pharmacogenomics and Genetics, IIB-Sant Pau, Spain
| | - Jordi Jiménez-Conde
- From the Neurovascular Research Laboratory (C.C., A.B.), Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; Stroke Pharmacogenomics and Genetics (N.C., N.-T.A.) and Stroke Genomics and Genetics (E.M.), Fundació Docència i Recerca Mútua Terrassa; Department of Neuroscience (A.D.), Hospital Germans Trias i Pujol; Stroke Unit (E.L.-C.), Hospital Universitario Central de Asturias; Stroke Unit (M.R., C.A.M.), Hospital Universitari Vall d'Hebron; Stroke Unit, Hospital Universitari Vall d'Hebron; Department of Neurology (E.G.-S., C.S.-T., M.M.-C., J.J.-C., J.R.), Neurovascular Research Group, IMIM-Hospital del Mar; Neurobiology Laboratory (C.V.-B.), Institut d'Investigacio Sanitaria de Palma; Department of Neurology (R.D.N.), Hospital Universitari Son Espases; Department of Neurology (V.O.), Hospital Clínic i Provincial de Barcelona; Department of Neurology (J.F.A.), Hospital Clínico Universitario, University of Valladolid; Department of Neurology (T.S.) and Experimental Research Unit (G.S.-H.), Hospital Universitario de Albacete; Department of Neurology (J.M.-F.), Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau; Department of Neurology (M.F.), Hospital de Basurto; Department of Neurology (J.A.C.), Virgen del Rocío & Macarena Hospitals, IBIS, Spain; Department of Clinical Neuroscience/Neurology (T.T.), Sahlgrenska Academy at University of Gothenburg and Sahlgrenska University Hospital, Sweden; Division of Emergency Medicine (L.H.), Department of Psychiatry (L.I., C.C.), and Department of Neurology (J.-M.L.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (D.S.), Helsinki University Hospital, Finland; Department of Neurology (J.M.), Virgen del Rocío & Macarena Hospitals, IBIS. Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; and Stroke Pharmacogenomics and Genetics (I.F.-C.), Fundació Docència i Recerca Mútua Terrassa, Hospital Universitari Mútua de Terrassa, Stroke Pharmacogenomics and Genetics, IIB-Sant Pau, Spain
| | - Jaume Roquer
- From the Neurovascular Research Laboratory (C.C., A.B.), Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; Stroke Pharmacogenomics and Genetics (N.C., N.-T.A.) and Stroke Genomics and Genetics (E.M.), Fundació Docència i Recerca Mútua Terrassa; Department of Neuroscience (A.D.), Hospital Germans Trias i Pujol; Stroke Unit (E.L.-C.), Hospital Universitario Central de Asturias; Stroke Unit (M.R., C.A.M.), Hospital Universitari Vall d'Hebron; Stroke Unit, Hospital Universitari Vall d'Hebron; Department of Neurology (E.G.-S., C.S.-T., M.M.-C., J.J.-C., J.R.), Neurovascular Research Group, IMIM-Hospital del Mar; Neurobiology Laboratory (C.V.-B.), Institut d'Investigacio Sanitaria de Palma; Department of Neurology (R.D.N.), Hospital Universitari Son Espases; Department of Neurology (V.O.), Hospital Clínic i Provincial de Barcelona; Department of Neurology (J.F.A.), Hospital Clínico Universitario, University of Valladolid; Department of Neurology (T.S.) and Experimental Research Unit (G.S.-H.), Hospital Universitario de Albacete; Department of Neurology (J.M.-F.), Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau; Department of Neurology (M.F.), Hospital de Basurto; Department of Neurology (J.A.C.), Virgen del Rocío & Macarena Hospitals, IBIS, Spain; Department of Clinical Neuroscience/Neurology (T.T.), Sahlgrenska Academy at University of Gothenburg and Sahlgrenska University Hospital, Sweden; Division of Emergency Medicine (L.H.), Department of Psychiatry (L.I., C.C.), and Department of Neurology (J.-M.L.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (D.S.), Helsinki University Hospital, Finland; Department of Neurology (J.M.), Virgen del Rocío & Macarena Hospitals, IBIS. Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; and Stroke Pharmacogenomics and Genetics (I.F.-C.), Fundació Docència i Recerca Mútua Terrassa, Hospital Universitari Mútua de Terrassa, Stroke Pharmacogenomics and Genetics, IIB-Sant Pau, Spain
| | - Cristófol Vives-Bauza
- From the Neurovascular Research Laboratory (C.C., A.B.), Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; Stroke Pharmacogenomics and Genetics (N.C., N.-T.A.) and Stroke Genomics and Genetics (E.M.), Fundació Docència i Recerca Mútua Terrassa; Department of Neuroscience (A.D.), Hospital Germans Trias i Pujol; Stroke Unit (E.L.-C.), Hospital Universitario Central de Asturias; Stroke Unit (M.R., C.A.M.), Hospital Universitari Vall d'Hebron; Stroke Unit, Hospital Universitari Vall d'Hebron; Department of Neurology (E.G.-S., C.S.-T., M.M.-C., J.J.-C., J.R.), Neurovascular Research Group, IMIM-Hospital del Mar; Neurobiology Laboratory (C.V.-B.), Institut d'Investigacio Sanitaria de Palma; Department of Neurology (R.D.N.), Hospital Universitari Son Espases; Department of Neurology (V.O.), Hospital Clínic i Provincial de Barcelona; Department of Neurology (J.F.A.), Hospital Clínico Universitario, University of Valladolid; Department of Neurology (T.S.) and Experimental Research Unit (G.S.-H.), Hospital Universitario de Albacete; Department of Neurology (J.M.-F.), Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau; Department of Neurology (M.F.), Hospital de Basurto; Department of Neurology (J.A.C.), Virgen del Rocío & Macarena Hospitals, IBIS, Spain; Department of Clinical Neuroscience/Neurology (T.T.), Sahlgrenska Academy at University of Gothenburg and Sahlgrenska University Hospital, Sweden; Division of Emergency Medicine (L.H.), Department of Psychiatry (L.I., C.C.), and Department of Neurology (J.-M.L.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (D.S.), Helsinki University Hospital, Finland; Department of Neurology (J.M.), Virgen del Rocío & Macarena Hospitals, IBIS. Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; and Stroke Pharmacogenomics and Genetics (I.F.-C.), Fundació Docència i Recerca Mútua Terrassa, Hospital Universitari Mútua de Terrassa, Stroke Pharmacogenomics and Genetics, IIB-Sant Pau, Spain
| | - Rosa Díaz Navarro
- From the Neurovascular Research Laboratory (C.C., A.B.), Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; Stroke Pharmacogenomics and Genetics (N.C., N.-T.A.) and Stroke Genomics and Genetics (E.M.), Fundació Docència i Recerca Mútua Terrassa; Department of Neuroscience (A.D.), Hospital Germans Trias i Pujol; Stroke Unit (E.L.-C.), Hospital Universitario Central de Asturias; Stroke Unit (M.R., C.A.M.), Hospital Universitari Vall d'Hebron; Stroke Unit, Hospital Universitari Vall d'Hebron; Department of Neurology (E.G.-S., C.S.-T., M.M.-C., J.J.-C., J.R.), Neurovascular Research Group, IMIM-Hospital del Mar; Neurobiology Laboratory (C.V.-B.), Institut d'Investigacio Sanitaria de Palma; Department of Neurology (R.D.N.), Hospital Universitari Son Espases; Department of Neurology (V.O.), Hospital Clínic i Provincial de Barcelona; Department of Neurology (J.F.A.), Hospital Clínico Universitario, University of Valladolid; Department of Neurology (T.S.) and Experimental Research Unit (G.S.-H.), Hospital Universitario de Albacete; Department of Neurology (J.M.-F.), Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau; Department of Neurology (M.F.), Hospital de Basurto; Department of Neurology (J.A.C.), Virgen del Rocío & Macarena Hospitals, IBIS, Spain; Department of Clinical Neuroscience/Neurology (T.T.), Sahlgrenska Academy at University of Gothenburg and Sahlgrenska University Hospital, Sweden; Division of Emergency Medicine (L.H.), Department of Psychiatry (L.I., C.C.), and Department of Neurology (J.-M.L.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (D.S.), Helsinki University Hospital, Finland; Department of Neurology (J.M.), Virgen del Rocío & Macarena Hospitals, IBIS. Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; and Stroke Pharmacogenomics and Genetics (I.F.-C.), Fundació Docència i Recerca Mútua Terrassa, Hospital Universitari Mútua de Terrassa, Stroke Pharmacogenomics and Genetics, IIB-Sant Pau, Spain
| | - Victor Obach
- From the Neurovascular Research Laboratory (C.C., A.B.), Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; Stroke Pharmacogenomics and Genetics (N.C., N.-T.A.) and Stroke Genomics and Genetics (E.M.), Fundació Docència i Recerca Mútua Terrassa; Department of Neuroscience (A.D.), Hospital Germans Trias i Pujol; Stroke Unit (E.L.-C.), Hospital Universitario Central de Asturias; Stroke Unit (M.R., C.A.M.), Hospital Universitari Vall d'Hebron; Stroke Unit, Hospital Universitari Vall d'Hebron; Department of Neurology (E.G.-S., C.S.-T., M.M.-C., J.J.-C., J.R.), Neurovascular Research Group, IMIM-Hospital del Mar; Neurobiology Laboratory (C.V.-B.), Institut d'Investigacio Sanitaria de Palma; Department of Neurology (R.D.N.), Hospital Universitari Son Espases; Department of Neurology (V.O.), Hospital Clínic i Provincial de Barcelona; Department of Neurology (J.F.A.), Hospital Clínico Universitario, University of Valladolid; Department of Neurology (T.S.) and Experimental Research Unit (G.S.-H.), Hospital Universitario de Albacete; Department of Neurology (J.M.-F.), Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau; Department of Neurology (M.F.), Hospital de Basurto; Department of Neurology (J.A.C.), Virgen del Rocío & Macarena Hospitals, IBIS, Spain; Department of Clinical Neuroscience/Neurology (T.T.), Sahlgrenska Academy at University of Gothenburg and Sahlgrenska University Hospital, Sweden; Division of Emergency Medicine (L.H.), Department of Psychiatry (L.I., C.C.), and Department of Neurology (J.-M.L.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (D.S.), Helsinki University Hospital, Finland; Department of Neurology (J.M.), Virgen del Rocío & Macarena Hospitals, IBIS. Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; and Stroke Pharmacogenomics and Genetics (I.F.-C.), Fundació Docència i Recerca Mútua Terrassa, Hospital Universitari Mútua de Terrassa, Stroke Pharmacogenomics and Genetics, IIB-Sant Pau, Spain
| | - Juan Francisco Arenillas
- From the Neurovascular Research Laboratory (C.C., A.B.), Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; Stroke Pharmacogenomics and Genetics (N.C., N.-T.A.) and Stroke Genomics and Genetics (E.M.), Fundació Docència i Recerca Mútua Terrassa; Department of Neuroscience (A.D.), Hospital Germans Trias i Pujol; Stroke Unit (E.L.-C.), Hospital Universitario Central de Asturias; Stroke Unit (M.R., C.A.M.), Hospital Universitari Vall d'Hebron; Stroke Unit, Hospital Universitari Vall d'Hebron; Department of Neurology (E.G.-S., C.S.-T., M.M.-C., J.J.-C., J.R.), Neurovascular Research Group, IMIM-Hospital del Mar; Neurobiology Laboratory (C.V.-B.), Institut d'Investigacio Sanitaria de Palma; Department of Neurology (R.D.N.), Hospital Universitari Son Espases; Department of Neurology (V.O.), Hospital Clínic i Provincial de Barcelona; Department of Neurology (J.F.A.), Hospital Clínico Universitario, University of Valladolid; Department of Neurology (T.S.) and Experimental Research Unit (G.S.-H.), Hospital Universitario de Albacete; Department of Neurology (J.M.-F.), Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau; Department of Neurology (M.F.), Hospital de Basurto; Department of Neurology (J.A.C.), Virgen del Rocío & Macarena Hospitals, IBIS, Spain; Department of Clinical Neuroscience/Neurology (T.T.), Sahlgrenska Academy at University of Gothenburg and Sahlgrenska University Hospital, Sweden; Division of Emergency Medicine (L.H.), Department of Psychiatry (L.I., C.C.), and Department of Neurology (J.-M.L.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (D.S.), Helsinki University Hospital, Finland; Department of Neurology (J.M.), Virgen del Rocío & Macarena Hospitals, IBIS. Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; and Stroke Pharmacogenomics and Genetics (I.F.-C.), Fundació Docència i Recerca Mútua Terrassa, Hospital Universitari Mútua de Terrassa, Stroke Pharmacogenomics and Genetics, IIB-Sant Pau, Spain
| | - Tomás Segura
- From the Neurovascular Research Laboratory (C.C., A.B.), Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; Stroke Pharmacogenomics and Genetics (N.C., N.-T.A.) and Stroke Genomics and Genetics (E.M.), Fundació Docència i Recerca Mútua Terrassa; Department of Neuroscience (A.D.), Hospital Germans Trias i Pujol; Stroke Unit (E.L.-C.), Hospital Universitario Central de Asturias; Stroke Unit (M.R., C.A.M.), Hospital Universitari Vall d'Hebron; Stroke Unit, Hospital Universitari Vall d'Hebron; Department of Neurology (E.G.-S., C.S.-T., M.M.-C., J.J.-C., J.R.), Neurovascular Research Group, IMIM-Hospital del Mar; Neurobiology Laboratory (C.V.-B.), Institut d'Investigacio Sanitaria de Palma; Department of Neurology (R.D.N.), Hospital Universitari Son Espases; Department of Neurology (V.O.), Hospital Clínic i Provincial de Barcelona; Department of Neurology (J.F.A.), Hospital Clínico Universitario, University of Valladolid; Department of Neurology (T.S.) and Experimental Research Unit (G.S.-H.), Hospital Universitario de Albacete; Department of Neurology (J.M.-F.), Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau; Department of Neurology (M.F.), Hospital de Basurto; Department of Neurology (J.A.C.), Virgen del Rocío & Macarena Hospitals, IBIS, Spain; Department of Clinical Neuroscience/Neurology (T.T.), Sahlgrenska Academy at University of Gothenburg and Sahlgrenska University Hospital, Sweden; Division of Emergency Medicine (L.H.), Department of Psychiatry (L.I., C.C.), and Department of Neurology (J.-M.L.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (D.S.), Helsinki University Hospital, Finland; Department of Neurology (J.M.), Virgen del Rocío & Macarena Hospitals, IBIS. Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; and Stroke Pharmacogenomics and Genetics (I.F.-C.), Fundació Docència i Recerca Mútua Terrassa, Hospital Universitari Mútua de Terrassa, Stroke Pharmacogenomics and Genetics, IIB-Sant Pau, Spain
| | - Gemma Serrano-Heras
- From the Neurovascular Research Laboratory (C.C., A.B.), Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; Stroke Pharmacogenomics and Genetics (N.C., N.-T.A.) and Stroke Genomics and Genetics (E.M.), Fundació Docència i Recerca Mútua Terrassa; Department of Neuroscience (A.D.), Hospital Germans Trias i Pujol; Stroke Unit (E.L.-C.), Hospital Universitario Central de Asturias; Stroke Unit (M.R., C.A.M.), Hospital Universitari Vall d'Hebron; Stroke Unit, Hospital Universitari Vall d'Hebron; Department of Neurology (E.G.-S., C.S.-T., M.M.-C., J.J.-C., J.R.), Neurovascular Research Group, IMIM-Hospital del Mar; Neurobiology Laboratory (C.V.-B.), Institut d'Investigacio Sanitaria de Palma; Department of Neurology (R.D.N.), Hospital Universitari Son Espases; Department of Neurology (V.O.), Hospital Clínic i Provincial de Barcelona; Department of Neurology (J.F.A.), Hospital Clínico Universitario, University of Valladolid; Department of Neurology (T.S.) and Experimental Research Unit (G.S.-H.), Hospital Universitario de Albacete; Department of Neurology (J.M.-F.), Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau; Department of Neurology (M.F.), Hospital de Basurto; Department of Neurology (J.A.C.), Virgen del Rocío & Macarena Hospitals, IBIS, Spain; Department of Clinical Neuroscience/Neurology (T.T.), Sahlgrenska Academy at University of Gothenburg and Sahlgrenska University Hospital, Sweden; Division of Emergency Medicine (L.H.), Department of Psychiatry (L.I., C.C.), and Department of Neurology (J.-M.L.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (D.S.), Helsinki University Hospital, Finland; Department of Neurology (J.M.), Virgen del Rocío & Macarena Hospitals, IBIS. Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; and Stroke Pharmacogenomics and Genetics (I.F.-C.), Fundació Docència i Recerca Mútua Terrassa, Hospital Universitari Mútua de Terrassa, Stroke Pharmacogenomics and Genetics, IIB-Sant Pau, Spain
| | - Joan Martí-Fàbregas
- From the Neurovascular Research Laboratory (C.C., A.B.), Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; Stroke Pharmacogenomics and Genetics (N.C., N.-T.A.) and Stroke Genomics and Genetics (E.M.), Fundació Docència i Recerca Mútua Terrassa; Department of Neuroscience (A.D.), Hospital Germans Trias i Pujol; Stroke Unit (E.L.-C.), Hospital Universitario Central de Asturias; Stroke Unit (M.R., C.A.M.), Hospital Universitari Vall d'Hebron; Stroke Unit, Hospital Universitari Vall d'Hebron; Department of Neurology (E.G.-S., C.S.-T., M.M.-C., J.J.-C., J.R.), Neurovascular Research Group, IMIM-Hospital del Mar; Neurobiology Laboratory (C.V.-B.), Institut d'Investigacio Sanitaria de Palma; Department of Neurology (R.D.N.), Hospital Universitari Son Espases; Department of Neurology (V.O.), Hospital Clínic i Provincial de Barcelona; Department of Neurology (J.F.A.), Hospital Clínico Universitario, University of Valladolid; Department of Neurology (T.S.) and Experimental Research Unit (G.S.-H.), Hospital Universitario de Albacete; Department of Neurology (J.M.-F.), Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau; Department of Neurology (M.F.), Hospital de Basurto; Department of Neurology (J.A.C.), Virgen del Rocío & Macarena Hospitals, IBIS, Spain; Department of Clinical Neuroscience/Neurology (T.T.), Sahlgrenska Academy at University of Gothenburg and Sahlgrenska University Hospital, Sweden; Division of Emergency Medicine (L.H.), Department of Psychiatry (L.I., C.C.), and Department of Neurology (J.-M.L.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (D.S.), Helsinki University Hospital, Finland; Department of Neurology (J.M.), Virgen del Rocío & Macarena Hospitals, IBIS. Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; and Stroke Pharmacogenomics and Genetics (I.F.-C.), Fundació Docència i Recerca Mútua Terrassa, Hospital Universitari Mútua de Terrassa, Stroke Pharmacogenomics and Genetics, IIB-Sant Pau, Spain
| | - Marimar Freijo
- From the Neurovascular Research Laboratory (C.C., A.B.), Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; Stroke Pharmacogenomics and Genetics (N.C., N.-T.A.) and Stroke Genomics and Genetics (E.M.), Fundació Docència i Recerca Mútua Terrassa; Department of Neuroscience (A.D.), Hospital Germans Trias i Pujol; Stroke Unit (E.L.-C.), Hospital Universitario Central de Asturias; Stroke Unit (M.R., C.A.M.), Hospital Universitari Vall d'Hebron; Stroke Unit, Hospital Universitari Vall d'Hebron; Department of Neurology (E.G.-S., C.S.-T., M.M.-C., J.J.-C., J.R.), Neurovascular Research Group, IMIM-Hospital del Mar; Neurobiology Laboratory (C.V.-B.), Institut d'Investigacio Sanitaria de Palma; Department of Neurology (R.D.N.), Hospital Universitari Son Espases; Department of Neurology (V.O.), Hospital Clínic i Provincial de Barcelona; Department of Neurology (J.F.A.), Hospital Clínico Universitario, University of Valladolid; Department of Neurology (T.S.) and Experimental Research Unit (G.S.-H.), Hospital Universitario de Albacete; Department of Neurology (J.M.-F.), Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau; Department of Neurology (M.F.), Hospital de Basurto; Department of Neurology (J.A.C.), Virgen del Rocío & Macarena Hospitals, IBIS, Spain; Department of Clinical Neuroscience/Neurology (T.T.), Sahlgrenska Academy at University of Gothenburg and Sahlgrenska University Hospital, Sweden; Division of Emergency Medicine (L.H.), Department of Psychiatry (L.I., C.C.), and Department of Neurology (J.-M.L.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (D.S.), Helsinki University Hospital, Finland; Department of Neurology (J.M.), Virgen del Rocío & Macarena Hospitals, IBIS. Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; and Stroke Pharmacogenomics and Genetics (I.F.-C.), Fundació Docència i Recerca Mútua Terrassa, Hospital Universitari Mútua de Terrassa, Stroke Pharmacogenomics and Genetics, IIB-Sant Pau, Spain
| | - Juan Antonio Cabezas
- From the Neurovascular Research Laboratory (C.C., A.B.), Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; Stroke Pharmacogenomics and Genetics (N.C., N.-T.A.) and Stroke Genomics and Genetics (E.M.), Fundació Docència i Recerca Mútua Terrassa; Department of Neuroscience (A.D.), Hospital Germans Trias i Pujol; Stroke Unit (E.L.-C.), Hospital Universitario Central de Asturias; Stroke Unit (M.R., C.A.M.), Hospital Universitari Vall d'Hebron; Stroke Unit, Hospital Universitari Vall d'Hebron; Department of Neurology (E.G.-S., C.S.-T., M.M.-C., J.J.-C., J.R.), Neurovascular Research Group, IMIM-Hospital del Mar; Neurobiology Laboratory (C.V.-B.), Institut d'Investigacio Sanitaria de Palma; Department of Neurology (R.D.N.), Hospital Universitari Son Espases; Department of Neurology (V.O.), Hospital Clínic i Provincial de Barcelona; Department of Neurology (J.F.A.), Hospital Clínico Universitario, University of Valladolid; Department of Neurology (T.S.) and Experimental Research Unit (G.S.-H.), Hospital Universitario de Albacete; Department of Neurology (J.M.-F.), Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau; Department of Neurology (M.F.), Hospital de Basurto; Department of Neurology (J.A.C.), Virgen del Rocío & Macarena Hospitals, IBIS, Spain; Department of Clinical Neuroscience/Neurology (T.T.), Sahlgrenska Academy at University of Gothenburg and Sahlgrenska University Hospital, Sweden; Division of Emergency Medicine (L.H.), Department of Psychiatry (L.I., C.C.), and Department of Neurology (J.-M.L.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (D.S.), Helsinki University Hospital, Finland; Department of Neurology (J.M.), Virgen del Rocío & Macarena Hospitals, IBIS. Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; and Stroke Pharmacogenomics and Genetics (I.F.-C.), Fundació Docència i Recerca Mútua Terrassa, Hospital Universitari Mútua de Terrassa, Stroke Pharmacogenomics and Genetics, IIB-Sant Pau, Spain
| | - Turgut Tatlisumak
- From the Neurovascular Research Laboratory (C.C., A.B.), Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; Stroke Pharmacogenomics and Genetics (N.C., N.-T.A.) and Stroke Genomics and Genetics (E.M.), Fundació Docència i Recerca Mútua Terrassa; Department of Neuroscience (A.D.), Hospital Germans Trias i Pujol; Stroke Unit (E.L.-C.), Hospital Universitario Central de Asturias; Stroke Unit (M.R., C.A.M.), Hospital Universitari Vall d'Hebron; Stroke Unit, Hospital Universitari Vall d'Hebron; Department of Neurology (E.G.-S., C.S.-T., M.M.-C., J.J.-C., J.R.), Neurovascular Research Group, IMIM-Hospital del Mar; Neurobiology Laboratory (C.V.-B.), Institut d'Investigacio Sanitaria de Palma; Department of Neurology (R.D.N.), Hospital Universitari Son Espases; Department of Neurology (V.O.), Hospital Clínic i Provincial de Barcelona; Department of Neurology (J.F.A.), Hospital Clínico Universitario, University of Valladolid; Department of Neurology (T.S.) and Experimental Research Unit (G.S.-H.), Hospital Universitario de Albacete; Department of Neurology (J.M.-F.), Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau; Department of Neurology (M.F.), Hospital de Basurto; Department of Neurology (J.A.C.), Virgen del Rocío & Macarena Hospitals, IBIS, Spain; Department of Clinical Neuroscience/Neurology (T.T.), Sahlgrenska Academy at University of Gothenburg and Sahlgrenska University Hospital, Sweden; Division of Emergency Medicine (L.H.), Department of Psychiatry (L.I., C.C.), and Department of Neurology (J.-M.L.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (D.S.), Helsinki University Hospital, Finland; Department of Neurology (J.M.), Virgen del Rocío & Macarena Hospitals, IBIS. Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; and Stroke Pharmacogenomics and Genetics (I.F.-C.), Fundació Docència i Recerca Mútua Terrassa, Hospital Universitari Mútua de Terrassa, Stroke Pharmacogenomics and Genetics, IIB-Sant Pau, Spain
| | - Laura Heitsch
- From the Neurovascular Research Laboratory (C.C., A.B.), Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; Stroke Pharmacogenomics and Genetics (N.C., N.-T.A.) and Stroke Genomics and Genetics (E.M.), Fundació Docència i Recerca Mútua Terrassa; Department of Neuroscience (A.D.), Hospital Germans Trias i Pujol; Stroke Unit (E.L.-C.), Hospital Universitario Central de Asturias; Stroke Unit (M.R., C.A.M.), Hospital Universitari Vall d'Hebron; Stroke Unit, Hospital Universitari Vall d'Hebron; Department of Neurology (E.G.-S., C.S.-T., M.M.-C., J.J.-C., J.R.), Neurovascular Research Group, IMIM-Hospital del Mar; Neurobiology Laboratory (C.V.-B.), Institut d'Investigacio Sanitaria de Palma; Department of Neurology (R.D.N.), Hospital Universitari Son Espases; Department of Neurology (V.O.), Hospital Clínic i Provincial de Barcelona; Department of Neurology (J.F.A.), Hospital Clínico Universitario, University of Valladolid; Department of Neurology (T.S.) and Experimental Research Unit (G.S.-H.), Hospital Universitario de Albacete; Department of Neurology (J.M.-F.), Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau; Department of Neurology (M.F.), Hospital de Basurto; Department of Neurology (J.A.C.), Virgen del Rocío & Macarena Hospitals, IBIS, Spain; Department of Clinical Neuroscience/Neurology (T.T.), Sahlgrenska Academy at University of Gothenburg and Sahlgrenska University Hospital, Sweden; Division of Emergency Medicine (L.H.), Department of Psychiatry (L.I., C.C.), and Department of Neurology (J.-M.L.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (D.S.), Helsinki University Hospital, Finland; Department of Neurology (J.M.), Virgen del Rocío & Macarena Hospitals, IBIS. Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; and Stroke Pharmacogenomics and Genetics (I.F.-C.), Fundació Docència i Recerca Mútua Terrassa, Hospital Universitari Mútua de Terrassa, Stroke Pharmacogenomics and Genetics, IIB-Sant Pau, Spain
| | - Laura Ibañez
- From the Neurovascular Research Laboratory (C.C., A.B.), Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; Stroke Pharmacogenomics and Genetics (N.C., N.-T.A.) and Stroke Genomics and Genetics (E.M.), Fundació Docència i Recerca Mútua Terrassa; Department of Neuroscience (A.D.), Hospital Germans Trias i Pujol; Stroke Unit (E.L.-C.), Hospital Universitario Central de Asturias; Stroke Unit (M.R., C.A.M.), Hospital Universitari Vall d'Hebron; Stroke Unit, Hospital Universitari Vall d'Hebron; Department of Neurology (E.G.-S., C.S.-T., M.M.-C., J.J.-C., J.R.), Neurovascular Research Group, IMIM-Hospital del Mar; Neurobiology Laboratory (C.V.-B.), Institut d'Investigacio Sanitaria de Palma; Department of Neurology (R.D.N.), Hospital Universitari Son Espases; Department of Neurology (V.O.), Hospital Clínic i Provincial de Barcelona; Department of Neurology (J.F.A.), Hospital Clínico Universitario, University of Valladolid; Department of Neurology (T.S.) and Experimental Research Unit (G.S.-H.), Hospital Universitario de Albacete; Department of Neurology (J.M.-F.), Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau; Department of Neurology (M.F.), Hospital de Basurto; Department of Neurology (J.A.C.), Virgen del Rocío & Macarena Hospitals, IBIS, Spain; Department of Clinical Neuroscience/Neurology (T.T.), Sahlgrenska Academy at University of Gothenburg and Sahlgrenska University Hospital, Sweden; Division of Emergency Medicine (L.H.), Department of Psychiatry (L.I., C.C.), and Department of Neurology (J.-M.L.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (D.S.), Helsinki University Hospital, Finland; Department of Neurology (J.M.), Virgen del Rocío & Macarena Hospitals, IBIS. Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; and Stroke Pharmacogenomics and Genetics (I.F.-C.), Fundació Docència i Recerca Mútua Terrassa, Hospital Universitari Mútua de Terrassa, Stroke Pharmacogenomics and Genetics, IIB-Sant Pau, Spain
| | - Carlos Cruchaga
- From the Neurovascular Research Laboratory (C.C., A.B.), Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; Stroke Pharmacogenomics and Genetics (N.C., N.-T.A.) and Stroke Genomics and Genetics (E.M.), Fundació Docència i Recerca Mútua Terrassa; Department of Neuroscience (A.D.), Hospital Germans Trias i Pujol; Stroke Unit (E.L.-C.), Hospital Universitario Central de Asturias; Stroke Unit (M.R., C.A.M.), Hospital Universitari Vall d'Hebron; Stroke Unit, Hospital Universitari Vall d'Hebron; Department of Neurology (E.G.-S., C.S.-T., M.M.-C., J.J.-C., J.R.), Neurovascular Research Group, IMIM-Hospital del Mar; Neurobiology Laboratory (C.V.-B.), Institut d'Investigacio Sanitaria de Palma; Department of Neurology (R.D.N.), Hospital Universitari Son Espases; Department of Neurology (V.O.), Hospital Clínic i Provincial de Barcelona; Department of Neurology (J.F.A.), Hospital Clínico Universitario, University of Valladolid; Department of Neurology (T.S.) and Experimental Research Unit (G.S.-H.), Hospital Universitario de Albacete; Department of Neurology (J.M.-F.), Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau; Department of Neurology (M.F.), Hospital de Basurto; Department of Neurology (J.A.C.), Virgen del Rocío & Macarena Hospitals, IBIS, Spain; Department of Clinical Neuroscience/Neurology (T.T.), Sahlgrenska Academy at University of Gothenburg and Sahlgrenska University Hospital, Sweden; Division of Emergency Medicine (L.H.), Department of Psychiatry (L.I., C.C.), and Department of Neurology (J.-M.L.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (D.S.), Helsinki University Hospital, Finland; Department of Neurology (J.M.), Virgen del Rocío & Macarena Hospitals, IBIS. Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; and Stroke Pharmacogenomics and Genetics (I.F.-C.), Fundació Docència i Recerca Mútua Terrassa, Hospital Universitari Mútua de Terrassa, Stroke Pharmacogenomics and Genetics, IIB-Sant Pau, Spain
| | - Jin-Moo Lee
- From the Neurovascular Research Laboratory (C.C., A.B.), Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; Stroke Pharmacogenomics and Genetics (N.C., N.-T.A.) and Stroke Genomics and Genetics (E.M.), Fundació Docència i Recerca Mútua Terrassa; Department of Neuroscience (A.D.), Hospital Germans Trias i Pujol; Stroke Unit (E.L.-C.), Hospital Universitario Central de Asturias; Stroke Unit (M.R., C.A.M.), Hospital Universitari Vall d'Hebron; Stroke Unit, Hospital Universitari Vall d'Hebron; Department of Neurology (E.G.-S., C.S.-T., M.M.-C., J.J.-C., J.R.), Neurovascular Research Group, IMIM-Hospital del Mar; Neurobiology Laboratory (C.V.-B.), Institut d'Investigacio Sanitaria de Palma; Department of Neurology (R.D.N.), Hospital Universitari Son Espases; Department of Neurology (V.O.), Hospital Clínic i Provincial de Barcelona; Department of Neurology (J.F.A.), Hospital Clínico Universitario, University of Valladolid; Department of Neurology (T.S.) and Experimental Research Unit (G.S.-H.), Hospital Universitario de Albacete; Department of Neurology (J.M.-F.), Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau; Department of Neurology (M.F.), Hospital de Basurto; Department of Neurology (J.A.C.), Virgen del Rocío & Macarena Hospitals, IBIS, Spain; Department of Clinical Neuroscience/Neurology (T.T.), Sahlgrenska Academy at University of Gothenburg and Sahlgrenska University Hospital, Sweden; Division of Emergency Medicine (L.H.), Department of Psychiatry (L.I., C.C.), and Department of Neurology (J.-M.L.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (D.S.), Helsinki University Hospital, Finland; Department of Neurology (J.M.), Virgen del Rocío & Macarena Hospitals, IBIS. Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; and Stroke Pharmacogenomics and Genetics (I.F.-C.), Fundació Docència i Recerca Mútua Terrassa, Hospital Universitari Mútua de Terrassa, Stroke Pharmacogenomics and Genetics, IIB-Sant Pau, Spain
| | - Daniel Strbian
- From the Neurovascular Research Laboratory (C.C., A.B.), Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; Stroke Pharmacogenomics and Genetics (N.C., N.-T.A.) and Stroke Genomics and Genetics (E.M.), Fundació Docència i Recerca Mútua Terrassa; Department of Neuroscience (A.D.), Hospital Germans Trias i Pujol; Stroke Unit (E.L.-C.), Hospital Universitario Central de Asturias; Stroke Unit (M.R., C.A.M.), Hospital Universitari Vall d'Hebron; Stroke Unit, Hospital Universitari Vall d'Hebron; Department of Neurology (E.G.-S., C.S.-T., M.M.-C., J.J.-C., J.R.), Neurovascular Research Group, IMIM-Hospital del Mar; Neurobiology Laboratory (C.V.-B.), Institut d'Investigacio Sanitaria de Palma; Department of Neurology (R.D.N.), Hospital Universitari Son Espases; Department of Neurology (V.O.), Hospital Clínic i Provincial de Barcelona; Department of Neurology (J.F.A.), Hospital Clínico Universitario, University of Valladolid; Department of Neurology (T.S.) and Experimental Research Unit (G.S.-H.), Hospital Universitario de Albacete; Department of Neurology (J.M.-F.), Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau; Department of Neurology (M.F.), Hospital de Basurto; Department of Neurology (J.A.C.), Virgen del Rocío & Macarena Hospitals, IBIS, Spain; Department of Clinical Neuroscience/Neurology (T.T.), Sahlgrenska Academy at University of Gothenburg and Sahlgrenska University Hospital, Sweden; Division of Emergency Medicine (L.H.), Department of Psychiatry (L.I., C.C.), and Department of Neurology (J.-M.L.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (D.S.), Helsinki University Hospital, Finland; Department of Neurology (J.M.), Virgen del Rocío & Macarena Hospitals, IBIS. Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; and Stroke Pharmacogenomics and Genetics (I.F.-C.), Fundació Docència i Recerca Mútua Terrassa, Hospital Universitari Mútua de Terrassa, Stroke Pharmacogenomics and Genetics, IIB-Sant Pau, Spain
| | - Joan Montaner
- From the Neurovascular Research Laboratory (C.C., A.B.), Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; Stroke Pharmacogenomics and Genetics (N.C., N.-T.A.) and Stroke Genomics and Genetics (E.M.), Fundació Docència i Recerca Mútua Terrassa; Department of Neuroscience (A.D.), Hospital Germans Trias i Pujol; Stroke Unit (E.L.-C.), Hospital Universitario Central de Asturias; Stroke Unit (M.R., C.A.M.), Hospital Universitari Vall d'Hebron; Stroke Unit, Hospital Universitari Vall d'Hebron; Department of Neurology (E.G.-S., C.S.-T., M.M.-C., J.J.-C., J.R.), Neurovascular Research Group, IMIM-Hospital del Mar; Neurobiology Laboratory (C.V.-B.), Institut d'Investigacio Sanitaria de Palma; Department of Neurology (R.D.N.), Hospital Universitari Son Espases; Department of Neurology (V.O.), Hospital Clínic i Provincial de Barcelona; Department of Neurology (J.F.A.), Hospital Clínico Universitario, University of Valladolid; Department of Neurology (T.S.) and Experimental Research Unit (G.S.-H.), Hospital Universitario de Albacete; Department of Neurology (J.M.-F.), Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau; Department of Neurology (M.F.), Hospital de Basurto; Department of Neurology (J.A.C.), Virgen del Rocío & Macarena Hospitals, IBIS, Spain; Department of Clinical Neuroscience/Neurology (T.T.), Sahlgrenska Academy at University of Gothenburg and Sahlgrenska University Hospital, Sweden; Division of Emergency Medicine (L.H.), Department of Psychiatry (L.I., C.C.), and Department of Neurology (J.-M.L.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (D.S.), Helsinki University Hospital, Finland; Department of Neurology (J.M.), Virgen del Rocío & Macarena Hospitals, IBIS. Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; and Stroke Pharmacogenomics and Genetics (I.F.-C.), Fundació Docència i Recerca Mútua Terrassa, Hospital Universitari Mútua de Terrassa, Stroke Pharmacogenomics and Genetics, IIB-Sant Pau, Spain
| | - Israel Fernández-Cadenas
- From the Neurovascular Research Laboratory (C.C., A.B.), Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; Stroke Pharmacogenomics and Genetics (N.C., N.-T.A.) and Stroke Genomics and Genetics (E.M.), Fundació Docència i Recerca Mútua Terrassa; Department of Neuroscience (A.D.), Hospital Germans Trias i Pujol; Stroke Unit (E.L.-C.), Hospital Universitario Central de Asturias; Stroke Unit (M.R., C.A.M.), Hospital Universitari Vall d'Hebron; Stroke Unit, Hospital Universitari Vall d'Hebron; Department of Neurology (E.G.-S., C.S.-T., M.M.-C., J.J.-C., J.R.), Neurovascular Research Group, IMIM-Hospital del Mar; Neurobiology Laboratory (C.V.-B.), Institut d'Investigacio Sanitaria de Palma; Department of Neurology (R.D.N.), Hospital Universitari Son Espases; Department of Neurology (V.O.), Hospital Clínic i Provincial de Barcelona; Department of Neurology (J.F.A.), Hospital Clínico Universitario, University of Valladolid; Department of Neurology (T.S.) and Experimental Research Unit (G.S.-H.), Hospital Universitario de Albacete; Department of Neurology (J.M.-F.), Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau; Department of Neurology (M.F.), Hospital de Basurto; Department of Neurology (J.A.C.), Virgen del Rocío & Macarena Hospitals, IBIS, Spain; Department of Clinical Neuroscience/Neurology (T.T.), Sahlgrenska Academy at University of Gothenburg and Sahlgrenska University Hospital, Sweden; Division of Emergency Medicine (L.H.), Department of Psychiatry (L.I., C.C.), and Department of Neurology (J.-M.L.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (D.S.), Helsinki University Hospital, Finland; Department of Neurology (J.M.), Virgen del Rocío & Macarena Hospitals, IBIS. Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona; and Stroke Pharmacogenomics and Genetics (I.F.-C.), Fundació Docència i Recerca Mútua Terrassa, Hospital Universitari Mútua de Terrassa, Stroke Pharmacogenomics and Genetics, IIB-Sant Pau, Spain.
| | | |
Collapse
|
12
|
Arranz MJ, Gonzalez-Rodriguez A, Perez-Blanco J, Penadés R, Gutierrez B, Ibañez L, Arias B, Brunet M, Cervilla J, Salazar J, Catalan R. A pharmacogenetic intervention for the improvement of the safety profile of antipsychotic treatments. Transl Psychiatry 2019; 9:177. [PMID: 31346157 PMCID: PMC6658489 DOI: 10.1038/s41398-019-0511-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 05/09/2019] [Accepted: 05/31/2019] [Indexed: 12/24/2022] Open
Abstract
Antipsychotic drugs fail to achieve adequate response in 30-50% of treated patients and about 50% of them develop severe and lasting side effects. Treatment failure results in poorer prognosis with devastating repercussions for the patients, carers and broader society. Our study evaluated the clinical benefits of a pharmacogenetic intervention for the personalisation of antipsychotic treatment. Pharmacogenetic information in key CYP polymorphisms was used to adjust clinical doses in a group of patients who started or switched treatment with antipsychotic drugs (PharmG+, N = 123), and their results were compared with those of a group of patients treated following existing clinical guides (PharmG-, N = 167). There was no evidence of significant differences in side effects between the two arms. Although patients who had their antipsychotic dose adjusted according to CYPs polymorphisms (PharmG+) had a bigger reduction in side effects than those treated as usual (PharmG-), the difference was not statistically significant (p > 0.05 for all comparisons). However, PharmG+ patients treated with CYP2D6 substrates that were carriers of CYP2D6 UMs or PMs variants showed a significantly higher improvement in global, psychic and other UKU side effects than PharmG- patients (p = 0.02, p = 0.05 and p = 0.01, respectively). PharmG+ clozapine treated patients with CYP1A2 or CYP2C19 UM and PMs variants also showed higher reductions in UKU scores than PharmG- clozapine patients in general. However, those differences were not statistically significant. Pharmacogenetic interventions may improve the safety of antipsychotic treatments by reducing associated side effects. This intervention may be particularly useful when considering treatment with antipsychotics with one major metabolic pathway, and therefore more susceptible to be affected by functional variants of CYP enzymes.
Collapse
Affiliation(s)
- Maria J. Arranz
- 0000 0004 1794 4956grid.414875.bFundació Docència i Recerca Mútua Terrassa, Terrassa, Spain ,Centro de Investigación en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Alex Gonzalez-Rodriguez
- 0000 0000 9238 6887grid.428313.fDepartment of Mental Health, Parc Taulí University Hospital Sabadell, Barcelona, Spain
| | - Josefina Perez-Blanco
- Centro de Investigación en Red de Salud Mental, CIBERSAM, Madrid, Spain ,0000 0004 1768 8905grid.413396.aDepartment of Psychiatry, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Rafael Penadés
- Centro de Investigación en Red de Salud Mental, CIBERSAM, Madrid, Spain ,Barcelona Clinic Schizophrenia Unit (BCSU), Neurosciences Institute, Hospital Clinic of Barcelona, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Blanca Gutierrez
- 0000000121678994grid.4489.1Department of Psychiatry, University of Granada, Granada, Spain
| | - Laura Ibañez
- 0000 0004 1794 4956grid.414875.bFundació Docència i Recerca Mútua Terrassa, Terrassa, Spain
| | - Barbara Arias
- Centro de Investigación en Red de Salud Mental, CIBERSAM, Madrid, Spain ,0000 0004 1937 0247grid.5841.8Department of Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Spain
| | - Mercè Brunet
- 0000 0000 9635 9413grid.410458.cPharmacology and Toxicology Unit, Department of Biochemistry and Molecular Genetics, Hospital Clinic, Barcelona, Spain
| | - Jorge Cervilla
- 0000000121678994grid.4489.1Department of Psychiatry, University of Granada, Granada, Spain
| | - Juliana Salazar
- 0000 0004 1768 8905grid.413396.aGenetics Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Rosa Catalan
- Centro de Investigación en Red de Salud Mental, CIBERSAM, Madrid, Spain. .,Barcelona Clinic Schizophrenia Unit (BCSU), Neurosciences Institute, Hospital Clinic of Barcelona, University of Barcelona, IDIBAPS, Barcelona, Spain.
| |
Collapse
|
13
|
Fernández MV, Budde J, Del-Aguila JL, Ibañez L, Deming Y, Harari O, Norton J, Morris JC, Goate AM, Cruchaga C. Evaluation of Gene-Based Family-Based Methods to Detect Novel Genes Associated With Familial Late Onset Alzheimer Disease. Front Neurosci 2018; 12:209. [PMID: 29670507 PMCID: PMC5893779 DOI: 10.3389/fnins.2018.00209] [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] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Accepted: 03/15/2018] [Indexed: 12/22/2022] Open
Abstract
Gene-based tests to study the combined effect of rare variants on a particular phenotype have been widely developed for case-control studies, but their evolution and adaptation for family-based studies, especially studies of complex incomplete families, has been slower. In this study, we have performed a practical examination of all the latest gene-based methods available for family-based study designs using both simulated and real datasets. We examined the performance of several collapsing, variance-component, and transmission disequilibrium tests across eight different software packages and 22 models utilizing a cohort of 285 families (N = 1,235) with late-onset Alzheimer disease (LOAD). After a thorough examination of each of these tests, we propose a methodological approach to identify, with high confidence, genes associated with the tested phenotype and we provide recommendations to select the best software and model for family-based gene-based analyses. Additionally, in our dataset, we identified PTK2B, a GWAS candidate gene for sporadic AD, along with six novel genes (CHRD, CLCN2, HDLBP, CPAMD8, NLRP9, and MAS1L) as candidate genes for familial LOAD.
Collapse
Affiliation(s)
- Maria V. Fernández
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, United States
| | - John Budde
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, United States
| | - Jorge L. Del-Aguila
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, United States
| | - Laura Ibañez
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, United States
| | - Yuetiva Deming
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, United States
| | - Oscar Harari
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, United States
| | - Joanne Norton
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, United States
| | - John C. Morris
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, United States
- Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, MO, United States
| | - Alison M. Goate
- Department of Neuroscience, Ronald M. Loeb Center for Alzheimer's Disease, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | | | | | - Carlos Cruchaga
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, United States
| |
Collapse
|
14
|
Sangil A, Arranz MJ, Güerri-Fernández R, Pérez M, Monzón H, Payeras A, Andrés M, Torviso J, Ibañez L, Garau J, Calbo E. Genetic susceptibility to invasive pneumococcal disease. Infect Genet Evol 2018; 59:126-131. [PMID: 29407193 DOI: 10.1016/j.meegid.2018.01.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 01/11/2018] [Accepted: 01/26/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND The pathogenesis of IPD remains unknown, especially among middle-aged individuals without risk factors (WRF). OBJECTIVES The aim of the present study was to investigate the role of single nucleotide polymorphisms (SNP) within key genes involved in innate immune response on IPD susceptibility. METHODS Forty-three SNPs within 10 immunological genes were investigated in a cohort of 144 Caucasian IPD patients and 280 ethnically matched controls. RESULTS The allele distribution of the NFKBIA rs1050851 and NFKBIE rs2282151 variants were associated with IPD susceptibility (χ2 = 4.23, p = 0.04 and χ2 = 5.13, p = 0.02, respectively). Additionally, the genotype distribution of NFKBIZ rs645781 (χ2 = 8.25, p = 0.02) and IL1R1 rs3917254 (χ2 = 6.70, p = 0.04) were also associated with IPD risk. When only IPD-WRF patients were considered; the allele distribution of IL1R1 rs2160227 (χ2 = 5.62, p = 0.03), rs13020778 (χ2 = 5.73, p = 0.02), rs3917267 (χ2 = 3.72, p = 0.05) and IL4 rs2227284 (χ2 = 3.76, p = 0.05) and the genotype distribution of IL10 rs3024509 (χ2 = 7.70, p = 0.02), IL1R1 rs3917254 (χ2 = 13.40, p = 0.001), NFKBIZ rs645781 (χ2 = 13.86, p = 0.001) and rs677011 (χ2 = 9.06, p = 0.01) variants were associated with IPD risk. CONCLUSIONS We found several associations between variants in the IL1R1, IL4, IL10, NFKBIE, NFKBIA, and NFKBIZ genes and risk of IPD. If validated, these biomarkers may help to identify people with higher risk of IPD.
Collapse
Affiliation(s)
- Anna Sangil
- Hospital Universitari Mutua Terrassa, Terrassa, Spain; Universitat Internacional de Catalunya, Barcelona, Spain
| | - María J Arranz
- Fundació Docència i Recerca Mútua Terrassa, Terrassa, Spain
| | | | - Maite Pérez
- Xerencia de Gestion Integrada de Vigo, Vigo, Spain
| | - Helena Monzón
- Hospital San Joan de Deu de Martorell, Martorell, Spain
| | - Antoni Payeras
- Hospital Universitari Son Llatzer, Palma de Mallorca, Spain
| | | | | | - Laura Ibañez
- Fundació Docència i Recerca Mútua Terrassa, Terrassa, Spain
| | - Javier Garau
- Clínica Rotger QuirónSalud, Palma de Mallorca, Spain
| | - Esther Calbo
- Hospital Universitari Mutua Terrassa, Terrassa, Spain; Universitat Internacional de Catalunya, Barcelona, Spain.
| |
Collapse
|
15
|
Fernández MV, Kim JH, Budde JP, Black K, Medvedeva A, Saef B, Deming Y, Del-Aguila J, Ibañez L, Dube U, Harari O, Norton J, Chasse R, Morris JC, Goate A, Cruchaga C. Analysis of neurodegenerative Mendelian genes in clinically diagnosed Alzheimer Disease. PLoS Genet 2017; 13:e1007045. [PMID: 29091718 PMCID: PMC5683650 DOI: 10.1371/journal.pgen.1007045] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [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: 05/04/2017] [Revised: 11/13/2017] [Accepted: 09/27/2017] [Indexed: 12/12/2022] Open
Abstract
Alzheimer disease (AD), Frontotemporal lobar degeneration (FTD), Amyotrophic lateral sclerosis (ALS) and Parkinson disease (PD) have a certain degree of clinical, pathological and molecular overlap. Previous studies indicate that causative mutations in AD and FTD/ALS genes can be found in clinical familial AD. We examined the presence of causative and low frequency coding variants in the AD, FTD, ALS and PD Mendelian genes, in over 450 families with clinical history of AD and over 11,710 sporadic cases and cognitive normal participants from North America. Known pathogenic mutations were found in 1.05% of the sporadic cases, in 0.69% of the cognitively normal participants and in 4.22% of the families. A trend towards enrichment, albeit non-significant, was observed for most AD, FTD and PD genes. Only PSEN1 and PINK1 showed consistent association with AD cases when we used ExAC as the control population. These results suggest that current study designs may contain heterogeneity and contamination of the control population, and that current statistical methods for the discovery of novel genes with real pathogenic variants in complex late onset diseases may be inadequate or underpowered to identify genes carrying pathogenic mutations.
Collapse
Affiliation(s)
- Maria Victoria Fernández
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States of America
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, United States of America
| | - Jong Hun Kim
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States of America
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, United States of America
- Department of Neurology, Dementia Center, Ilsan hospital, National Health Insurance Service, Goyang, South Korea
| | - John P. Budde
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States of America
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, United States of America
| | - Kathleen Black
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States of America
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, United States of America
| | - Alexandra Medvedeva
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States of America
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, United States of America
| | - Ben Saef
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States of America
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, United States of America
| | - Yuetiva Deming
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States of America
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, United States of America
| | - Jorge Del-Aguila
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States of America
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, United States of America
| | - Laura Ibañez
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States of America
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, United States of America
| | - Umber Dube
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States of America
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, United States of America
- Medical Scientist Training Program, Division of Biology and Biomedical sciences, School of Medicine, Washington University in Saint Louis, St. Louis, MO, United States of America
| | - Oscar Harari
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States of America
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, United States of America
| | - Joanne Norton
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States of America
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, United States of America
| | - Rachel Chasse
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States of America
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, United States of America
| | - John C. Morris
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, United States of America
- Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, MO, United States of America
| | - Alison Goate
- Ronald M. Loeb Center for Alzheimer’s disease, Dept of Neuroscience, Icahn School of Medicine at Mount Sinai, ICAHN 10–52, New York, NY, United States of America
| | | | | | - Carlos Cruchaga
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States of America
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, United States of America
- * E-mail:
| |
Collapse
|
16
|
Huang KL, Marcora E, Pimenova AA, Di Narzo AF, Kapoor M, Jin SC, Harari O, Bertelsen S, Fairfax BP, Czajkowski J, Chouraki V, Grenier-Boley B, Bellenguez C, Deming Y, McKenzie A, Raj T, Renton AE, Budde J, Smith A, Fitzpatrick A, Bis JC, DeStefano A, Adams HHH, Ikram MA, van der Lee S, Del-Aguila JL, Fernandez MV, Ibañez L, Sims R, Escott-Price V, Mayeux R, Haines JL, Farrer LA, Pericak-Vance MA, Lambert JC, van Duijn C, Launer L, Seshadri S, Williams J, Amouyel P, Schellenberg GD, Zhang B, Borecki I, Kauwe JSK, Cruchaga C, Hao K, Goate AM. A common haplotype lowers PU.1 expression in myeloid cells and delays onset of Alzheimer's disease. Nat Neurosci 2017; 20:1052-1061. [PMID: 28628103 PMCID: PMC5759334 DOI: 10.1038/nn.4587] [Citation(s) in RCA: 257] [Impact Index Per Article: 36.7] [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: 06/30/2016] [Accepted: 05/20/2017] [Indexed: 12/12/2022]
Abstract
A genome-wide survival analysis of 14,406 Alzheimer's disease (AD) cases and 25,849 controls identified eight previously reported AD risk loci and 14 novel loci associated with age at onset. Linkage disequilibrium score regression of 220 cell types implicated the regulation of myeloid gene expression in AD risk. The minor allele of rs1057233 (G), within the previously reported CELF1 AD risk locus, showed association with delayed AD onset and lower expression of SPI1 in monocytes and macrophages. SPI1 encodes PU.1, a transcription factor critical for myeloid cell development and function. AD heritability was enriched within the PU.1 cistrome, implicating a myeloid PU.1 target gene network in AD. Finally, experimentally altered PU.1 levels affected the expression of mouse orthologs of many AD risk genes and the phagocytic activity of mouse microglial cells. Our results suggest that lower SPI1 expression reduces AD risk by regulating myeloid gene expression and cell function.
Collapse
Affiliation(s)
- Kuan-lin Huang
- Department of Medicine, Washington University in St. Louis, Saint
Louis, MO, USA
- Department of McDonnell Genome Institute, Washington University in
St. Louis, Saint Louis, MO, USA
| | - Edoardo Marcora
- Department of Genetics and Genomic Sciences, Icahn School of
Medicine at Mount Sinai, New York, NY, USA
- Department of Ronald M. Loeb Center for Alzheimer’s disease,
Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY,
USA
| | - Anna A Pimenova
- Department of Ronald M. Loeb Center for Alzheimer’s disease,
Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY,
USA
| | - Antonio F Di Narzo
- Department of Genetics and Genomic Sciences, Icahn School of
Medicine at Mount Sinai, New York, NY, USA
| | - Manav Kapoor
- Department of Genetics and Genomic Sciences, Icahn School of
Medicine at Mount Sinai, New York, NY, USA
- Department of Ronald M. Loeb Center for Alzheimer’s disease,
Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY,
USA
| | - Sheng Chih Jin
- Department of Genetics, Yale University School of Medicine, New
Haven, CT, USA
| | - Oscar Harari
- Department of Psychiatry, Washington University in St. Louis, Saint
Louis, MO, USA
| | - Sarah Bertelsen
- Department of Ronald M. Loeb Center for Alzheimer’s disease,
Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY,
USA
| | - Benjamin P Fairfax
- Wellcome Trust Centre for Human Genetics, Nuffield Department of
Medicine, University of Oxford, Oxford, United Kingdom
| | - Jake Czajkowski
- Department of Genetics, Washington University in St. Louis, Saint
Louis, MO, USA
| | - Vincent Chouraki
- Department of Neurology, Boston University School of Medicine,
Boston, MA, USA
| | - Benjamin Grenier-Boley
- Inserm, U1167, RID-AGE –Risk factors and molecular
determinants of aging-related diseases, F-59000 Lille, France
- Univ. Lille - Excellence laboratory Labex DISTALZ, F-59000 Lille,
France
- Institut Pasteur de Lille, F-59000 Lille, France
| | - Céline Bellenguez
- Inserm, U1167, RID-AGE –Risk factors and molecular
determinants of aging-related diseases, F-59000 Lille, France
- Univ. Lille - Excellence laboratory Labex DISTALZ, F-59000 Lille,
France
- Institut Pasteur de Lille, F-59000 Lille, France
| | - Yuetiva Deming
- Department of Psychiatry, Washington University in St. Louis, Saint
Louis, MO, USA
| | - Andrew McKenzie
- Department of Genetics and Genomic Sciences, Icahn School of
Medicine at Mount Sinai, New York, NY, USA
| | - Towfique Raj
- Department of Genetics and Genomic Sciences, Icahn School of
Medicine at Mount Sinai, New York, NY, USA
- Department of Ronald M. Loeb Center for Alzheimer’s disease,
Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY,
USA
| | - Alan E Renton
- Department of Ronald M. Loeb Center for Alzheimer’s disease,
Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY,
USA
| | - John Budde
- Department of Psychiatry, Washington University in St. Louis, Saint
Louis, MO, USA
| | | | - Annette Fitzpatrick
- Department of Epidemiology, University of Washington, Seattle,
Washington, USA
| | - Joshua C Bis
- Department of Medicine, University of Washington, Seattle,
Washington, USA
| | - Anita DeStefano
- Department of Biostatistics, Boston University School of Public
Health, Boston, MA, USA
| | - Hieab HH Adams
- Department of Epidemiology, Erasmus University Medical Center,
Rotterdam, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus University Medical Center,
Rotterdam, The Netherlands
| | - Sven van der Lee
- Department of Epidemiology, Erasmus University Medical Center,
Rotterdam, The Netherlands
| | - Jorge L. Del-Aguila
- Department of Psychiatry, Washington University in St. Louis, Saint
Louis, MO, USA
| | | | - Laura Ibañez
- Department of Psychiatry, Washington University in St. Louis, Saint
Louis, MO, USA
| | | | | | - Rebecca Sims
- Psychological Medicine and Clinical Neurosciences, Medical Research
Council (MRC) Centre for Neuropsychiatric Genetics and Genomics, Cardiff University,
Cardiff, UK
| | - Valentina Escott-Price
- Psychological Medicine and Clinical Neurosciences, Medical Research
Council (MRC) Centre for Neuropsychiatric Genetics and Genomics, Cardiff University,
Cardiff, UK
| | - Richard Mayeux
- Taub Institute on Alzheimer’s Disease and the Aging Brain,
Columbia University, New York, NY, USA
- Gertrude H. Sergievsky Center, Columbia University, New York, NY,
USA
- Department of Neurology, Columbia University, New York, NY,
USA
| | - Jonathan L Haines
- Department of Epidemiology and Biostatistics, Case Western Reserve
University, Cleveland, OH, USA; Department of Ophthalmology, Boston University
School of Medicine, Boston, MA, USA
| | - Lindsay A Farrer
- Institut Pasteur de Lille, F-59000 Lille, France
- Department of Biostatistics, Boston University School of Public
Health, Boston, MA, USA
- Department of Medicine (Biomedical Genetics), Boston University
School of Medicine, Boston, MA, USA
- Department of Epidemiology, Boston University School of Public
Health, Boston, MA, USA
- The John P. Hussman Institute for Human Genomics, University of
Miami, Miami, FL, USA
| | - Margaret A. Pericak-Vance
- The John P. Hussman Institute for Human Genomics, University of
Miami, Miami, FL, USA
- Macdonald Foundation Department of Human Genetics, University of
Miami, Miami, FL, USA
| | - Jean Charles Lambert
- Inserm, U1167, RID-AGE –Risk factors and molecular
determinants of aging-related diseases, F-59000 Lille, France
- Univ. Lille - Excellence laboratory Labex DISTALZ, F-59000 Lille,
France
- Institut Pasteur de Lille, F-59000 Lille, France
| | - Cornelia van Duijn
- Department of Epidemiology, Erasmus University Medical Center,
Rotterdam, The Netherlands
| | - Lenore Launer
- Laboratory of Epidemiology and Population Sciences, National
Institute on Aging, Bethesda, Maryland, USA
| | - Sudha Seshadri
- Department of Neurology, Boston University School of Medicine,
Boston, MA, USA
| | - Julie Williams
- Psychological Medicine and Clinical Neurosciences, Medical Research
Council (MRC) Centre for Neuropsychiatric Genetics and Genomics, Cardiff University,
Cardiff, UK
| | - Philippe Amouyel
- Inserm, U1167, RID-AGE –Risk factors and molecular
determinants of aging-related diseases, F-59000 Lille, France
- Univ. Lille - Excellence laboratory Labex DISTALZ, F-59000 Lille,
France
- Institut Pasteur de Lille, F-59000 Lille, France
- Centre Hospitalier Universitaire de Lille, U1167, F-59000 Lille,
France
| | - Gerard D Schellenberg
- Department of Pathology and Laboratory Medicine, University of
Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Bin Zhang
- Department of Genetics and Genomic Sciences, Icahn School of
Medicine at Mount Sinai, New York, NY, USA
| | | | - John S K Kauwe
- Department of Biology, Brigham Young University, Provo, Utah,
USA
| | - Carlos Cruchaga
- Department of Psychiatry, Washington University in St. Louis, Saint
Louis, MO, USA
| | - Ke Hao
- Department of Genetics and Genomic Sciences, Icahn School of
Medicine at Mount Sinai, New York, NY, USA
| | - Alison M Goate
- Department of Genetics and Genomic Sciences, Icahn School of
Medicine at Mount Sinai, New York, NY, USA
- Department of Ronald M. Loeb Center for Alzheimer’s disease,
Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY,
USA
| |
Collapse
|
17
|
Carreras-Badosa G, Prats-Puig A, Diaz-Roldan F, Platero-Gutierrez E, Osiniri I, Riera-Perez E, de Zegher F, Ibañez L, Bassols J, López-Bermejo A. The macrophage activation product sCD163 is associated with a less favourable metabolic profile in prepubertal children. Pediatr Obes 2016; 11:543-550. [PMID: 26843034 DOI: 10.1111/ijpo.12104] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 12/10/2015] [Accepted: 12/16/2015] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Macrophages are known to be involved in low-grade inflammatory processes such as obesity. soluble cluster of differentiation 163 (sCD163) is shed from the cell surface as specific macrophage activation marker. In prepubertal children, we studied if circulating sCD163 is associated with metabolic and cardiovascular risk markers. METHODS A population of 236 school-aged Caucasian children (111 girls and 125 boys) aged 8 ± 1 year [81 normal weight (body mass index [BMI]-SDS < 1); 74 overweight (1 ≤ BMI-standard deviation score [SDS] < 2) and 81 with obesity (BMI-SDS ≥ 2)] were studied. BMI, waist circumference, fat mass and visceral fat were measured. Fasting serum sCD163, homeostatic model assessment of insulin resistance, high sensitivity C-reactive protein, gamma-glutamyl transpeptidase and lipids were quantified. RESULTS Circulating sCD163 concentrations were higher in children with obesity (p < 0.0001). Associations were observed between circulating sCD163 and a less favourable metabolic profile as judged by higher waist circumference, fat mass, visceral fat, epicardial fat, homeostatic model assessment of insulin resistance, high sensitivity C-reactive protein, gamma-glutamyl transpeptidase and triglycerides (all between r = 0.173 and r = 0.363; p < 0.05 to p < 0.0001) and lower high-density lipoprotein-cholesterol (r = -0.285, p < 0.0001). In multiple regression analyses, circulating sCD163 was independently associated with HOMA-IR (β = 0.162, p = 0.016; model R2 = 0.179) and high density lipoprotein-cholesterol/triglycerides ratio (β = -0.167, p = 0.012; model R2 = 0.209). CONCLUSIONS Childhood obesity may increase the risk of developing metabolic diseases later in life through chronic macrophage activation having deleterious effects on metabolism.
Collapse
Affiliation(s)
| | - A Prats-Puig
- Girona Institute for Biomedical Research, Girona, Spain.,EUSES University School, Girona, Spain
| | - F Diaz-Roldan
- Girona Institute for Biomedical Research, Girona, Spain.,Dr Josep Trueta Hospital, Girona, Spain
| | - E Platero-Gutierrez
- Girona Institute for Biomedical Research, Girona, Spain.,Dr Josep Trueta Hospital, Girona, Spain
| | - I Osiniri
- Salut Empordà Foundation, Figueres, Spain
| | | | | | - L Ibañez
- Sant Joan de Déu Children's Hospital, Barcelona, Spain.,CIBERDEM, Madrid, Spain
| | - J Bassols
- Girona Institute for Biomedical Research, Girona, Spain
| | - A López-Bermejo
- Girona Institute for Biomedical Research, Girona, Spain.,Dr Josep Trueta Hospital, Girona, Spain
| |
Collapse
|
18
|
Cabrera C, Arranz M, Calnge MS, Salas A, Tarroch X, Ibañez L, Garcia A, Jimenez SG, Campayo M, Cirera L. Genetic influence of EGFR-PI3K-mTOR pathway and other loci in triple-negative breast cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw363.57] [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: 11/14/2022] Open
|
19
|
Diez-Itza I, Arrue M, Ibañez L, Paredes J, Murgiondo A, Sarasqueta C. Influence of Mode of Delivery on Pelvic Organ Support 6 Months Postpartum. Gynecol Obstet Invest 2011; 72:123-9. [DOI: 10.1159/000323682] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2010] [Accepted: 12/01/2010] [Indexed: 01/17/2023]
|
20
|
Del Rio L, Di Gregorio S, Ibañez L, Ergun D, Rosales J, Bonell E, Sole C, Garcia M. Pediatric assessment with the Lunar iDXA. J Clin Densitom 2007. [DOI: 10.1016/j.jocd.2007.03.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
21
|
Abstract
OBJECTIVE To determine the frequency of mutant alleles in the CYP21 gene in Spanish girls presenting with precocious pubarche (PP) and to assess the relationships between genotype and endocrine-metabolic variables. DESIGN Fifty-three unrelated girls with a history of PP (14 prepubertal, 8 pubertal and 31 postmenarcheal) and 35 controls were studied. METHODS Genomic DNA was extracted from peripheral blood leukocytes. After selection against the pseudogen, an allele-specific PCR was used to identify 14 known mutations in the CYP21 gene. The mutations studied were Pro30Leu, splice intron 2, Ilel72Asn, Cluster E(6), Glyl92Ser, Ins T, GT-CT, Gln318-stop, Arg357Trp, Trp406-stop, Pro453Ser, Arg483Pro, Arg483 frameshift and Val281Leu. A standard 2-h oral glucose tolerance test was performed in all PP girls. Ovarian 17-hydroxyprogesterone (17-OHP) responses to gonadotrophin-releasing hormone-agonist stimulation was assessed in postmenarcheal PP girls. RESULTS Thirteen PP girls and eight control girls were heterozygous for one of the mutations studied. The frequency of the carrier status was 25% and 23% in the PP and control groups respectively. Severe mutations were found in 33% of the carrier girls. Serum 17-OHP responses to ACTH stimulation were similar in carriers and non-carriers (351+/-65 vs 334+/-22 ng/dl). The presence of ovarian hyperandrogenism and/or hyperinsulinism was also not related to the carrier status. CONCLUSION The incidence of molecular defects in the CYP21 gene in the present study was comparable in the PP and control groups. We found no relationship between the presence of carrier status and endocrine-metabolic abnormalities. Prospective studies of larger cohorts of PP girls are needed to ascertain the long-term clinical relevance of CYP21 heterozygosity.
Collapse
Affiliation(s)
- N Potau
- Hormonal Laboratory, Hospital Materno-Infantil Vall d'Hebron, Autonomous University of Barcelona, Barcelona, Spain.
| | | | | | | | | |
Collapse
|
22
|
Lladó L, Figueras J, Ramos E, Baliellas C, Torras J, Rafecas A, Fabregat J, Lama C, Ibañez L, Jaurrieta E. Prospective study of a tacrolimus-based quadruple immunosuppressive regimen: evaluation of safety and efficacy. Transplant Proc 2002; 34:1526-8. [PMID: 12176468 DOI: 10.1016/s0041-1345(02)03005-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- L Lladó
- Liver Transplantation Unit, CSU. Bellvitge, c/Feixa Llarga s/n, 09807 Hospitale L1, Barcelona, Spain
| | | | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Busquets J, Serrano T, Figueras J, Ramos E, Torras J, Rafecas A, Fabregat J, Xiol X, Lama C, Ibañez L, Jaurrieta E. Influence of donor postreperfusion changes on graft evolution after liver transplant. Transplant Proc 2002; 34:252-3. [PMID: 11959270 DOI: 10.1016/s0041-1345(01)02748-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- J Busquets
- Department of Surgery, Liver Transplant Unit, CSU Bellvitge, Barcelona, Spain
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Figueras J, Ibañez L, Ramos E, Jaurrieta E, Ortiz-de-Urbina J, Pardo F, Mir J, Loinaz C, Herrera L, López-Cillero P, Santoyo J. Selection criteria for liver transplantation in early-stage hepatocellular carcinoma with cirrhosis: results of a multicenter study. Liver Transpl 2001; 7:877-83. [PMID: 11679986 DOI: 10.1053/jlts.2001.27856] [Citation(s) in RCA: 127] [Impact Index Per Article: 5.5] [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] [Indexed: 02/07/2023]
Abstract
Orthotopic liver transplantation (OLT) offers the only chance to eliminate both tumor and liver disease in patients with hepatocellular carcinoma (HCC) and cirrhosis. However, tumor progression while on the waiting list and recurrence after OLT are frequent. We undertook a large multicenter study to assess survival and related factors of recurrence after OLT. This retrospective study analyses data from 307 consecutive patients with HCC and cirrhosis treated with OLT between 1990 and 1997 in eight centers in Spain. OLT was indicated only for small (<5 cm) localized tumors. Five-year rates after OLT were 63% for survival, 58% for disease-free survival, and 21% for recurrence. Tumor diameter larger than 5 cm was associated with other tumor characteristics that were significant indicators of poor outcome (absence of capsule, three or more nodules, bilobularity, satellite nodules, and vascular invasion). However, in multivariate analysis, alpha fetoprotein (AFP) levels greater than 300 ng/mL (P = .04; P = .02) and macroscopic vascular invasion (P = .01; P = .0001) were the only factors independently associated with mortality and recurrence, respectively. OLT is indicated in patients with small HCCs who have low AFP levels and no macroscopic vascular invasion or extrahepatic disease. By increasing our ability for preoperative tumor imaging, we will achieve better selection of patients with HCC before OLT.
Collapse
Affiliation(s)
- J Figueras
- Ciudad Sanitaria y Universitaria (CSU) Bellvitge, Barcelona, Spain.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Busquets J, Xiol X, Figueras J, Jaurrieta E, Torras J, Ramos E, Rafecas A, Fabregat J, Lama C, Ibañez L, Llado L, Ramon JM. The impact of donor age on liver transplantation: influence of donor age on early liver function and on subsequent patient and graft survival. Transplantation 2001; 71:1765-71. [PMID: 11455256 DOI: 10.1097/00007890-200106270-00011] [Citation(s) in RCA: 131] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND The urgent need to increase the organ donor pool has led to the expansion of criteria for donor selection. The aim of this study was to analyze the influence of donor age on early graft function, subsequent graft loss, and mortality after liver transplantation (LT). METHODS Data on LT were evaluated retrospectively in a population-based cohort of 400 LTs in 348 patients. Of these, 21 (5%) were from donors >70 years old. Pretransplantation donor and recipient characteristics and the evolution of recipients were analyzed. The influence of donor age as a risk factor was assessed using univariate and multivariate analyses. RESULTS Actuarial graft survival was 89% at 1 month after LT, 81% after 6 months, and 59% after 60 months. Multivariate analysis demonstrated that only donor age (>70 years old) was associated with a higher risk of long-term graft loss (relative risk [RR]=1.4, 95% confidence interval [CI]=1-1.9; P=0.03) and mortality (RR=1.7, 95% CI=1.2-2.3; P=0.01). Graft survival of septuagenarian livers was 80% at 1 month after LT, 56% after 6 months, and 25% after 54 months. Actuarial survival analysis (Kaplan-Meier curves) also demonstrated worse evolution in recipients of livers from old donors (log-rank test, P<0.001). CONCLUSIONS Advanced donor age is associated with lower graft and recipient survival.
Collapse
Affiliation(s)
- J Busquets
- Department of Surgery, Hospital Princeps d'Espanya, C/Feixa llarga s/n, 08907 Hospitalet de Llobregat, Barcelona, Spain
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Moran C, Azziz R, Carmina E, Dewailly D, Fruzzetti F, Ibañez L, Knochenhauer ES, Marcondes JA, Mendonca BB, Pignatelli D, Pugeat M, Rohmer V, Speiser PW, Witchel SF. 21-Hydroxylase-deficient nonclassic adrenal hyperplasia is a progressive disorder: a multicenter study. Am J Obstet Gynecol 2000; 183:1468-74. [PMID: 11120512 DOI: 10.1067/mob.2000.108020] [Citation(s) in RCA: 110] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Our aim was to determine whether the clinical features of 21-hydroxylase-deficient nonclassic adrenal hyperplasia are correlated with either age at symptom onset or age at presentation, or both, and with the degree of adrenocortical abnormality. STUDY DESIGN In a multicenter cohort design 220 women with nonclassic adrenal hyperplasia, with a basal or adrenocorticotropic hormone-stimulated 17-hydroxyprogesterone level >30.3 nmol/L, were studied, either prospectively (n = 39) or retrospectively (n = 181). Patients were stratified by age of presentation into 5 groups: (1) <10 years (n = 25), (2) 10 to 19 years (n = 64), (3) 20 to 29 years (n = 83), (4) 30 to 39 years (n = 30), and (5) 40 to 49 years (n = 16). Two patients >50 years old were excluded from the analysis because of age. RESULTS Ninety-two percent of patients <10 years old had premature pubarche at presentation, whereas clitoromegaly and acne were each present in only 20% of these younger subjects. With only patients > or =10 years old considered, presenting clinical features included hirsutism (59%), oligomenorrhea (54%), acne (33%), infertility (13%), clitoromegaly (10%), alopecia (8%), primary amenorrhea (4%), and premature pubarche (4%). Among the patients >/=10 years old, the prevalence but not the degree of hirsutism increased significantly with age. Basal levels of 17-hydroxyprogesterone in adolescents were significantly higher than the levels found either in children (<10 years old) or women 40 to 49 years old (P <.01 and P <.03, respectively), although no difference was noted in the stimulated 17-hydroxyprogesterone levels between age groups. The adrenocorticotropic hormone-stimulated levels but not the basal levels of 17-hydroxyprogesterone were significantly higher in patients with clitoromegaly than in women without clitoromegaly. Alternatively, there were no differences in either basal or stimulated 17-hydroxyprogesterone levels between patients with and those without hirsutism, acne, or alopecia. CONCLUSION In children <10 years old the most common presenting complaint was premature pubarche, whereas hirsutism and oligomenorrhea were more common in older patients. The prevalence of hirsutism increased with age, suggesting the progressive nature of nonclassic adrenal hyperplasia. Furthermore, the adrenocorticotropic hormone-stimulated levels of 17-hydroxyprogesterone were higher in patients with clitoromegaly, which suggests that the degree of adrenocortical dysfunction in nonclassic adrenal hyperplasia determines, at least in part, the clinical presentation.
Collapse
Affiliation(s)
- C Moran
- Departments of Obstetrics and Gynecology, The University of Alabama at Birmingham, 35249-7333, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Abstract
BACKGROUND/AIM The extent of gastric resection and the role of lymphadenectomy in the treatment of gastric cancer are controversial. METHODS This study evaluates the results of radical gastric resection (D2 lymphadenectomy) in 375 patients with a gastric carcinoma operated according to a prospective protocol. RESULTS Total gastrectomy was performed in 196 and a subtotal gastrectomy in 179 patients, with an operative mortality of 3.5 and 2.8%. The presence of lymph node metastasis was related to the depth of the tumor in the gastric wall. The cumulative 5-year survival was dependent on the depth of tumoral invasion in the gastric wall and also on the presence of lymphatic metastasis. Curative resection had a significantly better 5-year survival (72%) than noncurative resection (26%). CONCLUSION Although it is difficult to prove the benefits of extended lymphadenectomy in the surgical treatment of gastric carcinoma, the results of these series seem to support its usefulness.
Collapse
Affiliation(s)
- O Llanos
- Department of Digestive Surgery, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | | | | | | |
Collapse
|
28
|
Figueras J, Ramos E, Ibañez L, Rafecas A, Fabregat J, Torras J, Lama C, Ruiz D, Moreno G, Arteche N, Jaurrieta E. Comparative study of survival after liver transplantation in cirrhotic patients with and without hepatocellular carcinoma. Transplant Proc 1999; 31:2487-8. [PMID: 10500683 DOI: 10.1016/s0041-1345(99)00430-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- J Figueras
- Liver Transplant Unit, C.S.U. Bellvitge, University of Barcelona, Spain
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Figueras J, Ramos E, Ibañez L, Rafecas A, Fabregat J, Torras J, Lama C, Ruiz D, Moreno G, Arteche N, Jaurrieta E. Surgical treatment of hepatocellular carcinoma in cirrhotic and noncirrhotic patients. Transplant Proc 1999; 31:2455-6. [PMID: 10500668 DOI: 10.1016/s0041-1345(99)00415-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- J Figueras
- Liver Transplant Unit, C.S.U. Bellvitge, University of Barcelona, Spain
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Machuca I, Ibañez L, Bonnín MR, Rosel P, Arranz B, Navarro MA. Routine detection of point mutations in non-classic steroid 21-hydroxylase. Int J Clin Lab Res 1998; 27:257-60. [PMID: 9580211 DOI: 10.1007/bf02912468] [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: 02/07/2023]
Affiliation(s)
- I Machuca
- Department of Biochemistry, Ciutat Sanitària i Universitària de Bellvitge, Barcelona, Spain
| | | | | | | | | | | |
Collapse
|
31
|
Abstract
Using a simple and standardized method we estimated both insulin secretion and insulin sensitivity in peripheral tissues in relation to Tanner pubertal stages. Early insulin response, mean blood glucose (MBG), mean serum insulin (MSI), glucose uptake rate in peripheral tissues and insulin sensitivity index (SI) in response to the standard oral glucose tolerance test were evaluated in 73 normal girls. Study subjects were divided into 4 groups: group 1 (Tanner stage I, n = 20); group 2 (Tanner stage II, n = 14); group 3 (Tanner stages III and IV, n = 15), and group 4 (Tanner stage V, n = 24). Steroid levels and insulin-like growth factors were determined to characterize clinical pubertal development. MBG was similar in all groups but MSI increased at stage II and retained similar values throughout puberty, with those of group I being statistically lower than in the other groups (p < 0.001). When MSI values were adjusted per kilogram of body weight, a significant increase was observed in group II (p < 0.05). The MSI adjusted values were: group 1, 1.0 +/- 0.4; group 2, 1.4 +/- 0.4; group 3, 1.0 +/- 0.3, and group 4, 1.0 +/- 0.4 mU/l/kg. SI values were similar in groups 1 and 2 and significantly lower than in groups 3 and 4 (p < 0.001). Our results confirm both that insulin secretion is related to age and that an insulin-resistant state occurs during puberty. Thus, the insulin-resistant state coincides with Tanner stage II. In conclusion, this mathematical approach is considered to be a simple and reliable method for analyzing the possible alterations in insulin secretion and action in children and adolescents in whom more sophisticated procedures must be limited in this early period of life for ethical reasons.
Collapse
Affiliation(s)
- N Potau
- Hormonal Laboratory, Hospital Materno-Infantil Vall d'Hebron, Autonomous University, Barcelona, Spain
| | | | | | | |
Collapse
|
32
|
Tovar JL, Bujons I, Ruiz JC, Ibañez L, Salgado A. Treatment of severe combined overdose of calcium antagonists and converting enzyme inhibitors with angiotensin II. Nephron Clin Pract 1997; 77:239. [PMID: 9346394 DOI: 10.1159/000190280] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
|
33
|
Figueras J, Jaurrieta E, Valls C, Benasco C, Rafecas A, Xiol X, Fabregat J, Casanovas T, Torras J, Baliellas C, Ibañez L, Moreno P, Casais L. Survival after liver transplantation in cirrhotic patients with and without hepatocellular carcinoma: a comparative study. Hepatology 1997; 25:1485-9. [PMID: 9185772 DOI: 10.1002/hep.510250629] [Citation(s) in RCA: 215] [Impact Index Per Article: 8.0] [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] [Indexed: 02/04/2023]
Abstract
Cumulative recurrence after surgical resection for hepatocellular carcinoma (HCC) is very high. Several retrospective analyses have shown that liver transplantation was more effective than resection for patients with HCC at early tumor stages. Consequently, in January 1990, we decided to prospectively indicate orthotopic liver transplantation (OLT) as the first surgical treatment for small, localized HCC in cirrhotic patients without nodal involvement independently of the degree of liver function. The aim of this prospective cohort study was to analyze prognosis, recurrence rate, and survival after liver transplantation in patients in whom the main indication was HCC with cirrhosis. Thirty-eight patients in whom the main indication for liver transplantation was HCC and hepatic cirrhosis were compared with 136 transplantations because of cirrhosis without tumor, performed in our unit from January 1990 to December 1995. HCC arising in noncirrhotic livers and those incidently discovered after OLT were excluded from the study. Chemoembolization using doxorubicin, lipiodol, and Gelfoam was performed before OLT in 31 patients with good liver function. There were no differences in gender, but HCC patients were older (57 +/- 7 vs. 50 +/- 10 years [P < .001]). Liver function was better in HCC (Child-Pugh score: 6.9 +/- 2 vs. 8.6 +/- 1.8; P < .001), and hepatitis C virus antibody was positive in 31 (82%) vs. 51 (37%) (P < .007). Seven tumors had bilobar involvement (18%). Capsule was present in 22 (58%). The mean size of the tumor was 3.4 +/- 2 cm. Seventeen tumors (45%) were larger than 3 cm, and 4 (11%) were larger than 5 cm. The average number of nodules was 2 +/- 1. The tumor-node-metastasis stage of the tumors was pT1 in 6 patients (16%), 11 were pT2 (29%), 12 were pT3 (31%), and 9 were pT4 (24%). Seven patients were retransplanted in the HCC group (18%) and 19 (14%) in the nontumor group (not significant). Tumor recurrence was detected in three patients (8%). One, 3-, and 5-year survival rates were 82% vs. 79%, 75% vs. 71%, and 63% vs. 68%, respectively, for patients with and without HCC, and no differences were found between the two groups (P = .84). Survival was significantly reduced in patients with a macroscopic vascular invasion and tumors greater than 5 cm in diameter. Recurrence and mortality after liver transplantation in cirrhotic patients with carefully selected HCC are similar to the results in cirrhotic patients without tumor.
Collapse
Affiliation(s)
- J Figueras
- Liver Transplant Unit, C.S.U. Bellvitge, University of Barcelona, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Ibañez L, Hall JE, Potau N, Carrascosa A, Prat N, Taylor AE. Ovarian 17-hydroxyprogesterone hyperresponsiveness to gonadotropin-releasing hormone (GnRH) agonist challenge in women with polycystic ovary syndrome is not mediated by luteinizing hormone hypersecretion: evidence from GnRH agonist and human chorionic gonadotropin stimulation testing. J Clin Endocrinol Metab 1996; 81:4103-7. [PMID: 8923867 DOI: 10.1210/jcem.81.11.8923867] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Women with polycystic ovary syndrome (PCOS: hyperandrogenism and oligomenorrhea) have been shown to have exaggerated ovarian 17-hydroxyprogesterone (17-OHP) responses after GnRH agonist stimulation, suggestive of disordered ovarian cytochrome P450c17 alpha activity. However, most hyperandrogenic women also have an exaggerated LH response to both native GnRH and GnRH agonists. To assess whether the known LH hyperresponsiveness in PCOS patients mediates their exaggerated 17-OHP response to GnRH agonist challenge or whether the 17-OHP response can be duplicated by direct stimulation of the ovary with a fixed amount of hCG, 25 PCOS women [age, 20.6 +/- 1.1 yr; body mass index (BMI), 24.9 +/- 1.3 kg/m2] and 5 controls (age, 29.4 +/- 2.3 yr; BMI, 29.2 +/- 3.0) underwent both GnRH agonist (leuprolide acetate) and hCG testing. In addition, 23 normal women (age, 26.5 +/- 1.5 yr; BMI, 27.2 +/- 1.7 kg/m2) underwent hCG testing, and 21 other normal women (age, 19.3 +/- 0.5 yr; BMI, 23.0 +/- 0.8 kg/m2) underwent leuprolide acetate challenge. Blood was sampled before and 24 h after (the previously determined time of the peak response) leuprolide acetate (500 micrograms, sc) and hCG (5000 IU, im) stimulation tests. The tests were administered during the early follicular phase in women who were ovulatory and in randomized order in the subjects receiving both stimuli. Peak serum 17-OHP levels did not differ between leuprolide acetate or hCG stimulation in PCOS patients or controls when measured at 24 h (324.9 +/- 41.9 vs. 360.4 +/- 54.0 in PCOS; 183.2 +/- 19.6 vs. 141.2 +/- 11 ng/dL in controls). Peak 17-OHP levels after hCG challenge and GnRH agonist stimulation were highly correlated (r = 0.82; P < 0.001) in the subjects receiving both stimuli. Although leuprolide acetate elicited a higher estradiol (E2) response than hCG in all subjects, serum E2 levels increased significantly after hCG treatment in both patients and controls (P < 0.001 and P < 0.0001). The small, but significant, increase in serum E2 after hCG stimulation suggests that a rigid two-cell model of ovarian steroidogenesis may be an oversimplification of in vivo physiology. Our results suggest that exaggerated 17-OHP responses to GnRH agonist stimulation in hyperandrogenic women are not mediated by the known hyperresponsiveness of LH in these patients, but are due to increased ovarian androgen sensitivity to LH stimulation.
Collapse
Affiliation(s)
- L Ibañez
- Adolescent and Endocrinology Unit, Hospital Materno-Infantil Vall d'Hebron, Autonomous University, Barcelona, Spain
| | | | | | | | | | | |
Collapse
|
35
|
Ghizzoni L, Virdis R, Vottero A, Cappa M, Street ME, Zampolli M, Ibañez L, Bernasconi S. Pituitary-ovarian responses to leuprolide acetate testing in patients with congenital adrenal hyperplasia due to 21-hydroxylase deficiency. J Clin Endocrinol Metab 1996; 81:601-6. [PMID: 8636275 DOI: 10.1210/jcem.81.2.8636275] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [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] [Indexed: 02/01/2023]
Abstract
To assess whether patients with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency exhibit a steroidogenic response to GnRH agonist consistent with functional ovarian hyperandrogenism (FOH) and elucidate the relationship between adrenal and ovarian hyperandrogenism, the LH, FSH, estradiol, 17-hydroxyprogesterone (17-OHP), androstenedione, total testosterone, dehydroepiandrosterone, and 17-hydroxypregnenolone responses to a sc dose of leuprolide acetate (500 micrograms) were evaluated in 10 patients with classic CAH (mean age, 18.4 +/- 0.95 yr), 7 of whom had oligomenorrhea, pretreated with dexamethasone (2 mg/day for 5 days, including the day of the test). The results were compared with those obtained in 11 patients with FOH (mean age, 18.7 +/- 0.46 yr) and 17 normal women (mean age, 19.68 +/- 0.59 yr) not pretreated with dexamethasone. Leuprolide acetate stimulation caused a significant augmentation of plasma E2, 17-OHP, androstenedione, testosterone, and 17-hydroxypregnenolone concentrations in all CAH patients. However, in only 6 (60%) of them, all with oligomenorrhea, was the 17-OHP response (posttest minus pretest value) similar to that of FOH patients and significantly higher than that in controls. In this subset of CAH patients, LH plasma levels after stimulation were significantly higher than those of CAH subjects with 17-OHP responses in the normal range, controls, and FOH patients, whereas FSH levels were similar to those of controls. In this latter group, plasma FSH concentrations after stimulation were significantly higher than those in FOH. In conclusion, the results of the present study indicate that LH-dependent functional ovarian hyperandrogenism is frequent in patients with classic CAH. As ovarian hyperandrogenism might be partially responsible for the menstrual irregularities that are common complications in such patients, all classic CAH patients with oligomenorrhea should undergo short term stimulation with GnRH agonists to ascertain the presence of ovarian hyperandrogenism and receive appropriate treatment.
Collapse
Affiliation(s)
- L Ghizzoni
- Department of Pediatrics, University of Parma, Italy
| | | | | | | | | | | | | | | |
Collapse
|
36
|
Ibañez L, Potau N, Virdis R, Zampolli M, Terzi C, Gussinyé M, Carrascosa A, Vicens-Calvet E. Postpubertal outcome in girls diagnosed of premature pubarche during childhood: increased frequency of functional ovarian hyperandrogenism. J Clin Endocrinol Metab 1993; 76:1599-603. [PMID: 8501168 DOI: 10.1210/jcem.76.6.8501168] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.5] [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] [Indexed: 01/31/2023]
Abstract
The postpubertal outcome of a group of girls diagnosed of premature pubarche during childhood was assessed 1) to determine the incidence of functional ovarian hyperandrogenism (FOH) through the ovarian-steroidogenic response to the GnRH agonist leuprolide acetate, 2) to validate leuprolide acetate stimulation in FOH diagnosis, and 3) to ascertain whether FOH-predictive biochemical markers exist at the diagnosis of premature pubarche. Of 35 patients (age, 15.4 +/- 1.5 yr), 16 showed hirsutism, oligomenorrhea, and elevated baseline testosterone and/or androstenedione (delta 4-A) levels. Subcutaneous administration of leuprolide acetate (500 micrograms) produced similar increases in gonadotropin levels in oligomenorrheic patients, regularly menstruating patients (n = 19), and controls (n = 12; age, 15.3 +/- 1.3 yr) when tested at 6 h. Of all of the steroids measured, 17-hydroxyprogesterone (17-OHP) and delta 4-A levels 24 h postleuprolide acetate stimulation were significantly higher in oligomenorrheic patients than in the other two groups (P < 0.0001). No overlapping in 17-OHP responses occurred between oligomenorrheic patients and the other groups. Baseline dehydroepiandrosterone sulfate and delta 4-A levels at the diagnosis of premature pubarche correlated with 17-OHP values postleuprolide acetate challenge (r = 0.47; P < 0.005 and r = 0.67; P < 0.0001, respectively). These results show a distinct leuprolide acetate challenge response in 45% of the postpubertal premature pubarche girls studied, suggestive of an increased incidence of FOH, and support the need for continued routine postmenarcheal evaluation of this group of patients. Responses of 17-OHP to leuprolide acetate challenge facilitate the identification of FOH patients, establish this test as a reliable diagnostic tool in FOH diagnosis, and confirm the ovaries as the source of hyperandrogenemia in most patients with androgen excess. Although increased 17-OHP responses after leuprolide acetate stimulation seem to occur more frequently in girls with elevated dehydroepiandrosterone sulfate and/or delta 4-A levels at the diagnosis of premature pubarche, specific biochemical markers predictive of FOH in this group of patients are still lacking.
Collapse
Affiliation(s)
- L Ibañez
- Endocrinology Unit, Hospital Materno-Infantil Vall d'Hebron, Autonomous University, Barcelona, Spain
| | | | | | | | | | | | | | | |
Collapse
|
37
|
|
38
|
Ibañez L, Virdis R, Potau N, Zampolli M, Ghizzoni L, Albisu MA, Carrascosa A, Bernasconi S, Vicens-Calvet E. Natural history of premature pubarche: an auxological study. J Clin Endocrinol Metab 1992; 74:254-7. [PMID: 1730803 DOI: 10.1210/jcem.74.2.1730803] [Citation(s) in RCA: 16] [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] [Indexed: 12/28/2022]
Abstract
The natural history of girls with premature pubarche is reported to be normal, but the effects on puberty and on final height are not well documented. We assessed the outcome of a group of girls with premature pubarche from two Latin populations in whom 21-hydroxylase deficiency had been ruled out by an ACTH test. Patients comprised 127 girls (70 Northern-Italian and 57 Northern-Spanish), of whom 69 had entered puberty and 38 had attained adult height. Height, bone age, onset and progression of puberty, height prognosis, adult height, and baseline plasma androgen levels were evaluated. Advanced skeletal maturation and tall stature were constant features during the first years of follow-up and subsequently declined. Puberty began at 9.7 +/- 0.9 yr, and age at menarche (12.0 +/- 1.0 yr) was comparable to maternal and population menarcheal ages. The appearance and chronology of pubertal milestones in both populations were very similar. Adult heights correlated with the height prognosis at diagnosis and at onset of puberty, and were above midparental heights. Premature pubarche produces a transient acceleration in growth and bone maturation with no negative effects on the onset and progression of puberty and final height.
Collapse
Affiliation(s)
- L Ibañez
- Endocrinology Unit, Hospital Materno-Infantil Vall d'Hebron, Autonomous University, Barcelona, Spain
| | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Ibañez L, Chianale J, Siegel F, Miquel JF, Guzmán S, Llanos O. [Treatment of non-variceal upper digestive hemorrhage with endoscopic thermocoagulation]. Rev Med Chil 1992; 120:25-30. [PMID: 1305306] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Over a year period, 60 of 172 patients presenting with upper gastrointestinal bleeding were treated by endoscopic thermocoagulation. Entry criteria included active bleeding (pulsatile or oozing), a visible vessel, sentinel clot or the presence of a pigmented protuberance at the ulcer crater. Hemostatic therapy was performed using the heat probe. The physical status and risk of the patients was estimated according to the ASA classification. Hemostasis was obtained in 17 of 21 patients with pulsatile bleeding (81%), 30 of 30 patients with oozing (100%) and 18 of 18 patients with a visible vessel or a pigmented protuberance in the lesion (100%). Three patients, older than 70 years of age, died. All had pulsatile bleeding from a deep ulcer located at the posterior-inferior wall of the duodenal bulb. They were classified as ASA III (n = 1) or IV (n = 2) with significant concomitant illness. These results suggest that endoscopic thermocoagulation is an effective treatment of active upper gastrointestinal bleeding, especially useful in a group of high risk patients.
Collapse
Affiliation(s)
- L Ibañez
- Departamento de Gastroenterología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago
| | | | | | | | | | | |
Collapse
|
40
|
Vollrath V, Chianale J, Gonzalez S, Duarte I, Andrade L, Ibañez L. Multidrug resistance gene and P-glycoprotein expression in gastric adenocarcinoma and precursor lesions. Virchows Arch B Cell Pathol Incl Mol Pathol 1991; 60:133-8. [PMID: 1675510 DOI: 10.1007/bf02899538] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Overexpression of the Multiple Drug Resistance gene (MDR1) has been proposed as a major mechanism related to both intrinsic and acquired resistance to chemotherapeutic agents. The gene product is a membrane protein (P-glycoprotein), that acts as an energy-dependent drug efflux pump decreasing drug accumulation in resistant tumor cells. We have characterized MDR1 and P-Glycoprotein expression in human gastric adenocarcinoma and in precursor lesions. MDR1 mRNAs, analyzed by dot-blot technique, were detected in 9 of 10 non-tumoral gastric mucosae and in 8 of 10 gastric adenocarcinomas. Immunohistochemical analysis, using the MRK16 monoclonal antibody, revealed heterogeneous expression of P-Glycoprotein in individual cells. The P-Glycoprotein was found on the surface of cells of gastric areas with intestinal metaplasia subtype III. This type of intestinal metaplasia, also called "colonic metaplasia", has been strongly associated with a high risk for the development of gastric cancer. The fact that the P-Glycoprotein was detected in this precursor lesion is consistent with the intestinal metaplasia-dysplasia and carcinoma sequence proposed in the histogenesis of this tumour. The finding that P-Glycoprotein was heterogeneously expressed in malignant cells of some gastric adenocarcinomas also suggests that this transporter system probably contributes to primary and secondary multidrug resistance in this neoplasm.
Collapse
Affiliation(s)
- V Vollrath
- Department de Gastroenterologia, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago
| | | | | | | | | | | |
Collapse
|
41
|
De la Fuente H, Guzmán S, Llanos O, Ibañez L, Ross M. [Duodenal obstruction caused by cholelithiasis (Bouverets' syndrome): a clinical case]. Rev Med Chil 1989; 117:785-8. [PMID: 2519434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
A 55 year old man presented with vomiting, abdominal pain, diarrhea, jaundice and choluria. An obstruction of the gastric outlet by a large gallstone located at the duodenum was demonstrated by radiologic, ultrasonographic and endoscopic examinations. The stone could not be removed through endoscopy and the patient was successfully operated on. A review of published reports is included.
Collapse
|
42
|
|
43
|
Mas X, Laporte JR, Frati ME, Busquet L, Arnau JM, Ibañez L, Séculi E, Capellà D, Arbonés G. Drug prescribing and use among elderly people in Spain. Drug Intell Clin Pharm 1983; 17:378-82. [PMID: 6861631 DOI: 10.1177/106002808301700520] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
As a result of the lack of an adequate regulation, the supply and the use of medicines is irrational in Spain. In order to know the characteristics of the prescription and use of drugs among the elderly, two drug utilization studies were carried out. The first study was an analysis of 981 prescriptions from an outpatient clinic of the Spanish Social Security. The results show that a high proportion of fixed-dose combinations were prescribed and that drugs without any demonstrated therapeutic value are often prescribed for the elderly. The second study was a survey of 389 individuals randomly chosen among people affiliated with a pensioners' club. The results show that drug use is highly prevalent among the elderly, that many medicines without any demonstrated benefit are being taken, and that potentially harmful drugs were being used by a high proportion of patients without medical follow-up. The prevalence of the use of some particular groups of drugs is also presented.
Collapse
|
44
|
Ibañez L, Guzmán S, Duarte I, Llanos O. [Fiberoptic endoscopy of the upper gastrointestinal tract in patients with hypochromic anemia (author's transl)]. Rev Med Chil 1980; 108:321-3. [PMID: 6968965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|