Polygenic Parkinson's Disease Genetic Risk Score as Risk Modifier of Parkinsonism in Gaucher Disease

BACKGROUND

Biallelic pathogenic variants in GBA1 are the cause of Gaucher disease (GD) type 1 (GD1), a lysosomal storage disorder resulting from deficient glucocerebrosidase. Heterozygous GBA1 variants are also a common genetic risk factor for Parkinson's disease (PD). GD manifests with considerable clinical heterogeneity and is also associated with an increased risk for PD.

OBJECTIVE

The objective of this study was to investigate the contribution of PD risk variants to risk for PD in patients with GD1.

METHODS

We studied 225 patients with GD1, including 199 without PD and 26 with PD. All cases were genotyped, and the genetic data were imputed using common pipelines.

RESULTS

On average, patients with GD1 with PD have a significantly higher PD genetic risk score than those without PD (P = 0.021).

CONCLUSIONS

Our results indicate that variants included in the PD genetic risk score were more frequent in patients with GD1 who developed PD, suggesting that common risk variants may affect underlying biological pathways. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA.

The role of glucosylsphingosine as an early indicator of disease progression in early symptomatic type 1 Gaucher disease

Gaucher disease (GD), a lysosomal storage disorder caused by β-glucocerebrosidase deficiency, results in the accumulation of glucosylceramide and glucosylsphingosine. Glucosylsphingosine has emerged as a sensitive and specific biomarker for GD and treatment response. However, limited information exists on its role in guiding treatment decisions in pre-symptomatic patients identified at birth or due to a positive family history. We present two pediatric patients with GD1 and highlight the utility of glucosylsphingosine monitoring in guiding treatment initiation.

Gaucher disease and SARS-CoV-2 infection: Experience from 181 patients in New York

SARS-CoV-2 infection carries high morbidity and mortality in individuals with chronic disorders. Its impact in rare disease populations such as Gaucher disease (GD) is unknown. In GD, decreased acid β-glucosidase activity leads to the accumulation of inflammatory glycosphingolipids and chronic myeloid cell immune activation which a priori could predispose to the most severe effects of SARS-CoV-2. To evaluate the determinants of SARS-CoV-2 infection in GD, we conducted a cross-sectional study in a large cohort. 181 patients were enrolled, including 150 adults and 31 children, with a majority of patients on treatment (78%). Information on COVID-19 exposure, symptoms, and SARS-CoV-2 nucleic acid and/or antibody testing was obtained during the peak of the pandemic in the New York City metropolitan area. Forty-five adults reported a primary exposure to someone with COVID-19 and 17 (38%) of these patients reported at least one COVID-19 symptom. A subset of adults was tested (n = 88) and in this group 18% (16/88) were positive. Patients testing positive for SARS-CoV-2 had significantly more symptoms (4.4 vs 0.3, p < 0.001) than patients testing negative. Among patients who were antibody-positive, quantitative titers indicated moderate to high antibody response. In GD adults, male gender, older age, increased BMI, comorbidities, GBA genotype, prior splenectomy and treatment status were not associated with the probability of reporting symptoms or testing positive. No patient required COVID-19-specific treatments and there were no deaths. Our data suggests that GD does not confer a heightened risk for severe effects of SARS-CoV-2 infection feared based on the known chronic inflammatory state in these patients.

A-21 Inhibition of Overlearned Verbal Responses and Quantity of Speech Among Age Cohorts

Objective

Off-topic speech (OTS) has been linked with deficits in executive functioning, and specifically inhibition. OTS research has focused primarily on tangentiality, whereas in this study we focused on quantity of speech. The purpose of this study was to investigate the relationship between inhibition of overlearned responses using a Stroop task and quantity of speech.

Method

A college sample of young adults (n = 63; age 18-28) and healthy, community-dwelling older adults (n = 76; age 60-99) completed the Delis-Kaplan Executive Function Systems (D-KEFS) Color-Word Interference Test and provided a verbal sample in which they recounted a procedural memory and an episodic memory. These samples were transcribed and rated for quantity of speech by three independent judges.

Results

Among all participants, longer time to complete color naming (r = -.21, p = .02) and inhibition (r = -.21, p = .01) was associated with lower quantity of speech on procedural memory. Among young adults, longer time to complete inhibition was associated with lower quantity of speech (r = -.26, p = .04). Among older adults, longer time to complete color naming (r = -.32, p = .005), word reading (r = -.27, p = .02), and inhibition (r = -.35, p = .002) was associated with lower quantity of speech. No relationships were found between performance on Stroop conditions and quantity of speech for episodic memory.

Conclusions

Results suggest that among both age cohorts, difficulty inhibiting overlearned verbal responses is associated with lower quantity of speech regarding a procedural memory but not an episodic memory.

A-13 Sustained Attention, Impulsivity, and Tangentiality of Speech Among Young Adults and Older Adults

Objective

Previous research has linked off-topic verbosity (OTV) among older adults with lower performance on neuropsychological tests tapping attention and executive functioning. However, most of this research has utilized relatively brief neurocognitive measures. Continuous performance tests (CPTs) measure sustained attention and impulsivity. The purpose of this study was to investigate relationships between sustained attention, impulsivity, and tangentiality of speech among young adults and older adults.

Method

Young adult college students (age 18-29; n= 61) and healthy, community-dwelling older adults (age 60-99; n = 81) were administered the Conners’ Continuous Performance Test – 3 and provided a sample of speech (one episodic memory and one procedural memory). These speech samples were transcribed and rated for tangentiality by three independent reviewers.

Results

Among all participants, greater tangentiality of speech was associated with omission errors (r = .22, p = .01) but not with commission errors. This same pattern was found among older adults: omission errors (r = .23, p = .04) were associated with greater tangentiality but commission errors were not. Among young adults, these relationships were not statistically significant.

Conclusions

Results suggest that tangentiality of speech is associated with inattentiveness but not impulsivity, and this relationship may be more marked among older adults than young adults. OTV among older adults may stem from difficulty sustaining attention over time rather than diminished capacity for inhibiting impulses.

Tobacco, Alcohol, Diet and Risk of prostate Cancer

A hospital-based case-control study of the association between tobacco smoking, alcohol drinking and several relevant dietary items and prostate cancer was carried out in the National Cancer Institute of Uruguay between January 1988 and December 1994. The sample included 156 patients with histologically proven prostatic cancer and 302 controls with a variety of neoplastic and non-neoplastic diseases. The results showed increased risks of prostate cancer associated with beer drinking, meat, milk and fruit consumption, after adjusting for major confounders. The possible role of N-nitroso compounds from beer in prostatic carcinogenesis is discussed.

Tinea nigra by Hortaea werneckii, a report of 22 cases from Mexico

Tinea nigra is a superficial mycosis caused by Hortaea werneckii. It is an infrequent asymptomatic infection that affects human palms and soles, and is mostly observed in tropical countries. We evaluate retrospectively twenty-two confirmed cases of tinea nigra from a total of eleven yr (1997–2007) and discuss the epidemiology, clinical features and treatment of this disease. In twelve cases, adults were involved, in 10, children. In nineteen cases the disorder was located on palms of hands and in three on soles of feet. In all cases, the obtained isolates were morphologically identified as Hortaea werneckii and the identification of ten isolates was retrospectively confirmed with the help of sequences of the internal transcribed spacer regions of the ribosomal DNA. The patients received topical treatment with Whitfield ointment, ketoconazole, bifonazole, or terbinafine. Treatment with keratolytic agents and topical antifungals was effective.

Comparison of the activation of the Ca2+ release-activated Ca2+ current ICRAC to InsP3 in Jurkat T-lymphocytes, pulmonary artery endothelia and RBL-1 cells

In many electrically non-excitable cells, Ca2+ entry is mediated predominantly by the store-operated Ca2+ influx pathway. The best-characterised store-operated Ca2+ current is the Ca2+ release-activated Ca2+ current (ICRAC). It is generally believed that high concentrations of intracellular Ca2+ buffer are required to measure ICRAC, due to Ca2+-dependent inactivation of the channels. Recently, we have recorded robust ICRAC in rat basophilic leukaemia (RBL-1) cells at physiological levels of Ca2+ buffering when stores were depleted by inhibition of the sarcoplasmic/ endoplasmic reticulum Ca2+-activated adenosine triphosphatase (SERCA) pumps. However, the second messenger inositol 1,4,5-trisphosphate (InsP3) was not able to evoke the current under such conditions, despite inducing substantial Ca2+ release. We have therefore suggested that a threshold exists within the Ca2+ stores which has to be overcome for macroscopic ICRAC to activate. To establish whether this is a specific feature of ICRAC in RBL-1 cells or whether it is a more general phenomenon, we investigated whether a threshold is also seen in other cell-types used to study store-operated Ca2+ entry. In Jurkat-T lymphocytes, ICRAC is activated weakly by InsP3 in the presence of low concentrations of Ca2+ buffer, whereas the current is large when SERCA pumps are blocked simultaneously, as in RBL-1 cells. Although the electrophysiological properties of ICRAC in the Jurkat cell are very similar to those of RBL-1 cells, the Na+ conductance in the absence of external divalent cations is quite different. Unexpectedly, we failed consistently to record any store-operated Ca2+ current in macrovascular pulmonary artery endothelia whereas robust ICRAC was seen under the same conditions in RBL-1 cells. Our results show that ICRAC has a similar profile of activation in the presence of physiological levels of Ca2+ buffering for Jurkat T-lymphocytes and RBL-1 cells, indicating that the threshold mechanism may be a general feature of ICRAC activation. Because ICRAC in pulmonary artery endothelia is, at best, very small, additional Ca2+ influx pathways may also contribute to agonist-induced Ca2+ entry.

Substantial depletion of the intracellular Ca2+ stores is required for macroscopic activation of the Ca2+ release-activated Ca2+ current in rat basophilic leukaemia cells

1. Tight-seal whole-cell patch clamp experiments were performed to examine the ability of different intracellular Ca2+ mobilising agents to activate the Ca2+ release-activated Ca2+ current (ICRAC) in rat basophilic leukaemia (RBL-1) cells under conditions of weak cytoplasmic Ca2+ buffering. 2. Dialysis with a maximal concentration of inositol 1,4,5-trisphosphate (IP3) routinely failed to activate macroscopic ICRAC in low buffer (0.mM EGTA, BAPTA or dimethyl BAPTA), whereas it activated the current to its maximal extent in high buffer (10 mM EGTA). Dialysis with a poorly metabolisable analogue of IP3, with ionomycin, or with IP3 and ionomycin all failed to generate macroscopic ICRAC in low Ca2+ buffering conditions. 3. Dialysis with the sarco/endoplasmic reticulum Ca2+-ATPase (SERCA) pump blocker thapsigargin was able to activate ICRAC even in the presence of low cytoplasmic Ca2+ buffering, albeit at a slow rate. Exposure to IP3 together with the SERCA blockers thapsigargin, thapsigargicin or cyclopiazonic acid rapidly activated ICRAC in low buffer. 4. Following activation of ICRAC by intracellular dialysis with IP3 and thapsigargin in low buffer, the current was very selective for Ca2+ (apparent KD of 1 mM) Sr2+ and Ba2+ were less effective charge carriers and Na+ was not conducted to any appreciable extent. The ionic selectivity of ICRAC was very similar in low or high intracellular Ca2+ buffer. 5. Fast Ca2+-dependent inactivation of ICRAC occurred at a similar rate and to a similar extent in low or high Ca2+ buffer. Ca2+-dependent inactivation is not the reason why macroscopic ICRAC cannot be seen under conditions of low cytoplasmic Ca2+ buffering. 6. ICRAC could be activated by combining IP3 with thapsigargin, even in the presence of 100 microM Ca2+ and the absence of any exogenous Ca2+ chelator, where ATP and glutamate represented the only Ca2+ buffers in the pipette solution. 7. Our results suggest that a threshold exists within the IP3-sensitive Ca2+ store, below which intraluminal Ca2+ needs to fall before ICRAC activates. Possible models to explain the results are discussed.

On the characterisation of the mechanism underlying passive activation of the Ca2+ release-activated Ca2+ current ICRAC in rat basophilic leukaemia cells

1. Tight-seal whole-cell patch clamp experiments were performed to investigate the mechanism whereby passive depletion of stores activates the Ca2+ release-activated Ca2+ current (ICRAC) in rat basophilic leukaemia (RBL) cells. 2. Passive depletion of stores was achieved by dialysing cells with different concentrations of Ca2+ chelators. Low concentrations generally evoked a submaximal ICRAC, which developed slowly and monophasically. Higher concentrations resulted in a biphasic current in which the initial slow monophasic component developed into a faster and bigger second phase. 3. The kinetics of ICRAC as well as its final amplitude were not affected by Ca2+ chelators that had different affinities or speeds of binding. 4. Exogenous Ca2+ binding ratios > or = 16,670 were necessary to fully activate ICRAC. Because the Ca2+ binding ratio within the stores is presumably low, this indicates that other factors like Ca2+ transport across the stores membrane are rate limiting for passive store depletion. 5. Heparin and Ruthenium Red both failed to affect passive Ca2+ leak from the intracellular stores. 6. Treatment with sarco/endoplasmic reticulum Ca2+-ATPase (SERCA) pump blockers dramatically altered the kinetics of activation of biphasic currents, and increased the amplitude of monophasic ones. 7. Our results suggest that SERCA pumps are very effective in preventing ICRAC from activating passively, and are responsible for the phasic nature of the current, its time course of development and its overall extent.

The effects of interfering with GTP-binding proteins on the activation mechanism of calcium release-activated calcium current

In electrically non-excitable cells, Ca2+ entry is mediated predominantly by the store-operated Ca2+ influx pathway, which is activated by emptying the intracellular Ca2+ stores. Just how the Ca2+ content of the stores is communicated to the activity of store-operated Ca2+ channels in the plasma membrane is unclear. It has been suggested that, in some cell types, the link is accomplished by either a small or a heterotrimeric GTP-binding protein, which is inhibited by guanosine 5'-O-(3-thiotriphosphate) (GTP[gamma-S]) and, in some cases, pertussis toxin. Using the whole-cell patch-clamp technique to directly measure the store-operated Ca2+ current ICRAC (Ca2+-release-activated Ca2+ current) in RBL cells, we report that manipulations designed to interfere with GTP-binding protein activity (dialysis with GTP[gamma-S], exposure to pertussis toxin) routinely fail to affect the activation of ICRAC. However, these agents alter the activity of a K+ current in the same cells, demonstrating biological activity. Furthermore, activation of ICRAC does not seem to require the presence of a pre-existing diffusible messenger in the cytoplasm to any appreciable extent because the current reaches the same amplitude irrespective of the whole-cell dialysis time. We conclude that neither a mobile pre-existing molecule nor a GTP-dependent step is necessary for the activation of ICRAC in RBL-1 cells.

Fast calcium-dependent inactivation of calcium release-activated calcium current (CRAC) in RBL-1 cells

Fast inactivation of the Ca2+ release-activated Ca2+ current (ICRAC) was studied using whole cell patch-clamp recordings in rat basophilic leukemia (RBL-1) cells. Application of hyperpolarizing voltage steps from the holding potential of 0 mV revealed that ICRAC declined in amplitude over tens of milliseconds during steps more negative than -40 mV. This fast inactivation was predominantly Ca2+-dependent because first, it could be more effectively suppressed when BAPTA was included in the recording pipette instead of EGTA and second, replacing external Ca2+ with Sr2+ resulted in less inactivation. Recovery from inactivation was faster in the presence of BAPTA than EGTA. The extent of fast inactivation was independent of the whole cell ICRAC amplitude, compatible with the notion that the inactivation arose from a local feedback inhibition by permeating Ca2+ ions only on the channel it permeated. Ca2+ release from stores did not affect fast inactivation, nor did FCepsilonRI receptor stimulation. Current clamp recordings showed that the majority of RBL cells had a membrane potential close to -90 mV following stimulation of FCepsilonRI receptors. Hence fast inactivation is likely to impact on the extent of Ca2+ influx through CRAC channels under physiological conditions and appears to be an important negative feedback process that limits Ca2+ increases.

Meat intake, 'mate' drinking and renal cell cancer in Uruguay: a case-control study

In the period January 1988-December 1995, a case-control study of diet and renal cell carcinoma (RCC) risk involving 121 cases and 243 hospitalized controls was carried out in Montevideo, Uruguay. After adjusting for major covariates, red meat intake was associated with a 3.4 increase in risk for the highest category of intake, with a significant dose-response pattern. Also, barbecued meat, protein and heterocyclic amine intakes were associated with significant increases in risk of RCC. The consumption of the beverage known as 'mate' (a ocal tea derived from the herb Ilex paraguariensis) was associated with an increased risk of 3.0 for heavy drinkers.

Intracellular calcium clearance in Purkinje cell somata from rat cerebellar slices

1. The mechanisms governing the return of intracellular calcium (Cai2+) to baseline levels following depolarization-evoked [Ca2+]i rises were investigated in Purkinje cell somata using tight-seal whole-cell recordings and fura-2 microfluorometry, for peak [Ca2+]i ranging from 50 nm to 2 microM. 2. Cai2+ decay was well fitted by a double exponential with time constants of O.6 and 3 s. Both time constants were independent of peak [Ca2+]i but the contribution of the faster component increased with [Ca2+]i. 3. Thapsigargin (10 microM) and cyclopiazonic acid (50 microM) prolonged Cai2+ decay indicating that sarco-endoplasmic reticulum Ca2+ (SERCA) pumps contribute to Purkinje cell Cai2+ clearance. 4. A modest participation in clearance was found for the plasma membrane Ca2+ (PMCA) pumps using 5,6-succinimidyl carboxyeosin (40 microM). 5. The Na(+)-Ca2+ exchanger also contributed to the clearance process, since replacement of extracellular Na+ by Li+ slowed Cai2+ decay. 6. Carbonyl cyanide m-chlorophenylhydrazone (CCCP, 2 microM) and rotenone (10 microM) increased [Ca2+]i and elicited large inward currents at -60 mV. Both effects were also obtained with CCCP in the absence of external Ca2+, suggesting that mitochondrial Ca2+ uptake uncouplers release Ca2+ from intracellular stores and may alter the membrane permeability to Ca2+. These effects were irreversible and impeded tests on the role of mitochondria in Cai2+ clearance. 7. The relative contribution of the clearance systems characterized in this study varied as a function of [Ca2+]i. At 0.5 microM Cai2+, SERCA pumps and the Na(+)-Ca2+ exchanger contribute equally to removal and account for 78% of the process. Only 45% of the removal at 2 microM Cai2+ can be explained by these systems. In this high [Ca2+]i range the major contribution is that of SERCA pumps (21%) and of the Na(+)-Ca2+ exchanger (18%), whereas the contribution of PMCA pumps is only 6%.

Tobacco, alcohol, diet and risk of non-Hodgkin's lymphoma: a case-control study in Uruguay

To test whether high meat intake is associated with the development of non-Hodgkin lymphoma (NHL) in the Uruguayan population, a case-control study was performed at the Instituto Nacional de Oncologia, Montevideo, Uruguay. After controlling for age, sex, residence, education, urban/rural status and the habit of drinking the beverage 'mate', red meat intake was associated with an increased risk of NHL of 2.5. This finding was similar in both sexes separately. Odds ratios (OR) for the highest tertile of barbecued meat was 1.7 among men, whereas salted meat was associated with an increased risk of NHL (OR 4.9, 95% CI 1.4-17.7). The effect of processed and salted meat among women was of much less magnitude and the OR's were non-significant. Also, cumulative exposure to 'mate' drinking displayed an OR of 2.4 (95% CI 1.0-5.6). Smokers of black tobacco and hand-rolled cigarettes were associated with an increased risk of 3.5 (95% 1.1-10.9), whereas beer drinkers showed an increased OR of 5.5 (95% 1.1-26.7) in men. It could be concluded that red or salted meat intake, smoking of black tobacco, and beer and 'mate' drinking are risk factors for NHL in the Uruguayan population.

Hard liquor drinking is associated with higher risk of cancer of the oral cavity and pharynx than wine drinking. A case-control study in Uruguay

In order to examine the relationship between pure drinkers of alcoholic beverages and cancer of the oral cavity and pharynx, a case-control study was conducted in Uruguay between 1992 and 1996. 471 cases and 471 controls, admitted for diagnosis or treatment in the four major hospitals in Montevideo, were considered eligible for the study. Pure hard liquor drinking was associated with an increased risk of 3.6 (95% confidence limit (CL) 2.1-6.2), whereas pure wine drinking showed an odds ratio (OR) of 2.1 (95% CL 1.3-3.3). When pure hard liquor drinkers were compared with pure wine drinkers, the OR for pure liquor drinkers was 1.7 (95% CL 1.1-2.7). Furthermore, the risk associated with pure hard liquor drinking was analysed by subsite, and the highest odds ratios were observed for oral cavity cancer. Further studies should be carried out in order to replicate these findings in other populations.

High endogenous calcium buffering in Purkinje cells from rat cerebellar slices

1. The ability of Purkinje cells to rapidly buffer depolarization-evoked intracellular calcium changes (delta [Ca2+]i) was estimated by titrating the endogenous buffer against incremental concentrations of the Ca(2+)-sensitive dye fura-2. 2. In cells from 15-day-old rats, pulse-evoked delta [Ca2+]i were stable during the loading with 0.5 mM fura-2 through the patch pipette. In cells from 6-day-old rats, delta [Ca2+]i decreased by approximately 50% during equivalent experiments. This decrease was not related to changes in Ca2+ influx, since the integral of the Ca2+ currents remained constant throughout the recording. 3. Experiments with high fura-2 concentrations (1.75-3.5 mM) were performed in order to obtain for each cell the curve relating delta [Ca2+]i to fura-2 concentration. From this relationship, values for the Ca2+ binding ratio (the ratio of buffer-bound Ca2+ changes over free Ca2+ changes) were calculated. 4. In Purkinje cells from 15-day-old rats, the Ca2+ binding ratio was approximately 2000, an order of magnitude larger than that of other neurones and neuroendocrine cells studied to date. This Ca2+ binding ratio was significantly smaller (approximately 900) in Purkinje cells from 6-day-old rats. 5. We propose that the large Ca2+ binding ratio of Purkinje cells is related to the presence of large concentrations of Ca2+ binding proteins and that these cells regulate their ability to handle Ca2+ loads during development through changes in the concentration of Ca2+ binding proteins.

Mate drinking and risk of lung cancer in males: a case-control study from Uruguay

During the period from January 1988 to December 1994, a case-control study that included 497 cases of lung cancer and 497 controls was carried out at the Instituto de Oncologia, Montevideo, Uruguay, to evaluate the relationship between the drinking of mate (a local tea prepared with infusions of the herb Ilex paraguariensis) and the risk of lung cancer in men. Mate drinking has been associated with risk of most upper-aerodigestive tract cancers. After adjusting for major covariates, including pack-years of cigarette smoking, the amount of mate was associated with a 1.6-fold increase in risk for heavy drinkers, compared with light drinkers, with a significant dose-response pattern. When the analysis was performed by cell type, small cell lung cancer showed a significant increase in relative risk for mate amount (odds ratio, 2.9; 95% confidence interval, 1.3-6.2) and mate duration (odds ratio, 3.6; 95% confidence interval, 1.3-9.9). On the other hand, pulmonary adenocarcinoma was not associated with mate drinking. Possible reasons for these results are discussed, and areas for future research are suggested.

Salted meat consumption and the risk of laryngeal cancer

A hospital-based, case-control study of laryngeal cancer was conducted in the Oncology Institute, Montevideo, Uruguay, during 1988-1992, in which 143 new cases and 460 controls were interviewed. The study was restricted to males. As in most previous studies tobacco smoking and alcohol drinking were the major risk factors. Past and current salted meat consumption was associated with increased risks of laryngeal cancer, after controlling for the effects of tobacco and alcohol. Cigarette smoking and consumption of salted meat appeared to increase the risk of laryngeal cancer in a multiplicative fashion. Fresh meat consumption (beef) was also associated with an increased risk of laryngeal cancer (OR 2.0). After controlling for fresh meat ingestion, the estimates for salted meat remained significant.

Smoking of hand-rolled cigarettes as a risk factor for small cell lung cancer in men: a case-control study from Uruguay

During the time period January 1989-December 1992, a case-control study involving 476 cases of lung cancer and 561 controls was carried out at the Instituto Nacional de Oncología, Montevideo, Uruguay, in order to analyze the patterns of risk of the different cell types of lung cancer, associated with smoking manufactured and hand-rolled cigarettes. Lifelong smokers of hand-rolled cigarettes displayed a non-significant 30% increased risk, compared with smokers of commercial cigarettes, for all types of lung cancer combined. The analysis for cell-type disclosed a fourfold increase in the risk of small cell lung carcinoma associated with lifelong smoking of hand-rolled products. The possibilities of a chance finding and of misclassification of the disease appears to be an unlikely explanation of this strong and rather specific association.

Salted meat consumption as a risk factor for cancer of the oral cavity and pharynx: a case-control study from Uruguay

A hospital-based, case-control study of oropharyngeal cancer was conducted in the Oncology Institute, Montevideo, Uruguay, during 1988-1992, in which 246 new cases and 253 controls were interviewed. The study was restricted to males. As in most previous studies, tobacco smoking and alcohol drinking were the major risk factors. Past and current salted meat consumption was associated with increased risks of oropharyngeal cancer after controlling for the effects of tobacco and alcohol; current consumption was associated with a significant increase in risk (odds ratio, 2.3; 95% confidence interval, 1.1-5.2). Current heavy consumption of salted meat was associated with a significant 4.7% increased risk of oropharyngeal cancer after adjusting for tobacco smoking and alcohol drinking. These findings suggest that current consumption of salted meat is more relevant to the etiology of this set of neoplasms than past consumption. Furthermore, the joint effect of pack-years of cigarette smoking, alcohol drinking, and ever consumption of salted meat was associated with a high risk of oral and pharyngeal cancer (odds ratio, 10.0; 95% confidence interval, 4.7-21.3) using the referent category of moderate smokers, moderate drinkers, and never users of salted meat.

Cancer mortality trends in Uruguay 1953-1991

Cancer mortality trends from 1953 to 1991 were assessed by means of data supplied by the Department of Vital Statistics of the Ministry of Public Health. The population at risk was obtained from the Bureau of Statistics and Censuses. Age-specific and age-adjusted mortality rates were calculated, using the world standard population, for a number of sites or groups of sites. In order to obtain relative risks of death for each period, Poisson regression models were fitted to the data using the GLIM program. The main model included age and period as explanatory variables. Among males, the principal increase was observed for lung cancer, followed by prostatic cancer. The rates were mainly stable in colon cancer and leukaemias, whereas gastric cancer showed a marked decline. Also, a recent decline was seen for oesophageal cancer. In females a steady decline in mortality was observed for all sites combined. Major decreases were seen for oesophageal, gastric, cervical and total uterine cancers. The only cancers showing significant increases were breast cancer, and lung cancer for the most recent period. Providing that there were no changes in death registration or in survival rates, changes in prevalence of risk factors might be responsible for the observed trends.

Black (air-cured) and blond (flue-cured) tobacco and cancer risk. III: Oesophageal cancer

Relative risks of oesophageal cancer for smoking were higher in communities smoking mainly black tobacco, when compared with results from populations comprising mainly users of blond tobacco. Also, hand-rolled cigarette smoking, which could be considered as a proxy indicator of black tobacco smoking, was also associated with higher risk of oesophageal cancer, in comparison with the use of commercial (manufactured) cigarettes. Finally, the use of pipes and cigars showed odds ratios of higher magnitude than those associated with cigarettes. This indirect evidence of a higher risk of oesophageal cancer due to the use of black products was confirmed in three recent hospital-based case-control studies. These investigations were able to compare the effect of both types of tobacco; relative risks for black tobacco were two to three times higher than risks associated with blond tobacco smoking, after controlling for major potential confounders. Laboratory evidence suggests that swallowing tobacco condensates could be a major risk factor for oesophageal cancer. Also, the higher content of tobacco-specific N-nitroso compounds in black tobacco, including organospecific substances, could explain its higher carcinogenic effect on the oesophageal mucosa.

The effect of alcohol on the risk of lung cancer in Uruguay

A hospital-based case-control study of the association between alcohol drinking and lung cancer was carried out in Uruguay between January 1988 and December 1990. The sample included 327 men with lung cancer and 350 male controls. Personal interviews were conducted in the Institute of Oncology by trained personnel using a structured questionnaire. The results showed a significant positive association between beer intake and the risk of lung cancer. The odds ratio for beer drinkers in the highest quartile was 3.4 (95% confidence limits, 1.3-6.6) after adjustment for tobacco. The association between beer and lung cancer was consistent for all the cell types, analyzed separately. A moderate effect for total alcohol consumption was also observed, with a relative risk of 2.2 for those subjects in the highest quartile.

Hand-rolled cigarette smoking and risk of cancer of the mouth, pharynx, and larynx

A case-control study, involving 205 patients with cancer of the mouth, pharynx, and larynx and 273 control subjects with conditions considered not related to tobacco or alcohol consumption, was performed in Montevideo, Uruguay, between January 1988 and December 1990. Smokers of hand-rolled cigarettes showed an increased risk of cancer of the mouth and pharynx (odds ratio [OR] = 2.5; 95% confidence limit = 1.2-5.2) when compared with smokers of manufactured cigarettes. Also, the risk of laryngeal cancer was greater among smokers of hand-rolled cigarettes (OR = 2.7; 95% confidence limit = 1.3-5.7) as compared with smokers of commercial cigarettes.

[Induction and recovery of immunologic weakening]

During this experimental work, we studied the immunological recuperation in CD1 mice in whom a weakening disease was induced using intraperitoneal injections of a sterile mixture of dead staphylococci. After a deep depression of the synthesis of anti-sheep red blood cell antibodies (SRBC) during the following 10 days after the induction of wasting, the animals regained their capability to produce anti-SRBC antibodies, significantly increasing. Two weeks after the injections were applied, the average number of antibody producing cells rose significantly and even doubled in the control group of healthy mice. Finally, after two weeks after this "rebound", the number of antibody forming cells return to normality. The article includes a discussion on the biological significance of this carried out in experimental animals while offering a hope for children with secondary immunological deficiencies or for those with repeatedly severe infections.

Black tobacco, maté, and bladder cancer. A case-control study from Uruguay

A case-control study of bladder cancer involving interviews with 111 incident cases and 222 controls was carried out in Montevideo, Uruguay. The analysis was conducted separately for each sex. Point estimates of relative risk associated with smoking variables, ingestion of infusions of the herb Ilex paraguariensis (maté), and selected dietary items were obtained by stratified and logistic regression analysis. Among men, smokers of black tobacco showed a relative risk (RR) 2.7 higher than blond tobacco smokers and maté exposure showed a significant dose-response, after adjustment for age, residence, social class, hospital, type of tobacco, smoking intensity, smoking duration, and vegetable consumption, with a seven-fold increase in risk for heavy consumers. Joint exposure to type of tobacco and maté consumption showed a multiplicative effect. Women showed a similar increase in risk with maté consumption. The results suggest that the high mortality rates of bladder cancer observed in Uruguay could be explained by the combined effect of black tobacco smoking and maté ingestion.

Risk factors for cancer of the tongue in Uruguay

From 1987 to 1989, a hospital-based case-control study of cancer of the tongue was conducted in Montevideo, Uruguay, as part of a large study to investigate a number of risk factors for cancer of the oral cavity, pharynx, and larynx. The study involved interviews with 57 cases and 353 controls and was restricted to men. Relative risks (RR) associated with tobacco smoking, alcohol drinking, and selected dietary items were obtained by unconditional logistic-regression analysis. Users of black tobacco had a RR fourfold higher than users of blond tobacco, and heavy drinkers of alcohol had a RR of 11.6. Infrequent consumption of vegetables was associated with a significant RR of 5.3, and heavy drinkers of the local infusion "mate" had a RR of 2.5. It was concluded that black tobacco smoking and alcohol drinking were the strongest risk factors for cancer of the tongue in Uruguay. Their effects combine according to a multiplicative model. Also, infrequent vegetable intake and mate ingestion contribute to the risk of cancer of the tongue.