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Raut JR, Bhardwaj M, Schöttker B, Holleczek B, Schrotz-King P, Brenner H. Cancer-specific risk prediction with a serum microRNA signature. Cancer Sci 2024. [PMID: 38523358 DOI: 10.1111/cas.16135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 01/24/2024] [Accepted: 02/20/2024] [Indexed: 03/26/2024] Open
Abstract
We recently derived and validated a serum-based microRNA risk score (miR-score) that predicted colorectal cancer (CRC) occurrence with very high accuracy within 14 years of follow-up in a population-based cohort study from Germany (ESTHER cohort). Here, we aimed to evaluate associations of the CRC-specific miR-score with the risk of developing other common cancers, including female breast cancer (BC), lung cancer (LC), and prostate cancer (PC), in the ESTHER cohort. MicroRNAs (miRNAs) were profiled by quantitative real-time PCR in serum samples collected at baseline from randomly selected incident cases of BC (n = 90), LC (n = 88), and PC (n = 93) and participants without diagnosis of CRC, LC, BC, or PC (controls, n = 181) until the end of the 17-year follow-up. Multivariate logistic regression models were used to evaluate the associations of the miR-score with BC, LC, and PC incidence. The miR-score showed strong inverse associations with BC and LC incidence [odds ratio per 1 standard deviation increase: 0.60 (95% confidence interval [CI] 0.43-0.82), p = 0.0017, and 0.64 (95% CI 0.48-0.84),p = 0.0015, respectively]. Associations with PC were not statistically significant but pointed in the positive direction. Our study highlights the potential of serum-based miRNA biomarkers for cancer-specific risk prediction. Further large cohort studies aiming to investigate, validate, and optimize the use of circulating miRNA signatures for cancer risk assessment are warranted.
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Grants
- Ministerium für Wissenschaft, Forschung und Kunst Baden-Württemberg (Ministry of Science, Research and Art Baden-Württemberg, Stuttgart, Germany)
- Bundesministerium für Bildung und Forschung (Federal Ministry of Education and Research, Berlin, Germany)
- Bundesministerium für Familie, Senioren, Frauen und Jugend (Federal Ministry of Family Affairs, Senior Citizens, Women and Youth, Berlin, Germany)
- Ministerium für Soziales, Gesundheit, Frauen und Familie, Deutschland (Ministry for Social Affairs, Health, Women and Family Affairs, Saarbrücken, Germany)
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Affiliation(s)
- Janhavi R Raut
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Megha Bhardwaj
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Ben Schöttker
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Network Aging Research, University of Heidelberg, Heidelberg, Germany
| | | | - Petra Schrotz-King
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
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2
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Bhardwaj M, Schöttker B, Holleczek B, Brenner H. Enhanced selection of people for lung cancer screening using AHRR (cg05575921) or F2RL3 (cg03636183) methylation as biological markers of smoking exposure. Cancer Commun (Lond) 2023; 43:956-959. [PMID: 37278142 PMCID: PMC10397557 DOI: 10.1002/cac2.12450] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 03/15/2023] [Accepted: 05/26/2023] [Indexed: 06/07/2023] Open
Affiliation(s)
- Megha Bhardwaj
- Division of Clinical Epidemiology and Aging ResearchGerman Cancer Research Center (DKFZ)HeidelbergGermany
- Division of Preventive OncologyGerman Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT)HeidelbergGermany
- German Cancer Consortium (DKTK)German Cancer Research Center (DKFZ)HeidelbergGermany
| | - Ben Schöttker
- Division of Clinical Epidemiology and Aging ResearchGerman Cancer Research Center (DKFZ)HeidelbergGermany
- Network Aging ResearchUniversity of HeidelbergHeidelbergGermany
| | | | - Hermann Brenner
- Division of Clinical Epidemiology and Aging ResearchGerman Cancer Research Center (DKFZ)HeidelbergGermany
- Division of Preventive OncologyGerman Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT)HeidelbergGermany
- German Cancer Consortium (DKTK)German Cancer Research Center (DKFZ)HeidelbergGermany
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Bhardwaj M, Schöttker B, Holleczek B, Brenner H. Comparison of discrimination performance of 11 lung cancer risk models for predicting lung cancer in a prospective cohort of screening-age adults from Germany followed over 17 years. Lung Cancer 2022; 174:83-90. [PMID: 36356492 DOI: 10.1016/j.lungcan.2022.10.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 09/02/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022]
Abstract
Randomized trials have demonstrated considerable reduction in lung cancer (LC) mortality by screening pre-selected heavy smokers with low-dose computed tomography (LDCT). Newer screening guidelines recommend refined LC risk models for selecting the target population for screening. We aimed to evaluate and compare the discrimination performance of LC risk models and previously used trial criteria in predicting LC incidence and mortality in a large German cohort of screening-age adults. Within ESTHER, a population-based prospective cohort study conducted in Saarland, Germany, 4812 ever smokers aged 50-75 years were followed up with respect to LC incidence and mortality for up to 17 years. We quantified the performance of 11 different LC risk models by the area under the curve (AUC) and compared the proportion of correctly predicted LC cases between the best performing models and the LDCT trial criteria. Risk prediction of LC incidence in the ESTHER ever smokers was best for the Bach model, LCRAT and LCDRAT with AUCs ranging from 0.782 to 0.787, from 0.770 to 0.774, and from 0.765 to 0.771 for the follow-up time periods of cases identified at 6, 11, and 17 years, respectively. At cutoffs yielding comparable positivity rates as the LDCT trial criteria, these models would have identified between 11.8 (95% CI 3.0-20.5) and 17.6 (95% CI 10.1-25.2) percent units higher proportions of LC cases occurring during the initial 6 years of follow-up. Use of LC risk models is expected to result in substantially greater potential to identify people at highest risk of LC, suggesting enhanced potential for reducing LC mortality by LC screening.
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Affiliation(s)
- Megha Bhardwaj
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany; German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany.
| | - Ben Schöttker
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; Network Aging Research, University of Heidelberg, Bergheimer Strasse 20, 69115 Heidelberg, Germany
| | - Bernd Holleczek
- Saarland Cancer Registry, Präsident-Baltz-Strasse 5, 66119 Saarbrücken, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany; German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
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Trares K, Bhardwaj M, Perna L, Stocker H, Petrera A, Hauck SM, Beyreuther K, Brenner H, Schöttker B. Association of the inflammation-related proteome with dementia development at older age: results from a large, prospective, population-based cohort study. Alzheimers Res Ther 2022; 14:128. [PMID: 36085081 PMCID: PMC9461133 DOI: 10.1186/s13195-022-01063-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 08/16/2022] [Indexed: 11/25/2022]
Abstract
Background Chronic inflammation is a central feature of several forms of dementia. However, few details on the associations of blood-based inflammation-related proteins with dementia incidence have been explored yet. Methods The Olink Target 96 Inflammation panel was measured in baseline serum samples (collected 07/2000–06/2002) of 1782 older adults from a German, population-based cohort study in a case-cohort design. Logistic regression models were used to assess the associations of biomarkers with all-cause dementia, Alzheimer’s disease, and vascular dementia incidence. Results During 17 years of follow-up, 504 participants were diagnosed with dementia, including 163 Alzheimer’s disease and 195 vascular dementia cases. After correction for multiple testing, 58 out of 72 tested (80.6%) biomarkers were statistically significantly associated with all-cause dementia, 22 with Alzheimer’s disease, and 33 with vascular dementia incidence. We identified four biomarker clusters, among which the strongest representatives, CX3CL1, EN-RAGE, LAP TGF-beta-1, and VEGF-A, were significantly associated with dementia endpoints independently from other inflammation-related proteins. CX3CL1 (odds ratio [95% confidence interval] per 1 standard deviation increase: 1.41 [1.24–1.60]) and EN-RAGE (1.41 [1.25–1.60]) were associated with all-cause dementia incidence, EN-RAGE (1.51 [1.25–1.83]) and LAP TGF-beta-1 (1.46 [1.21–1.76]) with Alzheimer’s disease incidence, and VEGF-A (1.43 [1.20–1.70]) with vascular dementia incidence. All named associations were stronger among APOE ε4-negative subjects. Conclusion With this large, population-based cohort study, we show for the first time that the majority of inflammation-related proteins measured in blood samples are associated with total dementia incidence. Future studies should concentrate not only on single biomarkers but also on the complex relationships in biomarker clusters. Supplementary Information The online version contains supplementary material available at 10.1186/s13195-022-01063-y.
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Raut JR, Bhardwaj M, Niedermaier T, Miah K, Schrotz-King P, Brenner H. Assessment of a Serum Microrna Risk Score for Colorectal Cancer among Participants of Screening Colonoscopy at Various Stages of Colorectal Carcinogenesis. Cells 2022; 11:cells11152462. [PMID: 35954306 PMCID: PMC9367813 DOI: 10.3390/cells11152462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/29/2022] [Accepted: 08/01/2022] [Indexed: 11/20/2022] Open
Abstract
We recently derived and validated a serum-based microRNA risk score (miR-score) which predicted colorectal cancer (CRC) occurrence with very high accuracy within 14 years of follow-up in a large population-based cohort. Here, we aimed to assess and compare the distribution of the miR-score among participants of screening colonoscopy at various stages of colorectal carcinogenesis. MicroRNAs (miRNAs) were profiled by quantitative-real-time-polymerase-chain-reaction in the serum samples of screening colonoscopy participants with CRC (n = 52), advanced colorectal adenoma (AA, n = 100), non-advanced colorectal adenoma (NAA, n = 88), and participants free of colorectal neoplasms (n = 173). The mean values of the miR-score were compared between groups by the Mann–Whitney U test. The associations of the miR-score with risk for colorectal neoplasms were evaluated using logistic regression analyses. MicroRNA risk scores were significantly higher among participants with AA than among those with NAA (p = 0.027) and those with CRC (p = 0.014), whereas no statistically significant difference was seen between those with NAA and those with no colorectal neoplasms (p = 0.127). When comparing adjacent groups, miR-scores were inversely associated with CRC versus AA and positively associated with AA versus NAA [odds ratio (OR), 0.37 (95% confidence interval (CI), 0.16–0.86) and OR, 2.22 (95% CI, 1.06–4.64) for the top versus bottom tertiles, respectively]. Our results are consistent with the hypothesis that a high miR-score may be indicative of an increased CRC risk by an increased tendency of progression from non-advanced to advanced colorectal neoplasms, along with a change of the miR-patterns after CRC manifestation.
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Affiliation(s)
- Janhavi R. Raut
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
- Medical Faculty Heidelberg, University of Heidelberg, Im Neuenheimer Feld 672, 69120 Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany
| | - Megha Bhardwaj
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Tobias Niedermaier
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Kaya Miah
- Division of Biostatistics, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Petra Schrotz-King
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
- Correspondence: ; Tel.: +49-6221-421300; Fax: +49-6221-421302
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Yu H, Raut JR, Bhardwaj M, Zhang Y, Sandner E, Schöttker B, Holleczek B, Schrotz-King P, Brenner H. A serum microRNA signature for enhanced selection of people for lung cancer screening. Cancer Commun (Lond) 2022; 42:1222-1225. [PMID: 35929101 PMCID: PMC9648391 DOI: 10.1002/cac2.12346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 07/18/2022] [Accepted: 07/26/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Haixin Yu
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, 69120, Baden-Württemberg, Germany.,Medical Faculty Heidelberg, University of Heidelberg, Heidelberg, 69120, Baden-Württemberg, Germany
| | - Janhavi R Raut
- Medical Faculty Heidelberg, University of Heidelberg, Heidelberg, 69120, Baden-Württemberg, Germany.,Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, 69120, Baden-Württemberg, Germany
| | - Megha Bhardwaj
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, 69120, Baden-Württemberg, Germany
| | - Yan Zhang
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, 69120, Baden-Württemberg, Germany.,German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, 69120, Baden-Württemberg, Germany
| | - Evelin Sandner
- Pneumology and Thoracic Oncology, Robert-Bosch Krankenhaus, Klinik Schillerhoehe, Gerlingen, 70839, Baden-Württemberg, Germany
| | - Ben Schöttker
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, 69120, Baden-Württemberg, Germany.,Network Aging Research, University of Heidelberg, Bergheimer Straße 20, Heidelberg, 69115, Baden-Württemberg, Germany
| | - Bernd Holleczek
- Saarland Cancer Registry, Präsident-Baltz-Straße 5, Saarbrucken, 66119, Saarland, Germany
| | - Petra Schrotz-King
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, 69120, Baden-Württemberg, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, 69120, Baden-Württemberg, Germany.,Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, 69120, Baden-Württemberg, Germany.,German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, 69120, Baden-Württemberg, Germany
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Bhardwaj M, Schöttker B, Holleczek B, Benner A, Schrotz-King P, Brenner H. Potential of Inflammatory Protein Signatures for Enhanced Selection of People for Lung Cancer Screening. Cancers (Basel) 2022; 14:2146. [PMID: 35565275 PMCID: PMC9103423 DOI: 10.3390/cancers14092146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/22/2022] [Accepted: 04/23/2022] [Indexed: 12/10/2022] Open
Abstract
Randomized trials have demonstrated a substantial reduction in lung cancer (LC) mortality by screening heavy smokers with low-dose computed tomography (LDCT). The aim of this study was to assess if and to what extent blood-based inflammatory protein biomarkers might enhance selection of those at highest risk for LC screening. Ever smoking participants were chosen from 9940 participants, aged 50-75 years, who were followed up with respect to LC incidence for 17 years in a prospective population-based cohort study conducted in Saarland, Germany. Using proximity extension assay, 92 inflammation protein biomarkers were measured in baseline plasma samples of ever smoking participants, including 172 incident LC cases and 285 randomly selected participants free of LC. Smoothly clipped absolute deviation (SCAD) penalized regression with 0.632+ bootstrap for correction of overoptimism was applied to derive an inflammation protein biomarker score (INS) and a combined INS-pack-years score in a training set, and algorithms were further evaluated in an independent validation set. Furthermore, the performances of nine LC risk prediction models individually and in combination with inflammatory plasma protein biomarkers for predicting LC incidence were comparatively evaluated. The combined INS-pack-years score predicted LC incidence with area under the curves (AUCs) of 0.811 and 0.782 in the training and the validation sets, respectively. The addition of inflammatory plasma protein biomarkers to established nine LC risk models increased the AUCs up to 0.121 and 0.070 among ever smoking participants from training and validation sets, respectively. Our results suggest that inflammatory protein biomarkers may have potential to improve the selection of people for LC screening and thereby enhance screening efficiency.
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Affiliation(s)
- Megha Bhardwaj
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; (B.S.); (H.B.)
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany;
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Ben Schöttker
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; (B.S.); (H.B.)
- Network Aging Research, University of Heidelberg, Bergheimer Strasse 20, 69115 Heidelberg, Germany
| | - Bernd Holleczek
- Saarland Cancer Registry, Präsident-Baltz-Strasse 5, 66119 Saarbrücken, Germany;
| | - Axel Benner
- Division of Biostatistics, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany;
| | - Petra Schrotz-King
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany;
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; (B.S.); (H.B.)
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany;
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
- Network Aging Research, University of Heidelberg, Bergheimer Strasse 20, 69115 Heidelberg, Germany
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Ponce-de-Leon M, Linseisen J, Peters A, Linkohr B, Heier M, Grallert H, Schöttker B, Trares K, Bhardwaj M, Gào X, Brenner H, Kamiński KA, Paniczko M, Kowalska I, Baumeister SE, Meisinger C. Novel associations between inflammation-related proteins and adiposity: A targeted proteomics approach across four population-based studies. Transl Res 2022; 242:93-104. [PMID: 34780968 DOI: 10.1016/j.trsl.2021.11.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 10/28/2021] [Accepted: 11/04/2021] [Indexed: 11/27/2022]
Abstract
Chronic low-grade inflammation has been proposed as a linking mechanism between obesity and the development of inflammation-related conditions such as insulin resistance and cardiovascular disease. Despite major advances in the last 2 decades, the complex relationship between inflammation and obesity remains poorly understood. Therefore, we aimed to identify novel inflammation-related proteins associated with adiposity. We investigated the association between BMI and waist circumference and 72 circulating inflammation-related proteins, measured using the Proximity Extension Assay (Olink Proteomics), in 3,308 participants of four independent European population-based studies (KORA-Fit, BVSII, ESTHER, and Bialystok PLUS). In addition, we used body fat mass measurements obtained by Dual-energy X-ray absorptiometry (DXA) in the Bialystok PLUS study to further validate our results and to explore the relationship between inflammation-related proteins and body fat distribution. We found 14 proteins associated with at least one measure of adiposity across all four studies, including four proteins for which the association is novel: DNER, SLAMF1, RANKL, and CSF-1. We confirmed previously reported associations with CCL19, CCL28, FGF-21, HGF, IL-10RB, IL-18, IL-18R1, IL-6, SCF, and VEGF-A. The majority of the identified inflammation-related proteins were associated with visceral fat as well as with the accumulation of adipose tissue in the abdomen and the trunk. In conclusion, our study provides new insights into the immune dysregulation observed in obesity that might help uncover pathophysiological mechanisms of disease development.
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Affiliation(s)
- Mariana Ponce-de-Leon
- Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany; Chair of Epidemiology, University of Augsburg, University Hospital Augsburg, Augsburg, Germany; Independent Research Group Clinical Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany.
| | - Jakob Linseisen
- Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany; Chair of Epidemiology, University of Augsburg, University Hospital Augsburg, Augsburg, Germany; Independent Research Group Clinical Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum Munich, Neuherberg, Germany
| | - Birgit Linkohr
- Institute of Epidemiology, Helmholtz Zentrum Munich, Neuherberg, Germany
| | - Margit Heier
- Institute of Epidemiology, Helmholtz Zentrum Munich, Neuherberg, Germany; KORA Study Centre, University Hospital Augsburg, Augsburg, Germany
| | - Harald Grallert
- Institute of Epidemiology, Helmholtz Zentrum Munich, Neuherberg, Germany; German Center for Diabetes Research, Neuherberg, Germany
| | - Ben Schöttker
- Division of Clinical Epidemiology and Ageing Research, German Cancer Research Center, Heidelberg, Germany; Network Aging Research, University of Heidelberg, Heidelberg, Germany
| | - Kira Trares
- Division of Clinical Epidemiology and Ageing Research, German Cancer Research Center, Heidelberg, Germany; Network Aging Research, University of Heidelberg, Heidelberg, Germany
| | - Megha Bhardwaj
- Division of Clinical Epidemiology and Ageing Research, German Cancer Research Center, Heidelberg, Germany
| | - Xīn Gào
- Division of Clinical Epidemiology and Ageing Research, German Cancer Research Center, Heidelberg, Germany
| | - Herman Brenner
- Division of Clinical Epidemiology and Ageing Research, German Cancer Research Center, Heidelberg, Germany; Network Aging Research, University of Heidelberg, Heidelberg, Germany
| | - Karol Adam Kamiński
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Białystok, Białystok, Poland
| | - Marlena Paniczko
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Białystok, Białystok, Poland
| | - Irina Kowalska
- Department of Internal Medicine and Metabolic Diseases, Medical University of Białystok, Białystok, Poland
| | | | - Christa Meisinger
- Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany; Chair of Epidemiology, University of Augsburg, University Hospital Augsburg, Augsburg, Germany; Independent Research Group Clinical Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
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9
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Kirsten F, Marcote B, Nimmo K, Hessels JWT, Bhardwaj M, Tendulkar SP, Keimpema A, Yang J, Snelders MP, Scholz P, Pearlman AB, Law CJ, Peters WM, Giroletti M, Paragi Z, Bassa C, Hewitt DM, Bach U, Bezrukovs V, Burgay M, Buttaccio ST, Conway JE, Corongiu A, Feiler R, Forssén O, Gawroński MP, Karuppusamy R, Kharinov MA, Lindqvist M, Maccaferri G, Melnikov A, Ould-Boukattine OS, Possenti A, Surcis G, Wang N, Yuan J, Aggarwal K, Anna-Thomas R, Bower GC, Blaauw R, Burke-Spolaor S, Cassanelli T, Clarke TE, Fonseca E, Gaensler BM, Gopinath A, Kaspi VM, Kassim N, Lazio TJW, Leung C, Li DZ, Lin HH, Masui KW, Mckinven R, Michilli D, Mikhailov AG, Ng C, Orbidans A, Pen UL, Petroff E, Rahman M, Ransom SM, Shin K, Smith KM, Stairs IH, Vlemmings W. A repeating fast radio burst source in a globular cluster. Nature 2022; 602:585-589. [PMID: 35197615 DOI: 10.1038/s41586-021-04354-w] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 12/15/2021] [Indexed: 11/09/2022]
Abstract
Fast radio bursts (FRBs) are flashes of unknown physical origin1. The majority of FRBs have been seen only once, although some are known to generate multiple flashes2,3. Many models invoke magnetically powered neutron stars (magnetars) as the source of the emission4,5. Recently, the discovery6 of another repeater (FRB 20200120E) was announced, in the direction of the nearby galaxy M81, with four potential counterparts at other wavelengths6. Here we report observations that localized the FRB to a globular cluster associated with M81, where it is 2 parsecs away from the optical centre of the cluster. Globular clusters host old stellar populations, challenging FRB models that invoke young magnetars formed in a core-collapse supernova. We propose instead that FRB 20200120E originates from a highly magnetized neutron star formed either through the accretion-induced collapse of a white dwarf, or the merger of compact stars in a binary system7. Compact binaries are efficiently formed inside globular clusters, so a model invoking them could also be responsible for the observed bursts.
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Affiliation(s)
- F Kirsten
- Department of Space, Earth and Environment, Chalmers University of Technology, Onsala Space Observatory, Onsala, Sweden. .,ASTRON, Netherlands Institute for Radio Astronomy, Dwingeloo, The Netherlands.
| | - B Marcote
- Joint Institute for VLBI ERIC, Dwingeloo, The Netherlands
| | - K Nimmo
- ASTRON, Netherlands Institute for Radio Astronomy, Dwingeloo, The Netherlands.,Anton Pannekoek Institute for Astronomy, University of Amsterdam, Amsterdam, The Netherlands
| | - J W T Hessels
- ASTRON, Netherlands Institute for Radio Astronomy, Dwingeloo, The Netherlands.,Anton Pannekoek Institute for Astronomy, University of Amsterdam, Amsterdam, The Netherlands
| | - M Bhardwaj
- Department of Physics, McGill University, Montreal, Quebec, Canada.,McGill Space Institute, McGill University, Montreal, Quebec, Canada
| | - S P Tendulkar
- Department of Astronomy and Astrophysics, Tata Institute of Fundamental Research, Mumbai, India.,National Centre for Radio Astrophysics, Pune, India
| | - A Keimpema
- Joint Institute for VLBI ERIC, Dwingeloo, The Netherlands
| | - J Yang
- Department of Space, Earth and Environment, Chalmers University of Technology, Onsala Space Observatory, Onsala, Sweden
| | - M P Snelders
- Anton Pannekoek Institute for Astronomy, University of Amsterdam, Amsterdam, The Netherlands
| | - P Scholz
- Dunlap Institute for Astronomy & Astrophysics, University of Toronto, Toronto, Ontario, Canada
| | - A B Pearlman
- Department of Physics, McGill University, Montreal, Quebec, Canada.,McGill Space Institute, McGill University, Montreal, Quebec, Canada.,Division of Physics, Mathematics, and Astronomy, California Institute of Technology, Pasadena, CA, USA
| | - C J Law
- Cahill Center for Astronomy and Astrophysics, California Institute of Technology, Pasadena, CA, USA.,Owens Valley Radio Observatory, California Institute of Technology, Pasadena, CA, USA
| | - W M Peters
- Remote Sensing Division, US Naval Research Laboratory, Washington, DC, USA
| | - M Giroletti
- Istituto Nazionale di Astrofisica, Istituto di Radioastronomia, Bologna, Italy
| | - Z Paragi
- Joint Institute for VLBI ERIC, Dwingeloo, The Netherlands
| | - C Bassa
- ASTRON, Netherlands Institute for Radio Astronomy, Dwingeloo, The Netherlands
| | - D M Hewitt
- Anton Pannekoek Institute for Astronomy, University of Amsterdam, Amsterdam, The Netherlands
| | - U Bach
- Max Planck Institute for Radio Astronomy, Bonn, Germany
| | - V Bezrukovs
- Engineering Research Institute Ventspils International Radio Astronomy Centre (ERI VIRAC), Ventspils University of Applied Sciences (VUAS), Ventspils, Latvia
| | - M Burgay
- Istituto Nazionale di Astrofisica, Osservatorio Astronomico di Cagliari, Selargius, Italy
| | - S T Buttaccio
- Istituto Nazionale di Astrofisica, Istituto di Radioastronomia Radiotelescopio di Noto, Noto, Italy
| | - J E Conway
- Department of Space, Earth and Environment, Chalmers University of Technology, Onsala Space Observatory, Onsala, Sweden
| | - A Corongiu
- Istituto Nazionale di Astrofisica, Osservatorio Astronomico di Cagliari, Selargius, Italy
| | - R Feiler
- Institute of Astronomy, Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University, Toruń, Poland
| | - O Forssén
- Department of Space, Earth and Environment, Chalmers University of Technology, Onsala Space Observatory, Onsala, Sweden
| | - M P Gawroński
- Institute of Astronomy, Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University, Toruń, Poland
| | - R Karuppusamy
- Max Planck Institute for Radio Astronomy, Bonn, Germany
| | - M A Kharinov
- Institute of Applied Astronomy of the Russian Academy of Sciences, St. Petersburg, Russia
| | - M Lindqvist
- Department of Space, Earth and Environment, Chalmers University of Technology, Onsala Space Observatory, Onsala, Sweden
| | - G Maccaferri
- Istituto Nazionale di Astrofisica, Istituto di Radioastronomia, Bologna, Italy
| | - A Melnikov
- Institute of Applied Astronomy of the Russian Academy of Sciences, St. Petersburg, Russia
| | - O S Ould-Boukattine
- Anton Pannekoek Institute for Astronomy, University of Amsterdam, Amsterdam, The Netherlands
| | - A Possenti
- Istituto Nazionale di Astrofisica, Osservatorio Astronomico di Cagliari, Selargius, Italy.,Dipartimento di Fisica, Università di Cagliari, Monserrato, Italy
| | - G Surcis
- Istituto Nazionale di Astrofisica, Osservatorio Astronomico di Cagliari, Selargius, Italy
| | - N Wang
- Xinjiang Astronomical Observatory, Urumqi, China
| | - J Yuan
- Xinjiang Astronomical Observatory, Urumqi, China
| | - K Aggarwal
- Department of Physics and Astronomy, West Virginia University, Morgantown, WV, USA.,Center for Gravitational Waves and Cosmology, West Virginia University, Morgantown, WV, USA
| | - R Anna-Thomas
- Department of Physics and Astronomy, West Virginia University, Morgantown, WV, USA.,Center for Gravitational Waves and Cosmology, West Virginia University, Morgantown, WV, USA
| | - G C Bower
- Academia Sinica Institute of Astronomy and Astrophysics, Hilo, HI, USA
| | - R Blaauw
- ASTRON, Netherlands Institute for Radio Astronomy, Dwingeloo, The Netherlands
| | - S Burke-Spolaor
- Department of Physics and Astronomy, West Virginia University, Morgantown, WV, USA.,Center for Gravitational Waves and Cosmology, West Virginia University, Morgantown, WV, USA.,Canadian Institute for Advanced Research, CIFAR Azrieli Global Scholar, Toronto, Ontario, Canada
| | - T Cassanelli
- Dunlap Institute for Astronomy & Astrophysics, University of Toronto, Toronto, Ontario, Canada.,David A. Dunlap Department of Astronomy & Astrophysics, University of Toronto, Toronto, Ontario, Canada
| | - T E Clarke
- Remote Sensing Division, US Naval Research Laboratory, Washington, DC, USA
| | - E Fonseca
- Department of Physics, McGill University, Montreal, Quebec, Canada.,McGill Space Institute, McGill University, Montreal, Quebec, Canada.,Department of Physics and Astronomy, West Virginia University, Morgantown, WV, USA.,Center for Gravitational Waves and Cosmology, West Virginia University, Morgantown, WV, USA
| | - B M Gaensler
- Dunlap Institute for Astronomy & Astrophysics, University of Toronto, Toronto, Ontario, Canada.,David A. Dunlap Department of Astronomy & Astrophysics, University of Toronto, Toronto, Ontario, Canada
| | - A Gopinath
- Anton Pannekoek Institute for Astronomy, University of Amsterdam, Amsterdam, The Netherlands
| | - V M Kaspi
- Department of Physics, McGill University, Montreal, Quebec, Canada.,McGill Space Institute, McGill University, Montreal, Quebec, Canada
| | - N Kassim
- Remote Sensing Division, US Naval Research Laboratory, Washington, DC, USA
| | - T J W Lazio
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA, USA
| | - C Leung
- MIT Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, Cambridge, MA, USA.,Department of Physics, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - D Z Li
- Cahill Center for Astronomy and Astrophysics, California Institute of Technology, Pasadena, CA, USA
| | - H H Lin
- Canadian Institute for Theoretical Astrophysics, University of Toronto, Toronto, Ontario, Canada.,Institute of Astronomy and Astrophysics, Academia Sinica, Taipei, Taiwan
| | - K W Masui
- MIT Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, Cambridge, MA, USA.,Department of Physics, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - R Mckinven
- Dunlap Institute for Astronomy & Astrophysics, University of Toronto, Toronto, Ontario, Canada
| | - D Michilli
- Department of Physics, McGill University, Montreal, Quebec, Canada.,McGill Space Institute, McGill University, Montreal, Quebec, Canada.,MIT Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, Cambridge, MA, USA.,Department of Physics, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - A G Mikhailov
- Institute of Applied Astronomy of the Russian Academy of Sciences, St. Petersburg, Russia
| | - C Ng
- Dunlap Institute for Astronomy & Astrophysics, University of Toronto, Toronto, Ontario, Canada
| | - A Orbidans
- Engineering Research Institute Ventspils International Radio Astronomy Centre (ERI VIRAC), Ventspils University of Applied Sciences (VUAS), Ventspils, Latvia
| | - U L Pen
- Dunlap Institute for Astronomy & Astrophysics, University of Toronto, Toronto, Ontario, Canada.,Canadian Institute for Advanced Research, CIFAR Azrieli Global Scholar, Toronto, Ontario, Canada.,Canadian Institute for Theoretical Astrophysics, University of Toronto, Toronto, Ontario, Canada.,Perimeter Institute for Theoretical Physics, Waterloo, Ontario, Canada.,Institute of Astronomy and Astrophysics, Academia Sinica, Taipei, Taiwan
| | - E Petroff
- Anton Pannekoek Institute for Astronomy, University of Amsterdam, Amsterdam, The Netherlands.,Department of Physics, McGill University, Montreal, Quebec, Canada.,McGill Space Institute, McGill University, Montreal, Quebec, Canada
| | - M Rahman
- Sidrat Research, Toronto, Ontario, Canada
| | - S M Ransom
- National Radio Astronomy Observatory, Charlottesville, VA, USA
| | - K Shin
- MIT Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, Cambridge, MA, USA.,Department of Physics, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - K M Smith
- Perimeter Institute for Theoretical Physics, Waterloo, Ontario, Canada
| | - I H Stairs
- Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia, Canada
| | - W Vlemmings
- Department of Space, Earth and Environment, Chalmers University of Technology, Onsala Space Observatory, Onsala, Sweden
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10
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Zhao Z, Zhu A, Bhardwaj M, Schrotz-King P, Brenner H. Fecal microRNAs, Fecal microRNA Panels, or Combinations of Fecal microRNAs with Fecal Hemoglobin for Early Detection of Colorectal Cancer and Its Precursors: A Systematic Review. Cancers (Basel) 2021; 14:cancers14010065. [PMID: 35008229 PMCID: PMC8750731 DOI: 10.3390/cancers14010065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 12/14/2021] [Accepted: 12/20/2021] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Screening for colorectal cancer is effective for the reduction of both CRC incidence and mortality in the population at average risk. The use of innovative and robust biomarkers to enhance the potential of noninvasive CRC screening remains desirable. We aimed to conduct a systematic literature review on the diagnostic performance of fecal miRNA markers for CRC and its precursors. Several studies have reported quite promising results, in particular by combining fecal miRNA measurements with fecal hemoglobin. However, current evidence is limited by substantial heterogeneity in the methodology from study design to biosample analysis. Our review is intended to provide a valuable reference for future biomarker studies in early colorectal cancer detection. Looking at fecal miRNAs, we draw attention to the various biases to be avoided or at least minimized, by applying a harmonized methodology including true screening settings and comparable sample pre-analytics, as well as the validation of biomarkers. Abstract Colorectal cancer (CRC) is the third most common cancer and the second leading cause of cancer mortality globally. Fecal miRNAs have been suggested to be promising biomarkers for CRC early detection. We aimed to conduct a systematic literature review on the diagnostic performance of fecal miRNA markers for CRC and its precursors. PubMed and Web of Science were searched to retrieve relevant articles published up to 7 December 2021. Information on study design, characteristics of study population, pre-analytics (sample collection, processing, and storage), fecal miRNA extraction and quantification technologies, and diagnostic performance (including sensitivity, specificity, and area under the curve (AUC)) were summarized. Twenty studies reporting on 31 individual miRNAs and 16 miRNA panels (with 2–9 markers) for CRC diagnosis were identified. Substantial heterogeneity existed regarding stool sample collection, processing, storage, and miRNA extraction and normalization. For two individual miRNAs and one miRNA panel, values ≥ 80% were reported for both sensitivity and specificity; however, none of these results were either internally or externally validated. In a study among fecal immunochemical test-positive cases recruited from a true screening setting, better diagnostic performance was identified and internally validated for a combination panel including two miRNAs, fecal hemoglobin level, and patient age and sex, compared with fecal hemoglobin concentration alone. Fecal miRNAs or miRNA panels, possibly in combination with fecal hemoglobin test, may be promising candidates for noninvasive CRC early detection. However, large prospective and well-designed studies in CRC screening cohorts are required to validate promising miRNAs or miRNA panels.
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Affiliation(s)
- Zitong Zhao
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; (Z.Z.); (A.Z.)
- Medical Faculty Heidelberg, University of Heidelberg, 69120 Heidelberg, Germany
| | - Anna Zhu
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; (Z.Z.); (A.Z.)
- Medical Faculty Heidelberg, University of Heidelberg, 69120 Heidelberg, Germany
| | - Megha Bhardwaj
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany; (M.B.); (P.S.-K.)
| | - Petra Schrotz-King
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany; (M.B.); (P.S.-K.)
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; (Z.Z.); (A.Z.)
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany; (M.B.); (P.S.-K.)
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
- Correspondence: ; Tel.: +49-6221-42-1301
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11
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Bhardwaj M, Soanes K, Lahoz-Monfort JJ, Lumsden LF, van der Ree R. Artificial lighting reduces the effectiveness of wildlife-crossing structures for insectivorous bats. J Environ Manage 2020; 262:110313. [PMID: 32250796 DOI: 10.1016/j.jenvman.2020.110313] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 02/07/2020] [Accepted: 02/19/2020] [Indexed: 06/11/2023]
Abstract
In an attempt to improve cost-effectiveness, it has become increasingly popular to adapt wildlife crossing structures to enable people to also use them for safe passage across roads. However, the required needs of humans and wildlife may conflict, resulting in a structure that does not actually provide the perceived improvement in cost-effectiveness, but instead a reduction in conservation benefits. For example, lighting within crossing structures for human safety at night may reduce use of the structure by nocturnal wildlife, thus contributing to barrier and mortality effects of roads rather than mitigating them. In this study, we experimentally evaluated the impact of artificial light at night on the rate of use of wildlife crossing structures, specifically underpasses, by ten insectivorous bat species groups in south-eastern Australia. We monitored bat activity before, during and after artificially lighting the underpasses. We found that bats tended to avoided lit underpasses, and only one species consistently showed attraction to the light. Artificial light at night in underpasses hypothetically increases the vulnerability of bats to road-mortality or to the barrier effect of roads. The most likely outcomes of lighting underpasses were 1. an increase in crossing rate above the freeway and a decrease under the underpasses, or 2. a reduction in crossing rate both above freeways and under the underpasses, when structures were lit. Our results corroborate those of studies on terrestrial mammals, and thus we recommend that underpasses intended to facilitate the movement of wildlife across roads should not be lit.
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Affiliation(s)
- M Bhardwaj
- School of BioSciences, University of Melbourne, Parkville, Victoria, 3010, Australia.
| | - K Soanes
- School of BioSciences, University of Melbourne, Parkville, Victoria, 3010, Australia; School of Ecosystem and Forest Sciences, University of Melbourne, Parkville, Victoria, 3010, Australia
| | - J J Lahoz-Monfort
- School of BioSciences, University of Melbourne, Parkville, Victoria, 3010, Australia
| | - L F Lumsden
- Arthur Rylah Institute for Environmental Research, Department of Environment, Land, Water and Planning, 123 Brown Street, Heidelberg, Victoria, 3084, Australia
| | - R van der Ree
- School of BioSciences, University of Melbourne, Parkville, Victoria, 3010, Australia; Ecology and Infrastructure International, PO Box 6031, Wantirna, Victoria, 3152, Australia; WSP Australia Pty Ltd, 28 Freshwater Place, Southbank, Victoria, Australia
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12
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Bhardwaj M, Weigl K, Tikk K, Holland-Letz T, Schrotz-King P, Borchers CH, Brenner H. Multiplex quantitation of 270 plasma protein markers to identify a signature for early detection of colorectal cancer. Eur J Cancer 2020; 127:30-40. [PMID: 31972396 DOI: 10.1016/j.ejca.2019.11.021] [Citation(s) in RCA: 16] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 11/19/2019] [Accepted: 11/25/2019] [Indexed: 02/07/2023]
Abstract
Blood-based protein biomarker signatures might be an alternative or supplement to existing methods for early detection of colorectal cancer (CRC) for population-based screening. The objective of this study was to derive a protein biomarker signature for early detection of CRC and its precursor advanced adenoma (AA). In a two-stage design, 270 protein markers were measured by liquid chromatography/multiple reaction monitoring/mass spectrometry in plasma samples of discovery and validation sets. In the discovery set consisting of 100 newly diagnosed CRC cases and 100 age- and sex-matched controls free of neoplasm at screening colonoscopy, the algorithms predicting the presence of early- or late-stage CRC were derived by Lasso regression and .632 + bootstrap. The prediction algorithms were then externally validated in an independent validation set consisting of participants of screening colonoscopy including 56 participants with CRC, 99 with AA and 99 controls without any colorectal neoplasms. Three different signatures for all-, early- and late-stage CRC consisting of five-, three- and eight-protein markers were obtained in the discovery set with areas under the curves (AUCs) after .632 + bootstrap adjustment of 0.85, 0.83 and 0.96, respectively. External validation in the representative screening population yielded AUCs of 0.79 (95% CI, 0.70-0.86), 0.79 (95% CI, 0.66-0.89) and 0.80 (95% CI, 0.70-0.89) for all-, early- and late-stage CRCs, respectively. The three-marker early-stage algorithm yielded an AUC of 0.65 (95% CI, 0.56-0.73) for detection of AA in the validation set. Although not yet competitive with available stool-based tests for CRC early detection, the identified proteins may contribute to the development of powerful blood-based tests for early detection of CRC and its precursors AAs.
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Affiliation(s)
- Megha Bhardwaj
- Division of Preventive Oncology, German Cancer Research Center (DKFZ), National Center for Tumour Diseases (NCT), Heidelberg, Germany; Medical Faculty Heidelberg, University of Heidelberg, Heidelberg, Germany
| | - Korbinian Weigl
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany; German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Kaja Tikk
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany; German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Tim Holland-Letz
- Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Petra Schrotz-King
- Division of Preventive Oncology, German Cancer Research Center (DKFZ), National Center for Tumour Diseases (NCT), Heidelberg, Germany
| | - Christoph H Borchers
- University of Victoria - Genome British Columbia Proteomics Centre, University of Victoria (UVic), Victoria, British Columbia, V8Z 7X8, Canada; Department of Biochemistry and Microbiology, University of Victoria, Victoria, British Columbia, V8P 5C2, Canada; Segal Cancer Proteomics Centre, Lady Davis Institute, Jewish General Hospital, McGill University, Montreal, Quebec, H3T 1E2, Canada; Gerald Bronfman Department of Oncology, Jewish General Hospital, McGill University, Montreal, Quebec, H3T 1E2, Canada
| | - Hermann Brenner
- Division of Preventive Oncology, German Cancer Research Center (DKFZ), National Center for Tumour Diseases (NCT), Heidelberg, Germany; Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany; German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany.
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13
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Bhardwaj M, Weigl K, Tikk K, Benner A, Schrotz-King P, Brenner H. Multiplex screening of 275 plasma protein biomarkers to identify a signature for early detection of colorectal cancer. Mol Oncol 2019; 14:8-21. [PMID: 31652396 PMCID: PMC6944100 DOI: 10.1002/1878-0261.12591] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [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: 07/12/2019] [Revised: 10/09/2019] [Accepted: 10/24/2019] [Indexed: 02/06/2023] Open
Abstract
Blood-based protein biomarkers may be an attractive option for early detection of colorectal cancer (CRC). Here, we used a two-stage design to measure 275 protein markers by proximity extension assay (PEA), first in plasma samples of a discovery set consisting of 98 newly diagnosed CRC cases and 100 age- and gender-matched controls free of neoplasm at screening colonoscopy. An algorithm predicting the presence of early- or late-stage CRC was derived by least absolute shrinkage and selection operator regression with .632+ bootstrap method, and the algorithms were then validated using PEA again in an independent validation set consisting of participants of screening colonoscopy with and without CRC (n = 56 and 102, respectively). Three different signatures for all-, early-, and late-stage CRC consisting of 9, 12, and 11 protein markers were obtained in the discovery set with areas under the curves (AUCs) after .632 + bootstrap adjustment of 0.92, 0.91, and 0.96, respectively. External validation among participants of screening colonoscopy yielded AUCs of 0.76 [95% confidence interval (95% CI), 0.67-0.84], 0.75 (95% CI, 0.62-0.87), and 0.80 (95% CI, 0.68-0.89) for all-, early-, and late-stage CRC, respectively. Although the identified protein markers are not competitive with the best available stool tests, these proteins may contribute to the development of powerful blood-based tests for CRC early detection in the future.
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Affiliation(s)
- Megha Bhardwaj
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany.,Medical Faculty Heidelberg, University of Heidelberg, Germany
| | - Korbinian Weigl
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.,German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Kaja Tikk
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.,German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Axel Benner
- Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Petra Schrotz-King
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Hermann Brenner
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany.,Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.,German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
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14
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Bhardwaj M, Gies A, Weigl K, Tikk K, Benner A, Schrotz-King P, Borchers CH, Brenner H. Evaluation and Validation of Plasma Proteins Using Two Different Protein Detection Methods for Early Detection of Colorectal Cancer. Cancers (Basel) 2019; 11:cancers11101426. [PMID: 31557860 PMCID: PMC6826652 DOI: 10.3390/cancers11101426] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [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: 07/29/2019] [Revised: 09/11/2019] [Accepted: 09/17/2019] [Indexed: 12/24/2022] Open
Abstract
Objective: Plasma protein biomarkers could be an efficient alternative for population-based screening for early detection of colorectal cancer (CRC). The objective of this study was to evaluate and validate plasma proteins individually and as a signature for early detection of CRC. Methods: In a three-stage design, proteins were measured firstly by liquid chromatography/multiple reaction monitoring-mass spectrometry (LC/MRM-MS) and later by proximity extension assay (PEA) in a discovery set consisting of 96 newly diagnosed CRC cases and 94 controls free of neoplasms at screening colonoscopy. Two algorithms (one for each measurement method) were derived by Lasso regression and .632+ bootstrap based on 11 proteins that were included in both the LC/MRM-MS and PEA measurements. Additionally, another algorithm was constructed from the same eleven biomarkers plus amphireglin, the most promising protein marker in the PEA measurements that had not been available from the LC/MRM-MS measurements. Lastly the three prediction signatures were validated with PEA in independent samples of participants of screening colonoscopy (CRC (n = 56), advanced adenoma (n = 101), and participants free of neoplasm (n = 102)). Results: The same four proteins were included in all three prediction signatures; mannan binding lectin serine protease 1, osteopontin, serum paraoxonase lactonase 3 and transferrin receptor protein 1, and the third prediction signature additionally included amphiregulin. In the independent validation set from a true screening setting, the five-marker blood-based signature including AREG presented areas under the curves of 0.82 (95% CI, 0.74–0.89), 0.86 (95% CI, 0.77–0.92) and 0.76 (95% CI, 0.64–0.86) for all, early and late stages CRC, respectively. Conclusion: Two different measurement methods consistently identified four protein markers and an algorithm additionally including amphiregulin, a marker measured by PEA only, showed promising performance for detecting early stage CRC in an independent validation in a true screening setting. These proteins may be potential candidates for blood-based tests for early detection of CRC.
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Affiliation(s)
- Megha Bhardwaj
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany.
- Medical Faculty Heidelberg, University of Heidelberg, 69120 Heidelberg, Germany.
| | - Anton Gies
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany.
- Medical Faculty Heidelberg, University of Heidelberg, 69120 Heidelberg, Germany.
| | - Korbinian Weigl
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany.
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany.
| | - Kaja Tikk
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany.
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany.
| | - Axel Benner
- Division of Biostatistics, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany.
| | - Petra Schrotz-King
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany.
| | - Christoph H Borchers
- University of Victoria-Genome British Columbia Proteomics Centre, University of Victoria (UVic), Victoria, BC V8Z 7X8, Canada.
- Department of Biochemistry and Microbiology, University of Victoria, Victoria, BC V8P 5C2, Canada.
- Segal Cancer Proteomics Centre, Lady Davis Institute, Jewish General Hospital, McGill University, Montreal, QC H3T 1E2, Canada.
- Gerald Bronfman Department of Oncology, Jewish General Hospital, McGill University, Montreal, QC H3T 1E2, Canada.
| | - Hermann Brenner
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany.
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany.
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany.
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15
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Dewan A, Kini L, Sharma S, Bhardwaj M. P11.53 Genotype trumps phenotype: Oligodendroglioma and oligodendroglioma like tumors- A 1p19q fluorescence in situ hybridization based study at a tertiary referral centre in north India. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND
The 2016 WHO update of CNS tumours defines oligodendroglioma as a diffusely infiltrating glioma with IDH 1 or IDH 2 mutation and co-deletion of chromosomal arms 1p and 19q. We evaluated the role of 1p19q testing by Fluorescence in situ hybridization (FISH) in the diagnosis and correct classification of CNS tumours in accordance with WHO 2016 classification and exclusion of morphological mimickers of oligodendrogliomas.
MATERIAL AND METHODS
A retrospective analysis of CNS tumours was carried out that were tested for 1p19q co-deletion by FISH over a period of fourteen months at our institute. Correlation with tumour morphology as well as other molecular tests (IDH mutation and MGMT) where available was then done. A tumour was considered to have 1p or 19q deletion when the 1p probe to 1q probe ratio (1p/1q) or the 19q probe to 19p probe ratio (19q/19p) was <0.80.
RESULTS
A total of 125 cases underwent FISH testing for 1p19q co-deletion over a period of last fourteen months at our institute with 74 male patients and 51 women. Thirty-eight of the 125 evaluated patients demonstrated 1p19q co-deletion on FISH. These included 25 oligodendrogliomas, 9 astrocytomas (Grade II/III) and 4 cases of oligoastrocytomas by morphology. Out of these cases, 21 cases had a co-existent IDH mutation, while two cases were IDH wild type and for 15 cases the status was unknown. Rest of the 87 patients were negative for 1p19q co-deletion and included cases of oligodendroglioma, other gliomas (pilocytic astrocytoma, oligoastrocytoma, glioblastoma) and few glioneuronal tumours (ganglioglioma, dysembryoplastic neuroepithelial tumour and central neurocytoma).
CONCLUSION
1. Analysis of 1p19q co-deletion by FISH plays an important role in correctly identifying cases of oligodendroglioma as shown in our study. This is important as it is both a predictive as well as prognostic biomarker 2. In cases with co-deletion but IDH wild type status, the 1p19q status should be confirmed by other methods such as comparative genomic hybridization to confirm the presence of whole chromosome loss.3. FISH analysis also helps in excluding morphologic mimics of oligodendroglioma such as glioneuronal tumours and pilocytic astrocytomas in young patients. 4. However, in a resource limited country like ours, a good morphological diagnosis should still form the basis for FISH and other molecular tests to avoid unnecessary testing.
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Affiliation(s)
- A Dewan
- CORE Diagnostics, Gurugram, Haryana, India
| | - L Kini
- CORE Diagnostics, Gurugram, Haryana, India
| | - S Sharma
- CORE Diagnostics, Gurugram, Haryana, India
| | - M Bhardwaj
- CORE Diagnostics, Gurugram, Haryana, India
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Shah SB, Bhardwaj M, Bhargava AK, Kansal A. Meeting the challenges in HIV patients undergoing robotic oncosurgery. J Anaesthesiol Clin Pharmacol 2018; 34:402-404. [PMID: 30386029 PMCID: PMC6194818 DOI: 10.4103/joacp.joacp_111_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- S B Shah
- Department of Anaesthesia, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
| | - M Bhardwaj
- Department of Anaesthesia, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
| | - A K Bhargava
- Department of Anaesthesia, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
| | - A Kansal
- Department of Anaesthesia, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
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17
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Erben V, Bhardwaj M, Schrotz-King P, Brenner H. Metabolomics Biomarkers for Detection of Colorectal Neoplasms: A Systematic Review. Cancers (Basel) 2018; 10:E246. [PMID: 30060469 PMCID: PMC6116151 DOI: 10.3390/cancers10080246] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 07/23/2018] [Accepted: 07/25/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Several approaches have been suggested to be useful in the early detection of colorectal neoplasms. Since metabolites are closely related to the phenotype and are available from different human bio-fluids, metabolomics are candidates for non-invasive early detection of colorectal neoplasms. OBJECTIVES We aimed to summarize current knowledge on performance characteristics of metabolomics biomarkers that are potentially applicable in a screening setting for the early detection of colorectal neoplasms. DESIGN We conducted a systematic literature search in PubMed and Web of Science and searched for biomarkers for the early detection of colorectal neoplasms in easy-to-collect human bio-fluids. Information on study design and performance characteristics for diagnostic accuracy was extracted. RESULTS Finally, we included 41 studies in our analysis investigating biomarkers in different bio-fluids (blood, urine, and feces). Although single metabolites mostly had limited ability to distinguish people with and without colorectal neoplasms, promising results were reported for metabolite panels, especially amino acid panels in blood samples, as well as nucleosides in urine samples in several studies. However, validation of the results is limited. CONCLUSIONS Panels of metabolites consisting of amino acids in blood and nucleosides in urinary samples might be useful biomarkers for early detection of advanced colorectal neoplasms. However, to make metabolomic biomarkers clinically applicable, future research in larger studies and external validation of the results is required.
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Affiliation(s)
- Vanessa Erben
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany.
- Medical Faculty Heidelberg, Heidelberg University, 69120 Heidelberg, Germany.
| | - Megha Bhardwaj
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany.
- Medical Faculty Heidelberg, Heidelberg University, 69120 Heidelberg, Germany.
| | - Petra Schrotz-King
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany.
| | - Hermann Brenner
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany.
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany.
- German Cancer Consortium (DKTK), 69120 Heidelberg, Germany.
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18
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Mahapatra HS, Pursnani L, Verma H, Bhardwaj M. Kimura's Disease Presenting as Proliferative Glomerulonephritis with Complete Heart Block. Indian J Nephrol 2018; 28:251-253. [PMID: 29962683 PMCID: PMC5998726 DOI: 10.4103/ijn.ijn_189_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- H. S. Mahapatra
- Department of Nephrology, Dr. R.M.L Hospital, PGIMER, New Delhi, India
| | - L. Pursnani
- Department of Nephrology, Dr. R.M.L Hospital, PGIMER, New Delhi, India
| | - H. Verma
- Department of Nephrology, Dr. R.M.L Hospital, PGIMER, New Delhi, India
| | - M. Bhardwaj
- Department of Pathology, Dr. R.M.L Hospital, PGIMER, New Delhi, India
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19
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Khanna G, Pathak P, Suri V, Sharma MC, Chaturvedi S, Ahuja A, Bhardwaj M, Garg A, Sarkar C, Sharma R. Immunohistochemical and molecular genetic study on epithelioid glioblastoma: Series of seven cases with review of literature. Pathol Res Pract 2018; 214:679-685. [PMID: 29615337 DOI: 10.1016/j.prp.2018.03.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Revised: 03/08/2018] [Accepted: 03/20/2018] [Indexed: 10/17/2022]
Abstract
Epithelioid glioblastoma (e-gbm) is a recently described variant of glioblastoma (GBM) which is associated with short survival and now added as a provisional entity to WHO 2016 classification of CNStumors. About half of these tumors show characteristic BRAF-V600E mutation. However, unlike conventional GBMs, e-gbm lack specific diagnostic and prognostic markers. Hence, we aimed to molecularly characterize these tumors. An extensive review of literature was performed.In a multi-institutional effort, all the cases of glioblastoma of year 2017 were reviewed. Cases with predominant epithelioid morphology were analysed. Seven cases of e-gbm (adults:4 and pediatric: 3) were identified. Duration of symptoms varied from 2 weeks to one month. Radiologically, all cases were supratentorial, contrast enhancing with solid and cystic appearance. Majority of the cases were immunopositive for GFAP (71%), EMA (71%), S100 (71%) and vimentin (85%). All the cases showed ATRX, INI-1 and H3K27me3 expression. BRAFV600Emutation was seen in 28% of cases. TERT mutation was seen in 40% cases, while one case showed EGFR amplification. H3F3A mutations and PTEN deletions were seen in none. Although e-gbms are rare, epithelioid morphology of a CNS tumor in a young adult or children with areas of necrosis needs thorough histomorphological and genetic workup.
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Affiliation(s)
- Gaurav Khanna
- Department of Pathology, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India.
| | - Pankaj Pathak
- Department of Pathology, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India.
| | - Vaishali Suri
- Department of Pathology, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India.
| | - Mehar Chand Sharma
- Department of Pathology, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India.
| | - Sujata Chaturvedi
- Department of Pathology, Institute of Human Behaviour and Allied Sciences, New Delhi, India.
| | - Arvind Ahuja
- Department of Pathology, PGIMER & Dr. RML Hospital, New Delhi, India.
| | - M Bhardwaj
- Department of Pathology, PGIMER & Dr. RML Hospital, New Delhi, India.
| | - Ajay Garg
- Department of Neuroradiology,All India Institute of Medical Sciences (AIIMS), New Delhi, India.
| | - Chitra Sarkar
- Department of Pathology, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India.
| | - Rajeev Sharma
- Department of Neurosurgery, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
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20
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Gies A, Bhardwaj M, Stock C, Schrotz-King P, Brenner H. Quantitative fecal immunochemical tests for colorectal cancer screening. Int J Cancer 2018; 143:234-244. [PMID: 29277897 DOI: 10.1002/ijc.31233] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 12/01/2017] [Accepted: 12/12/2017] [Indexed: 12/19/2022]
Abstract
Fecal immunochemical tests (FITs) for hemoglobin (Hb) are increasingly used for colorectal cancer (CRC) screening. We aimed to review, summarize and compare reported diagnostic performance of various FITs. PubMed and Web of Science were searched from inception to July 24, 2017. Data on diagnostic performance of quantitative FITs, conducted in colonoscopy-controlled average-risk screening populations, were extracted. Summary receiver operating characteristic (ROC) curves were plotted and correlations between thresholds, positivity rates (PRs), sensitivities and specificities were assessed. Seven test brands were investigated across 22 studies. Although reported sensitivities for CRC, advanced adenoma (AA) and any advanced neoplasm (AN) varied widely (ranges: 25-100%, 6-44% and 9-60%, respectively), with specificities for AN ranging from 82% to 99%, the estimates were very close to the respective summary ROC curves whose areas under the curve (95% CI) were 0.905 (0.88-0.94), 0.683 (0.67-0.70) and 0.710 (0.70-0.72) for CRC, AA and AN, respectively. The seemingly large heterogeneity essentially reflected variations in test thresholds (range: 2-82 µg Hb/g feces) and showed moderate correlations with sensitivity (r = -0.49) and specificity (r = 0.60) for AN. By contrast, observed PRs (range: 1-21%) almost perfectly correlated with sensitivity (r = 0.84) and specificity (r = -0.94) for AN. The apparent large heterogeneity in diagnostic performance between various FITs can be almost completely overcome by appropriate threshold adjustments. Instead of simply applying the threshold recommended by the manufacturer, screening programs should adjust the threshold to yield a desired PR which is a very good proxy indicator for the specificity and the subsequent colonoscopy workload.
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Affiliation(s)
- Anton Gies
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Megha Bhardwaj
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Christian Stock
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Petra Schrotz-King
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Hermann Brenner
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany.,Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.,German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
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21
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Bhardwaj M, Gies A, Werner S, Schrotz-King P, Brenner H. Blood-Based Protein Signatures for Early Detection of Colorectal Cancer: A Systematic Review. Clin Transl Gastroenterol 2017; 8:e128. [PMID: 29189767 PMCID: PMC5717517 DOI: 10.1038/ctg.2017.53] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 10/10/2017] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES Blood-based proteins might be an attractive option for early detection of colorectal cancer (CRC), but individually they are unlikely to achieve the diagnostic performance required for population based screening. We aimed at summarizing current evidence of diagnostic performance of signatures based on multiple proteins for early detection of CRC. METHODS A systematic literature review adhering to the PRISMA (preferred reporting items for systematic reviews and meta-analysis) guidelines was performed. PubMed and Web of Science databases were searched for potentially relevant studies published until 28th August, 2017. Relevant studies were identified by predefined eligibility criteria. Estimates of indicators of diagnostic performance such as sensitivity, specificity, and the area under the curve (AUC), along with information on validation and other key methodological procedures were extracted. Study quality was assessed by a QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies 2) instrument tool. RESULTS Thirty six eligible studies with numbers of CRC cases ranging from 23 to 512 and the number of proteins included in signatures ranged from 3 to 13 were identified. Reported Youden's Index and AUC ranged from 0.19 to 0.95 and from 0.62 to 0.996, respectively. However most studies, especially those reporting better diagnostic performance, were conducted in clinical rather than screening setting and many studies lacked any internal or external validation of identified algorithm. CONCLUSIONS Blood-based tests using signatures of multiple proteins may be a promising approach for non-invasive CRC screening. However, promising signatures identified in clinical settings still require rigorous evaluation in large studies conducted in true screening setting.
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Affiliation(s)
- Megha Bhardwaj
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Anton Gies
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Simone Werner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Petra Schrotz-King
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Hermann Brenner
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
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22
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Bhardwaj M, Erben V, Schrotz-King P, Brenner H. Cell Line Secretome and Tumor Tissue Proteome Markers for Early Detection of Colorectal Cancer: A Systematic Review. Cancers (Basel) 2017; 9:cancers9110156. [PMID: 29144439 PMCID: PMC5704174 DOI: 10.3390/cancers9110156] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 11/06/2017] [Accepted: 11/08/2017] [Indexed: 12/12/2022] Open
Abstract
Objective: In order to find low abundant proteins secretome and tumor tissue proteome data have been explored in the last few years for the diagnosis of colorectal cancer (CRC). In this review we aim to summarize the results of studies evaluating markers derived from the secretome and tumor proteome for blood based detection of colorectal cancer. Methods: Observing the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines PubMed and Web of Science databases were searched systematically for relevant studies published up to 18 July 2017. After screening for predefined eligibility criteria a total of 47 studies were identified. Information on diagnostic performance indicators, methodological procedures and validation was extracted. Functions of proteins were identified from the UniProt database and the the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was used to assess study quality. Results: Forty seven studies meeting inclusion criteria were identified. Overall, 83 different proteins were identified, with carcinoembryonic Antigen (CEA) being by far the most commonly reported (reported in 24 studies). Evaluation of the markers or marker combinations in blood samples from CRC cases and controls yielded apparently very promising diagnostic performances, with area under the curve >0.9 in several cases, but lack of internal or external validation, overoptimism due to overfitting and spectrum bias due to evaluation in clinical setting rather than screening settings are major concerns. Conclusions: Secretome and tumor proteome-based biomarkers when validated in blood yield promising candidates. However, for discovered protein markers to be clinically applicable as screening tool they have to be specific for early stages and need to be validated externally in larger studies with participants recruited in true screening setting.
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Affiliation(s)
- Megha Bhardwaj
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg 69120, Germany.
| | - Vanessa Erben
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg 69120, Germany.
| | - Petra Schrotz-King
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg 69120, Germany.
| | - Hermann Brenner
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg 69120, Germany.
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg 69120, Germany.
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg 69120, Germany.
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Bhardwaj M, Price J, Landry M, Harvey P, Hensel J. The Association Between Depression Severity and Cardiac Risk Factors Among Women Referred to a Cardiac Rehabilitation and Prevention Clinic. Can J Cardiol 2016. [DOI: 10.1016/j.cjca.2016.02.029] [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: 11/29/2022] Open
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24
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Mahapatra HS, Ramanarayanan S, Gupta A, Bhardwaj M. Co-existence of classic familial lecithin-cholesterol acyl transferase deficiency and fish eye disease in the same family. Indian J Nephrol 2015; 25:362-5. [PMID: 26664212 PMCID: PMC4663774 DOI: 10.4103/0971-4065.157802] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
We report a family with a rare genetic disorder arising out of mutation in the gene that encodes for the enzyme lecithin-cholesterol acyltransferase (LCAT). The proband presented with nephrotic syndrome, hemolytic anemia, cloudy cornea, and dyslipidemia. Kidney biopsy showed certain characteristic features to suggest LCAT deficiency, and the enzyme activity in the serum was undetectable. Mother and younger sister showed corneal opacity and dyslipidemia but no renal or hematological involvement. These two members had a milder manifestation of the disease called fish eye disease. This case is presented to emphasize the importance of taking family history and doing a good clinical examination in patients with nephrotic syndrome and carefully analyze the lipid fractions in these subset of patients.
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Affiliation(s)
- H S Mahapatra
- Department of Nephrology, PGIMER, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - S Ramanarayanan
- Department of Nephrology, PGIMER, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - A Gupta
- Department of Nephrology, PGIMER, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - M Bhardwaj
- Department of Nephrology, PGIMER, Dr. Ram Manohar Lohia Hospital, New Delhi, India
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25
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Bhardwaj M, Arteta M, Batmunkh T, Briceno Leonardo L, Caraballo Y, Carvalho D, Dan W, Erdogan S, Brborovic H, Gudrun K, Ilse U, Ingle GK, Joshi SK, Kishore J, Khan Z, Retneswari M, Menses C, Moraga D, Njan A, Okonkwo FO, Ozlem K, Ravichandran S, Rosales J, Rybacki M, Sainnyambuu M, Shathanapriya K, Radon K. Attitude of medical students towards occupational safety and health: a multi-national study. Int J Occup Environ Med 2015; 6:7-19. [PMID: 25588221 PMCID: PMC6977061 DOI: 10.15171/ijoem.2015.488] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 09/17/2014] [Indexed: 11/09/2022]
Abstract
BACKGROUND Work-related diseases contribute immensely to the global burden of diseases. Better understanding of attitudes of health care workers towards occupational safety and health (OSH) is important for planning. OBJECTIVE To assess the attitude of medical students towards OSH around the globe. METHODS A questionnaire assessing the attitude towards OSH was administered to medical and paramedical students of 21 Medical Universities across the globe. In the current study 1895 students, aged 18-36 years, from 17 countries were included. After having performed a principal components analysis, the associations of interest between the identified components and other socio demographic characteristics were assessed by multivariate linear regression. RESULTS Principal component analysis revealed 3 components. Students from lower and lower-middle-income countries had a more positive attitude towards OSH, but the importance of OSH was still rated higher by students from upper-income countries. Although students from Asian and African continents showed high interest for OSH, European and South-Central American students comparatively rated importance of OSH to be higher. Paramedical students had more positive attitude towards OSH than medical students. CONCLUSION The attitude of students from lower-income and lower-middle-income towards importance of OSH is negative. This attitude could be changed by recommending modifications to OSH courses that reflect the importance of OSH. Since paramedical students showed more interest in OSH than medical students, modifications in existing health care system with major role of paramedics in OSH service delivery is recommended.
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Affiliation(s)
- M Bhardwaj
- Institute for Medical Informatics, Biometry and Epidemiology, Ludwig Maximilians University of Munich, Munich, Germany.
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Taxak S, Vashisht K, Kaur KP, Ahlawat G, Bhardwaj M. A study to evaluate fibreoptic-guided intubation through the i-gel™. Southern African Journal of Anaesthesia and Analgesia 2014. [DOI: 10.1080/22201173.2013.10872907] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- S Taxak
- Department of Anaesthesiology and Critical Care, Pt. B.D. Sharma PGIMS Haryana, India
| | - K Vashisht
- Department of Anaesthesiology and Critical Care, Pt. B.D. Sharma PGIMS Haryana, India
| | - KP Kaur
- Department of Anaesthesiology and Critical Care, Pt. B.D. Sharma PGIMS Haryana, India
| | - G Ahlawat
- Department of Anaesthesiology and Critical Care, Pt. B.D. Sharma PGIMS Haryana, India
| | - M Bhardwaj
- Department of Anaesthesiology and Critical Care, Pt. B.D. Sharma PGIMS Haryana, India
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Bhardwaj M, Baum U, Markevych I, Mohamed A, Weinmann T, Nowak D, Radon K. Are primary school students exposed to higher noise levels than secondary school students in Germany? Int J Occup Environ Med 2013; 4:2-11. [PMID: 23279793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Accepted: 11/23/2012] [Indexed: 06/01/2023]
Abstract
BACKGROUND Noise, one of the major environmental nuisances, affects the learning ability of children negatively. OBJECTIVE With the assumption that in the existing German 4-type school system children are exposed to various noise levels in each type of school, we investigated the association between children's school type and environmental noise level. METHODS In this cross-sectional study, we included 550 children, primary and secondary school students, aged 8-12 years, and who lived in 4 Bavarian cities. The environmental noise level was assessed by personal 24-h dosimeter measurements. The associations of interest were assessed by linear regression. RESULTS The average day noise level of 80.0 dB(A) was relatively high, exceeding the threshold level of 60 dB(A). In the model adjusted for sex, socioeconomic status (SES), and place of residence, noise level was significantly higher for primary schools by almost 2.3 dB(A); however, after additional adjustments for age, this association was distorted. The mean night noise level of 43.7 dB(A) was not associated with the school level. We could not find any significant differences in the noise level between different types of secondary schools. CONCLUSION We found evidence that in Germany, children, especially of a younger age from primary school, are exposed to high noise levels during day in and outside the school environment. School administration and parents should work to make schools less noisy and more accomplished for learning to achieve a bright future for the children.
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Affiliation(s)
- M Bhardwaj
- Clinical Center of the Ludwig-Maximilian-University of Munich, Munich, Germany.
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Soltanifar S, Tunstill S, Bhardwaj M, Russell R. The incidence of postoperative morbidity following general anaesthesia for caesarean section. Int J Obstet Anesth 2011; 20:365. [DOI: 10.1016/j.ijoa.2011.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2011] [Revised: 07/04/2011] [Accepted: 07/06/2011] [Indexed: 11/28/2022]
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29
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Bhardwaj M, Dixit A. Dialysis for severe hyponatraemia in preeclampsia. Obstet Med 2010; 3:87. [PMID: 27582851 DOI: 10.1258/om.2010.100019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- M Bhardwaj
- Department of Anaesthesia, High Wycombe Hospital , High Wycombe , UK
| | - Archana Dixit
- Department of Obstetrics and Gynaecology, West Middlesex University Hospital , Isleworth , UK
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Shashi A, Sharma N, Bhardwaj M. Pathological evaluation of pancreatic exocrine glands in experimental fluorosis. ASIAN PAC J TROP MED 2010. [DOI: 10.1016/s1995-7645(10)60028-4] [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: 10/19/2022] Open
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32
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Kar HK, Raina A, Sharma PK, Bhardwaj M. Annular vesiculobullous eruptions in type 2 reaction in borderline lepromatous leprosy: a case report. Indian J Lepr 2009; 81:205-208. [PMID: 20704077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
An untreated case of BL presented with clinical features of type 2 reaction (T2R) confirmed by histopathology. The case was a 18-year-old female with borderline lepromatous leprosy who developed annular vesiculobullous eruptions oversome of the pre-existing plaques on arms and upper back along with fever and severe neuritis after a short course of ofloxacin intake prescribed for urinary tract infection. In addition to the above lesions, some of the existing lesions showed acute exacerbation characterized by erythema, oedema, tenderness and vesiculobullous eruption. This can be considered as an example of leprous exacerbation as described in older literature. T2Rs are common in lepromatous leprosy and not so uncommonly are observed in borderline lepromatous leprosy. The vesiculobullous and crusted lesions developing over the existing borderline plaques, some of them presenting in an annular pattern in T2R in the form of leprous exacerbation, have been reported rarely in the literature.
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MESH Headings
- Adolescent
- Clofazimine/administration & dosage
- Dose-Response Relationship, Drug
- Drug Therapy, Combination
- Erythema Nodosum/drug therapy
- Erythema Nodosum/pathology
- Female
- Glucocorticoids/administration & dosage
- Humans
- Leprostatic Agents/administration & dosage
- Leprosy, Borderline/complications
- Leprosy, Borderline/drug therapy
- Leprosy, Borderline/pathology
- Leprosy, Lepromatous/drug therapy
- Leprosy, Lepromatous/pathology
- Prednisolone/administration & dosage
- Recurrence
- Skin/pathology
- Skin Diseases, Vesiculobullous/complications
- Skin Diseases, Vesiculobullous/drug therapy
- Skin Diseases, Vesiculobullous/pathology
- Treatment Outcome
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Affiliation(s)
- H K Kar
- Department of Dermatology, PGIMER and Dr Ram Manohar Lohia Hospital, New Delhi-110001, India
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Sharma P, Bhardwaj M, Kar HK. Inoculation leprosy and HIV co-infection: a rare case with nerve involvement preceding development of skin patch and type 1 reaction as immune reconstitution syndrome following antiretroviral therapy. Indian J Lepr 2009; 81:75-79. [PMID: 20509336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The transmission of leprosy has been universally accepted to be primarily, through nasal dissemination from multibacillary patients to the susceptible persons. However, the possibility of leprosy transmission through prolonged skin contact with abraded leprous skin or through skin inoculation can not be ruled out. We report a case of development of a paucibacillary leprosy patch close to the site of a local trauma, after an interval of about 13-14 years, in a HIV positive subject. Also discussed are the various hypotheses in the aetiopathogenesis of leprosy like entry route of lepra bacilli into the body, viability of lepra bacilli in the environment and evolution of skin and nerve lesions of leprosy.
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Affiliation(s)
- P Sharma
- Department of Dermatology, STDs and Leprosy, Dr Ram Manohar Lohia Hospital and PGIMER, Baba Kharag Singh Marg, New Delhi-110001, India
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Sharma P, Kar HK, Singh B, Deepak D, Bhardwaj M. Systemic sarcoidosis in a case of lepromatous leprosy: a case report. Indian J Lepr 2008; 80:275-278. [PMID: 19432358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The clinical features of cutaneous sarcoidosis and leprosy are some times difficult to differentiate and there have been many reports where pulmonary sarcoidosis was treated as pulmonary tuberculosis or a case of sarcoidosis was treated with anti-leprosy multidrug therapy, before a correct diagnosis was made. So far there has been only one published case report of leprosy and sarcoidosis co-infection, where tuberculoid leprosy developed in a case of sarcoidosis, known for over a decade. We are reporting a case of dual affliction, where sarcoidosis was discovered (on routine screening) in a case of lepromatous leprosy, after administration of 2 years of multidrug therapy. The role of mycobacterial antigens (among a vast array of different animate or inanimate particles) in causation of sarcoidosis, is still speculative, as reviewed from literature.
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Affiliation(s)
- P Sharma
- Department of Dermatology, STDs and Leprosy, Dr Ram Manohar Lohia Hospital and PGIMER, Baba Kharak Singh Marg, New Delhi-110001, India
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Ichhpujani RL, Mala C, Veena M, Singh J, Bhardwaj M, Bhattacharya D, Pattanaik SK, Balakrishnan N, Reddy AK, Samnpath G, Gandhi N, Nagar SS, Shiv L. Epidemiology of animal bites and rabies cases in India. A multicentric study. J Commun Dis 2008; 40:27-36. [PMID: 19127666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Rabies, a disease of antiquity continues to be a major public health problem in India. Multiple factors contribute to high mortality and morbidity due to animal bites. An effective strategy for control of rabies takes into account the epidemiology of animal bites, rabies and factors influencing post exposure treatment. The study was carried out as a part of Agreement for Performance of Work (APW) from World Health Organization (WHO) during the period April 2001 to September 2002. Two sets of proformae were developed and used after field testing to interview cases of animal bites and get retrospective information about rabies cases. The study was carried out at six selected centres across the country viz. Delhi, Hyderabad, Raipur, Jamnagar, Coonoor and Rajahmundry and was co-ordinated by National Institute of Communicable Diseases (NICD), Delhi. The officials engaged in the study work were thoroughly trained in the study methodology before the start of the study itself. To maintain quality and uniformity supervisory checks were done during the survey. A total of 1357 fresh animal bite victims were interviewed (exit interview) from the anti-rabies centres (ARCs). Dog bites caused maximum morbidity (92%). Second most common biting animal was monkey (3.2%), followed by cat (1.8%), fox (0.4%) etc. Most bites (64.3%) were unprovoked bites by stray (64.7%) animals. In this study 72.4% animal bite victims were males and 47.5% were children in age group of 2-18 years. 63% had Category III exposure as per the WHO classification. Before coming to ARCs 58.5% people had washed the wound with water/soap or water alone. Some of the bite victims (10.8%) had also applied chillies, salt, turmeric powder, lime, snuff powder, paste of leaves, acid, ash given by Peer Baba (magician) etc. These practices varied from one region to another. The practice of wound washing at the ARC which is an important component of animal bite management was being practiced at only one of the six centres. Of the six centres, Rabies Immunoglobulin (RIG) was available and was being used at only two centres. The study was conducted in public sector ARCs where Nervous Tissue Vaccine (NTV) was available free of cost. All the centres were using NTV except Coonoor, which is using indigenously produced Tissue Culture Vaccine along with NTV. Analysis of 192 case records of rabies cases, from two centres, revealed that dog bites caused maximum mortality (96.9%). Nearly 40% were children below 15 years of age and 78.6% were males indicating that it is an exposure related disease. In all cases, failure to seek timely and appropriate treatment led to development of disease. This paper provides an overview of epidemiology of animal bites and retrospective information about rabies patients. There is a need to strengthen Information, Education and Communication (IEC) programme regarding merits of local wound management including "do's and don'ts". ARCs should be strengthened in terms of facilities and availability of safe and effective anti rabies immunobiologicals. There is a need to create awareness regarding epidemiology and at-home and hospital management of animal bites among the service providers and general community.
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Affiliation(s)
- R L Ichhpujani
- WHO Collaborating Centre for Rabies Epidemiology, National Institute of Communicable Diseases, 22-Shamnath Marg, Delhi
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Saxena K, Nischal H, Bhardwaj M, Gaba P, Shastry B. Right molar approach to tracheal intubation in a child with Pierre Robin syndrome, cleft palate, and tongue tie. Br J Anaesth 2008; 100:141-2. [DOI: 10.1093/bja/aem359] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Abstract
The management of Jehovah's Witnesses suffering from severe haemorrhage can be very difficult. Those patients who are taking oral anticoagulant therapy pose an additional risk and the difficulty may be compounded by the development of coagulopathy. Several alternatives to blood products have been reported to be useful in this situation. We report the successful management of an emergency postsurgical wound bleeding in a Jehovah's Witness using Beriplex (a concentrate of factors II, VII, IX and X). The patient, who was taking warfarin, presented 10 days after an elective laminectomy with significant bleeding from the surgical wound and coagulopathy. Despite early surgical measures, there was continuing haemorrhage. This was arrested by giving Beriplex intra-operatively. To our knowledge this is the first reported case of the use of Beriplex in a Jehovah's Witness for control of emergency haemorrhage and coagulopathy.
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Affiliation(s)
- M Bhardwaj
- Department of Anaesthetics, Stoke Madeville Hospital, Aylesbury, UK.
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Kumar P, Sharma PK, Jain RK, Gautam RK, Bhardwaj M, Kar HK. Oral ulcer as an unusual feature of visceral leishmaniasis in an AIDS patient. Indian J Med Sci 2007; 61:97-101. [PMID: 17259689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Leishmaniasis, a globally prevalent parasitic disease, occurs in three forms, viz, visceral, cutaneous and mucocutaneous. It is transmitted by female Phlebotomus sandflies. Human immunodeficiency virus (HIV) infection is increasing worldwide and several reports indicate a rising trend of VL / HIV co-infection, modifying the traditional anthroponotic pattern of VL transmission. India is one of the countries having the largest burden of leishmaniasis; nevertheless, there are very few HIV / leishmania co-infection cases reported so far. We report a 35-year-old homemaker infected with the human immunodeficiency virus; she presented with an oral ulcer. The investigations carried out on her revealed that she was afflicted by visceral leishmaniasis and the oral ulceration was a part of the same. This is only the second such case from the Indian subcontinent and more significantly from a non-endemic area.
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Affiliation(s)
- Pramod Kumar
- Department of Dermatology, Dr. Ram Manohar Lohia Hospital, New Delhi, India.
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39
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Ghosh A, Bhardwaj M, Satyanarayana T, Khurana M, Mayilraj S, Jain RK. Bacillus lehensis sp. nov., an alkalitolerant bacterium isolated from soil. Int J Syst Evol Microbiol 2007; 57:238-242. [PMID: 17267957 DOI: 10.1099/ijs.0.64617-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [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: 11/18/2022] Open
Abstract
A Gram-positive, endospore-forming, alkalitolerant bacterial strain, designated MLB2T, was isolated from soil from Leh, India, and was subjected to a polyphasic taxonomic study. The strain exhibited phenotypic properties that included chemotaxonomic characteristics consistent with its classification in the genusBacillus. Growth was observed at pH 7.0–11.0, but not at pH 6.0. The DNA G+C content was 41.4 mol%. The highest level of 16S rRNA gene sequence similarity was withBacillus oshimensisJCM 12663T(98.8 %). However, DNA–DNA hybridization experiments indicated low levels of genomic relatedness with the type strains ofB. oshimensis(62 %),Bacillus patagoniensis(55 %),Bacillus clausii(51 %) andBacillus gibsonii(34 %), the species with which strain MLB2Tformed a coherent cluster (based on the results of the phylogenetic analysis). On the basis of the phenotypic characteristics and genotypic distinctiveness of strain MLB2T, it should be classified within a novel species ofBacillus, for which the nameBacillus lehensissp. nov. is proposed. The type strain is MLB2T(=MTCC 7633T=JCM 13820T).
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MESH Headings
- Alkalies/pharmacology
- Anti-Bacterial Agents/pharmacology
- Bacillus/classification
- Bacillus/cytology
- Bacillus/isolation & purification
- Bacillus/physiology
- Bacterial Typing Techniques
- Base Composition
- DNA, Bacterial/chemistry
- DNA, Bacterial/genetics
- DNA, Ribosomal/chemistry
- DNA, Ribosomal/genetics
- Drug Resistance, Bacterial
- Genes, rRNA/genetics
- Hydrogen-Ion Concentration
- India
- Molecular Sequence Data
- Nucleic Acid Hybridization
- Phylogeny
- RNA, Bacterial/genetics
- RNA, Ribosomal, 16S/genetics
- Sequence Analysis, DNA
- Sequence Homology, Nucleic Acid
- Soil Microbiology
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Affiliation(s)
- A Ghosh
- Microbial Type Culture Collection and Gene Bank (MTCC), Institute of Microbial Technology, Sector-39A, Chandigarh 160036, India
| | - M Bhardwaj
- Microbiology, University of Delhi, South Campus, Benito Juarez Road, New Delhi 110021, India
| | - T Satyanarayana
- Microbiology, University of Delhi, South Campus, Benito Juarez Road, New Delhi 110021, India
| | - M Khurana
- Microbial Type Culture Collection and Gene Bank (MTCC), Institute of Microbial Technology, Sector-39A, Chandigarh 160036, India
| | - S Mayilraj
- Microbial Type Culture Collection and Gene Bank (MTCC), Institute of Microbial Technology, Sector-39A, Chandigarh 160036, India
| | - R K Jain
- Microbial Type Culture Collection and Gene Bank (MTCC), Institute of Microbial Technology, Sector-39A, Chandigarh 160036, India
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Kumar P, Sharma PK, Jain RK, Gautam RK, Bhardwaj M, Kar HK. Oral ulcer as an unusual feature of visceral leishmaniasis in an AIDS patient. ACTA ACUST UNITED AC 2007. [DOI: 10.4103/0019-5359.30350] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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41
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Chhabra M, Ichhpujani RL, Bhardwaj M, Tiwari KN, Panda RC, Lal S. Safety and immunogenicity of the intradermal Thai red cross (2-2-2-0-1-1) post exposure vaccination regimen in the Indian population using purified chick embryo cell rabies vaccine. Indian J Med Microbiol 2005; 23:24-8. [PMID: 15928417 DOI: 10.4103/0255-0857.13868] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
PURPOSE To test the immunogenicity of the WHO recommended "2-2-2-0-1-1" post-exposure rabies vaccination regimen in Indian subjects to determine the feasibility of replacing crude sheep brain nerve tissue rabies vaccine with modern tissue culture rabies vaccine at major anti-rabies treatment centers throughout India. METHODS Purified chick embryo cell vaccine (PCECV) was administered in the dosage of 0.1 mL per site to 53 Indian subjects. RESULTS All subjects produced rabies antibodies above 0.5 IU/mL by day 14 post-vaccination. Only minor adverse reactions including swelling (6.6%), erythema (5.4%) and pain (1.4%) were observed for which no treatment was required. CONCLUSIONS This study demonstrated that PCECV is safe and highly immunogenic in Indian subjects when administered intradermally as 0.1 mL/site using the "2-2-2-0-1-1" post-exposure regimen.
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Affiliation(s)
- Mala Chhabra
- National Institute of Communicable Diseases, Sham Nath Marg, New Delhi 110 054, India.
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Affiliation(s)
- A V R Reddy
- Department of Surgery and Paediatric Surgery, All India Institute of Medical Sciences, New Delhi, India
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Abstract
Posttraumatic intra-abdominal cysts generally develop in relation to solid abdominal organs and most originate as a result of the organization of fluid or blood collection after trauma. They lack true endothelial lining and are hence called "pseudocysts." We report herein the rare case of a traumatic pseudocyst of the greater omentum in a 6-year-old child who was successfully treated by laparotomy and excision of the cyst.
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Affiliation(s)
- S K Ratan
- Department of Paediatric Surgery, Dr Ram Manohar Lohia Hospital, New Delhi, India
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Abstract
A 12-year-old boy with a pleomorphic adenoma of the parotid is reported. The excised gland specimen also showed evidence of chronic sialadenitis. The co-existence of these two entities has not been previously reported in the literature surveyed by us. The authors feel that the two conditions may have a common underlying etiology.
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Affiliation(s)
- S K Ratan
- Department of Pediatric Surgery, Dr. RML Hospital, New Delhi 110 001, India
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Bhardwaj M, Eckert CG. Functional analysis of synchronous dichogamy in flowering rush, Butomus umbellatus (Butomaceae). Am J Bot 2001; 88:2204-2213. [PMID: 21669653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Dichogamy is one of the most widespread floral mechanisms in flowering plants and is thought to have evolved to reduce interference between pollen import and export within flowers, especially self-pollination. Self-pollination between flowers may also be reduced if dichogamy is synchronous among flowers on an inflorescence. The analysis of dichogamy at both levels requires that the sexual phases of individual flowers be defined functionally in terms of pollen deposition and removal. We conducted morphological and functional analyses to investigate the degree of dichogamy within flowers and the synchronicity of dichogamy between flowers within inflorescences in an emergent, aquatic monocot, flowering rush (Butomus umbellatus). Based on daily observations of the development of marked flowers, data on the schedule of anther dehiscence within flowers, and repeat surveys of floral sex ratios in three populations, individual flowers appear to be strictly protandrous. On average, each flower spends ∼1 d in each of male and female phases with an intervening 1-d neuter phase during which there is no available pollen in anthers and stigmas are not yet exposed to receive pollen. Morphological criteria used to delimit the beginning and end of each of these three sex phases were validated by quantifying the temporal schedule of pollen removal from anthers and pollen deposition on stigmas. Experimental pollinations showed that the morphological changes marking the end of female phase are hastened by pollen deposition. At the umbel level, synchronous development within sequential cohorts of flowers reduced overlap of male and female sexual phases between flowers. On average (±1 SE), 72 ± 3% of flowers completed their female phase while no other flowers on the same umbel were in male phase. Computer simulations of umbel development showed that this value is significantly higher than expected if the timing of flower development within umbels was random (30 ± 1%). Surveys of floral sex ratios in three populations revealed that 87% of umbels were either unisexual male or female at any given time. Pollinators usually visited more than one flower in sequence when foraging on umbels, suggesting that synchronous dichogamy may be an adaptation to avoid geitonogamy. The adaptiveness of both flower- and umbel-level dichogamy is also suggested because both traits are expressed to a lesser extent in obligately clonal, triploid populations, where flowers do not make seeds and hence floral adaptations are not maintained by natural selection.
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Affiliation(s)
- M Bhardwaj
- Department of Biology, Queen's University, Kingston, Ontario, Canada K7L 3N6
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Sharma PK, Gautam RK, Bhardwaj M, Kar HK. Isonicotinic acid hydrazide induced anagen effluvium and associated lichenoid eruption. J Dermatol 2001; 28:737-41. [PMID: 11804071] [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: 02/23/2023]
Abstract
A 32 year-old woman developed generalised lichenoid eruptions on her body followed by diffuse loss of scalp hair of the anagen effluvium type. She was receiving several anti-tubercular drugs, including rifampicin, isonicotinic acid hydrazide (INH), pyrazinamide, and ethambutol, for abdominal tuberculosis. INH, which is a leading cause of drug eruptions in the above group of drugs was withdrawn. However, the other antitubercular drugs were continued along with 40 mg of prednisolone in a single daily morning dose. The latter was discontinued slowly over a period of 10 weeks. There was complete recovery of hair loss and the regrowth started after 12 weeks of alopecia. Such anagen effluvium with lichenoid eruption following INH therapy has not been observed previously. The complete recovery from anagen effluvium is difficult to explain, but it could have been because of the early initiation of corticosteroid.
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Affiliation(s)
- P K Sharma
- Department of Dermatology, Dr. Ram Manohar Lohia Hospital, New Delhi, India
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Kar HK, Jain RK, Sharma PK, Gautam RK, Kumar P, Bhardwaj M. Epidemic dropsy: a study of cutaneous manifestations with histopathological correlation. Indian J Dermatol Venereol Leprol 2001; 67:178-9. [PMID: 17664732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Clinical and histopathological features of epidemic dropsy were studied in 19 patients. Bilateral pitting pedal oedema, erythrocyanosis and tachycardia without fever were the predominant clinical features. Histology revealed deposition of hyaline material on the walls of dermal blood vessels.
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Affiliation(s)
- H K Kar
- Department of Dermatology & S.T.D. and Pathology, Dr. Ram Manohar Lohia Hospital, New Delhi-110001, India
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Yadav TP, Singh R, Yadav R, Bhardwaj M, Satyanarayana L. Role of cetirizine in treatment of eosinophilia. Indian Pediatr 2000; 37:1098-101. [PMID: 11042709] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Affiliation(s)
- T P Yadav
- Department of Pediatrics, Dr. Ram Manohar Lohia Hospital, New Delhi 110 011, India
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Singh J, Balakrishnan N, Bhardwaj M, Amuthadevi P, George EG, Subramani K, Soundararajan K, Appavoo NC, Jain DC, Ichhpujani RL, Bhatia R, Sokhey J. Silent spread of dengue and dengue haemorrhagic fever to Coimbatore and Erode districts in Tamil Nadu, India, 1998: need for effective surveillance to monitor and control the disease. Epidemiol Infect 2000; 125:195-200. [PMID: 11057977 PMCID: PMC2869587 DOI: 10.1017/s0950268899003866] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [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: 11/06/2022] Open
Abstract
Dengue fever (DF) or dengue haemorrhagic fever (DHF) has not previously been reported in Coimbatore and Erode districts in Tamil Nadu in India. In 1998, 20 hospitalized cases of fever tested positive for dengue virus IgM and/or IgG antibodies. All of them had dengue-compatible illness, and at least four had DHF. Two of them died. Sixteen cases were below 10 years of age. The cases were scattered in 15 distantly located villages and 5 urban localities that had a high Aedes aegypti population. Although the incidence of dengue-like illness has not increased recently, almost 89% (95/107) of samples from healthy persons in the community tested positive for dengue IgG antibodies. The study showed that dengue has been endemic in the area, but was not suspected earlier. A strong laboratory-based surveillance system is essential to monitor and control DF/DHF.
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Affiliation(s)
- J Singh
- National Institute of Communicable Diseases, Delhi, India
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Sharma R, Choudhary SK, Mohan MR, Padma MV, Jain S, Bhardwaj M, Bhan A, Kiran U, Saxena N, Venugopal P. Neurological evaluation and intelligence testing in the child with operated congenital heart disease. Ann Thorac Surg 2000; 70:575-81. [PMID: 10969683 DOI: 10.1016/s0003-4975(00)01397-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [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: 11/20/2022]
Abstract
BACKGROUND The immediate and intermediate-term neurodevelopmental outcome in infants undergoing open heart procedures using deep hypothermic cardiopulmonary bypass was assessed prospectively. METHODS One hundred consecutive infants (age 2 to 174 days) were operated on using either deep hypothermic bypass only (group A, n = 28), or with associated circulatory arrest (group B, n = 72). Early neurological outcome was recorded. Survivors underwent mental development evaluation after 31 to 55 months. Fifty other children of similar demographic profile but without heart disease were also tested as controls. RESULTS In group A, there were two neurological deaths. In group B, 5 patients had clinical seizures, 1 had monoparesis and 1 had hyperkinetic syndrome with decreased attention span. Mean mental performance quotient was 90.0+/-8.2 in group A, and 89.1+/-6.8 in group B, (group A vs. B, p = 0.60). Mean mental performance quotient in the control group was 101.4+/-8.4, which was significantly higher than the patient population (p << 0.001). No correlation was found between duration of circulatory arrest and postoperative mental performance quotient. CONCLUSIONS There was significant retardation of mental development in infants operated with deep hypothermic cardiopulmonary bypass. However, use of total circulatory arrest and its duration did not affect clinical outcome up to preschool age.
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Affiliation(s)
- R Sharma
- Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, Ansari Nagar, New Delhi.
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