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Owens HA, Thorburn LE, Walsby E, Moon OR, Rizkallah P, Sherwani S, Tinsley CL, Rogers L, Cerutti C, Ridley AJ, Williams J, Knäuper V, Ager A. Alzheimer's disease-associated P460L variant of EphA1 dysregulates receptor activity and blood-brain barrier function. Alzheimers Dement 2024; 20:2016-2033. [PMID: 38184788 PMCID: PMC10984439 DOI: 10.1002/alz.13603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 10/11/2023] [Accepted: 11/20/2023] [Indexed: 01/08/2024]
Abstract
INTRODUCTION Genome-wide association studies link susceptibility to late-onset Alzheimer's disease (LOAD) with EphA1. Sequencing identified a non-synonymous substitution P460L as a LOAD risk variant. Other Ephs regulate vascular permeability and immune cell recruitment. We hypothesized that P460L dysregulates EphA1 receptor activity and impacts neuroinflammation. METHODS EphA1/P460L receptor activity was assayed in isogenic Human Embryonic Kidney (HEK) cells. Soluble EphA1/P460L (sEphA1/sP460L) reverse signaling in brain endothelial cells was assessed by T-cell recruitment and barrier function assays. RESULTS EphA1 and P460L were expressed in HEK cells, but membrane and soluble P460L were significantly reduced. Ligand engagement induced Y781 phosphorylation of EphA1 but not P460L. sEphA1 primed brain endothelial cells for increased T-cell recruitment; however, sP460L was less effective. sEphA1 decreased the integrity of the brain endothelial barrier, while sP460L had no effect. DISCUSSION These findings suggest that P460L alters EphA1-dependent forward and reverse signaling, which may impact blood-brain barrier function in LOAD. HIGHLIGHTS EphA1-dependent reverse signaling controls recruitment of T cells by brain endothelial cells. EphA1-dependent reverse signaling remodels brain endothelial cell contacts. LOAD-associated P460L variant of EphA1 shows reduced membrane expression and reduced ligand responses. LOAD-associated P460L variant of EphA1 fails to reverse signal to brain endothelial cells.
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Affiliation(s)
- Helen A. Owens
- Division of Infection and ImmunitySchool of Medicine, Cardiff UniversityCardiffUK
- School of DentistryCardiff UniversityCardiffUK
| | - Lauren E. Thorburn
- Division of Infection and ImmunitySchool of Medicine, Cardiff UniversityCardiffUK
- UK Dementia Research Institute, Cardiff UniversityCardiffUK
| | - Elisabeth Walsby
- Division of Cancer & GeneticsSchool of Medicine, Cardiff UniversityCardiffUK
| | - Owen R. Moon
- Division of Infection and ImmunitySchool of Medicine, Cardiff UniversityCardiffUK
| | - Pierre Rizkallah
- Division of Infection and ImmunitySchool of Medicine, Cardiff UniversityCardiffUK
| | - Subuhi Sherwani
- Division of Infection and ImmunitySchool of Medicine, Cardiff UniversityCardiffUK
| | - Caroline L. Tinsley
- Division of Infection and ImmunitySchool of Medicine, Cardiff UniversityCardiffUK
| | - Louise Rogers
- Division of Infection and ImmunitySchool of Medicine, Cardiff UniversityCardiffUK
| | - Camilla Cerutti
- School of Cellular and Molecular Medicine, University of BristolBristolUK
| | - Anne J. Ridley
- School of Cellular and Molecular Medicine, University of BristolBristolUK
| | | | | | - Ann Ager
- Division of Infection and ImmunitySchool of Medicine, Cardiff UniversityCardiffUK
- Systems Immunity University Research InstituteCardiff UniversityCardiffUK
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Kalaitsidou M, Moon OR, Sykorova M, Bao L, Qu Y, Sukumaran S, Valentine M, Zhou X, Pandey V, Foos K, Medvedev S, Powell Jr DJ, Udyavar A, Gschweng E, Rodriguez R, Dudley ME, Hawkins RE, Kueberuwa G, Bridgeman JS. Signaling via a CD28/CD40 chimeric costimulatory antigen receptor (CoStAR™), targeting folate receptor alpha, enhances T cell activity and augments tumor reactivity of tumor infiltrating lymphocytes. Front Immunol 2023; 14:1256491. [PMID: 38022678 PMCID: PMC10664248 DOI: 10.3389/fimmu.2023.1256491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
Transfer of autologous tumor infiltrating lymphocytes (TIL) to patients with refractory melanoma has shown clinical efficacy in a number of trials. However, extending the clinical benefit to patients with other cancers poses a challenge. Inefficient costimulation in the tumor microenvironment can lead to T cell anergy and exhaustion resulting in poor anti-tumor activity. Here, we describe a chimeric costimulatory antigen receptor (CoStAR) comprised of FRα-specific scFv linked to CD28 and CD40 intracellular signaling domains. CoStAR signaling alone does not activate T cells, while the combination of TCR and CoStAR signaling enhances T cell activity resulting in less differentiated T cells, and augmentation of T cell effector functions, including cytokine secretion and cytotoxicity. CoStAR activity resulted in superior T cell proliferation, even in the absence of exogenous IL-2. Using an in vivo transplantable tumor model, CoStAR was shown to improve T cell survival after transfer, enhanced control of tumor growth, and improved host survival. CoStAR could be reliably engineered into TIL from multiple tumor indications and augmented TIL activity against autologous tumor targets both in vitro and in vivo. CoStAR thus represents a general approach to improving TIL therapy with synthetic costimulation.
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Affiliation(s)
| | - Owen R. Moon
- Department of Research, Instil Bio, Dallas, TX, United States
| | | | - Leyuan Bao
- Department of Research, Instil Bio, Dallas, TX, United States
| | - Yun Qu
- Department of Research, Instil Bio, Dallas, TX, United States
| | | | | | - Xingliang Zhou
- Department of Research, Instil Bio, Dallas, TX, United States
| | - Veethika Pandey
- Ovarian Cancer Research Center, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Kay Foos
- Ovarian Cancer Research Center, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Sergey Medvedev
- Ovarian Cancer Research Center, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Daniel J. Powell Jr
- Ovarian Cancer Research Center, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Akshata Udyavar
- Department of Research, Instil Bio, Dallas, TX, United States
| | - Eric Gschweng
- Department of Research, Instil Bio, Dallas, TX, United States
| | - Ruben Rodriguez
- Department of Research, Instil Bio, Dallas, TX, United States
| | - Mark E. Dudley
- Department of Research, Instil Bio, Dallas, TX, United States
| | | | - Gray Kueberuwa
- Department of Research, Instil Bio, Dallas, TX, United States
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Moon OR, Qu Y, King MG, Mojadidi M, Chauvin-Fleurence C, Yarka C, Evans A, Zhou X, Katopodi T(T, Udyavar A, Bridgeman JS, Kueberuwa G, Alvarez-Rodríguez R. Antitumor activity of T cells expressing a novel anti-folate receptor alpha (FOLR1) costimulatory antigen receptor (CoStAR) in a human xenograft murine solid tumor model and implications for in-human studies. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.2535] [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: 11/20/2022] Open
Abstract
2535 Background: ITIL-306 is an autologous tumor-infiltrating lymphocyte (TIL) therapy that integrates T-cell receptor (TCR)-specific antigen recognition (Signal 1) with robust costimulation via the novel CoStAR transgene upon engagement with FOLR1 (Signal 2; Sukumaran, et al. JITC. 2021;9:198). Here, we assessed IL-2 independent effector function by anti-FOLR1 CoStAR T cells in vitro and evaluated activity in a novel, more representative murine solid tumor model. Methods: For in vitro studies, healthy donor T cells were manufactured to express anti-FOLR1 CoStAR or left nontransduced (NTD). Product cells were stimulated with a single (Day [D]0; ±IL-2) or serial (D0, 7, 14, 21; no IL-2) addition of target cells expressing membrane-anchored OKT3 (Signal 1) and FOLR1 (Signal 2). T-cell activation and proliferation were measured. For in vivo studies, the carcinoembryonic antigen (CEA)-positive (Signal 1) H508 cell line was engineered to express FOLR1 (Signal 2) and injected into 6 mice/group (D–21). NTD or healthy donor T cells expressing HLA-A*02-restricted anti-CEA TCR only, anti-FOLR1 CoStAR only, or dual TCR+CoStAR were given intravenously (D0), and compared with PBS control. Tumor growth, survival, and T-cell expansion were assessed in 2 donors to D96. Results: After single and serial stimulation, only anti-FOLR1 CoStAR T cells showed sustained proliferation without exogenous IL-2. PD-1 positivity was low ( < 10%) on anti-FOLR1 T cells up to D24. In vivo, T-cell persistence on D14 was increased in dual TCR+CoStAR vs anti-CEA TCR only mice ( P<.001) and all other groups ( P<.01-.001). Tumor growth up to D58 was significantly lower in dual TCR+CoStAR ( <.5 cm3) vs all other groups (each > 2 cm3; P<.0001). Survival was significantly longer in dual TCR+CoStAR ( P<.01) vs all other groups; only dual TCR+CoStAR mice were alive at D58, with 5/6 alive at D96. The second donor showed similar tumor control irrespective of exogenous IL-2 in responder mice, with > 50% alive at D96, and robust T-cell expansion in dual TCR+CoStAR mice. Conclusions: When combined with TCR-specific binding, CoStAR significantly enhanced T-cell proliferation, persistence, and antitumor activity in vivo vs TCR alone, resulting in tumor control and prolonged survival. Effects were not observed with CoStAR alone, underscoring that signaling through CoStAR alone does not induce T-cell effector function. The sustained proliferation of anti-FOLR1 CoStAR T cells without exogenous IL-2 support in vitro and in vivo supports a clinical TIL regimen free of high-dose IL-2. These results suggest that CoStAR may improve the clinical performance and benefit/risk profile of TILs, whereby fewer toxicities are expected with the removal of post-TIL IL-2 support. This will be explored in an upcoming first-in-human clinical study with ITIL-306.
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Affiliation(s)
| | - Yun Qu
- Instil Bio, Inc., Dallas, TX
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Codd AS, Hanna SJ, Compeer EB, Richter FC, Pring EJ, Gea-Mallorquí E, Borsa M, Moon OR, Scourfield DO, Gallimore AM, Milicic A. Neutrophilia, lymphopenia and myeloid dysfunction: a living review of the quantitative changes to innate and adaptive immune cells which define COVID-19 pathology. Oxf Open Immunol 2021; 2:iqab016. [PMID: 35593707 PMCID: PMC8371938 DOI: 10.1093/oxfimm/iqab016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Destabilization of balanced immune cell numbers and frequencies is a common feature of viral infections. This occurs due to, and further enhances, viral immune evasion and survival. Since the discovery of the Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), which manifests in coronavirus disease 2019 (COVID-19), a great number of studies have described the association between this virus and pathologically increased or decreased immune cell counts. In this review, we consider the absolute and relative changes to innate and adaptive immune cell numbers, in COVID-19. In severe disease particularly, neutrophils are increased, which can lead to inflammation and tissue damage. Dysregulation of other granulocytes, basophils and eosinophils represents an unusual COVID-19 phenomenon. Contrastingly, the impact on the different types of monocytes leans more strongly to an altered phenotype, e.g. HLA-DR expression, rather than numerical changes. However, it is the adaptive immune response that bears the most profound impact of SARS-CoV-2 infection. T cell lymphopenia correlates with increased risk of intensive care unit admission and death; therefore, this parameter is particularly important for clinical decision-making. Mild and severe diseases differ in the rate of immune cell counts returning to normal levels post disease. Tracking the recovery trajectories of various immune cell counts may also have implications for long-term COVID-19 monitoring. This review represents a snapshot of our current knowledge, showing that much has been achieved in a short period of time. Alterations in counts of distinct immune cells represent an accessible metric to inform patient care decisions or predict disease outcomes.
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Affiliation(s)
- Amy S Codd
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - Stephanie J Hanna
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - Ewoud B Compeer
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Kennedy Institute of Rheumatology, University of Oxford, Oxford, UK
| | - Felix C Richter
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Kennedy Institute of Rheumatology, University of Oxford, Oxford, UK
| | - Eleanor J Pring
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - Ester Gea-Mallorquí
- Viral Immunology Unit, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Mariana Borsa
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Kennedy Institute of Rheumatology, University of Oxford, Oxford, UK
| | - Owen R Moon
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - D Oliver Scourfield
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - Awen M Gallimore
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - Anita Milicic
- Nuffield Department of Medicine, The Jenner Institute, University of Oxford, Oxford, UK
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Hanna SJ, Codd AS, Gea-Mallorqui E, Scourfield DO, Richter FC, Ladell K, Borsa M, Compeer EB, Moon OR, Galloway SAE, Dimonte S, Capitani L, Shepherd FR, Wilson JD, Uhl LFK, Gallimore AM, Milicic A. T cell phenotypes in COVID-19 - a living review. Oxf Open Immunol 2020; 2:iqaa007. [PMID: 33575657 PMCID: PMC7798577 DOI: 10.1093/oxfimm/iqaa007] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [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: 10/02/2020] [Revised: 12/06/2020] [Accepted: 12/16/2020] [Indexed: 12/15/2022] Open
Abstract
COVID-19 is characterized by profound lymphopenia in the peripheral blood, and the remaining T cells display altered phenotypes, characterized by a spectrum of activation and exhaustion. However, antigen-specific T cell responses are emerging as a crucial mechanism for both clearance of the virus and as the most likely route to long-lasting immune memory that would protect against re-infection. Therefore, T cell responses are also of considerable interest in vaccine development. Furthermore, persistent alterations in T cell subset composition and function post-infection have important implications for patients' long-term immune function. In this review, we examine T cell phenotypes, including those of innate T cells, in both peripheral blood and lungs, and consider how key markers of activation and exhaustion correlate with, and may be able to predict, disease severity. We focus on SARS-CoV-2-specific T cells to elucidate markers that may indicate formation of antigen-specific T cell memory. We also examine peripheral T cell phenotypes in recovery and the likelihood of long-lasting immune disruption. Finally, we discuss T cell phenotypes in the lung as important drivers of both virus clearance and tissue damage. As our knowledge of the adaptive immune response to COVID-19 rapidly evolves, it has become clear that while some areas of the T cell response have been investigated in some detail, others, such as the T cell response in children remain largely unexplored. Therefore, this review will also highlight areas where T cell phenotypes require urgent characterisation.
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Affiliation(s)
- Stephanie J Hanna
- Division of Infection and Immunity, School of Medicine, Cardiff University, Heath Park, Cardiff, CF14 4XN, UK,Correspondence address. Division of Infection and Immunity, School of Medicine, Cardiff University, Heath Park, Cardiff, CF14 4XN, UK. Tel: +44 29206 87342, E-mail:
| | - Amy S Codd
- Division of Infection and Immunity, School of Medicine, Cardiff University, Heath Park, Cardiff, CF14 4XN, UK
| | - Ester Gea-Mallorqui
- Nuffield Department of Medicine, University of Oxford, Old Road Campus, Roosevelt Drive, Headington, Oxford, OX3 7FZ, UK
| | - D Oliver Scourfield
- Division of Infection and Immunity, School of Medicine, Cardiff University, Heath Park, Cardiff, CF14 4XN, UK
| | - Felix C Richter
- Kennedy Institute of Rheumatology, NDORMS, University of Oxford, OX3 FTY, UK
| | - Kristin Ladell
- Division of Infection and Immunity, School of Medicine, Cardiff University, Heath Park, Cardiff, CF14 4XN, UK
| | - Mariana Borsa
- Kennedy Institute of Rheumatology, NDORMS, University of Oxford, OX3 FTY, UK
| | - Ewoud B Compeer
- Kennedy Institute of Rheumatology, NDORMS, University of Oxford, OX3 FTY, UK
| | - Owen R Moon
- Division of Infection and Immunity, School of Medicine, Cardiff University, Heath Park, Cardiff, CF14 4XN, UK
| | - Sarah A E Galloway
- Division of Infection and Immunity, School of Medicine, Cardiff University, Heath Park, Cardiff, CF14 4XN, UK
| | - Sandra Dimonte
- Division of Infection and Immunity, School of Medicine, Cardiff University, Heath Park, Cardiff, CF14 4XN, UK
| | - Lorenzo Capitani
- Division of Infection and Immunity, School of Medicine, Cardiff University, Heath Park, Cardiff, CF14 4XN, UK
| | - Freya R Shepherd
- Division of Infection and Immunity, School of Medicine, Cardiff University, Heath Park, Cardiff, CF14 4XN, UK
| | - Joseph D Wilson
- Medical Sciences Division, University of Oxford, Headington, Oxford, OX3 9DU
| | - Lion F K Uhl
- Kennedy Institute of Rheumatology, NDORMS, University of Oxford, OX3 FTY, UK
| | | | - Awen M Gallimore
- Division of Infection and Immunity, School of Medicine, Cardiff University, Heath Park, Cardiff, CF14 4XN, UK
| | - Anita Milicic
- Nuffield Department of Medicine, The Jenner Institute, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Oxford, OX3 7DQ, UK
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Mohammed RN, Wehenkel SC, Galkina EV, Yates EK, Preece G, Newman A, Watson HA, Ohme J, Bridgeman JS, Durairaj RRP, Moon OR, Ladell K, Miners KL, Dolton G, Troeberg L, Kashiwagi M, Murphy G, Nagase H, Price DA, Matthews RJ, Knäuper V, Ager A. ADAM17-dependent proteolysis of L-selectin promotes early clonal expansion of cytotoxic T cells. Sci Rep 2019; 9:5487. [PMID: 30940840 PMCID: PMC6445073 DOI: 10.1038/s41598-019-41811-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 03/12/2019] [Indexed: 01/15/2023] Open
Abstract
L-selectin on T-cells is best known as an adhesion molecule that supports recruitment of blood-borne naïve and central memory cells into lymph nodes. Proteolytic shedding of the ectodomain is thought to redirect activated T-cells from lymph nodes to sites of infection. However, we have shown that activated T-cells re-express L-selectin before lymph node egress and use L-selectin to locate to virus-infected tissues. Therefore, we considered other roles for L-selectin proteolysis during T cell activation. In this study, we used T cells expressing cleavable or non-cleavable L-selectin and determined the impact of L-selectin proteolysis on T cell activation in virus-infected mice. We confirm an essential and non-redundant role for ADAM17 in TCR-induced proteolysis of L-selectin in mouse and human T cells and show that L-selectin cleavage does not regulate T cell activation measured by CD69 or TCR internalisation. Following virus infection of mice, L-selectin proteolysis promoted early clonal expansion of cytotoxic T cells resulting in an 8-fold increase over T cells unable to cleave L-selectin. T cells unable to cleave L-selectin showed delayed proliferation in vitro which correlated with lower CD25 expression. Based on these results, we propose that ADAM17-dependent proteolysis of L-selectin should be considered a regulator of T-cell activation at sites of immune activity.
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Affiliation(s)
- Rebar N Mohammed
- Divsion of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, CF14 4XN, UK
- College of Veterinary Medicine, University of Sulaimani, Sulaimani, Kurdistan, Iraq
| | - Sophie C Wehenkel
- Divsion of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, CF14 4XN, UK
| | - Elena V Galkina
- Francis Crick Institute, London, NW1 1AT, UK
- Department of Microbiology and Molecular Cell Biology, Eastern Virginia Medical School, Norfolk, VA, 23507, USA
| | | | | | - Andrew Newman
- Divsion of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, CF14 4XN, UK
| | - H Angharad Watson
- Divsion of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, CF14 4XN, UK
| | - Julia Ohme
- Divsion of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, CF14 4XN, UK
| | - John S Bridgeman
- Divsion of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, CF14 4XN, UK
| | - Ruban R P Durairaj
- Divsion of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, CF14 4XN, UK
| | - Owen R Moon
- Divsion of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, CF14 4XN, UK
| | - Kristin Ladell
- Divsion of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, CF14 4XN, UK
| | - Kelly L Miners
- Divsion of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, CF14 4XN, UK
| | - Garry Dolton
- Divsion of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, CF14 4XN, UK
| | - Linda Troeberg
- Norwich Medical School, University of East Anglia, Norwich, NR4 7UQ, UK
| | | | - Gillian Murphy
- University of Cambridge Depratment of Oncology, Cancer Research UK Cambridge Insitute, Li Ka Shing Centre, Cambridge, CB2 0RE, UK
| | - Hideaki Nagase
- Kennedy Institute of Rheumatology, University of Oxford, Oxford, OX3 7FY, UK
| | - David A Price
- Divsion of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, CF14 4XN, UK
- Systems Immunity Research Institute, Cardiff University, Heath Park, Cardiff, CF14 4XN, UK
| | - R James Matthews
- Divsion of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, CF14 4XN, UK
| | - Vera Knäuper
- School of Dentistry, Cardiff University, Heath Park, Cardiff, CF14 4XN, UK
| | - Ann Ager
- Divsion of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, CF14 4XN, UK.
- Systems Immunity Research Institute, Cardiff University, Heath Park, Cardiff, CF14 4XN, UK.
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Moon OR, Kim NS, Jang SM, Yoon TH, Kim SO. The relationship between body mass index and the prevalence of obesity-related diseases based on the 1995 National Health Interview Survey in Korea. Obes Rev 2002; 3:191-6. [PMID: 12164471 DOI: 10.1046/j.1467-789x.2002.00073.x] [Citation(s) in RCA: 84] [Impact Index Per Article: 3.8] [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
This study estimated the body mass index (BMI) distribution of Koreans and examined the relationship between BMI and obesity-related diseases, in particular hypertension and diabetes mellitus. We also attempted to provide primary data to determine suitable BMI cut-off points for obesity in Korea. The 1995 National Health Interview Study (NHIS) data were used to estimate BMI and the prevalence of hypertension and diabetes mellitus. A random sample of 5750 Koreans (15-69 years of age) were investigated. BMI was calculated by self-reported weights and heights. The diagnoses of hypertension and diabetes mellitus were obtained from self-reported conditions specified in response to consultations with physicians. The mean BMI was 22.6+/-2.6 kg m(-2) for males and 21.7+/-4.8 kg m(-2) for females. The prevalence of hypertension and diabetes mellitus increased with BMI. The odds ratios of the third quartile of BMI (21.9-23.8 kg m(-2)) for hypertension and diabetes mellitus compared with the first quartile were 6.04 and 3.22, respectively. The odds ratio of the fourth quartile (>23.8 kg m(-2)) of BMI was not significantly different from that of the third quartile. The risk of hypertension and diabetes mellitus increased at the third quartile of BMI (21.9-23.8 kg m(-2)), this quartile being much lower than both the current World Health Organization (WHO) BMI cut-off point of overweight of 25.0 kg m(-2), and the 90th percentile proposed in the Monica project, BMI 26.4 kg m(-2). This finding was notable considering the fact that both hypertension and diabetes mellitus occur in Koreans with lower BMIs than whites. Further studies are necessary to identify the BMI cut-off point for obesity in Korea.
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Affiliation(s)
- O R Moon
- Graduate School of Public Health, Seoul National University, Korea.
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Abstract
Cost containment is the major determinant of a successful national health insurance system. From this point of view, the financial situation and factors influencing the rise of health care costs in the Korean health insurance program were analyzed. Current measures of cost containment in use are discussed in terms of price cutting and utilization reduction approaches.
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Affiliation(s)
- O R Moon
- Department of Health Administration, School of Public Health, Seoul National University, Korea
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Moon OR. The experiences of health services research and health services research training in Korea. Ingu Pogon Nonjip 1984; 4:189-206. [PMID: 12313501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
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