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Goutzelas Y, Kontou P, Mamuris Z, Bagos P, Sarafidou T. Meta-analysis of gene expression data in adipose tissue reveals new obesity associated genes. Gene 2022; 818:146223. [PMID: 35063573 DOI: 10.1016/j.gene.2022.146223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 09/11/2021] [Revised: 11/28/2021] [Accepted: 01/13/2022] [Indexed: 01/16/2023]
Abstract
High-throughput transcriptomic and proteomic data like microarray data are deposited in public databases such as Gene Expression Omnibus (GEO). Omics data integration and processing from different and independent studies is achieved by using efficient and effective computational tools through meta-analysis. Meta-analysis is a statistical powerful tool combining data from numerous studies, minimizes bias and increases statistical power by increasing sample size compared to individual studies. Therefore, we performed a meta-analysis of gene expression data in adipose tissue to identify genes that are differentially expressed between obese and non-obese subjects as well as to detect gene expression signatures, pathways and networks associated with obesity. We identified 821 differentially expressed genes (DEGs) in adipose tissue of obese subjects compared to non-obese. A protein-protein interactions (PPIs) network was reconstructed consisting of 168 proteins. Functional enrichment analysis in the network revealed proteins involved in RNA and energy metabolism. The KEGG pathway analysis revealed 15 enriched pathway terms. Furthermore, multiple testing correction methods identified five statistically significant obesity associated genes (NDUFA12, SFI1, SSB, FAR2 and LACE1) that require further investigation.
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Affiliation(s)
- Yiannis Goutzelas
- Department of Biochemistry and Biotechnology, University of Thessaly, Larissa, Greece
| | - Panagiota Kontou
- Department of Computer Science and Biomedical Informatics, University of Thessaly, Lamia, Greece
| | - Zissis Mamuris
- Department of Biochemistry and Biotechnology, University of Thessaly, Larissa, Greece
| | - Pantelis Bagos
- Department of Computer Science and Biomedical Informatics, University of Thessaly, Lamia, Greece
| | - Theologia Sarafidou
- Department of Biochemistry and Biotechnology, University of Thessaly, Larissa, Greece.
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Dimou N, Bagos P. Meta-Analysis Methods of Diagnostic Test Accuracy Studies. Methods Mol Biol 2022; 2345:173-185. [PMID: 34550591 DOI: 10.1007/978-1-0716-1566-9_11] [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] [Indexed: 03/25/2024]
Abstract
Meta-analytic techniques are used to combine the results of different studies that have evaluated the accuracy of diagnostic tests. In this article, we present univariate and multivariate meta-analysis methods for a single test and we provide an extensive description of methods for meta-analysis and comparison of multiple diagnostic tests. We close with a practical example of a meta-analysis that aimed to determine whether Rheumatoid Factor identifies patients with Rheumatoid Arthritis.
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Affiliation(s)
- Niki Dimou
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France.
| | - Pantelis Bagos
- Department of Computer Science and Biomedical Informatics, University of Thessaly, Lamia, Greece
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Abstract
INTRODUCTION BCOR rearranged sarcomas comprise a group of malignant mesenchymal tumors that until recently were classified as Ewing sarcomas or as undifferentiated round cell sarcomas. The identification of alterations involving BCOR gene such as BCOR-CCNB3, BCOR-MAML3, ZC3H7B-BCOR fusion genes and BCOR internal tandem duplication (ITD) is characteristic for the differential diagnosis of BCOR rearranged sarcomas. Due to the rarity of these tumors there is no consensus or guidelines regarding the optimal therapeutic algorithm, that clinicians should follow. PATIENTS AND METHODS Herein we have conducted a meta-analysis of the current reports dealing with the therapeutic approach of BCOR rearranged sarcomas. RESULTS Meta-analysis of the 57 eligible cases from 10 studies resulted to similar Incidence Rate Ratio (IRR) and overall survival (OS) for patients who received Ewing protocols and non-Ewing oriented treatment. Further similar death rate was reported for both strategies (non-Ewing 20% Vs Ewing 21.8%). CONCLUSION Our data support that non-Ewing treatment strategy can be considered a safe option, being at least equal to Ewing protocols. The current study provides a hint toward the optimal therapeutic approach of BCOR rearranged sarcomas. Further, the present study challenges the use of the term Ewing-like sarcomas, since the current literature supports that BCOR rearranged sarcomas deserve their own distinct classification in terms of genetics, pathology and therapy.
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Affiliation(s)
- Anastasios Kyriazoglou
- Second Propaedeutic Department of Medicine, Attikon University Hospital, Chaidari, Athens, Greece
| | - Pantelis Bagos
- Department of Computer Science and Biomedical Informatics, University of Thessaly, Lamia, Greece
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Kapoula G, Anagnostopoulou V, Moisoglou I, Kontou P, Bagos P. Diagnsotic accuracy of YLK-40 for diabetic nephropathy in type 2 diabetic patients. A systematic review and meta-analysis. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.635] [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: 11/27/2022]
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Kontou P, Pavlopoulou A, Braliou G, Bogiatzi S, Dimou N, Bangalore S, Bagos P. Identification of gene expression profiles in myocardial infarction: a systematic review and meta-analysis. BMC Med Genomics 2018; 11:109. [PMID: 30482209 PMCID: PMC6260684 DOI: 10.1186/s12920-018-0427-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 09/20/2018] [Accepted: 11/07/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Myocardial infarction (MI) is a multifactorial disease with complex pathogenesis, mainly the result of the interplay of genetic and environmental risk factors. The regulation of thrombosis, inflammation and cholesterol and lipid metabolism are the main factors that have been proposed thus far to be involved in the pathogenesis of MI. Traditional risk-estimation tools depend largely on conventional risk factors but there is a need for identification of novel biochemical and genetic markers. The aim of the study is to identify differentially expressed genes that are consistently associated with the incidence myocardial infarction (MI), which could be potentially incorporated into the traditional cardiovascular diseases risk factors models. METHODS The biomedical literature and gene expression databases, PubMed and GEO, respectively, were searched following the PRISMA guidelines. The key inclusion criteria were gene expression data derived from case-control studies on MI patients from blood samples. Gene expression datasets regarding the effect of medicinal drugs on MI were excluded. The t-test was applied to gene expression data from case-control studies in MI patients. RESULTS A total of 162 articles and 174 gene expression datasets were retrieved. Of those a total of 4 gene expression datasets met the inclusion criteria, which contained data on 31,180 loci in 93 MI patients and 89 healthy individuals. Collectively, 626 differentially expressed genes were detected in MI patients as compared to non-affected individuals at an FDR q-value = 0.01. Of those, 88 genes/gene products were interconnected in an interaction network. Totally, 15 genes were identified as hubs of the network. CONCLUSIONS Functional enrichment analyses revealed that the DEGs and that they are mainly involved in inflammatory/wound healing, RNA processing/transport mechanisms and a yet not fully characterized pathway implicated in RNA transport and nuclear pore proteins. The overlap between the DEGs identified in this study and the genes identified through genetic-association studies is minimal. These data could be useful in future studies on the molecular mechanisms of MI as well as diagnostic and prognostic markers.
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Affiliation(s)
- Panagiota Kontou
- Department of Computer Science and Biomedical Informatics, University of Thessaly, 35131, Lamia, Greece
| | - Athanasia Pavlopoulou
- Izmir Biomedicine and Genome Institute, Dokuz Eylül University Health Campus, 35340, Izmir, Turkey
| | - Georgia Braliou
- Department of Computer Science and Biomedical Informatics, University of Thessaly, 35131, Lamia, Greece
| | - Spyridoula Bogiatzi
- Department of Computer Science and Biomedical Informatics, University of Thessaly, 35131, Lamia, Greece
| | - Niki Dimou
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Stavros Niarchos Av, 45110, Ioannina, Greece
| | - Sripal Bangalore
- School of Medicine, New York University, New York, NY 10016, USA
| | - Pantelis Bagos
- Department of Computer Science and Biomedical Informatics, University of Thessaly, 35131, Lamia, Greece. .,Lamia, University of Thessaly, Papasiopoulou 2-4, 35131, Lamia, Greece.
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Hatzigeorgiou AG, Bagos P, Benos PV, Nikolaou C, Moreau Y, Kavakiotis I. ECCB 2018: The 17th European Conference on Computational Biology. Bioinformatics 2018; 34:i595-i598. [PMID: 30423102 DOI: 10.1093/bioinformatics/bty740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Artemis G Hatzigeorgiou
- DIANA-Lab, Department of Electrical & Computer Engineering, University of Thessaly, Volos, Greece.,DIANA-Lab, Hellenic Pasteur Institute, 127 Vasilissis Sofias Avenue, Athens, Greece
| | - Pantelis Bagos
- Department of Computer Science and Biomedical Informatics, University of Thessaly, Papasiopoulou 24, Lamia, Greece
| | - Panayiotis V Benos
- Department of Computational and Systems Biology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Christoforos Nikolaou
- Computational Genomics Group, Department of Biology, University of Crete, Herakleion, Greece
| | - Yves Moreau
- Department of Electrical Engineering (ESAT), STADIUS Center for Dynamical Systems, Signal Processing and Data Analytics, University of Leuven, Belgium
| | - Ioannis Kavakiotis
- DIANA-Lab, Department of Electrical & Computer Engineering, University of Thessaly, Volos, Greece
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Tsantes A, Bagos P, Rapti E, Mantzios G, Kapsimali V, Travlou A, Nikolopoulos G. Association between the plasminogen activator inhibitor-1 4G/5G polymorphism and venous thrombosis. Thromb Haemost 2017. [DOI: 10.1160/th06-12-0745] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
SummaryThe effect of the 675 insertion/deletion (4G/5G) polymorphism of plasminogen activator inhibitor-1 (PAI-1) gene on the risk of venous thromboembolism (VTE) remains controversial. In this study, we performed a meta-analysis of published data regarding this issue. A comprehensive electronic search was carried out up until September 2006. A total of 22 articles were included in the analysis that was performed using random effects models. Eighteen papers, concerning patients without another known risk factor, comprised 2,644 cases and 3,739 controls. The alleles contrast (4G vs. 5G allele) yielded a statistically significant odds ratio (OR) of 1.153 (95% confidence interval [CI]: 1.068–1.246). In a sub-analysis of five studies that included 256 cases with another genetic risk factor and 147 controls, the combined per-allele OR was still significant (OR:1.833,95% CI:1.325–2.536). On the contrary, the analysis of five studies regarding cases with a non-genetic risk factor for VTE (antiphospholipid antibody syndrome, Behcet disease) provided insignificant results in all aspects. There was no evidence for heterogeneity and publication bias in all analyses. Based on our findings, the 4G allele appears to increase the risk of venous thrombosis, particularly in subjects with other genetic thrombophilic defects. Recommendation for detection of this polymorphism in evaluating thrombophilia in such patients might be considered.
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Polymeropoulos E, Bagos P, Papadimitriou M, Rizos I, Patsouris E, Τoumpoulis I. Vitamin C for the Prevention of Postoperative Atrial Fibrillation after Cardiac Surgery: A Meta-Analysis. Adv Pharm Bull 2016; 6:243-50. [PMID: 27478787 DOI: 10.15171/apb.2016.033] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 05/30/2016] [Accepted: 05/31/2016] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Several studies have investigated the administration of vitamin C (vitC) for the prevention of postoperative atrial fibrillation (AF) after cardiac surgery. However, their findings were inconsistent. The purpose of this meta-analysis was to evaluate the efficacy of vitC as prophylaxis for the prevention of postoperative AF in cardiac surgery. METHODS A systematic search of PubMed, EMBASE, Google Scholar, the Cochrane Library, and clinical trial registries, was performed. 9 studies, published from August 2001 to May 2015, were included, with a total of 1,037 patients. Patients were randomized to receive vitC, or placebo. RESULTS Cardiac surgery patients who received vitC as prophylaxis, had a significantly lower incidence of postoperative AF (random effects OR=0.478, 95% CI 0.340 - 0.673, P < 10(-4)). No significant heterogeneity was detected across the analyzed studies (I(2)=21.7%), and no publication bias or other small study-related bias was found. CONCLUSION Our findings suggest that VitC is effective as prophylaxis for the prevention of postoperative AF. The administration of vitC may be considered in all patients undergoing cardiac surgery.
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Affiliation(s)
| | - Pantelis Bagos
- Department of Computer Science and Biomedical Informatics, University of Thessaly, Lamia, Greece
| | | | - Ioannis Rizos
- Cardiology Department, Attiko Hospital, Athens, Greece
| | - Efstratios Patsouris
- Department of Pathology, Medical School of the National University of Athens, Greece
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Tsata V, Velegraki A, Ioannidis A, Poulopoulou C, Bagos P, Magana M, Chatzipanagiotou S. Effects of Yeast and Bacterial Commensals and Pathogens of the Female Genital Tract on the Transepithelial Electrical Resistance of HeLa Cells. Open Microbiol J 2016; 10:90-6. [PMID: 27335621 PMCID: PMC4899535 DOI: 10.2174/1874285801610010090] [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] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 08/06/2015] [Accepted: 09/03/2015] [Indexed: 01/05/2023] Open
Abstract
Commensals of the human body can shift to a pathogenic phase when the host
immune system is impaired. This study aims to investigate the effect of seven
yeast and two bacterial commensals and opportunistic pathogens isolated from
blood and the female genital tract on the transepithelial electrical resistance
(TER) of human cervical epithelial cell cultures (HeLa). The pathogens
Candida tropicalis, C. parapsilosis,C. glabrata, C. krusei, C.
albicans and Saccharomyces cerevisiae, caused a significant decrease
in TER as compared to the controls; Lactobacillus spp caused a
significant increase in TER versus the controls and Escherichia coli
had no effect on the TER of the cell monolayers. The above data show that
Candida spp., S. cerevisiae and Lactobacillus spp. have a
non-selective effect on the TER of HeLa cell monolayers. These results are
consistent with the in vivo non-selective action of these microorganisms
on the various human mucosal epithelia.
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Affiliation(s)
- Vassiliki Tsata
- Laboratory of Experimental Neurophysiology, Department of Neurology, Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Greece
| | - Aristea Velegraki
- Laboratory of Experimental Neurophysiology, Department of Neurology, Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Greece
| | - Anastasios Ioannidis
- Mycology Research Laboratory, Microbiology Department, Medical School, National and Kapodistrian University of Athens, Greece
| | - Cornelia Poulopoulou
- Department of Nursing, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Sparta, Greece
| | - Pantelis Bagos
- Department of Computer Science and Biomedical Informatics, University of Thessaly, Greece
| | - Maria Magana
- Department of Biopathology and Clinical Microbiology, Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Greece
| | - Stylianos Chatzipanagiotou
- Department of Biopathology and Clinical Microbiology, Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Greece
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Bonovas S, Nikolopoulos G, Bagos P. Bisphosphonate use and risk of colorectal cancer: a systematic review and meta-analysis. Br J Clin Pharmacol 2014; 76:329-37. [PMID: 23594375 DOI: 10.1111/bcp.12135] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2012] [Accepted: 03/08/2013] [Indexed: 12/13/2022] Open
Abstract
AIM A growing body of evidence suggests that bisphosphonates may have chemopreventive potential against colorectal cancer. Our aim was to examine this association through a meta-analysis of observational studies. METHODS A comprehensive search for relevant articles published up to October 2012 was performed, reviews of each study were conducted and data were abstracted. Prior to meta-analysis, the studies were evaluated for publication bias and heterogeneity. Pooled relative risk (RR) estimates and 95% confidence intervals (CIs) were calculated using the random effects and the fixed effects models. Subgroup and sensitivity analyses were also performed. RESULTS Eight large population-based epidemiological studies (one case-control, two nested case-control analyses within a cohort and five cohort studies), involving more than 630 000 participants, contributed to the analysis. We found no evidence of publication bias. However, significant heterogeneity was detected among the cohort studies. The analysis revealed a significant protective association between bisphosphonate use and colorectal cancer risk (fixed RR = 0.85, 95% CI 0.80, 0.90, random RR = 0.85, 95% CI 0.75, 0.96). When the analysis was stratified into subgroups according to study design, the association was inverse in both case-control and cohort studies, but only in the former was it statistically significant. The sensitivity analysis confirmed the stability of our results. Furthermore, we found evidence for a dose effect; Long term bisphosphonate use was associated with a 27% decrease in the risk of developing colorectal cancer as compared with non-use (RR = 0.73, 95% CI 0.57, 0.93). CONCLUSION Our findings support a protective effect of bisphosphonates against colorectal cancer. However, further evidence is warranted.
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Affiliation(s)
- Stefanos Bonovas
- Department of Pharmacology, School of Medicine, University of Athens, Athens, Greece; Hellenic Centre for Disease Control and Prevention, Athens, Greece; Department of Computer Science and Biomedical Informatics, University of Central Greece, Lamia, Greece
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Efthimiou O, Mavridis D, Cipriani A, Leucht S, Bagos P, Salanti G. An approach for modelling multiple correlated outcomes in a network of interventions using odds ratios. Stat Med 2014; 33:2275-87. [DOI: 10.1002/sim.6117] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Orestis Efthimiou
- Department of Hygiene and Epidemiology; University of Ioannina School of Medicine; Ioannina Greece
| | - Dimitris Mavridis
- Department of Hygiene and Epidemiology; University of Ioannina School of Medicine; Ioannina Greece
- Department of Primary Education; University of Ioannina; Ioannina Greece
| | - Andrea Cipriani
- Department of Public Health and Community Medicine, Section of Psychiatry; University of Verona; Verona Italy
- Department of Psychiatry; University of Oxford; Oxford U.K
| | - Stefan Leucht
- Department of Psychiatry and Psychotherapy; Technische Universität München; Munich Germany
| | - Pantelis Bagos
- Department of Computer Science and Biomedical Informatics; University of Thessaly; Lamia Greece
| | - Georgia Salanti
- Department of Hygiene and Epidemiology; University of Ioannina School of Medicine; Ioannina Greece
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Ioannidou V, Ioannidis A, Magiorkinis E, Bagos P, Nicolaou C, Legakis N, Chatzipanagiotou S. Multilocus sequence typing (and phylogenetic analysis) of Campylobacter jejuni and Campylobacter coli strains isolated from clinical cases in Greece. BMC Res Notes 2013; 6:359. [PMID: 24010733 PMCID: PMC3844450 DOI: 10.1186/1756-0500-6-359] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [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: 04/12/2013] [Accepted: 09/04/2013] [Indexed: 01/25/2023] Open
Abstract
Background The molecular epidemiology of C. jejuni and C. coli clinical strains isolated from children with gastroenteritis, was investigated using the multilocus sequence typing method (MLST). This analysis establishes for the first time in Greece and constitutes an important tool for the epidemiological surveillance and control of Campylobacter infection in our country. Methods The MLST genotypes were compared with those gained by other typing methods (HS-typing, PFGE and FlaA typing) and were also phylogenetically analyzed, in order to uncover genetic relationships. Results Among 68 C. jejuni strains, 41 different MLST-Sequence Types (MLST-STs) were found. Fifty six strains or 34 MLST-STs could be sorted into 15 different MLST-Sequence Type Complexes (MLST-STCs), while twelve strains or seven MLST-STs did not match any of the MLST-STCs of the database. Twenty C. coli strains belonged to 14 different MLST-STs. Eleven MLST-STs were classified in the same MLST-STC (828), and three were unclassifiable. There was no significant association between the MLST-STs and the results of the other typing methods. Phylogenetic analysis revealed that some strains, classified to the species of C. jejuni, formed a separate, phylogenetically distinct group. In eight strains some alleles belonging to the taxonomic cluster of C. jejuni, were also detected in C. coli and vice versa, a phenomenon caused by the genetic mosaic encountered inside the genus Campylobacter. Conclusions The MLST-ST determination proved to be a very useful tool for the typing as well as the identification of Campylobacter on the species level.
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Affiliation(s)
- Vasiliki Ioannidou
- Department of Biopathology and Clinical Microbiology, Athens Medical School, Aeginition Hospital, Vass, Sophias av, 72-74, Athens 115 28, Greece.
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Tsantes AE, Kopterides P, Bonovas S, Bagos P, Antonakos G, Nikolopoulos GK, Gialeraki A, Kapsimali V, Kyriakou E, Kokori S, Dima K, Armaganidis A, Tsangaris I. Effect of angiotensin converting enzyme gene I/D polymorphism and its expression on clinical outcome in acute respiratory distress syndrome. Minerva Anestesiol 2013; 79:861-870. [PMID: 23635999] [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: 06/02/2023]
Abstract
BACKGROUND The role of the D allele of the angiotensin-converting enzyme (ACE) gene I/D polymorphism in the clinical outcomes of patients with acute lung injury and acute respiratory distress syndrome (ALI/ARDS) remains controversial. Our aim was to assess simultaneously the effect of the ACE I/D polymorphisms as well as the serum and BALF ACE levels on prognosis of patients with ARDS. METHODS Sixty-nine mechanically ventilated patients with ALI/ARDS were recruited. ACE activity levels both in serum and BALF were assessed by chemical methods. Patients were genotyped for ACE I/D polymorphisms. Time-to-event analysis evaluated the variables associated with the 28-day and 90-day mortality. Finally, we performed a meta-analysis of studies examining the association between ACE I/D polymorphisms and mortality of ALI/ARDS patients. RESULTS In the multivariable model, age, lung compliance, serum lactate and serum ACE levels were significantly associated with both 28- and 90-day mortality. No significant correlation was found between serum and BALF ACE levels (Spearman's rho=0.054; P=0.66). Serum ACE concentrations were significantly higher (P=0.046) in patients with D/D genotype versus the two other groups combined (I/D and I/I genotypes). The meta-analysis of 6 studies (including ours) provided evidence that D allele is significantly associated with increased mortality in ALI/ARDS patients, yielding a per-allele odds ratio of 1.76 (95% CI: 1.19, 2.59). CONCLUSION Serum ACE levels appear to be affected by the I/D polymorphism and are correlated with prognosis in patients with ALI/ARDS indicating that further investigation of the clinical significance of the ACE in ARDS might be of value.
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Affiliation(s)
- A E Tsantes
- Laboratory of Haematology and Blood Bank Unit, Attiko University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
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Rabe GL, Wellmann J, Bagos P, Busch MA, Hense HW, Spies C, Weiss-Gerlach E, McCarthy W, Gareca Arizaga MJ, Neuner B. Efficacy of emergency department-initiated tobacco control--systematic review and meta-analysis of randomized controlled trials. Nicotine Tob Res 2013; 15:643-55. [PMID: 23024250 DOI: 10.1093/ntr/nts212] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [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: 11/14/2022]
Abstract
AIM Systematic review and meta-analysis of randomized controlled trials evaluating the efficacy of emergency department-initiated tobacco control (ETC). METHODS Literature search in 7 databases and gray literature sources. Point prevalence tobacco abstinence at 1-, 3-, 6-, and/or 12-month follow-up was abstracted from each study. The proportionate effect (relative risk) of ETC on tobacco abstinence was calculated separately for each study and follow-up time and pooled, at different follow-up times, by Mantel-Haenszel relative risks. The effects of ETC on combined point prevalence tobacco abstinence across all follow-up times were calculated using generalized linear mixed models. RESULTS Seven studies with overall 1,986 participants were included. The strongest effect of ETC on point prevalence tobacco abstinence was found at 1 month: Relative risk (RR) = 1.47 (3 studies) (95% confidence interval [CI]: 1.06-2.06), while the effect at 3, 6, and 12 months was RR = 1.24 (6 studies) (95% CI: 0.93-1.65); 1.13 (5 studies) (95% CI: 0.86-1.49); and 1.25 (1 study) (95% CI: 0.91-1.72). The benefit on combined point prevalence tobacco abstinence was RR = 1.33 (7 studies) (95% CI: 0.96-1.83), p = .08; with RR = 1.33 (95% CI: 0.92-1.92), p = .10, for the 5 studies combining motivational interviewing and booster phone calls. CONCLUSIONS ETC combining motivational interviewing and booster phone calls showed a trend toward increased episodically measured tobacco abstinence up to 12 months. More methodologically rigorous trials are needed to effectively evaluate the impact of ETC.
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Affiliation(s)
- Gwen Lisa Rabe
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
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Nikolopoulos G, Bagos P, Lytras T, Bonovas S. An ecological study of the determinants of differences in 2009 pandemic influenza mortality rates between countries in Europe. PLoS One 2011; 6:e19432. [PMID: 21589928 PMCID: PMC3092762 DOI: 10.1371/journal.pone.0019432] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2011] [Accepted: 03/28/2011] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Pandemic A (H1N1) 2009 mortality rates varied widely from one country to another. Our aim was to identify potential socioeconomic determinants of pandemic mortality and explain between-country variation. METHODOLOGY Based on data from a total of 30 European countries, we applied random-effects Poisson regression models to study the relationship between pandemic mortality rates (May 2009 to May 2010) and a set of representative environmental, health care-associated, economic and demographic country-level parameters. The study was completed by June 2010. PRINCIPAL FINDINGS Most regression approaches indicated a consistent, statistically significant inverse association between pandemic influenza-related mortality and per capita government expenditure on health. The findings were similar in univariable [coefficient: -0.00028, 95% Confidence Interval (CI): -0.00046, -0.00010, p = 0.002] and multivariable analyses (including all covariates, coefficient: -0.00107, 95% CI: -0.00196, -0.00018, p = 0.018). The estimate was barely insignificant when the multivariable model included only significant covariates from the univariate step (coefficient: -0.00046, 95% CI: -0.00095, 0.00003, p = 0.063). CONCLUSIONS Our findings imply a significant inverse association between public spending on health and pandemic influenza mortality. In an attempt to interpret the estimated coefficient (-0.00028) for the per capita government expenditure on health, we observed that a rise of 100 international dollars was associated with a reduction in the pandemic influenza mortality rate by approximately 2.8%. However, further work needs to be done to unravel the mechanisms by which reduced government spending on health may have affected the 2009 pandemic influenza mortality.
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Affiliation(s)
- Georgios Nikolopoulos
- Hellenic Centre for Disease Control and Prevention, Athens, Greece
- Department of Computer Science and Biomedical Informatics, University of Central Greece, Lamia, Greece
| | - Pantelis Bagos
- Department of Computer Science and Biomedical Informatics, University of Central Greece, Lamia, Greece
| | - Theodoros Lytras
- Hellenic Centre for Disease Control and Prevention, Athens, Greece
| | - Stefanos Bonovas
- Hellenic Centre for Disease Control and Prevention, Athens, Greece
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Tsantes A, Tsangaris I, Nikolopoulos G, Bagos P, Kopterides P, Antonakos G, Dimopoulou I, Vrioni G, Kapsimali V, Dima K, Armaganidis A, Travlou A. The effect of homocysteine on the clinical outcomes of ventilated patients with severe sepsis. Minerva Anestesiol 2010; 76:787-794. [PMID: 20935614] [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: 05/30/2023]
Abstract
BACKGROUND There is considerable evidence that elevated plasma homocysteine levels are associated with a prothrombotic milieu, whereas activation of the coagulation cascade is an important component of the pathogenesis of sepsis. The protein C pathway has been reported to play a central role both in the propagation of sepsis and a hyperhomocysteinemia-induced hypercoagulable state. Our primary aim was to measure plasma homocysteine levels in mechanically ventilated patients with severe sepsis/septic shock and to assess the association of these levels with relevant clinical outcomes. METHODS The study cohort included 102 mechanically ventilated patients with severe sepsis or septic shock. Demographics, comorbidities, clinical data and severity scores were recorded. Plasma homocysteine, vitamin B12, folate, creatinine, and protein C levels were measured in all study subjects upon enrollment, and genotyping for the C677T and A1298C polymorphisisms of the methylenetetrahydrofolate reductase (MTHFR) gene and for factor V Leiden (FVL) mutations was performed as well. The primary outcomes were mortality at 28 and 90 days; secondary outcomes included the number of days without renal or cardiovascular failure and the ventilator-free days during the study period. RESULTS Homocysteine levels were not significantly associated with any primary or secondary outcomes in the multivariable analysis. In addition, a synergistic effect of homocysteine with protein C levels was not detected. CONCLUSION Our data suggest that plasma homocysteine levels may not inform the prognosis of mechanically ventilated patients with severe sepsis/septic shock.
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Affiliation(s)
- A Tsantes
- Attikon University General Hospital, Medical School, University of Athens, Athens 12462, Greece.
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Bonovas S, Nikolopoulos G, Filioussi K, Peponi E, Bagos P, Sitaras NM. Can statin therapy reduce the risk of melanoma? A meta-analysis of randomized controlled trials. Eur J Epidemiol 2009; 25:29-35. [PMID: 19844794 DOI: 10.1007/s10654-009-9396-x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2009] [Accepted: 10/07/2009] [Indexed: 12/12/2022]
Abstract
A growing body of literature suggests that statins may have a chemopreventive potential against melanoma through pleiotropic anti-inflammatory, immunomodulatory, and antiangiogenesis mechanisms. Our aim was to examine this association through a detailed meta-analysis of randomized controlled trials (RCTs). A comprehensive search for trials published up to June 2009 was performed, reviews of each study were conducted and data were abstracted. Prior to meta-analysis, the studies were evaluated for publication bias and heterogeneity. Pooled relative risk estimates (RR) and 95% confidence intervals (CIs) were calculated using the fixed- and the random-effects models. Subgroup and sensitivity analyses were also conducted. Sixteen RCTs of statins for cardiovascular outcomes, involving 62,568 individuals with a mean age of 60 years and an average follow-up of nearly 4.7 years, contributed to the analysis. We found no evidence of publication bias (P = 0.47) or heterogeneity among the studies (P = 0.25). Statin use did not significantly affect the risk of developing melanoma assuming either a fixed- (RR = 0.92, 95% CI: 0.67-1.26), or a random-effects model (RR = 0.92, 95% CI: 0.62-1.36). This neutral effect was further supported by the results of subgroup and sensitivity analyses. Our findings do not support a protective effect of statins against melanoma.
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Affiliation(s)
- Stefanos Bonovas
- Department of Pharmacology, School of Medicine, University of Athens, 75 Mikras Asias Str., 11527 Athens, Greece.
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Liappas IA, Nicolaou C, Chatzipanagiotou S, Tzavellas EO, Piperi C, Papageorgiou C, Boufidou F, Bagos P, Soldatos CR. Vitamin B12 and hepatic enzyme serum levels correlate with interleukin-6 in alcohol-dependent individuals without liver disease. Clin Biochem 2007; 40:781-6. [PMID: 17442294 DOI: 10.1016/j.clinbiochem.2007.03.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2007] [Revised: 03/05/2007] [Accepted: 03/07/2007] [Indexed: 12/20/2022]
Abstract
Alcohol abuse is a major cause of liver cirrhosis as well as chronic liver disease. The aim of the present study was to investigate the possible correlation, between liver dysfunction biological markers and vitamin B12, with interleukin-6, in the serum of alcohol-dependent individuals without liver disease (AWLD). In a sample of 43 alcohol abusing/dependent subjects (33 males and 10 females) treated on an inpatient basis according to a standard detoxification protocol, the serum activities of the hepatic enzymes (ASAT, ALAT, gamma-GT), as well as the concentration of B12 and IL-6, were determined on admission. A strong positive correlation has been observed between IL-6 and B12, ASAT, ALAT, and gamma-GT at the beginning of the detoxification period. The results confirmed that in alcohol-dependent individuals, the median serum concentration of IL-6, before the beginning of the treatment, had a significant positive correlation with the liver dysfunction biological markers and B12. In conclusion, IL-6 might be used as an additional diagnostic marker for the degree of liver dysfunction in alcohol dependent individuals.
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Affiliation(s)
- Ioannis A Liappas
- University of Athens Medical School-Aeginition Hospital, Department of Psychiatry, Vas. Sophias av 72-74, Athens, Greece
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Tsirpanlis G, Bagos P, Ioannou D, Bleta A, Marinou I, Lagouranis A, Chatzipanagiotou S, Nicolaou C. Serum albumin: a late-reacting negative acute-phase protein in clinically evident inflammation in dialysis patients. Nephrol Dial Transplant 2005; 20:658-9; author reply 659-60. [PMID: 15795948 DOI: 10.1093/ndt/gfh663] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Tsirpanlis G, Bagos P, Ioannou D, Bleta A, Marinou I, Lagouranis A, Chatzipanagiotou S, Nicolaou C. The variability and accurate assessment of microinflammation in haemodialysis patients. Nephrol Dial Transplant 2004; 19:150-7. [PMID: 14671050 DOI: 10.1093/ndt/gfg486] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.8] [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: 11/12/2022] Open
Abstract
BACKGROUND Systemic microinflammation is correlated with atherosclerosis. It needs a reliable assessment. This study explores the temporal variations of three inflammatory indexes [C-reactive protein (CRP), serum amyloid A (SAA) and interleukin-6 (IL-6)] in a period free of clinical events and tests the reliability of their multiple measurements for the assessment of microinflammation in haemodialysis (HD) patients, a population at high risk of atherosclerotic cardiovascular disease. METHODS For 4 months, serum CRP, SAA and IL-6 were measured in 29 HD patients during the weeks they were free of inflammatory clinical events (> or =12 measurements for each index in every patient). The components of the variance as well as the reliability of two to five measurements for each index, aimed at assessing microinflammation precisely, were computed. RESULTS The median (interquartile range) of CRP was 2.3 (0.9-4.9) mg/l, of SAA 3.7 (2.1-9.3) mg/l and of IL-6 4.4 (2.2-7.7) pg/ml. Patients were approximately equally distributed between three groups of low, intermediate and high variability for each index. The contribution of intraindividual (biological) variation to the total of variance was 71.3%, 69.3% and 86.7% for CRP, SAA and IL-6, respectively (higher than in all other similar studies in healthy populations). Using two measurements, the estimated reliability was 57-68% for CRP in two-thirds of the patients (comparable with that found in healthy subjects) and 57% for SAA and IL-6 in only one-third of the patients. Increasing the number of measurements up to five did not change the reliability. CONCLUSIONS Individual factors significantly influence the levels of inflammatory indexes in HD patients in periods free of inflammatory clinical events. The mean of two weekly CRP measurements, but not of SAA or IL-6, seems to assess microinflammation in most patients with a sufficient reliability.
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Affiliation(s)
- George Tsirpanlis
- Renal Unit, Department of Cell Biology and Biophysics, Faculty of Biology, University of Athens, Alexandra General Hospital, Kriezi 61, Polydroso, Marousi, 15125 Athens, Greece.
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Tsirpanlis G, Bagos P, Ioannou D, Bleta A, Marinou I, Lagouranis A, Chatzipanagiotou S, Nicolaou C. Exploring Inflammation in Hemodialysis Patients: Persistent and Superimposed Inflammation. Kidney Blood Press Res 2004; 27:63-70. [PMID: 14691348 DOI: 10.1159/000075809] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2003] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Inflammation is frequently elevated, and seems to be episodic in hemodialysis (HD) patients. Whether, its episodic character is due to the temporal variability, in periods free of clinical events, of the inflammatory indices or due, to the acute phase response induced by common inflammatory stimuli, has not been investigated yet in a longitudinal study. This study explores inflammation forms, characteristics and causes which are probably related to the high cardiovascular disease (CVD) morbidity in HD patients. METHODS In 37 HD patients, high-sensitivity C-reactive protein (hs-CRP), serum amyloid A (SAA) and interleukin-6 (IL-6) were weekly measured for 16 consecutive weeks. Inflammatory clinical events, in the week before every measurement, were recorded. Repeated measures ANOVA were applied for statistical analysis. RESULTS Fifty-one of 533 patient-weeks were positive for a clinical event. Mean +/- SD (range) hs-CRP was 7.01 +/- 16.06 (0.2-169) mg/l for all the weeks of the study, 38.25 +/- 39.35 (2.1-169) mg/l for the weeks with clinical events and 3.70 +/- 3.86 (0.2-26.1) mg/l for the weeks free of events. Variations for SAA and IL-6 were similar. 'Clinical events' strongly influenced acute-phase proteins and IL-6 levels. The effect of the factor 'time' (as assessed by inflammatory indices variation in weekly repeated measurements) was significant for all the 3 indices measured, independently of the factor 'clinical events'. CONCLUSIONS In periods free of clinical events, microinflammation characterizes HD patients and fluctuates in time. Inflammation due to common clinical events is added, periodically, to this microinflammation. The high level persistent microinflammation as well as the superimposed--due to clinical events--inflammation could be related to the CVD in these patients.
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Affiliation(s)
- George Tsirpanlis
- Renal Unit, Alexandra General Hospital, Faculty of Biology, University of Athens, Athens, Greece.
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Tsirpanlis G, Chatzipanagiotou S, Ioannidis A, Ifanti K, Bagos P, Lagouranis A, Poulopoulou C, Nicolaou C. The effect of viable Chlamydia pneumoniae on serum cytokines and adhesion molecules in hemodialysis patients. Kidney Int Suppl 2003:S72-5. [PMID: 12694314 DOI: 10.1046/j.1523-1755.63.s84.42.x] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Chlamydia pneumoniae (Cp) induces the production of cytokines and adhesion molecules in infected host eukaryotic cells. The causes for pro-inflammatory cytokine and adhesion molecule increase in hemodialysis (HD) patients have not been fully elucidated. The possibility that, in this particularly atherosclerotic population, Cp, a microorganism implicated in the infectious-based inflammatory hypothesis of atherosclerosis' is also responsible for these molecules' increase is assessed in this study. METHODS In 130 stable HD patients, serum interleukin-1 beta (IL-1), interleukin-6, tumor necrosis factor alpha, interleukin-10, L-selectin, E-selectin, intercellular adhesion molecule-1, and vascular cell adhesion molecule-1 (VCAM-1) levels were determined. Cp presence was identified by inoculation of the patient's peripheral blood mononuclear cells (PBMCs) in Hep-2 cell lines and subsequent polymerase chain reaction (PCR) in DNA extracted from cell cultures, as well as by determination of serum IgG antibodies against Cp (IgGCp). RESULTS Patients, positive or negative for IgGCp, had no statistically significant differences in all molecules measured. Patients with viable Cp in PBMCs had higher serum levels of IL-1 and soluble VCAM-1 than negative ones for IgGCp (IL-1 6.87 +/- 7.35 vs. 2.34 +/- 1.47 pg/mL; P = 0.0009 and VCAM-1 1647.16 +/- 513.64 vs. 1162.14 +/- 546.83 ng/mL; P = 0.0115, respectively). Viable Cp in PBMCs remained a significant predictor factor for IL-1 and VCAM-1 in statistical analysis, when patients' characteristics and dialysis conditions were also evaluated. CONCLUSIONS Our results showed that some serum cytokine and adhesion molecule increase in HD patients could be attributed to viable Cp presence in PBMCs. These findings support the Cp-based inflammatory atherogenous hypothesis and add a better understanding of these molecules' increase in HD patients.
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