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Houben J, Janssens M, Winkler C, Besser REJ, Dzygalo K, Fehn A, Hommel A, Lange K, Elding Larsson H, Lundgren M, Roloff F, Snape M, Szypowska A, Weiss A, Zapardiel-Gonzalo J, Zubizarreta N, Ziegler AG, Casteels K, Arnolds S, Bißbort M, Blasius K, Friedl N, Gezginci C, Göppel G, Heigermoser M, Höfelschweiger B, Jolink M, Kisfügedi K, Klein N, Lickert R, Matzke C, Alvarez KM, Niewöhner R, Scholz M, Schütte‐Borkovec K, Voß F, Weiß A, Gonzalo JMZ, Schmidt S, Sifft P, Kapfelsberger H, Vurucu M, Sarcletti K, Sporreiter M, Jacobson S, Zeller I, Warncke K, Bonifacio E, Lernmark Å, Todd JA, Achenbach P, Bonficio E, Larsson HE, Ziegler AG, Achenbach P, Schütte‐Borkovec K, Ziegler AG, Casteels K, Jannsen C, Rochtus A, Jacobs A, Morobé H, Paulus J, Vrancken B, Van den Driessche N, Van Heyste R, Houben J, Smets L, Vanhuyse V, Bonifacio E, Berner R, Arabi S, Blechschmidt R, Dietz S, Gemulla G, Gholizadeh Z, Heinke S, Hoffmann R, Hommel A, Lange F, Loff A, Morgenstern R, Ehrlich F, Loff A, Weigelt M, Zubizarreta N, Kordonouri O, Danne T, Galuschka L, Holtkamp U, Janzen N, Kruse C, Landsberg S, Lange K, Marquardt E, Reschke F, Roloff F, Semler K, von dem Berge T, Weiskorn J, Ziegler AG, Achenbach P, Bunk M, Färber‐Meisterjahn S, Grätz W, Greif I, Herbst M, Hofelich A, Kaiser M, Kaltenecker H, Karapinar E, Kölln A, Marcus B, Munzinger A, Ohli J, Ramminger C, Reinmüller F, Vollmuth V, Welzhofer T, Winkler C, Szypowska A, Ołtarzewski M, Dybkowska S, Dżygało K, Groele L, Kajak K, Owczarek D, Piechowiak K, Popko K, Skrobot A, Szpakowski R, Taczanowska A, Zduńczyk B, Zych A, Larsson HE, Lundgren M, Lernmark Å, Agardh D, Mortin SA, Aronsson CA, Bennet R, Brundin C, Dahlberg S, Fransson L, Jonsdottir B, Jönsson I, Maroufkhani S, Mestan Z, Nilsson C, Ramelius A, Amboh ET, Törn C, Ulvendag U, Way S, Snape M, Todd JA, Haddock G, Bendor‐Samuel O, Bland J, Choi E, Craik R, Davis K, Hawkins S, de la Horra A, Farooq Y, Scudder C, Smith I, Roseman F, Robinson H, Taj N, Vatish M, Willis L, Whelan C, Wishlade T. The emotional well-being of parents with children at genetic risk for type 1 diabetes before and during participation in the POInT-study. Pediatr Diabetes 2022; 23:1707-1716. [PMID: 36323590 DOI: 10.1111/pedi.13448] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 10/19/2022] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION This study examined the emotional impact that parents experience when confronted with an increased genetic risk of type 1 diabetes (T1D) in their child. Population-based screening of neonates for genetic risk of chronic disease carries the risk of increased emotional burden for parents. METHODS Information was collected using a well-being questionnaire for parents of infants identified as having an increased risk for T1D in a multinational research study. Parents were asked to complete this questionnaire after they were told their child had an increased risk for T1D (Freder1k-study) and at several time points during an intervention study (POInT-study), where oral insulin was administered daily. RESULTS Data were collected from 2595 parents of 1371 children across five countries. Panic-related anxiety symptoms were reported by only 4.9% after hearing about their child having an increased risk. Symptoms of depression were limited to 19.4% of the parents at the result-communication visit and declined over time during the intervention study. When thinking about their child's risk for developing T1D (disease-specific anxiety), 47.2% worried, felt nervous and tense. Mothers and parents with a first-degree relative (FDR) with T1D reported more symptoms of depression and disease-specific anxiety (p < 0.001) than fathers and parents without a FDR. CONCLUSION Overall, symptoms of depression and panic-related anxiety are comparable with the German population. When asked about their child's risk for T1D during the intervention study, some parents reported disease-specific anxiety, which should be kept in mind when considering population-based screening. As certain subgroups are more prone, it will be important to continue psychological screening and, when necessary, to provide support by an experienced, multidisciplinary team.
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Affiliation(s)
- Janne Houben
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
| | - Martha Janssens
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
| | - Christiane Winkler
- Institute of Diabetes Research, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich, Germany
| | - Rachel Elizabeth Jane Besser
- Department of pediatrics, University of Oxford, Oxford, UK.,NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Katarzyna Dzygalo
- Department of Pediatrics, Medical University of Warsaw, Warsaw, Poland
| | - Annika Fehn
- Institute of Diabetes Research, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich, Germany
| | - Angela Hommel
- Department of Pediatrics, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Karin Lange
- Medical Psychology Unit, Hannover Medical School, Hannover, Germany
| | - Helena Elding Larsson
- Unit for Pediatric Endocrinology, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.,Department of Pediatrics, Skåne University Hospital, Malmö, Sweden
| | - Markus Lundgren
- Unit for Pediatric Endocrinology, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.,Department of pediatrics, Kristianstad Hospital, Kristianstad, Sweden
| | - Frank Roloff
- Diabetes Center for Children and Adolescents, Children's Hospital AUF DER BULT, Hannover, Germany
| | - Matthew Snape
- Department of pediatrics, University of Oxford, Oxford, UK.,NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Trust, Oxford, UK
| | | | - Andreas Weiss
- Institute of Diabetes Research, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich, Germany
| | - Jose Zapardiel-Gonzalo
- Institute of Diabetes Research, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich, Germany
| | - Nicole Zubizarreta
- Department of Pediatrics, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Anette-Gabriele Ziegler
- Institute of Diabetes Research, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich, Germany.,Forschergruppe Diabetes, Technische University Munich, Munich, Germany
| | - Kristina Casteels
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium.,Department of Development and Regeneration, KU Leuven, Leuven, Belgium
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Martinelli V, Albanese M, Altieri M, Annovazzi P, Arabi S, Bucello S, Caleri F, Cerqua R, Costanzi C, Cottone S, Dalla Costa G, Direnzo V, Fantozzi R, Favaretto A, Lorefice L, Montini F, Noce A, Plewnia K, Repice AM, Sacco R, Vecchio D. Gut-oriented interventions in patients with multiple sclerosis: fact or fiction? Eur Rev Med Pharmacol Sci 2022; 26:935-946. [PMID: 35179760 DOI: 10.26355/eurrev_202202_28003] [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: 06/14/2023]
Abstract
OBJECTIVE Multiple sclerosis (MS) is a chronic, inflammatory, demyelinating, disimmune disease of the central nervous system whose etiology and pathogenesis remain poorly understood, due to its complex and multifactorial nature. Evidence of a bidirectional connection linking the gut microbiome with the intestinal barrier and the immune system (the gut-brain axis) may have implications for the pathogenesis of inflammatory demyelinating diseases such as MS. This narrative review summarizes the evidence for the gut-brain axis involvement in the pathogenesis of MS and examines the role of gut-oriented interventions in MS. PATIENTS AND METHODS We reviewed all available studies in PubMed concerning gut-directed interventions and MS. This research was conducted using different combinations of pertinent keywords (multiple sclerosis, immune-mediated inflammatory diseases, autoimmune diseases, first demyelinating event, neurocognition, neurological disorders, neurology practice, risk factors, taxonomic biomarkers, nutrition, diet, dietary additives, complementary treatment, gut bacteria, gut microbiome, microbiome, gut-brain axis, epidemiology, alpha-linolenic acid, fermentative metabolites, fat, saturated fat, monounsaturated fat, polyunsaturated fat, omega-3 fatty acids, calorie restricted diet, fasting, fecal microbiome, fecal microbiota transplantation, animal testing). RESULTS There is an emerging evidence that alterations in the gut microbiome and increased intestinal permeability may be causative factors in the complex interplay between nutrition, metabolic status and the immune-inflammatory response in patients with MS. This suggests the possibility that modification of lifestyle and the microbiome, for example by specific diets or fecal microbiota transplantation, supplementation with bile acids and intestinal barrier enhancers, may positively influence the pathogenesis of MS. CONCLUSIONS Although the role of nutritional factors in the pathogenesis of MS remains to be established, there is evidence that appropriate gut-directed interventions such as diet, nutritional supplementation or fecal transplantation may modulate the inflammatory response and improve the course of MS as a complementary treatment in the disease.
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Affiliation(s)
- V Martinelli
- Neurology Unit, Department of Neurology, MS Center, Ospedale San Raffaele, Milan, Italy.
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Arabi S, Moghaddam M, Pourfathollah AA, Aghaie A, Mosaed M. Group O blood donors in Iran: evaluation of isoagglutinin titers and immunoglobulin G subclasses. Immunohematology 2021; 37:5-12. [PMID: 33962489 DOI: 10.21307/immunohematology-2021-002] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This study aims to determine the most frequent titers of anti-A and anti-B (both presumed immunoglobulin [Ig]M and IgG) in Iranian group O blood donors and to compare these titer values with those found in other studies. In addition, alloantibody production and plasma levels of four IgG subclasses were compared between the high-titer and non-high-titer study groups. This study investigated anti-A and anti-B titers in 358 plasma samples. Based on these results, two study groups (high-titer and non-high-titer) were formed. Antibody detection tests were performed to detect unexpected antibodies to D, C, c, E, e, K, k, Fya, Fyb, Jka, Jkb, M, N, S, s, P1, Lea, and Leb. Four IgG subclasses were also evaluated through nephelometry assay. The most frequent titer obtained by room temperature and indirect antiglobulin tube tests was 256. The frequency of titers ≥512 was 31.5 percent. None of the cases showed unexpected RBC alloantibodies. IgG2 levels were significantly higher in the high-titer group. Evaluation of isoagglutinin titers in group O Iranian blood donors can provide insight into the frequency of isoagglutinin titers both within the Iranian population and as compared with other populations. A significant difference in IgG2 levels between the high-titer and non-high-titer groups was identified. More investigation needs to be conducted on the root cause of this finding. Immunohematology 2021;37:5-12 . This study aims to determine the most frequent titers of anti-A and anti-B (both presumed immunoglobulin [Ig]M and IgG) in Iranian group O blood donors and to compare these titer values with those found in other studies. In addition, alloantibody production and plasma levels of four IgG subclasses were compared between the high-titer and non–high-titer study groups. This study investigated anti-A and anti-B titers in 358 plasma samples. Based on these results, two study groups (high-titer and non–high-titer) were formed. Antibody detection tests were performed to detect unexpected antibodies to D, C, c, E, e, K, k, Fya, Fyb, Jka, Jkb, M, N, S, s, P1, Lea, and Leb. Four IgG subclasses were also evaluated through nephelometry assay. The most frequent titer obtained by room temperature and indirect antiglobulin tube tests was 256. The frequency of titers ≥512 was 31.5 percent. None of the cases showed unexpected RBC alloantibodies. IgG2 levels were significantly higher in the high-titer group. Evaluation of isoagglutinin titers in group O Iranian blood donors can provide insight into the frequency of isoagglutinin titers both within the Iranian population and as compared with other populations. A significant difference in IgG2 levels between the high-titer and non–high-titer groups was identified. More investigation needs to be conducted on the root cause of this finding. Immunohematology 2021;37:5–12 .
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Affiliation(s)
- S Arabi
- Department of Immunology, Faculty of Medical Sciences, Tarbiat Modares University , Tehran , Iran
| | - M Moghaddam
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Iranian Blood Transfusion Organization Building , Hemmat Expressway, PO Box 14665-1157, Tehran , Iran
| | - A A Pourfathollah
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran, and Department of Immunology, Faculty of Medical Sciences, Tarbiat Modares University , Tehran , Iran
| | - A Aghaie
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine , Tehran , Iran
| | - M Mosaed
- Department of Immunology, Faculty of Medical Sciences, Tarbiat Modares University , Tehran , Iran
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Hosseini S, Arabi S, Yari F, Pourfatollah A, Rezaie N, Moazezi S, Aghaie A. HLA-DRB1*01:01, but not HLA-DRB1:1503 or HLA-DRB1*11, is associated with decreased inhibitor risk in Iranian hemophilia A patients. Transfus Apher Sci 2019; 58:669-673. [PMID: 31537466 DOI: 10.1016/j.transci.2019.08.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 03/18/2019] [Revised: 07/24/2019] [Accepted: 08/02/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND/OBJECTIVE Hemophilia A is a genetic disorder through which patients suffer from recurrent bleeding. This can be caused by a defect in human plasma coagulation factor VIII. High incidence of FVIII inhibitors in some severe hemophilia A patients after FVIII therapy is a considerable complication. Determination of good predictive factors can improve the safety of this treatment. HLA-II have been shown as a predictive element for inhibitor development. The goal of this study is to determine the association between HLA-DRB1*15:03, HLA-DRB1*11 and HLA-DRB1*01:01 alleles and FVIII inhibitors in severe hemophilia A patients in Iran. MATERIALS/METHODS HLA-DRB1 genotyping was performed using Multiplex sequences Specific Primers (PCR-SSP) in two groups of severe hemophilia A patients comprising 51 and 50 individuals with and without FVIII inhibitors respectively. The levels of inhibitor were determined through Nijmegen-modified Bethesda assay. HLA-DRB1 allele frequencies were compared between groups by using multiple logistic regression models. RESULTS HLA-DRB1*01:01 allele frequency was significantly higher in patients without inhibitor ORadj: 2.7 (95%CI: 1.08, 6.97; P = 0.034). There wasn't any statistically significant difference in HLA-DRB1*11 allele frequency between groups ORadj: 0.7 (95%CI: 0.27, 1.82; P = 0.47). There was no connection between HLA-DRB1*15:03 and inhibitor development ORadj: 0.94 (95%CI: 0.38, 2.35; P = 0.94). CONCLUSION An association between HLA-DRB1*01:01 and paucity of FVIII inhibitor showed that this allele has probably a protective effect in severe hemophilia A patients in Iran. Determination of the predictive and protective alleles are beneficial in pre-treatment activities and decrease the risk of unsuccessful therapy with FVIII in each population.
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Affiliation(s)
- S Hosseini
- Biotechnology, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran.
| | - S Arabi
- Immunology, Department of Immunology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
| | - F Yari
- Immunology, Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran.
| | - A Pourfatollah
- Immunology, Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran.
| | - N Rezaie
- Epidemiology, Non-Communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - S Moazezi
- Iranian Comprehensive Hemophilia Care Center (ICHCC), Iran.
| | - A Aghaie
- Immunology, Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran.
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