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Midya V, Nagdeo K, Lane JM, Torres-Olascoaga LA, Torres-Calapiz M, Gennings C, Horton MK, Téllez-Rojo MM, Wright RO, Arora M, Eggers S. Prenatal metal exposures and childhood gut microbial signatures are associated with depression score in late childhood. Sci Total Environ 2024; 916:170361. [PMID: 38278245 PMCID: PMC10922719 DOI: 10.1016/j.scitotenv.2024.170361] [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] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/19/2024] [Accepted: 01/20/2024] [Indexed: 01/28/2024]
Abstract
BACKGROUND Childhood depression is a major public health issue worldwide. Previous studies have linked both prenatal metal exposures and the gut microbiome to depression in children. However, few, if any, have studied their interacting effect in specific subgroups of children. OBJECTIVES Using an interpretable machine-learning method, this study investigates whether children with specific combinations of prenatal metals and childhood microbial signatures (cliques or groups of metals and microbes) were more likely to have higher depression scores at 9-11 years of age. METHODS We leveraged data from a well-characterized pediatric longitudinal birth cohort in Mexico City and its microbiome substudy (n = 112). Eleven metal exposures were measured in maternal whole blood samples in the second and third trimesters of pregnancy. The gut microbial abundances were measured at 9-11-year-olds using shotgun metagenomic sequencing. Depression symptoms were assessed using the Child Depression Index (CDI) t-scores at 9-11 years of age. We used Microbial and Chemical Exposure Analysis (MiCxA), which combines interpretable machine-learning into a regression framework to identify and estimate joint associations of metal-microbial cliques in specific subgroups. Analyses were adjusted for relevant covariates. RESULTS We identified a subgroup of children (11.6 % of the sample) characterized by a four-component metal-microbial clique that had a significantly high depression score (15.4 % higher than the rest) in late childhood. This metal-microbial clique consisted of high Zinc in the second trimester, low Cobalt in the third trimester, a high abundance of Bacteroides fragilis, a high abundance of Faecalibacterium prausnitzii. All combinations of cliques (two-, three-, and four-components) were significantly associated with increased log-transformed t-scored CDI (β = 0.14, 95%CI = [0.05,0.23], P < 0.01 for the four-component clique). SIGNIFICANCE This study offers a new approach to chemical-microbial analysis and a novel demonstration that children with specific gut microbiome cliques and metal exposures during pregnancy may have a higher likelihood of elevated depression scores.
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Affiliation(s)
- Vishal Midya
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Kiran Nagdeo
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jamil M Lane
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Libni A Torres-Olascoaga
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Mariana Torres-Calapiz
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Chris Gennings
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Megan K Horton
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Martha M Téllez-Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Manish Arora
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Shoshannah Eggers
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IA, USA
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Midya V, Nagdeo K, Lane J, Torres-Olascoaga L, Martínez G, Horton M, Gennings C, Téllez-Rojo M, Wright R, Arora M, Eggers S. Akkermansia muciniphila modifies the association between metal exposure during pregnancy and depressive symptoms in late childhood. Res Sq 2024:rs.3.rs-3922286. [PMID: 38410473 PMCID: PMC10896378 DOI: 10.21203/rs.3.rs-3922286/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
Emerging research suggests that exposures to metals during pregnancy and gut microbiome (GM) disruptions are associated with depressive disorders in childhood. Akkermansia muciniphila, a GM bacteria, has been studied for its potential antidepressant effects. However, its role in the influence of prenatal metal exposures on depressive symptoms during childhood is unknown. Leveraging a well-characterized pediatric longitudinal birth cohort and its microbiome substudy (n=112) and using a state-of-the-art machine-learning model, we investigated whether the presence of A.muciniphila in GM of 9-11-year-olds modifies the associations between exposure to a specific group of metals (or metal-clique) during pregnancy and concurrent childhood depressive symptoms. Among children with no A.muciniphila, a metal-clique of Zinc-Chromium-Cobalt was strongly associated with increased depression score (P<0.0001), whereas, for children with A.muciniphila, this same metal-clique was weakly associated with decreased depression score(P<0.4). Our analysis provides the first exploratory evidence hypothesizing A. muciniphila as a probiotic intervention attenuating the effect of prenatal metal-exposures-associated depressive disorders in late childhood.
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Affiliation(s)
| | | | | | | | - Gabriela Martínez
- Center for Research on Nutrition and Health, National Institute of Public Health
| | | | | | - Martha Téllez-Rojo
- Center for Research on Nutrition and Health, National Institute of Public Health
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Midya V, Lane JM, Gennings C, Torres-Olascoaga LA, Gregory JK, Wright RO, Arora M, Téllez-Rojo MM, Eggers S. Prenatal Lead Exposure Is Associated with Reduced Abundance of Beneficial Gut Microbial Cliques in Late Childhood: An Investigation Using Microbial Co-Occurrence Analysis (MiCA). Environ Sci Technol 2023; 57:16800-16810. [PMID: 37878664 PMCID: PMC10634322 DOI: 10.1021/acs.est.3c04346] [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] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 09/08/2023] [Accepted: 09/11/2023] [Indexed: 10/27/2023]
Abstract
Many analytical methods used in gut microbiome research focus on either single bacterial taxa or the whole microbiome, ignoring multibacteria relationships (microbial cliques). We present a novel analytical approach to identify microbial cliques within the gut microbiome of children at 9-11 years associated with prenatal lead (Pb) exposure. Data came from a subset of participants (n = 123) in the Programming Research in Obesity, Growth, Environment and Social Stressors cohort. Pb concentrations were measured in maternal whole blood from the second and third trimesters of pregnancy. Stool samples collected at 9-11 years old underwent metagenomic sequencing to assess the gut microbiome. Using a novel analytical approach, Microbial Co-occurrence Analysis (MiCA), we paired a machine learning algorithm with randomization-based inference to first identify microbial cliques that were predictive of prenatal Pb exposure and then estimate the association between prenatal Pb exposure and microbial clique abundance. With second-trimester Pb exposure, we identified a two-taxa microbial clique that included Bifidobacterium adolescentis and Ruminococcus callidus and a three-taxa clique that also included Prevotella clara. Increasing second-trimester Pb exposure was associated with significantly increased odds of having the two-taxa microbial clique below the median relative abundance (odds ratio (OR) = 1.03, 95% confidence interval (CI) [1.01-1.05]). Using a novel combination of machine learning and causal inference, MiCA identified a significant association between second-trimester Pb exposure and the reduced abundance of a probiotic microbial clique within the gut microbiome in late childhood.
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Affiliation(s)
- Vishal Midya
- Department
of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York 10029, United States
| | - Jamil M. Lane
- Department
of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York 10029, United States
| | - Chris Gennings
- Department
of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York 10029, United States
| | - Libni A. Torres-Olascoaga
- Center
for Research on Nutrition and Health, National
Institute of Public Health, Cuernavaca 62100, Mexico
| | - Jill K. Gregory
- Instructional
Technology Group, Icahn School of Medicine
at Mount Sinai, New York, New York 10029, United States
| | - Robert O. Wright
- Department
of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York 10029, United States
| | - Manish Arora
- Department
of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York 10029, United States
| | - Martha Maria Téllez-Rojo
- Center
for Research on Nutrition and Health, National
Institute of Public Health, Cuernavaca 62100, Mexico
| | - Shoshannah Eggers
- Department
of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York 10029, United States
- Department
of Epidemiology, University of Iowa College
of Public Health, Iowa City, Iowa 52242, United States
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Lane JM, Wright RO, Eggers S. The interconnection between obesity and executive function in adolescence: The role of the gut microbiome. Neurosci Biobehav Rev 2023; 153:105337. [PMID: 37524139 PMCID: PMC10592180 DOI: 10.1016/j.neubiorev.2023.105337] [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: 03/17/2023] [Revised: 07/25/2023] [Accepted: 07/28/2023] [Indexed: 08/02/2023]
Abstract
In the United States, adolescent obesity is a growing epidemic associated with maladaptive executive functioning. Likewise, data link the microbiome to obesity. Emerging microbiome research has demonstrated an interconnection between the gut microbiome and the brain, indicating a bidirectional communication system within the gut-microbiome-brain axis in the pathophysiology of obesity. This narrative review identifies and summarizes relevant research connecting adolescent obesity as it relates to three core domains of executive functioning and the contribution of the gut microbiome in the relationship between obesity and executive functions in adolescence. The review suggests that (1) the interconnection between obesity, executive function, and the gut microbiome is a bidirectional connection, and (2) the gut microbiome may mediate the neurobiological pathways between obesity and executive function deficits. The findings of this review provide valuable insights into obesity-associated executive function deficits and elucidate the possible mediation role of the gut microbiome.
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Affiliation(s)
- Jamil M Lane
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, USA
| | - Shoshannah Eggers
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IA, USA.
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Zuniga-Chaves I, Eggers S, Kates AE, Safdar N, Suen G, Malecki KMC. Neighborhood socioeconomic status is associated with low diversity gut microbiomes and multi-drug resistant microorganism colonization. NPJ Biofilms Microbiomes 2023; 9:61. [PMID: 37640705 PMCID: PMC10462741 DOI: 10.1038/s41522-023-00430-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 01/20/2023] [Accepted: 08/18/2023] [Indexed: 08/31/2023] Open
Abstract
Social disparities continue to limit universal access to health care, directly impacting both lifespan and quality of life. Concomitantly, the gut microbiome has been associated with downstream health outcomes including the global rise in antibiotic resistance. However, limited evidence exists examining socioeconomic status (SES) associations with gut microbiome composition. To address this, we collected information on the community-level SES, gut microbiota, and other individual cofactors including colonization by multidrug-resistant organisms (MDROs) in an adult cohort from Wisconsin, USA. We found an association between SES and microbial composition that is mediated by food insecurity. Additionally, we observed a higher prevalence of MDROs isolated from individuals with low diversity microbiomes and low neighborhood SES. Our integrated population-based study considers how the interplay of several social and economic factors combine to influence gut microbial composition while providing a framework for developing future interventions to help mitigate the SES health gap.
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Affiliation(s)
- Ibrahim Zuniga-Chaves
- Department of Bacteriology, University of Wisconsin-Madison, Madison, WI, USA
- Microbiology Doctoral Training Program, University of Wisconsin-Madison, Madison, WI, USA
| | - Shoshannah Eggers
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IA, USA
| | - Ashley E Kates
- Division of Infectious Disease, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Nasia Safdar
- Division of Infectious Disease, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Garret Suen
- Department of Bacteriology, University of Wisconsin-Madison, Madison, WI, USA.
| | - Kristen M C Malecki
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA.
- Environmental and Occupational Health Sciences, School of Public Health, University of Chicago Illinois, IL, Chicago, USA.
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Eggers S, Midya V, Bixby M, Gennings C, Torres-Olascoaga LA, Walker RW, Wright RO, Arora M, Téllez-Rojo MM. Prenatal lead exposure is negatively associated with the gut microbiome in childhood. Front Microbiol 2023; 14:1193919. [PMID: 37426026 PMCID: PMC10325945 DOI: 10.3389/fmicb.2023.1193919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 05/23/2023] [Indexed: 07/11/2023] Open
Abstract
Background Metal exposures are associated with gut microbiome (GM) composition and function, and exposures early in development may be particularly important. Considering the role of the GM in association with many adverse health outcomes, understanding the relationship between prenatal metal exposures and the GM is critically important. However, there is sparse knowledge of the association between prenatal metal exposure and GM later in childhood. Objectives This analysis aims to identify associations between prenatal lead (Pb) exposure and GM composition and function in children 9-11 years old. Methods Data come from the Programming Research in Obesity, Growth, Environment and Social Stressors (PROGRESS) cohort based in Mexico City, Mexico. Prenatal metal concentrations were measured in maternal whole blood drawn during the second and third trimesters of pregnancy. Stool samples collected at 9-11 years old underwent metagenomic sequencing to assess the GM. This analysis uses multiple statistical modeling approaches, including linear regression, permutational analysis of variance, weighted quantile sum regression (WQS), and individual taxa regressions, to estimate the association between maternal blood Pb during pregnancy and multiple aspects of the child GM at 9-11 years old, adjusting for relevant confounders. Results Of the 123 child participants in this pilot data analysis, 74 were male and 49 were female. Mean prenatal maternal blood Pb was 33.6 (SE = 2.1) ug/L and 34.9 (SE = 2.1) ug/L at second and third trimesters, respectively. Analysis suggests a consistent negative relationship between prenatal maternal blood Pb and the GM at age 9-11, including measures of alpha and beta diversity, microbiome mixture analysis, and individual taxa. The WQS analysis showed a negative association between prenatal Pb exposure and the gut microbiome, for both second and third trimester exposures (2Tβ = -0.17, 95%CI = [-0.46,0.11]; 3Tβ = -0.17, 95%CI = [-0.44,0.10]). Ruminococcus gnavus, Bifidobacterium longum, Alistipes indistinctus, Bacteroides caccae, and Bifidobacterium bifidum all had weights above the importance threshold from 80% or more of the WQS repeated holdouts in association with both second and third trimester Pb exposure. Discussion Pilot data analysis suggests a negative association between prenatal Pb exposure and the gut microbiome later in childhood; however, additional investigation is needed.
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Affiliation(s)
- Shoshannah Eggers
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IA, United States
| | - Vishal Midya
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Moira Bixby
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Chris Gennings
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Libni A. Torres-Olascoaga
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Ryan W. Walker
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Robert O. Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Manish Arora
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Martha María Téllez-Rojo
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
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Midya V, Lane JM, Gennings C, Torres-Olascoaga LA, Wright RO, Arora M, Téllez-Rojo MM, Eggers S. Prenatal Pb exposure is associated with reduced abundance of beneficial gut microbial cliques in late childhood: an investigation using Microbial Co-occurrence Analysis (MiCA). medRxiv 2023:2023.05.18.23290127. [PMID: 37293091 PMCID: PMC10246125 DOI: 10.1101/2023.05.18.23290127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Background Many analytical methods used in gut microbiome research focus on either single bacterial taxa or the whole microbiome, ignoring multi-bacteria relationships (microbial cliques). We present a novel analytical approach to identify multiple bacterial taxa within the gut microbiome of children at 9-11 years associated with prenatal Pb exposure. Methods Data came from a subset of participants (n=123) in the Programming Research in Obesity, Growth, Environment and Social Stressors (PROGRESS) cohort. Pb concentrations were measured in maternal whole blood from the second and third trimesters of pregnancy. Stool samples collected at 9-11 years old underwent metagenomic sequencing to assess the gut microbiome. Using a novel analytical approach, Microbial Co-occurrence Analysis (MiCA), we paired a machine-learning algorithm with randomization-based inference to first identify microbial cliques that were predictive of prenatal Pb exposure and then estimate the association between prenatal Pb exposure and microbial clique abundance. Results With second-trimester Pb exposure, we identified a 2-taxa microbial clique that included Bifidobacterium adolescentis and Ruminococcus callidus, and a 3-taxa clique that added Prevotella clara. Increasing second-trimester Pb exposure was associated with significantly increased odds of having the 2-taxa microbial clique below the 50th percentile relative abundance (OR=1.03,95%CI[1.01-1.05]). In an analysis of Pb concentration at or above vs. below the United States and Mexico guidelines for child Pb exposure, odds of the 2-taxa clique in low abundance were 3.36(95%CI[1.32-8.51]) and 6.11(95%CI[1.87-19.93]), respectively. Trends were similar with the 3-taxa clique but not statistically significant. Discussion Using a novel combination of machine-learning and causal-inference, MiCA identified a significant association between second-trimester Pb exposure and reduced abundance of a probiotic microbial clique within the gut microbiome in late childhood. Pb exposure levels at the guidelines for child Pb poisoning in the United States, and Mexico are not sufficient to protect against the potential loss of probiotic benefits.
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Affiliation(s)
- V Midya
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - J M Lane
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - C Gennings
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - L A Torres-Olascoaga
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
| | - R O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - M Arora
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - M M Téllez-Rojo
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
| | - S Eggers
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa, USA
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Eggers S, Midya V, Bixby M, Gennings C, Torres-Olascoaga LA, Walker RW, Wright RO, Arora M, Téllez-Rojo MM. Prenatal Lead Exposure is Negatively Associated with the Gut Microbiome in Childhood. medRxiv 2023:2023.05.10.23289802. [PMID: 37214901 PMCID: PMC10197792 DOI: 10.1101/2023.05.10.23289802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Background Metal exposures are associated with gut microbiome (GM) composition and function, and exposures early in development may be particularly important. Considering the role of the GM in association with many adverse health outcomes, understanding the relationship between prenatal metal exposures and the GM is critically important. However, there is sparse knowledge of the association between prenatal metal exposure and GM later in childhood. Objectives This analysis aims to identify associations between prenatal lead (Pb) exposure and GM composition and function in children 9-11 years old. Methods Data come from the Programming Research in Obesity, Growth, Environment and Social Stressors (PROGRESS) cohort based in Mexico City, Mexico. Prenatal metal concentrations were measured in maternal whole blood drawn during the second and third trimesters of pregnancy. Stool samples collected at 9-11 years old underwent metagenomic sequencing to assess the GM. This analysis uses multiple statistical modeling approaches, including linear regression, permutational analysis of variance, weighted quantile sum regression (WQS), and individual taxa regressions, to estimate the association between maternal blood Pb during pregnancy and multiple aspects of the child GM at 9-11 years old, adjusting for relevant confounders. Results Of the 123 child participants in this pilot data analysis, 74 were male and 49 were female. Mean prenatal maternal blood Pb was 33.6(SE=2.1) ug/L and 34.9(SE=2.1) ug/L at second and third trimesters, respectively. Analysis suggests a consistent negative relationship between prenatal maternal blood Pb and the GM at age 9-11, including measures of alpha and beta diversity, microbiome mixture analysis, and individual taxa. The WQS analysis showed a negative association between prenatal Pb exposure and the gut microbiome, for both second and third trimester exposures (2Tβ=-0.17,95%CI=[-0.46,0.11]; 3Tβ=-0.17,95%CI=[-0.44,0.10]). Ruminococcus gnavus, Bifidobacterium longum, Alistipes indistinctus, Bacteroides caccae, and Bifidobacterium bifidum all had weights above the importance threshold from 80% or more of the WQS repeated holdouts in association with both second and third trimester Pb exposure. Discussion Pilot data analysis suggests a negative association between prenatal Pb exposure and the gut microbiome later in childhood; however, additional investigation is needed.
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Affiliation(s)
- Shoshannah Eggers
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa, USA
| | - Vishal Midya
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Moira Bixby
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Chris Gennings
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Libni A Torres-Olascoaga
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Ryan W. Walker
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Robert O. Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Manish Arora
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Martha María Téllez-Rojo
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
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Eggers S, Bixby M, Renzetti S, Curtin P, Gennings C. Human Microbiome Mixture Analysis Using Weighted Quantile Sum Regression. Int J Environ Res Public Health 2022; 20:ijerph20010094. [PMID: 36612415 PMCID: PMC9819204 DOI: 10.3390/ijerph20010094] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/13/2022] [Accepted: 12/16/2022] [Indexed: 05/30/2023]
Abstract
Studies of the health effects of the microbiome often measure overall associations by using diversity metrics, and individual taxa associations in separate analyses, but do not consider the correlated relationships between taxa in the microbiome. In this study, we applied random subset weighted quantile sum regression with repeated holdouts (WQSRSRH), a mixture method successfully applied to 'omic data to account for relationships between many predictors, to processed amplicon sequencing data from the Human Microbiome Project. We simulated a binary variable associated with 20 operational taxonomic units (OTUs). WQSRSRH was used to test for the association between the microbiome and the simulated variable, adjusted for sex, and sensitivity and specificity were calculated. The WQSRSRH method was also compared to other standard methods for microbiome analysis. The method was further illustrated using real data from the Growth and Obesity Cohort in Chile to assess the association between the gut microbiome and body mass index. In the analysis with simulated data, WQSRSRH predicted the correct directionality of association between the microbiome and the simulated variable, with an average sensitivity and specificity of 75% and 70%, respectively, in identifying the 20 associated OTUs. WQSRSRH performed better than all other comparison methods. In the illustration analysis of the gut microbiome and obesity, the WQSRSRH analysis identified an inverse association between body mass index and the gut microbe mixture, identifying Bacteroides, Clostridium, Prevotella, and Ruminococcus as important genera in the negative association. The application of WQSRSRH to the microbiome allows for analysis of the mixture effect of all the taxa in the microbiome, while simultaneously identifying the most important to the mixture, and allowing for covariate adjustment. It outperformed other methods when using simulated data, and in analysis with real data found results consistent with other study findings.
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Affiliation(s)
- Shoshannah Eggers
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1057, New York, NY 10029, USA
| | - Moira Bixby
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1057, New York, NY 10029, USA
| | - Stefano Renzetti
- Department of Medical-Surgical Specialties, Radiological Sciences and Public Health, Università degli Studi di Brescia, Piazza del Mercato, 15, 25121 Brescia, Italy
| | - Paul Curtin
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1057, New York, NY 10029, USA
| | - Chris Gennings
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1057, New York, NY 10029, USA
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Bixby M, Gennings C, Malecki KMC, Sethi AK, Safdar N, Peppard PE, Eggers S. Individual Nutrition Is Associated with Altered Gut Microbiome Composition for Adults with Food Insecurity. Nutrients 2022; 14:3407. [PMID: 36014913 PMCID: PMC9416073 DOI: 10.3390/nu14163407] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/13/2022] [Accepted: 08/14/2022] [Indexed: 11/17/2022] Open
Abstract
Diet is widely recognized as a key contributor to human gut microbiome composition and function. However, overall nutrition can be difficult to compare across a population with varying diets. Moreover, the role of food security in the relationship with overall nutrition and the gut microbiome is unclear. This study aims to investigate the association between personalized nutrition scores, variation in the adult gut microbiome, and modification by food insecurity. The data originate from the Survey of the Health of Wisconsin and the Wisconsin Microbiome Study. Individual nutrition scores were assessed using My Nutrition Index (MNI), calculated using data from food frequency questionnaires, and additional health history and demographic surveys. Food security and covariate data were measured through self-reported questionnaires. The gut microbiome was assessed using 16S amplicon sequencing of DNA extracted from stool samples. Associations, adjusted for confounding and interaction by food security, were estimated using Weighted Quantile Sum (WQS) regression models with Random Subset and Repeated Holdout extensions (WQSRSRH), with bacterial taxa used as components in the weighted index. Of 643 participants, the average MNI was 66.5 (SD = 31.9), and 22.8% of participants were food insecure. Increased MNI was significantly associated with altered gut microbial composition (β = 2.56, 95% CI = 0.52−4.61), with Ruminococcus, Oscillospira, and Blautia among the most heavily weighted of the 21 genera associated with the MNI score. In the stratified interaction WQSRSRH models, the bacterial taxa most heavily weighted in the association with MNI differed by food security, but the level of association between MNI and the gut microbiome was not significantly different. More bacterial genera are important in the association with higher nutrition scores for people with food insecurity versus food security, including Streptococcus, Parabacteroides Faecalibacterium, and Desulfovibrio. Individual nutrition scores are associated with differences in adult gut microbiome composition. The bacterial taxa most associated with nutrition vary by level of food security. While further investigation is needed, results showed a higher nutrition score was associated with a wider range of bacterial taxa for food insecure vs. secure, suggesting nutritional quality in food insecure individuals is important in maintaining health and reducing disparities.
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Affiliation(s)
- Moira Bixby
- Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY 10029, USA
| | - Chris Gennings
- Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY 10029, USA
| | - Kristen M. C. Malecki
- Population Health Sciences, University of Wisconsin School of Medicine and Public Health, 610 Walnut St., WARF 707, Madison, WI 53726, USA
| | - Ajay K. Sethi
- Population Health Sciences, University of Wisconsin School of Medicine and Public Health, 610 Walnut St., WARF 707, Madison, WI 53726, USA
| | - Nasia Safdar
- Department of Medicine, Division of Infectious Disease, School of Medicine and Public Health, University of Wisconsin-Madison, UW Med. Fndtn. Centennial Bldg., 1685 Highland Ave, Madison, WI 53705, USA
- William S. Middleton Veterans Affairs Medical Center, 2500 Overlook Terrace, Madison, WI 53705, USA
| | - Paul E. Peppard
- Population Health Sciences, University of Wisconsin School of Medicine and Public Health, 610 Walnut St., WARF 707, Madison, WI 53726, USA
| | - Shoshannah Eggers
- Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY 10029, USA
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Niedzwiecki MM, Eggers S, Joshi A, Dolios G, Cantoral A, Lamadrid-Figueroa H, Amarasiriwardena C, Téllez-Rojo MM, Wright RO, Petrick L. Lead exposure and serum metabolite profiles in pregnant women in Mexico City. Environ Health 2021; 20:125. [PMID: 34893088 PMCID: PMC8665540 DOI: 10.1186/s12940-021-00810-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 09/02/2021] [Accepted: 11/22/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Lead (Pb) exposure is a global health hazard causing a wide range of adverse health outcomes. Yet, the mechanisms of Pb toxicology remain incompletely understood, especially during pregnancy. To uncover biological pathways impacted by Pb exposure, this study investigated serum metabolomic profiles during the third trimester of pregnancy that are associated with blood Pb and bone Pb. METHODS We used data and specimens from 99 women enrolled in the Programming Research in Obesity, Growth, Environment, and Social Stressors birth cohort in Mexico City. Maternal Pb exposure was measured in whole blood samples from the third trimester of pregnancy and in the tibia and patella bones at 1 month postpartum. Third-trimester serum samples underwent metabolomic analysis; metabolites were identified based on matching to an in-house analytical standard library. A metabolome-wide association study was performed using multiple linear regression models. Class- and pathway-based enrichment analyses were also conducted. RESULTS The median (interquartile range) blood Pb concentration was 2.9 (2.6) µg/dL. Median bone Pb, measured in the tibia and patella, were 2.5 (7.3) µg/g and 3.6 (9.5) µg/g, respectively. Of 215 total metabolites identified in serum, 31 were associated with blood Pb (p < 0.05). Class enrichment analysis identified significant overrepresentation of metabolites classified as fatty acids and conjugates, amino acids and peptides, and purines. Tibia and patella Pb were associated with 14 and 8 metabolites, respectively (p < 0.05). Comparing results from bone and blood Pb, glycochenodeoxycholic acid, glycocholic acid, and 1-arachidonoylglycerol were positively associated with blood Pb and tibia Pb, and 7-methylguanine was negatively associated with blood Pb and patella Pb. One metabolite, 5-aminopentanoic acid, was negatively associated with all three Pb measures. CONCLUSIONS This study identified serum metabolites in pregnant women associated with Pb measured in blood and bone. These findings provide insights on the metabolic profile around Pb exposure in pregnancy and information to guide mechanistic studies of toxicological effects for mothers and children.
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Affiliation(s)
- Megan M Niedzwiecki
- Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, United States, NY
| | - Shoshannah Eggers
- Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, United States, NY
| | - Anu Joshi
- Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, United States, NY
| | - Georgia Dolios
- Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, United States, NY
| | | | | | - Chitra Amarasiriwardena
- Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, United States, NY
| | | | - Robert O Wright
- Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, United States, NY
| | - Lauren Petrick
- Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, United States, NY
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12
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Eggers S, Gennings C, Malecki KMC, Safdar N, Arora M. Exposure to environmental chemical mixtures is associated with nasal colonization by Staphylococcus aureus: NHANES 2001-2004. Environ Res 2020; 190:109994. [PMID: 32771801 PMCID: PMC7530026 DOI: 10.1016/j.envres.2020.109994] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 07/20/2020] [Accepted: 07/22/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Understanding the health effects of exposure to chemical mixtures is critically important given the broad range of concurrent exposures throughout the life-course. While investigations of environmental chemicals and components of the human microbiome are becoming more common, few have examined associations with chemical mixtures. This study assesses the association between exposure to mixtures of 66 different environmental chemicals and nasal colonization of Staphylococcus aureus (SA) and methicillin resistant SA (MRSA). METHODS Data came from the National Health and Nutrition Examination Survey (NHANES) 2001-2004. The analytical sample consists of 10,312 participants, age 6 years and older, subdivided into 8 groups with different chemical exposure mixtures. Within each of 6 chemical classes (metals, phthalates, polycyclic aromatic hydrocarbons (PAHs), polybrominated diphenyl ethers (PBDEs), polyfluorochemicals (PFCs), and phenols), weighted quantile sum (WQS) regression was used to analyze the joint association of the component compounds and nasal SA colonization. WQS was also used to assess the joint association of 3 chemical mixtures (metals, metal and PAHs, and metal and triclosan) and nasal MRSA colonization. All regression models were adjusted for confounders. RESULTS The analytical sample was between ages 6-85, slightly more female, and predominantly non-smokers. Prevalence of SA carriage was 29.2%, and MRSA colonization prevalence was 1.2%. Within each chemical class, odds of SA colonization increased statistically significantly with exposure to mixtures of metals (OR = 1.11, 95% CI = 1.02-1.20), phthalates (OR = 1.09, 95% CI = 1.04-1.14), and phenols (OR = 1.08, 95% CI = 1.01-1.15). Exposure to a mixture of metals combined with PAHs was also associated with increased odds of MRSA carriage (OR = 1.38, 95% CI = 1.02-1.86). CONCLUSION Results indicate an association between multiple environmental chemical mixtures and SA colonization, including MRSA. These findings support the need for further analysis of associations between chemical mixtures and SA colonization, as well as other components of the human microbiome.
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Affiliation(s)
- Shoshannah Eggers
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1057, New York, NY, 10029, USA.
| | - Chris Gennings
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1057, New York, NY, 10029, USA.
| | - Kristen M C Malecki
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin - Madison, 610 Walnut St, WARF 707, Madison, WI, 53726, USA.
| | - Nasia Safdar
- Division of Infectious Disease, Department of Medicine, School of Medicine and Public Health, University of Wisconsin - Madison, UW Med Fndtn Centennial Bldg, 1685 Highland Ave, Madison, WI, 53705, USA; William S. Middleton Veterans Affairs Medical Center, 2500 Overlook Terrace, Madison, WI, 53705, USA.
| | - Manish Arora
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1057, New York, NY, 10029, USA.
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13
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Sitarik AR, Arora M, Austin C, Bielak LF, Eggers S, Johnson CC, Lynch SV, Kyun Park S, Hank Wu KH, Yong GJM, Cassidy-Bushrow AE. Fetal and early postnatal lead exposure measured in teeth associates with infant gut microbiota. Environ Int 2020; 144:106062. [PMID: 32871381 PMCID: PMC7572588 DOI: 10.1016/j.envint.2020.106062] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 08/11/2020] [Accepted: 08/17/2020] [Indexed: 05/18/2023]
Abstract
BACKGROUND Lead (Pb) is an environmentally ubiquitous heavy metal associated with a wide range of adverse health effects in children. Both lead exposure and the early life microbiome- which plays a critical role in human development-have been linked to similar health outcomes, but it is unclear if the adverse effects of lead are partially driven by early life gut microbiota dysbiosis. The objective of this study was to examine the association between in utero and postnatal lead levels (measured in deciduous baby teeth) and early life bacterial and fungal gut microbiota in the first year of life. METHODS Data from the Wayne County Health, Environment, Allergy and Asthma Longitudinal Study (WHEALS) birth cohort were analyzed. Tooth lead levels during the 2nd and 3rd trimesters and postnatally (<1 year of age) were quantified using high-resolution microspatial mapping of dentin growth rings. Early life microbiota were measured in stool samples collected at approximately 1 and 6 months of age, using both 16S rRNA (bacterial) and ITS2 (fungal) sequencing. Of the 1,258 maternal-child pairs in WHEALS, 146 had data on both tooth metals and early life microbiome. RESULTS In utero tooth lead levels were significantly associated with gut fungal community composition at 1-month of age, where higher levels of 2nd trimester tooth lead was associated with lower abundances of Candida and Aspergillus and higher abundances of Malassezia and Saccharomyces; 3rd trimester lead was also associated with lower abundances of Candida. Though lead did not significantly associate with the overall structure of the infant gut bacterial community, it associated with the abundance of some specific bacterial taxa, including the increased abundance of Collinsella and Bilophila and a decreased abundance of Bacteroides taxa. CONCLUSIONS The observed associations between lead exposure and infant gut microbiota could play a role in the impact of lead on childhood development. Given the paucity of research examining these associations in humans-particularly for fungal microbiota-further investigation is needed.
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Affiliation(s)
- Alexandra R Sitarik
- Department of Public Health Sciences, Henry Ford Health System, Detroit, USA.
| | - Manish Arora
- Senator Frank R Lautenberg Environmental Health Sciences Laboratory, Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York City, USA.
| | - Christine Austin
- Senator Frank R Lautenberg Environmental Health Sciences Laboratory, Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York City, USA.
| | | | - Shoshannah Eggers
- Senator Frank R Lautenberg Environmental Health Sciences Laboratory, Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York City, USA.
| | - Christine C Johnson
- Department of Public Health Sciences, Henry Ford Health System, Detroit, USA.
| | - Susan V Lynch
- Division of Gastroenterology, Department of Medicine, University of California, San Francisco, USA.
| | - Sung Kyun Park
- Department of Epidemiology, University of Michigan, Ann Arbor, USA; Department of Environmental Health Sciences, University of Michigan, Ann Arbor, USA.
| | - Kuan-Han Hank Wu
- Department of Public Health Sciences, Henry Ford Health System, Detroit, USA.
| | - Germaine J M Yong
- Division of Gastroenterology, Department of Medicine, University of California, San Francisco, USA.
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14
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Eggers S, Safdar N, Sethi AK, Suen G, Peppard PE, Kates AE, Skarlupka JH, Kanarek M, Malecki KMC. Urinary lead concentration and composition of the adult gut microbiota in a cross-sectional population-based sample. Environ Int 2019; 133:105122. [PMID: 31518933 PMCID: PMC7230144 DOI: 10.1016/j.envint.2019.105122] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 08/22/2019] [Accepted: 08/22/2019] [Indexed: 05/09/2023]
Abstract
BACKGROUND Lead (Pb) is a ubiquitous environmental contaminant with an array of detrimental health effects in children and adults, including neurological and immune dysfunction. Emerging evidence suggests that Pb exposure may alter the composition of the gut microbiota, however few studies have examined this association in human populations. The purpose of this study was to examine the association between urinary Pb concentration and the composition of the adult gut microbiota in a population-based sample of adults. METHODS Data used in this study were collected as part of the Survey of the Health of Wisconsin (SHOW) and its ancillary microbiome study. The SHOW is a household-based health examination survey of Wisconsin residents, collecting a variety of survey data on health determinants and outcomes, as well as objective measurements of body habitus, and biological specimens including urine. The ancillary microbiome study added additional questions and biological specimen collection, including stool, from participants age 18+. Pb concentration was analyzed in urine samples, and gut microbiota composition was assessed using DNA sequencing of the 16S rRNA V4 region, extracted from stool samples. Data processing and statistical analyses were performed in mothur, Python, R, and SAS. RESULTS Of 696 participants, urinary Pb concentration was highest in those age 70+, females, those with a high school diploma or lower, current and former smokers, and those without indoor pets. In adjusted models, increasing urinary Pb levels were associated with increases in microbial α-diversity (p = 0.071) and richness (p = 0.005). Differences in microbial β-diversity were significantly associated (p = 0.003) with differences in urinary Pb level. Presence of Proteobacteria, including members of the Burkholderiales, was significantly associated with increased urinary Pb. CONCLUSION These results suggest that Pb exposure is associated with differences in the composition of the adult gut microbiota in a population-based human sample. Further investigation of this association is warranted.
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Affiliation(s)
- Shoshannah Eggers
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin - Madison, 610 Walnut St, WARF 707, Madison, WI 53726, USA; Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1057, New York, NY 10029, USA.
| | - Nasia Safdar
- Division of Infectious Disease, Department of Medicine, School of Medicine and Public Health, University of Wisconsin - Madison, UW Med Fndtn Centennial Bldg, 1685 Highland Ave, Madison, WI 53705, USA; William S. Middleton Veterans Affairs Medical Center, 2500 Overlook Terrace, Madison, WI 53705, USA.
| | - Ajay K Sethi
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin - Madison, 610 Walnut St, WARF 707, Madison, WI 53726, USA.
| | - Garret Suen
- Department of Bacteriology, University of Wisconsin - Madison, 1550 Linden Dr, Madison, WI 53706, USA.
| | - Paul E Peppard
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin - Madison, 610 Walnut St, WARF 707, Madison, WI 53726, USA.
| | - Ashley E Kates
- Division of Infectious Disease, Department of Medicine, School of Medicine and Public Health, University of Wisconsin - Madison, UW Med Fndtn Centennial Bldg, 1685 Highland Ave, Madison, WI 53705, USA; William S. Middleton Veterans Affairs Medical Center, 2500 Overlook Terrace, Madison, WI 53705, USA.
| | - Joseph H Skarlupka
- Department of Bacteriology, University of Wisconsin - Madison, 1550 Linden Dr, Madison, WI 53706, USA.
| | - Marty Kanarek
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin - Madison, 610 Walnut St, WARF 707, Madison, WI 53726, USA; Nelson Institute for Environmental Studies, University of Wisconsin - Madison, 122 Science Hall, 550 North Park St, Madison, WI 53706, USA.
| | - Kristen M C Malecki
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin - Madison, 610 Walnut St, WARF 707, Madison, WI 53726, USA.
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15
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Sethi A, Eggers S, Mares J, Christensen K, Gangnon R, Suen G, Watson L, Shirley D, Shukla S, Poulsen K, Malecki K, Peppard P, Safdar N. 2582. The Association Between Dietary Fiber and Diet and Gut Colonization with Clostridium difficile. Open Forum Infect Dis 2019. [PMCID: PMC6809574 DOI: 10.1093/ofid/ofz360.2260] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
There is little research on the relationship between diet and Clostridium difficile infection. Animal studies have shown potential benefits of dietary fiber in modulating C. difficile infection.
Methods
In 2016–2017, we carried out a microbiota study among adults in the Survey of the Health of Wisconsin, a population-based health survey collecting data on a wide range of health determinants and outcomes. We administered the Dietary History Questionnaire and asked about risk factors for C. difficile and collected fecal samples for 16S rRNA sequencing of gut microbiota and cultured for C. difficile. Dietary components were standardized to 1,000 kcal energy intake. Logistic regression was used to examine diet factors associated with C. difficile colonization. The quasi-conditional association test (QCAT) was performed to identify taxa that were significantly associated with fiber intake.
Results
In our general population sample of adults [(N = 238; 58% female; mean (range) age = 54 (18–94)], the prevalence of gut colonization with C. difficile was 9.2% (18 toxigenic/3 non-toxigenic). After adjusting for age, sex, and antibiotic use, C. difficile colonization was associated with usual daily fiber consumption over the last year. ORs (95% CI) in the highest vs. lowest quartile were 0.18 (0.03, 0.89) for total fiber, 0.09 (0.01, 0.77) for soluble fiber, and 0.10 (0.1, 0.80) for insoluble fiber. Lower odds of C. difficile colonization were associated with greater consumption of dark green vegetables and less consumption of solid fats, total saturated fats, and added sugar, but not significantly. Omega 3 fatty acids and fruit consumption were either non-monotonically or not associated with C. difficile colonization. Higher levels of total dietary fiber intake were also associated with increased colonization by bacteria within the order Clostridiales, the families Coriobacteriaceae, Lactobacillaceae, and Veillonellacea, and the genera Bifidobacterium, and Lactobacillus.
Conclusion
Higher average daily dietary fiber (total, soluble, and insoluble) appears to be associated with lower odds of gut colonization with C. difficile. Future research should examine the impact of dietary interventions on C. difficile colonization and infection.
Disclosures
All authors: No reported disclosures.
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Affiliation(s)
- Ajay Sethi
- University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin
| | | | - Julie Mares
- University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin
| | - Krista Christensen
- University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin
| | - Ronald Gangnon
- University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin
| | - Garret Suen
- University of Wisconsin-Madison, Madison, Wisconsin
| | | | - Daniel Shirley
- University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin
| | - Sanjay Shukla
- Marshfield Clinic Research Institute, Marshfield, Wisconsin
| | - Keith Poulsen
- University of Wisconsin-Madison School of Veterinary Medicine, Madison, Wisconsin
| | - Kristen Malecki
- University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin
| | - Paul Peppard
- University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin
| | - Nasia Safdar
- University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin
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De Wolfe TJ, Eggers S, Barker AK, Kates AE, Dill-McFarland KA, Suen G, Safdar N. Oral probiotic combination of Lactobacillus and Bifidobacterium alters the gastrointestinal microbiota during antibiotic treatment for Clostridium difficile infection. PLoS One 2018; 13:e0204253. [PMID: 30265691 PMCID: PMC6161886 DOI: 10.1371/journal.pone.0204253] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [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: 04/11/2018] [Accepted: 09/04/2018] [Indexed: 12/21/2022] Open
Abstract
Perturbations in the gastrointestinal microbiome caused by antibiotics are a major risk factor for Clostridium difficile infection (CDI). Probiotics are often recommended to mitigate CDI symptoms; however, there exists only limited evidence showing probiotic efficacy for CDI. Here, we examined changes to the GI microbiota in a study population where probiotic treatment was associated with significantly reduced duration of CDI diarrhea. Subjects being treated with standard of care antibiotics for a primary episode of CDI were randomized to probiotic treatment or placebo for 4 weeks. Probiotic treatment consisted of a daily multi-strain capsule (Lactobacillus acidophilus NCFM, ATCC 700396; Lactobacillus paracasei Lpc-37, ATCC SD5275; Bifidobacterium lactis Bi-07, ATCC SC5220; Bifidobacterium lactis B1-04, ATCC SD5219) containing 1.7 x 1010 CFUs. Stool was collected and analyzed using 16S rRNA sequencing. Microbiome analysis revealed apparent taxonomic differences between treatments and timepoints. Subjects administered probiotics had reduced Verrucomicrobiaceae at week 8 compared to controls. Bacteroides were significantly reduced between weeks 0 to 4 in probiotic treated subjects. Ruminococcus (family Lachnospiraceae), tended to be more abundant at week 8 than week 4 within the placebo group and at week 8 than week 0 within the probiotic group. Similar to these results, previous studies have associated these taxa with probiotic use and with mitigation of CDI symptoms. Compositional prediction of microbial community function revealed that subjects in the placebo group had microbiomes enriched with the iron complex transport system, while probiotic treated subjects had microbiomes enriched with the antibiotic transport system. Results indicate that probiotic use may impact the microbiome function in the face of a CDI; yet, more sensitive methods with higher resolution are warranted to better elucidate the roles associated with these changes. Continuing studies are needed to better understand probiotic effects on microbiome structure and function and the resulting impacts on CDI.
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Affiliation(s)
- T. J. De Wolfe
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Department of Medicine, Division of Infectious Disease, University of Wisconsin – Madison School of Medicine and Public Health, Madison, Wisconsin, United States of America
| | - S. Eggers
- Department of Population Health Sciences, University of Wisconsin – Madison School of Medicine and Public Health, Madison, Wisconsin, United States of America
| | - A. K. Barker
- Department of Population Health Sciences, University of Wisconsin – Madison School of Medicine and Public Health, Madison, Wisconsin, United States of America
| | - A. E. Kates
- Department of Medicine, Division of Infectious Disease, University of Wisconsin – Madison School of Medicine and Public Health, Madison, Wisconsin, United States of America
- William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin, United States of America
| | - K. A. Dill-McFarland
- Department of Bacteriology, University of Wisconsin – Madison, Madison, Wisconsin, United States of America
| | - G. Suen
- Department of Bacteriology, University of Wisconsin – Madison, Madison, Wisconsin, United States of America
| | - N. Safdar
- Department of Medicine, Division of Infectious Disease, University of Wisconsin – Madison School of Medicine and Public Health, Madison, Wisconsin, United States of America
- William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin, United States of America
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17
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Eggers S, Malecki KMC, Peppard P, Mares J, Shirley D, Shukla SK, Poulsen K, Gangnon R, Duster M, Kates A, Suen G, Sethi AK, Safdar N. Wisconsin microbiome study, a cross-sectional investigation of dietary fibre, microbiome composition and antibiotic-resistant organisms: rationale and methods. BMJ Open 2018; 8:e019450. [PMID: 29588324 PMCID: PMC5875638 DOI: 10.1136/bmjopen-2017-019450] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Prevention of multidrug-resistant organism (MDRO) infections, such as those caused by methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, fluoroquinolone-resistant Gram-negative bacteria and Clostridium difficile is crucial. Evidence suggests that dietary fibre increases gut microbial diversity, which may help prevent colonisation and subsequent infection by MDROs. The aim of the Winning the War on Antibiotic Resistance (WARRIOR) project is to examine associations of dietary fibre consumption with the composition of the gut microbiota and gut colonisation by MDROs. The secondary purpose of the study is to create a biorepository of multiple body site specimens for future microbiota research. METHODS AND ANALYSIS The WARRIOR project collects biological specimens, including nasal, oral and skin swabs and saliva and stool samples, along with extensive data on diet and MDRO risk factors, as an ancillary study of the Survey of the Health of Wisconsin (SHOW). The SHOW is a population-based health survey collecting data on several different health determinants and outcomes, as well as objective body measurements and biological specimens. WARRIOR participants include 600 randomly selected Wisconsin residents age 18 and over. Specimens are screened for MDRO colonisation and DNA is extracted for 16S ribosomal RNA-based microbiota sequencing. Data will be analysed to assess the relationship between dietary fibre, the gut microbiota composition and gut MDRO colonisation. ETHICS AND DISSEMINATION The WARRIOR project is approved by the University of Wisconsin Institutional Review Board. The main results of this study will be published in a peer-reviewed scientific journal.
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Affiliation(s)
- Shoshannah Eggers
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Kristen MC Malecki
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Paul Peppard
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Julie Mares
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Daniel Shirley
- Division of Infectious Disease, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Sanjay K Shukla
- Center for Human Genetics, Marshfield Clinic Research Institute, Marshfield, Wisconsin, USA
| | - Keith Poulsen
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Ronald Gangnon
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Megan Duster
- Division of Infectious Disease, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Ashley Kates
- Division of Infectious Disease, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Garret Suen
- Department of Bacteriology, College of Agricultural and Life Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Ajay K Sethi
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Nasia Safdar
- Division of Infectious Disease, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
- William S. Middleton Veterans Affairs Medical Center, Madison, Wisconsin, USA
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Eggers S, Barker AK, Valentine S, Hess T, Duster M, Safdar N. Effect of Lactobacillus rhamnosus HN001 on carriage of Staphylococcus aureus: results of the impact of probiotics for reducing infections in veterans (IMPROVE) study. BMC Infect Dis 2018; 18:129. [PMID: 29540160 PMCID: PMC5853063 DOI: 10.1186/s12879-018-3028-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [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: 08/11/2017] [Accepted: 02/28/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Infection by Staphylococcus aureus (S. aureus) is a major cause of morbidity and mortality. Colonization by S. aureus increases the risk of infection. Little is known about decolonization strategies for S. aureus beyond antibiotics, however probiotics represent a promising alternative. A randomized controlled trial was conducted to determine the efficacy of Lactobacillus rhamnosus (L. rhamnosus) HN001 in reducing carriage of S. aureus at multiple body sites. METHODS One hundred thirteen subjects, positive for S. aureus carriage, were recruited from the William S. Middleton Memorial Medical Center, Madison, WI, USA, and randomized by initial site of colonization, either gastrointestinal (GI) or extra-GI, to 4-weeks of oral L. rhamnosus HN001 probiotic, or placebo. Nasal, oropharyngeal, and axillary/groin swabs were obtained, and serial blood and fecal samples were collected. Differences in prevalence of S. aureus carriage at the end of the 4-weeks of treatment were assessed. RESULTS The probiotic and placebo groups were similar in age, gender, and health history at baseline. S. aureus colonization within the stool samples of the extra-GI group was 15% lower in the probiotic than placebo group at the endpoint of the trial. Those in the probiotic group compared to the placebo group had 73% reduced odds (OR 0.27, 95% CI 0.07-0.98) of methicillin-susceptible S. aureus presence, and 83% reduced odds (OR 0.17, 95% CI 0.04-0.73) of any S. aureus presence in the stool sample at endpoint. CONCLUSION Use of daily oral L. rhamnosus HN001 reduced odds of carriage of S. aureus in the GI tract, however it did not eradicate S. aureus from other body sites. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01321606 . Registered March 21, 2011.
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Affiliation(s)
- Shoshannah Eggers
- William S. Middleton Veterans Affairs Medical Center, 2500 Overlook Terrace, Madison, WI 53705 USA ,0000 0001 2167 3675grid.14003.36Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin – Madison, Warf Office Bldg, 610 Walnut St #707, Madison, WI 53726 USA
| | - Anna K. Barker
- 0000 0001 2167 3675grid.14003.36Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin – Madison, Warf Office Bldg, 610 Walnut St #707, Madison, WI 53726 USA
| | - Susan Valentine
- William S. Middleton Veterans Affairs Medical Center, 2500 Overlook Terrace, Madison, WI 53705 USA
| | - Timothy Hess
- 0000 0001 2167 3675grid.14003.36Department of Medicine, School of Medicine and Public Health, University of Wisconsin – Madison, 1685 Highland Ave, Madison, WI 53705 USA
| | - Megan Duster
- 0000 0001 2167 3675grid.14003.36Division of Infectious Disease, Department of Medicine, School of Medicine and Public Health, University of Wisconsin – Madison, 1685 Highland Ave, 5th Floor, Madison, WI 53705 USA
| | - Nasia Safdar
- William S. Middleton Veterans Affairs Medical Center, 2500 Overlook Terrace, Madison, WI 53705 USA ,0000 0001 2167 3675grid.14003.36Division of Infectious Disease, Department of Medicine, School of Medicine and Public Health, University of Wisconsin – Madison, 1685 Highland Ave, 5th Floor, Madison, WI 53705 USA
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Kalluru S, Eggers S, Barker A, Shirley D, Sethi AK, Sengupta S, Yeptho K, Safdar N. Risk factors for infection with multidrug-resistant organisms in Haryana, India. Am J Infect Control 2018; 46:341-345. [PMID: 29102426 DOI: 10.1016/j.ajic.2017.08.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 08/19/2017] [Accepted: 08/20/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND The objective of this study was to investigate risk factors for multidrug-resistant organism (MDRO) infection within patients from a tertiary care hospital in Northern India. This case-control study examined MDRO infection risk factors, including diet, health history, and medical device use. We administered a diet questionnaire to collect data on usual diet and collected data on other risk factors from chart review. All participants were inpatients identified through hospital microbiology reports. A total of 39 MDRO patient cases and 91 controls were included. METHODS Descriptive statistics, univariate analysis, and multivariate logistic regression were performed to evaluate the association between risk factors and MDRO infection. RESULTS All cases had gram-negative MDRO infections. Univariate analyses found length of hospital stay, connective tissue disease, hospitalization in the last 12 months, hospitalization of a family member, in-hospital antibiotic use, antibiotic use in the last 12 months, and feeding tube, central venous line, and urinary catheter use to be significantly different between cases and controls. Logistic regression showed a >3-fold increase in the odds of infection with antibiotic use in the last 12 months (odds ratio [OR], 3.30; 95% confidence interval [CI], 1.22-8.91) and urinary catheter use (OR, 3.63; 95% CI, 1.14-11.58). Differences in dietary preferences and fruit, vegetable, and fiber consumption were not significantly associated with infection. CONCLUSIONS Antibiotic use is a major driver of MDRO infections. Our findings suggest that interventions optimizing antibiotic stewardship and reducing device use should be a priority to prevent MDRO infections.
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Schönewolf-Greulich B, Bisgaard AM, Møller R, Dunø M, Brøndum-Nielsen K, Kaur S, Van Bergen N, Lunke S, Eggers S, Jespersgaard C, Christodoulou J, Tümer Z. Clinician’s guide to genes associated with Rett-like phenotypes-Investigation of a Danish cohort and review of the literature. Clin Genet 2018; 95:221-230. [DOI: 10.1111/cge.13153] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 10/04/2017] [Accepted: 10/05/2017] [Indexed: 12/16/2022]
Affiliation(s)
- B. Schönewolf-Greulich
- Center for Rett Syndrome, Kennedy Center, Department of Paediatrics; Copenhagen University Hospital, Rigshospitalet; Copenhagen Denmark
- Applied Human Molecular Genetics, Kennedy Center, Department of Clinical Genetics; Copenhagen University Hospital, Rigshospitalet; Copenhagen Denmark
| | - A-M. Bisgaard
- Center for Rett Syndrome, Kennedy Center, Department of Paediatrics; Copenhagen University Hospital, Rigshospitalet; Copenhagen Denmark
| | - R.S. Møller
- Danish Epilepsy Centre; Dianalund Denmark
- Institute for Regional Health Services; University of Southern Denmark; Odense Denmark
| | - M. Dunø
- Department of Clinical Genetics; Copenhagen University Hospital, Rigshospitalet; Copenhagen Denmark
| | - K. Brøndum-Nielsen
- Department of Clinical Genetics; Copenhagen University Hospital, Rigshospitalet; Copenhagen Denmark
| | - S. Kaur
- Neurodevelopmental Genomics Research Group; Murdoch Children's Research Institute; Melbourne Australia
- Department of Paediatrics; Melbourne Medical School, University of Melbourne; Melbourne Australia
| | - N.J. Van Bergen
- Neurodevelopmental Genomics Research Group; Murdoch Children's Research Institute; Melbourne Australia
- Department of Paediatrics; Melbourne Medical School, University of Melbourne; Melbourne Australia
| | - S. Lunke
- Translational Genomics Unit; Murdoch Children’s Research Institute; Melbourne Australia
| | - S. Eggers
- Translational Genomics Unit; Murdoch Children’s Research Institute; Melbourne Australia
| | - C. Jespersgaard
- Applied Human Molecular Genetics, Kennedy Center, Department of Clinical Genetics; Copenhagen University Hospital, Rigshospitalet; Copenhagen Denmark
| | - J. Christodoulou
- Neurodevelopmental Genomics Research Group; Murdoch Children's Research Institute; Melbourne Australia
- Department of Paediatrics; Melbourne Medical School, University of Melbourne; Melbourne Australia
| | - Z. Tümer
- Applied Human Molecular Genetics, Kennedy Center, Department of Clinical Genetics; Copenhagen University Hospital, Rigshospitalet; Copenhagen Denmark
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Eggers S, Safdar N, Malecki KMC. Heavy metal exposure and nasal Staphylococcus aureus colonization: analysis of the National Health and Nutrition Examination Survey (NHANES). Environ Health 2018; 17:2. [PMID: 29304819 PMCID: PMC5756436 DOI: 10.1186/s12940-017-0349-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 12/18/2017] [Indexed: 05/10/2023]
Abstract
BACKGROUND Heavy metals including lead and cadmium can disrupt the immune system and the human microbiota. and are increasingly of concern with respect to the propogation of antibiotic-resistence. Infection by methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of global morbidity and mortality. Heavy metal exposure may be associated with increased MRSA colonization and infection, and a decrease in methicillin-susceptible Staphylococcus aureus (MSSA) through co-selection mechanisms and natural selection of antibiotic resistance in the presence of heavy metals. This study examines the association between blood lead (Pb) and cadmium (Cd) level, and MRSA and MSSA nasal colonization. METHODS All data used for this analysis came from the 2001-2004 National Health and Nutrition Examination Survey (NHANES). The analytical sample consisted of 18,626 participants aged 1 year and older. Multivariate logistic regression, including adjustment for demographic and dietary factors, was used to analyze the association between blood Pb and Cd, and nasal colonization by MRSA and MSSA. RESULTS Prevalence of MRSA and MSSA carriage were 1.2%, and 29.3% respectively. MRSA was highest in women, individuals age 70 and older, who self-identified as black, had only a high school diploma, lived below 200% of the Federal Poverty Level, and had a history of smoking. While not significantly different from those colonized with MSSA, geometric mean blood Pb (1.74 μg/dL) and blood Cd (0.31 μg/L) were highest in those colonized with MRSA. Associations with MRSA colonization appeared to increase in a dose-dependent manner with increasing quartile of blood Pb level. Blood Cd level in the fourth quartile was also significantly associated with lower odds of MRSA colonization. Both metals were associated with lower odds of MSSA colonization. CONCLUSIONS Both MRSA and MSSA results suggest that general population levels of blood Pb but not Cd are associated with differences in nasal carriage of S. aureus. While further research is needed, reduction in heavy metal exposures such as lead, concurrently with maintaining a healthy microbiota may be two modifiable options to consider in the fight against antibiotic-resistance.
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Affiliation(s)
- Shoshannah Eggers
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin – Madison, Warf Office Bldg, 610 Walnut St #707, Madison, WI 53726 USA
| | - Nasia Safdar
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin – Madison, 750 Highland Ave, Madison, WI 53726 USA
- William S. Middleton Veterans Affairs Medical Center, 2500 Overlook Terrace, Madison, WI 53705 USA
| | - Kristen MC Malecki
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin – Madison, Warf Office Bldg, 610 Walnut St #707, Madison, WI 53726 USA
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Eggers S, De Wolfe T, Barker A, Duster M, Dill-McFarland K, Suen G, Safdar N. Changes to the Composition of the Gastrointestinal Microbiome after Probiotics for Clostridium difficile Infection in Adults. Open Forum Infect Dis 2017. [PMCID: PMC5631571 DOI: 10.1093/ofid/ofx163.964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background Clostridium difficile infections (CDI) in the US have markedly increased. Disturbances to the gastrointestinal (GI) microbiome due to antibiotic use predisposes patients to CDI. Probiotics are recommended to prevent GI microbiota changes during CDI antibiotic treatment, but efficacy is unknown. We conducted a randomized, double-blinded, placebo-controlled, examination of clinical and GI microbiota changes in subjects administered probiotics during a primary episode of CDI. Methods 33 subjects with a primary episode of CDI were randomized to once daily oral probiotic, consisting of four different bacterial strains, or placebo for 4-weeks (week 0–4) concurrent to antibiotic treatment. Subjects completed a daily stool diary, and stool samples were collected at enrollment (week 0), at the end of the probiotic or placebo adjunct regimen (week 4), and 4 weeks post-treatment (week 8). DNA was extracted for 16S rRNA sequencing with Illumina MiSeq. Microbial diversity, richness, and community structure were compared using analysis of variance and permutational analysis of variance. Similarity percentage analysis identified the operational taxonomic units driving the variation in β diversity. Results The duration of diarrhea (P = 0.039) and total days of diarrhea (P = 0.005) both decreased in the probiotic group compared with the placebo group. Analysis of community structure showed significant differences between treatment groups overall (P = 0.017) and in both groups over time (P = 0.007), but not between groups at each individual time point. Subjects in the probiotic group had a higher abundance of the family Lachnospiraceae at week 4 than subjects in the placebo group. By week 8 the abundance of Lachnospiraceae did not differ between subjects administered probiotic or placebo. Conclusion Lack of difference in overall community structure between groups at each time point is likely due to concurrent antibiotic therapy. The differential abundance of Lachnospiraceae likely contributes to the differences in the diarrheal outcomes observed between groups, as it has previously been associated with attenuated C. difficile pathology. Shortening the duration of diarrhea from an initial CDI may reduce the spread of C. difficile and improve clinical outcomes. Disclosures All authors: No reported disclosures.
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Affiliation(s)
- Shoshannah Eggers
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin – Madison, Madison, Wisconsin
| | - Travis De Wolfe
- Department of Food Science, University of Wisconsin – Madison, Madison, Wisconsin
| | - Anna Barker
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin – Madison, Madison, Wisconsin
| | - Megan Duster
- Division of Infectious Diseases, School of Medicine and Public Health, University of Wisconsin – Madison, Madison, Wisconsin
| | - Kimberly Dill-McFarland
- Department of Bacteriology, College of Agriculture and Life Sciences, University of Wisconsin – Madison, Madison, Wisconsin
| | - Garret Suen
- Department of Bacteriology, College of Agriculture and Life Sciences, University of Wisconsin – Madison, Madison, Wisconsin
| | - Nasia Safdar
- Division of Infectious Diseases, School of Medicine and Public Health, University of Wisconsin – Madison, Madison, Wisconsin
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Eggers S, Malecki K, Peppard P, Mares J, Shirley D, Shukla S, Poulsen K, Gangnon R, Suen G, Sethi A, Safdar N. High Dietary Fiber is Associated with Reduced Prevalence of Gut Colonization by Multi-Drug-resistant Organisms. Open Forum Infect Dis 2017. [DOI: 10.1093/ofid/ofx163.497] [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: 11/14/2022] Open
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Eggers S, Barker A, Valentine S, Hess T, Duster M, Safdar N. Impact of Probiotics for Reducing Infections in Veterans (IMPROVE): Study protocol for a double-blind, randomized controlled trial to reduce carriage of Staphylococcus aureus. Contemp Clin Trials 2016; 52:39-45. [PMID: 27836508 DOI: 10.1016/j.cct.2016.11.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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: 07/15/2016] [Revised: 11/02/2016] [Accepted: 11/07/2016] [Indexed: 12/27/2022]
Abstract
BACKGROUND Staphylococcus aureus (S. aureus) is an organism of great public health importance, causing 20,000 deaths annually. Decolonization of patients with S. aureus may prevent infections, yet current options are limited to antimicrobials that promote antibiotic resistance and can cause adverse side effects. Probiotics have potential to reduce colonization of pathogenic bacteria, representing a promising alternative for S. aureus decolonization, but thus far lack rigorous evaluation. METHODS Potential subjects were recruited from inpatient and outpatient settings within a VA medical center and screened for S. aureus gastrointestinal (GI) or extra-GI colonization using swabs at multiple body sites. Positive, eligible, consenting participants were stratified by colonization site and randomized in a 1:1 ratio to 4-weeks of daily placebo or Lactobacillus rhamnosus (L. rhamnosus) HN001 probiotic treatment. Blood and stool samples, and treatment adherence reports were collected from each subject throughout the study, along with a final set of swabs at study completion to detect S. aureus carriage. The outcomes of this study are GI or extra-GI carriage by S. aureus at the end of 4weeks of therapy, change in phagocytic activity of polymorphonuclear cells from pre-intervention to post-intervention, and symptomatic S. aureus infection at any site during the study period. CONCLUSION 114 participants have been recruited for this study. Analysis of outcomes is underway. This is the first clinical trial to examine the efficacy of L. rhamnosus HN001 for decolonization of S. aureus, and investigates the mechanism by which L. rhamnosus HN001 mediates its effect on S. aureus colonization. ClinicalTrials.govIdentifier NCT01321606.
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Affiliation(s)
- Shoshannah Eggers
- William S. Middleton Memorial Veterans Affairs Medical Center, Department of Medicine, Madison, WI, USA; University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA; Department of Population Health Sciences, University of Wisconsin - Madison School of Medicine and Public Health, Madison, WI, USA
| | - Anna Barker
- Department of Population Health Sciences, University of Wisconsin - Madison School of Medicine and Public Health, Madison, WI, USA
| | - Susan Valentine
- William S. Middleton Memorial Veterans Affairs Medical Center, Department of Medicine, Madison, WI, USA
| | - Timothy Hess
- William S. Middleton Memorial Veterans Affairs Medical Center, Department of Medicine, Madison, WI, USA; University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Megan Duster
- University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Nasia Safdar
- William S. Middleton Memorial Veterans Affairs Medical Center, Department of Medicine, Madison, WI, USA; Department of Population Health Sciences, University of Wisconsin - Madison School of Medicine and Public Health, Madison, WI, USA; University of Wisconsin Hospitals and Clinics, Madison, WI, USA.
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Eggers S, Remington PL, Ryan K, Nieto J, Peppard P, Malecki K. Obesity Prevalence and Health Consequences: Findings From the Survey of the Health of Wisconsin, 2008-2013. WMJ 2016; 115:238-244. [PMID: 29095585 PMCID: PMC6230699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
IMPORTANCE Although the trends in obesity in Wisconsin overall are well described, less is known about characteristics and health consequences of different degrees of obesity. The Survey of the Health of Wisconsin is a novel population-based health examination survey that provides reliable and valid objective measurements of body mass index. OBJECTIVE Data from the Survey of the Health of Wisconsin is used to characterize the prevalence and consequences of different levels of obesity and track trends over time. METHODS A total of 3,384 participants age 21-74 years and living in Wisconsin at the time of data collection were surveyed in 2008-2013. Participants completed computer-assisted interviews and physical exams. Predictors and comorbidities of different levels of obesity were measured as prevalence, odds ratios, and population-attributable prevalence. RESULTS Of Wisconsin adults, 1.2% (CI, 0.7-1.7) are underweight, 26.1% (CI, 23.8-28.4) are normal weight, 33.4% (CI, 31.0-35.7) are overweight, and 39.4% (CI, 35.0-43.7) are obese—with 20.1 % (CI, 18.4-21.9), 10.3% (CI, 9.0-11.7), and 8.9% (CI, 7.6-10.2) in Class I, Class II, and Class III obesity categories, respectively. Obesity rates are higher in people who are older, poor, less educated, minorities, or who live in a community with high economic hardship. There is a dose response relationship between level of obesity and prevalence of all 9 comorbidities that were examined. CONCLUSIONS AND RELEVANCE Measured rates of obesity in Wisconsin adults are higher than previously reported for the state, and obesity accounts for a significant proportion of chronic diseases.
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Emmerson M, Morales M, Oñate J, Batáry P, Berendse F, Liira J, Aavik T, Guerrero I, Bommarco R, Eggers S, Pärt T, Tscharntke T, Weisser W, Clement L, Bengtsson J. How Agricultural Intensification Affects Biodiversity and Ecosystem Services. ADV ECOL RES 2016. [DOI: 10.1016/bs.aecr.2016.08.005] [Citation(s) in RCA: 159] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Malecki K, Wisk LE, Walsh M, McWilliams C, Eggers S, Olson M. Oral health equity and unmet dental care needs in a population-based sample: findings from the Survey of the Health of Wisconsin. Am J Public Health 2015; 105 Suppl 3:S466-74. [PMID: 25905843 DOI: 10.2105/ajph.2014.302338] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We used objective oral health screening and survey data to explore individual-, psychosocial-, and community-level predictors of oral health status in a statewide population of adults. METHODS We examined oral health status in a sample of 1453 adult Wisconsin residents who participated in the Survey of the Health of Wisconsin Oral Health Screening project, conducted with the Wisconsin Department of Health Services during 2010. RESULTS We found significant disparities in oral health status across all individual-, psychosocial-, and community-level predictors. More than 15% of participants had untreated cavities, and 20% did not receive needed oral health care. Individuals who self-reported unmet need for dental care were 4 times as likely to have untreated cavities as were those who did not report such a need, after controlling for sociodemographic and behavioral factors. CONCLUSIONS Our results suggested that costs were a primary predictor of access to care and poor oral health status. The results underscored the role that primary care, in conjunction with dental health care providers, could play in promoting oral health care, particularly in reducing barriers (e.g., the costs associated with unmet dental care) and promoting preventive health behaviors (e.g., teeth brushing).
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Affiliation(s)
- Kristen Malecki
- Kristen Malecki, Lauren E. Wisk, Matthew Walsh, Christine McWilliams, and Shoshannah Eggers are with the Department of Population Health Sciences, University of Wisconsin, Madison. Melissa Olson is with the Wisconsin Department of Health Services Oral Health Program, Madison
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Klotz S, Eggers S, Sievers H. Measurement of Quality of Life with LVAD Destination Therapy. Thorac Cardiovasc Surg 2015. [DOI: 10.1055/s-0035-1544433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Lattka E, Eggers S, Moeller G, Heim K, Weber M, Mehta D, Prokisch H, Illig T, Adamski J. A common FADS2 promoter polymorphism increases promoter activity and facilitates binding of transcription factor ELK1. J Lipid Res 2010; 51:182-91. [PMID: 19546342 DOI: 10.1194/jlr.m900289-jlr200] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Fatty acid desaturases (FADS) play an important role in the formation of omega-6 and omega-3 highly unsaturated fatty acids (HUFAs). The composition of HUFAs in the human metabolome is important for membrane fluidity and for the modulation of essential physiological functions such as inflammation processes and brain development. Several recent studies reported significant associations of single nucleotide polymorphisms (SNPs) in the human FADS gene cluster with HUFA levels and composition. The presence of the minor allele correlated with a decrease of desaturase reaction products and an accumulation of substrates. We performed functional studies with two of the associated polymorphisms (rs3834458 and rs968567) and showed an influence of polymorphism rs968567 on FADS2 promoter activity by luciferase reporter gene assays. Electrophoretic mobility shift assays proved allele-dependent DNA-binding ability of at least two protein complexes to the region containing SNP rs968567. One of the proteins binding to this region in an allele-specific manner was shown to be the transcription factor ELK1 (a member of ETS domain transcription factor family). These results indicate that rs968567 influences FADS2 transcription and offer first insights into the modulation of complex regulation mechanisms of FADS2 gene transcription by SNPs.
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Affiliation(s)
- E Lattka
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg Germany
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Eggers S, Petronilho CC, Brandt K, Jericó-Daminello C, Filippini J, Reinhard KJ. How does a riverine setting affect the lifestyle of shellmound builders in Brazil? Homo 2008; 59:405-27. [PMID: 19027113 DOI: 10.1016/j.jchb.2008.04.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2007] [Accepted: 04/27/2008] [Indexed: 10/21/2022]
Abstract
The contact of inland and coastal prehistoric groups in Brazil is believed to have been restricted to regions with no geographical barrier, as is the case in the Ribeira de Iguape valley. The inland osteological collection from the riverine shellmound Moraes (5800-4500 BP) represents a unique opportunity to test this assumption for this region. Despite cultural similarities between riverine and coastal shellmounds, important ecological and site distribution differences are expected to impact on lifestyle. The purpose of this study is thus to document and interpret health and lifestyle indicators in Moraes in comparison to coastal shellmound groups. Specifically we test if the rare evidence of fish and mollusc remains in the riverine shellmound led to (a) higher caries rates and (b) lower auditory exostosis frequency and (c) if the small size of the riverine shellmound translates into reduced demographic density and thus rarity of communicable infectious diseases. Of the three hypotheses, (a) was confirmed, (b) was rejected and (c) was partly rejected. Bioanthropological similarities between Moraes and coastal shellmounds include auditory exostoses with equally high frequencies; significantly more frequent osteoarthritis in upper than in lower limbs; cranial and dental morphological affinities and low frequencies of violent trauma. However, there are also important differences: Moraes subsisted on a much broader protein diet and consumed more cariogenic food, but showed a stature even shorter than coastal groups. Thus, despite the contact also suggested by treponematoses in both site types, there was enough time for the people at the riverine site to adapt to local conditions.
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Affiliation(s)
- S Eggers
- Laboratório de Antropologia Biológica, Departamento de Genética e Biologia Evolutiva, Instituto de Biociências, Universidade de São Paulo, 05508-900 São Paulo, Brazil.
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Abstract
Sambaquis are huge shellmounds built along almost the entire Brazilian coast between 8000 and 600 years ago. In the present article, 14 osteological markers from 89 individuals excavated at the Sambaqui Jabuticabeira II (2890+/-55/2186+/-60 BP) are analyzed in order to reconstruct the population's health status and way of life. The present palaeopathological findings (such as lower frequency of degenerative joint diseases in legs, as compared to arms, and the rarity of traumas) together with archaeological findings support the idea of nearby resource abundance and infrequent interpersonal competition. The presence of auditory exostoses mainly in males corroborates previous findings indicating the importance of marine resources. The low caries frequency and the high degrees of dental wear point to a diet poor in cariogenic food, and rich in abrasives such as sand, shell fragments and phytoliths. This suggests a broader diet, based on marine protein as well as plants, than previously thought. The etiology of cribra orbitalia could be explained by gastrointestinal parasites or other sources of physiological stress. These parasites, in turn, could have led to higher frequencies of infectious diseases, either by the debilitation of the immune system or by the direct contact with infectious agents. Despite the periods of illness various individuals experienced, the daily life among the builders of the Sambaqui Jabuticabeira II seems to have been relatively easy due to the abundance and predictability of resources and the paucity of violent traumas.
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Affiliation(s)
- M M M Okumura
- Laboratório de Estudos Evolutivos Humanos, Universidade de São Paulo, Brazil.
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33
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Pods R, Schmidt C, Quetz J, Eggers S, Maune S. Entwicklung eines Konzeptes zur Erfassung der Lebensqualität bei Patienten mit Septorhinoplastik. Laryngorhinootologie 2004. [DOI: 10.1055/s-2004-823593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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34
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Hashimoto DM, Schmid J, Martins FM, Fonseca AM, Andrade LHB, Kirchengast S, Eggers S. The impact of the weight status on subjective symptomatology of the Polycystic Ovary Syndrome: A cross-cultural comparison between Brazilian and Austrian women. anthranz 2003. [DOI: 10.1127/anthranz/61/2003/297] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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35
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Hashimoto DM, Schmid J, Martins FM, Fonseca AM, Andrade LH, Kirchengast S, Eggers S. The impact of the weight status on subjective symptomatology of the Polycystic Ovary Syndrome: a cross-cultural comparison between Brazilian and Austrian women. Anthropol Anz 2003; 61:297-310. [PMID: 14524003] [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: 04/27/2023]
Abstract
Group differences in symptomatology and symptom perception of young women ageing between 18 and 32 years suffering from polycystic ovarian syndrome (PCOS) were tested according to cultural background and weight status. In detail 31 Austrian women, living in Carinthia, Austria, and 102 Brazilian women, living in São Paulo, Brazil, were enrolled in the present study. All participants suffered from diagnosed PCOS. The prevalence of hirsutism, infertility, menstrual disturbances and overweight/obesity and their individual impact on health related quality of life were analysed. Furthermore the impact of weight status (BMI) on symptom perception was tested. It turned out, that the Brazilian sample exhibited higher prevalence of PCOS symptoms and these symptoms had a more negative impact on quality of life. The only exception was body weight. Although significantly leaner, the Austrian women showed a higher Cronin score of body weight than their Brazilian counterparts. The results of the present study may indicate that in western industrialized societies the fear of overweight is much more prevalent than in a developing country such as Brazil and thus it has more influence on the quality of life than all the other symptoms.
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Affiliation(s)
- D M Hashimoto
- Laboratório de Antropologia Biológica, Depto. Biologia, Centro de Estudos do Genoma Humano, Universidade de São Paulo, São Paulo, Brazil
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36
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Lippert BM, Eggers S, Schlüter E, Rudert H, Werner JA. Lipoma of the larynx. Report of 2 cases and review of the literature. Otolaryngol Pol 2003; 56:669-74. [PMID: 12577479] [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: 02/28/2023]
Abstract
Among the primary mesenchymal tumors of the hypopharynx and larynx lipomas are very rare, as they often look macroscopically like retention cysts. Up today approximately 112 cases have been described in literature. We present two further cases of laryngeal lipomas, which were removed endoscopically and by an external approach. Both patients were free of local recurrence.
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Affiliation(s)
- B M Lippert
- Department of Otolaryngology, Head and Neck Surgery, Phillips-University of Marburg
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37
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Eggers S, Kirchengast S. The polycystic ovary syndrome--a medical condition but also an important psychosocial problem. Coll Antropol 2001; 25:673-85. [PMID: 11811299] [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: 02/23/2023]
Abstract
PCOS, the leading cause of anovulatory infertility that affects up to one fifth of the female population, is a complex chronic disease of genetic as well as environmental determination, but still unclear etiology. Besides of infertility, PCOS leads to menstrual dysfunctions, hirsutism and obesity--symptoms that are known to cause profound psychosocial distress. The present paper review the problematic of etiology and symptom expression of PCOS, which is not only a disease needing medical treatment but also a psychosocial problem for the affected women. PCOS may not only coinduced by psychosocial factors, the main symptoms of PCOS such as infertility, menstrual dysfunctions, hirsutism and obesity cause by themselves increased psychosocial stress.
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Affiliation(s)
- S Eggers
- Laboratory of Biological Antropology, Centre of Human Genome Studies, Institute of Bioscience, University of Sao Paulo, Brasil
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38
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Mertens J, Eggers S, Maune S. [Long-term outcome of frontal sinus surgery: comparison of extranasal and endonasal surgical techniques]. Laryngorhinootologie 2000; 79:396-9. [PMID: 11005091 DOI: 10.1055/s-2000-4640] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [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: 10/17/2022]
Abstract
BACKGROUND During the last decades rhinosurgery largely developed up to endonasal accesses. Meanwhile many of the new techniques are established, so that the outcome of traditional extranasal methods should be compared with those of endonasal accesses, in order to estimate the status and for critical consideration. METHODS A retrospective analysis recorded the results of 236 patients, operated on primary frontal sinus disease 1985-1993. The records were consulted concerning inpatient treatment and outpatient aftercare during standardized paranasal sinus consulting hours. RESULTS During the follow-up period (3-10 years) 8% of the patients underwent resurgery. The lowest revision rate was found after using endonasal technique (5.9%), compared with osteoclastic methods (Ritter-Jansen, Riedel: 10.6%). The domain of osteoplastic operations with a revision rate of 9.4% were fractures, osteomas and mucoceles, because of an impossible endonasal access. In decision on osteoclastic procedures, the already osteoclastically operated site was of prime importance, especially since 1990. CONCLUSION Already during the early years endonasal techniques of paranasal sinus surgery showed better outcome than osteoclastic accesses. The analysis indicates that the change to endonasal functional paranasal sinus surgery is justified and should be kept up. The traditional methods still have their rare authorization in case of special indications, especially if an osteoclastic procedure has been carried out already.
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Affiliation(s)
- J Mertens
- Klinik für HNO-Krankheiten und plastische Gesichtschirurgie, St. Vincentius-Krankenhäuser Karlsruhe
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Abstract
The aim of the present study was to assess the impact of genetic counseling in young women at risk to have Duchenne muscular dystrophy (DMD) children prior to childbearing. A total of 263 potential DMD carriers, who had had genetic counseling and were given different genetic risks, were included in this investigation. Their reproductive outcome and future plans as well as their requests for DNA tests (for carrier detection and prenatal diagnosis) were analyzed according to genetic risk magnitude, comprehension of genetic counseling is- sues, family and personal history, socio-educational level, and subjective opinion about selective abortion. We noted that genetic risk magnitude had no significant influence on reproductive plans or outcome nor on the request for additional DNA testing, even considering only those clients with good comprehension and retention of issues discussed during genetic counseling. On the other hand, counselees who had more than one affected or at least one deceased DMD case in their family understood genetic counseling significantly better, suggesting that "learning with life" has a stronger impact than genetic counseling.
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Affiliation(s)
- S Eggers
- Departamento de Biologia, Centro de Estudos do Genoma Humano, Universidade de São Paulo, São Paulo, Brazil.
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Maune S, Rudert H, Heissenberg MC, Schmidt C, Eggers S, Landmann K, Küchler T. [Concepts for measuring quality of life in patients with chronic sinusitis]. Laryngorhinootologie 1999; 78:475-80. [PMID: 10535063 DOI: 10.1055/s-2007-996912] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [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: 10/21/2022]
Abstract
BACKGROUND In 1997, Benninger developed the Rhinosinusitis Disability Index (RSBI) for patients who suffered from chronic sinusitis. Its content related validity and construct related validity were established, as were its sensitivity and reliability. The aim of our study is to introduce a concept to measure quality of life in these patients according to circumstances prevalent in Germany. METHODS The questionnaire (Rhinusitis-Beeinträchtigungs-Index, RSBI) contains 30 questions that describe the 5 aspects of quality of life. Moreover we used a standardized data sheet to acquire further information about history and diagnostic results. Using this method it is possible to specificity more precisely the patients current complaints and condition. Evaluation is possible according to complex of questions as well as simple items. The influence of treatment on quality of life can be measured as the sum of the specific scores and is expressed comprehensively in the total score. The concept of the study includes a prospective inquiry as well as before and after surgical intervention. CONCLUSION A disadvantage of the American RSDI is that the clinical symptoms are not described in a detailed catalogue which allows the correlation of the clinical factors. Therefore we added a detailed questionnaire concerning the clinical symptoms and the individual treatment of the patient (RSBI). That permits comprehensive analysis of quality of life as it relates to different aspects of disease and different strategies in treatment.
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Affiliation(s)
- S Maune
- Klinik für Hals-, Nasen-, Ohrenheilkunde, Kopf- und Halschirurgie, Christian-Albrechts-Universität zu Kiel
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Abstract
BACKGROUND Systemic absorption of iodinated contrast material occurs during endoscopic retrograde cholangiopancreatography (ERCP), the clinical significance of which has not yet been determined. METHODS Urinary iodine excretion was measured before and after coronary angiography (n = 20) and ERCP (n = 12). Thyroid hormone levels were determined before iodine load and after 6 and 24 weeks. RESULTS Before coronary angiography, iodine excretion was 101 +/- 38.3 micromol/mol creatinine and increased to 865. 10(5) +/- 721. 10(5) micromol/mol on the next day (p </= 0.001). After 6 weeks, it was still elevated (167 +/- 88.8 micromol/mol, p < 0.01). Before ERCP, iodine excretion was 115 +/- 60.3 micromol/mol and reached a peak of 5.3. 10(5) +/- 4.9. 10(5) micromol/mol (p < 0.001). Six weeks later, it had returned to baseline. Two patients in the coronary angiography group but none in the ERCP group had suppressed thyrotropin after 6 weeks. CONCLUSIONS The systemic iodine load during ERCP is approximately 0.6% of the iodine load during coronary angiography. Therefore routine measurement of thyroid hormones before ERCP is not recommended.
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Affiliation(s)
- H Mönig
- Medical Clinic I, University of Kiel, Germany
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42
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Eggers S, Zatz M. How the magnitude of clinical severity and recurrence risk affects reproductive decisions in adult males with different forms of progressive muscular dystrophy. J Med Genet 1998; 35:189-95. [PMID: 9541101 PMCID: PMC1051240 DOI: 10.1136/jmg.35.3.189] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [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: 02/07/2023]
Abstract
The reproductive history of 177 male patients affected with Becker (BMD) (n=69), limb-girdle (LGMD) (n=54), and facioscapulohumeral (FSHMD) (n=54) muscular dystrophy (MD) was analysed according to severity of the disease (BMD>LGMD>FSHMD) and magnitude of recurrence risk (RR) (high for FSHMD, intermediate for BMD, and low for LGMD). Additionally, 62 male patients were interviewed on psychosocial issues, in order to disentangle the factors influencing reproductive decisions among patients affected with MD. Among male adults, significantly more FSHMD than LGMD or BMD patients were married and had children. Age specific reproductive outcome was 0.31-0.32 for BMD, 0.51-0.62 for LGMD, and 0.58-1.02 for FSHMD, reflecting the influence of the disease's severity. High RRs did not significantly diminish reproduction after genetic counselling or correlate with less prospective desire for children. Instead, early onset, severity of the disease, and past reproductive history were found to diminish reproductive outcome after genetic counselling, and prospective family planning was also found to be influenced by past reproductive history as well as by emotional/sexual dysfunction with the opposite sex.
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Affiliation(s)
- S Eggers
- Centro de Miopatias, Departamento de Biologia, Instituto de Biologia, USP, São Paulo, Brazil
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43
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Abstract
Adult male patients affected with Becker (BMD, N = 22), limb girdle (LGMD, N = 22) and facioscapulohumeral (FSHMD, N = 18) muscular dystrophy were interviewed to assess for the first time how the disease's severity and recurrence risk (RR) magnitude alter their social adjustment. BMD (X-linked recessive) is the severest form and confers an intermediate RR because all daughters will be carriers, LGMD (autosomal-recessive) is moderately severe with a low RR in the absence of consanguineous marriage, and FSHMD (autosomal-dominant) is clinically the mildest of these three forms of MD but with the highest RR, of 50%. Results of the semistructured questionnaire [WHO (1988): Psychiatric Disability Assessment Schedule] showed no significant difference between the three clinical groups, but more severely handicapped patients as well as patients belonging to lower socioeconomic levels from all clinical groups showed poorer social adjustment. Taken together, myopathic patients displayed intermediate social dysfunction compared to controls and schizophrenics studied by Jablensky [1988: WHO Psychiatric Disability Assessment Schedule]. Since the items of major dysfunction proportion among myopathic patients concern intimate relationships (70%), interest in working among those unemployed (67%), and social isolation (53%), emotional support and social and legal assistance should concentrate on these aspects. Interestingly, the results of this study also suggest that high RRs do not affect relationships to the opposite sex.
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Affiliation(s)
- S Eggers
- Centro de Miopatias, Departamento de Biologia, Universidade de São Paulo, Brazil.
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Weber EH, Gottschlich S, Lippert BM, Görögh T, Folz BJ, Eggers S, Werner JA. [Re-amplification of differentially expressed mRNA fragments of head-neck cancers without cloning]. Laryngorhinootologie 1998; 77:43-7. [PMID: 9522312 DOI: 10.1055/s-2007-996929] [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: 02/06/2023]
Abstract
BACKGROUND mRNA expression of healthy and malignant cells can be compared to each other by employing the "differential display" (DD) technique. Most studies describe sequence analysis of differentially expressed fragments after reamplification by a second round of PCR and subsequent molecular cloning to gain a sufficient amount of DNA for sequencing. The aim of this study was to show whether a sufficient amount of differentially expressed mRNA of squamous cell carcinoma cells of the head and neck region can be generated by PCR alone without cloning steps. MATERIAL AND METHODS mRNA isolated from cultivated keratinocytes and squamous cell carcinoma cells was reverse transcribed into cDNA which was amplified with PCR. Differentially expressed fragments detected after gel electrophoresis were isolated from the gel and reamplified in a second PCR. The resulting cDNA amounts of the second PCR were suitable for cloning but not for direct sequencing. A third round of PCR with the undiluted final product of the second PCR as template regularly failed. Dilutions of the second PCR products between 1:10 and 1:10(10) were prepared. The third round of PCR was carried out with these various template concentrations. RESULTS A sufficient amount of differentially expressed fragments for sequencing procedures resulted when dilutions of the second PCR products ranging from 1:10(2) to 1:10(7) were used as templates in the third round of PCR. CONCLUSION Modifications of PCR parameters provide high DNA copy numbers of differentially expressed mRNA fragments from squamous cell carcinoma cells of the upper aerodigestive tract in amounts that are needed for sequence analysis. This may make it possible to avoid labor-intensive cloning procedures requiring high safety standards.
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Affiliation(s)
- E H Weber
- Klinik für Hals-, Nasen-, und Ohrenheilkunde, Kopf-und Halschirurgie, Christian-Albrechts-Universität Kiel
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Schultze J, Eggers S, Kimmig B. Results of radiation therapy and combined radio-ehemotherapy in the treatment of the CB-CC non-Hodgkin's lymphoma. Eur J Cancer 1997. [DOI: 10.1016/s0959-8049(97)86117-5] [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: 11/16/2022]
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Eggers S, Hilbert C, Lippert BM, Werner JA. [The interesting case no. 4. Right-sided elongated styloid process]. Laryngorhinootologie 1997; 76:450-2. [PMID: 9333298 DOI: 10.1055/s-2007-997459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- S Eggers
- Klinik für Hals-, Nasen- und Ohrenheilkunde, Kopf- und Hals-chirurgie des Klinikums, Christian-Albrechts-Universität zu Kiel
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Bershad BN, Savage S, Pardyak P, Sirer EG, Fiuczynski ME, Becker D, Chambers C, Eggers S. Extensibility safety and performance in the SPIN operating system. ACTA ACUST UNITED AC 1995. [DOI: 10.1145/224057.224077] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- B. N. Bershad
- Department of Computer Science and Engineering, University of Washington, Seattle, WA
| | - S. Savage
- Department of Computer Science and Engineering, University of Washington, Seattle, WA
| | - P. Pardyak
- Department of Computer Science and Engineering, University of Washington, Seattle, WA
| | - E. G. Sirer
- Department of Computer Science and Engineering, University of Washington, Seattle, WA
| | - M. E. Fiuczynski
- Department of Computer Science and Engineering, University of Washington, Seattle, WA
| | - D. Becker
- Department of Computer Science and Engineering, University of Washington, Seattle, WA
| | - C. Chambers
- Department of Computer Science and Engineering, University of Washington, Seattle, WA
| | - S. Eggers
- Department of Computer Science and Engineering, University of Washington, Seattle, WA
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Eggers S, Lauriano V, Melo M, Takata RI, Akiyama J, Passos-Bueno MR, Gentil V, Frota-Pessoa O, Zatz M. Why is the reproductive performance lower in Becker (BMD) as compared to limb girdle (LGMD) muscular dystrophy male patients? Am J Med Genet 1995; 60:27-32. [PMID: 7485231 DOI: 10.1002/ajmg.1320600106] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
We had previously reported that patients affected with BMD have a significantly reduced reproductive performance (f = 0.12) as compared to male LGMD patients of similar age and physical impairment (f = 0.98). In the present study parameters such as the socio-economic level, as well as psychosocial, intellectual, and psychiatric functionings could not explain the low fitness of BMD patients. The effect of genetic counseling, a greater difficulty in coping with the disease, and relating to women and/or a potential malfunction of reproductive physiology are discussed as possible causes.
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Affiliation(s)
- S Eggers
- Departamento de Biologia, Universidade de São Paulo, Brazil
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Melo M, Lauriano V, Gentil V, Eggers S, Del Bianco SS, Gimenez PR, Akiyama J, Okabaiashi H, Frota-Pessoa O, Passos-Bueno MR. Becker and limb-girdle muscular dystrophies: a psychiatric and intellectual level comparative study. Am J Med Genet 1995; 60:33-8. [PMID: 7485232 DOI: 10.1002/ajmg.1320600107] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
There are some indications that Becker muscular dystrophy (BMD) might be related to mental disorders and mental retardation (MR). To investigate this question, we made a standardized psychiatric and intellectual level assessment of 22 BMD patients in comparison with 22 limb-girdle muscular dystrophy (LGMD) patients. There were not significant differences between the two groups. Twelve patients (54.5%) in each group received at least one lifetime psychiatric diagnosis, the most frequent being depressive disorders. The intelligence quotient means for BMD was 85.9 and 87.8 for LGMD. There was one case of mild MR among BMD patients and two cases among LGMD patients.
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Affiliation(s)
- M Melo
- Departamento de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo, Brazil
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50
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Eggers S, Passos-Bueno MR, Zatz M. Facioscapulohumeral muscular dystrophy: aspects of genetic counselling, acceptance of preclinical diagnosis, and fitness. J Med Genet 1993; 30:589-92. [PMID: 8411033 PMCID: PMC1016460 DOI: 10.1136/jmg.30.7.589] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
A questionnaire about the interest in and demand for preclinical diagnosis for facioscapulohumeral muscular dystrophy (FSH) was sent to 46 patients. Most stated that they would have liked to have known their diagnosis earlier in order to seek more efficient help, to avoid strenuous activities, to prepare themselves emotionally, or to choose an appropriate profession. Similar arguments were used to explain their interest in preclinical diagnosis for their children. Most patients also favoured prenatal diagnosis although only two stated they would abort a pregnancy in the case of an affected fetus. Genetic counselling had apparently little influence on family planning. According to this study, FSH does not seem to reduce reproductive performance in our population.
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Affiliation(s)
- S Eggers
- Departamento de Biologia, Universidade de São Paulo, Brazil
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