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Skorupskaite K, Hardy M, Bhandari H, Yasmin E, Saab W, Seshadri S. Evidence based management of patients with endometriosis undergoing assisted conception: British fertility society policy and practice recommendations. HUM FERTIL 2024; 27:2288634. [PMID: 38226584 DOI: 10.1080/14647273.2023.2288634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 09/27/2023] [Indexed: 01/17/2024]
Abstract
Endometriosis is a chronic inflammatory condition in women of reproductive age, which can lead to infertility and pelvic pain. Endometriosis associated infertility is multifactorial in nature adversely affecting each step of the natural reproductive physiology and thereby processes and outcomes of Assisted Reproductive Technology (ART) cycles. These outcomes are further complicated by the subtype of endometriosis, being peritoneal, deep infiltrating and ovarian, which bear negative effects on ovarian reserve, response to stimulation, accessibility for oocyte retrieval, intraoperative safety and endometrial receptivity. There is still a lack of clear guidance about the role of surgery for ovarian endometriosis/endometriomas. This guideline evaluates the evidence of the impact of pelvic endometriosis and endometriomas on the outcome of ART and provides recommendations for management options before and during ART including intra-uterine insemination. Recommendations are made based on the current evidence for the management of patients with endometriosis across each step of ART with the primary aim of improving ART outcomes.
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Affiliation(s)
- Karolina Skorupskaite
- Edinburgh Fertility & Reproductive Endocrine Centre, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Madeleine Hardy
- Leeds Centre for Reproductive Medicine at Leeds Teaching Hospitals NHS Trust, Seacroft Hospital, Leeds, UK
| | - Harish Bhandari
- Leeds Centre for Reproductive Medicine at Leeds Teaching Hospitals NHS Trust, Seacroft Hospital, Leeds, UK
| | - Ephia Yasmin
- Reproductive Medicine Unit, University College London Hospital NHS Foundation Trust, London, UK
| | - Wael Saab
- The Centre for Reproductive & Genetic Health, London, UK
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Nguyen-Hoang L, Papastefanou I, Sahota DS, Pooh RK, Zheng M, Chaiyasit N, Tokunaka M, Shaw SW, Seshadri S, Choolani M, Yapan P, Sim WS, Poon LC. Evaluation of screening performance of first-trimester competing-risks prediction model for small-for-gestational age in Asian population. Ultrasound Obstet Gynecol 2024; 63:331-341. [PMID: 37552550 DOI: 10.1002/uog.27447] [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: 03/26/2023] [Revised: 06/17/2023] [Accepted: 07/21/2023] [Indexed: 08/10/2023]
Abstract
OBJECTIVE To examine the external validity of the Fetal Medicine Foundation (FMF) competing-risks model for the prediction of small-for-gestational age (SGA) at 11-14 weeks' gestation in an Asian population. METHODS This was a secondary analysis of a multicenter prospective cohort study in 10 120 women with a singleton pregnancy undergoing routine assessment at 11-14 weeks' gestation. We applied the FMF competing-risks model for the first-trimester prediction of SGA, combining maternal characteristics and medical history with measurements of mean arterial pressure (MAP), uterine artery pulsatility index (UtA-PI) and serum placental growth factor (PlGF) concentration. We calculated risks for different cut-offs of birth-weight percentile (< 10th , < 5th or < 3rd percentile) and gestational age at delivery (< 37 weeks (preterm SGA) or SGA at any gestational age). Predictive performance was examined in terms of discrimination and calibration. RESULTS The predictive performance of the competing-risks model for SGA was similar to that reported in the original FMF study. Specifically, the combination of maternal factors with MAP, UtA-PI and PlGF yielded the best performance for the prediction of preterm SGA with birth weight < 10th percentile (SGA < 10th ) and preterm SGA with birth weight < 5th percentile (SGA < 5th ), with areas under the receiver-operating-characteristics curve (AUCs) of 0.765 (95% CI, 0.720-0.809) and 0.789 (95% CI, 0.736-0.841), respectively. Combining maternal factors with MAP and PlGF yielded the best model for predicting preterm SGA with birth weight < 3rd percentile (SGA < 3rd ) (AUC, 0.797 (95% CI, 0.744-0.850)). After excluding cases with pre-eclampsia, the combination of maternal factors with MAP, UtA-PI and PlGF yielded the best performance for the prediction of preterm SGA < 10th and preterm SGA < 5th , with AUCs of 0.743 (95% CI, 0.691-0.795) and 0.762 (95% CI, 0.700-0.824), respectively. However, the best model for predicting preterm SGA < 3rd without pre-eclampsia was the combination of maternal factors and PlGF (AUC, 0.786 (95% CI, 0.723-0.849)). The FMF competing-risks model including maternal factors, MAP, UtA-PI and PlGF achieved detection rates of 42.2%, 47.3% and 48.1%, at a fixed false-positive rate of 10%, for the prediction of preterm SGA < 10th , preterm SGA < 5th and preterm SGA < 3rd , respectively. The calibration of the model was satisfactory. CONCLUSION The screening performance of the FMF first-trimester competing-risks model for SGA in a large, independent cohort of Asian women is comparable with that reported in the original FMF study in a mixed European population. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- L Nguyen-Hoang
- Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
| | - I Papastefanou
- Fetal Medicine Research Institute, King's College Hospital, London, UK
- Department of Women and Children's Health, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - D S Sahota
- Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
| | - R K Pooh
- CRIFM Prenatal Medical Clinic, Osaka, Japan
| | - M Zheng
- Center for Obstetrics and Gynecology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - N Chaiyasit
- Department of Obstetrics and Gynecology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - M Tokunaka
- Department of Obstetrics and Gynecology, Showa University Hospital, Tokyo, Japan
| | - S W Shaw
- Department of Obstetrics and Gynecology, Taipei Chang Gung Memorial Hospital, Taipei, Taiwan
| | | | - M Choolani
- Department of Obstetrics and Gynecology, National University Hospital, Singapore
| | - P Yapan
- Faculty of Medicine, Siriraj Hospital, Bangkok, Thailand
| | - W S Sim
- Maternal-Fetal Medicine, KK Women's and Children's Hospital, Singapore
| | - L C Poon
- Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
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Viñals Gonzalez X, Thrasivoulou C, Naja RP, Seshadri S, Serhal P, Gupta SS. Integrating imaging-based classification and transcriptomics for quality assessment of human oocytes according to their reproductive efficiency. J Assist Reprod Genet 2023; 40:2545-2556. [PMID: 37610606 PMCID: PMC10643756 DOI: 10.1007/s10815-023-02911-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 08/09/2023] [Indexed: 08/24/2023] Open
Abstract
PURPOSE Utilising non-invasive imaging parameters to assess human oocyte fertilisation, development and implantation; and their influence on transcriptomic profiles. METHODS A ranking tool was designed using imaging data from 957 metaphase II stage oocytes retrieved from 102 patients undergoing ART. Hoffman modulation contrast microscopy was conducted with an Olympus IX53 microscope. Images were acquired prior to ICSI and processed using ImageJ for optical density and grey-level co-occurrence matrices texture analysis. Single-cell RNA sequencing of twenty-three mature oocytes classified according to their competence was performed. RESULT(S) Overall fertilisation, blastulation and implantation rates were 73.0%, 62.6% and 50.8%, respectively. Three different algorithms were produced using binary logistic regression methods based on "optimal" quartiles, resulting in an accuracy of prediction of 76.6%, 67% and 80.7% for fertilisation, blastulation and implantation. Optical density, gradient, inverse difference moment (homogeneity) and entropy (structural complexity) were the parameters with highest predictive properties. The ranking tool showed high sensitivity (68.9-90.8%) but with limited specificity (26.5-62.5%) for outcome prediction. Furthermore, five differentially expressed genes were identified when comparing "good" versus "poor" competent oocytes. CONCLUSION(S) Imaging properties can be used as a tool to assess differences in the ooplasm and predict laboratory and clinical outcomes. Transcriptomic analysis suggested that oocytes with lower competence may have compromised cell cycle either by non-reparable DNA damage or insufficient ooplasmic maturation. Further development of algorithms based on image parameters is encouraged, with an increased balanced cohort and validated prospectively in multicentric studies.
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Affiliation(s)
- Xavier Viñals Gonzalez
- Preimplantation Genetics Group, Institute for Women's Health, University College London, 84-86 Chenies Mews, Bloomsbury, London, WC1E 6HU, UK.
| | - Christopher Thrasivoulou
- Research Department of Cell and Developmental Biology, University College London, Rockefeller Building, London, WC1E 6DE, UK
| | - Roy Pascal Naja
- Preimplantation Genetics Group, Institute for Women's Health, University College London, 84-86 Chenies Mews, Bloomsbury, London, WC1E 6HU, UK
| | - Srividya Seshadri
- The Centre for Reproductive and Genetic Health, 230-232 Great Portland St, Fitzrovia, W1W 5QS, London, UK
| | - Paul Serhal
- The Centre for Reproductive and Genetic Health, 230-232 Great Portland St, Fitzrovia, W1W 5QS, London, UK
| | - Sioban Sen Gupta
- Preimplantation Genetics Group, Institute for Women's Health, University College London, 84-86 Chenies Mews, Bloomsbury, London, WC1E 6HU, UK
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Jojo N, Nattala P, Seshadri S, Krishnakumar P, Thomas S. Knowledge of sexual abuse and resistance ability among children with intellectual disability. Child Abuse Negl 2023; 136:105985. [PMID: 36603444 DOI: 10.1016/j.chiabu.2022.105985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 11/18/2022] [Accepted: 11/27/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Sexual abuse is a global concern among children with intellectual disabilities. Sexual abuse is frequent and long-lasting when the victim is a child with an intellectual disability. Moreover, the rate of sexual abuse is two to eight times the rate in the general population. OBJECTIVE This study aimed to investigate the knowledge of sexual abuse and resistance ability among children with intellectual disabilities. PARTICIPANTS AND SETTING The study was conducted among 120 children with mild or moderate intellectual disabilities attending twelve schools for specific purposes. METHODS We adopted a cross-sectional design to assess knowledge and resistance ability. Personal Safety Questionnaire and Modified What If Situation Test were administered verbally during individual interviews. Institutional Ethics Committee approved our study. RESULTS Current study suggests that children with intellectual disabilities have average knowledge (M = 6.6, SD = 1.6) regarding sexual abuse. More than 90 % of children demonstrated poor reporting skills. Although children exhibited good knowledge in differentiating appropriate from inappropriate touch requests, most children reported they would not disclose this incident to anyone. CONCLUSIONS This study strongly suggests the need for a structured training program for children with intellectual disabilities to prevent sexual abuse.
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Affiliation(s)
- N Jojo
- Faculty of Health, University of Canberra, Bruce, ACT, Australia.
| | - P Nattala
- Department of Nursing, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - S Seshadri
- Department of Child and Adolescent Psychiatry, NIMHANS, Bangalore, India
| | - P Krishnakumar
- Institute of Mental Health and Neurosciences (IMHANS), Kozhikode, Kerala, India
| | - S Thomas
- Department of Statistics, Christ University, Bangalore, India
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Halimeh R, Chronopoulou E, Duran M, Saab W, Serhal P, Seshadri S. P-399 Effect of male body mass index on miscarriage rate following fertility treatment, a systematic review and meta-analysis. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
Is raised paternal body mass index (BMI) important for the miscarriage rate following assisted reproductive technology (ART)?
Summary answer
Based on the available evidence, raised male BMI is not associated with higher risk of miscarriage following ART.
What is known already
More than half women and men of reproductive age worldwide are overweight or obese.There is extensive literature exploring the importance of normal female BMI for reproductive outcomes. However, little attention has been given to male BMI for couples seeking fertility treatment [1] .The adverse effect of male obesity on sperm parameters including DNA damage is well documented and there is evidence suggesting that raised male BMI results in significant decrease in live birth rate following ART [2] .Furthermore, emerging evidence from human and animal studies demonstrates that paternal obesity can affect the future health of the offspring through epigenetic pathways[3].
Study design, size, duration
A computerized literature search was performed using EMBASE, MEDLINE, CINAHL and the Cochrane Central register of trials from database inception to November 2021. The aim was to explore the association between male BMI on miscarriage rate following ART. Reference lists of relevant studies were cross-checked. Only articles with full manuscripts available and published in English were included. Papers not relating to human subjects were excluded. All eligible studies were included (observational, prospective and retrospective studies).
Participants/materials, setting, methods
Included studies reported on couples undergoing ART for any indication using partner’s fresh sperm. Outcomes of interest were miscarriage rate and clinical pregnancy rate. Outcome data from each study were pooled and expressed as odds ratio (OR) with 95% confidence interval (CI) by using a random-effect model due to statistical heterogeneity in the outcome data[4]. Heterogeneity of treatment effects was evaluated using the I2 statistic to quantify the variation across studies caused by heterogeneity.
Main results and the role of chance
Abstract screening identified 197 relevant studies. After excluding duplicates, reviews and studies which did not fulfill the inclusion criteria, full manuscripts were accessed for 13 studies. Six studies were identified exploring the effect of male BMI on miscarriage following ART, two prospective and four retrospective. The quality of evidence was low using the GRADE framework. Meta-analysis was possible for three studies including 6793 couples undergoing ART. Outcomes were compared for male BMI < 25 kg/m2 versus BMI >/=25 kg/m2 . The pooled results did not show a statistically significant increase in miscarriage rate when the male partner was overweight or obese compare to normoweight (OR 1.32, 95% CI 0.82–2.1, P = 0.249). There was significant heterogeneity between the included studies (I 2 = 48.7%). There was no significant effect of male BMI on clinical pregnancy rate (OR 0.90, 95% CI 0.59–1.38, P = 0.637). For two of the remaining studies which could not be included in the meta-analysis due to missing data, the authors concluded that male BMI >25 was not associated with increased miscarriage risk whilst the most recent prospective study showed that high male BMI was associated with increased risk of chromosomal aberration-related miscarriages.
Limitations, reasons for caution
The number of the included studies and significant heterogeneity are the main limitations. It was not possible to account for important confounders such as age, subfertility diagnosis, type of stimulation and laboratory parameters including embryo grade. We grouped participants in two BMI categories therefore did not distinguish between overweight/obesity/morbid obesity.
Wider implications of the findings
Despite increasing evidence suggestive of adverse effect of raised male BMI on reproductive outcomes, there is limited literature exploring the impact on miscarriage rate following ART. More well-designed studies are needed for sound conclusions. Paternal characteristics, general health and preconception lifestyle should not be overlooked in the fertility consultation.
Trial registration number
not applicable
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Affiliation(s)
- R Halimeh
- The Centre for Reproductive and Genetic Health, The Centre for Reproductive and Genetic Health CRGH- 230-232 Great Portland St- Fitzrovia- London- W1W 5QS- UK. , London, United Kingdom
| | - E Chronopoulou
- The Centre for Reproductive and Genetic Health, The Centre for Reproductive and Genetic Health CRGH- 230-232 Great Portland St- Fitzrovia- London- W1W 5QS- UK. , London, United Kingdom
| | - M Duran
- The Centre for Reproductive and Genetic Health, The Centre for Reproductive and Genetic Health CRGH- 230-232 Great Portland St- Fitzrovia- London- W1W 5QS- UK. , London, United Kingdom
| | - W Saab
- The Centre for Reproductive and Genetic Health, The Centre for Reproductive and Genetic Health CRGH- 230-232 Great Portland St- Fitzrovia- London- W1W 5QS- UK. , London, United Kingdom
| | - P Serhal
- The Centre for Reproductive and Genetic Health, The Centre for Reproductive and Genetic Health CRGH- 230-232 Great Portland St- Fitzrovia- London- W1W 5QS- UK. , London, United Kingdom
| | - S Seshadri
- The Centre for Reproductive and Genetic Health, The Centre for Reproductive and Genetic Health CRGH- 230-232 Great Portland St- Fitzrovia- London- W1W 5QS- UK. , London, United Kingdom
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Craze H, Odia R, Cawood S, Gaunt M, Seshadri S, Marvelos D, Saab W, Ozturk O, Serhal P. P-472 Extended oocyte cryostorage period is not associated with decreased post-warm survival rate: a retrospective study of 5208 vitrified/warmed oocytes at a single centre. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Study question
Is extended oocyte cryostorage period associated with decreased post-warm survival rate?
Summary answer
There is a weak inverse correlation between oocyte cryostorage duration and post-warm survival (r = 0.09, p = 0.01). This equates clinically to a reduction of 0.0003% survival/day.
What is known already
It is widely reported that extended embryo storage is not associated with reduced post-warm survival rates, however there are no such studies in the literature relating to the effect of extended cryostorage duration on oocytes.
Successful outcomes from oocyte vitrification are related to reduced patient age however UK government regulations only permit those with a medical indication to store and use their gametes over 10 years.
With the intended extension of this 10-year limit, it is therefore fair for clinics to expect an increasing population of younger patients choosing to store their oocytes for longer periods.
Study design, size, duration
A retrospective audit of all vitrified/warmed oocyte cycles at a single centre from 2014-2021. A total of 5208 oocytes were included in the study, from 602 treatment cycles.
Participants/materials, setting, methods
Patients of all ages were included in the study. Data was obtained retrospectively from IDEAS V6.0 at CRGH, UK. All oocytes were vitrified/warmed according to the Irvine Scientific/Kitazato media protocols, with all other protocols excluded. Data was analysed using IBM® SPSS® Statistics V24. Kendall’s tau-b and Spearman’s Rho correlation coefficients measured the strength and direction of association between variables. A linear regression model was used to establish the effect of duration on survival per day.
Main results and the role of chance
The median age at oocyte vitrification was 31 years (range 18-45 years, LQR=25 years, UQR=37 years). There was a median of 8 oocytes thawed per case (LQR=6, UQR 11 oocytes) with a median of 6 oocytes surviving (LQR=3, UQR=9 oocytes). The median survival rate across all ages was 81% (LQR=58%, UQR=100%). There was no significant difference in oocyte survival rate between age categories (<35 years vs > 35 years; p = 0.137, n = 414 & 188 respectively). Increasing age was however, significantly correlated with fewer oocytes vitrified (r = 0.283, p = 0.001).
There is a weak inverse correlation between oocyte cryostorage duration and post-warm survival (r = 0.09). This correlation reaches statistical significance (p = 0.01), however this equates clinically to a reduction of 0.0003% survival rate per day.
No significant difference was observed in post-warm oocyte survival rate across duration of vitrification categories (≤3 years vs 4-5 years vs > 5 years; p = 0.154, n = 416, 141 & 45 cases respectively).
The median duration for which oocytes remained in cryostorage was 565 days (1.6 years) (LQR & UQR=233 days (0.64 years) and 1390 days (3.8 years) respectively).
Limitations, reasons for caution
Although retrospective, the study benefits from many cycles, all of which were carried out at the same unit, using the same vitrification/warming media protocol. Limitations of this study include a relatively short median cryostorage duration time which could be masking the true effect of duration on post-warm oocyte survival.
Wider implications of the findings
Following a public consultation in 2020 regarding the 10-year storage limit for gametes and embryos, the UK Government proposed changes the current legislation which will allow patients to extend cryostorage beyond 10 years without a medical indication. To our knowledge, this is the first study to lend support this movement.
Trial registration number
IRB-001C03-01-22
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Affiliation(s)
- H Craze
- CRGH, Embryology , LONDON, United Kingdom
| | - R Odia
- CRGH, Embryology , LONDON, United Kingdom
| | - S Cawood
- CRGH, Embryology , LONDON, United Kingdom
| | - M Gaunt
- CRGH, Embryology , LONDON, United Kingdom
| | - S Seshadri
- CRGH, Embryology , LONDON, United Kingdom
| | - D Marvelos
- CRGH, Embryology , LONDON, United Kingdom
| | - W Saab
- CRGH, Embryology , LONDON, United Kingdom
| | - O Ozturk
- CRGH, Embryology , LONDON, United Kingdom
| | - P Serhal
- CRGH, Embryology , LONDON, United Kingdom
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Seshadri S, Odia R, Ozturk O, Saab W, AlChami A, Gonzalez XV, Salim S, Saab W, Serha P. A Comparative Analysis of Outcomes Between Two Different Intramuscular Progesterone Preparations in Women Undergoing Frozen Embryo Transfer Cycles. J Reprod Infertil 2022; 23:46-53. [PMID: 36045879 PMCID: PMC9361726 DOI: 10.18502/jri.v23i1.8452] [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] [Received: 02/18/2021] [Accepted: 07/05/2021] [Indexed: 11/24/2022] Open
Abstract
Background: The purpose of the current study was to assess if luteal support with intramuscular (IM) 17 alpha-hydroxyprogesterone caproate (17-OHPC) (Lentogest, IBSA, Italy) improves the pregnancy outcome in comparison to natural intramuscu-lar progesterone (Prontogest, AMSA, Italy) when administered to recipients in a frozen embryo transfer cycle.
Methods: A retrospective comparative study was performed to evaluate outcomes between two different intramuscular regimens used for luteal support in frozen embryo transfer cycles in patients underwent autologous in vitro fertilization (IVF) cycles (896 IVF cycles) and intracytoplasmic sperm injection (ICSI) who had a blastocyst transfer from February 2014 to March 2017 at the Centre for Reproduct-ive and Genetic Health (CRGH) in London.
Results: The live birth rates were significantly lower for the IM natural progesterone group when compared to 17-OHPC group (41.8% vs. 50.9%, adjusted OR of 0.63 (0.31-0.91)). The miscarriage rates were significantly lower in the 17-OHPC group compared to the IM natural progesterone group (14.5% vs. 19.2%, OR of 1.5, 95% CI of 1.13-2.11). The gestational age at birth and birth weight were similar in both groups (p=0.297 and p=0.966, respectively).
Conclusion: It is known that both intramuscular and vaginal progesterone prepar-ations are the standard of care for luteal phase support in women having frozen embryo transfer cycles. However, there is no clear scientific consensus regarding the optimal luteal support. In this study, it was revealed that live birth rates are sig-nificantly higher in women who received artificial progesterone compared to women who received natural progesterone in frozen embryo transfer cycles.
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Affiliation(s)
- Srividya Seshadri
- The Centre for Reproductive and Genetic Health, London, UK
- Corresponding Author: Srividya Seshadri, The Centre for Reproductive and Genetic Health, 230-232 Great Portland St, Fitzrovia, London, UK, E-mail:
| | - Rabi Odia
- The Centre for Reproductive and Genetic Health, London, UK
| | - Ozkan Ozturk
- The Centre for Reproductive and Genetic Health, London, UK
| | - Wiam Saab
- Gilbert and Rose-Marie Chagoury Health Sciences Center, The Lebanese American University, Beirut, Lebanon
| | - Ali AlChami
- The Centre for Reproductive and Genetic Health, London, UK
| | | | - Saba Salim
- The Centre for Reproductive and Genetic Health, London, UK
| | - Wael Saab
- The Centre for Reproductive and Genetic Health, London, UK
| | - Paul Serha
- The Centre for Reproductive and Genetic Health, London, UK
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Gonzales MM, Garbarino VR, Marques Zilli E, Petersen RC, Kirkland JL, Tchkonia T, Musi N, Seshadri S, Craft S, Orr ME. Senolytic Therapy to Modulate the Progression of Alzheimer's Disease (SToMP-AD): A Pilot Clinical Trial. J Prev Alzheimers Dis 2022; 9:22-29. [PMID: 35098970 PMCID: PMC8612719 DOI: 10.14283/jpad.2021.62] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [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: 07/12/2021] [Accepted: 07/25/2021] [Indexed: 12/13/2022]
Abstract
Preclinical studies indicate an age-associated accumulation of senescent cells across multiple organ systems. Emerging evidence suggests that tau protein accumulation, which closely correlates with cognitive decline in Alzheimer's disease and other tauopathies, drives cellular senescence in the brain. Pharmacologically clearing senescent cells in mouse models of tauopathy reduced brain pathogenesis. Compared to vehicle treated mice, intermittent senolytic administration reduced tau accumulation and neuroinflammation, preserved neuronal and synaptic density, restored aberrant cerebral blood flow, and reduced ventricular enlargement. Intermittent dosing of the senolytics, dasatinib plus quercetin, has shown an acceptable safety profile in clinical studies for other senescence-associated conditions. With these data, we proposed and herein describe the objectives and methods for a clinical vanguard study. This initial open-label clinical trial pilots an intermittent senolytic combination therapy of dasatinib plus quercetin in five older adults with early-stage Alzheimer's disease. The primary objective is to evaluate the central nervous system penetration of dasatinib and quercetin through analysis of cerebrospinal fluid collected at baseline and after 12 weeks of treatment. Further, through a series of secondary outcome measures to assess target engagement of the senolytic compounds and Alzheimer's disease-relevant cognitive, functional, and physical outcomes, we will collect preliminary data on safety, feasibility, and efficacy. The results of this study will be used to inform the development of a randomized, double-blind, placebo-controlled multicenter phase II trial to further explore of the safety, feasibility, and efficacy of senolytics for modulating the progression of Alzheimer's disease. Clinicaltrials.gov registration number and date: NCT04063124 (08/21/2019).
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Affiliation(s)
- Mitzi M. Gonzales
- Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, Department of Neurology, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229 USA
| | - V. R. Garbarino
- Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, Department of Neurology, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229 USA
| | - E. Marques Zilli
- Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, Department of Neurology, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229 USA
| | | | - J. L. Kirkland
- Mayo Clinic, Robert and Arlene Kogod Center on Aging, Rochester, MN USA
| | - T. Tchkonia
- Mayo Clinic, Robert and Arlene Kogod Center on Aging, Rochester, MN USA
| | - N. Musi
- University of Texas Health Science Center at San Antonio, Barshop Institute for Longevity and Aging Studies, San Antonio Geriatric Research, Education and Clinical Center (GRECC), Department of Medicine, San Antonio, TX USA
| | - S. Seshadri
- Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, Department of Neurology, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229 USA
- Boston University School of Medicine, Department of Neurology, Boston, MA USA
| | - S. Craft
- Wake Forest School of Medicine, Gerontology and Geriatric Medicine, 575 Patterson Avenue, Winston-Salem, NC 27101 USA
| | - Miranda E. Orr
- Wake Forest School of Medicine, Gerontology and Geriatric Medicine, 575 Patterson Avenue, Winston-Salem, NC 27101 USA
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Jacob M, O’Donnell A, Samra J, Gonzales M, Satizabal C, Pase M, Murabito J, Beiser A, Seshadri S. Grip Strength, Gait Speed and Plasma Markers of Neurodegeneration in Asymptomatic Middle-aged and Older Adults. J Frailty Aging 2022; 11:291-298. [DOI: 10.14283/jfa.2022.17] [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: 11/11/2022]
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10
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Kalpana K, Rani VA, Seshadri S, Kiran BR. BMIM[BF4]: An Efficient Ionic Liquid Medium for the Synthesis of Chromeno[b]pyridines as Potential Anticancer Agents. Russ J Org Chem 2021. [DOI: 10.1134/s1070428021090177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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11
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Morris G, Mavrelos D, Odia R, Viñals Gonzalez X, Cawood S, Yasmin E, Saab W, Serhal P, Seshadri S. Paternal age over 50 years decreases assisted reproductive technology (ART) success: A single UK center retrospective analysis. Acta Obstet Gynecol Scand 2021; 100:1858-1867. [PMID: 34405396 DOI: 10.1111/aogs.14221] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 06/23/2021] [Accepted: 06/24/2021] [Indexed: 12/15/2022]
Abstract
INTRODUCTION To study whether paternal age exerts an effect, independent of maternal age, on the outcomes of fresh in vitro fertilization/ intracytoplasmic sperm injection (IVF/ICSI) cycles. Semen quality deteriorates with increasing paternal age; however, there is conflicting evidence for any impact paternal age may have on the outcome of IVF/ICSI. Several retrospective and prospective cohort studies have shown that paternal age increases the miscarriage rate and reduces the live birth rate. Some studies have shown no effect of paternal age on live birth rate or miscarriage rate. Studies involving donor oocytes have tended to show no independent effect of paternal age on assisted reproductive technology (ART) outcomes. The age at which paternal age may exert a significant deleterious effect on outcome is not known and there is no limit to paternal age in IVF/ICSI treatment. MATERIAL AND METHODS A single-center retrospective cohort study was carried out at the Centre for Reproductive and Genetic Health, London, UK. Included in the analysis were all couples with primary or secondary infertility undergoing IVF/ICSI cycles in which the male partner produced a fresh semen sample and the cycle proceeded to fresh embryo transfer. All cycles of IVF/ICSI that used donor oocytes-donor sperm, frozen sperm, cycles leading to embryo storage and cycles including preimplantation genetic testing (PGT-A/PGT-M)-were excluded from analysis. The primary outcome was live birth rate and secondary outcomes were clinical pregnancy rate and miscarriage rate. Multivariate logistic regression analysis with live birth as a dependent variable and maternal and paternal age class as independent variables was performed. RESULTS During the study period there were 4833 cycles, involving 4271 men, eligible for analysis; 1974/4833 (40.8%, 95% confiene intervals [CI] 39.5-42.2%) cycles resulted in a live birth. A significantly lower proportion of men over 51 years met World Health Organization semen analysis criteria (56/133, [42.1%, 95% CI 34.1-50.6]) compared with men under 51 years of age (2530/4138 [61.1%, 95% CI 60.0-62.6]) (p = 0.001). Both maternal and paternal age were retained in the multivariate model and for all maternal age subgroups the probability of live birth decreased with paternal age over 50 years (odds ratio [OR] 0.674, 95% CI 0.482-0.943) (p = 0.021). Paternal age over 50 years was not an independent predictor of miscarriage (OR 0.678, 95% CI 0.369-1.250) (p = 0.214). CONCLUSIONS Paternal age over 50 significantly affects the chance of achieving a live birth following ART. Paternal age does not independently affect the risk of miscarriage following ART. There should be a public health message for men not to delay fatherhood.
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Affiliation(s)
- Guy Morris
- Centre for Reproductive and Genetic Health, London, UK.,Reproductive Medicine Unit, University College London Hospitals NHS Foundation Trust, London, UK
| | - Dimitrios Mavrelos
- Centre for Reproductive and Genetic Health, London, UK.,Reproductive Medicine Unit, University College London Hospitals NHS Foundation Trust, London, UK
| | - Rabi Odia
- Centre for Reproductive and Genetic Health, London, UK
| | | | | | - Ephia Yasmin
- Centre for Reproductive and Genetic Health, London, UK.,Reproductive Medicine Unit, University College London Hospitals NHS Foundation Trust, London, UK
| | - Wael Saab
- Centre for Reproductive and Genetic Health, London, UK
| | - Paul Serhal
- Centre for Reproductive and Genetic Health, London, UK
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Merrett C, Schlager D, Yasmin E, Seshadri S, Serhal P, Ralph D, Sangster P. P–128 Audit of testicular sperm in assisted conception for non-azoospermic infertile couples. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
What live birth rate do we see when we use testicular sperm in ART for non-azoospermic couples after at least one previous failed cycle?
Summary answer
In our cohort of couples 24% had a live birth using testicular sperm and therefore was not higher than national average ART rates.
What is known already
There is increased interest in using testicular sperm in assisted reproduction technology (ART) to improve outcomes after previous failed cycles. Mehta et al. reported results of a 50% live birth rate using testicular sperm in the first cycle for couples with oligospermia and a history of failed cycles with ejaculated sperm. We aim to audit our results in a similar population of couples.
Study design, size, duration
St Peters Andrology Centre in London, United Kingdom completed 128 surgical testicular sperm retrievals reviewed between the two-year period of 2018–2019. We conducted a retrospective audit of their paper-based records to identify those couples with injectable sperm on their semen analysis and who had previous cycles attempts using ejaculated sperm.
Participants/materials, setting, methods
We identified 27 couples who underwent testicular sperm extraction despite having an ejaculated semen analysis with injectable sperm and at least one previous failed cycle. A systematic review of their paper and electronic medical record was conducted to assess live birth rates and fertilization rates from ART.
Main results and the role of chance
Couples had an average male age of 41 (range 31–60) and an average female age of 38 (range 30–45). The men had an average serum testosterone of 15 nmol/L (range 8–35 nmol/L) and an average serum FSH of 8.9 IU/L (range 1.7–30 IU/L). 59% (n = 17) of men had a DNA fragmentation index completed with an average score of 41% (range 31%–51[Y1]%). In the women the mean serum anti-Müllerian hormone (AMH) was 15.8 pmol/l (range 1–64 pmol/l). With ejaculated sperm the fertilization rate was 59% (95% CI [27%, 59%]) and blastocyst conversion rate was 43% (95% CI [50%, 69%]). There was no statistical significance with testicular sperm where the fertilization rate was 58% (95% CI [51%, 65%]) and blastocyst conversion rate was 54% (95% CI [40%, 67%]). Overall, there were 7 clinical pregnancies in this population of couples. Of these clinical pregnancies, 2 miscarried and 5 progressed to a live birth. This audit yielded a live birth rate per cycle of 15% and a live birth rate per couple of 24%.
Limitations, reasons for caution
Limitations of the study are low number of patients and absence of a control group.
Wider implications of the findings: We recommend caution and further analysis going forward using testicular sperm in ART where ejaculated sperm in available.
Trial registration number
Not applicable
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Affiliation(s)
- C Merrett
- University College London Hospital, Andrology, London, United Kingdom
| | - D Schlager
- University of Freiburg, Department of Urology, Hugstetter, Germany
| | - E Yasmin
- University College London Hospital, Reproductive Medicine, London, United Kingdom
| | - S Seshadri
- The Centre for Reproductive & Genetic Health, Reproductive Medicine, London, United Kingdom
| | - P Serhal
- University College London Hospital, Reproductive Medicine, London, United Kingdom
| | - D Ralph
- University College London Hospital, Andrology, London, United Kingdom
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13
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Cardenas Armas D, Duran-Retamal M, Odia R, Cawood S, Drew E, Yasmin E, Saab W, Serhal P, Seshadri S. O-093 Male translocations in recurrent pregnancy loss: Natural conception versus PGD treatment: what is the right option?: A systematic review and meta-analysis. Hum Reprod 2021. [DOI: 10.1093/humrep/deab125.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
Does PGD treatment in couples with a history of RPL due to male translocations improve the outcome, increasing LBR and reducing miscarriage rate and time taken to live birth?
Summary answer
Live birth rate is significantly increased, miscarriage rate is significantly reduced using PGD. Time taken to achieve live birth rate is shorter in PGD treatment.
What is known already
Reciprocal translocation are the most common structural rearrangement in infertile men. The specific chromosomes and breakpoints involved might play an important role, often expressed as abnormal semen parameters or repeated pregnancy loss (RPL). The genetic counselling of these men remains challenging. Previous studies and meta-analysis performed showed no difference in live birth rate when comparing natural conception versus PGD treatment. However, the difference in miscarriage rate and time to live birth between PGD and natural conception has not been reported before in the medical literature.
Study design, size, duration
A systematic review of the literature was conducted through MEDLINE, EMBASE, and the Cochrane database up until December 2020. A comprehensive search yield 287 articles, 25 of which were included for abstract reading, finally, six were included in the meta-analysis.
Participants/materials, setting, methods
The six selected articles, reported on Live birth rate (LBR), miscarriage rate and time to live birth (TTLB) for natural conception compared to PGD for the same cohort of patients. All of the included articles were of retrospective design. The primary outcome was the comparison in LBR and the second outcome was the analysis in miscarriage rate and TTLB in the PGD group versus natural conception.
Main results and the role of chance
A total of 1438 couples that conceived naturally, had a LBR of 22.46%, compared with 43,17% among 681 couples that underwent PGD (0.53 95% CI (0.43-0.65) p o < 0,00001). The six articles included in this meta-analysis had significant homogeneity (I2 = 96%). Comparison of miscarriage rates, natural conception represented 1339 miscarriages out of 1836 pregnancies, in comparison with 44 miscarriages out of 558 pregnancies achieved through PGD. The OR showed a 10 fold increase risk of miscarriage when conceiving naturally in couples with a male translocation (10.18; 95% CI (2.88-36.04) p = 0.0003).
Regarding TTLB, the difference was not statistically significant, however it did reflect that PGD patients will have a shorter TTLB (3.56 95% CI (-0.88-8.00)p = 0.12). One of the studies included, took into account the waiting list to access PGD funding, prolonging therefore the TTLB in the PGD group.
Limitations, reasons for caution
The main limitation of this study is the low number of studies. TTLB should be interpreted with caution given that one of the articles included the time of the waiting lists. More studies could demonstrate a shorter time period for these couples to conceive and have a successful ongoing pregnancy.
Wider implications of the findings
First study to demonstrate the value of PGD in decreasing miscarriage rates in couples with RPL. Specially when counselling couples with history of RPL with male translocations. PGD should be offered in these couples to improve the outcome, and to diminish the physical, emotional and sequelae of RPL and TOP.
Trial registration number
not applicable
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Affiliation(s)
- D Cardenas Armas
- The Centre for Reproductive and Genetic Health, The Centre for Reproductive and Genetic Health, London, United Kingdom
| | - M Duran-Retamal
- The Centre for Reproductive and Genetic Health, The Centre for Reproductive and Genetic Health, London, United Kingdom
| | - R Odia
- The Centre for Reproductive and Genetic Health, The Centre for Reproductive and Genetic Health, London, United Kingdom
| | - S Cawood
- The Centre for Reproductive and Genetic Health, The Centre for Reproductive and Genetic Health, London, United Kingdom
| | - E Drew
- The Centre for Reproductive and Genetic Health, The Centre for Reproductive and Genetic Health, London, United Kingdom
| | - E Yasmin
- University College Hospital UCLH, Reproductive Medicine, London, United Kingdom
| | - W Saab
- The Centre for Reproductive and Genetic Health, The Centre for Reproductive and Genetic Health, London, United Kingdom
| | - P Serhal
- The Centre for Reproductive and Genetic Health, The Centre for Reproductive and Genetic Health, London, United Kingdom
| | - S Seshadri
- The Centre for Reproductive and Genetic Health, The Centre for Reproductive and Genetic Health, London, United Kingdom
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Merrett C, Schlager D, Yasmin E, Seshadri S, Serhal P, Ralph D, Sangster P. Audit of testicular sperm in assisted conception for non-azoospermic infertile couples. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00891-5] [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: 11/15/2022]
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15
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Kumaravelan S, Seshadri S, Suresh R, Ravichandran K, Sathishkumar P, Shanthaseelan K, Suganthi N. Effect of Zn dopant on SnO2 nano-pyramids for photocatalytic degradation. Chem Phys Lett 2021. [DOI: 10.1016/j.cplett.2021.138352] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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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16
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Gonzalez XV, Ahmed-Odia R, Gupta SS, Naja RP, Arshad F, Serhal P, Saab W, Seshadri S. Chromosomal Analysis of Cumulus Cells as a Future Predictor for Oocyte Aneuploidy: A Case Report. J Reprod Infertil 2021; 22:138-143. [PMID: 34041011 PMCID: PMC8143009 DOI: 10.18502/jri.v22i2.5803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: Within the ovary, the optimal growth of the follicle, oocyte maturation and ovulation are highly conditioned by the two-way cross talk and interactions between the oocyte and the immediate somatic cells, known as cumulus cells (CCs). This biological communication between cell lines triggered the interest in the study of CCs as a biomarker of oocyte competence. Case Presentation: The findings of a 45,X mosaic pattern on CCs from a female patient with unremarkable medical history are reported in this study. The patient came to the Centre for Reproductive and Genetic Health, London on 14th August 2019 for her first visit and the follow up procedures were done for her to determine underlying genetic status. For this purpose, four sources of DNA including CCs, blood lymphocytes, buccal cells and immature oocytes were analyzed in the present report. Conclusion: In the present case study, the hypothesis of the female patient being mosaic 45,X was confirmed although the degree of mosaicism and whether this was affecting the germinal line could not be determined. In the event of the discovery of a cell line with an apparently abnormal genetic makeup, genetic counselling is important in order to understand the implications from somatic to germinal cells for patients exploring fertility journeys.
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Affiliation(s)
- Xavier Viñals Gonzalez
- Department of Embryology, The Centre for Reproductive and Genetic Health, London, UK.,Institute for Women's Health, University College London, London, UK
| | - Rabi Ahmed-Odia
- Department of Embryology, The Centre for Reproductive and Genetic Health, London, UK
| | - Sioban Sen Gupta
- Institute for Women's Health, University College London, London, UK
| | - Roy Pascal Naja
- Institute for Women's Health, University College London, London, UK
| | - Falak Arshad
- School of Medicine, Cardiff University, Cardiff, UK
| | - Paul Serhal
- Department of Embryology, The Centre for Reproductive and Genetic Health, London, UK
| | - Wael Saab
- Department of Embryology, The Centre for Reproductive and Genetic Health, London, UK
| | - Srividya Seshadri
- Department of Embryology, The Centre for Reproductive and Genetic Health, London, UK
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17
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Abstract
Background The first successful livebirth using warmed oocytes (vitrified by the GAVITM system) is reported in this paper. Embryologists throughout the world have vitrified oocytes using a manual technique which is susceptible to error and variation. In this era of automated laboratory procedures, vitrification was made semi-automatic by using the GAVITM system. Case Presentation Donor oocytes were initially vitrified using the GAVITM system. They remained in the clinic's oocyte bank until they were allocated to the patient. Donor oocytes were warmed as per Genea BIOMEDX protocol and inseminated to create embryos. Resulting embryos for the 42-year-old patient were cultured to the blastocyst stage, biopsied to perform PGT-A, using next generation sequencing and subsequently vitrified. The patient underwent a single euploid transfer in a frozen embryo transfer cycle which resulted in a healthy livebirth. Conclusion The introduction of a semi-automated system should minimize the risk to the oocytes, standardize the procedure worldwide and potentially reduce the laboratory time taken by the embryologists. This case report demonstrates the safety of the technology used for vitrification, but larger randomized studies need to be performed to demonstrate the safety and efficacy of newer technologies like the GAVITM system before adopting it as a standard laboratory procedure.
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Affiliation(s)
| | - Suzanne Cawood
- - The Centre for Reproductive and Genetic Health, London, United Kingdom
| | - Matthew Gaunt
- - The Centre for Reproductive and Genetic Health, London, United Kingdom
| | - Wael Saab
- - The Centre for Reproductive and Genetic Health, London, United Kingdom
| | - Paul Serhal
- - The Centre for Reproductive and Genetic Health, London, United Kingdom
| | - Srividya Seshadri
- - The Centre for Reproductive and Genetic Health, London, United Kingdom
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18
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Saab W, Seshadri S, Huang C, Alsubki L, Sung N, Kwak-Kim J. A systemic review of intravenous immunoglobulin G treatment in women with recurrent implantation failures and recurrent pregnancy losses. Am J Reprod Immunol 2021; 85:e13395. [PMID: 33511656 DOI: 10.1111/aji.13395] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 12/07/2020] [Revised: 01/22/2021] [Accepted: 01/23/2021] [Indexed: 11/28/2022] Open
Abstract
Over the last few decades, the advancement in reproductive technologies and protocols to improve embryo quality through culture techniques and genetic testing to eliminate chromosomally abnormal embryos resulted in better pregnancy rates and outcomes after fertility treatments. Unfortunately, some patients still struggle with recurrent implantation failures (RIFs) and recurrent pregnancy losses (RPLs). Immune etiologies have been attributed to play an important role in some of those patients. Maintaining a pre-conceptional anti-inflammatory environment for implantation and pregnancy continuation yields superior results. Intravenous immunoglobulin G (IVIG) treatment has been reported to enhance reproductive outcome in patients with RIF and RPL with immune dysregulations. In this systemic review, we analyzed outcomes of IVIG trials for RIF and RPL, its mechanism of action, dosing, administration, side-effects, and evidence for its use in women with RIF and RPL.
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Affiliation(s)
- Wael Saab
- Assisted Conception unit, The Centre for Reproductive and Genetic Health, London, UK
| | - Srividya Seshadri
- Assisted Conception unit, The Centre for Reproductive and Genetic Health, London, UK
| | - Changsheng Huang
- Reproductive Medicine and Immunology, Obstetrics and Gynecology, Clinical Sciences Department, Chicago Medical School, Rosalind Franklin University of Medicine and Science, Vernon Hills, IL, USA.,Department of Traditional Chinese Medicine Rheumatology, Shenzhen Nanshan People's Hospital and The 6th Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, Guangdong, China
| | - Lujain Alsubki
- Reproductive Medicine and Immunology, Obstetrics and Gynecology, Clinical Sciences Department, Chicago Medical School, Rosalind Franklin University of Medicine and Science, Vernon Hills, IL, USA.,Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Nayoung Sung
- Reproductive Medicine and Immunology, Obstetrics and Gynecology, Clinical Sciences Department, Chicago Medical School, Rosalind Franklin University of Medicine and Science, Vernon Hills, IL, USA
| | - Joanne Kwak-Kim
- Reproductive Medicine and Immunology, Obstetrics and Gynecology, Clinical Sciences Department, Chicago Medical School, Rosalind Franklin University of Medicine and Science, Vernon Hills, IL, USA
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19
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Chronopoulou E, Seifalian A, Stephenson J, Serhal P, Saab W, Seshadri S. Preconceptual care for couples seeking fertility treatment, an evidence-based approach. ACTA ACUST UNITED AC 2021. [DOI: 10.1016/j.xfnr.2020.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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20
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Chronopoulou E, Raperport C, Serhal P, Saab W, Seshadri S. Preconception tests at advanced maternal age. Best Pract Res Clin Obstet Gynaecol 2020; 70:28-50. [PMID: 33358154 DOI: 10.1016/j.bpobgyn.2020.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 11/15/2020] [Accepted: 11/23/2020] [Indexed: 11/17/2022]
Abstract
Pregnancies at an advanced reproductive age are increasingly common. However, the safety of pregnancy remains a concern as maternal age is a recognized independent factor for various obstetric complications. Also, age is a risk factor for most systematic health problems and older women are more likely to enter into pregnancy with pre-existing conditions. At the moment there is no separate, structured guidance on preconception tests at advanced maternal age. However, the preconceptual period offers an ideal window to recognize and address underlying health issues, social issues and harmful lifestyle behaviours in order to optimize maternal health ultimately reducing infertility, perinatal morbidity and mortality. Preconception tests should be clinically relevant aiming to identify risk factors and address them to predict and prevent infertility and pregnancy complications. The importance of preconception care is magnified for women of advanced age for whom the risks are higher and the potential benefits greater.
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Affiliation(s)
- Elpiniki Chronopoulou
- Homerton Fertility Centre, Homerton University Hospital, Homerton Row, Clapton, London, E9 6SR, UK.
| | - Claudia Raperport
- Homerton Fertility Centre, Homerton University Hospital, Homerton Row, Clapton, London, E9 6SR, UK
| | - Paul Serhal
- The Centre for Reproductive and Genetic Health (CRGH), 230-232 Great Portland St, Fitzrovia, London, W1W 5QS, UK
| | - Wael Saab
- The Centre for Reproductive and Genetic Health (CRGH), 230-232 Great Portland St, Fitzrovia, London, W1W 5QS, UK
| | - Srividya Seshadri
- The Centre for Reproductive and Genetic Health (CRGH), 230-232 Great Portland St, Fitzrovia, London, W1W 5QS, UK
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21
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Robati S, Saab W, Durán-Retamal M, Saab W, Theodorou E, Cawood S, Serhal P, Seshadri S. The Association Between Elevated Progesterone Level on Day of hCG Trigger and Live Birth Rates in ART Cycles: A Single Centre Observational Study. J Reprod Infertil 2020; 21:283-290. [PMID: 33209745 PMCID: PMC7648872 DOI: 10.18502/jri.v21i4.4333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The advent of ovarian stimulation within an in vitro fertilization (IVF) cycle has resulted in modifying the physiology of stimulated cycles and has helped optimize pregnancy outcomes. In this regard, the importance of progesterone (P4) elevation at time of human chorionic gonadotrophin (hCG) administration within an IVF cycle has been studied over several decades. Our study aimed to evaluate the association of P4 levels at time of hCG trigger with live birth rate (LBR), clinical pregnancy rate (CPR) and miscarriage rate (MR) in fresh IVF or IVF-ICSI cycles. METHODS This was a retrospective cohort study (n=170) involving patients attending the Centre for Reproductive and Genetic Health (CRGH) in London. The study cohort consisted of women undergoing controlled ovarian stimulation using GnRH antagonist or GnRH agonist protocols. Univariate and multiple logistic regression analyses were used to evaluate the association of clinical outcomes. Differences were considered statistically significant if p≤0.05. RESULTS As serum progesterone increased, a decrease in LBR was observed. Following multivariate logistical analyses, LBR significantly decreased with P4 thresholds of 4.0 ng/ml (OR 0.42, 95% CI:0.17-1.0) and 4.5 ng/ml (OR 0.35, 95% CI:0.12-0.96). CONCLUSION P4 levels are important in specific groups and the findings were statistically significant with a P4 threshold value between 4.0-4.5 ng/ml. Therefore, it seems logical to selectively measure serum P4 levels for patients who have ovarian dysfunction or an ovulatory cycles and accordingly prepare the individualized management packages for such patients.
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Affiliation(s)
- Shahin Robati
- Institute for Women's Health, Faculty of Population Health Sciences, University College London, Lebanon, United Kingdom
| | - Wiam Saab
- Department of Obstetrics and Gynaecology, The American University of Beirut Medical Centre, Beirut, Lebanon
| | - Montserrat Durán-Retamal
- Institute for Women's Health, Faculty of Population Health Sciences, University College London, Lebanon, United Kingdom
| | - Wael Saab
- Institute for Women's Health, Faculty of Population Health Sciences, University College London, Lebanon, United Kingdom
| | - Efstathios Theodorou
- Institute for Women's Health, Faculty of Population Health Sciences, University College London, Lebanon, United Kingdom
| | - Suzanne Cawood
- Institute for Women's Health, Faculty of Population Health Sciences, University College London, Lebanon, United Kingdom
| | - Paul Serhal
- Institute for Women's Health, Faculty of Population Health Sciences, University College London, Lebanon, United Kingdom
| | - Srividya Seshadri
- Institute for Women's Health, Faculty of Population Health Sciences, University College London, Lebanon, United Kingdom
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22
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Seshadri S, Morris G, Serhal P, Saab W. Assisted conception in women of advanced maternal age. Best Pract Res Clin Obstet Gynaecol 2020; 70:10-20. [PMID: 32921559 DOI: 10.1016/j.bpobgyn.2020.06.012] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [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: 05/04/2020] [Accepted: 06/14/2020] [Indexed: 11/18/2022]
Abstract
A delay in childbearing to later in life has increased the number of women of advanced maternal age (AMA) opting for assisted reproduction. Women should be made aware that there are age-related changes to fertility, including a decline in oocyte reserve and quality, in addition to an increase in the number of oocyte chromosomal aberrations. Success rates of assisted reproductive technology (ART) cycles decrease with advanced maternal age. There are different fertility options for women of AMA, including fertility preservation (oocyte or embryo freezing), in vitro fertilisation (IVF treatment) with or without preimplantation genetic screening and oocyte or embryo donation. Detailed counselling needs to be offered to these women with regard to the risks, success rates, ethical and legal implications of these fertility treatment options. Women of AMA should be screened for underlying medical conditions that could have an impact on maternal and neonatal morbidity and mortality.
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Affiliation(s)
- S Seshadri
- The Centre for Reproductive and Genetic Health (CRGH), London, UK.
| | - G Morris
- St Michael's Hospital, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - P Serhal
- The Centre for Reproductive and Genetic Health (CRGH), London, UK
| | - W Saab
- The Centre for Reproductive and Genetic Health (CRGH), London, UK
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Chaemsaithong P, Sahota D, Pooh RK, Zheng M, Ma R, Chaiyasit N, Koide K, Shaw SW, Seshadri S, Choolani M, Panchalee T, Yapan P, Sim WS, Sekizawa A, Hu Y, Shiozaki A, Saito S, Leung TY, Poon LC. First-trimester pre-eclampsia biomarker profiles in Asian population: multicenter cohort study. Ultrasound Obstet Gynecol 2020; 56:206-214. [PMID: 31671479 DOI: 10.1002/uog.21905] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 10/08/2019] [Accepted: 10/11/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES To (i) evaluate the applicability of the European-derived biomarker multiples of the median (MoM) formulae for risk assessment of preterm pre-eclampsia (PE) in seven Asian populations, spanning the east, southeast and south regions of the continent, (ii) perform quality-assurance (QA) assessment of the biomarker measurements and (iii) establish criteria for prospective ongoing QA assessment of biomarker measurements. METHODS This was a prospective, non-intervention, multicenter study in 4023 singleton pregnancies, at 11 to 13 + 6 weeks' gestation, in 11 recruiting centers in China, Hong Kong, India, Japan, Singapore, Taiwan and Thailand. Women were screened for preterm PE between December 2016 and June 2018 and gave written informed consent to participate in the study. Maternal and pregnancy characteristics were recorded and mean arterial pressure (MAP), mean uterine artery pulsatility index (UtA-PI) and maternal serum placental growth factor (PlGF) were measured in accordance with The Fetal Medicine Foundation (FMF) standardized measurement protocols. MAP, UtA-PI and PlGF were transformed into MoMs using the published FMF formulae, derived from a largely Caucasian population in Europe, which adjust for gestational age and covariates that affect directly the biomarker levels. Variations in biomarker MoM values and their dispersion (SD) and cumulative sum tests over time were evaluated in order to identify systematic deviations in biomarker measurements from the expected distributions. RESULTS In the total screened population, the median (95% CI) MoM values of MAP, UtA-PI and PlGF were 0.961 (0.956-0.965), 1.018 (0.996-1.030) and 0.891 (0.861-0.909), respectively. Women in this largely Asian cohort had approximately 4% and 11% lower MAP and PlGF MoM levels, respectively, compared with those expected from normal median formulae, based on a largely Caucasian population, whilst UtA-PI MoM values were similar. UtA-PI and PlGF MoMs were beyond the 0.4 to 2.5 MoM range (truncation limits) in 16 (0.4%) and 256 (6.4%) pregnancies, respectively. QA assessment tools indicated that women in all centers had consistently lower MAP MoM values than expected, but were within 10% of the expected value. UtA-PI MoM values were within 10% of the expected value at all sites except one. Most PlGF MoM values were systematically 10% lower than the expected value, except for those derived from a South Asian population, which were 37% higher. CONCLUSIONS Owing to the anthropometric differences in Asian compared with Caucasian women, significant differences in biomarker MoM values for PE screening, particularly MAP and PlGF MoMs, were noted in Asian populations compared with the expected values based on European-derived formulae. If reliable and consistent patient-specific risks for preterm PE are to be reported, adjustment for additional factors or development of Asian-specific formulae for the calculation of biomarker MoMs is required. We have also demonstrated the importance and need for regular quality assessment of biomarker values. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- P Chaemsaithong
- Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR
| | - D Sahota
- Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR
| | - R K Pooh
- CRIFM Clinical Research Institute of Fetal Medicine PMC, Osaka, Japan
| | - M Zheng
- Nanjing Drum Tower Hospital, Nanjing, China
| | - R Ma
- First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - N Chaiyasit
- King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - K Koide
- Showa University Hospital, Tokyo, Japan
| | - S W Shaw
- Taipei Chang Gung Memorial Hospital, Taipei, Taiwan
| | | | | | | | - P Yapan
- Siriraj Hospital, Bangkok, Thailand
| | - W S Sim
- KK Women's and Children's Hospital, Singapore
| | | | - Y Hu
- Nanjing Drum Tower Hospital, Nanjing, China
| | - A Shiozaki
- University of Toyama University Hospital, Toyama, Japan
| | - S Saito
- University of Toyama University Hospital, Toyama, Japan
| | - T Y Leung
- Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR
| | - L C Poon
- Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR
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Baril A, Beiser AS, Redline S, McGrath ER, Aparicio HJ, Gottlieb DJ, Seshadri S, Himali JJ, Pase MP. 0419 IL-6 Moderates the Association Between Obstructive Sleep Apnea Severity and Incident Alzheimer’s Disease: The Framingham Heart Study. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Both sleep disturbances and inflammation are potential risk factors for Alzheimer’s disease (AD). However, it is unknown how inflammation and sleep interact together to influence the risk of developing AD dementia. Our objective was to evaluate whether interleukin-6 (IL-6) levels interact with sleep disturbances when predicting incident clinical AD.
Methods
We studied participants in the Framingham Heart Study Offspring cohort who completed in-home overnight polysomnography. Sleep characteristics were continuous and included sleep duration, wake after sleep onset (WASO), and apnea-hypopnea index (AHI). Participants were stratified into quartiles of IL-6 levels. Surveillance for incident AD dementia occurred over a mean follow-up of 13.4±5.4 years. Using Cox proportional hazards regression models, we tested the interaction of sleep measures by IL-6 quartiles on incident AD dementia. All analyses adjusted for age and sex and P<0.05 was considered significant.
Results
The final sample included 291 dementia-free participants at baseline (age 67.5±4.9 years, 51.6% men). Approximately one quarter of participants had obstructive sleep apnea (OSA; AHI>15) at baseline (median:6.2, Q1:2,3, Q3:14.3). We observed 33 cases of incident AD dementia during follow-up. Although no interaction was observed for either sleep duration or WASO with IL-6 levels, there was a significant interaction of AHI with IL-6 in predicting AD dementia (p=0.002). In the lowest IL-6 quartile, higher AHI was associated with an elevated risk of AD dementia (hazard ratio, 4.15 [95%CI, 1.42, 12.1], p=0.01) whereas no association between AHI and incident AD was observed in other IL-6 quartiles.
Conclusion
Our findings suggest that the pro-inflammatory cytokine IL-6 moderates the association between OSA and incident AD risk. The association between increasing OSA severity and incident AD was only observed in those with lower IL-6 levels, suggesting that this association might be especially apparent when no other confounding risk factors such as inflammation are present.
Support
The Framingham Heart Study is supported by contracts from the National Heart, Lung and Blood Institute, grants from the National Institute on Aging, and grants from the National Institute of Neurological Disorders and Stroke.
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Affiliation(s)
- A Baril
- The Framingham Heart Study, Boston University School of Medicine, Boston, MA
| | - A S Beiser
- The Framingham Heart Study, Boston University School of Medicine, Boston, MA
| | - S Redline
- Brigham & Women’s Hospital, Harvard Medical School, Boston, MA
| | | | - H J Aparicio
- The Framingham Heart Study, Boston University School of Medicine, Boston, MA
| | | | - S Seshadri
- Glenn Biggs Institute for Alzheimer’s & Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, TX
| | - J J Himali
- Glenn Biggs Institute for Alzheimer’s & Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, TX
| | - M P Pase
- The University of Melbourne, Melbourne, AUSTRALIA
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Duran-Retamal M, Morris G, Achilli C, Gaunt M, Theodorou E, Saab W, Serhal P, Seshadri S. Live birth and miscarriage rate following intracytoplasmic morphologically selected sperm injection vs intracytoplasmic sperm injection: An updated systematic review and meta-analysis. Acta Obstet Gynecol Scand 2019; 99:24-33. [PMID: 31403712 DOI: 10.1111/aogs.13703] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 07/11/2019] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Intracytoplasmic morphologically selected sperm injection (IMSI) is one of the sperm selection techniques used for assisted reproduction which has been applied for a variety of indications including previously failed fertilization with intracytoplasmic sperm injection (ICSI). A Cochrane review1 found no difference in outcomes between either modality of sperm selection. Since the Cochrane review was published there have been a further two randomized controlled trials comparing IMSI and ICSI. This systematic review and meta-analysis aims to compare IMSI with ICSI as insemination methods regarding live birth rate and miscarriage rate. MATERIAL AND METHODS Systematic review of randomized controlled trials, observational studies and similar reviews in electronic databases published before January 2018. RESULTS We found nine randomized controlled trials, evaluating 1610 cycles of in vitro fertilization and 15 observational studies evaluating 1243 cycles of in vitro fertilization. Meta-analysis of the included randomized controlled trials showed no difference in the live birth rate or miscarriage rate between the ICSI and IMSI groups. Meta-analysis of five observational studies showed a significantly higher number of live births in the IMSI group than ICSI group (live birth rate odds ratio 1.47, 95% confidence interval 1.16-4.07), with a moderate degree of heterogeneity (I2 = 41%). Additionally, from six observational studies, a significantly lower miscarriage rate was observed in the IMSI group than in the ICSI group (odds ratio 0.51, 95% confidence interval 0.37-0.70, I2 = 0%). CONCLUSIONS Meta-analysis of randomized studies comparing IMSI to ICSI has not shown any difference in live birth rate and miscarriage rate. Meta-analysis of observational studies, which must be interpreted with caution, revealed an increased live birth rate and decreased miscarriage rate with IMSI vs ICSI.
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Affiliation(s)
| | - Guy Morris
- Center for Reproductive and Genetic Health, London, UK
| | | | - Matthew Gaunt
- Center for Reproductive and Genetic Health, London, UK
| | | | - Wael Saab
- Center for Reproductive and Genetic Health, London, UK
| | - Paul Serhal
- Center for Reproductive and Genetic Health, London, UK
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Viñals Gonzalez X, Odia R, Naja R, Serhal P, Saab W, Seshadri S, Ben-Nagi J. Euploid blastocysts implant irrespective of their morphology after NGS-(PGT-A) testing in advanced maternal age patients. J Assist Reprod Genet 2019; 36:1623-1629. [PMID: 31165389 DOI: 10.1007/s10815-019-01496-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [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: 01/30/2019] [Accepted: 05/24/2019] [Indexed: 11/29/2022] Open
Abstract
PURPOSE Does blastocyst morphology following euploid elective single embryo transfer (eSET) after preimplantation genetic testing for aneuploidies (PGT-A) via next generation sequencing impact clinical outcome? METHODS Two hundred ninety-six patients underwent PGT-A. Of 1549 blastocysts, 1410 blastocysts had a conclusive result after PGT-A and were included for analysis. An eSET policy was followed in a frozen embryo replacement cycle. A total of 179 euploid blastocysts were thawed and transferred. Clinical outcomes were categorized in four different embryo quality groups: excellent, good, average and poor. RESULTS Euploidy rate was 19/36 (52.7%, 95% CI 37-68), 199/470 (42.3%, 95% CI 38-47), 156/676 (23.0%, 95% CI 20-26) and 39/228 (17.1%, 95% CI 13-23) in the excellent, good, average and poor quality blastocyst groups, respectively. Fitted logistic regression analysis taking into account the following covariables: female, age, embryo chromosomal status and day of blastocyst development/biopsy showed that morphology was predictive of the comprehensive chromosome screening result (p < 0.05). A logistic regression analysis was also performed on clinical outcomes taking into account the effect of blastocyst morphology and day of blastocyst development/biopsy. None of the parameters were shown to be significant, suggesting morphology and day of blastocyst development/biopsy do not reduce the competence of euploid embryos (p > 0.05). CONCLUSIONS After eSET, implantation rate was 80-86%; live birth rate per embryo transfer was 60-73% and clinical miscarriage rate was found to be < 10% and were not significantly affected by the embryo morphology. Results are concordant with those reported when using aCGH and highlights the competence of poor-quality euploid embryos.
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Affiliation(s)
- X Viñals Gonzalez
- Embryology Department, The Centre For Reproductive and Genetic Health, 230-232 Great Portland St, London, W1W 5QS, UK.
| | - R Odia
- Embryology Department, The Centre For Reproductive and Genetic Health, 230-232 Great Portland St, London, W1W 5QS, UK
| | - R Naja
- IGENOMIX, 40 Occam Road, Guildford, Surrey, GU2 7YG, UK
| | - P Serhal
- Clinical Department, The Centre For Reproductive and Genetic Health, 230-232 Great Portland St, London, W1W 5QS, UK
| | - W Saab
- Clinical Department, The Centre For Reproductive and Genetic Health, 230-232 Great Portland St, London, W1W 5QS, UK
| | - S Seshadri
- Clinical Department, The Centre For Reproductive and Genetic Health, 230-232 Great Portland St, London, W1W 5QS, UK
| | - J Ben-Nagi
- Clinical Department, The Centre For Reproductive and Genetic Health, 230-232 Great Portland St, London, W1W 5QS, UK
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Verma S, Khambhala P, Joshi S, Kothari V, Patel T, Seshadri S. Evaluating the role of dithiolane rich fraction of Ferula asafoetida (apiaceae) for its antiproliferative and apoptotic properties: in vitro studies. Exp Oncol 2019; 41:90-94. [PMID: 31262162 DOI: 10.32471/exp-oncology.2312-8852.vol-41-no-2.12989] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
UNLABELLED Asafoetida resin has been reported for various biological activities but its use has been widely restricted owing to its pungent smell and pool water solubility. AIM In vitro study of the anticancer potential of microwave-extracted essential oil (EO) of Ferula asafoetida. MATERIALS AND METHODS The phytochemical investigation and in vitro cytotoxicity assessment was carried out in two human liver cancer cell lines. The expression of NFKB1, TGFB1, TNF, CASP3 was analyzed by reverse transcription polymerase chain reaction. RESULTS Ferula asafoetida EO contains high concentrations of dithiolane, which possess antiproliferative activity in human liver carcinoma cell lines (HepG2 and SK-Hep1) in a dose-dependent manner. The bioactive compounds in F. asafoetida are capable of induction of apoptosis and altered NF-kB and TGF-β signalling with increase in caspase-3 and TNF-α expression. CONCLUSION Further elucidation of bioactive molecules and underlying mechanisms could lead to potential intervention in liver cancer in animal models. The safety and efficacy as well as the mode of EO action in animal models would be highly crucial.
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Affiliation(s)
- S Verma
- Institute of Science, Nirma University, Ahmedabad 382481, India
| | - P Khambhala
- Institute of Science, Nirma University, Ahmedabad 382481, India
| | - S Joshi
- National Foods - The Hing Research Center, GIDC-Waghodia, Vadodara 391243, India
| | - V Kothari
- Institute of Science, Nirma University, Ahmedabad 382481, India
| | - T Patel
- Institute of Science, Nirma University, Ahmedabad 382481, India
| | - S Seshadri
- Institute of Science, Nirma University, Ahmedabad 382481, India
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Kamath MS, Bosteels J, D'Hooghe TM, Seshadri S, Weyers S, Mol BWJ, Broekmans FJ, Sunkara SK. Screening hysteroscopy in subfertile women and women undergoing assisted reproduction. Cochrane Database Syst Rev 2019; 4:CD012856. [PMID: 30991443 PMCID: PMC6472583 DOI: 10.1002/14651858.cd012856.pub2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Screening hysteroscopy in infertile women with unexplained infertility, or prior to intrauterine insemination (IUI) or in vitro fertilisation (IVF) may reveal intrauterine pathology that may not be detected by routine transvaginal ultrasound. Hysteroscopy, whether purely diagnostic or operative may improve reproductive outcomes. OBJECTIVES To assess the effectiveness and safety of screening hysteroscopy in subfertile women undergoing evaluation for infertility, and subfertile women undergoing IUI or IVF. SEARCH METHODS We searched the Cochrane Gynaecology and Fertility Group Specialised Register, CENTRAL CRSO, MEDLINE, Embase, ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry Platform (September 2018). We searched reference lists of relevant articles and handsearched relevant conference proceedings. SELECTION CRITERIA Randomised controlled trials comparing screening hysteroscopy versus no intervention in subfertile women wishing to conceive spontaneously, or before undergoing IUI or IVF. DATA COLLECTION AND ANALYSIS We independently screened studies, extracted data, and assessed the risk of bias. The primary outcomes were live birth rate and complications following hysteroscopy. We analysed data using risk ratio (RR) and a fixed-effect model. We assessed the quality of the evidence by using GRADE criteria. MAIN RESULTS We retrieved 11 studies. We included one trial that evaluated screening hysteroscopy versus no hysteroscopy, in women with unexplained subfertility, who were trying to conceive spontaneously. We are uncertain whether ongoing pregnancy rate improves following a screening hysteroscopy in women with at least two years of unexplained subfertility (RR 4.30, 95% CI 2.29 to 8.07; 1 RCT; participants = 200; very low-quality evidence). For a typical clinic with a 10% ongoing pregnancy rate without hysteroscopy, performing a screening hysteroscopy would be expected to result in ongoing pregnancy rates between 23% and 81%. The included study reported no adverse events in either treatment arm. We are uncertain whether clinical pregnancy rate is improved (RR 3.80, 95% CI 2.31 to 6.24; 1 RCT; participants = 200; very low-quality evidence), or miscarriage rate increases (RR 2.80, 95% CI 1.05 to 7.48; 1 RCT; participants = 200; very low-quality evidence), following screening hysteroscopy in women with at least two years of unexplained subfertility.We included ten trials that included 1836 women who had a screening hysteroscopy and 1914 women who had no hysteroscopy prior to IVF. Main limitations in the quality of evidence were inadequate reporting of study methods and higher statistical heterogeneity. Eight of the ten trials had unclear risk of bias for allocation concealment.Performing a screening hysteroscopy before IVF may increase live birth rate (RR 1.26, 95% CI 1.11 to 1.43; 6 RCTs; participants = 2745; I² = 69 %; low-quality evidence). For a typical clinic with a 22% live birth rate, performing a screening hysteroscopy would be expected to result in live birth rates between 25% and 32%. However, sensitivity analysis done by pooling results from trials at low risk of bias showed no increase in live birth rate following a screening hysteroscopy (RR 0.99, 95% CI 0.82 to 1.18; 2 RCTs; participants = 1452; I² = 0%).Only four trials reported complications following hysteroscopy; of these, three trials recorded no events in either group. We are uncertain whether a screening hysteroscopy is associated with higher adverse events (Peto odds ratio 7.47, 95% CI 0.15 to 376.42; 4 RCTs; participants = 1872; I² = not applicable; very low-quality evidence).Performing a screening hysteroscopy before IVF may increase clinical pregnancy rate (RR 1.32, 95% CI 1.20 to 1.45; 10 RCTs; participants = 3750; I² = 49%; low-quality evidence). For a typical clinic with a 28% clinical pregnancy rate, performing a screening hysteroscopy would be expected to result in clinical pregnancy rates between 33% and 40%.There may be little or no difference in miscarriage rate following screening hysteroscopy (RR 1.01, 95% CI 0.67 to 1.50; 3 RCTs; participants = 1669; I² = 0%; low-quality evidence).We found no trials that compared a screening hysteroscopy versus no hysteroscopy before IUI. AUTHORS' CONCLUSIONS At present, there is no high-quality evidence to support the routine use of hysteroscopy as a screening tool in the general population of subfertile women with a normal ultrasound or hysterosalpingogram in the basic fertility work-up for improving reproductive success rates.In women undergoing IVF, low-quality evidence, including all of the studies reporting these outcomes, suggests that performing a screening hysteroscopy before IVF may increase live birth and clinical pregnancy rates. However, pooled results from the only two trials with a low risk of bias did not show a benefit of screening hysteroscopy before IVF.Since the studies showing an effect are those with unclear allocation concealment, we are uncertain whether a routine screening hysteroscopy increases live birth and clinical pregnancy, be it for all women, or those with two or more failed IVF attempts. There is insufficient data to draw conclusions about the safety of screening hysteroscopy.
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Affiliation(s)
- Mohan S Kamath
- Christian Medical CollegeDepartment of Reproductive MedicineIda Scudder RoadVelloreTamil NaduIndia632004
| | - Jan Bosteels
- Cochrane BelgiumAcademic Centre for General PracticeKapucijnenvoer 33blok J bus 7001LeuvenBelgium3000
| | - Thomas M D'Hooghe
- University Hospital GasthuisbergLeuven University Fertility CentreHerestraat 49LeuvenBelgium3000
| | - Srividya Seshadri
- The Centre for Reproductive & Genetic Health256 Gray’s Inn RoadLondonUKWC1X 8LD
| | - Steven Weyers
- University Hospital GhentObstetrics and GynaecologyDe Pintelaan 185GhentBelgium
| | - Ben Willem J Mol
- Monash UniversityDepartment of Obstetrics and Gynaecology246 Clayton RoadClaytonVictoriaAustralia3168
| | - Frank J Broekmans
- University Medical CenterDepartment of Reproductive Medicine and GynecologyHeidelberglaan 100UtrechtNetherlands3584 CX
| | - Sesh Kamal Sunkara
- King's College LondonDivision of Women's Health, Faculty of Life Sciences & MedicineStrandLondonUKWC2R 2LS
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Seshadri S, Saab W, Serhal P. Time lapse imaging of embryos is useful in in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) treatment: FOR: Time-lapse monitoring of embryos. BJOG 2018; 126:287. [PMID: 30051957 DOI: 10.1111/1471-0528.15159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | - Wael Saab
- The Centre for Reproductive and Genetic Health (CRGH), London, UK
| | - Paul Serhal
- The Centre for Reproductive and Genetic Health (CRGH), London, UK
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Ravichandran P, Sugumaran P, Seshadri S, Basta AH. Optimizing the route for production of activated carbon from Casuarina equisetifolia fruit waste. R Soc Open Sci 2018; 5:171578. [PMID: 30109042 PMCID: PMC6083678 DOI: 10.1098/rsos.171578] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 06/07/2018] [Indexed: 05/06/2023]
Abstract
This work deals with optimizing the conditions of pyrolysis and type of activator to upgrade the use of Casuarina equisetifolia fruit waste (CFW) as available and a potential precursor, in production of activated carbon (AC). In this respect, the route of activation was carried out through one- and two-step pyrolysis processes, using different chemical activating agents, such as H3PO4, KOH and ZnCl2. The performance of the CFW-based ACs is assessed by estimating the physico-chemical characteristics (pH, electrical conductivity, bulk density and hardness), surface morphology and scanning electron microscopy, together with carbon yield, surface area and adsorption performance of pollutants in aqueous medium (methylene blue, iodine and molasses colour removal efficiencies). The results show that the two-step activation process was more effective than one-step activation for providing high adsorption performance CFW-based ACs. The maximum Brunauer-Emmett-Teller surface area 547.89 m2 g-1 was produced by using H3PO4 activating agents, and applied two-step pyrolysis. According to the American Water Work Association and based on bulk density of the investigated ACs, we recommend that most of produced ACs are suitable for treating waste water.
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Affiliation(s)
- P. Ravichandran
- Shri AMM Murugappa Chettiar Research Centre (MCRC), Taramani, Chennai 600 113, Tamil Nadu, India
- Authors for correspondence: P. Ravichandran E-mail:
| | - P. Sugumaran
- Shri AMM Murugappa Chettiar Research Centre (MCRC), Taramani, Chennai 600 113, Tamil Nadu, India
| | - S. Seshadri
- Shri AMM Murugappa Chettiar Research Centre (MCRC), Taramani, Chennai 600 113, Tamil Nadu, India
| | - Altaf H. Basta
- National Research Centre, Cellulose and Paper Department, El-Bohousse Street, Dokki 12622, Cairo, Egypt
- Authors for correspondence: Altaf H. Basta e-mail:
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Seshadri S, Saab W, Exeter H, Drew E, Petrie A, Davies M, Serhal P. Clinical outcomes of a vitrified donor oocyte programme: A single UK centre experience. Eur J Obstet Gynecol Reprod Biol 2018; 225:136-140. [PMID: 29709727 DOI: 10.1016/j.ejogrb.2018.04.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Accepted: 04/10/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To assess the survival rate of vitrified oocytes used in an egg recipient programme and compare the clinical outcomes of pregnancy and live-birth rates per warmed oocyte with fresh autologous oocytes. The differences in the obstetrical outcomes between the two groups were also studied. DESIGN A prospective case control study from a single in-vitro fertilisaton (IVF) Centre in UK SETTING: Centre of Reproductive and Genetic Health (CRGH), London POPULATION: Vitrified oocytes from egg donors and autologous fresh oocytes from patients attending for an IVF cycle METHODS: The study group consisted of 1490 vitrified oocytes, which were obtained from 145 egg donors who underwent a stimulation cycle at CRGH Centre. The control group included 145 age-matched women who underwent intra cytoplasmic sperm injection (ICSI) treatment with their own oocytes (n = 1528). The clinical outcomes clinical pregnancy rates (CPR) and live-birth rates (LBR) and obstetrical outcomes (gestational age and weight at delivery) were compared between the two groups. Statistical analysis of the summary data and logistic regression analysis was performed using statistical packages (SPSS Version 23 and Stata 2015). The percentages of all parameters in the cases and control groups were compared by Fisher's exact test. A statistical significance level of 5% was adopted throughout the study. MAIN OUTCOME MEASURES Survival rate per thawed oocyte, clinical pregnancy rate and live-birth rate per embryo transfer was compared to the autologous oocyte group RESULTS: The survival rate of vitrified oocytes was 73.6% (95% CI: 71.3-75.8%). The clinical pregnancy rate (per embryo transfer) using vitrified oocytes was found to be 51.8% compared to 59.3% in the control group. The live birth rate per embryo transfer in the vitrified oocyte group was 46% (95% CI 37.4-54.7%) compared to 57.1% (95% CI 48.5-68.5%) in the control group. The live-birth rate per thawed oocyte was found to be 4.2%. The gestational ages of the fetus at delivery in both the groups were comparable 39.0 (95% CI 32.7-41.9%) and 39.1 (95% CI 25.6-42.0) (p = 0.38). There was no statistically significant difference in the birth weight between the study and the control group 3100 g (750-4337) and 3232 g (1616-4500) respectively (p = 0.28). CONCLUSIONS This is the first study reporting on the efficacy of a vitrified donor oocyte programme from within the UK. There were no significant differences in the obstetrical outcomes between vitrified donor oocytes and autologous oocytes. The above data will be encouraging for women who are undertaking egg freezing for medical and or social reasons.
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Affiliation(s)
- S Seshadri
- The Centre for Reproductive & Genetic Health, 230-232 Great Portland Street, London, W1W 5QS, UK.
| | - W Saab
- The Centre for Reproductive & Genetic Health, 230-232 Great Portland Street, London, W1W 5QS, UK
| | - H Exeter
- The Centre for Reproductive & Genetic Health, 230-232 Great Portland Street, London, W1W 5QS, UK
| | - E Drew
- The Centre for Reproductive & Genetic Health, 230-232 Great Portland Street, London, W1W 5QS, UK
| | - A Petrie
- The Centre for Reproductive & Genetic Health, 230-232 Great Portland Street, London, W1W 5QS, UK; Biostatistics Unit, UCL Eastman Dental Institute, 256 Grays Inn Road, London, UK
| | - M Davies
- Department of Women's Health, University College London Hospitals, London, UK
| | - P Serhal
- The Centre for Reproductive & Genetic Health, 230-232 Great Portland Street, London, W1W 5QS, UK
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Olson NC, Raffield LM, Lange LA, Lange EM, Longstreth WT, Chauhan G, Debette S, Seshadri S, Reiner AP, Tracy RP. Associations of activated coagulation factor VII and factor VIIa-antithrombin levels with genome-wide polymorphisms and cardiovascular disease risk. J Thromb Haemost 2018; 16:19-30. [PMID: 29112333 PMCID: PMC5760305 DOI: 10.1111/jth.13899] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [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: 05/22/2017] [Indexed: 11/26/2022]
Abstract
ESSENTIALS Essentials A fraction of coagulation factor VII circulates in blood as an activated protease (FVIIa). We evaluated FVIIa and FVIIa-antithrombin (FVIIa-AT) levels in the Cardiovascular Health Study. Polymorphisms in the F7 and PROCR loci were associated with FVIIa and FVIIa-AT levels. FVIIa may be an ischemic stroke risk factor in older adults and FVIIa-AT may assess mortality risk. SUMMARY Background A fraction of coagulation factor (F) VII circulates as an active protease (FVIIa). FVIIa also circulates as an inactivated complex with antithrombin (FVIIa-AT). Objective Evaluate associations of FVIIa and FVIIa-AT with genome-wide single nucleotide polymorphisms (SNPs) and incident coronary heart disease, ischemic stroke and mortality. Patients/Methods We measured FVIIa and FVIIa-AT in 3486 Cardiovascular Health Study (CHS) participants. We performed a genome-wide association scan for FVIIa and FVIIa-AT in European-Americans (n = 2410) and examined associations of FVII phenotypes with incident cardiovascular disease. Results In European-Americans, the most significant SNP for FVIIa and FVIIa-AT was rs1755685 in the F7 promoter region on chromosome 13 (FVIIa, β = -25.9 mU mL-1 per minor allele; FVIIa-AT, β = -26.6 pm per minor allele). Phenotypes were also associated with rs867186 located in PROCR on chromosome 20 (FVIIa, β = 7.8 mU mL-1 per minor allele; FVIIa-AT, β = 9.9 per minor allele). Adjusted for risk factors, a one standard deviation higher FVIIa was associated with increased risk of ischemic stroke (hazard ratio [HR], 1.12; 95% confidence interval [CI], 1.01, 1.23). Higher FVIIa-AT was associated with mortality from all causes (HR, 1.08; 95% CI, 1.03, 1.12). Among European-American CHS participants the rs1755685 minor allele was associated with lower ischemic stroke (HR, 0.69; 95% CI, 0.54, 0.88), but this association was not replicated in a larger multi-cohort analysis. Conclusions The results support the importance of the F7 and PROCR loci in variation in circulating FVIIa and FVIIa-AT. The findings suggest FVIIa is a risk factor for ischemic stroke in older adults, whereas higher FVIIa-AT may reflect mortality risk.
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Affiliation(s)
- N C Olson
- Department of Pathology and Laboratory Medicine, Robert Larner, M.D. College of Medicine, University of Vermont, Burlington, VT, USA
- Cardiovascular Research Institute of Vermont, Robert Larner, M.D. College of Medicine, University of Vermont, Burlington, VT, USA
| | - L M Raffield
- Department of Genetics, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - L A Lange
- Division of Biomedical Informatics and Personalized Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - E M Lange
- Division of Biomedical Informatics and Personalized Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - W T Longstreth
- Department of Neurology, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - G Chauhan
- INSERM U1219 Neuroepidemiology, Bordeaux, France
- University of Bordeaux, Bordeaux, France
- Centre for Brain Research, Indian Institute of Science, Bangalore, India
| | - S Debette
- INSERM U1219 Neuroepidemiology, Bordeaux, France
- University of Bordeaux, Bordeaux, France
- Department of Neurology, Bordeaux University Hospital, Bordeaux, France
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- National Heart, Lung, and Blood Institute Framingham Heart Study, Framingham, MA, USA
| | - S Seshadri
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- National Heart, Lung, and Blood Institute Framingham Heart Study, Framingham, MA, USA
| | - A P Reiner
- Department of Neurology, Bordeaux University Hospital, Bordeaux, France
| | - R P Tracy
- Department of Pathology and Laboratory Medicine, Robert Larner, M.D. College of Medicine, University of Vermont, Burlington, VT, USA
- Cardiovascular Research Institute of Vermont, Robert Larner, M.D. College of Medicine, University of Vermont, Burlington, VT, USA
- Department of Biochemistry, Robert Larner, M.D. College of Medicine, University of Vermont, Burlington, VT, USA
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Beecham GW, Bis JC, Martin ER, Choi SH, DeStefano AL, van Duijn CM, Fornage M, Gabriel SB, Koboldt DC, Larson DE, Naj AC, Psaty BM, Salerno W, Bush WS, Foroud TM, Wijsman E, Farrer LA, Goate A, Haines JL, Pericak-Vance MA, Boerwinkle E, Mayeux R, Seshadri S, Schellenberg G. The Alzheimer's Disease Sequencing Project: Study design and sample selection. Neurol Genet 2017; 3:e194. [PMID: 29184913 PMCID: PMC5646177 DOI: 10.1212/nxg.0000000000000194] [Citation(s) in RCA: 108] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 08/17/2017] [Indexed: 11/25/2022]
Affiliation(s)
- Gary W Beecham
- John P. Hussman Institute for Human Genomics (G.W.B., E.R.M., M.A.P.-V.) and Dr. John T. Macdonald Foundation Department of Human Genetics (G.W.B., E.R.M., M.A.P.-V.), Miller School of Medicine, University of Miami, FL; Cardiovascular Health Research Unit (J.C.B.), Department of Medicine, Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, Health Services, Department of Biostatistics (E.W.), and Division of Medical Genetics (E.W.), Department of Medicine, University of Washington, Seattle; Department of Biostatistics (S.-H.C., A.D., L.A.F.), Boston University School of Public Health, MA; The Framingham Heart Study (A.D., S.S.), MA; Department of Neurology (A.D., L.A.F., S.S.), Boston University School of Medicine, MA; Department of Epidemiology (C.M.v.D), Erasmus MC, Rotterdam, Netherlands; Brown Foundation Institute of Molecular Medicine (M.F.) and Human Genetics Center (M.F.), University of Texas Health Science Center, Houston; The Eli and Edythe L. Broad Institute of Massachusetts Institute of Technology (S.B.G.), Cambridge; Harvard University (S.B.G.), Cambridge, MA; The McDonnell Genome Institute (D.C.K., D.E.L.) and Department of Genetics (D.E.L.), Washington University, St. Louis, MO; Department of Biostatistics and Epidemiology (A.C.N.) and Perelman School of Medicine (G.S.), University of Pennsylvania, Philadelphia; Group Health Research Institute (B.M.P.), Group Health Cooperative, Seattle, WA; Human Genome Sequencing Center (W.S., E.B.), Baylor College of Medicine, Houston, TX; Department of Epidemiology and Biostatistics (W.S.B., J.L.H.), Case Western Reserve University, Cleveland, OH; Department of Medical and Molecular Genetics (T.M.F.), Indiana University School of Medicine, Indianapolis; Department of Medicine (Biomedical Genetics) (L.A.F.), Department of Ophthalmology (L.A.F.), and Department of Epidemiology (L.A.F.), Boston University School of Medicine and Public Health, MA; Department of Neuroscience (A.G.), Icahn School of Medicine at Mount Sinai, New York, NY; Human Genetics Center (E.B.), UT Health School of Public Health, Houston, TX; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (R.M.) and Gertrude H. Sergievsky Center (R.M.), Columbia University Medical Center, New York, NY; Department of Neurology (R.M.), Columbia University Medical Center and New York Presbyterian Hospital, NY; and Department of Epidemiology (R.M.), Mailman School of Public Health, Columbia University, New York, NY
| | - J C Bis
- John P. Hussman Institute for Human Genomics (G.W.B., E.R.M., M.A.P.-V.) and Dr. John T. Macdonald Foundation Department of Human Genetics (G.W.B., E.R.M., M.A.P.-V.), Miller School of Medicine, University of Miami, FL; Cardiovascular Health Research Unit (J.C.B.), Department of Medicine, Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, Health Services, Department of Biostatistics (E.W.), and Division of Medical Genetics (E.W.), Department of Medicine, University of Washington, Seattle; Department of Biostatistics (S.-H.C., A.D., L.A.F.), Boston University School of Public Health, MA; The Framingham Heart Study (A.D., S.S.), MA; Department of Neurology (A.D., L.A.F., S.S.), Boston University School of Medicine, MA; Department of Epidemiology (C.M.v.D), Erasmus MC, Rotterdam, Netherlands; Brown Foundation Institute of Molecular Medicine (M.F.) and Human Genetics Center (M.F.), University of Texas Health Science Center, Houston; The Eli and Edythe L. Broad Institute of Massachusetts Institute of Technology (S.B.G.), Cambridge; Harvard University (S.B.G.), Cambridge, MA; The McDonnell Genome Institute (D.C.K., D.E.L.) and Department of Genetics (D.E.L.), Washington University, St. Louis, MO; Department of Biostatistics and Epidemiology (A.C.N.) and Perelman School of Medicine (G.S.), University of Pennsylvania, Philadelphia; Group Health Research Institute (B.M.P.), Group Health Cooperative, Seattle, WA; Human Genome Sequencing Center (W.S., E.B.), Baylor College of Medicine, Houston, TX; Department of Epidemiology and Biostatistics (W.S.B., J.L.H.), Case Western Reserve University, Cleveland, OH; Department of Medical and Molecular Genetics (T.M.F.), Indiana University School of Medicine, Indianapolis; Department of Medicine (Biomedical Genetics) (L.A.F.), Department of Ophthalmology (L.A.F.), and Department of Epidemiology (L.A.F.), Boston University School of Medicine and Public Health, MA; Department of Neuroscience (A.G.), Icahn School of Medicine at Mount Sinai, New York, NY; Human Genetics Center (E.B.), UT Health School of Public Health, Houston, TX; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (R.M.) and Gertrude H. Sergievsky Center (R.M.), Columbia University Medical Center, New York, NY; Department of Neurology (R.M.), Columbia University Medical Center and New York Presbyterian Hospital, NY; and Department of Epidemiology (R.M.), Mailman School of Public Health, Columbia University, New York, NY
| | - E R Martin
- John P. Hussman Institute for Human Genomics (G.W.B., E.R.M., M.A.P.-V.) and Dr. John T. Macdonald Foundation Department of Human Genetics (G.W.B., E.R.M., M.A.P.-V.), Miller School of Medicine, University of Miami, FL; Cardiovascular Health Research Unit (J.C.B.), Department of Medicine, Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, Health Services, Department of Biostatistics (E.W.), and Division of Medical Genetics (E.W.), Department of Medicine, University of Washington, Seattle; Department of Biostatistics (S.-H.C., A.D., L.A.F.), Boston University School of Public Health, MA; The Framingham Heart Study (A.D., S.S.), MA; Department of Neurology (A.D., L.A.F., S.S.), Boston University School of Medicine, MA; Department of Epidemiology (C.M.v.D), Erasmus MC, Rotterdam, Netherlands; Brown Foundation Institute of Molecular Medicine (M.F.) and Human Genetics Center (M.F.), University of Texas Health Science Center, Houston; The Eli and Edythe L. Broad Institute of Massachusetts Institute of Technology (S.B.G.), Cambridge; Harvard University (S.B.G.), Cambridge, MA; The McDonnell Genome Institute (D.C.K., D.E.L.) and Department of Genetics (D.E.L.), Washington University, St. Louis, MO; Department of Biostatistics and Epidemiology (A.C.N.) and Perelman School of Medicine (G.S.), University of Pennsylvania, Philadelphia; Group Health Research Institute (B.M.P.), Group Health Cooperative, Seattle, WA; Human Genome Sequencing Center (W.S., E.B.), Baylor College of Medicine, Houston, TX; Department of Epidemiology and Biostatistics (W.S.B., J.L.H.), Case Western Reserve University, Cleveland, OH; Department of Medical and Molecular Genetics (T.M.F.), Indiana University School of Medicine, Indianapolis; Department of Medicine (Biomedical Genetics) (L.A.F.), Department of Ophthalmology (L.A.F.), and Department of Epidemiology (L.A.F.), Boston University School of Medicine and Public Health, MA; Department of Neuroscience (A.G.), Icahn School of Medicine at Mount Sinai, New York, NY; Human Genetics Center (E.B.), UT Health School of Public Health, Houston, TX; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (R.M.) and Gertrude H. Sergievsky Center (R.M.), Columbia University Medical Center, New York, NY; Department of Neurology (R.M.), Columbia University Medical Center and New York Presbyterian Hospital, NY; and Department of Epidemiology (R.M.), Mailman School of Public Health, Columbia University, New York, NY
| | - S-H Choi
- John P. Hussman Institute for Human Genomics (G.W.B., E.R.M., M.A.P.-V.) and Dr. John T. Macdonald Foundation Department of Human Genetics (G.W.B., E.R.M., M.A.P.-V.), Miller School of Medicine, University of Miami, FL; Cardiovascular Health Research Unit (J.C.B.), Department of Medicine, Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, Health Services, Department of Biostatistics (E.W.), and Division of Medical Genetics (E.W.), Department of Medicine, University of Washington, Seattle; Department of Biostatistics (S.-H.C., A.D., L.A.F.), Boston University School of Public Health, MA; The Framingham Heart Study (A.D., S.S.), MA; Department of Neurology (A.D., L.A.F., S.S.), Boston University School of Medicine, MA; Department of Epidemiology (C.M.v.D), Erasmus MC, Rotterdam, Netherlands; Brown Foundation Institute of Molecular Medicine (M.F.) and Human Genetics Center (M.F.), University of Texas Health Science Center, Houston; The Eli and Edythe L. Broad Institute of Massachusetts Institute of Technology (S.B.G.), Cambridge; Harvard University (S.B.G.), Cambridge, MA; The McDonnell Genome Institute (D.C.K., D.E.L.) and Department of Genetics (D.E.L.), Washington University, St. Louis, MO; Department of Biostatistics and Epidemiology (A.C.N.) and Perelman School of Medicine (G.S.), University of Pennsylvania, Philadelphia; Group Health Research Institute (B.M.P.), Group Health Cooperative, Seattle, WA; Human Genome Sequencing Center (W.S., E.B.), Baylor College of Medicine, Houston, TX; Department of Epidemiology and Biostatistics (W.S.B., J.L.H.), Case Western Reserve University, Cleveland, OH; Department of Medical and Molecular Genetics (T.M.F.), Indiana University School of Medicine, Indianapolis; Department of Medicine (Biomedical Genetics) (L.A.F.), Department of Ophthalmology (L.A.F.), and Department of Epidemiology (L.A.F.), Boston University School of Medicine and Public Health, MA; Department of Neuroscience (A.G.), Icahn School of Medicine at Mount Sinai, New York, NY; Human Genetics Center (E.B.), UT Health School of Public Health, Houston, TX; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (R.M.) and Gertrude H. Sergievsky Center (R.M.), Columbia University Medical Center, New York, NY; Department of Neurology (R.M.), Columbia University Medical Center and New York Presbyterian Hospital, NY; and Department of Epidemiology (R.M.), Mailman School of Public Health, Columbia University, New York, NY
| | - A L DeStefano
- John P. Hussman Institute for Human Genomics (G.W.B., E.R.M., M.A.P.-V.) and Dr. John T. Macdonald Foundation Department of Human Genetics (G.W.B., E.R.M., M.A.P.-V.), Miller School of Medicine, University of Miami, FL; Cardiovascular Health Research Unit (J.C.B.), Department of Medicine, Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, Health Services, Department of Biostatistics (E.W.), and Division of Medical Genetics (E.W.), Department of Medicine, University of Washington, Seattle; Department of Biostatistics (S.-H.C., A.D., L.A.F.), Boston University School of Public Health, MA; The Framingham Heart Study (A.D., S.S.), MA; Department of Neurology (A.D., L.A.F., S.S.), Boston University School of Medicine, MA; Department of Epidemiology (C.M.v.D), Erasmus MC, Rotterdam, Netherlands; Brown Foundation Institute of Molecular Medicine (M.F.) and Human Genetics Center (M.F.), University of Texas Health Science Center, Houston; The Eli and Edythe L. Broad Institute of Massachusetts Institute of Technology (S.B.G.), Cambridge; Harvard University (S.B.G.), Cambridge, MA; The McDonnell Genome Institute (D.C.K., D.E.L.) and Department of Genetics (D.E.L.), Washington University, St. Louis, MO; Department of Biostatistics and Epidemiology (A.C.N.) and Perelman School of Medicine (G.S.), University of Pennsylvania, Philadelphia; Group Health Research Institute (B.M.P.), Group Health Cooperative, Seattle, WA; Human Genome Sequencing Center (W.S., E.B.), Baylor College of Medicine, Houston, TX; Department of Epidemiology and Biostatistics (W.S.B., J.L.H.), Case Western Reserve University, Cleveland, OH; Department of Medical and Molecular Genetics (T.M.F.), Indiana University School of Medicine, Indianapolis; Department of Medicine (Biomedical Genetics) (L.A.F.), Department of Ophthalmology (L.A.F.), and Department of Epidemiology (L.A.F.), Boston University School of Medicine and Public Health, MA; Department of Neuroscience (A.G.), Icahn School of Medicine at Mount Sinai, New York, NY; Human Genetics Center (E.B.), UT Health School of Public Health, Houston, TX; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (R.M.) and Gertrude H. Sergievsky Center (R.M.), Columbia University Medical Center, New York, NY; Department of Neurology (R.M.), Columbia University Medical Center and New York Presbyterian Hospital, NY; and Department of Epidemiology (R.M.), Mailman School of Public Health, Columbia University, New York, NY
| | - C M van Duijn
- John P. Hussman Institute for Human Genomics (G.W.B., E.R.M., M.A.P.-V.) and Dr. John T. Macdonald Foundation Department of Human Genetics (G.W.B., E.R.M., M.A.P.-V.), Miller School of Medicine, University of Miami, FL; Cardiovascular Health Research Unit (J.C.B.), Department of Medicine, Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, Health Services, Department of Biostatistics (E.W.), and Division of Medical Genetics (E.W.), Department of Medicine, University of Washington, Seattle; Department of Biostatistics (S.-H.C., A.D., L.A.F.), Boston University School of Public Health, MA; The Framingham Heart Study (A.D., S.S.), MA; Department of Neurology (A.D., L.A.F., S.S.), Boston University School of Medicine, MA; Department of Epidemiology (C.M.v.D), Erasmus MC, Rotterdam, Netherlands; Brown Foundation Institute of Molecular Medicine (M.F.) and Human Genetics Center (M.F.), University of Texas Health Science Center, Houston; The Eli and Edythe L. Broad Institute of Massachusetts Institute of Technology (S.B.G.), Cambridge; Harvard University (S.B.G.), Cambridge, MA; The McDonnell Genome Institute (D.C.K., D.E.L.) and Department of Genetics (D.E.L.), Washington University, St. Louis, MO; Department of Biostatistics and Epidemiology (A.C.N.) and Perelman School of Medicine (G.S.), University of Pennsylvania, Philadelphia; Group Health Research Institute (B.M.P.), Group Health Cooperative, Seattle, WA; Human Genome Sequencing Center (W.S., E.B.), Baylor College of Medicine, Houston, TX; Department of Epidemiology and Biostatistics (W.S.B., J.L.H.), Case Western Reserve University, Cleveland, OH; Department of Medical and Molecular Genetics (T.M.F.), Indiana University School of Medicine, Indianapolis; Department of Medicine (Biomedical Genetics) (L.A.F.), Department of Ophthalmology (L.A.F.), and Department of Epidemiology (L.A.F.), Boston University School of Medicine and Public Health, MA; Department of Neuroscience (A.G.), Icahn School of Medicine at Mount Sinai, New York, NY; Human Genetics Center (E.B.), UT Health School of Public Health, Houston, TX; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (R.M.) and Gertrude H. Sergievsky Center (R.M.), Columbia University Medical Center, New York, NY; Department of Neurology (R.M.), Columbia University Medical Center and New York Presbyterian Hospital, NY; and Department of Epidemiology (R.M.), Mailman School of Public Health, Columbia University, New York, NY
| | - M Fornage
- John P. Hussman Institute for Human Genomics (G.W.B., E.R.M., M.A.P.-V.) and Dr. John T. Macdonald Foundation Department of Human Genetics (G.W.B., E.R.M., M.A.P.-V.), Miller School of Medicine, University of Miami, FL; Cardiovascular Health Research Unit (J.C.B.), Department of Medicine, Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, Health Services, Department of Biostatistics (E.W.), and Division of Medical Genetics (E.W.), Department of Medicine, University of Washington, Seattle; Department of Biostatistics (S.-H.C., A.D., L.A.F.), Boston University School of Public Health, MA; The Framingham Heart Study (A.D., S.S.), MA; Department of Neurology (A.D., L.A.F., S.S.), Boston University School of Medicine, MA; Department of Epidemiology (C.M.v.D), Erasmus MC, Rotterdam, Netherlands; Brown Foundation Institute of Molecular Medicine (M.F.) and Human Genetics Center (M.F.), University of Texas Health Science Center, Houston; The Eli and Edythe L. Broad Institute of Massachusetts Institute of Technology (S.B.G.), Cambridge; Harvard University (S.B.G.), Cambridge, MA; The McDonnell Genome Institute (D.C.K., D.E.L.) and Department of Genetics (D.E.L.), Washington University, St. Louis, MO; Department of Biostatistics and Epidemiology (A.C.N.) and Perelman School of Medicine (G.S.), University of Pennsylvania, Philadelphia; Group Health Research Institute (B.M.P.), Group Health Cooperative, Seattle, WA; Human Genome Sequencing Center (W.S., E.B.), Baylor College of Medicine, Houston, TX; Department of Epidemiology and Biostatistics (W.S.B., J.L.H.), Case Western Reserve University, Cleveland, OH; Department of Medical and Molecular Genetics (T.M.F.), Indiana University School of Medicine, Indianapolis; Department of Medicine (Biomedical Genetics) (L.A.F.), Department of Ophthalmology (L.A.F.), and Department of Epidemiology (L.A.F.), Boston University School of Medicine and Public Health, MA; Department of Neuroscience (A.G.), Icahn School of Medicine at Mount Sinai, New York, NY; Human Genetics Center (E.B.), UT Health School of Public Health, Houston, TX; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (R.M.) and Gertrude H. Sergievsky Center (R.M.), Columbia University Medical Center, New York, NY; Department of Neurology (R.M.), Columbia University Medical Center and New York Presbyterian Hospital, NY; and Department of Epidemiology (R.M.), Mailman School of Public Health, Columbia University, New York, NY
| | - S B Gabriel
- John P. Hussman Institute for Human Genomics (G.W.B., E.R.M., M.A.P.-V.) and Dr. John T. Macdonald Foundation Department of Human Genetics (G.W.B., E.R.M., M.A.P.-V.), Miller School of Medicine, University of Miami, FL; Cardiovascular Health Research Unit (J.C.B.), Department of Medicine, Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, Health Services, Department of Biostatistics (E.W.), and Division of Medical Genetics (E.W.), Department of Medicine, University of Washington, Seattle; Department of Biostatistics (S.-H.C., A.D., L.A.F.), Boston University School of Public Health, MA; The Framingham Heart Study (A.D., S.S.), MA; Department of Neurology (A.D., L.A.F., S.S.), Boston University School of Medicine, MA; Department of Epidemiology (C.M.v.D), Erasmus MC, Rotterdam, Netherlands; Brown Foundation Institute of Molecular Medicine (M.F.) and Human Genetics Center (M.F.), University of Texas Health Science Center, Houston; The Eli and Edythe L. Broad Institute of Massachusetts Institute of Technology (S.B.G.), Cambridge; Harvard University (S.B.G.), Cambridge, MA; The McDonnell Genome Institute (D.C.K., D.E.L.) and Department of Genetics (D.E.L.), Washington University, St. Louis, MO; Department of Biostatistics and Epidemiology (A.C.N.) and Perelman School of Medicine (G.S.), University of Pennsylvania, Philadelphia; Group Health Research Institute (B.M.P.), Group Health Cooperative, Seattle, WA; Human Genome Sequencing Center (W.S., E.B.), Baylor College of Medicine, Houston, TX; Department of Epidemiology and Biostatistics (W.S.B., J.L.H.), Case Western Reserve University, Cleveland, OH; Department of Medical and Molecular Genetics (T.M.F.), Indiana University School of Medicine, Indianapolis; Department of Medicine (Biomedical Genetics) (L.A.F.), Department of Ophthalmology (L.A.F.), and Department of Epidemiology (L.A.F.), Boston University School of Medicine and Public Health, MA; Department of Neuroscience (A.G.), Icahn School of Medicine at Mount Sinai, New York, NY; Human Genetics Center (E.B.), UT Health School of Public Health, Houston, TX; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (R.M.) and Gertrude H. Sergievsky Center (R.M.), Columbia University Medical Center, New York, NY; Department of Neurology (R.M.), Columbia University Medical Center and New York Presbyterian Hospital, NY; and Department of Epidemiology (R.M.), Mailman School of Public Health, Columbia University, New York, NY
| | - D C Koboldt
- John P. Hussman Institute for Human Genomics (G.W.B., E.R.M., M.A.P.-V.) and Dr. John T. Macdonald Foundation Department of Human Genetics (G.W.B., E.R.M., M.A.P.-V.), Miller School of Medicine, University of Miami, FL; Cardiovascular Health Research Unit (J.C.B.), Department of Medicine, Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, Health Services, Department of Biostatistics (E.W.), and Division of Medical Genetics (E.W.), Department of Medicine, University of Washington, Seattle; Department of Biostatistics (S.-H.C., A.D., L.A.F.), Boston University School of Public Health, MA; The Framingham Heart Study (A.D., S.S.), MA; Department of Neurology (A.D., L.A.F., S.S.), Boston University School of Medicine, MA; Department of Epidemiology (C.M.v.D), Erasmus MC, Rotterdam, Netherlands; Brown Foundation Institute of Molecular Medicine (M.F.) and Human Genetics Center (M.F.), University of Texas Health Science Center, Houston; The Eli and Edythe L. Broad Institute of Massachusetts Institute of Technology (S.B.G.), Cambridge; Harvard University (S.B.G.), Cambridge, MA; The McDonnell Genome Institute (D.C.K., D.E.L.) and Department of Genetics (D.E.L.), Washington University, St. Louis, MO; Department of Biostatistics and Epidemiology (A.C.N.) and Perelman School of Medicine (G.S.), University of Pennsylvania, Philadelphia; Group Health Research Institute (B.M.P.), Group Health Cooperative, Seattle, WA; Human Genome Sequencing Center (W.S., E.B.), Baylor College of Medicine, Houston, TX; Department of Epidemiology and Biostatistics (W.S.B., J.L.H.), Case Western Reserve University, Cleveland, OH; Department of Medical and Molecular Genetics (T.M.F.), Indiana University School of Medicine, Indianapolis; Department of Medicine (Biomedical Genetics) (L.A.F.), Department of Ophthalmology (L.A.F.), and Department of Epidemiology (L.A.F.), Boston University School of Medicine and Public Health, MA; Department of Neuroscience (A.G.), Icahn School of Medicine at Mount Sinai, New York, NY; Human Genetics Center (E.B.), UT Health School of Public Health, Houston, TX; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (R.M.) and Gertrude H. Sergievsky Center (R.M.), Columbia University Medical Center, New York, NY; Department of Neurology (R.M.), Columbia University Medical Center and New York Presbyterian Hospital, NY; and Department of Epidemiology (R.M.), Mailman School of Public Health, Columbia University, New York, NY
| | - D E Larson
- John P. Hussman Institute for Human Genomics (G.W.B., E.R.M., M.A.P.-V.) and Dr. John T. Macdonald Foundation Department of Human Genetics (G.W.B., E.R.M., M.A.P.-V.), Miller School of Medicine, University of Miami, FL; Cardiovascular Health Research Unit (J.C.B.), Department of Medicine, Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, Health Services, Department of Biostatistics (E.W.), and Division of Medical Genetics (E.W.), Department of Medicine, University of Washington, Seattle; Department of Biostatistics (S.-H.C., A.D., L.A.F.), Boston University School of Public Health, MA; The Framingham Heart Study (A.D., S.S.), MA; Department of Neurology (A.D., L.A.F., S.S.), Boston University School of Medicine, MA; Department of Epidemiology (C.M.v.D), Erasmus MC, Rotterdam, Netherlands; Brown Foundation Institute of Molecular Medicine (M.F.) and Human Genetics Center (M.F.), University of Texas Health Science Center, Houston; The Eli and Edythe L. Broad Institute of Massachusetts Institute of Technology (S.B.G.), Cambridge; Harvard University (S.B.G.), Cambridge, MA; The McDonnell Genome Institute (D.C.K., D.E.L.) and Department of Genetics (D.E.L.), Washington University, St. Louis, MO; Department of Biostatistics and Epidemiology (A.C.N.) and Perelman School of Medicine (G.S.), University of Pennsylvania, Philadelphia; Group Health Research Institute (B.M.P.), Group Health Cooperative, Seattle, WA; Human Genome Sequencing Center (W.S., E.B.), Baylor College of Medicine, Houston, TX; Department of Epidemiology and Biostatistics (W.S.B., J.L.H.), Case Western Reserve University, Cleveland, OH; Department of Medical and Molecular Genetics (T.M.F.), Indiana University School of Medicine, Indianapolis; Department of Medicine (Biomedical Genetics) (L.A.F.), Department of Ophthalmology (L.A.F.), and Department of Epidemiology (L.A.F.), Boston University School of Medicine and Public Health, MA; Department of Neuroscience (A.G.), Icahn School of Medicine at Mount Sinai, New York, NY; Human Genetics Center (E.B.), UT Health School of Public Health, Houston, TX; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (R.M.) and Gertrude H. Sergievsky Center (R.M.), Columbia University Medical Center, New York, NY; Department of Neurology (R.M.), Columbia University Medical Center and New York Presbyterian Hospital, NY; and Department of Epidemiology (R.M.), Mailman School of Public Health, Columbia University, New York, NY
| | - A C Naj
- John P. Hussman Institute for Human Genomics (G.W.B., E.R.M., M.A.P.-V.) and Dr. John T. Macdonald Foundation Department of Human Genetics (G.W.B., E.R.M., M.A.P.-V.), Miller School of Medicine, University of Miami, FL; Cardiovascular Health Research Unit (J.C.B.), Department of Medicine, Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, Health Services, Department of Biostatistics (E.W.), and Division of Medical Genetics (E.W.), Department of Medicine, University of Washington, Seattle; Department of Biostatistics (S.-H.C., A.D., L.A.F.), Boston University School of Public Health, MA; The Framingham Heart Study (A.D., S.S.), MA; Department of Neurology (A.D., L.A.F., S.S.), Boston University School of Medicine, MA; Department of Epidemiology (C.M.v.D), Erasmus MC, Rotterdam, Netherlands; Brown Foundation Institute of Molecular Medicine (M.F.) and Human Genetics Center (M.F.), University of Texas Health Science Center, Houston; The Eli and Edythe L. Broad Institute of Massachusetts Institute of Technology (S.B.G.), Cambridge; Harvard University (S.B.G.), Cambridge, MA; The McDonnell Genome Institute (D.C.K., D.E.L.) and Department of Genetics (D.E.L.), Washington University, St. Louis, MO; Department of Biostatistics and Epidemiology (A.C.N.) and Perelman School of Medicine (G.S.), University of Pennsylvania, Philadelphia; Group Health Research Institute (B.M.P.), Group Health Cooperative, Seattle, WA; Human Genome Sequencing Center (W.S., E.B.), Baylor College of Medicine, Houston, TX; Department of Epidemiology and Biostatistics (W.S.B., J.L.H.), Case Western Reserve University, Cleveland, OH; Department of Medical and Molecular Genetics (T.M.F.), Indiana University School of Medicine, Indianapolis; Department of Medicine (Biomedical Genetics) (L.A.F.), Department of Ophthalmology (L.A.F.), and Department of Epidemiology (L.A.F.), Boston University School of Medicine and Public Health, MA; Department of Neuroscience (A.G.), Icahn School of Medicine at Mount Sinai, New York, NY; Human Genetics Center (E.B.), UT Health School of Public Health, Houston, TX; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (R.M.) and Gertrude H. Sergievsky Center (R.M.), Columbia University Medical Center, New York, NY; Department of Neurology (R.M.), Columbia University Medical Center and New York Presbyterian Hospital, NY; and Department of Epidemiology (R.M.), Mailman School of Public Health, Columbia University, New York, NY
| | - B M Psaty
- John P. Hussman Institute for Human Genomics (G.W.B., E.R.M., M.A.P.-V.) and Dr. John T. Macdonald Foundation Department of Human Genetics (G.W.B., E.R.M., M.A.P.-V.), Miller School of Medicine, University of Miami, FL; Cardiovascular Health Research Unit (J.C.B.), Department of Medicine, Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, Health Services, Department of Biostatistics (E.W.), and Division of Medical Genetics (E.W.), Department of Medicine, University of Washington, Seattle; Department of Biostatistics (S.-H.C., A.D., L.A.F.), Boston University School of Public Health, MA; The Framingham Heart Study (A.D., S.S.), MA; Department of Neurology (A.D., L.A.F., S.S.), Boston University School of Medicine, MA; Department of Epidemiology (C.M.v.D), Erasmus MC, Rotterdam, Netherlands; Brown Foundation Institute of Molecular Medicine (M.F.) and Human Genetics Center (M.F.), University of Texas Health Science Center, Houston; The Eli and Edythe L. Broad Institute of Massachusetts Institute of Technology (S.B.G.), Cambridge; Harvard University (S.B.G.), Cambridge, MA; The McDonnell Genome Institute (D.C.K., D.E.L.) and Department of Genetics (D.E.L.), Washington University, St. Louis, MO; Department of Biostatistics and Epidemiology (A.C.N.) and Perelman School of Medicine (G.S.), University of Pennsylvania, Philadelphia; Group Health Research Institute (B.M.P.), Group Health Cooperative, Seattle, WA; Human Genome Sequencing Center (W.S., E.B.), Baylor College of Medicine, Houston, TX; Department of Epidemiology and Biostatistics (W.S.B., J.L.H.), Case Western Reserve University, Cleveland, OH; Department of Medical and Molecular Genetics (T.M.F.), Indiana University School of Medicine, Indianapolis; Department of Medicine (Biomedical Genetics) (L.A.F.), Department of Ophthalmology (L.A.F.), and Department of Epidemiology (L.A.F.), Boston University School of Medicine and Public Health, MA; Department of Neuroscience (A.G.), Icahn School of Medicine at Mount Sinai, New York, NY; Human Genetics Center (E.B.), UT Health School of Public Health, Houston, TX; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (R.M.) and Gertrude H. Sergievsky Center (R.M.), Columbia University Medical Center, New York, NY; Department of Neurology (R.M.), Columbia University Medical Center and New York Presbyterian Hospital, NY; and Department of Epidemiology (R.M.), Mailman School of Public Health, Columbia University, New York, NY
| | - W Salerno
- John P. Hussman Institute for Human Genomics (G.W.B., E.R.M., M.A.P.-V.) and Dr. John T. Macdonald Foundation Department of Human Genetics (G.W.B., E.R.M., M.A.P.-V.), Miller School of Medicine, University of Miami, FL; Cardiovascular Health Research Unit (J.C.B.), Department of Medicine, Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, Health Services, Department of Biostatistics (E.W.), and Division of Medical Genetics (E.W.), Department of Medicine, University of Washington, Seattle; Department of Biostatistics (S.-H.C., A.D., L.A.F.), Boston University School of Public Health, MA; The Framingham Heart Study (A.D., S.S.), MA; Department of Neurology (A.D., L.A.F., S.S.), Boston University School of Medicine, MA; Department of Epidemiology (C.M.v.D), Erasmus MC, Rotterdam, Netherlands; Brown Foundation Institute of Molecular Medicine (M.F.) and Human Genetics Center (M.F.), University of Texas Health Science Center, Houston; The Eli and Edythe L. Broad Institute of Massachusetts Institute of Technology (S.B.G.), Cambridge; Harvard University (S.B.G.), Cambridge, MA; The McDonnell Genome Institute (D.C.K., D.E.L.) and Department of Genetics (D.E.L.), Washington University, St. Louis, MO; Department of Biostatistics and Epidemiology (A.C.N.) and Perelman School of Medicine (G.S.), University of Pennsylvania, Philadelphia; Group Health Research Institute (B.M.P.), Group Health Cooperative, Seattle, WA; Human Genome Sequencing Center (W.S., E.B.), Baylor College of Medicine, Houston, TX; Department of Epidemiology and Biostatistics (W.S.B., J.L.H.), Case Western Reserve University, Cleveland, OH; Department of Medical and Molecular Genetics (T.M.F.), Indiana University School of Medicine, Indianapolis; Department of Medicine (Biomedical Genetics) (L.A.F.), Department of Ophthalmology (L.A.F.), and Department of Epidemiology (L.A.F.), Boston University School of Medicine and Public Health, MA; Department of Neuroscience (A.G.), Icahn School of Medicine at Mount Sinai, New York, NY; Human Genetics Center (E.B.), UT Health School of Public Health, Houston, TX; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (R.M.) and Gertrude H. Sergievsky Center (R.M.), Columbia University Medical Center, New York, NY; Department of Neurology (R.M.), Columbia University Medical Center and New York Presbyterian Hospital, NY; and Department of Epidemiology (R.M.), Mailman School of Public Health, Columbia University, New York, NY
| | - W S Bush
- John P. Hussman Institute for Human Genomics (G.W.B., E.R.M., M.A.P.-V.) and Dr. John T. Macdonald Foundation Department of Human Genetics (G.W.B., E.R.M., M.A.P.-V.), Miller School of Medicine, University of Miami, FL; Cardiovascular Health Research Unit (J.C.B.), Department of Medicine, Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, Health Services, Department of Biostatistics (E.W.), and Division of Medical Genetics (E.W.), Department of Medicine, University of Washington, Seattle; Department of Biostatistics (S.-H.C., A.D., L.A.F.), Boston University School of Public Health, MA; The Framingham Heart Study (A.D., S.S.), MA; Department of Neurology (A.D., L.A.F., S.S.), Boston University School of Medicine, MA; Department of Epidemiology (C.M.v.D), Erasmus MC, Rotterdam, Netherlands; Brown Foundation Institute of Molecular Medicine (M.F.) and Human Genetics Center (M.F.), University of Texas Health Science Center, Houston; The Eli and Edythe L. Broad Institute of Massachusetts Institute of Technology (S.B.G.), Cambridge; Harvard University (S.B.G.), Cambridge, MA; The McDonnell Genome Institute (D.C.K., D.E.L.) and Department of Genetics (D.E.L.), Washington University, St. Louis, MO; Department of Biostatistics and Epidemiology (A.C.N.) and Perelman School of Medicine (G.S.), University of Pennsylvania, Philadelphia; Group Health Research Institute (B.M.P.), Group Health Cooperative, Seattle, WA; Human Genome Sequencing Center (W.S., E.B.), Baylor College of Medicine, Houston, TX; Department of Epidemiology and Biostatistics (W.S.B., J.L.H.), Case Western Reserve University, Cleveland, OH; Department of Medical and Molecular Genetics (T.M.F.), Indiana University School of Medicine, Indianapolis; Department of Medicine (Biomedical Genetics) (L.A.F.), Department of Ophthalmology (L.A.F.), and Department of Epidemiology (L.A.F.), Boston University School of Medicine and Public Health, MA; Department of Neuroscience (A.G.), Icahn School of Medicine at Mount Sinai, New York, NY; Human Genetics Center (E.B.), UT Health School of Public Health, Houston, TX; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (R.M.) and Gertrude H. Sergievsky Center (R.M.), Columbia University Medical Center, New York, NY; Department of Neurology (R.M.), Columbia University Medical Center and New York Presbyterian Hospital, NY; and Department of Epidemiology (R.M.), Mailman School of Public Health, Columbia University, New York, NY
| | - T M Foroud
- John P. Hussman Institute for Human Genomics (G.W.B., E.R.M., M.A.P.-V.) and Dr. John T. Macdonald Foundation Department of Human Genetics (G.W.B., E.R.M., M.A.P.-V.), Miller School of Medicine, University of Miami, FL; Cardiovascular Health Research Unit (J.C.B.), Department of Medicine, Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, Health Services, Department of Biostatistics (E.W.), and Division of Medical Genetics (E.W.), Department of Medicine, University of Washington, Seattle; Department of Biostatistics (S.-H.C., A.D., L.A.F.), Boston University School of Public Health, MA; The Framingham Heart Study (A.D., S.S.), MA; Department of Neurology (A.D., L.A.F., S.S.), Boston University School of Medicine, MA; Department of Epidemiology (C.M.v.D), Erasmus MC, Rotterdam, Netherlands; Brown Foundation Institute of Molecular Medicine (M.F.) and Human Genetics Center (M.F.), University of Texas Health Science Center, Houston; The Eli and Edythe L. Broad Institute of Massachusetts Institute of Technology (S.B.G.), Cambridge; Harvard University (S.B.G.), Cambridge, MA; The McDonnell Genome Institute (D.C.K., D.E.L.) and Department of Genetics (D.E.L.), Washington University, St. Louis, MO; Department of Biostatistics and Epidemiology (A.C.N.) and Perelman School of Medicine (G.S.), University of Pennsylvania, Philadelphia; Group Health Research Institute (B.M.P.), Group Health Cooperative, Seattle, WA; Human Genome Sequencing Center (W.S., E.B.), Baylor College of Medicine, Houston, TX; Department of Epidemiology and Biostatistics (W.S.B., J.L.H.), Case Western Reserve University, Cleveland, OH; Department of Medical and Molecular Genetics (T.M.F.), Indiana University School of Medicine, Indianapolis; Department of Medicine (Biomedical Genetics) (L.A.F.), Department of Ophthalmology (L.A.F.), and Department of Epidemiology (L.A.F.), Boston University School of Medicine and Public Health, MA; Department of Neuroscience (A.G.), Icahn School of Medicine at Mount Sinai, New York, NY; Human Genetics Center (E.B.), UT Health School of Public Health, Houston, TX; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (R.M.) and Gertrude H. Sergievsky Center (R.M.), Columbia University Medical Center, New York, NY; Department of Neurology (R.M.), Columbia University Medical Center and New York Presbyterian Hospital, NY; and Department of Epidemiology (R.M.), Mailman School of Public Health, Columbia University, New York, NY
| | - E Wijsman
- John P. Hussman Institute for Human Genomics (G.W.B., E.R.M., M.A.P.-V.) and Dr. John T. Macdonald Foundation Department of Human Genetics (G.W.B., E.R.M., M.A.P.-V.), Miller School of Medicine, University of Miami, FL; Cardiovascular Health Research Unit (J.C.B.), Department of Medicine, Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, Health Services, Department of Biostatistics (E.W.), and Division of Medical Genetics (E.W.), Department of Medicine, University of Washington, Seattle; Department of Biostatistics (S.-H.C., A.D., L.A.F.), Boston University School of Public Health, MA; The Framingham Heart Study (A.D., S.S.), MA; Department of Neurology (A.D., L.A.F., S.S.), Boston University School of Medicine, MA; Department of Epidemiology (C.M.v.D), Erasmus MC, Rotterdam, Netherlands; Brown Foundation Institute of Molecular Medicine (M.F.) and Human Genetics Center (M.F.), University of Texas Health Science Center, Houston; The Eli and Edythe L. Broad Institute of Massachusetts Institute of Technology (S.B.G.), Cambridge; Harvard University (S.B.G.), Cambridge, MA; The McDonnell Genome Institute (D.C.K., D.E.L.) and Department of Genetics (D.E.L.), Washington University, St. Louis, MO; Department of Biostatistics and Epidemiology (A.C.N.) and Perelman School of Medicine (G.S.), University of Pennsylvania, Philadelphia; Group Health Research Institute (B.M.P.), Group Health Cooperative, Seattle, WA; Human Genome Sequencing Center (W.S., E.B.), Baylor College of Medicine, Houston, TX; Department of Epidemiology and Biostatistics (W.S.B., J.L.H.), Case Western Reserve University, Cleveland, OH; Department of Medical and Molecular Genetics (T.M.F.), Indiana University School of Medicine, Indianapolis; Department of Medicine (Biomedical Genetics) (L.A.F.), Department of Ophthalmology (L.A.F.), and Department of Epidemiology (L.A.F.), Boston University School of Medicine and Public Health, MA; Department of Neuroscience (A.G.), Icahn School of Medicine at Mount Sinai, New York, NY; Human Genetics Center (E.B.), UT Health School of Public Health, Houston, TX; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (R.M.) and Gertrude H. Sergievsky Center (R.M.), Columbia University Medical Center, New York, NY; Department of Neurology (R.M.), Columbia University Medical Center and New York Presbyterian Hospital, NY; and Department of Epidemiology (R.M.), Mailman School of Public Health, Columbia University, New York, NY
| | - L A Farrer
- John P. Hussman Institute for Human Genomics (G.W.B., E.R.M., M.A.P.-V.) and Dr. John T. Macdonald Foundation Department of Human Genetics (G.W.B., E.R.M., M.A.P.-V.), Miller School of Medicine, University of Miami, FL; Cardiovascular Health Research Unit (J.C.B.), Department of Medicine, Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, Health Services, Department of Biostatistics (E.W.), and Division of Medical Genetics (E.W.), Department of Medicine, University of Washington, Seattle; Department of Biostatistics (S.-H.C., A.D., L.A.F.), Boston University School of Public Health, MA; The Framingham Heart Study (A.D., S.S.), MA; Department of Neurology (A.D., L.A.F., S.S.), Boston University School of Medicine, MA; Department of Epidemiology (C.M.v.D), Erasmus MC, Rotterdam, Netherlands; Brown Foundation Institute of Molecular Medicine (M.F.) and Human Genetics Center (M.F.), University of Texas Health Science Center, Houston; The Eli and Edythe L. Broad Institute of Massachusetts Institute of Technology (S.B.G.), Cambridge; Harvard University (S.B.G.), Cambridge, MA; The McDonnell Genome Institute (D.C.K., D.E.L.) and Department of Genetics (D.E.L.), Washington University, St. Louis, MO; Department of Biostatistics and Epidemiology (A.C.N.) and Perelman School of Medicine (G.S.), University of Pennsylvania, Philadelphia; Group Health Research Institute (B.M.P.), Group Health Cooperative, Seattle, WA; Human Genome Sequencing Center (W.S., E.B.), Baylor College of Medicine, Houston, TX; Department of Epidemiology and Biostatistics (W.S.B., J.L.H.), Case Western Reserve University, Cleveland, OH; Department of Medical and Molecular Genetics (T.M.F.), Indiana University School of Medicine, Indianapolis; Department of Medicine (Biomedical Genetics) (L.A.F.), Department of Ophthalmology (L.A.F.), and Department of Epidemiology (L.A.F.), Boston University School of Medicine and Public Health, MA; Department of Neuroscience (A.G.), Icahn School of Medicine at Mount Sinai, New York, NY; Human Genetics Center (E.B.), UT Health School of Public Health, Houston, TX; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (R.M.) and Gertrude H. Sergievsky Center (R.M.), Columbia University Medical Center, New York, NY; Department of Neurology (R.M.), Columbia University Medical Center and New York Presbyterian Hospital, NY; and Department of Epidemiology (R.M.), Mailman School of Public Health, Columbia University, New York, NY
| | - A Goate
- John P. Hussman Institute for Human Genomics (G.W.B., E.R.M., M.A.P.-V.) and Dr. John T. Macdonald Foundation Department of Human Genetics (G.W.B., E.R.M., M.A.P.-V.), Miller School of Medicine, University of Miami, FL; Cardiovascular Health Research Unit (J.C.B.), Department of Medicine, Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, Health Services, Department of Biostatistics (E.W.), and Division of Medical Genetics (E.W.), Department of Medicine, University of Washington, Seattle; Department of Biostatistics (S.-H.C., A.D., L.A.F.), Boston University School of Public Health, MA; The Framingham Heart Study (A.D., S.S.), MA; Department of Neurology (A.D., L.A.F., S.S.), Boston University School of Medicine, MA; Department of Epidemiology (C.M.v.D), Erasmus MC, Rotterdam, Netherlands; Brown Foundation Institute of Molecular Medicine (M.F.) and Human Genetics Center (M.F.), University of Texas Health Science Center, Houston; The Eli and Edythe L. Broad Institute of Massachusetts Institute of Technology (S.B.G.), Cambridge; Harvard University (S.B.G.), Cambridge, MA; The McDonnell Genome Institute (D.C.K., D.E.L.) and Department of Genetics (D.E.L.), Washington University, St. Louis, MO; Department of Biostatistics and Epidemiology (A.C.N.) and Perelman School of Medicine (G.S.), University of Pennsylvania, Philadelphia; Group Health Research Institute (B.M.P.), Group Health Cooperative, Seattle, WA; Human Genome Sequencing Center (W.S., E.B.), Baylor College of Medicine, Houston, TX; Department of Epidemiology and Biostatistics (W.S.B., J.L.H.), Case Western Reserve University, Cleveland, OH; Department of Medical and Molecular Genetics (T.M.F.), Indiana University School of Medicine, Indianapolis; Department of Medicine (Biomedical Genetics) (L.A.F.), Department of Ophthalmology (L.A.F.), and Department of Epidemiology (L.A.F.), Boston University School of Medicine and Public Health, MA; Department of Neuroscience (A.G.), Icahn School of Medicine at Mount Sinai, New York, NY; Human Genetics Center (E.B.), UT Health School of Public Health, Houston, TX; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (R.M.) and Gertrude H. Sergievsky Center (R.M.), Columbia University Medical Center, New York, NY; Department of Neurology (R.M.), Columbia University Medical Center and New York Presbyterian Hospital, NY; and Department of Epidemiology (R.M.), Mailman School of Public Health, Columbia University, New York, NY
| | - J L Haines
- John P. Hussman Institute for Human Genomics (G.W.B., E.R.M., M.A.P.-V.) and Dr. John T. Macdonald Foundation Department of Human Genetics (G.W.B., E.R.M., M.A.P.-V.), Miller School of Medicine, University of Miami, FL; Cardiovascular Health Research Unit (J.C.B.), Department of Medicine, Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, Health Services, Department of Biostatistics (E.W.), and Division of Medical Genetics (E.W.), Department of Medicine, University of Washington, Seattle; Department of Biostatistics (S.-H.C., A.D., L.A.F.), Boston University School of Public Health, MA; The Framingham Heart Study (A.D., S.S.), MA; Department of Neurology (A.D., L.A.F., S.S.), Boston University School of Medicine, MA; Department of Epidemiology (C.M.v.D), Erasmus MC, Rotterdam, Netherlands; Brown Foundation Institute of Molecular Medicine (M.F.) and Human Genetics Center (M.F.), University of Texas Health Science Center, Houston; The Eli and Edythe L. Broad Institute of Massachusetts Institute of Technology (S.B.G.), Cambridge; Harvard University (S.B.G.), Cambridge, MA; The McDonnell Genome Institute (D.C.K., D.E.L.) and Department of Genetics (D.E.L.), Washington University, St. Louis, MO; Department of Biostatistics and Epidemiology (A.C.N.) and Perelman School of Medicine (G.S.), University of Pennsylvania, Philadelphia; Group Health Research Institute (B.M.P.), Group Health Cooperative, Seattle, WA; Human Genome Sequencing Center (W.S., E.B.), Baylor College of Medicine, Houston, TX; Department of Epidemiology and Biostatistics (W.S.B., J.L.H.), Case Western Reserve University, Cleveland, OH; Department of Medical and Molecular Genetics (T.M.F.), Indiana University School of Medicine, Indianapolis; Department of Medicine (Biomedical Genetics) (L.A.F.), Department of Ophthalmology (L.A.F.), and Department of Epidemiology (L.A.F.), Boston University School of Medicine and Public Health, MA; Department of Neuroscience (A.G.), Icahn School of Medicine at Mount Sinai, New York, NY; Human Genetics Center (E.B.), UT Health School of Public Health, Houston, TX; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (R.M.) and Gertrude H. Sergievsky Center (R.M.), Columbia University Medical Center, New York, NY; Department of Neurology (R.M.), Columbia University Medical Center and New York Presbyterian Hospital, NY; and Department of Epidemiology (R.M.), Mailman School of Public Health, Columbia University, New York, NY
| | - Margaret A Pericak-Vance
- John P. Hussman Institute for Human Genomics (G.W.B., E.R.M., M.A.P.-V.) and Dr. John T. Macdonald Foundation Department of Human Genetics (G.W.B., E.R.M., M.A.P.-V.), Miller School of Medicine, University of Miami, FL; Cardiovascular Health Research Unit (J.C.B.), Department of Medicine, Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, Health Services, Department of Biostatistics (E.W.), and Division of Medical Genetics (E.W.), Department of Medicine, University of Washington, Seattle; Department of Biostatistics (S.-H.C., A.D., L.A.F.), Boston University School of Public Health, MA; The Framingham Heart Study (A.D., S.S.), MA; Department of Neurology (A.D., L.A.F., S.S.), Boston University School of Medicine, MA; Department of Epidemiology (C.M.v.D), Erasmus MC, Rotterdam, Netherlands; Brown Foundation Institute of Molecular Medicine (M.F.) and Human Genetics Center (M.F.), University of Texas Health Science Center, Houston; The Eli and Edythe L. Broad Institute of Massachusetts Institute of Technology (S.B.G.), Cambridge; Harvard University (S.B.G.), Cambridge, MA; The McDonnell Genome Institute (D.C.K., D.E.L.) and Department of Genetics (D.E.L.), Washington University, St. Louis, MO; Department of Biostatistics and Epidemiology (A.C.N.) and Perelman School of Medicine (G.S.), University of Pennsylvania, Philadelphia; Group Health Research Institute (B.M.P.), Group Health Cooperative, Seattle, WA; Human Genome Sequencing Center (W.S., E.B.), Baylor College of Medicine, Houston, TX; Department of Epidemiology and Biostatistics (W.S.B., J.L.H.), Case Western Reserve University, Cleveland, OH; Department of Medical and Molecular Genetics (T.M.F.), Indiana University School of Medicine, Indianapolis; Department of Medicine (Biomedical Genetics) (L.A.F.), Department of Ophthalmology (L.A.F.), and Department of Epidemiology (L.A.F.), Boston University School of Medicine and Public Health, MA; Department of Neuroscience (A.G.), Icahn School of Medicine at Mount Sinai, New York, NY; Human Genetics Center (E.B.), UT Health School of Public Health, Houston, TX; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (R.M.) and Gertrude H. Sergievsky Center (R.M.), Columbia University Medical Center, New York, NY; Department of Neurology (R.M.), Columbia University Medical Center and New York Presbyterian Hospital, NY; and Department of Epidemiology (R.M.), Mailman School of Public Health, Columbia University, New York, NY
| | - E Boerwinkle
- John P. Hussman Institute for Human Genomics (G.W.B., E.R.M., M.A.P.-V.) and Dr. John T. Macdonald Foundation Department of Human Genetics (G.W.B., E.R.M., M.A.P.-V.), Miller School of Medicine, University of Miami, FL; Cardiovascular Health Research Unit (J.C.B.), Department of Medicine, Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, Health Services, Department of Biostatistics (E.W.), and Division of Medical Genetics (E.W.), Department of Medicine, University of Washington, Seattle; Department of Biostatistics (S.-H.C., A.D., L.A.F.), Boston University School of Public Health, MA; The Framingham Heart Study (A.D., S.S.), MA; Department of Neurology (A.D., L.A.F., S.S.), Boston University School of Medicine, MA; Department of Epidemiology (C.M.v.D), Erasmus MC, Rotterdam, Netherlands; Brown Foundation Institute of Molecular Medicine (M.F.) and Human Genetics Center (M.F.), University of Texas Health Science Center, Houston; The Eli and Edythe L. Broad Institute of Massachusetts Institute of Technology (S.B.G.), Cambridge; Harvard University (S.B.G.), Cambridge, MA; The McDonnell Genome Institute (D.C.K., D.E.L.) and Department of Genetics (D.E.L.), Washington University, St. Louis, MO; Department of Biostatistics and Epidemiology (A.C.N.) and Perelman School of Medicine (G.S.), University of Pennsylvania, Philadelphia; Group Health Research Institute (B.M.P.), Group Health Cooperative, Seattle, WA; Human Genome Sequencing Center (W.S., E.B.), Baylor College of Medicine, Houston, TX; Department of Epidemiology and Biostatistics (W.S.B., J.L.H.), Case Western Reserve University, Cleveland, OH; Department of Medical and Molecular Genetics (T.M.F.), Indiana University School of Medicine, Indianapolis; Department of Medicine (Biomedical Genetics) (L.A.F.), Department of Ophthalmology (L.A.F.), and Department of Epidemiology (L.A.F.), Boston University School of Medicine and Public Health, MA; Department of Neuroscience (A.G.), Icahn School of Medicine at Mount Sinai, New York, NY; Human Genetics Center (E.B.), UT Health School of Public Health, Houston, TX; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (R.M.) and Gertrude H. Sergievsky Center (R.M.), Columbia University Medical Center, New York, NY; Department of Neurology (R.M.), Columbia University Medical Center and New York Presbyterian Hospital, NY; and Department of Epidemiology (R.M.), Mailman School of Public Health, Columbia University, New York, NY
| | - R Mayeux
- John P. Hussman Institute for Human Genomics (G.W.B., E.R.M., M.A.P.-V.) and Dr. John T. Macdonald Foundation Department of Human Genetics (G.W.B., E.R.M., M.A.P.-V.), Miller School of Medicine, University of Miami, FL; Cardiovascular Health Research Unit (J.C.B.), Department of Medicine, Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, Health Services, Department of Biostatistics (E.W.), and Division of Medical Genetics (E.W.), Department of Medicine, University of Washington, Seattle; Department of Biostatistics (S.-H.C., A.D., L.A.F.), Boston University School of Public Health, MA; The Framingham Heart Study (A.D., S.S.), MA; Department of Neurology (A.D., L.A.F., S.S.), Boston University School of Medicine, MA; Department of Epidemiology (C.M.v.D), Erasmus MC, Rotterdam, Netherlands; Brown Foundation Institute of Molecular Medicine (M.F.) and Human Genetics Center (M.F.), University of Texas Health Science Center, Houston; The Eli and Edythe L. Broad Institute of Massachusetts Institute of Technology (S.B.G.), Cambridge; Harvard University (S.B.G.), Cambridge, MA; The McDonnell Genome Institute (D.C.K., D.E.L.) and Department of Genetics (D.E.L.), Washington University, St. Louis, MO; Department of Biostatistics and Epidemiology (A.C.N.) and Perelman School of Medicine (G.S.), University of Pennsylvania, Philadelphia; Group Health Research Institute (B.M.P.), Group Health Cooperative, Seattle, WA; Human Genome Sequencing Center (W.S., E.B.), Baylor College of Medicine, Houston, TX; Department of Epidemiology and Biostatistics (W.S.B., J.L.H.), Case Western Reserve University, Cleveland, OH; Department of Medical and Molecular Genetics (T.M.F.), Indiana University School of Medicine, Indianapolis; Department of Medicine (Biomedical Genetics) (L.A.F.), Department of Ophthalmology (L.A.F.), and Department of Epidemiology (L.A.F.), Boston University School of Medicine and Public Health, MA; Department of Neuroscience (A.G.), Icahn School of Medicine at Mount Sinai, New York, NY; Human Genetics Center (E.B.), UT Health School of Public Health, Houston, TX; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (R.M.) and Gertrude H. Sergievsky Center (R.M.), Columbia University Medical Center, New York, NY; Department of Neurology (R.M.), Columbia University Medical Center and New York Presbyterian Hospital, NY; and Department of Epidemiology (R.M.), Mailman School of Public Health, Columbia University, New York, NY
| | - S Seshadri
- John P. Hussman Institute for Human Genomics (G.W.B., E.R.M., M.A.P.-V.) and Dr. John T. Macdonald Foundation Department of Human Genetics (G.W.B., E.R.M., M.A.P.-V.), Miller School of Medicine, University of Miami, FL; Cardiovascular Health Research Unit (J.C.B.), Department of Medicine, Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, Health Services, Department of Biostatistics (E.W.), and Division of Medical Genetics (E.W.), Department of Medicine, University of Washington, Seattle; Department of Biostatistics (S.-H.C., A.D., L.A.F.), Boston University School of Public Health, MA; The Framingham Heart Study (A.D., S.S.), MA; Department of Neurology (A.D., L.A.F., S.S.), Boston University School of Medicine, MA; Department of Epidemiology (C.M.v.D), Erasmus MC, Rotterdam, Netherlands; Brown Foundation Institute of Molecular Medicine (M.F.) and Human Genetics Center (M.F.), University of Texas Health Science Center, Houston; The Eli and Edythe L. Broad Institute of Massachusetts Institute of Technology (S.B.G.), Cambridge; Harvard University (S.B.G.), Cambridge, MA; The McDonnell Genome Institute (D.C.K., D.E.L.) and Department of Genetics (D.E.L.), Washington University, St. Louis, MO; Department of Biostatistics and Epidemiology (A.C.N.) and Perelman School of Medicine (G.S.), University of Pennsylvania, Philadelphia; Group Health Research Institute (B.M.P.), Group Health Cooperative, Seattle, WA; Human Genome Sequencing Center (W.S., E.B.), Baylor College of Medicine, Houston, TX; Department of Epidemiology and Biostatistics (W.S.B., J.L.H.), Case Western Reserve University, Cleveland, OH; Department of Medical and Molecular Genetics (T.M.F.), Indiana University School of Medicine, Indianapolis; Department of Medicine (Biomedical Genetics) (L.A.F.), Department of Ophthalmology (L.A.F.), and Department of Epidemiology (L.A.F.), Boston University School of Medicine and Public Health, MA; Department of Neuroscience (A.G.), Icahn School of Medicine at Mount Sinai, New York, NY; Human Genetics Center (E.B.), UT Health School of Public Health, Houston, TX; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (R.M.) and Gertrude H. Sergievsky Center (R.M.), Columbia University Medical Center, New York, NY; Department of Neurology (R.M.), Columbia University Medical Center and New York Presbyterian Hospital, NY; and Department of Epidemiology (R.M.), Mailman School of Public Health, Columbia University, New York, NY
| | - G Schellenberg
- John P. Hussman Institute for Human Genomics (G.W.B., E.R.M., M.A.P.-V.) and Dr. John T. Macdonald Foundation Department of Human Genetics (G.W.B., E.R.M., M.A.P.-V.), Miller School of Medicine, University of Miami, FL; Cardiovascular Health Research Unit (J.C.B.), Department of Medicine, Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, Health Services, Department of Biostatistics (E.W.), and Division of Medical Genetics (E.W.), Department of Medicine, University of Washington, Seattle; Department of Biostatistics (S.-H.C., A.D., L.A.F.), Boston University School of Public Health, MA; The Framingham Heart Study (A.D., S.S.), MA; Department of Neurology (A.D., L.A.F., S.S.), Boston University School of Medicine, MA; Department of Epidemiology (C.M.v.D), Erasmus MC, Rotterdam, Netherlands; Brown Foundation Institute of Molecular Medicine (M.F.) and Human Genetics Center (M.F.), University of Texas Health Science Center, Houston; The Eli and Edythe L. Broad Institute of Massachusetts Institute of Technology (S.B.G.), Cambridge; Harvard University (S.B.G.), Cambridge, MA; The McDonnell Genome Institute (D.C.K., D.E.L.) and Department of Genetics (D.E.L.), Washington University, St. Louis, MO; Department of Biostatistics and Epidemiology (A.C.N.) and Perelman School of Medicine (G.S.), University of Pennsylvania, Philadelphia; Group Health Research Institute (B.M.P.), Group Health Cooperative, Seattle, WA; Human Genome Sequencing Center (W.S., E.B.), Baylor College of Medicine, Houston, TX; Department of Epidemiology and Biostatistics (W.S.B., J.L.H.), Case Western Reserve University, Cleveland, OH; Department of Medical and Molecular Genetics (T.M.F.), Indiana University School of Medicine, Indianapolis; Department of Medicine (Biomedical Genetics) (L.A.F.), Department of Ophthalmology (L.A.F.), and Department of Epidemiology (L.A.F.), Boston University School of Medicine and Public Health, MA; Department of Neuroscience (A.G.), Icahn School of Medicine at Mount Sinai, New York, NY; Human Genetics Center (E.B.), UT Health School of Public Health, Houston, TX; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (R.M.) and Gertrude H. Sergievsky Center (R.M.), Columbia University Medical Center, New York, NY; Department of Neurology (R.M.), Columbia University Medical Center and New York Presbyterian Hospital, NY; and Department of Epidemiology (R.M.), Mailman School of Public Health, Columbia University, New York, NY
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Pant A, Pasupureddy R, Pande V, Seshadri S, Dixit R, Pandey KC. Proteases in Mosquito Borne Diseases: New Avenues in Drug Development. Curr Top Med Chem 2017; 17:2221-2232. [PMID: 28137230 DOI: 10.2174/1568026617666170130122231] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 09/12/2016] [Accepted: 10/27/2016] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Mosquito borne diseases continue to propagate and cause millions of deaths annually. They are caused either by protozoan parasites such as Plasmodium, Toxoplasma or by flaviviruses including Dengue and Zika. Among the proteome of such parasitic organisms, proteases play essential roles in events such as host invasion, hemoglobin hydrolysis, replication and immune evasion. Plasmepsin V (PMV), an endoplasmic reticulum resident aspartic protease of Plasmodium spp., is involved in the export of ~400 proteins containing the conserved Plasmodium Export Element motif (PEXEL). Interactions and cleavage of PEXEL proteins by PM V is necessary for export to and across the parasitophorous vacuole membrane. Protease System: Similarly in flaviviruses, a two-component protease system consisting of nonstructural proteins, NS2B and NS3, interacts with other non-structural proteins and plays a major role in viral replication, polyprotein cleavage and virion particle assembly. Thus, proteases involved in indispensable roles in pathogen machinery can be considered as attractive drug targets. Inhibitors against proteases are being used in clinical trials for other communicable and non-communicable diseases. Currently, hydroxyethylamine based inhibitors targeting the catalytic site of PM V with picomolar inhibitory concentrations have been tested in vitro. CONCLUSION For recently characterized disease such as Zika, no known treatments exist while compound such as Policresulen has high affinity for Dengue NS2B/NS3 complex. Understanding proteases structure-function relationship and protease-inhibitor interactions can provide new insights for novel chemotherapeutic strategies.
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Affiliation(s)
- A Pant
- National Institute of Malaria Research, Dwarka Sector - 8, New Delhi - 110077, India,Department of Biotechnology, Kumaun University, Nainital, Uttarakhand – 263001, India
| | - R Pasupureddy
- National Institute of Malaria Research, Dwarka Sector - 8, New Delhi - 110077, India,Institute of Science, Nirma University, SG Highway, Ahmedabad, Gujarat - 382481, India
| | - V Pande
- Department of Biotechnology, Kumaun University, Nainital, Uttarakhand – 263001, India
| | - S Seshadri
- Institute of Science, Nirma University, SG Highway, Ahmedabad, Gujarat - 382481, India
| | - R Dixit
- National Institute of Malaria Research, Dwarka Sector - 8, New Delhi - 110077, India
| | - K C Pandey
- Department of Biochemistry, National Institute for Research in Environmental Health, Bhopal, MP - 462001, India
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Jacob P, Srinath S, Girimaji S, Seshadri S, Sagar JV. Co-morbidity in Attention-Deficit Hyperactivity Disorder: A Clinical Study from India. East Asian Arch Psychiatry 2016; 26:148-153. [PMID: 28053283] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To assess the prevalence of neurodevelopmental and psychiatric co-morbidities in children and adolescents diagnosed with attention-deficit hyperactivity disorder at a tertiary care child and adolescent psychiatry centre. METHODS A total of 63 children and adolescents who were diagnosed with attention-deficit hyperactivity disorder and fulfilled the inclusion criteria were comprehensively assessed for neurodevelopmental and psychiatric co-morbidities. The tools used included the Mini-International Neuropsychiatric Interview for Children and Adolescents, Attention Deficit Hyperactivity Disorder Rating Scale IV (ADHD-RS), Children's Global Assessment Scale, Clinical Global Impression Scale, Vineland Social Maturity Scale, and Childhood Autism Rating Scale. RESULTS All except 1 subject had neurodevelopmental and / or psychiatric disorder co-morbid with attention-deficit hyperactivity disorder; 66.7% had both neurodevelopmental and psychiatric disorders. Specific learning disability was the most common co-existing neurodevelopmental disorder and oppositional defiant disorder was the most common psychiatric co-morbidity. The mean baseline ADHD-RS scores were significantly higher in the group with psychiatric co-morbidities, especially in the group with oppositional defiant disorder. CONCLUSION Co-morbidity is present at a very high frequency in clinic-referred children diagnosed with attention-deficit hyperactivity disorder. Psychiatric co-morbidity, specifically oppositional defiant disorder, has an impact on the severity of attention-deficit hyperactivity disorder. Co-morbidity needs to be explicitly looked for during evaluation and managed appropriately.
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Affiliation(s)
- P Jacob
- Department of Child and Adolescent Psychiatry, National Institute of Mental Health And Neuro Sciences, Bangalore, India
| | - S Srinath
- Department of Child and Adolescent Psychiatry, National Institute of Mental Health And Neuro Sciences, Bangalore, India
| | - S Girimaji
- Department of Child and Adolescent Psychiatry, National Institute of Mental Health And Neuro Sciences, Bangalore, India
| | - S Seshadri
- Department of Child and Adolescent Psychiatry, National Institute of Mental Health And Neuro Sciences, Bangalore, India
| | - J V Sagar
- Department of Child and Adolescent Psychiatry, National Institute of Mental Health And Neuro Sciences, Bangalore, India
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Abstract
BACKGROUND Ovarian cancer is seventh most common cancer in women worldwide. Approximately 1.3% of women will be diagnosed with ovarian cancer at some point during their life time. The majority of tumours arise from surface of the ovary (epithelial). Two thirds of these women will present with advanced disease, requiring aggressive treatment, which includes debulking surgery (removal of as much disease as possible) and chemotherapy. However, most women (75%) with advanced epithelial ovarian cancer (EOC) will relapse following surgery and chemotherapy. Patients who relapse are treated with either platinum or non-platinum drugs and this is dependent on the platinum-sensitivity and platinum-free interval. These drug regimens are generally well-tolerated although there are potential severe side effects. New treatments that can be used to treat recurrence or prevent disease progression after first-line or subsequent chemotherapy are important, especially those with a low toxicity profile. Hormones such as luteinising hormone releasing hormone (LHRH) agonists have been used in the treatment of relapsed EOC. Some studies have shown objective remissions, while other studies have shown little or no benefit. Most small studies report a better side-effect profile for LHRH agonists when compared to standard chemotherapeutic agents used in EOC. OBJECTIVES To compare the effectiveness and safety of luteinising hormone releasing hormone (LHRH) agonists with chemotherapeutic agents or placebo in relapsed epithelial ovarian cancer (EOC). SEARCH METHODS We searched the Cochrane Gynaecological Cancer Group trials register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and Embase up to January 2016. We also searched registers of clinical trials and abstracts of scientific meetings. SELECTION CRITERIA Randomised controlled trials (RCTs) that compared LHRH agonists with chemotherapeutic agents or placebo in relapsed EOC. DATA COLLECTION AND ANALYSIS Two review authors independently assessed whether relevant studies met the inclusion criteria, retrieved data and assessed risk of bias. MAIN RESULTS Two studies, including 97 women, met our inclusion criteria: one assessed LHRH agonist (leuprorelin) use in relapsed (platinum-resistant and platinum-refractory) EOC in comparison with a chemotherapeutic agent (treosulfan) (Du Bois 2002); the other examined LHRH agonist (decapeptyl) versus a placebo (Currie 1994). Since both studies had different control groups, a meta-analysis was not possible.There may be little or no difference between treatment with leuprorelin or treosulfan in overall survival (OS) (hazard ratio (HR) 0.98, 95% confidence interval (CI) 0.58 to 1.67; very low-quality evidence) or progression-free survival (PFS) at six and 12 months (risk ratio (RR) 0.61, 95% CI 0.22 to 1.68, and RR 0.65, 95% CI 0.12 to 3.66; very low-quality evidence), respectively (Du Bois 2002). The duration of follow-up was 2.5 years and quality of life (QoL) was not reported in this study.Alopecia and fatigue were probably more common with treosulfan than leuprorelin (alopecia RR 0.32, 95% CI 0.12 to 0.91 (very low-quality evidence)). There may be little or no difference in other Grade 3/4 side effects: nausea and vomiting (RR 0.65, 95% CI 0.12 to 3.66 (very low-quality evidence)); neurotoxicity (RR 0.32, 95% CI 0.01 to 7.71 (very low-quality evidence)) and neutropenia (RR 0.97, 95% 0.06 to 14.97 (very low-quality evidence)),The Currie 1994 study, which compared decapeptyl treatment with placebo, reported mean PFS of 16 weeks verus 11.2 weeks, respectively. No relative effects measures or P value at a particular time point were reported. Overall survival (OS) and QoL outcomes were not reported. In addition, adverse events were only mentioned for the decapeptyl group.Adverse events were incompletely reported (no adverse events in decapeptyl group, but not reported for the placebo group). AUTHORS' CONCLUSIONS Based on this review of two small RCTs, there is not enough evidence to comment on the safety and effectiveness of LHRH agonists in the treatment of platinum-refractory and platinum-resistant (relapsed) EOC. Overall, the quality of evidence for all outcomes (including OS, PFS, QoL and adverse events) is very low.
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Affiliation(s)
- Rekha Wuntakal
- Gynaecological Oncology, Barking, Havering & Redbridge University Hospitals NHS Trust, Rom Valley Way, Romford, UK, RM7 0AG
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Ibrahim-Verbaas CA, Bressler J, Debette S, Schuur M, Smith AV, Bis JC, Davies G, Trompet S, Smith JA, Wolf C, Chibnik LB, Liu Y, Vitart V, Kirin M, Petrovic K, Polasek O, Zgaga L, Fawns-Ritchie C, Hoffmann P, Karjalainen J, Lahti J, Llewellyn DJ, Schmidt CO, Mather KA, Chouraki V, Sun Q, Resnick SM, Rose LM, Oldmeadow C, Stewart M, Smith BH, Gudnason V, Yang Q, Mirza SS, Jukema JW, deJager PL, Harris TB, Liewald DC, Amin N, Coker LH, Stegle O, Lopez OL, Schmidt R, Teumer A, Ford I, Karbalai N, Becker JT, Jonsdottir MK, Au R, Fehrmann RSN, Herms S, Nalls M, Zhao W, Turner ST, Yaffe K, Lohman K, van Swieten JC, Kardia SLR, Knopman DS, Meeks WM, Heiss G, Holliday EG, Schofield PW, Tanaka T, Stott DJ, Wang J, Ridker P, Gow AJ, Pattie A, Starr JM, Hocking LJ, Armstrong NJ, McLachlan S, Shulman JM, Pilling LC, Eiriksdottir G, Scott RJ, Kochan NA, Palotie A, Hsieh YC, Eriksson JG, Penman A, Gottesman RF, Oostra BA, Yu L, DeStefano AL, Beiser A, Garcia M, Rotter JI, Nöthen MM, Hofman A, Slagboom PE, Westendorp RGJ, Buckley BM, Wolf PA, Uitterlinden AG, Psaty BM, Grabe HJ, Bandinelli S, Chasman DI, Grodstein F, Räikkönen K, Lambert JC, Porteous DJ, Price JF, Sachdev PS, Ferrucci L, Attia JR, Rudan I, Hayward C, Wright AF, Wilson JF, Cichon S, Franke L, Schmidt H, Ding J, de Craen AJM, Fornage M, Bennett DA, Deary IJ, Ikram MA, Launer LJ, Fitzpatrick AL, Seshadri S, van Duijn CM, Mosley TH. GWAS for executive function and processing speed suggests involvement of the CADM2 gene. Mol Psychiatry 2016; 21:189-197. [PMID: 25869804 PMCID: PMC4722802 DOI: 10.1038/mp.2015.37] [Citation(s) in RCA: 103] [Impact Index Per Article: 12.9] [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: 12/18/2013] [Revised: 01/21/2015] [Accepted: 02/11/2015] [Indexed: 01/20/2023]
Abstract
To identify common variants contributing to normal variation in two specific domains of cognitive functioning, we conducted a genome-wide association study (GWAS) of executive functioning and information processing speed in non-demented older adults from the CHARGE (Cohorts for Heart and Aging Research in Genomic Epidemiology) consortium. Neuropsychological testing was available for 5429-32,070 subjects of European ancestry aged 45 years or older, free of dementia and clinical stroke at the time of cognitive testing from 20 cohorts in the discovery phase. We analyzed performance on the Trail Making Test parts A and B, the Letter Digit Substitution Test (LDST), the Digit Symbol Substitution Task (DSST), semantic and phonemic fluency tests, and the Stroop Color and Word Test. Replication was sought in 1311-21860 subjects from 20 independent cohorts. A significant association was observed in the discovery cohorts for the single-nucleotide polymorphism (SNP) rs17518584 (discovery P-value=3.12 × 10(-8)) and in the joint discovery and replication meta-analysis (P-value=3.28 × 10(-9) after adjustment for age, gender and education) in an intron of the gene cell adhesion molecule 2 (CADM2) for performance on the LDST/DSST. Rs17518584 is located about 170 kb upstream of the transcription start site of the major transcript for the CADM2 gene, but is within an intron of a variant transcript that includes an alternative first exon. The variant is associated with expression of CADM2 in the cingulate cortex (P-value=4 × 10(-4)). The protein encoded by CADM2 is involved in glutamate signaling (P-value=7.22 × 10(-15)), gamma-aminobutyric acid (GABA) transport (P-value=1.36 × 10(-11)) and neuron cell-cell adhesion (P-value=1.48 × 10(-13)). Our findings suggest that genetic variation in the CADM2 gene is associated with individual differences in information processing speed.
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Affiliation(s)
- CA Ibrahim-Verbaas
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus
University Medical Center, Rotterdam, The Netherlands,Department of Neurology, Erasmus University Medical Center,
Rotterdam, The Netherlands,Geriatric Unit, Azienda Sanitaria Firenze (ASF), Florence,
Italy
| | - J Bressler
- Human Genetics Center, School of Public Health, University of
Texas Health Science Center at Houston, Houston, TX, USA,Geriatric Unit, Azienda Sanitaria Firenze (ASF), Florence,
Italy
| | - S Debette
- Department of Neurology, Boston University School of Medicine,
Boston, MA, USA,Institut National de la Santé et de la Recherche
Médicale (INSERM), U897, Epidemiology and Biostatistics, University of Bordeaux,
Bordeaux, France,Department of Neurology, Bordeaux University Hospital, Bordeaux,
France,Geriatric Unit, Azienda Sanitaria Firenze (ASF), Florence,
Italy
| | - M Schuur
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus
University Medical Center, Rotterdam, The Netherlands,Department of Neurology, Erasmus University Medical Center,
Rotterdam, The Netherlands,Geriatric Unit, Azienda Sanitaria Firenze (ASF), Florence,
Italy
| | - AV Smith
- Icelandic Heart Association, Kopavogur, Iceland,Faculty of Medicine, University of Iceland, Reykjavik,
Iceland,Geriatric Unit, Azienda Sanitaria Firenze (ASF), Florence,
Italy
| | - JC Bis
- Cardiovascular Health Research Unit, Department of Medicine,
University of Washington, Seattle, WA, USA,Geriatric Unit, Azienda Sanitaria Firenze (ASF), Florence,
Italy
| | - G Davies
- Centre for Cognitive Ageing and Cognitive Epidemiology, The
University of Edinburgh, Edinburgh, UK,Geriatric Unit, Azienda Sanitaria Firenze (ASF), Florence,
Italy
| | - S Trompet
- Department of Cardiology, Leiden University Medical Center,
Leiden, The Netherlands,Department of Gerontology and Geriatrics, Leiden University
Medical Center, Leiden, The Netherlands
| | - JA Smith
- Department of Epidemiology, University of Michigan, Ann Arbor,
MI, USA
| | - C Wolf
- RG Statistical Genetics, Max Planck Institute of Psychiatry,
Munich, Germany
| | - LB Chibnik
- Program in Translational Neuropsychiatric Genomics, Department
of Neurology, Brigham and Women's Hospital, Boston, MA, USA
| | - Y Liu
- Department of Epidemiology, Wake Forest School of Medicine,
Winston-Salem, NC, USA
| | - V Vitart
- MRC Human Genetics Unit, Institute of Genetics and Molecular
Medicine, University of Edinburgh, Edinburgh, UK
| | - M Kirin
- Centre for Population Health Sciences, University of Edinburgh,
Edinburgh, UK
| | - K Petrovic
- Department of Neurology, Medical University and General
Hospital of Graz, Graz, Austria
| | - O Polasek
- Department of Public Health, University of Split, Split,
Croatia
| | - L Zgaga
- Department of Public Health and Primary Care, Trinity College
Dublin, Dublin, Ireland
| | - C Fawns-Ritchie
- Centre for Cognitive Ageing and Cognitive Epidemiology, The
University of Edinburgh, Edinburgh, UK
| | - P Hoffmann
- Institute of Neuroscience and Medicine (INM -1), Research
Center Juelich, Juelich, Germany,Division of Medical Genetics, Department of Biomedicine,
University of Basel, Basel, Switzerland,Department of Genomics, Life and Brain Research Center,
Institute of Human Genetics, University of Bonn, Bonn, Germany
| | - J Karjalainen
- Department of Genetics, University Medical Centre Groningen,
University of Groningen, Groningen, The Netherlands
| | - J Lahti
- Institute of Behavioural Sciences, University of Helsinki,
Helsinki, Finland,Folkhälsan Research Centre, Helsinki, Finland
| | - DJ Llewellyn
- Institute of Biomedical and Clinical Sciences, University of
Exeter Medical School, Exeter, UK
| | - CO Schmidt
- Institute for Community Medicine, University Medicine
Greifswald, Greifswald, Germany
| | - KA Mather
- Centre for Healthy Brain Ageing, School of Psychiatry, UNSW
Medicine, University of New South Wales, Sydney, Australia
| | - V Chouraki
- Inserm, U1167, Institut Pasteur de Lille, Université
Lille-Nord de France, Lille, France
| | - Q Sun
- Channing Division of Network Medicine, Department of Medicine,
Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - SM Resnick
- Laboratory of Behavioral Neuroscience, National Institute on
Aging, NIH, Baltimore, MD, USA
| | - LM Rose
- Division of Preventive Medicine, Brigham and Women's Hospital,
Boston, MA, USA
| | - C Oldmeadow
- Hunter Medical Research Institute and Faculty of Health,
University of Newcastle, Newcastle, NSW, Australia
| | - M Stewart
- Centre for Population Health Sciences, University of Edinburgh,
Edinburgh, UK
| | - BH Smith
- Medical Research Institute, University of Dundee, Dundee,
UK
| | - V Gudnason
- Icelandic Heart Association, Kopavogur, Iceland,Faculty of Medicine, University of Iceland, Reykjavik,
Iceland
| | - Q Yang
- The National Heart Lung and Blood Institute's Framingham Heart
Study, Framingham, MA, USA,Department of Biostatistics, Boston University School of Public
Health, Boston, MA, USA
| | - SS Mirza
- Department of Epidemiology, Erasmus University Medical Center,
Rotterdam, The Netherlands,Netherlands Consortium for Healthy Ageing, Leiden, The
Netherlands
| | - JW Jukema
- Department of Cardiology, Leiden University Medical Center,
Leiden, The Netherlands
| | - PL deJager
- Program in Translational Neuropsychiatric Genomics, Department
of Neurology, Brigham and Women's Hospital, Boston, MA, USA
| | - TB Harris
- Laboratory of Epidemiology and Population Sciences, National
Institute on Aging, Bethesda, MD, USA
| | - DC Liewald
- Centre for Cognitive Ageing and Cognitive Epidemiology, The
University of Edinburgh, Edinburgh, UK,Department of Psychology, University of Edinburgh, Edinburgh,
UK
| | - N Amin
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus
University Medical Center, Rotterdam, The Netherlands
| | - LH Coker
- Division of Public Health Sciences and Neurology, Wake Forest
School of Medicine, Winston-Salem, NC, USA
| | - O Stegle
- Max Planck Institute for Developmental Biology, Max Planck
Institute for Intelligent Systems, Tübingen, Germany
| | - OL Lopez
- Department of Neurology, University of Pittsburgh, Pittsburgh,
PA, USA
| | - R Schmidt
- Department of Neurology, Medical University and General
Hospital of Graz, Graz, Austria
| | - A Teumer
- Interfaculty Institute for Genetics and Functional Genomics,
University Medicine Greifswald, Greifswald, Germany
| | - I Ford
- Robertson Center for biostatistics, University of Glasgow,
Glasgow, UK
| | - N Karbalai
- RG Statistical Genetics, Max Planck Institute of Psychiatry,
Munich, Germany
| | - JT Becker
- Department of Neurology, University of Pittsburgh, Pittsburgh,
PA, USA,Department of Psychiatry, University of Pittsburgh, Pittsburgh,
PA, USA,Department of Psychology, University of Pittsburgh, Pittsburgh,
PA, USA
| | | | - R Au
- Department of Neurology, Boston University School of Medicine,
Boston, MA, USA,The National Heart Lung and Blood Institute's Framingham Heart
Study, Framingham, MA, USA
| | - RSN Fehrmann
- Department of Genetics, University Medical Centre Groningen,
University of Groningen, Groningen, The Netherlands
| | - S Herms
- Division of Medical Genetics, Department of Biomedicine,
University of Basel, Basel, Switzerland,Department of Genomics, Life and Brain Research Center,
Institute of Human Genetics, University of Bonn, Bonn, Germany
| | - M Nalls
- Laboratory of Neurogenetics, National Institute on Aging,
Bethesda, MD, USA
| | - W Zhao
- Department of Epidemiology, University of Michigan, Ann Arbor,
MI, USA
| | - ST Turner
- Division of Nephrology and Hypertension, Department of Internal
Medicine, Mayo Clinic, Rochester, MN, USA
| | - K Yaffe
- Departments of Psychiatry, Neurology and Epidemiology,
University of California, San Francisco and San Francisco VA Medical Center, San Francisco,
CA, USA
| | - K Lohman
- Department of Epidemiology, Wake Forest School of Medicine,
Winston-Salem, NC, USA
| | - JC van Swieten
- Department of Neurology, Erasmus University Medical Center,
Rotterdam, The Netherlands
| | - SLR Kardia
- Department of Epidemiology, University of Michigan, Ann Arbor,
MI, USA
| | - DS Knopman
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - WM Meeks
- Department of Medicine, Division of Geriatrics, University of
Mississippi Medical Center, Jackson, MS, USA
| | - G Heiss
- Department of Epidemiology, Gillings School of Global Public
Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - EG Holliday
- Hunter Medical Research Institute and Faculty of Health,
University of Newcastle, Newcastle, NSW, Australia
| | - PW Schofield
- School of Medicine and Public Health, Faculty of Health,
University of Newcastle, Newcastle, SW, Australia
| | - T Tanaka
- Translational Gerontology Branch, National Institute on Aging,
Baltimore, MD, USA
| | - DJ Stott
- Department of Cardiovascular and Medical Sciences, University
of Glasgow, Glasgow, UK
| | - J Wang
- Department of Biostatistics, Boston University School of Public
Health, Boston, MA, USA
| | - P Ridker
- Division of Preventive Medicine, Brigham and Women's Hospital,
Boston, MA, USA
| | - AJ Gow
- Centre for Cognitive Ageing and Cognitive Epidemiology, The
University of Edinburgh, Edinburgh, UK,Department of Psychology, University of Edinburgh, Edinburgh,
UK
| | - A Pattie
- Centre for Cognitive Ageing and Cognitive Epidemiology, The
University of Edinburgh, Edinburgh, UK
| | - JM Starr
- Centre for Cognitive Ageing and Cognitive Epidemiology, The
University of Edinburgh, Edinburgh, UK,Alzheimer Scotland Research Centre, Edinburgh, UK
| | - LJ Hocking
- Division of Applied Medicine, University of Aberdeen, Aberdeen,
UK
| | - NJ Armstrong
- Centre for Healthy Brain Ageing, School of Psychiatry, UNSW
Medicine, University of New South Wales, Sydney, Australia,Cancer Research Program, Garvan Institute of Medical Research,
Sydney, NSW, Australia,School of Mathematics & Statistics and Prince of Wales
Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - S McLachlan
- Centre for Population Health Sciences, University of Edinburgh,
Edinburgh, UK
| | - JM Shulman
- Department of Neurology, Baylor College of Medicine, Houston,
TX, USA,Department of Molecular and Human Genetics, The Jan and Dan
Duncan Neurological Research Institute, Texas Children's Hospital, Houston, TX, USA
| | - LC Pilling
- Epidemiology and Public Health Group, University of Exeter
Medical School, Exeter, UK
| | | | - RJ Scott
- Hunter Medical Research Institute and Faculty of Health,
University of Newcastle, Newcastle, NSW, Australia
| | - NA Kochan
- Centre for Healthy Brain Ageing, School of Psychiatry, UNSW
Medicine, University of New South Wales, Sydney, Australia,Neuropsychiatric Institute, The Prince of Wales Hospital,
Sydney, NSW, Australia
| | - A Palotie
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus,
Cambridge, UK,Institute for Molecular Medicine Finland (FIMM), University of
Helsinki, Helsinki, Finland,Department of Medical Genetics, University of Helsinki and
University Central Hospital, Helsinki, Finland
| | - Y-C Hsieh
- School of Public Health, Taipei Medical University, Taipei,
Taiwan
| | - JG Eriksson
- Folkhälsan Research Centre, Helsinki, Finland,Department of General Practice and Primary Health Care,
University of Helsinki, Helsinki, Finland,National Institute for Health and Welfare, Helsinki,
Finland,Helsinki University Central Hospital, Unit of General Practice,
Helsinki, Finland,Vasa Central Hospital, Vasa, Finland
| | - A Penman
- Center of Biostatistics and Bioinformatics, University of
Mississippi Medical Center, Jackson, MS, USA
| | - RF Gottesman
- Department of Neurology, Johns Hopkins University School of
Medicine, Baltimore, MD, USA
| | - BA Oostra
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus
University Medical Center, Rotterdam, The Netherlands
| | - L Yu
- Rush Alzheimer's Disease Center, Rush University Medical
Center, Chicago, IL, USA
| | - AL DeStefano
- Department of Neurology, Boston University School of Medicine,
Boston, MA, USA,The National Heart Lung and Blood Institute's Framingham Heart
Study, Framingham, MA, USA,Department of Biostatistics, Boston University School of Public
Health, Boston, MA, USA
| | - A Beiser
- Department of Neurology, Boston University School of Medicine,
Boston, MA, USA,The National Heart Lung and Blood Institute's Framingham Heart
Study, Framingham, MA, USA,Department of Biostatistics, Boston University School of Public
Health, Boston, MA, USA
| | - M Garcia
- Laboratory of Epidemiology and Population Sciences, National
Institute on Aging, Bethesda, MD, USA
| | - JI Rotter
- Medical Genetics Institute, Cedars-Sinai Medical Center, Los
Angeles, CA, USA,Institute for Translational Genomics and Population Sciences,
Los Angeles BioMedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA,
USA,Division of Genetic Outcomes, Department of Pediatrics,
Harbor-UCLA Medical Center, Torrance, CA, USA
| | - MM Nöthen
- Department of Genomics, Life and Brain Research Center,
Institute of Human Genetics, University of Bonn, Bonn, Germany,German Center for Neurodegenerative Diseases (DZNE), Bonn,
Germany
| | - A Hofman
- Department of Epidemiology, Erasmus University Medical Center,
Rotterdam, The Netherlands,Netherlands Consortium for Healthy Ageing, Leiden, The
Netherlands
| | - PE Slagboom
- Department of Molecular Epidemiology, Leiden University Medical
Center, Leiden, The Netherlands
| | - RGJ Westendorp
- Leiden Academy of Vitality and Ageing, Leiden, The
Netherlands
| | - BM Buckley
- Department of Pharmacology and Therapeutics, University College
Cork, Cork, Ireland
| | - PA Wolf
- Department of Neurology, Boston University School of Medicine,
Boston, MA, USA,The National Heart Lung and Blood Institute's Framingham Heart
Study, Framingham, MA, USA
| | - AG Uitterlinden
- Department of Epidemiology, Erasmus University Medical Center,
Rotterdam, The Netherlands,Netherlands Consortium for Healthy Ageing, Leiden, The
Netherlands,Department of Internal Medicine, Erasmus University Medical
Center, Rotterdam, The Netherlands
| | - BM Psaty
- Cardiovascular Health Research Unit, Department of Medicine,
University of Washington, Seattle, WA, USA,Department of Epidemiology, University of Washington, Seattle,
WA, USA,Department of Health Services, University of Washington,
Seattle, WA, USA,Group Health Research Institute, Group Health, Seattle, WA,
USA
| | - HJ Grabe
- Department of Psychiatry and Psychotherapy, University Medicine
Greifswald, HELIOS-Hospital Stralsund, Stralsund, Germany
| | - S Bandinelli
- Geriatric Unit, Azienda Sanitaria Firenze (ASF), Florence,
Italy
| | - DI Chasman
- Division of Preventive Medicine, Brigham and Women's Hospital,
Boston, MA, USA
| | - F Grodstein
- Channing Division of Network Medicine, Department of Medicine,
Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - K Räikkönen
- Institute of Behavioural Sciences, University of Helsinki,
Helsinki, Finland
| | - J-C Lambert
- Inserm, U1167, Institut Pasteur de Lille, Université
Lille-Nord de France, Lille, France
| | - DJ Porteous
- Centre for Genomic and Experimental Medicine, Institute of
Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | | | - JF Price
- Centre for Population Health Sciences, University of Edinburgh,
Edinburgh, UK
| | - PS Sachdev
- Centre for Healthy Brain Ageing, School of Psychiatry, UNSW
Medicine, University of New South Wales, Sydney, Australia,Neuropsychiatric Institute, The Prince of Wales Hospital,
Sydney, NSW, Australia
| | - L Ferrucci
- Translational Gerontology Branch, National Institute on Aging,
Baltimore, MD, USA
| | - JR Attia
- Hunter Medical Research Institute and Faculty of Health,
University of Newcastle, Newcastle, NSW, Australia
| | - I Rudan
- Centre for Population Health Sciences, University of Edinburgh,
Edinburgh, UK
| | - C Hayward
- MRC Human Genetics Unit, Institute of Genetics and Molecular
Medicine, University of Edinburgh, Edinburgh, UK
| | - AF Wright
- MRC Human Genetics Unit, Institute of Genetics and Molecular
Medicine, University of Edinburgh, Edinburgh, UK
| | - JF Wilson
- Centre for Population Health Sciences, University of Edinburgh,
Edinburgh, UK
| | - S Cichon
- Division of Medical Genetics, Department of Biomedicine,
University of Basel, Basel, Switzerland,Department of Genomics, Life and Brain Research Center,
Institute of Human Genetics, University of Bonn, Bonn, Germany,Institute of Neuroscience and Medicine (INM-1), Research Center
Juelich, Juelich, Germany
| | - L Franke
- Department of Genetics, University Medical Centre Groningen,
University of Groningen, Groningen, The Netherlands
| | - H Schmidt
- Department of Neurology, Medical University and General
Hospital of Graz, Graz, Austria
| | - J Ding
- Department of Internal Medicine, Wake Forest University School
of Medicine, Winston-Salem, NC, USA
| | - AJM de Craen
- Department of Gerontology and Geriatrics, Leiden University
Medical Center, Leiden, The Netherlands
| | - M Fornage
- Institute for Molecular Medicine and Human Genetics Center,
University of Texas Health Science Center at Houston, Houston, TX, USA
| | - DA Bennett
- Rush Alzheimer's Disease Center, Rush University Medical
Center, Chicago, IL, USA
| | - IJ Deary
- Centre for Cognitive Ageing and Cognitive Epidemiology, The
University of Edinburgh, Edinburgh, UK,Department of Psychology, University of Edinburgh, Edinburgh,
UK
| | - MA Ikram
- Department of Neurology, Erasmus University Medical Center,
Rotterdam, The Netherlands,Department of Epidemiology, Erasmus University Medical Center,
Rotterdam, The Netherlands,Netherlands Consortium for Healthy Ageing, Leiden, The
Netherlands,Department of Radiology, Erasmus University Medical Center,
Rotterdam, The Netherlands
| | - LJ Launer
- Laboratory of Epidemiology and Population Sciences, National
Institute on Aging, Bethesda, MD, USA
| | - AL Fitzpatrick
- Department of Epidemiology, University of Washington, Seattle,
WA, USA
| | - S Seshadri
- Department of Neurology, Boston University School of Medicine,
Boston, MA, USA,The National Heart Lung and Blood Institute's Framingham Heart
Study, Framingham, MA, USA
| | - CM van Duijn
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus
University Medical Center, Rotterdam, The Netherlands,Netherlands Consortium for Healthy Ageing, Leiden, The
Netherlands
| | - TH Mosley
- Department of Medicine and Neurology, University of Mississippi
Medical Center, Jackson, MS, USA
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Rajesh P, Gunasekaran S, Gnanasambandan T, Seshadri S. Experimental and theoretical study of ornidazole. Spectrochim Acta A Mol Biomol Spectrosc 2016; 153:496-504. [PMID: 26408856 DOI: 10.1016/j.saa.2015.08.032] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 08/08/2015] [Accepted: 08/14/2015] [Indexed: 06/05/2023]
Abstract
The Fourier transform infrared (FT-IR) and the Fourier transform Raman (FT-Raman) spectra of the title molecule in solid phase were recorded in the region 4000-400 cm(-1) and 4000-100 cm(-1) respectively. The geometrical parameters and energies were investigated with the help of Density Functional Theory (DFT) employing B3LYP method and 6-31G (d, p) basis set. The analysis was supported by electrostatic potential maps and calculation of HOMO-LUMO. UV, FT-IR and FT-Raman spectra of ornidazole were calculated and compared with experimental results. Thermodynamic properties like entropy, heat capacity, have been calculated for the molecule. The predicted first hyperpolarizability also shows that the molecule might have a reasonably good non-linear optical (NLO) behavior. The intramolecular contacts have been interpreted using natural bond orbital (NBO) and natural localized molecular orbital (NLMO) analysis.
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Affiliation(s)
- P Rajesh
- Department of Physics, Pachaiyappa's College, Chennai 600030, India; Department of Physics, Meenakshi Academy of Higher Education & Research, Faculty of Humanities and Science, Meenakshi University, Chennai-600078, India.
| | - S Gunasekaran
- Research & Development, St. Peter's University, Avadi, Chennai 600 054, India
| | - T Gnanasambandan
- Department of Physics, Pallavan College of Engineering, Kanchipuram 63150, India
| | - S Seshadri
- Department of Physics, L.N. Govt. Arts College, Ponneri 601204, India
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40
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Kano S, Yuan M, Cardarelli RA, Maegawa G, Higurashi N, Gaval-Cruz M, Wilson AM, Tristan C, Kondo MA, Chen Y, Koga M, Obie C, Ishizuka K, Seshadri S, Srivastava R, Kato TA, Horiuchi Y, Sedlak TW, Lee Y, Rapoport JL, Hirose S, Okano H, Valle D, O'Donnell P, Sawa A, Kai M. Clinical utility of neuronal cells directly converted from fibroblasts of patients for neuropsychiatric disorders: studies of lysosomal storage diseases and channelopathy. Curr Mol Med 2015; 15:138-45. [PMID: 25732146 DOI: 10.2174/1566524015666150303110300] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Revised: 12/20/2014] [Accepted: 01/18/2015] [Indexed: 11/22/2022]
Abstract
Methodologies for generating functional neuronal cells directly from human fibroblasts [induced neuronal (iN) cells] have been recently developed, but the research so far has only focused on technical refinements or recapitulation of known pathological phenotypes. A critical question is whether this novel technology will contribute to elucidation of novel disease mechanisms or evaluation of therapeutic strategies. Here we have addressed this question by studying Tay-Sachs disease, a representative lysosomal storage disease, and Dravet syndrome, a form of severe myoclonic epilepsy in infancy, using human iN cells with feature of immature postmitotic glutamatergic neuronal cells. In Tay-Sachs disease, we have successfully characterized canonical neuronal pathology, massive accumulation of GM2 ganglioside, and demonstrated the suitability of this novel cell culture for future drug screening. In Dravet syndrome, we have identified a novel functional phenotype that was not suggested by studies of classical mouse models and human autopsied brains. Taken together, the present study demonstrates that human iN cells are useful for translational neuroscience research to explore novel disease mechanisms and evaluate therapeutic compounds. In the future, research using human iN cells with well-characterized genomic landscape can be integrated into multidisciplinary patient-oriented research on neuropsychiatric disorders to address novel disease mechanisms and evaluate therapeutic strategies.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - A Sawa
- Departments of Psychiatry and Behavioral Sciences and Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
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41
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Olson NC, Butenas S, Lange LA, Lange EM, Cushman M, Jenny NS, Walston J, Souto JC, Soria JM, Chauhan G, Debette S, Longstreth WT, Seshadri S, Reiner AP, Tracy RP. Coagulation factor XII genetic variation, ex vivo thrombin generation, and stroke risk in the elderly: results from the Cardiovascular Health Study. J Thromb Haemost 2015; 13:1867-77. [PMID: 26286125 PMCID: PMC4946166 DOI: 10.1111/jth.13111] [Citation(s) in RCA: 12] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 06/12/2015] [Accepted: 08/02/2015] [Indexed: 12/31/2022]
Abstract
BACKGROUND The relationships of thrombin generation (TG) with cardiovascular disease risk are underevaluated in population-based cohorts. OBJECTIVES To evaluate the relationships of TG influenced by the contact and tissue factor coagulation pathways ex vivo with common single-nucleotide polymorphisms (SNPs) and incident cardiovascular disease and stroke. PATIENTS/METHODS We measured peak TG (pTG) in baseline plasma samples of Cardiovascular Health Study participants (n = 5411), both with and without inhibitory anti-factor XIa antibody (pTG/FXIa(-) ). We evaluated their associations with ~ 50 000 SNPs by using the IBCv2 genotyping array, and with incident cardiovascular disease and stroke events over a median follow-up of 13.2 years. RESULTS The minor allele for an SNP in the FXII gene (F12), rs1801020, was associated with lower pTG in European-Americans (β = - 34.2 ± 3.5 nm; P = 3.3 × 10(-22) ; minor allele frequency [MAF] = 0.23) and African-Americans (β = - 31.1 ± 7.9 nm; P = 9.0 × 10(-5) ; MAF = 0.42). Lower FXIa-independent pTG (pTG/FXIa(-) ) was associated with the F12 rs1801020 minor allele, and higher pTG/FXIa(-) was associated with the ABO SNP rs657152 minor allele (β = 16.3 nm; P = 4.3 × 10(-9) ; MAF = 0.37). The risk factor-adjusted ischemic stroke hazard ratios were 1.09 (95% confidence interval CI 1.01-1.17; P = 0.03) for pTG, 1.06 (95% CI 0.98-1.15; P = 0.17) for pTG/FXIa(-) , and 1.11 (95% CI 1.02-1.21; P = 0.02) for FXIa-dependent pTG (pTG/FXIa(+) ), per one standard deviation increment (n = 834 ischemic strokes). In a multicohort candidate gene analysis, rs1801020 was not associated with incident ischemic stroke (β = - 0.02; standard error = 0.08; P = 0.81). CONCLUSIONS These results support the importance of contact activation pathway-dependent TG as a risk factor for ischemic stroke, and indicate the importance of F12 SNPs for TG ex vivo and in vivo.
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Affiliation(s)
- N C Olson
- Department of Pathology and Laboratory Medicine, University of Vermont College of Medicine, Burlington, VT, USA
| | - S Butenas
- Department of Biochemistry, University of Vermont College of Medicine, Burlington, VT, USA
| | - L A Lange
- Department of Genetics, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - E M Lange
- Department of Genetics, University of North Carolina School of Medicine, Chapel Hill, NC, USA
- Department of Biostatistics, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - M Cushman
- Department of Pathology and Laboratory Medicine, University of Vermont College of Medicine, Burlington, VT, USA
- Department of Medicine, University of Vermont College of Medicine, Burlington, VT, USA
| | - N S Jenny
- Department of Pathology and Laboratory Medicine, University of Vermont College of Medicine, Burlington, VT, USA
| | - J Walston
- Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - J C Souto
- Department of Hematology, Institute of Biomedical Research (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - J M Soria
- Unit of Genomics of Complex Diseases, Institute of Biomedical Research (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - G Chauhan
- INSERM U897, University of Bordeaux, Bordeaux, France
- University of Bordeaux, Bordeaux, France
| | - S Debette
- INSERM U897, University of Bordeaux, Bordeaux, France
- University of Bordeaux, Bordeaux, France
- Bordeaux University Hospital, Bordeaux, France
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - W T Longstreth
- Department of Neurology, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - S Seshadri
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - A P Reiner
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - R P Tracy
- Department of Pathology and Laboratory Medicine, University of Vermont College of Medicine, Burlington, VT, USA
- Department of Biochemistry, University of Vermont College of Medicine, Burlington, VT, USA
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42
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Agbenyikey W, Karasek R, Cifuentes M, Wolf PA, Seshadri S, Taylor JA, Beiser AS, Au R. Job strain and cognitive decline: a prospective study of the framingham offspring cohort. Int J Occup Environ Med 2015; 6:79-94. [PMID: 25890602 PMCID: PMC5282587 DOI: 10.15171/ijoem.2015.534] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [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] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 02/02/2015] [Indexed: 11/09/2022]
Abstract
BACKGROUND Workplace stress is known to be related with many behavioral and disease outcomes. However, little is known about its prospective relationship with measures of cognitive decline. OBJECTIVE To investigate the association of job strain, psychological demands and job control on cognitive decline. METHODS Participants from Framingham Offspring cohort (n=1429), were assessed on job strain, and received neuropsychological assessment approximately 15 years and 21 years afterwards. RESULTS High job strain and low control were associated with decline in verbal learning and memory. Job strain was associated with decline in word recognition skills. Active job and passive job predicted decline in verbal learning and memory relative to low strain jobs in the younger subgroup. Active job and demands were positively associated with abstract reasoning skills. CONCLUSIONS Job strain and job control may influence decline in cognitive performance.
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Affiliation(s)
- W Agbenyikey
- Department of Environmental and Occupational Health, Drexel University, Philadelphia, PA, USA.
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43
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Raj RK, Gunasekaran S, Gnanasambandan T, Seshadri S. Combined spectroscopic and DFT studies on 6-bromo-4-chloro-3-formyl coumarin. Spectrochim Acta A Mol Biomol Spectrosc 2015; 139:505-514. [PMID: 25576949 DOI: 10.1016/j.saa.2014.12.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 11/16/2014] [Accepted: 12/09/2014] [Indexed: 06/04/2023]
Abstract
The FTIR and FT-Raman spectra of 6-bromo-4-chloro-3-formyl coumarin (6B4C3FC) have been recorded in the region 4000-400 and 4000-100 cm(-1), respectively. The optimized geometry, frequency and intensity of the vibrational bands were obtained by the density functional theory (DFT) using 6-31G(d,p) basis set. The harmonic vibrational frequencies were scaled and compared with experimental values. The observed and the calculated frequencies were found to be in good agreement. The UV-Visible spectrum was also recorded and compared with the theoretical values. The calculated HOMO and LUMO energies show that charge transfer occurs within molecule. The first order hyperpolarizability (β0) of 6B4C3FC is 21 times greater than that of urea. Stability of the molecule arising from hyperconjugative interactions, charge delocalization have been analyzed using natural bond orbital (NBO) analysis. Information about the charge density distribution of the molecule and its chemical reactivity has been obtained by mapping molecular electrostatic potential surface. In addition, the non-linear optical properties were discussed from the dipole moment values and the excitation wavelength in the UV-Visible region.
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Affiliation(s)
- R K Raj
- Department of Physics, SCSVMV University, Enathur, Kanchipuram 631561, India; Department of Physics, Pachaiyappa's College for Men, Kanchipuram 631 503, India.
| | - S Gunasekaran
- Research & Development, St. Peter's University, Avadi, Chennai 600 054, India
| | - T Gnanasambandan
- Department of Physics, Pallavan College of Engineering, Kanchipuram 631 502, India
| | - S Seshadri
- Department of Physics, L.N. Govt. Arts College, Ponneri, India
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44
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Saravanan RR, Seshadri S, Gunasekaran S, Mendoza-Meroño R, Garcia-Granda S. Conformational analysis, X-ray crystallographic, FT-IR, FT-Raman, DFT, MEP and molecular docking studies on 1-(1-(3-methoxyphenyl) ethylidene) thiosemicarbazide. Spectrochim Acta A Mol Biomol Spectrosc 2015; 139:321-328. [PMID: 25574651 DOI: 10.1016/j.saa.2014.12.026] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 11/22/2014] [Accepted: 12/10/2014] [Indexed: 06/04/2023]
Abstract
Conformational analysis, X-ray crystallographic, FT-IR, FT-Raman, DFT, MEP and molecular docking studies on 1-(1-(3-methoxyphenyl) ethylidene) thiosemicarbazide (MPET) are investigated. From conformational analysis the examination of the positions of a molecule taken and the energy changes is observed. The docking studies of the ligand MPET with target protein showed that this is a good molecule which docks well with target related to HMG-CoA. Hence MPET can be considered for developing into a potent anti-cholesterol drug. MEP assists in optimization of electrostatic interactions between the protein and the ligand. The MEP surface displays the molecular shape, size and electrostatic potential values. The optimized geometry of the compound was calculated from the DFT-B3LYP gradient calculations employing 6-31G (d, p) basis set and calculated vibrational frequencies are evaluated via comparison with experimental values.
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Affiliation(s)
- R R Saravanan
- Department of Physics, Misrimal Navajee Munoth Jain Engineering College, Thoraipakkam, Chennai 600 097, India.
| | - S Seshadri
- Department of Physics, L.N. Govt. Arts College, Ponneri, Thiruvallur 601 001, India
| | - S Gunasekaran
- Research & Development, St. Peter's University, Avadi, Chennai 600 054, India
| | - R Mendoza-Meroño
- Faculty of Chemistry, Department of Physical and Analytical Chemistry, University Oviedo, C/ Julian Claveria, 8, 33006 Oviedo, Asturias, Spain
| | - S Garcia-Granda
- Faculty of Chemistry, Department of Physical and Analytical Chemistry, University Oviedo, C/ Julian Claveria, 8, 33006 Oviedo, Asturias, Spain
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45
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Raja R, Seshadri S, Gnanasambandan T, Saravanan RR. Crystal growth and properties of NLO optical crystal - Butylated Hydroxy Toluene (BHT). Spectrochim Acta A Mol Biomol Spectrosc 2015; 138:13-20. [PMID: 25437840 DOI: 10.1016/j.saa.2014.10.098] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 10/05/2014] [Accepted: 10/23/2014] [Indexed: 06/04/2023]
Abstract
Crystallographic, experimental and theoretical density functional theory (DFT) of Butylated Hydroxy Toluene (BHT) are investigated. The grown crystals were identified by single crystal X-ray analysis. The first order hyperpolarizability (β0) and related properties (β, α0 and Δα) of BHT is calculated using B3LYP/6-31G(d,p) method on the finite-field approach. The stability of molecule has been analyzed by using NBO/NLMO analysis. The molecular electrostatic potential (MESP) mapping is very useful in the investigation of the molecular structure with its physiochemical property relationship. The calculated HOMO and LUMO energies show that charge transfer occurs within these molecules. Mulliken population analysis on atomic charge is also calculated. Because of vibrational analysis, the thermodynamic properties of the title compound at different temperatures have been calculated. Finally, the UV-Vis spectra and electronic absorption properties are explained and illustrated from the frontier molecular orbitals. The grown crystals were characterized by measuring their thermal properties by Differential Thermal Analysis (DTA) and Thermo Gravimetric Analysis (TGA) measurements.
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Affiliation(s)
- R Raja
- Department of Physics, SCSVMV University, Kanchipuram 631561, India
| | - S Seshadri
- Department of Physics, L.N.Govt. Arts College, Ponneri 601204, India.
| | - T Gnanasambandan
- Department of Physics, Pallavan College of Engineering, Kanchipuram 631501, India
| | - R R Saravanan
- Department of Physics, M.N.M. Jain College of Engg, Thoraipakkam, Chennai, India
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46
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Srinivasaraghavan R, Thamaraikannan S, Seshadri S, Gnanasambandan T. Molecular conformational stability and Spectroscopic analysis of Parared with experimental techniques and quantum chemical calculations. Spectrochim Acta A Mol Biomol Spectrosc 2015; 137:1194-1205. [PMID: 25305611 DOI: 10.1016/j.saa.2014.07.046] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Revised: 07/02/2014] [Accepted: 07/18/2014] [Indexed: 06/04/2023]
Abstract
The complete vibrational assignment and analysis of the fundamental modes of Parared was carried out using the experimental FTIR and FT-Raman data and quantum chemical studies. The observed vibrational data were compared with the wavenumbers derived theoretically from the optimized geometry of the compound from the DFT-B3LYP gradient calculations employing 6-31G(d,p) and 6-311++G(d,p) basis sets. Thermodynamic properties like entropy, heat capacity and enthalpy have been calculated for the molecule. HOMO-LUMO energy gap has been calculated. The intramolecular contacts have been interpreted using natural bond orbital (NBO) and natural localized molecular orbital (NLMO) analysis. Important non-linear properties such as electric dipole moment and first hyperpolarizability of Parared have been computed using B3LYP quantum chemical calculations. Finally, the Mulliken population analysis on atomic charges of the title compound has been calculated.
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Affiliation(s)
- R Srinivasaraghavan
- Department of Physics, SCSVMV University, Enathur, Kanchipuram 631 561, India
| | - S Thamaraikannan
- Department of Physics, SCSVMV University, Enathur, Kanchipuram 631 561, India
| | - S Seshadri
- Department of Physics, L.N. Govt. College, Ponneri 601 204, India.
| | - T Gnanasambandan
- Department of Physics, Pallavan College of Engineering, Kanchipuram 631502, India
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47
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Rajesh P, Gunasekaran S, Gnanasambandan T, Seshadri S. Molecular structure and vibrational analysis of Trifluoperazine by FT-IR, FT-Raman and UV-Vis spectroscopies combined with DFT calculations. Spectrochim Acta A Mol Biomol Spectrosc 2015; 137:1184-93. [PMID: 25305610 DOI: 10.1016/j.saa.2014.08.100] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Revised: 08/11/2014] [Accepted: 08/24/2014] [Indexed: 05/07/2023]
Abstract
The complete vibrational assignment and analysis of the fundamental vibrational modes of Trifluoperazine (TFZ) was carried out using the experimental FT-IR, FT-Raman and UV-Vis data and quantum chemical studies. The observed vibrational data were compared with the wavenumbers derived theoretically for the optimized geometry of the compound from the DFT-B3LYP gradient calculations employing 6-31G (d,p) basis set. Thermodynamic properties like entropy, heat capacity and enthalpy have been calculated for the molecule. The HOMO-LUMO energy gap has been calculated. The intramolecular contacts have been interpreted using natural bond orbital (NBO) and natural localized molecular orbital (NLMO) analysis. Important non-linear properties such as first hyperpolarizability of TFZ have been computed using B3LYP quantum chemical calculation.
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Affiliation(s)
- P Rajesh
- Department of Physics, Pachaiyappa's College, Chennai 600030, India.
| | - S Gunasekaran
- Research & Development, St. Peter's Univerisity, Avadi, Chennai 600054, India
| | - T Gnanasambandan
- Department of Physics, Pallavan College of Engineering, Kanchipuram 631502, India
| | - S Seshadri
- Department of Physics, L.N. Govt. Arts College, Ponneri 601204, India
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48
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Rajesh P, Gunasekaran S, Gnanasambandan T, Seshadri S. Experimental, quantum chemical and NBO/NLMO investigations of pantoprazole. Spectrochim Acta A Mol Biomol Spectrosc 2015; 136 Pt B:247-255. [PMID: 25315871 DOI: 10.1016/j.saa.2014.09.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2014] [Revised: 08/11/2014] [Accepted: 09/11/2014] [Indexed: 06/04/2023]
Abstract
The complete vibrational assignment and analysis of the fundamental modes of pantoprazole (PPZ) was carried out using the experimental FT-IR, FT-Raman and UV-Vis data and quantum chemical studies. The observed vibrational data were compared with the wavenumbers derived theoretically for the optimized geometry of the compound from the DFT-B3LYP gradient calculations employing 6-31G (d, p) basis set. Thermodynamic properties like entropy, heat capacity and enthalpy have been calculated for the molecule. HOMO-LUMO energy gap has been calculated. The intramolecular contacts have been interpreted using natural bond orbital (NBO) and natural localized molecular orbital (NLMO) analysis. Important non-linear properties such as electric dipole moment and first hyperpolarizability of PPZ have been computed using B3LYP quantum chemical calculation. Finally, the Mulliken population analysis on atomic charges of the title compound has been calculated.
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Affiliation(s)
- P Rajesh
- Department of Physics, Pachaiyappa's College, Chennai 600 030, India.
| | - S Gunasekaran
- Research & Development, St. Peter's University, Avadi, Chennai 600 054, India
| | - T Gnanasambandan
- Department of Physics, Pallavan College of Engineering, Kanchipuram 631502, India
| | - S Seshadri
- Department of Physics, L.N. Govt. Arts College, Ponneri 601204, India
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49
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Davies G, Armstrong N, Bis JC, Bressler J, Chouraki V, Giddaluru S, Hofer E, Ibrahim-Verbaas CA, Kirin M, Lahti J, van der Lee SJ, Le Hellard S, Liu T, Marioni RE, Oldmeadow C, Postmus I, Smith AV, Smith JA, Thalamuthu A, Thomson R, Vitart V, Wang J, Yu L, Zgaga L, Zhao W, Boxall R, Harris SE, Hill WD, Liewald DC, Luciano M, Adams H, Ames D, Amin N, Amouyel P, Assareh AA, Au R, Becker JT, Beiser A, Berr C, Bertram L, Boerwinkle E, Buckley BM, Campbell H, Corley J, De Jager PL, Dufouil C, Eriksson JG, Espeseth T, Faul JD, Ford I, Scotland G, Gottesman RF, Griswold ME, Gudnason V, Harris TB, Heiss G, Hofman A, Holliday EG, Huffman J, Kardia SLR, Kochan N, Knopman DS, Kwok JB, Lambert JC, Lee T, Li G, Li SC, Loitfelder M, Lopez OL, Lundervold AJ, Lundqvist A, Mather KA, Mirza SS, Nyberg L, Oostra BA, Palotie A, Papenberg G, Pattie A, Petrovic K, Polasek O, Psaty BM, Redmond P, Reppermund S, Rotter JI, Schmidt H, Schuur M, Schofield PW, Scott RJ, Steen VM, Stott DJ, van Swieten JC, Taylor KD, Trollor J, Trompet S, Uitterlinden AG, Weinstein G, Widen E, Windham BG, Jukema JW, Wright AF, Wright MJ, Yang Q, Amieva H, Attia JR, Bennett DA, Brodaty H, de Craen AJM, Hayward C, Ikram MA, Lindenberger U, Nilsson LG, Porteous DJ, Räikkönen K, Reinvang I, Rudan I, Sachdev PS, Schmidt R, Schofield PR, Srikanth V, Starr JM, Turner ST, Weir DR, Wilson JF, van Duijn C, Launer L, Fitzpatrick AL, Seshadri S, Mosley TH, Deary IJ. Genetic contributions to variation in general cognitive function: a meta-analysis of genome-wide association studies in the CHARGE consortium (N=53949). Mol Psychiatry 2015; 20:183-92. [PMID: 25644384 PMCID: PMC4356746 DOI: 10.1038/mp.2014.188] [Citation(s) in RCA: 258] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Revised: 11/11/2014] [Accepted: 11/24/2014] [Indexed: 01/14/2023]
Abstract
General cognitive function is substantially heritable across the human life course from adolescence to old age. We investigated the genetic contribution to variation in this important, health- and well-being-related trait in middle-aged and older adults. We conducted a meta-analysis of genome-wide association studies of 31 cohorts (N=53,949) in which the participants had undertaken multiple, diverse cognitive tests. A general cognitive function phenotype was tested for, and created in each cohort by principal component analysis. We report 13 genome-wide significant single-nucleotide polymorphism (SNP) associations in three genomic regions, 6q16.1, 14q12 and 19q13.32 (best SNP and closest gene, respectively: rs10457441, P=3.93 × 10(-9), MIR2113; rs17522122, P=2.55 × 10(-8), AKAP6; rs10119, P=5.67 × 10(-9), APOE/TOMM40). We report one gene-based significant association with the HMGN1 gene located on chromosome 21 (P=1 × 10(-6)). These genes have previously been associated with neuropsychiatric phenotypes. Meta-analysis results are consistent with a polygenic model of inheritance. To estimate SNP-based heritability, the genome-wide complex trait analysis procedure was applied to two large cohorts, the Atherosclerosis Risk in Communities Study (N=6617) and the Health and Retirement Study (N=5976). The proportion of phenotypic variation accounted for by all genotyped common SNPs was 29% (s.e.=5%) and 28% (s.e.=7%), respectively. Using polygenic prediction analysis, ~1.2% of the variance in general cognitive function was predicted in the Generation Scotland cohort (N=5487; P=1.5 × 10(-17)). In hypothesis-driven tests, there was significant association between general cognitive function and four genes previously associated with Alzheimer's disease: TOMM40, APOE, ABCG1 and MEF2C.
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Affiliation(s)
- G Davies
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK,Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - N Armstrong
- School of Mathematics and Statistics, University of Sydney, Sydney, NSW, Australia
| | - J C Bis
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | - J Bressler
- Human Genetics Center, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - V Chouraki
- Inserm-UMR744, Institut Pasteur de Lille, Unité d'Epidémiologie et de Santé Publique, Lille, France,Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - S Giddaluru
- K.G. Jebsen Centre for Psychosis Research and the Norwegian Centre for Mental Disorders Research (NORMENT), Department of Clinical Science, University of Bergen, Bergen, Norway,Dr Einar Martens Research Group for Biological Psychiatry, Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen, Norway
| | - E Hofer
- Department of Neurology, Medical University of Graz, Graz, Austria,Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - C A Ibrahim-Verbaas
- Department of Neurology, Erasmus University Medical Center, Rotterdam, The Netherlands,Genetic Epidemiology Unit, Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - M Kirin
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
| | - J Lahti
- Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland,Folkhälsan Research Centre, Helsinki, Finland
| | - S J van der Lee
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - S Le Hellard
- K.G. Jebsen Centre for Psychosis Research and the Norwegian Centre for Mental Disorders Research (NORMENT), Department of Clinical Science, University of Bergen, Bergen, Norway,Dr Einar Martens Research Group for Biological Psychiatry, Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen, Norway
| | - T Liu
- Max Planck Institute for Human Development, Berlin, Germany,Max Planck Institute for Molecular Genetics, Berlin, Germany
| | - R E Marioni
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK,Medical Genetics Section, University of Edinburgh Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, Western General Hospital, Edinburgh, UK,Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
| | - C Oldmeadow
- Hunter Medical Research Institute and Faculty of Health, University of Newcastle, Newcastle, NSW, Australia
| | - I Postmus
- Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands,Netherlands Consortium for Healthy Ageing, Leiden, The Netherlands
| | - A V Smith
- Icelandic Heart Association, Kopavogur, Iceland,University of Iceland, Reykjavik, Iceland
| | - J A Smith
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
| | - A Thalamuthu
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - R Thomson
- Menzies Research Institute, Hobart, Tasmania
| | - V Vitart
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - J Wang
- Framingham Heart Study, Framingham, MA, USA,Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - L Yu
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - L Zgaga
- Department of Public Health and Primary Care, Trinity College Dublin, Dublin, Ireland,Andrija Stampar School of Public Health, Medical School, University of Zagreb, Zagreb, Croatia
| | - W Zhao
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
| | - R Boxall
- Medical Genetics Section, University of Edinburgh Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, Western General Hospital, Edinburgh, UK
| | - S E Harris
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK,Medical Genetics Section, University of Edinburgh Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, Western General Hospital, Edinburgh, UK
| | - W D Hill
- Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - D C Liewald
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - M Luciano
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK,Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - H Adams
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands,Netherlands Consortium for Healthy Ageing, Leiden, The Netherlands
| | - D Ames
- National Ageing Research Institute, Royal Melbourne Hospital, Melbourne, VIC, Australia,Academic Unit for Psychiatry of Old Age, St George's Hospital, University of Melbourne, Kew, Australia
| | - N Amin
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands,Netherlands Consortium for Healthy Ageing, Leiden, The Netherlands
| | - P Amouyel
- Inserm-UMR744, Institut Pasteur de Lille, Unité d'Epidémiologie et de Santé Publique, Lille, France
| | - A A Assareh
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - R Au
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA,Framingham Heart Study, Framingham, MA, USA
| | - J T Becker
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA,Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA,Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - A Beiser
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA,Framingham Heart Study, Framingham, MA, USA
| | - C Berr
- Inserm, U106, Montpellier, France,Université Montpellier I, Montpellier, France
| | - L Bertram
- Max Planck Institute for Molecular Genetics, Berlin, Germany,Faculty of Medicine, School of Public Health, Imperial College, London, UK
| | - E Boerwinkle
- Human Genetics Center, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA,Brown Foundation Institute of Molecular Medicine for the Prevention of Human Diseases, University of Texas Health Science Center at Houston, Houston, TX, USA,Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, USA
| | - B M Buckley
- Department of Pharmacology and Therapeutics, University College Cork, Cork, Ireland
| | - H Campbell
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
| | - J Corley
- Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - P L De Jager
- Program in Translational NeuroPsychiatric Genomics, Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA,Harvard Medical School, Boston, MA, USA,Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA
| | - C Dufouil
- Inserm U708, Neuroepidemiology, Paris, France,Inserm U897, Université Bordeaux Segalen, Bordeaux, France
| | - J G Eriksson
- Folkhälsan Research Centre, Helsinki, Finland,National Institute for Health and Welfare, Helsinki, Finland,Department of General Practice and Primary health Care, University of Helsinki, Helsinki, Finland,Unit of General Practice, Helsinki University Central Hospital, Helsinki, Finland
| | - T Espeseth
- K.G. Jebsen Centre for Psychosis Research, Norwegian Centre For Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Department of Psychology, University of Oslo, Oslo, Norway
| | - J D Faul
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - I Ford
- Robertson Center for Biostatistics, Glasgow, UK
| | - Generation Scotland
- Generation Scotland, University of Edinburgh Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, Western General Hospital, Edinburgh, UK
| | - R F Gottesman
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - M E Griswold
- Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson, MS, USA
| | - V Gudnason
- Icelandic Heart Association, Kopavogur, Iceland,University of Iceland, Reykjavik, Iceland
| | - T B Harris
- Intramural Research Program National Institutes on Aging, National Institutes of Health, Bethesda, MD, USA
| | - G Heiss
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - A Hofman
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands,Netherlands Consortium for Healthy Ageing, Leiden, The Netherlands
| | - E G Holliday
- Hunter Medical Research Institute and Faculty of Health, University of Newcastle, Newcastle, NSW, Australia
| | - J Huffman
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - S L R Kardia
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
| | - N Kochan
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia,Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, NSW, Australia
| | - D S Knopman
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - J B Kwok
- Neuroscience Research Australia, Randwick, NSW, Australia,School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - J-C Lambert
- Inserm-UMR744, Institut Pasteur de Lille, Unité d'Epidémiologie et de Santé Publique, Lille, France
| | - T Lee
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia,Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, NSW, Australia
| | - G Li
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | - S-C Li
- Max Planck Institute for Human Development, Berlin, Germany,Technische Universität Dresden, Dresden, Germany
| | - M Loitfelder
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - O L Lopez
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA
| | - A J Lundervold
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway,Kavli Research Centre for Aging and Dementia, Haraldsplass Deaconess Hospital, Bergen, Norway,K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, University of Bergen, Bergen, Norway
| | - A Lundqvist
- Umeå Center for Functional Brain Imaging (UFBI), Umeå University, Umeå, Sweden
| | - K A Mather
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - S S Mirza
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands,Netherlands Consortium for Healthy Ageing, Leiden, The Netherlands
| | - L Nyberg
- Umeå Center for Functional Brain Imaging (UFBI), Umeå University, Umeå, Sweden,Department of Radiation Sciences, Umeå University, Umeå, Sweden,Department of Integrative Medical Biology, Umeå University, Umeå, Sweden
| | - B A Oostra
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - A Palotie
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Cambridge, UK,Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland,Department of Medical Genetics, University of Helsinki and University Central Hospital, Helsinki, Finland
| | - G Papenberg
- Max Planck Institute for Human Development, Berlin, Germany,Karolinska Institutet, Aging Research Center, Stockholm University, Stockholm, Sweden
| | - A Pattie
- Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - K Petrovic
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - O Polasek
- Faculty of Medicine, Department of Public Health, University of Split, Split, Croatia
| | - B M Psaty
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA,Deparment of Epidemiology, University of Washington, Seattle, WA, USA,Deparment of Health Services, University of Washington, Seattle, WA, USA,Group Health Research Unit, Group Health Cooperative, Seattle, WA, USA
| | - P Redmond
- Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - S Reppermund
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - J I Rotter
- Institute for Translational Genomics and Population Sciences Los Angeles BioMedical Research Institute, Harbor-UCLA Medical Center, Los Angeles, CA, USA,Division of Genetic Outcomes, Department of Pediatrics, Harbor-UCLA Medical Center, Los Angeles, CA, USA
| | - H Schmidt
- Department of Neurology, Medical University of Graz, Graz, Austria,Centre for Molecular Medicine, Institute of Molecular Biology and Biochemistry, Medical University of Graz, Graz, Austria
| | - M Schuur
- Department of Neurology, Erasmus University Medical Center, Rotterdam, The Netherlands,Genetic Epidemiology Unit, Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - P W Schofield
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - R J Scott
- Hunter Medical Research Institute and Faculty of Health, University of Newcastle, Newcastle, NSW, Australia
| | - V M Steen
- K.G. Jebsen Centre for Psychosis Research and the Norwegian Centre for Mental Disorders Research (NORMENT), Department of Clinical Science, University of Bergen, Bergen, Norway,Dr Einar Martens Research Group for Biological Psychiatry, Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen, Norway
| | - D J Stott
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - J C van Swieten
- Department of Neurology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - K D Taylor
- Institute for Translational Genomics and Population Sciences Los Angeles BioMedical Research Institute, Harbor-UCLA Medical Center, Los Angeles, CA, USA,Department of Pediatrics, Harbor-UCLA Medical Center, Los Angeles, CA, USA
| | - J Trollor
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia,Department of Developmental Disability Neuropsychiatry, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - S Trompet
- Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands,Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - A G Uitterlinden
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands,Netherlands Consortium for Healthy Ageing, Leiden, The Netherlands,Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - G Weinstein
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA,Framingham Heart Study, Framingham, MA, USA
| | - E Widen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - B G Windham
- Division of Geriatrics, Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - J W Jukema
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands,Durrer Center for Cardiogenetic Research, Amsterdam, The Netherlands,Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands
| | - A F Wright
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - M J Wright
- Neuroimaging Genetics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Q Yang
- Framingham Heart Study, Framingham, MA, USA,Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - H Amieva
- Inserm U897, Université Bordeaux Segalen, Bordeaux, France
| | - J R Attia
- Hunter Medical Research Institute and Faculty of Health, University of Newcastle, Newcastle, NSW, Australia
| | - D A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - H Brodaty
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia,Dementia Collaborative Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - A J M de Craen
- Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands,Netherlands Consortium for Healthy Ageing, Leiden, The Netherlands
| | - C Hayward
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - M A Ikram
- Department of Neurology, Erasmus University Medical Center, Rotterdam, The Netherlands,Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands,Netherlands Consortium for Healthy Ageing, Leiden, The Netherlands,Department of Radiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - U Lindenberger
- Max Planck Institute for Human Development, Berlin, Germany
| | - L-G Nilsson
- ARC, Karolinska Institutet, Stockholm and UFBI, Umeå University, Umeå, Sweden
| | - D J Porteous
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK,Medical Genetics Section, University of Edinburgh Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, Western General Hospital, Edinburgh, UK,Generation Scotland, University of Edinburgh Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, Western General Hospital, Edinburgh, UK
| | - K Räikkönen
- Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland
| | - I Reinvang
- Department of Psychology, University of Oslo, Oslo, Norway
| | - I Rudan
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
| | - P S Sachdev
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia,Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, NSW, Australia
| | - R Schmidt
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - P R Schofield
- Neuroscience Research Australia, Sydney, NSW, Australia,Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - V Srikanth
- Menzies Research Institute, Hobart, Tasmania,Stroke and Ageing Research, Medicine, Southern Clinical School, Monash University, Melbourne, VIC, Australia
| | - J M Starr
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK,Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK
| | - S T Turner
- Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - D R Weir
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - J F Wilson
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
| | - C van Duijn
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands,Netherlands Consortium for Healthy Ageing, Leiden, The Netherlands
| | - L Launer
- Intramural Research Program National Institutes on Aging, National Institutes of Health, Bethesda, MD, USA
| | - A L Fitzpatrick
- Deparment of Epidemiology, University of Washington, Seattle, WA, USA,Department of Global Health, University of Washington, Seattle, WA, USA
| | - S Seshadri
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA,Framingham Heart Study, Framingham, MA, USA
| | - T H Mosley
- Division of Geriatrics, Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - I J Deary
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK,Department of Psychology, University of Edinburgh, Edinburgh, UK,Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, 7 George Square, Edinburgh EH8 9JZ, Scotland, UK. E-mail:
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Seshadri S, Khalil M, Osman A, Clough A, Jayaprakasan K, Khalaf Y. The evolving role of saline infusion sonography (SIS) in infertility. Eur J Obstet Gynecol Reprod Biol 2014; 185:66-73. [PMID: 25528732 DOI: 10.1016/j.ejogrb.2014.11.037] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [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: 05/19/2014] [Revised: 11/19/2014] [Accepted: 11/27/2014] [Indexed: 10/24/2022]
Abstract
Saline infusion sonography (SIS) has become a valuable diagnostic modality in gynaecology over the last three decades. SIS is now commonly employed for detailed evaluation of the uterine cavity as part of pre-treatment assessment in infertile women. The objective of this paper is review the scientific literature on SIS in infertility. Medline, Ovid and Cochrane databases were searched for relevant articles. The indications, technical aspects and the potential advantages of SIS are discussed. The efficacy and sensitivity of SIS are compared to hysteroscopy in the evaluation of uterine polyps, fibroids, intrauterine adhesions and uterine anomalies. Increasing evidence suggests the use of SIS prior to an in-vitro fertilization (IVF) cycle as it has increased sensitivity in the detection of intrauterine pathology. SIS is cost-effective and results in better patient satisfaction scores than hysteroscopy.
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Affiliation(s)
- S Seshadri
- Assisted Conception Unit, Guys Hospital, 11th Floor, Tower Wing, Great Maze Pond, London SE1 9RT, United Kingdom.
| | - M Khalil
- Assisted Conception Unit, Guys Hospital, 11th Floor, Tower Wing, Great Maze Pond, London SE1 9RT, United Kingdom
| | - A Osman
- Assisted Conception Unit, Guys Hospital, 11th Floor, Tower Wing, Great Maze Pond, London SE1 9RT, United Kingdom
| | - A Clough
- Assisted Conception Unit, Guys Hospital, 11th Floor, Tower Wing, Great Maze Pond, London SE1 9RT, United Kingdom
| | - K Jayaprakasan
- Royal Derby Hospital, Derby & NURTURE, University of Nottingham, Nottingham NG7 2UH, United Kingdom
| | - Y Khalaf
- Assisted Conception Unit, Guys Hospital, 11th Floor, Tower Wing, Great Maze Pond, London SE1 9RT, United Kingdom
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