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Sobotka SA, Lynch E, Liao C, Graham RJ, Msall ME. Autism and neurodevelopmental disability risks in children with tracheostomies and ventilators. Pediatr Pulmonol 2024; 59:1380-1387. [PMID: 38426806 DOI: 10.1002/ppul.26921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/31/2024] [Accepted: 02/06/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND/OBJECTIVE Infants who survive prematurity and other critical illnesses and require continued invasive mechanical ventilation (IMV) postdischarge (at home) are at high risk of developmental delays and disabilities. Studies of extremely preterm cohorts (<28-week gestation) demonstrate rates of 25% for intellectual disability (ID) and 7% for autism spectrum disorder (ASD). Rates of ASD and ID in children with IMV are unknown. This study aimed to determine neurodevelopmental disability risk in a cohort of children with postdischarge IMV. DESIGN/METHODS A consecutive series of children with IMV were assessed 1 month, 6 months, and 1 year after discharge. Cognitive, social, and communicative domains were assessed by a Developmental and Behavioral Pediatrician using (1) clinical adaptive test/clinical linguistic and auditory milestone scale (CAT/CLAMS) of the capute scales; (2) pediatric evaluation of disability inventory computer adaptive test (PEDI-CAT); and (3) modified checklist for autism in toddlers, revised (MCHAT-R). Red flag signs and symptoms of ASD using DSM-V criteria were noted. Longitudinal testing was reviewed. Expert consensus impressions of evolving ASD and/or ID were determined. RESULTS Eighteen children were followed for 1 year; at 1 year, the median age (range) was 23 (17-42) months. Children were 44% male, 33% non-Hispanic White, 39% non-Hispanic Black, and 28% Hispanic. Fifteen (83%) children were prematurity survivors. Median (range) developmental quotients (DQs): full-scale DQ 59 (11-86), CAT DQ 66.5 (8-96), and CLAMS DQ 49.5 (13-100). Twelve (67%) children were highly suspicious for ASD and/or evolving ID. CONCLUSIONS/SIGNIFICANCE This cohort of children with at-home IMV demonstrates a higher risk of ASD and ID than prior premature cohorts. Larger investigations with longer follow-up are needed.
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Affiliation(s)
- Sarah A Sobotka
- Section of Developmental and Behavioral Pediatrics, Department of Pediatrics, The University of Chicago, Chicago, Illinois, USA
| | - Emma Lynch
- Section of Developmental and Behavioral Pediatrics, Department of Pediatrics, The University of Chicago, Chicago, Illinois, USA
| | - Chuanhong Liao
- Department of Public Health Sciences, The University of Chicago, Chicago, Illinois, USA
| | - Robert J Graham
- Department of Anesthesiology, Critical Care and Pain Medicine, Division of Critical Care Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Michael E Msall
- Section of Developmental and Behavioral Pediatrics, Department of Pediatrics, The University of Chicago, Chicago, Illinois, USA
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Junla D, Yotanyamaneewong S. Cultural values, parenting and child adjustment in Thailand. Int J Psychol 2024. [PMID: 38253263 DOI: 10.1002/ijop.13111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 12/25/2023] [Indexed: 01/24/2024]
Abstract
The purpose of this study was to understand the associations of Thai parents' cultural values (i.e., individualism, collectivism and conformity) with parenting behaviour (i.e., warmth, autonomy granting, rules/limit-setting, knowledge solicitation and expectations regarding children's family obligations) and children's adjustment (i.e., internalising and externalising problems). These data were collected via child, mother and father reports when the children were 10 years old, on average. Mothers' individualism was correlated with more parental autonomy granting. Fathers' individualism was correlated with higher maternal expectations regarding children's family obligations. Parents' higher collectivism was correlated with more with parental warmth. Mothers' higher collectivism was also correlated with more parental knowledge solicitation, and fathers' higher collectivism was also associated with mothers' and fathers' higher expectations regarding children's family obligations. Fathers' higher conformity values were correlated with more parental autonomy granting and with fewer child internalising and externalising behaviours. However, after controlling for child gender, parent education and the other cultural values, mothers' and fathers' collectivism remained the only significant cultural value predicting parenting behaviours. Results advance understanding of relations between cultural values of Thai mothers and fathers and their parenting behaviours and children's adjustment.
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Affiliation(s)
- Daranee Junla
- Department of Psychology, Chiang Mai University, Chiang Mai, Thailand
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Bank TC, Stika CS, Venkataramanan R, Field C, Costantine MM. Challenges in Conducting Therapeutic Trials in Pregnancy: Emphasizing Recent Lessons Learned. J Clin Pharmacol 2023; 63 Suppl 1:S117-S125. [PMID: 37317490 DOI: 10.1002/jcph.2226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 02/17/2023] [Indexed: 06/16/2023]
Abstract
Pregnant people have traditionally been excluded from therapeutic research by restrictions intended for fetal protection. Despite a movement toward inclusion, concerns for the feasibility and safety of including pregnant people in studies continue to limit this research. This article reviews the history of research guidelines in pregnancy and illustrates ongoing challenges, as seen in the development of vaccines and therapies during the coronavirus disease 2019 pandemic and investigation of statins for preeclampsia prevention. It explores new approaches that may be used to improve therapeutic research in pregnancy. A major cultural shift is needed to balance potential maternal and/or fetal risks with potential benefits from participation in research, as well as harm from withholding treatment or providing one that is not evidence-based. Finally, it is important to honor maternal autonomy in decision-making regarding participation in clinical trials.
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Affiliation(s)
- Tracy Caroline Bank
- Division of Maternal Fetal Medicine, Department of Obstetrics & Gynecology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Catherine S Stika
- Department of Obstetrics & Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Raman Venkataramanan
- Department of Pharmaceutical Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Christine Field
- Division of Maternal Fetal Medicine, Department of Obstetrics & Gynecology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Maged M Costantine
- Division of Maternal Fetal Medicine, Department of Obstetrics & Gynecology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
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Yerger J, Cougnoux AC, Abbott CB, Luke R, Clark TS, Cawley NX, Porter FD, Davidson CD. Phenotype assessment for neurodegenerative murine models with ataxia and application to Niemann-Pick disease, type C1. Biol Open 2022; 11:bio059052. [PMID: 35452076 PMCID: PMC9096702 DOI: 10.1242/bio.059052] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 03/28/2022] [Indexed: 11/20/2022] Open
Abstract
Identifying meaningful predictors of therapeutic efficacy from preclinical studies is challenging. However, clinical manifestations occurring in both patients and mammalian models offer significant translational value. Many neurological disorders, including inherited, metabolic Niemann-Pick disease, type C (NPC), exhibit ataxia. Both individuals with NPC and murine models manifest ataxia, and investigational therapies impacting this phenotype in mice have been reported to slow disease progression in patients (e.g. miglustat, intrathecal 2-hydroxypropyl-beta-cyclodextrin, and acetyl-L-leucine). Reproducible phenotypic scoring of animal models can facilitate comparisons between genotypes, sexes, disease course, and therapies. Previously, other groups have developed a composite phenotypic scoring system (CPSS), which was subsequently used to distinguish strain-dependent phenotypes and, with modifications, to evaluate potential therapies. However, high inter-rater reliability is paramount to widespread use. We have created a comprehensive, easy-to-follow phenotypic assessment based on the CPSS and have verified its reproducibility using murine models of NPC disease. Application of this scoring system is not limited to NPC disease and may be applicable to other models of neurodegeneration exhibiting motor incoordination, thereby increasing its utility in translational studies.
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Affiliation(s)
- Julia Yerger
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Section on Molecular Dysmorphology, NIH, Bethesda, MD, 20892, USA
| | - Antony C. Cougnoux
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Section on Molecular Dysmorphology, NIH, Bethesda, MD, 20892, USA
| | - Craig B. Abbott
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Section on Molecular Dysmorphology, NIH, Bethesda, MD, 20892, USA
| | - Rachel Luke
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Section on Molecular Dysmorphology, NIH, Bethesda, MD, 20892, USA
| | - Tannia S. Clark
- National Human Genome Research Institute, Genetic Disease Research Branch, NIH, Bethesda, MD 20892, USA
| | - Niamh X. Cawley
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Section on Molecular Dysmorphology, NIH, Bethesda, MD, 20892, USA
| | - Forbes D. Porter
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Section on Molecular Dysmorphology, NIH, Bethesda, MD, 20892, USA
| | - Cristin D. Davidson
- National Human Genome Research Institute, Genetic Disease Research Branch, NIH, Bethesda, MD 20892, USA
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Brindle E, Lillis L, Barney R, Bansil P, Hess SY, Wessells KR, Ouédraogo CT, Arredondo F, Barker MK, Craft NE, Fischer C, Graham JL, Havel PJ, Karakochuk CD, Zhang M, Mussai EX, Mapango C, Randolph JM, Wander K, Pfeiffer CM, Murphy E, Boyle DS. A multicenter analytical performance evaluation of a multiplexed immunoarray for the simultaneous measurement of biomarkers of micronutrient deficiency, inflammation and malarial antigenemia. PLoS One 2021; 16:e0259509. [PMID: 34735520 PMCID: PMC8568126 DOI: 10.1371/journal.pone.0259509] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 10/20/2021] [Indexed: 11/19/2022] Open
Abstract
A lack of comparative data across laboratories is often a barrier to the uptake and adoption of new technologies. Furthermore, data generated by different immunoassay methods may be incomparable due to a lack of harmonization. In this multicenter study, we describe validation experiments conducted in a single lab and cross-lab comparisons of assay results to assess the performance characteristics of the Q-plex™ 7-plex Human Micronutrient Array (7-plex), an immunoassay that simultaneously quantifies seven biomarkers associated with micronutrient (MN) deficiencies, inflammation and malarial antigenemia using plasma or serum; alpha-1-acid glycoprotein, C-reactive protein, ferritin, histidine-rich protein 2, retinol binding protein 4, soluble transferrin receptor, and thyroglobulin. Validations included repeated testing (n = 20 separately prepared experiments on 10 assay plates) in a single lab to assess precision and linearity. Seven independent laboratories tested 76 identical heparin plasma samples collected from a cohort of pregnant women in Niger using the same 7-plex assay to assess differences in results across laboratories. In the analytical validation experiments, intra- and inter-assay coefficients of variation were acceptable at <6% and <15% respectively and assay linearity was 96% to 99% with the exception of ferritin, which had marginal performance in some tests. Cross-laboratory comparisons showed generally good agreement between laboratories in all analyte results for the panel of 76 plasma specimens, with Lin's concordance correlation coefficient values averaging ≥0.8 for all analytes. Excluding plates that would fail routine quality control (QC) standards, the inter-assay variation was acceptable for all analytes except sTfR, which had an average inter-assay coefficient of variation of ≥20%. This initial cross-laboratory study demonstrates that the 7-plex test protocol can be implemented by users with some experience in immunoassay methods, but familiarity with the multiplexed protocol was not essential.
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Affiliation(s)
- Eleanor Brindle
- Center for Studies in Demography and Ecology, University of Washington, Seattle, Washington, United States of America
| | | | | | - Pooja Bansil
- PATH, Seattle, Washington, United States of America
| | - Sonja Y. Hess
- Department of Molecular Biosciences, School of Veterinary Medicine and Department of Nutrition, University of California, Davis, California, United States of America
| | - K. Ryan Wessells
- Department of Molecular Biosciences, School of Veterinary Medicine and Department of Nutrition, University of California, Davis, California, United States of America
| | - Césaire T. Ouédraogo
- Department of Molecular Biosciences, School of Veterinary Medicine and Department of Nutrition, University of California, Davis, California, United States of America
- Helen Keller International, Niamey, Niger
| | - Francisco Arredondo
- Duke University Medical Ctr. Durham, Durham, North Carolina, United States of America
| | - Mikaela K. Barker
- Faculty of Land and Food Systems, University of British Columbia, Vancouver, British Columbia, Canada
| | - Neal E. Craft
- Craft Nutrition Consulting, Elm City, North Carolina, United States of America
| | - Christina Fischer
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - James L. Graham
- Department of Molecular Biosciences, School of Veterinary Medicine and Department of Nutrition, University of California, Davis, California, United States of America
| | - Peter J. Havel
- Department of Molecular Biosciences, School of Veterinary Medicine and Department of Nutrition, University of California, Davis, California, United States of America
| | - Crystal D. Karakochuk
- Faculty of Land and Food Systems, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mindy Zhang
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Ei-Xia Mussai
- Faculty of Land and Food Systems, University of British Columbia, Vancouver, British Columbia, Canada
| | - Carine Mapango
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jody M. Randolph
- Department of Molecular Biosciences, School of Veterinary Medicine and Department of Nutrition, University of California, Davis, California, United States of America
| | - Katherine Wander
- Binghamton University (SUNY), Binghamton, New York, United States of America
| | - Christine M. Pfeiffer
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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Mason B, Calhoun C, Woytowicz V, Pina L, Kanda R, Dunn C, Alves A, Donaldson ST. CXCR4 inhibition with AMD3100 attenuates amphetamine induced locomotor activity in adolescent Long Evans male rats. PLoS One 2021; 16:e0247707. [PMID: 33647040 PMCID: PMC7920371 DOI: 10.1371/journal.pone.0247707] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 02/11/2021] [Indexed: 02/02/2023] Open
Abstract
Adolescent psychostimulant abuse has been on the rise over the past decade. This trend has demonstrable ramifications on adolescent behavior and brain morphology, increasing risk for development of addiction during adolescence and in later adulthood. Neuroimmune substrates are implicated in the etiology of substance use disorders. To add to this body of work, the current study was developed to explore the role of a chemokine receptor, CXC Chemokine Receptor 4 (CXCR4), in the development of amphetamine (AMPH) sensitization. We targeted CXCR4 as it is implicated in developmental processes, dopaminergic transmission, neuroimmune responses, and the potentiation of psychostimulant abuse pathology. To evaluate the role of CXCR4 activity on the development of AMPH sensitization, a CXCR4 antagonist (Plerixafor; AMD3100) was administered to rats as a pretreatment variable. Specifically, adolescent Long Evans male rats (N = 37) were divided into four groups: (1) AMD3100 (IP, 4.0 mg/kg) + AMPH (IP, 4.0 mg/kg), (2) saline (SAL; 0.9% NaCl) + AMPH, (3) AMD3100 + SAL, and (4) SAL + SAL. Animals were first habituated to locomotor activity (LMA) chambers, then injected with a pretreatment drug (AMD3100 or SAL) followed by AMPH or SAL every other for four days. After a one-week withdrawal period, all animals were administered a low challenge dose of AMPH (IP, 1.0 mg/kg). AMPH-injected rats displayed significantly more locomotor activity compared to controls across all testing days. CXCR4 antagonism significantly attenuated AMPH-induced locomotor activity. On challenge day, AMD3100 pre-treated animals exhibited diminutive AMPH-induced locomotor activity compared to SAL pre-treated animals. Postmortem analyses of brain tissue revealed elevated CXCR4 protein levels in the striatum of all experimental groups. Our results implicate CXCR4 signaling in the development of AMPH sensitization and may represent an important therapeutic target for future research in psychostimulant abuse.
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Affiliation(s)
- Briana Mason
- Department of Pharmacology, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States of America
- * E-mail:
| | - Corey Calhoun
- Department of Psychology, University of Massachusetts Boston, Boston, Massachusetts, United States of America
| | - Victoria Woytowicz
- Department of Psychology, University of Massachusetts Boston, Boston, Massachusetts, United States of America
| | - Latifa Pina
- Department of Psychology, University of Massachusetts Boston, Boston, Massachusetts, United States of America
| | - Roshninder Kanda
- Department of Psychology, University of Massachusetts Boston, Boston, Massachusetts, United States of America
| | - Curtis Dunn
- Department of Psychology, University of Massachusetts Boston, Boston, Massachusetts, United States of America
| | - Antonio Alves
- Department of Psychology, University of Massachusetts Boston, Boston, Massachusetts, United States of America
| | - S. Tiffany Donaldson
- Department of Psychology, University of Massachusetts Boston, Boston, Massachusetts, United States of America
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Giovenco D, Pettifor A, MacPhail C, Kahn K, Wagner R, Piwowar‐Manning E, Wang J, Hughes JP. Assessing risk for HIV infection among adolescent girls in South Africa: an evaluation of the VOICE risk score (HPTN 068). J Int AIDS Soc 2019; 22:e25359. [PMID: 31353814 PMCID: PMC6661402 DOI: 10.1002/jia2.25359] [Citation(s) in RCA: 15] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 07/04/2019] [Indexed: 01/16/2023] Open
Abstract
INTRODUCTION To maximize impact and minimize costs, antiretroviral pre-exposure prophylaxis (PrEP) interventions should be offered to those at highest risk for HIV infection. The risk score derived from the VOICE trial is one tool currently being utilized to determine eligibility in adolescent PrEP trials in sub-Saharan Africa. This study is aimed at evaluating the utility of the risk score in predicting HIV incidence among a cohort of adolescent girls in rural South Africa. METHODS We utilized data from HIV Prevention Trials Network (HPTN) 068, a phase III randomized controlled trial conducted in rural Mpumalanga province, South Africa. School-attending young women aged 13 to 20 years were enrolled into the trial from 2011 to 2012 and followed for up to three years. A risk score based on individual-level risk factors measured at enrolment was calculated for HPTN 068 participants who completed a one-year follow-up visit and were HIV seronegative at enrolment. Possible scores ranged from 0 to 10. A proportional hazards model was then used to determine if risk score at enrolment was predictive of incident HIV infection at follow-up and an area under the curve analysis was used to examine the predictive ability of the score. RESULTS AND DISCUSSION The risk score had limited variability in the HPTN 068 sample. Scores ≥5 identified 85% of incident infections from 94% of the sample, compared to the VOICE sample in which scores ≥5 identified 91% of incident infections from only 64% of participants. The risk score did not predict HIV incidence after one year of follow-up (hazard ratio = 1.029; 95% confidence interval (CI): 0.704, 1.503, p = .884) and showed poor predictive ability (area under the curve = 0.55; 95% CI: 0.44, 0.65). Certain individual risk factors that comprise the risk score may be context specific or not relevant for adolescent populations. Additional factors should be considered when assessing risk for the purposes of determining PrEP eligibility. CONCLUSIONS The VOICE risk score demonstrated low utility to predict HIV incidence in the HPTN 068 sample. Findings highlight the need for an age and developmentally appropriate tool for assessing risk for HIV infection among adolescents. Use of the VOICE risk score for determining PrEP eligibility in younger populations should be carefully considered.
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Affiliation(s)
- Danielle Giovenco
- Department of EpidemiologyUniversity of North Carolina at Chapel HillChapel HillNCUSA
| | - Audrey Pettifor
- Department of EpidemiologyUniversity of North Carolina at Chapel HillChapel HillNCUSA
| | - Catherine MacPhail
- School of Health and SocietyUniversity of WollongongWollongongNew South WalesAustralia
- MRC/Wits RuralPublic Health and Health Transitions Research Unit (Agincourt)AcornhoekSouth Africa
| | - Kathleen Kahn
- MRC/Wits RuralPublic Health and Health Transitions Research Unit (Agincourt)AcornhoekSouth Africa
| | - Ryan Wagner
- MRC/Wits RuralPublic Health and Health Transitions Research Unit (Agincourt)AcornhoekSouth Africa
| | | | - Jing Wang
- Fred Hutchinson Cancer Research CenterSeattleWAUSA
| | - James P Hughes
- Department of BiostatisticsUniversity of WashingtonSeattleWAUSA
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Komesu YM, Richter HE, Carper B, Dinwiddie DL, Lukacz ES, Siddiqui NY, Sung VW, Zyczynski HM, Ridgeway B, Rogers RG, Arya LA, Mazloomdoost D, Gantz MG. The urinary microbiome in women with mixed urinary incontinence compared to similarly aged controls. Int Urogynecol J 2018; 29:1785-1795. [PMID: 29909556 PMCID: PMC6295358 DOI: 10.1007/s00192-018-3683-6] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [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: 02/22/2018] [Accepted: 05/28/2018] [Indexed: 01/18/2023]
Abstract
INTRODUCTION & HYPOTHESIS Previous studies have suggested that women with urinary incontinence have an altered urinary microbiome. We hypothesized that the microbiome in women with mixed urinary incontinence (MUI) differed from controls and tested this hypothesis using bacterial gene sequencing techniques. METHODS This multicenter study compared the urinary microbiome in women with MUI and similarly aged controls. Catheterized urine samples were obtained; v4-6 regions of the 16S rRNA gene were sequenced to identify bacteria. Bacterial predominance (> 50% of an individual's genera) was compared between MUI and controls. Bacterial sequences were categorized into "community types" using Dirichlet multinomial mixture (DMM) methods. Generalized linear mixed models predicted MUI/control status based on clinical characteristics and community type. Post-hoc analyses were performed in women < 51 and ≥ 51 years. Sample size estimates required 200 samples to detect a 20% difference in Lactobacillus predominance with P < 0.05. RESULTS Of 212 samples, 97.6% were analyzed (123 MUI/84 controls, mean age 53 ± 11 years). Overall Lactobacillus predominance did not differ between MUI and controls (45/123 = 36.6% vs. 36/84 = 42.9%, P = 0.36). DMM analyses revealed six community types; communities differed by age (P = 0.001). A High-Lactobacillus (89.2% Lactobacillus) community had a greater proportion of controls (19/84 = 22.6%, MUI 11/123 = 8.9%). Overall, bacterial community types did not differ in MUI and controls. However, post-hoc analysis of women < 51 years found that bacterial community types distinguished MUI from controls (P = 0.041); Moderate-Lactobacillus (aOR 7.78, CI 1.85-32.62) and Mixed (aOR 7.10, CI 1.32-38.10) community types were associated with MUI. Community types did not differentiate MUI and controls in women ≥ 51 years (P = 0.94). CONCLUSIONS Women with MUI and controls did not differ in overall Lactobacillus predominance. In younger women, urinary bacterial community types differentiated MUI from controls.
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Affiliation(s)
- Yuko M Komesu
- Department of Obstetrics and Gynecology, University of New Mexico Health Sciences Center, MSC 10 5580 1 University of New Mexico, Albuquerque, NM, 87131-0001, USA.
| | - Holly E Richter
- Obstetrics & Gynecology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Benjamin Carper
- Social, Statistical & Environmental Sciences, RTI International, Research Triangle Park, NC, USA
| | - Darrell L Dinwiddie
- Pediatrics and Clinical Translational Science Center, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Emily S Lukacz
- Department of Reproductive Medicine, University of California San Diego, San Diego, CA, USA
| | | | - Vivian W Sung
- Obstetrics & Gynecology, Alpert Medical School of Brown University, Providence, RI, USA
| | - Halina M Zyczynski
- Obstetrics, Gynecology and Reproductive Sciences, Magee-Womens Research Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Beri Ridgeway
- Obstetrics & Gynecology, Cleveland Clinic, Cleveland, OH, USA
| | - Rebecca G Rogers
- Department of Obstetrics and Gynecology, University of New Mexico Health Sciences Center, MSC 10 5580 1 University of New Mexico, Albuquerque, NM, 87131-0001, USA
- Obstetrics & Gynecology, Dell Medical School University of Texas Austin, Austin, TX, USA
| | - Lily A Arya
- Obstetrics & Gynecology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Donna Mazloomdoost
- Gynecologic Health and Disease Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) National Institutes of Health (NIH), Bethesda, MD, USA
| | - Marie G Gantz
- Social, Statistical & Environmental Sciences, RTI International, Research Triangle Park, NC, USA
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Battaglia M, Anderson MS, Buckner JH, Geyer SM, Gottlieb PA, Kay TWH, Lernmark Å, Muller S, Pugliese A, Roep BO, Greenbaum CJ, Peakman M. Understanding and preventing type 1 diabetes through the unique working model of TrialNet. Diabetologia 2017; 60:2139-2147. [PMID: 28770323 PMCID: PMC5838353 DOI: 10.1007/s00125-017-4384-2] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 06/09/2017] [Indexed: 12/11/2022]
Abstract
Type 1 diabetes is an autoimmune disease arising from the destruction of pancreatic insulin-producing beta cells. The disease represents a continuum, progressing sequentially at variable rates through identifiable stages prior to the onset of symptoms, through diagnosis and into the critical periods that follow, culminating in a variable depth of beta cell depletion. The ability to identify the very earliest of these presymptomatic stages has provided a setting in which prevention strategies can be trialled, as well as furnishing an unprecedented opportunity to study disease evolution, including intrinsic and extrinsic initiators and drivers. This niche opportunity is occupied by Type 1 Diabetes TrialNet, an international consortium of clinical trial centres that leads the field in intervention and prevention studies, accompanied by deep longitudinal bio-sampling. In this review, we focus on discoveries arising from this unique bioresource, comprising more than 70,000 samples, and outline the processes and science that have led to new biomarkers and mechanistic insights, as well as identifying new challenges and opportunities. We conclude that via integration of clinical trials and mechanistic studies, drawing in clinicians and scientists and developing partnership with industry, TrialNet embodies an enviable and unique working model for understanding a disease that to date has no cure and for designing new therapeutic approaches.
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Affiliation(s)
- Manuela Battaglia
- Diabetes Research Institute (DRI), IRCCS San Raffaele Scientific Institute, Via Olgettina 58, 20132, Milan, Italy.
| | - Mark S Anderson
- Diabetes Center, University of California, San Francisco, CA, USA
| | - Jane H Buckner
- Translational Research Program, Benaroya Research Institute, Seattle, WA, USA
| | - Susan M Geyer
- Health Informatics Institute, University of South Florida, Tampa, FL, USA
| | - Peter A Gottlieb
- Barbara Davis Center for Childhood Diabetes, University of Colorado School of Medicine, Aurora, CO, USA
| | - Thomas W H Kay
- St Vincent's Institute, Fitzroy, VIC, Australia
- Department of Medicine, St Vincent's Hospital, University of Melbourne, Fitzroy, VIC, Australia
| | - Åke Lernmark
- Lund University/CRC, Department of Clinical Sciences, Skane University Hospital, Malmö, Sweden
| | - Sarah Muller
- Health Informatics Institute, University of South Florida, Tampa, FL, USA
| | - Alberto Pugliese
- Diabetes Research Institute, Department of Medicine, Division of Diabetes Endocrinology and Metabolism, Department of Microbiology and Immunology, Leonard Miller School of Medicine University of Miami, Miami, FL, USA
| | - Bart O Roep
- Department of Diabetes Immunology, Diabetes & Metabolism Research Institute, Beckman Research Institute at the City of Hope, Duarte, CA, USA
- Department of Immunohaematology & Blood Transfusion, Leiden University Medical Center, Leiden, the Netherlands
| | | | - Mark Peakman
- Department of Immunobiology, Faculty of Life Sciences & Medicine, King's College London, London, SE1 9RT, UK.
- National Institute for Health Research Biomedical Research Centre at Guy's and St Thomas' Hospital Foundation Trust and King's College London, London, UK.
- Institute of Diabetes, Endocrinology and Obesity, King's Health Partners, London, UK.
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