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Visser T, Laktabai J, Kimachas E, Kipkoech J, Menya D, Arthur D, Zhou Y, Chepkwony T, Abel L, Robie E, Amunga M, Ambani G, Uhomoibhi P, Ogbulafor N, Oshinowo B, Ogunsola O, Woldeghebriel M, Garber E, Olaleye T, Eze N, Nwidae L, Mudabai P, Gallis J, Fashanu C, Saran I, Woolsey A, Turner E, Prudhomme O’Meara W. A cluster-randomized trial of client and provider directed financial interventions to align incentives with appropriate case management in private medicine retailers: results of the TESTsmART Trial in Lagos, Nigeria. medRxiv 2024:2024.01.30.24302026. [PMID: 38352390 PMCID: PMC10862997 DOI: 10.1101/2024.01.30.24302026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/19/2024]
Abstract
Malaria remains a major health priority in Nigeria. Among children with fever who seek care, less than a quarter gets tested for malaria, leading to inappropriate use of the recommended treatment for malaria; Artemether Combination Therapies (ACT). Here we test an innovative strategy to target ACT subsidies to clients seeking care in Nigeria's private retail health sector who have a confirmed malaria diagnosis. We supported point-of-care malaria testing (mRDTs) in 48 Private Medicine Retailers (PMRs) in the city of Lagos, Nigeria and randomized them to two study arms; a control arm offering subsidized mRDT testing for USD $0.66, and an intervention arm where, in addition to access to subsidized testing as in the control arm, clients who received a positive mRDT at the PMR were eligible for a free (fully subsidized) first-line ACT and PMRs received USD $0.2 for every mRDT performed. Our primary outcome was the proportion of ACTs dispensed to individuals with a positive diagnostic test. Secondary outcomes included proportion of clients who were tested at the PMR and adherence to diagnostic test results. Overall, 23% of clients chose to test at the PMR. Test results seemed to inform treatment decisions and resulted in enhanced targeting of ACTs to confirmed malaria cases with only 26% of test-negative clients purchasing an ACT compared to 58% of untested clients. However, the intervention did not offer further improvements, compared to the control arm, in testing rates or dispensing of ACTs to test-positive clients. We found that ACT subsidies were not passed on to clients testing positive in the intervention arm. We conclude that RDTs could reduce ACT overconsumption in Nigeria's private retail health sector, but PMR-oriented incentive structures are difficult to implement and may need to be complemented with interventions targeting clients of PMRs to increase test uptake and adherence. Clinical Trials Registration Number: NCT04428307.
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Affiliation(s)
- T. Visser
- Clinton Health Access Initiative (CHAI), Boston, Massachusetts, United States of America
| | - J. Laktabai
- Moi University School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya
| | - E. Kimachas
- Academic Model Providing Access to Health Care, Eldoret, Kenya
| | - J. Kipkoech
- Academic Model Providing Access to Health Care, Eldoret, Kenya
| | - D. Menya
- Moi University School of Public Health, College of Health Sciences, Moi University, Kenya
| | - D. Arthur
- Department of Biostatistics & Bioinformatics and Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| | - Y. Zhou
- Department of Biostatistics, University of Washington, Seattle, Washington, United States of America
| | - T. Chepkwony
- Academic Model Providing Access to Health Care, Eldoret, Kenya
| | - L. Abel
- Moi University School of Public Health, College of Health Sciences, Moi University, Kenya
| | - E. Robie
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| | - M. Amunga
- Academic Model Providing Access to Health Care, Eldoret, Kenya
| | - G. Ambani
- Academic Model Providing Access to Health Care, Eldoret, Kenya
| | - P. Uhomoibhi
- National Malaria Elimination Program, Federal Ministry of Health & Social Welfare, Abuja, Nigeria
| | - N. Ogbulafor
- National Malaria Elimination Program, Federal Ministry of Health & Social Welfare, Abuja, Nigeria
| | - B. Oshinowo
- Lagos State Malaria Elimination Program, Lagos State Ministry of Health, Lagos, Nigeria
| | - O. Ogunsola
- Simon Business School, University of Rochester, Rochester, New York, United States of America
| | | | - E. Garber
- Clinton Health Access Initiative (CHAI), Abuja, Nigeria
| | - T. Olaleye
- Clinton Health Access Initiative (CHAI), Abuja, Nigeria
| | - N. Eze
- Clinton Health Access Initiative (CHAI), Abuja, Nigeria
| | - L. Nwidae
- Clinton Health Access Initiative (CHAI), Abuja, Nigeria
| | - P. Mudabai
- Clinton Health Access Initiative (CHAI), Abuja, Nigeria
| | - J.A. Gallis
- Department of Biostatistics & Bioinformatics and Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| | - C. Fashanu
- Clinton Health Access Initiative (CHAI), Abuja, Nigeria
| | - I. Saran
- School of Social Work, Boston College, Massachusetts, United States of America
| | - A. Woolsey
- Clinton Health Access Initiative (CHAI), Boston, Massachusetts, United States of America
| | - E.L. Turner
- Department of Biostatistics & Bioinformatics and Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| | - W. Prudhomme O’Meara
- Duke Global Health Institute and Moi University School of Public Health, College of Health Science
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Laktabai J, Kimachas E, Kipkoech J, Menya D, Arthur D, Zhou Y, Chepkwony T, Abel L, Robie E, Amunga M, Ambani G, Woldeghebriel M, Garber E, Eze N, Mudabai P, Gallis JA, Fashanu C, Saran I, Woolsey A, Visser T, Turner EL, O'Meara WP. A cluster-randomized trial of client and provider-directed financial interventions to align incentives with appropriate case management in retail medicine outlets: results of the TESTsmART Trial in western Kenya. medRxiv 2023:2023.09.14.23295586. [PMID: 37745516 PMCID: PMC10516073 DOI: 10.1101/2023.09.14.23295586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
ACTs are responsible for a substantial proportion of the global reduction in malaria mortality over the last ten years. These reductions would not have been possible without publicly-funded subsidies making these drugs accessible and affordable in the private sector. However, inexpensive ACTs available in retail outlets have contributed substantially to their overconsumption. We test an innovative, scalable, and sustainable strategy to target ACT subsidies to clients with a confirmatory diagnosis. We supported point-of-care malaria testing (mRDTs) in 39 retail medicine outlets in western Kenya and randomized them to three study arms; control arm offering subsidized RDT testing for 0.4USD, client-directed intervention where all clients who received a positive RDT at the outlet were eligible for a free (fully subsidized) first-line ACT, and a combined client and provider directed intervention where clients with a positive RDT were eligible for free ACT and outlets received 0.1USD for every RDT performed. Our primary outcome was the proportion of ACT dispensed to individuals with a positive diagnostic test. Secondary outcomes included proportion of clients tested at the outlet and adherence to diagnostic test results. 43% of clients chose to test at the outlet. Test results informed treatment decisions and resulted in targeting of ACTs to confirmed malaria cases - 25.3% of test-negative clients purchased an ACT compared to 75% of untested clients. Client-directed and client+provider-directed interventions did not offer further improvements, compared to the control arm, in testing rates (RD=0.09, 95%CI:-0.08,0.26) or dispensing of ACTs to test-positive clients (RD=0.01,95% CI: -0.14, 0.16). Clients were often unaware of the price they paid for the ACT leading to uncertainty in whether the ACT subsidy was passed on to the client. We conclude that mRDTs could reduce ACT overconsumption in the private retail sector, but incentive structures are difficult to scale and their value to private providers is uncertain.
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Affiliation(s)
- J Laktabai
- Moi University School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya
| | - E Kimachas
- Academic Model Providing Access to Health Care, Eldoret, Kenya
| | - J Kipkoech
- Academic Model Providing Access to Health Care, Eldoret, Kenya
| | - D Menya
- Moi University School of Public Health, College of Health Sciences, Moi University
| | - D Arthur
- Department of Biostatistics & Bioinformatics and Duke Global Health Institute, Duke University, Durham, NC
| | - Y Zhou
- Department of Biostatistics, University of Washington, Seattle WA
| | - T Chepkwony
- Academic Model Providing Access to Health Care, Eldoret, Kenya
| | - L Abel
- Academic Model Providing Access to Health Care, Eldoret, Kenya
| | - E Robie
- Duke Global Health Institute
| | - M Amunga
- Academic Model Providing Access to Health Care, Eldoret, Kenya
| | - G Ambani
- Academic Model Providing Access to Health Care, Eldoret, Kenya
| | | | - E Garber
- Clinton Health Access Initiative (CHAI) Nigeria
| | - Nwamaka Eze
- Clinton Health Access Initiative (CHAI) Nigeria
| | | | - J A Gallis
- Department of Biostatistics & Bioinformatics and Duke Global Health Institute, Duke University, Durham, NC
| | | | - I Saran
- School of Social Work, Boston College
| | - A Woolsey
- Clinton Health Access Initiative (CHAI) Boston, Massachusetts
| | - T Visser
- Clinton Health Access Initiative (CHAI) Boston, Massachusetts
| | - E L Turner
- Department of Biostatistics & Bioinformatics and Duke Global Health Institute, Duke University, Durham, NC
| | - W Prudhomme O'Meara
- Duke Global Health Institute and Moi University School of Public Health, College of Health Science
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Lyu A, Silva AE, Cheung SH, Thompson B, Abel L, Cheong AMY. Effects of visual span on Chinese reading performance in normal peripheral vision. Vision Res 2022; 201:108119. [PMID: 36108416 DOI: 10.1016/j.visres.2022.108119] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 08/16/2022] [Accepted: 08/29/2022] [Indexed: 01/25/2023]
Abstract
The current study examined the relationships among temporal processing speed, spatial visual span and Chinese character reading speed in normal central and peripheral vision. Maximum reading speed (MRS) and critical print size (CPS) of 26 native Chinese readers (13 young and 13 older adults) were determined at three visual field locations: central vision, 10° left and 10° below fixation using a rapid serial visual presentation (RSVP) task. Temporal processing speed was measured using trigrams of randomly selected Chinese characters presented at a range of exposure durations, while spatial visual span was measured using trigrams presented at different spatial positions. It was found that shorter temporal processing speed and larger spatial visual span were associated with faster MRS at the central and inferior visual field locations, but not at the left of fixation location. As expected, reading and visual span metrics were better in central vision compared to both peripheral locations. In addition, reading, temporal processing, and spatial visual span metrics were better in the young than older subjects (except for similar temporal processing speed at two peripheral locations). The results for central and inferior presentation locations support the hypothesis that temporal processing speed and spatial visual span were associated with Chinese character reading speed. Surprisingly, no correlation was observed for the 10° left of the fixation location, suggesting that the factors affecting reading speed might differ for inferior and lateral peripheral viewing locations.
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Affiliation(s)
- A Lyu
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong.
| | - A E Silva
- School of Optometry and Vision Science, University of Waterloo, ON, Canada.
| | - S H Cheung
- Department of Psychology, The University of Hong Kong, Hong Kong.
| | - B Thompson
- School of Optometry and Vision Science, University of Waterloo, ON, Canada; Centre for Eye and Vision Research Limited, Hong Kong.
| | - L Abel
- School of Medicine, Deakin University, Burwood, VIC, Australia.
| | - A M Y Cheong
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong; Centre for Eye and Vision Research Limited, Hong Kong; Research Centre for SHARP Vision, The Hong Kong Polytechnic University, Hong Kong.
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Foulon M, Robbe-Saule M, Manry J, Esnault L, Boucaud Y, Alcaïs A, Malloci M, Fanton d’Andon M, Beauvais T, Labarriere N, Jeannin P, Abel L, Saint-André JP, Croué A, Delneste Y, Boneca IG, Marsollier L, Marion E. Mycolactone toxin induces an inflammatory response by targeting the IL-1β pathway: Mechanistic insight into Buruli ulcer pathophysiology. PLoS Pathog 2020; 16:e1009107. [PMID: 33338061 PMCID: PMC7748131 DOI: 10.1371/journal.ppat.1009107] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [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: 06/09/2020] [Accepted: 10/29/2020] [Indexed: 12/12/2022] Open
Abstract
Mycolactone, a lipid-like toxin, is the major virulence factor of Mycobacterium ulcerans, the etiological agent of Buruli ulcer. Its involvement in lesion development has been widely described in early stages of the disease, through its cytotoxic and immunosuppressive activities, but less is known about later stages. Here, we revisit the role of mycolactone in disease outcome and provide the first demonstration of the pro-inflammatory potential of this toxin. We found that the mycolactone-containing mycobacterial extracellular vesicles produced by M. ulcerans induced the production of IL-1β, a potent pro-inflammatory cytokine, in a TLR2-dependent manner, targeting NLRP3/1 inflammasomes. We show our data to be relevant in a physiological context. The in vivo injection of these mycolactone-containing vesicles induced a strong local inflammatory response and tissue damage, which were prevented by corticosteroids. Finally, several soluble pro-inflammatory factors, including IL-1β, were detected in infected tissues from mice and Buruli ulcer patients. Our results revisit Buruli ulcer pathophysiology by providing new insight, thus paving the way for the development of new therapeutic strategies taking the pro-inflammatory potential of mycolactone into account. Buruli ulcer is a neglected tropical disease occurring mainly in poor rural areas of West and Central Africa. This cutaneous disease is caused by Mycobacterium ulcerans, a bacterium belonging to the same family as M. tuberculosis and M. leprae. The skin lesions are caused by a cytotoxic toxin named mycolactone, also known to act as an immunosuppressor and an anti-inflammatory molecule. However, Buruli ulcer lesions are characterized by a chronic cutaneous inflammation with a recruitment of cellular immune cells trying to counteract M. ulcerans. Our work allows for a reconcilitation of previous observations. We found by in vitro experiment on macrophages that the mycolactone-containing mycobacterial extracellular vesicles produced by M. ulcerans induced the production of IL-1β, a potent pro-inflammatory molecule, while other pro-inflammatory soluble factors are inhibited. We also detected IL-1β protein in a mouse model of M. ulcerans infection as well as in biopsies of Buruli ulcer patients. The pro-inflammatory potential of mycolacone has to be taken into account to understand the full pathophysiology of Buruli ulcer.
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Affiliation(s)
- M. Foulon
- Université d’Angers, INSERM, CRCINA, Angers, France
| | | | - J. Manry
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, Paris, France
- Université de Paris, Imagine Institute, France
| | - L. Esnault
- Université d’Angers, INSERM, CRCINA, Angers, France
| | - Y. Boucaud
- Université d’Angers, INSERM, CRCINA, Angers, France
| | - A. Alcaïs
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, Paris, France
- Université de Paris, Imagine Institute, France
| | - M. Malloci
- Plateforme MicroPiCell, SFR santé François Bonamy, Nantes, France
| | - M. Fanton d’Andon
- Institut Pasteur, Unité Biologie et Génétique de la Paroi Bactérienne, Paris, France; CNRS, INSERM, Équipe Avenir, Paris, France
| | - T. Beauvais
- Université de Nantes, INSERM, CRCINA, Nantes
| | | | - P. Jeannin
- Université d’Angers, INSERM, CRCINA, Angers, France
- Laboratoire d’Immunologie et Allergologie, CHU Angers, Angers, France
| | - L. Abel
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, Paris, France
- Université de Paris, Imagine Institute, France
| | - J. P. Saint-André
- Département de Pathologie Cellulaire et Tissulaire, CHU Angers, Angers, France
| | - A. Croué
- Département de Pathologie Cellulaire et Tissulaire, CHU Angers, Angers, France
| | - Y. Delneste
- Université d’Angers, INSERM, CRCINA, Angers, France
- Laboratoire d’Immunologie et Allergologie, CHU Angers, Angers, France
| | - I. G. Boneca
- Institut Pasteur, Unité Biologie et Génétique de la Paroi Bactérienne, Paris, France; CNRS, INSERM, Équipe Avenir, Paris, France
| | | | - E. Marion
- Université d’Angers, INSERM, CRCINA, Angers, France
- * E-mail:
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Affiliation(s)
- J Howick
- Faculty of Philosophy, 6396University of Oxford, Oxford OX2 6GG, UK
| | - S Mittoo
- University Health Network, 7938University of Toronto, Toronto, Ontario, M5G 2C4 Canada
| | - L Abel
- Nuffield Department of Primary Care Health Sciences, 6396University of Oxford, Oxford OX2 6GG, UK
| | - J Halpern
- School of Public Health, University of California at Berkeley, CA 94720-7360, USA
| | - S W Mercer
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, EH8 9AG UK
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Tonkie-Crine S, Abel L, Van Hecke O, Wang K, Butler C. Tackling antimicrobial resistance in the community. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.1202] [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
Antibiotic prescription is a major driver of antibiotic resistance. The majority of antibiotic prescribing occurs in community care settings, often for respiratory infections. A substantial proportion of prescriptions are issued not according to guidelines, particularly for acute respiratory infections which can be self-limiting. Prescribers in these settings need support to prescribe antibiotics more prudently. Patients and the public also need support to manage infections which are self-limiting. This presentation presents a summary of how antimicrobial stewardship (AMS) activities are being used in community settings. Firstly, types of community-level interventions are discussed, including those aimed at clinicians, patients and the public. Next, we assess interventions based on their effectiveness at reducing antibiotic prescriptions or use and their cost-effectiveness. Finally, we discuss directions for future research and consider how the research to date could influence policy.
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Affiliation(s)
- S Tonkie-Crine
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - L Abel
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - O Van Hecke
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - K Wang
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - C Butler
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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El Azbaoui S, Sabri A, Ouraini S, Hassani A, Asermouh A, Agadr A, Abilkassem R, Dini N, Kmari M, Akhaddar A, Laktati Z, Aieche S, El Hafidi N, Ben Brahim F, Bousfiha AA, Ailal F, Deswarte C, Schurr E, Amar L, Bustamante J, Boisson-Dupuis S, Casanova JL, Abel L, El Baghdadi J. Utility of the QuantiFERON-TB Gold In-Tube assay for the diagnosis of tuberculosis in Moroccan children. Int J Tuberc Lung Dis 2018; 20:1639-1646. [PMID: 27931340 DOI: 10.5588/ijtld.16.0382] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING The utility of interferon-gamma release assays (IGRAs), such as the QuantiFERON-TB Gold In-Tube (QFT-GIT) test, in diagnosing active tuberculosis (TB) in children is unclear and depends on the epidemiological setting. OBJECTIVE To evaluate the performance of QFT-GIT for TB diagnosis in children living in Morocco, an intermediate TB incidence country with high bacille Calmette-Gurin vaccination coverage. DESIGN We prospectively recruited 109 Moroccan children hospitalised for clinically suspected TB, all of whom were tested using QFT-GIT. RESULTS For 81 of the 109 children, the final diagnosis was TB. The remaining 28 children did not have TB. QFT-GIT had a sensitivity of 66% (95%CI 5277) for the diagnosis of TB, and a specificity of 100% (95%CI 88100). The tuberculin skin test (TST) had lower sensitivity, at 46% (95%CI 3360), and its concordance with QFT-GIT was limited (69%). Combining QFT-GIT and TST results increased sensitivity to 83% (95%CI 6992). CONCLUSION In epidemiological settings such as those found in Morocco, QFT-GIT is more sensitive than the TST for active TB diagnosis in children. Combining the TST and QFT-GIT would be useful for the diagnosis of active TB in children, in combination with clinical, radiological and laboratory data.
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Affiliation(s)
- S El Azbaoui
- Genetics Unit, Mohammed V Military Hospital, Rabat, Faculty of ScienceKenitra IbnTofail University, Kenitra
| | - A Sabri
- Genetics Unit, Mohammed V Military Hospital, Rabat, Faculty of ScienceKenitra IbnTofail University, Kenitra
| | - S Ouraini
- Ear, Nose, Throat Department, Head and Neck Surgery, Medical and Pharmacy School of Rabat, Mohammed V Military Hospital, University of Mohammed V, Rabat
| | - A Hassani
- Department of Paediatrics, Mohammed V Military Hospital, Medical and Pharmacy School of Rabat, University of Mohammed V, Rabat
| | - A Asermouh
- Department of Paediatric Infectious Diseases, Rabat Childrens Hospital, Rabat
| | - A Agadr
- Department of Paediatrics, Mohammed V Military Hospital, Medical and Pharmacy School of Rabat, University of Mohammed V, Rabat
| | - R Abilkassem
- Department of Paediatrics, Mohammed V Military Hospital, Medical and Pharmacy School of Rabat, University of Mohammed V, Rabat
| | - N Dini
- Department of Paediatrics, Mohammed V Military Hospital, Medical and Pharmacy School of Rabat, University of Mohammed V, Rabat
| | - M Kmari
- Department of Paediatrics, Mohammed V Military Hospital
| | - A Akhaddar
- Department of Neurosurgery, Avicenne Military Hospital, Marrakech, University of Mohammed V Souissi, Rabat
| | - Z Laktati
- Genetics Unit, Mohammed V Military Hospital, Rabat, Faculty of Sciences of Rabat, University of Mohammed V, Rabat
| | - S Aieche
- Genetics Unit, Mohammed V Military Hospital, Rabat, Faculty of Sciences of Rabat, University of Mohammed V, Rabat
| | - N El Hafidi
- Medical and Pharmacy School of Rabat, University of Mohammed V, Rabat, Department of Paediatric Infectious Diseases, Rabat Childrens Hospital, Rabat
| | - F Ben Brahim
- Department of Paediatric Infectious Diseases, Rabat Childrens Hospital, Rabat
| | - A A Bousfiha
- Clinical Immunology Unit, Casablanca Childrens Hospital, Ibn Rochd Medical School
| | - F Ailal
- Department of Paediatric Infectious Diseases, Ibn Rochd Hospital University Centre, King Hassan II University, Casablanca, Morocco
| | - C Deswarte
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Sant et de la Recherche Mdicale Unit 1163, Paris, Imagine Institute, Paris Descartes University, Paris, France
| | - E Schurr
- McGill Centre for the Study of Host Resistance, The Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - L Amar
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Sant et de la Recherche Mdicale Unit 1163, Paris, Imagine Institute, Paris Descartes University, Paris, France
| | - J Bustamante
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Sant et de la Recherche Mdicale Unit 1163, Paris, Imagine Institute, Paris Descartes University, Paris, France, Center for the Study of Primary Immunodeficiencies, Assistance Publique-Hpitaux de Paris (AP-HP), Necker Hospital, Paris, France
| | - S Boisson-Dupuis
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Sant et de la Recherche Mdicale Unit 1163, Paris, Imagine Institute, Paris Descartes University, Paris, France
| | - J L Casanova
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Sant et de la Recherche Mdicale Unit 1163, Paris, Imagine Institute, Paris Descartes University, Paris, France, St Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, Howard Hughes Medical Institute, New York, New York, USA, Paediatric Haematology-Immunology Unit, AP-HP, Necker Hospital, Paris, France
| | - L Abel
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Sant et de la Recherche Mdicale Unit 1163, Paris, Imagine Institute, Paris Descartes University, Paris, France, St Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York
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Keita A, Toure A, Sow M, Raoul H, Magassouba N, Delaporte E, Etard JF, Abel L, Ayouba A, Baize S, Bangoura K, Barry A, Barry M, Cissé M, Delaporte E, Delmas C, Desclaux A, Diallo S, Diallo M, Diallo M, Étard JF, Etienne C, Faye O, Fofana I, Granouillac B, Hébert E, Izard S, Kassé D, Keita A, Koivugui L, Kpamou C, Lacarabaratz C, Leroy S, Marchal C, Levy Y, Magassouba N, March L, Msellati P, Niane H, Peeters M, Pers YM, Raoul H, Sacko S, Savané I, Sow M, Taverne B, Touré A, Traoré F. Extraordinary long-term and fluctuating persistence of Ebola virus RNA in semen of survivors in Guinea: implications for public health. Clin Microbiol Infect 2017; 23:412-413. [DOI: 10.1016/j.cmi.2016.11.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2016] [Revised: 09/01/2016] [Accepted: 11/02/2016] [Indexed: 11/16/2022]
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El Azbaoui S, Alaoui Mrani N, Sabri A, Jouhadi Z, Ailal F, Bousfiha AA, Najib J, El Hafidi N, Deswarte C, Schurr E, Bustamante J, Boisson-Dupuis S, Casanova JL, Abel L, El Baghdadi J. Pott's disease in Moroccan children: clinical features and investigation of the interleukin-12/interferon-γ pathway. Int J Tuberc Lung Dis 2016; 19:1455-62. [PMID: 26614186 DOI: 10.5588/ijtld.15.0290] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
SETTING Tuberculosis spondylodiscitis (TS), or Pott's disease, an extra-pulmonary form of tuberculosis (TB), is rare and difficult to diagnose in children. Some cases of severe TB in children were recently explained by inborn errors of immunity affecting the interleukin-12/interferon-gamma (IL-12/IFN-γ) axis. OBJECTIVE To analyse clinical data on Moroccan children with TS, and to perform immunological and genetic explorations of the IL-12/IFN-γ axis. DESIGN We studied nine children with TS diagnosed between 2012 and 2014. We investigated the IL-12/IFN-γ circuit by both whole-blood assays and sequencing of the coding regions of 14 core genes of this pathway. RESULTS A diagnosis of TS was based on a combination of clinical, biological, histological and radiological data. QuantiFERON(®)-TB Gold In-Tube results were positive in 75% of patients. Whole-blood assays showed normal IL-12 and IFN-γ production in all but one patient, who displayed impaired decreased response to IL-12. No candidate disease-causing mutations were detected in the exonic regions of the 14 genes. CONCLUSIONS TS diagnosis in children remains challenging, and is based largely on imaging. Further investigations of TS in children are required to determine the role of genetic defects in pathways that may or may not be related to the IL-12/IFN-γ axis.
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Affiliation(s)
- S El Azbaoui
- Genetics Unit, Military Hospital Mohamed V, Hay Riad, Rabat, Morocco; Faculty of Science-Kenitra, Ibn Tofail University, Kenitra, Morocco
| | - N Alaoui Mrani
- Department of Paediatric Surgery, Rabat Children Hospital, Medical and Pharmacy School of Rabat, Mohamed V University, Rabat, Morocco
| | - A Sabri
- Genetics Unit, Military Hospital Mohamed V, Hay Riad, Rabat, Morocco; Faculty of Science-Kenitra, Ibn Tofail University, Kenitra, Morocco
| | - Z Jouhadi
- Department of Paediatric Infectious Diseases, Ibn Rochd Hospital University Centre, King Hassan II University, Casablanca, Morocco
| | - F Ailal
- Department of Paediatric Infectious Diseases, Ibn Rochd Hospital University Centre, King Hassan II University, Casablanca, Morocco
| | - A A Bousfiha
- Department of Paediatric Infectious Diseases, Ibn Rochd Hospital University Centre, King Hassan II University, Casablanca, Morocco
| | - J Najib
- Department of Paediatric Infectious Diseases, Ibn Rochd Hospital University Centre, King Hassan II University, Casablanca, Morocco
| | - N El Hafidi
- Department of Paediatrics, Medical and Pharmacy School of Rabat, Rabat Children Hospital, Rabat, Morocco
| | - C Deswarte
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale Unit 1163, Paris, France
| | - E Schurr
- McGill International TB Centre, The Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - J Bustamante
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale Unit 1163, Paris, France; Imagine Institute, Paris Descartes University, Paris, France; Centre for the Study of Primary Immunodeficiencies, Assistance Publique-Hôpitaux de Paris, Necker Hospital for Sick Children, Paris, France
| | - S Boisson-Dupuis
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale Unit 1163, Paris, France; Imagine Institute, Paris Descartes University, Paris, France; St Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, USA
| | - J-L Casanova
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale Unit 1163, Paris, France; Imagine Institute, Paris Descartes University, Paris, France; St Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, USA; Howard Hughes Medical Institute, New York, New York, USA; Paediatric Haematology-Immunology Unit, Necker Hospital for Sick Children, Paris, France, France
| | - L Abel
- Department of Paediatrics, Medical and Pharmacy School of Rabat, Rabat Children Hospital, Rabat, Morocco; Imagine Institute, Paris Descartes University, Paris, France; St Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, USA
| | - J El Baghdadi
- Genetics Unit, Military Hospital Mohamed V, Hay Riad, Rabat, Morocco
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Grant AV, Sabri A, Abid A, Abderrahmani Rhorfi I, Benkirane M, Souhi H, Naji Amrani H, Alaoui-Tahiri K, Gharbaoui Y, Lazrak F, Sentissi I, Manessouri M, Belkheiri S, Zaid S, Bouraqadi A, El Amraoui N, Hakam M, Belkadi A, Orlova M, Boland A, Deswarte C, Amar L, Bustamante J, Boisson-Dupuis S, Casanova JL, Schurr E, El Baghdadi J, Abel L. A genome-wide association study of pulmonary tuberculosis in Morocco. Hum Genet 2016; 135:299-307. [PMID: 26767831 DOI: 10.1007/s00439-016-1633-2] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2015] [Accepted: 01/04/2016] [Indexed: 01/04/2023]
Abstract
Although epidemiological evidence suggests a human genetic basis of pulmonary tuberculosis (PTB) susceptibility, the identification of specific genes and alleles influencing PTB risk has proven to be difficult. Previous genome-wide association (GWA) studies have identified only three novel loci with modest effect sizes in sub-Saharan African and Russian populations. We performed a GWA study of 550,352 autosomal SNPs in a family-based discovery Moroccan sample (on the full population and on the subset with PTB diagnosis at <25 years), which identified 143 SNPs with p < 1 × 10(-4). The replication study in an independent case/control sample identified four SNPs displaying a p < 0.01 implicating the same risk allele. In the combined sample including 556 PTB subjects and 650 controls these four SNPs showed suggestive association (2 × 10(-6) < p < 4 × 10(-5)): rs358793 and rs17590261 were intergenic, while rs6786408 and rs916943 were located in introns of FOXP1 and AGMO, respectively. Both genes are involved in the function of macrophages, which are the site of latency and reactivation of Mycobacterium tuberculosis. The most significant finding (p = 2 × 10(-6)) was obtained for the AGMO SNP in an early (<25 years) age-at-onset subset, confirming the importance of considering age-at-onset to decipher the genetic basis of PTB. Although only suggestive, these findings highlight several avenues for future research in the human genetics of PTB.
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Affiliation(s)
- A V Grant
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale U1163, 75015, Paris, France, EU
- Paris Descartes University, Imagine Institute, 75015, Paris, France, EU
| | - A Sabri
- Genetics Unit, Military Hospital Mohammed V, Hay Riad, 10100, Rabat, Morocco
- Faculty of Sciences-Kenitra, Ibn Tofail University, Kenitra, Morocco
| | - A Abid
- Department of Pneumology, Military Hospital Mohammed V, Hay Riad, 10100, Rabat, Morocco
| | - I Abderrahmani Rhorfi
- Department of Pneumology, Military Hospital Mohammed V, Hay Riad, 10100, Rabat, Morocco
| | - M Benkirane
- Blood Transfusion Center, Military Hospital Mohammed V, Hay Riad, 10100, Rabat, Morocco
| | - H Souhi
- Department of Pneumology, Military Hospital Mohammed V, Hay Riad, 10100, Rabat, Morocco
| | - H Naji Amrani
- Department of Pneumology, Military Hospital Mohammed V, Hay Riad, 10100, Rabat, Morocco
| | - K Alaoui-Tahiri
- Department of Pneumology, Military Hospital Mohammed V, Hay Riad, 10100, Rabat, Morocco
| | - Y Gharbaoui
- Department of Pneumology, Military Hospital Mohammed V, Hay Riad, 10100, Rabat, Morocco
| | - F Lazrak
- Centre de Diagnostic de la tuberculose et des Maladies Respiratoires [CDTMR], Salé, Morocco
| | - I Sentissi
- Centre de Diagnostic de la tuberculose et des Maladies Respiratoires [CDTMR], Salé, Morocco
| | - M Manessouri
- Centre de Diagnostic de la tuberculose et des Maladies Respiratoires [CDTMR], Salé, Morocco
| | - S Belkheiri
- Centre de Diagnostic de la tuberculose et des Maladies Respiratoires [CDTMR], Salé, Morocco
| | - S Zaid
- Centre de Diagnostic de la tuberculose et des Maladies Respiratoires [CDTMR], Salé, Morocco
| | - A Bouraqadi
- Centre de Diagnostic de la tuberculose et des Maladies Respiratoires [CDTMR], Salé, Morocco
| | - N El Amraoui
- National Blood Transfusion Center, Rabat, Morocco
| | - M Hakam
- National Blood Transfusion Center, Rabat, Morocco
| | - A Belkadi
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale U1163, 75015, Paris, France, EU
- Paris Descartes University, Imagine Institute, 75015, Paris, France, EU
| | - M Orlova
- McGill Centre for the Study of Host Resistance, The Research Institute of the McGill University Health Centre, Montreal, PQ H3G 1A4, Canada
| | - A Boland
- CEA, Institut de Génomique, Centre National de Génotypage, 91000, Evry, France, EU
| | - C Deswarte
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale U1163, 75015, Paris, France, EU
- Paris Descartes University, Imagine Institute, 75015, Paris, France, EU
| | - L Amar
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale U1163, 75015, Paris, France, EU
- Paris Descartes University, Imagine Institute, 75015, Paris, France, EU
| | - J Bustamante
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale U1163, 75015, Paris, France, EU
- Paris Descartes University, Imagine Institute, 75015, Paris, France, EU
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, 10065, New York, NY, USA
| | - S Boisson-Dupuis
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale U1163, 75015, Paris, France, EU
- Paris Descartes University, Imagine Institute, 75015, Paris, France, EU
- Center for the Study of Primary Immunodeficiencies, AP-HP, Necker hospital, 75015, Paris, France, EU
| | - J L Casanova
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale U1163, 75015, Paris, France, EU
- Paris Descartes University, Imagine Institute, 75015, Paris, France, EU
- Center for the Study of Primary Immunodeficiencies, AP-HP, Necker hospital, 75015, Paris, France, EU
- Howard Hughes Medical Institute, New York, NY, USA
- Pediatric Hematology-Immunology Unit, AP-HP, Necker Hospital, 75015, Paris, France, EU
| | - E Schurr
- McGill Centre for the Study of Host Resistance, The Research Institute of the McGill University Health Centre, Montreal, PQ H3G 1A4, Canada
| | - J El Baghdadi
- Genetics Unit, Military Hospital Mohammed V, Hay Riad, 10100, Rabat, Morocco.
| | - L Abel
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale U1163, 75015, Paris, France, EU.
- Paris Descartes University, Imagine Institute, 75015, Paris, France, EU.
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, 10065, New York, NY, USA.
- Human Genetics of Infectious Diseases, INSERM, Université Paris Descartes, Unit 1163, Imagine Institute, 24 Bd du Montparnasse, 75105, Paris, France.
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Rüeger S, Bochud PY, Dufour JF, Müllhaupt B, Semela D, Heim MH, Moradpour D, Cerny A, Malinverni R, Booth DR, Suppiah V, George J, Argiro L, Halfon P, Bourlière M, Talal AH, Jacobson IM, Patin E, Nalpas B, Poynard T, Pol S, Abel L, Kutalik Z, Negro F. Impact of common risk factors of fibrosis progression in chronic hepatitis C. Gut 2015; 64:1605-15. [PMID: 25214320 DOI: 10.1136/gutjnl-2014-306997] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 08/22/2014] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The natural course of chronic hepatitis C varies widely. To improve the profiling of patients at risk of developing advanced liver disease, we assessed the relative contribution of factors for liver fibrosis progression in hepatitis C. DESIGN We analysed 1461 patients with chronic hepatitis C with an estimated date of infection and at least one liver biopsy. Risk factors for accelerated fibrosis progression rate (FPR), defined as ≥ 0.13 Metavir fibrosis units per year, were identified by logistic regression. Examined factors included age at infection, sex, route of infection, HCV genotype, body mass index (BMI), significant alcohol drinking (≥ 20 g/day for ≥ 5 years), HIV coinfection and diabetes. In a subgroup of 575 patients, we assessed the impact of single nucleotide polymorphisms previously associated with fibrosis progression in genome-wide association studies. Results were expressed as attributable fraction (AF) of risk for accelerated FPR. RESULTS Age at infection (AF 28.7%), sex (AF 8.2%), route of infection (AF 16.5%) and HCV genotype (AF 7.9%) contributed to accelerated FPR in the Swiss Hepatitis C Cohort Study, whereas significant alcohol drinking, anti-HIV, diabetes and BMI did not. In genotyped patients, variants at rs9380516 (TULP1), rs738409 (PNPLA3), rs4374383 (MERTK) (AF 19.2%) and rs910049 (major histocompatibility complex region) significantly added to the risk of accelerated FPR. Results were replicated in three additional independent cohorts, and a meta-analysis confirmed the role of age at infection, sex, route of infection, HCV genotype, rs738409, rs4374383 and rs910049 in accelerating FPR. CONCLUSIONS Most factors accelerating liver fibrosis progression in chronic hepatitis C are unmodifiable.
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Affiliation(s)
- S Rüeger
- Department of Medical Genetics, University of Lausanne, Lausanne, Switzerland Institute of Social and Preventive Medicine, University Hospital and University of Lausanne, Lausanne, Switzerland Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - P-Y Bochud
- Infectious Diseases Service, University Hospital and University of Lausanne, Lausanne, Switzerland
| | - J-F Dufour
- Department of Hepatology, University of Berne, Berne, Switzerland
| | - B Müllhaupt
- Department of Gastroenterology and Hepatology, University Hospital of Zurich, Zurich, Switzerland
| | - D Semela
- Department of Gastroenterology, Canton Hospital St Gallen, St Gallen, Switzerland
| | - M H Heim
- Department of Gastroenterology and Hepatology, University Hospital of Basel, Basel, Switzerland
| | - D Moradpour
- Department of Gastroenterology and Hepatology, University Hospital and University of Lausanne, Lausanne, Switzerland
| | - A Cerny
- Epatologia, Clinica Moncucco, Lugano, Switzerland
| | | | - D R Booth
- Institute for Immunology and Allergy Research, Westmead Millennium Institute, University of Sydney, Sydney, Australia
| | - V Suppiah
- Institute for Immunology and Allergy Research, Westmead Millennium Institute, University of Sydney, Sydney, Australia Storr Liver Unit, Westmead Millennium Institute and Westmead Hospital, University of Sydney and University of Sydney Medical Foundation, Sydney, Australia
| | - J George
- Storr Liver Unit, Westmead Millennium Institute and Westmead Hospital, University of Sydney and University of Sydney Medical Foundation, Sydney, Australia
| | - L Argiro
- Laboratoire d'Immunologie et de Génétique des Maladies Parasitaires, INSERM-UMR 906/Université de la Méditerranée, Marseilles, France
| | - P Halfon
- Laboratoire Alphabio, Hôpital Ambroise Paré, Marseilles, France
| | - M Bourlière
- Service d'Hépato-gastroentérologie, Hôpital Saint-Joseph, Marseilles, France
| | - A H Talal
- Division of Gastroenterology and Hepatology, Weill Cornell Medical College, New York, USA
| | - I M Jacobson
- Division of Gastroenterology and Hepatology, Weill Cornell Medical College, New York, USA
| | - E Patin
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, U980, Imagine Institute, Paris, France University Paris Descartes, Paris, France
| | - B Nalpas
- University Paris Descartes, Paris, France Département d'Hépatologie, INSERM Unité 1016, Groupe Hospitalier Cochin-Hôtel Dieu-Broca, Paris, France
| | - T Poynard
- Université Pierre et Marie Curie, Service d'Hépato-gastroentérologie, Hôpital Pitié-Salpêtrière (AP-HP), Paris, France
| | - S Pol
- University Paris Descartes, Paris, France Département d'Hépatologie, INSERM Unité 1016, Groupe Hospitalier Cochin-Hôtel Dieu-Broca, Paris, France
| | - L Abel
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, U980, Imagine Institute, Paris, France University Paris Descartes, Paris, France St Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, New York, USA
| | - Z Kutalik
- Institute of Social and Preventive Medicine, University Hospital and University of Lausanne, Lausanne, Switzerland Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - F Negro
- Clinical Pathology, University Hospitals of Geneva, Geneva, Switzerland Department of Gastroenterology and Hepatology, University Hospitals of Geneva, Geneva, Switzerland
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Pedergnana V, Syx L, Cobat A, Guergnon J, Brice P, Ferme C, Carde P, Hermine O, Le Pendeven C, Amiel C, Theodorou I, Abel L, Besson C. Combined Linkage and Association Studies of Antibodies against EBV Antigens Confirm the Role of HLA Class II Variants in the Control of Anti-EBNA1 IgG Levels and in the Risk of Hodgkin's Lymphoma. Klin Padiatr 2014. [DOI: 10.1055/s-0034-1371107] [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: 10/25/2022]
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El Baghdadi J, Grant AV, Sabri A, El Azbaoui S, Zaidi H, Cobat A, Schurr E, Boisson-Dupuis S, Casanova JL, Abel L. [Human genetics of tuberculosis]. ACTA ACUST UNITED AC 2013; 61:11-6. [PMID: 23399414 DOI: 10.1016/j.patbio.2013.01.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Tuberculosis (TB), caused by Mycobacterium tuberculosis, remains a major public health problem worldwide, resulting in 8.7 million new cases and 1.4 million deaths each year. One third of the world's population is exposed to M. tuberculosis and, after exposure, most, but not all, individuals become infected. Among infected subjects, only a minority (∼10%) will eventually develop clinical disease, which is typically either a primary, often extra-pulmonary, TB in children, or a reactivation, pulmonary TB in adults. Considerable genetic epidemiological evidence has accumulated to support a major role for human genetic factors in the development of TB. Numerous association studies with various candidate genes have been conducted in pulmonary TB, with very few consistent results. Recent genome-wide association studies revealed only a modest role for two inter-genic polymorphisms. However, a first major locus for pulmonary TB was mapped to chromosome 8q12-q13 in a Moroccan population after a genome-wide linkage screen. Using a similar strategy, two other major loci controlling TB infection were recently identified. While the precise identification of these major genes is ongoing, the other fascinating observation of these last years was the demonstration that TB can also reflect a Mendelian predisposition. Following the findings obtained in the syndrome of Mendelian susceptibility to mycobacterial diseases, several children with complete IL-12Rβ1 deficiency, were found to have severe TB as their sole phenotype. Overall, these recent findings provide the proof of concept that the human genetics of TB involves a continuous spectrum from Mendelian to complex predisposition with intermediate major gene involvement. The understanding of the molecular genetic basis of TB will have fundamental immunological and medical implications, in particular for the development of new vaccines and treatments.
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Affiliation(s)
- J El Baghdadi
- Unité de génétique, hôpital militaire d'instruction Mohammed V, Hay Riad, Rabat, Maroc
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Walterfang M, Macfarlane MD, Looi JCL, Abel L, Bowman E, Fahey MC, Desmond P, Velakoulis D. Pontine-to-midbrain ratio indexes ocular-motor function and illness stage in adult Niemann-Pick disease type C. Eur J Neurol 2012; 19:462-7. [PMID: 22329857 DOI: 10.1111/j.1468-1331.2011.03545.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE Niemann-Pick disease type C (NPC) is a progressive neurovisceral disorder associated with dystonia, ataxia and a characteristic gaze palsy. Neuropathological studies have demonstrated brainstem atrophy associated with neuronal inclusions and loss, and neurofibrillary tangles, although it is not known whether this pathology can be detected in vivo or how these changes relate to illness variables, particularly ocular-motor changes. Our aim was to utilize a method for brainstem atrophy, validated in progressive supranuclear palsy (PSP), in a group of adult patients with NPC, and explore its relationship to illness variables and ocular-motor functioning. METHODS We calculated the midbrain and pontine area, and pontine-to-midbrain ratio (PMR) from midsagittal images of 10 adult patients with NPC and 27 age- and gender-matched controls. Measures were correlated with illness variables, and measures of horizontal saccadic functioning. RESULTS Pontine-to-midbrain ratio was 14% higher in the NPC group, but this difference was not significant. However, PMR showed a significant positive correlation with duration of illness and a measure of illness severity. Furthermore, PMR was significantly negatively correlated with saccadic peak velocity and gain, and self-paced saccadic performance. CONCLUSIONS Pontine-to-midbrain ratio was increased in adult patients with NPC compared to controls, although not to the same degree as previously described in PSP, which also presents with significant gaze palsy. These changes were driven predominantly by progressive midbrain atrophy. The strong correlation with illness and ocular-motor variables suggests that it may be a useful marker for illness progression in NPC.
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Affiliation(s)
- M Walterfang
- Melbourne Neuropsychiatry Centre, University of Melbourne, Melbourne
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15
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Walterfang M, Macfarlane MD, Looi JCL, Abel L, Bowman E, Fahey MC, Desmond P, Velakoulis D. Pontine-to-midbrain ratio indexes ocular-motor function and illness stage in adult Niemann-Pick disease type C. Eur J Neurol 2011. [DOI: 10.1111/j.1468-1331.2011.3545.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Walterfang M, Fahey M, Abel L, Fietz M, Wood A, Bowman E, Reutens D, Velakoulis D. Size and shape of the corpus callosum in adult Niemann-Pick type C reflects state and trait illness variables. AJNR Am J Neuroradiol 2011; 32:1340-6. [PMID: 21596811 DOI: 10.3174/ajnr.a2490] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND AND PURPOSE Variable alterations to the structure of the corpus callosum have been described in adults with NPC, a neurometabolic disorder known to result in both white and gray matter pathology. This study sought to examine the structure of the callosum in a group of adult patients with NPC and compared callosal structure with a group of matched controls, and to relate callosal structure with state and trait illness variables. MATERIALS AND METHODS Nine adult patients with NPC were matched to control subjects (n = 26) on age and sex. The corpus callosum was segmented from the midsagittal section of T1-weighted images on all subjects, and total area, length, bending angle, and mean thickness were calculated. In addition, 39 regional thickness measures were derived by using a previously published method. All measures were compared between groups, and analyzed alongside symptom measures, biochemical parameters, and ocular-motor measures. RESULTS The callosal area and mean thickness were significantly reduced in the patient group, and regional thickness differences were greatest in the genu, posterior body, isthmus, and anterior splenium. Global callosal measures correlated significantly with duration of illness and symptom score, and at trend level with degree of filipin staining. Measures of reflexive saccadic peak velocity and gain, and self-paced saccades, correlated strongly with total callosal area. CONCLUSIONS Callosal structure and size reflect both state and trait markers in adult NPC, and they may be useful biomarkers to index both white and gray matter changes that reflect illness severity and progression.
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Affiliation(s)
- M Walterfang
- Melbourne Neuropsychiatry Centre, University of Melbourne, Melbourne, Australia.
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Werneck RI, Lázaro FP, Cobat A, Grant AV, Xavier MB, Abel L, Alcaïs A, Trevilatto PC, Mira MT. A major gene effect controls resistance to caries. J Dent Res 2011; 90:735-9. [PMID: 21364090 DOI: 10.1177/0022034510397614] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Despite recent advances revealing genetic factors influencing caries susceptibility, questions regarding the model of inheritance involved are yet to be addressed. We conducted a Complex Segregation Analysis on decayed teeth in a sample of homogenous, isolated families recruited from the Brazilian Amazon. A dominant, major gene effect controlling resistance to phenotype was detected. The frequency of the resistance allele "A" was 0.63; mean numbers of decayed teeth were 1.53 and 9.53 for genotypes AA/AB and BB, respectively. These results represent a step toward a description of the exact nature of the genetic risk factors controlling human susceptibility to caries.
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Affiliation(s)
- R I Werneck
- Core for Advanced Molecular Investigation, Graduate Program in Health Sciences, Center for Biological and Health Sciences, Pontifical Catholic University of Paraná, Imaculada Conceição St 1155 - CCBS/PPGCS, Prado Velho, CEP 80215-901 Curitiba, Paraná, Brazil
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18
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Gallant CJ, Cobat A, Simkin L, Black GF, Stanley K, Hughes J, Doherty TM, Hanekom WA, Eley B, Beyers N, Jaïs JP, van Helden P, Abel L, Alcaïs A, Hoal EG, Schurr E. Impact of age and sex on mycobacterial immunity in an area of high tuberculosis incidence. Int J Tuberc Lung Dis 2010; 14:952-959. [PMID: 20626938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
SETTING The extent of immune reactivity measured by the tuberculin skin test (TST) and interferon-gamma (IFN-gamma) T-cell assays is usually not analysed. OBJECTIVE To determine the impact of age and sex on assay positivity and on the extent of reactivity of both TST and T-cell assays in young persons in an area of South Africa with high TB transmission. RESULTS Age had a strong impact on assay positivity for all seven immune phenotypes tested (P < 0.0007). Among positive responders, the extent of purified protein derivative (PPD) triggered IFN-gamma release (P < 0.003) was sensitive to age. ESAT-6 triggered IFN-gamma release (day 7, P = 0.03) and the frequency of PPD-specific IFN-gamma(+)CD4(+) (P = 0.03) and IFN-gamma(+)CD8(+) cells (P = 0.04) were weakly dependent on age. By contrast, the extent of TST induration was insensitive to age (P > 0.05), and sex had no significant impact on any phenotype measured (P > 0.05). The high proportion of positive responders in the 1-10 year age-group observed with long-term whole blood assays, but not with 3-day assays and TST, suggests that long-term whole blood assays may be confounded by bacille Calmette-Guérin vaccination in this age group. CONCLUSION There is a significant impact of age, but not sex, on different assays of immune reactivity in this high TB transmission setting.
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Affiliation(s)
- C J Gallant
- Department of Human Genetics and Medicine, McGill University, McGill Centre for the Study of Host Resistance, Montreal, Canada
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Kleensang A, Franke D, Alcaïs A, Abel L, Müller-Myhsok B, Ziegler A. An extensive comparison of quantitative trait Loci mapping methods. Hum Hered 2010; 69:202-11. [PMID: 20203525 DOI: 10.1159/000289596] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2009] [Accepted: 12/21/2009] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The choices of study design and statistical approach for mapping a quantitative trait (QT) are of great importance. Larger sibships and a study design based upon phenotypically extreme siblings can be expected to have a greater statistical power. On the other hand, selected samples and/or deviation from normality can influence the robustness and power. Unfortunately, the effects of violation of multivariate normality assumptions and/or selected samples are only known for a limited number of methods. Some recommendations are available in the literature, but an extensive comparison of robustness and power under several different conditions is lacking. METHODS We compared eight freely available and commonly applied QT mapping methods in a Monte-Carlo simulation study under 36 different models and study designs (three genetic models, three selection schemes, two family structures and the possible effect of deviation from normality). RESULTS Empirical type I error fractions and empirical power are presented and explained as a whole and for each method separately, followed by a thorough discussion. CONCLUSIONS The results from this extensive comparison could serve as a valuable source for the choice of the study design and the statistical approach for mapping a QT.
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Affiliation(s)
- A Kleensang
- Institut für Medizinische Biometrie und Statistik, Universität zu Lübeck, DE-23538 Lübeck, Germany
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Walterfang M, Fietz M, Abel L, Bowman E, Mocellin R, Velakoulis D. Gender dimorphism in siblings with schizophrenia-like psychosis due to Niemann-Pick disease type C. J Inherit Metab Dis 2009; 32 Suppl 1:S221-6. [PMID: 19609713 DOI: 10.1007/s10545-009-1173-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [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] [Received: 02/15/2009] [Revised: 05/11/2009] [Accepted: 05/19/2009] [Indexed: 10/20/2022]
Abstract
We describe the differential presentation of schizophrenia-like psychosis in two siblings with the 'variant' biochemical presentation of adult Niemann-Pick disease type C. The male sibling presented with psychosis at age 16 years and cognitive and motor disturbance at age 25 years, whereas his elder sister, sharing the same mutation but showing less severe biochemical, neuroimaging and ocular motor parameters, presented with a similar schizophrenia-like illness with associated cognitive and motor disturbance at age 31 years. Their illness onset, course and response to treatment mirrors the sex dimorphism seen in schizophrenia, and is suggestive of an interaction between the neurobiology of their metabolic disorder and sex differences in neurodevelopment.
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Affiliation(s)
- M Walterfang
- Neuropsychiatry Unit, Royal Melbourne Hospital, Royal Melbourne Hospital 3050, Melbourne, Victoria, Australia.
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21
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Ranque B, Orlova M, Nguyen VT, Schurr E, Abel L, Alcaïs A. Recherche de déterminants génétiques prédisposant aux réactions de réversion au cours de la lèpre : analyse des voies d’activation du TNF-α. Rev Med Interne 2009. [DOI: 10.1016/j.revmed.2009.03.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Plancoulaine S, Mohamed MK, Arafa N, Bakr I, Rekacewicz C, Trégouët DA, Obach D, El Daly M, Thiers V, Féray C, Abdel-Hamid M, Abel L, Fontanet A. Dissection of familial correlations in hepatitis C virus (HCV) seroprevalence suggests intrafamilial viral transmission and genetic predisposition to infection. Gut 2008; 57:1268-74. [PMID: 18480169 DOI: 10.1136/gut.2007.140681] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [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] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Unsafe injections and transfusions used during treatments are considered to be responsible for many cases of transmission of hepatitis C virus (HCV) in developing countries, but cannot account for a substantial proportion of present infections. The aim of the present work was to investigate familial clustering of HCV infection in a population living in a highly endemic area. DESIGN, SETTING AND PARTICIPANTS A large seroepidemiological survey was conducted on 3994 subjects (age range, 2-88 years) from 475 familial clusters in an Egyptian rural area. Epidemiological methods appropriate for the analysis of correlated data were used to estimate risk factors and familial dependences for HCV infection. A phylogenetic analysis was conducted to investigate HCV strain similarities within and among families. MAIN OUTCOME MEASURES HCV familial correlations adjusted for known risk factors, similarities between viral strains. RESULTS Overall HCV seroprevalence was 12.3%, increasing with age. After adjustment for relevant risk factors, highly significant intrafamilial resemblances in HCV seroprevalence were obtained between father-offspring (odds ratio (OR) = 3.4 (95% confidence interval (CI), 1.8 to 6.2)), mother-offspring (OR = 3.8 (95% CI, 2.5 to 5.8)), and sibling-sibling (OR = 9.3 (95% CI, 4.9 to 17.6)), while a weaker dependence between spouses (OR = 2.2 (95% CI, 1.3 to 3.7)) was observed. Phylogenetic analysis showed greater HCV strain similarity between family members than between unrelated subjects, indicating that correlations can be explained, in part, by familial sources of virus transmission. In addition, refined dissection of correlations between first-degree relatives supported the role of host genes predisposing to HCV infection. CONCLUSIONS Current HCV infection in endemic countries has a strong familial component explained, at least partly, by specific modes of intrafamilial viral transmission and by genetic predisposition to infection.
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Affiliation(s)
- S Plancoulaine
- INSERM U550, Laboratoire de Génétique Humaine des Maladies Infectieuses, Faculté de Médecine Necker, 156 rue de Vaugirard, 75015 Paris, France.
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Bustamante J, Blancas-Galicia L, Picard C, Abel L, Casanova J. SFRP-01 – Recherche expérimentale – Défaut héréditaire de CYBB et prédisposition mendélienne aux infections mycobactériennes. Arch Pediatr 2008. [DOI: 10.1016/s0929-693x(08)72419-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abel L, Gut-Gobert C, André M. Susceptibilité génétique et infection tuberculeuse sévère. Rev Mal Respir 2008. [DOI: 10.1016/s0761-8425(08)56024-4] [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: 11/28/2022]
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25
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Marquet S, Doumbo O, Cabantous S, Poudiougou B, Argiro L, Safeukui I, Konate S, Sissoko S, Chevereau E, Traore A, Keita MM, Chevillard C, Abel L, Dessein AJ. A functional promoter variant in IL12B predisposes to cerebral malaria. Hum Mol Genet 2008; 17:2190-2195. [DOI: 10.1093/hmg/ddn118] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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Abstract
An overview of investigations indicating an important role of host genetics, both major histocompatibility complex (MHC) and non-MHC, in leprosy.
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Affiliation(s)
- E Schurr
- Montreal General Hospital Research Institute, McGill Center for the Study of Host Resistance, Montreal, PQ, Canada.
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Fortin A, Abel L, Casanova JL, Gros P. Host genetics of mycobacterial diseases in mice and men: forward genetic studies of BCG-osis and tuberculosis. Annu Rev Genomics Hum Genet 2007; 8:163-92. [PMID: 17492906 DOI: 10.1146/annurev.genom.8.080706.092315] [Citation(s) in RCA: 123] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In humans, genetic factors have long been suspected to contribute to the onset and outcome of tuberculosis. Such effects are difficult to identify owing to their complex inheritance, and to the confounding impact of environmental factors, notably pathogen-associated virulence determinants. Recently, forward genetic approaches in mouse models and in human populations have been used to elucidate a molecular basis for predisposition to mycobacterial diseases. The genetic dissection of host predisposition to infection with Mycobacterium bovis BCG and M. tuberculosis will help to define the key molecules involved in host antituberculous immunity and should provide new insights into this important infectious disease.
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Affiliation(s)
- A Fortin
- Emerillon Therapeutics, Montréal, Canada
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29
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Pelet A, de Pontual L, Clément-Ziza M, Salomon R, Mugnier C, Matsuda F, Lathrop M, Munnich A, Feingold J, Lyonnet S, Abel L, Amiel J. Homozygosity for a frequent and weakly penetrant predisposing allele at the RET locus in sporadic Hirschsprung disease. J Med Genet 2006; 42:e18. [PMID: 15744028 PMCID: PMC1736014 DOI: 10.1136/jmg.2004.028746] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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30
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Plancoulaine S, Mohamed M, Arafa N, Bakr I, Rekacewicz C, Obach D, Abdel-Hamid M, Abel L, Fontanet A. O.144 Intra-familial transmission of HCV infection in a rural area from Egypt. J Clin Virol 2006. [DOI: 10.1016/s1386-6532(06)80138-1] [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: 11/28/2022]
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Abstract
Tuberculosis, caused by Mycobacterium tuberculosis, is the most common mycobacterial disease in the world and remains a leading public health problem. Numerous other mycobacterial species are present in the environment and are most often termed atypical or nontuberculous mycobacteria. Like the attenuated vaccine Bacille Calmette-Guérin (BCG) they are generally poorly virulent, even so they can be at the origin of severe infections if the host immune response is impaired. It has been clearly demonstrated that the intrinsic virulence of a mycobacterial species is not the only factor determining disease severity, which is illustrated by the observation that the majority of individuals infected with M. tuberculosis do not develop clinical disease. Numerous arguments suggest that disease severity depends largely on susceptibility/resistance determined by the host genetic make up. In the following review we will discuss the studies on the genes implicated in complex predisposition to tuberculosis and Mendelian predisposition to disease caused by less virulent mycobacteria, proposing a continuous spectrum between those two types of predisposition.
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Affiliation(s)
- N Remus
- Laboratoire de génétique humaine des maladies infectieuse, faculté de médecine Necker-Enfants-Malades, université Paris-René-Descartes, Inserm U550, 75015 Paris, France
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Affiliation(s)
- A Alcaïs
- Laboratoire de Génétique Humaine des Maladies Infectieuses, INSERM U.550, Université René Descartes, Faculté de Médecine Necker, 156, rue de Vaugirard, 75015 Paris
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El Baghdadi J, Remus N, Benslimane A, El Annaz H, Chentoufi M, Abel L, Schurr E. Variants of the human NRAMP1 gene and susceptibility to tuberculosis in Morocco. Int J Tuberc Lung Dis 2003; 7:599-602. [PMID: 12797705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023] Open
Abstract
It has been well established that the host genetic background is an important modulator of tuberculosis susceptibility. The NRAMP1 (alias SLC11A1) gene has been associated with tuberculosis susceptibility in several ethnic groups. Here we studied the association and linkage of NRAMP1 with tuberculosis in 116 nuclear families, comprising 211 affected offspring, from Casablanca, Morocco. All enrolled tuberculosis cases were culture-positive. No evidence was found of linkage or association of NRAMP1 with tuberculosis. These findings suggest heterogeneity in the genetic control of tuberculosis susceptibility.
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Affiliation(s)
- J El Baghdadi
- Service de Génétique Microbienne, Institut Pasteur du Maroc, Casablanca, Maroc
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Bucheton B, Abel L, Kheir MM, Mirgani A, El-Safi SH, Chevillard C, Dessein A. Genetic control of visceral leishmaniasis in a Sudanese population: candidate gene testing indicates a linkage to the NRAMP1 region. Genes Immun 2003; 4:104-9. [PMID: 12618857 DOI: 10.1038/sj.gene.6363927] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
There is some evidence showing that genetic factors are involved in human susceptibility to parasitic diseases such as schistosomiasis and malaria. Studies have shown that the Nramp1 and H-2 genes are implicated in the control of Leishmania donovani infection in mice. We sought genetic loci involved in the control of susceptibility to visceral disease caused by L. donovani in humans. We studied 37 families with at least two affected sibs living in a village in eastern Sudan, where an outbreak of visceral leishmaniasis occurred between 1995 and 2000. The genetic markers located in five chromosomal regions containing candidate genes were typed: 2q35 (NRAMP1), 5q31-q33 (Th2 cytokine cluster), 6p21 (HLA/TNF-alpha), 6q23 (INFGRI) and 12q15 (INF-gamma). Linkage (multipoint lod-score=1.08; P=0.01) was observed for the 5'(CA) repeat polymorphism in the NRAMP1 promoter. This suggests that genetic variations of this gene affect susceptibility to visceral leishmaniasis in this population.
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Affiliation(s)
- B Bucheton
- Genétique et Immunologie des Maladies Parasities, INSERM U399, Faculté de Médicine de La Timone, Marseille, France
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Mira MT, Alcais A, di Pietrantonio T, Thuc NV, Phuong MC, Abel L, Schurr E. Segregation of HLA/TNF region is linked to leprosy clinical spectrum in families displaying mixed leprosy subtypes. Genes Immun 2003; 4:67-73. [PMID: 12595904 DOI: 10.1038/sj.gene.6363911] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Each year an estimated 600000 new leprosy cases are diagnosed worldwide. The spectrum of the disease varies widely from limited tuberculoid forms to extensive lepromatous forms. A measure of the risk to develop lepromatous forms of leprosy is provided by the extent of skin reactivity to lepromin (Mitsuda reaction). To address a postulated oligogenic control of leprosy pathogenesis, we investigated in the present study linkage of leprosy susceptibility, leprosy clinical subtypes, and extent of the Mitsuda reaction to six chromosomal regions carrying known or suspected leprosy susceptibility loci. The only significant result obtained was linkage of leprosy clinical subtype to the HLA/TNF region on human chromosome 6p21 (P(corrected)=0.00126). In addition, we established that within the same family different HLA/TNF haplotypes segregate into patients with different leprosy subtypes directly demonstrating the importance of this genome region for the control of clinical leprosy presentation.
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Affiliation(s)
- M T Mira
- Departments of Human Genetics, Medicine and Biochemistry, McGill University, Montreal, PQ, Canada
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Alcaïs A, Plancoulaine S, Abel L. An autosome-wide search for loci underlying wheezing age of onset in German asthmatic children identifies a new region of interest on 6q24-q25. Genet Epidemiol 2002; 21 Suppl 1:S168-73. [PMID: 11793663 DOI: 10.1002/gepi.2001.21.s1.s168] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
While numerous familial studies of asthma have identified several distinct chromosomal regions, no linkage studies have been performed taking into account the age of onset of disease. Here, we performed a genome-wide scan to search for loci linked either to asthma or wheezing age of onset in a population of German asthmatic children by incorporating survival analysis techniques in the maximum-likelihood-binomial approach. In addition to several regions already reported in asthma, wheezing age of onset was found to be strongly linked to chromosome 6q24-q25 (lod score = 3.56). Interestingly, this region contains some candidates genes such as the gene coding for the IFN-gamma receptor ligand-binding chain.
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Affiliation(s)
- A Alcaïs
- INSERM U436, Faculté Pitié-Salpêtrière, Laboratory of Human Genetics of Infectious Diseases, Faculté Necker, Paris, France
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Plancoulaine S, Alcaïs A, Abel L, Casanova JL. [Human mycobacterial infections: impact of host genetic factors]. Rev Med Liege 2002; 57:165-70. [PMID: 12014265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Humans are exposed worldwide to a variety of environmental mycobacteria (EM) and most children are inoculated with live Bacille Calmette-Guérin (BCG) vaccine. Although rarely pathogenic, poorly virulent mycobacteria, including BCG and most EM, may cause a variety of clinical diseases. M. tuberculosis and M. leprae are more virulent, causing tuberculosis, and leprosy, respectively. Remarkably, only a minority of individuals develop clinical disease, even if infected with virulent mycobacteria. There is now accumulating evidence that the large interindividual variability of clinical outcome results in part from variability in the human genes that control host defense. We review here in current knowledge about genetic predisposition to common (leprosy and tuberculosis) and rare (BCG and EM infections) mycobacterial infections.
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Affiliation(s)
- S Plancoulaine
- INSERM U550, Laboratoire de Génétique Humaine des Maladies Infectieuses (GHMI), Faculté de Médecine Necker-Enfants Malades, 156 rue de Vaugirard, 75015 Paris
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Zinn-Justin A, Marquet S, Hillaire D, Dessein A, Abel L. Genome search for additional human loci controlling infection levels by Schistosoma mansoni. Am J Trop Med Hyg 2001; 65:754-8. [PMID: 11791970 DOI: 10.4269/ajtmh.2001.65.754] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Schistosomiasis is a major public health problem in many developing countries. Previous studies have shown that infection levels by Schistosoma mansoni in a Brazilian population is controlled by a major gene, denoted as SM1, which was mapped to chromosome 5q31-q33 by use of a model-based (logarithm of the odds [lod] score) analysis method. The present study is an autosome-wide scan searching for additional human loci implicated in the regulation of S. mansoni infection intensities. The weighted pairwise correlation model-free linkage method was used in order to consider large pedigrees and to conduct a 2-locus analysis (i.e., to search for a second locus taking into account linkage to 5q31-q33). The most significant linkage results were again obtained in the 5q31-q33 region. Two additional regions provided linkage results with significance levels around 0.001, 1p21-q23 (results independent of 5q31-q33) and 6p21-q21 (results in interaction with 5q31-q33). The investigation of these regions, which contain some candidate genes, is ongoing in other populations to confirm the role of these regions.
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Affiliation(s)
- A Zinn-Justin
- Mathematical and Statistical Modeling in Biology and Medicine, Institut National de la Santé et de la Recherche Médicale (INSERM) U.436, Faculté de Médecine Pitié-Salpêtrière, Paris, France
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Abel L, Alcaïs A, Casanova JL. [Human genetics of tuberculosis: a continuous spectrum of simple monogenic predisposition to complex polygenic heredity]. Pathol Biol (Paris) 2001; 49:603-5. [PMID: 11692746 DOI: 10.1016/s0369-8114(01)00215-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Alcaïs A, Abel L. Incorporation of covariates in multipoint model-free linkage analysis of binary traits: how important are unaffecteds? Eur J Hum Genet 2001; 9:613-20. [PMID: 11528507 DOI: 10.1038/sj.ejhg.5200682] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2001] [Revised: 04/24/2001] [Accepted: 05/07/2001] [Indexed: 11/08/2022] Open
Abstract
When the mode of inheritance is unknown, genetic linkage analysis of binary trait is commonly performed using affected-sib-pair approaches. When there is evidence that some covariates influence the phenotype, incorporation of this information is expected to increase the power of the analysis since it allows (1) a better specification of the phenotype and (2) to take into account unaffected subjects. Here, we show how to account for covariates in the sibship-oriented Maximum-Likelihood-Binomial (MLB) linkage method by means of Pearson's logistic regression residuals which are computed using phenotypic and covariate information on both affected and unaffected subjects. These residuals are subsequently analysed as a quantitative phenotype with the corresponding extension of the MLB approach which can be used without any assumption on the distribution of these residuals. Then, a large simulation study is performed to study the relative power of incorporating or not unaffected sibs. To this aim, two different strategies in the multipoint analysis of family data are compared: (1) using residuals of the whole sibships (ie both covariate and genotypic information on unaffecteds is needed), and (2) using affecteds only (no information on unaffecteds is needed), under different generating models according to genetic and covariate effects. The results show that there is a clear increment in the power to detect the susceptibility locus when making use of the information carried by unaffecteds, in particular for dominant mode of inheritance and when values of the covariates influencing the disease are shared by all the members of the family.
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Affiliation(s)
- A Alcaïs
- Laboratory of Human Genetics of Infectious Diseases, INSERM U.550, Necker Medical School, Paris, France.
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Abstract
Positron emission tomography with uptake of [(18)F]fluorodeoxyglucose (FDG) and quantitative EEG were simultaneously performed in 18 medication-free patients with schizophrenia and in 13 normal volunteers. Subjects performed the Continuous Performance Task (CPT) during FDG uptake. Correlations were calculated between alpha power during the CPT and glucose metabolic rate (GMR) in thalamic regions and between alpha power during the CPT and GMR in occipital cortices. Regression analyses were used to describe the prediction of GMR in the occipital cortices and in the thalamic regions of occipital alpha power. In normal controls, we found (1) significant negative correlations between absolute alpha power and GMR in the left occipital cortex, (2) significant positive correlations between normalized alpha power and GMR in the right and left lateral thalamus and (3) combined effects of GMR in the thalamic regions and the occipital cortices on alpha power, which accounted for 98% of the variance of alpha power. In patients with schizophrenia, we found no significant correlations between alpha power and GMR in the occipital cortices or between alpha power and GMR in the thalamic regions. Correlation coefficients between absolute alpha power and GMR in the left occipital cortex and between normalized alpha power and GMR in the left lateral thalamus were significantly different in normal subjects compared to schizophrenic patients. The present findings provide evidence for involvement of the thalamus in the generation of alpha rhythm in humans. Furthermore, the present results suggest differences in thalamocortical circuits between normal controls and schizophrenic subjects.
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Affiliation(s)
- P Danos
- Neuroscience PET Laboratory, Mount Sinai Medical Center, New York, NY, USA.
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Zinn-Justin A, Ziegler A, Abel L. Multipoint development of the weighted pairwise correlation (WPC) linkage method for pedigrees of arbitrary size and application to the analysis of breast cancer and alcoholism familial data. Genet Epidemiol 2001; 21:40-52. [PMID: 11443733 DOI: 10.1002/gepi.1017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The weighted pairwise correlation (WPC) method is a simple and powerful model-free method of linkage analysis that has the advantages of being applicable to binary, ordered categorical, quantitative, or censored traits, and to consider all pairs of relatives in large pedigrees. The originally implemented approach was limited to the use of the identical by state (IBS) information, and we recently extended the WPC method to incorporate the identical by descent (IBD) information for two-point linkage analysis. Here, we develop a multipoint WPC method suitable for pedigrees of arbitrary size and large number of markers. The multipoint IBD estimation procedure for relative pairs is based on the efficient regression approach developed for pedigrees implemented in SOLAR. A robust and fast Monte-Carlo procedure is used to determine reliable P values. Application of the method to the 214 pedigrees from the Breast Cancer Linkage Consortium provided for the Genetic Analysis Workshop (GAW) 9 shows that multipoint WPC statistic values were not far from two-point maximum lod-score values obtained by the classical parametric linkage method and were higher than multipoint variance component analysis lod-scores obtained with SOLAR. The multipoint WPC method is also used to analyze the familial Collaborative Study of the Genetics of Alcoholism data on alcoholism released for GAW11. It allows a better specification of the linkage results previously obtained within the chromosome 4 region.
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Affiliation(s)
- A Zinn-Justin
- INSERM U.436, Mathematical and Statistical Modeling in Biology and Medicine, Faculté de Médecine Pitié-Salpêtrière, Paris, France
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Siegel BV, Asarnow R, Tanguay P, Call JD, Abel L, Ho A, Lott I, Buchsbaum MS. Regional cerebral glucose metabolism and attention in adults with a history of childhood autism. J Neuropsychiatry Clin Neurosci 2001; 4:406-14. [PMID: 1422167 DOI: 10.1176/jnp.4.4.406] [Citation(s) in RCA: 66] [Impact Index Per Article: 2.9] [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: 12/27/2022]
Abstract
Sixteen high-functioning adults with a history of childhood autism and 26 normal control subjects underwent [18F]fluoro-2-deoxyglucose positron-emission tomography to assess regional cerebral glucose metabolic rate (GMR). Autistic patients had a left > right anterior rectal gyrus asymmetry, as opposed to the normal right > left asymmetry in that region. Patients also showed low GMR in the left posterior putamen and high GMR in the right posterior calcarine cortex. Brain regions with GMR > 3 SD from the normal mean were more prevalent in patients than in control subjects. This variable pattern of abnormal activity is consistent with heterogeneous neurophysiological etiology; group differences in striatum and cortex may represent a final common pathway.
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Affiliation(s)
- B V Siegel
- California College of Medicine, University of California, Irvine
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Schröder J, Buchsbaum MS, Shihabuddin L, Tang C, Wei TC, Spiegel-Cohen J, Hazlett EA, Abel L, Luu-Hsia C, Ciaravolo TM, Marin D, Davis KL. Patterns of cortical activity and memory performance in Alzheimer's disease. Biol Psychiatry 2001; 49:426-36. [PMID: 11274654 DOI: 10.1016/s0006-3223(00)00983-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Declarative memory changes are the hallmark of Alzheimer's disease, although their functional neuroanatomy is not restricted to a single structure. Factor analysis provides statistical methods for evaluating patterns of cerebral changes in regional glucose uptake. METHODS Thirty-three Alzheimer's patients and 33 age- and gender-matched control subjects were studied with magnetic resonance imaging and positron emission tomography with [(18)F] deoxyglucose. During the tracer-uptake period, subjects performed a serial verbal learning task. Cortical activity was measured in 32 regions of interest, four in each lobe on both hemispheres. RESULTS Factor analysis with varimax rotation identified seven factors explaining 80% of the variance ("parietal cortex," "occipital cortex," "right temporo-prefrontal areas," "frontal cortex," "motor strip," "left temporal cortex," and "posterior temporal cortex"). Relative to control subjects, Alzheimer's patients showed significantly reduced values on the factors occipital cortex, right temporo-prefrontal areas, frontal cortex, and left temporal cortex. The factor temporo-prefrontal areas showed large differences between patients with good and poor performance, but little difference when control subjects were similarly divided. CONCLUSIONS Findings suggest that Alzheimer's disease is characterized by altered patterns of cortical activity, rather than deficits in a single location, and emphasize the importance of right temporo-prefrontal circuitry for understanding memory deficits.
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Affiliation(s)
- J Schröder
- Section of Gerontopsychiatry, Department of Psychiatry, University of Heidelberg, Heidelberg, Germany
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Gottschalk LA, Fronczek J, Abel L, Buchsbaum MS, Fallon JH. The cerebral neurobiology of anxiety, anxiety displacement, and anxiety denial. Psychother Psychosom 2001; 70:17-24. [PMID: 11150934 DOI: 10.1159/000056220] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Previous studies examining the relationship of anxiety scores, derived from the content analysis of speech of normal individuals, have revealed that the anxiety scores occurring in the dreams associated with rapid eye movement (REM) sleep are significantly correlated with localized cerebral glucose metabolic rates assessed by positron emission tomography (PET) scanning. These significant intercorrelations occur in different cerebral areas when the anxiety scores are obtained from mental experiences reported during non-REM sleep or during wakeful silent mentation. OBJECTIVE The purpose of the present study was to examine the intercorrelations found between anxiety attributed to the self, anxiety-displacement, and anxiety denial measured from computerized content analysis of 5-min verbal reports of subjective thoughts and feelings obtained from wakeful normal subjects and localized cerebral glucose metabolic rates during PET scanning. METHODS The subjects were 10 wakeful young males. Their anxiety scores were derived from computerized content analysis of 5-min reports they gave of their subjective thoughts, feelings and fantasies during a 30-min period following an intravenous injection of F D-deoxyglucose (FDG). The subjects were moved 32--45 min after this injection to obtain a PET scan, which records all of the localized cerebral glucose metabolic rates during the 30 min following the FDG injection. RESULTS Significant intercorrelations of localized cerebral glucose metabolic rates with the scores of self-anxiety, anxiety displacement, and anxiety-denial were found in dissimilar cerebral locations depending on the type of anxiety involved. The significant correlations occurred in brain regions known to be associated with the functions of emotions, cognition, memory, and vision. CONCLUSIONS Specific combinations of cerebral areas, based on glucose metabolic rates, appear to distinguish and be associated with different verbal expressions of anxiety. Replication of this preliminary research will be carried out.
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Affiliation(s)
- L A Gottschalk
- The Brain Imaging Center, Department of Psychiatry and Human Behavior, College of Medicine, University of California, Irvine, CA 92697, USA.
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Dupuis S, Döffinger R, Picard C, Fieschi C, Altare F, Jouanguy E, Abel L, Casanova JL. Human interferon-gamma-mediated immunity is a genetically controlled continuous trait that determines the outcome of mycobacterial invasion. Immunol Rev 2000; 178:129-37. [PMID: 11213797 DOI: 10.1034/j.1600-065x.2000.17810.x] [Citation(s) in RCA: 119] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Individuals with inherited disorders of interferon gamma (IFN-gamma)-mediated immunity appear to be specifically vulnerable to mycobacterial infections. The severity of clinical features of affected individuals differs between cases. Some patients die of mycobacterial infection in early childhood, whereas others have long asymptomatic periods in childhood and as adults. This rare syndrome also shows high allelic and non-allelic genetic heterogeneity. Mutations in IL12B, encoding the interleukin (IL)-12 p40 subunit, and in IL12RB1, encoding the beta1 chain of the IL-12 receptor, result in impaired IFN-gamma production. Mutations in IFNGR1 and IFNGR2, encoding the two IFN-gamma receptor chains, and mutations in STAT1, encoding an essential signaling component, result in impaired cellular responses to IFN gamma. Different types of mutation define two types of complete and two types of partial IFNgammaR1 deficiency. Complete and partial IFNgammaR2 deficiency have also been described. We herein compare the genotypes, cellular phenotypes, and clinical phenotypes of healthy individuals and patients with the seven known genetic disorders impairing cellular responses to IFN-gamma. Patients with defective IFN-gamma production were not considered in this study. The mutations and clinical features of patients with IFNgammaR1, IFNgammaR2, and STAT-1 deficiency are reviewed. Selected cell lines from each of the eight groups were tested for their response to IFN-gamma. We find that individuals may be classified into four broad groups based on genotype, cellular phenotype, and clinical phenotype (normal individuals and patients with mild, intermediate, or severe disease). This correlation suggests that IFN-gamma-mediated cell activation is a genetically controlled quantitative trait and that it determines the outcome of mycobacterial invasion in man.
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Affiliation(s)
- S Dupuis
- Laboratory of Human Genetics of Infectious Diseases, Necker Medical School, Paris, France, EU
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Abstract
BACKGROUND The vertical forced vergence fixation disparity (VFD) curve represents the amount of vertical fixation disparity, the steady-state vertical bifixation error of the eyes, at various levels of vertical vergence demand. The main aim of the present study was to examine the effects of vertical vergence training on the slope of the VFD curve in a normal, young adult population. METHODS Forty-five subjects with normal vision and binocular function underwent vertical vergence training for 1 week. The training was done using a vertical prism bar, and the vertical fixation disparity was measured using the Disparometer. RESULTS The mean slope of the VFD curve in a normal, young adult population was 1.103 min arc/delta. The slope of the VFD curve decreased significantly after the training and remained flattened for at least 3 months. There was no evidence to support the idea that the decrease in the VFD slope was related to the increase of vertical fusional amplitude. CONCLUSIONS Vertical prism bar training provided a long-term effect, both increasing the vertical fusional amplitude and flattening the slope of the VFD curve. The decrease in the slope of the VFD curve was thought to be independent of the increase of vertical fusional amplitude.
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Affiliation(s)
- C D Luu
- School of Orthoptics, La Trobe University, Bundoora, Victoria, Australia.
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Plancoulaine S, Abel L, van Beveren M, Trégouët DA, Joubert M, Tortevoye P, de Thé G, Gessain A. Human herpesvirus 8 transmission from mother to child and between siblings in an endemic population. Lancet 2000; 356:1062-5. [PMID: 11009141 DOI: 10.1016/s0140-6736(00)02729-x] [Citation(s) in RCA: 203] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Transmission of human herpesvirus 8 (HHV-8), the aetiological agent of Kaposi's sarcoma, is known to occur during sex among homosexual men. However, other modes of HHV-8 transmission remain to be elucidated in endemic populations. METHODS We did a population-based seroepidemiological survey in a village in French Guiana among 1337 individuals of African origin (age 2-91 years) who had reliable genealogical data. Plasma samples were taken and tested for HHV-specific IgG by immunofluorescence assay. Risk factors and familial correlations for HHV-8 seropositivity were modelled by logistic regression analysis by use of the estimating equations approach, which expresses familial dependences in terms of odds ratios. Familial odds ratios were also acquired by use of the distribution of all possible pairs of a given familial dependence. FINDINGS The overall HHV-8 seroprevalence was 13.2% with no difference according to sex. HHV-8 seropositivity was strongly age dependent: at 1.2% under 5 years, HHV-8 seroprevalence rose up to a plateau around 15% between 15 and 40 years, and showed a seroprevalence of more than 27% in individuals older than 40 years. Strong familial aggregation in HHV-8 seroprevalence was found with high mother-child (odd ratio 2.8 [95% CI 1.6-5.0]) and sib-sib (3.8 [1.6-9.5]) correlations. By contrast, no significant correlation between spouses (0.6 [0.2-1.9]) was seen. INTERPRETATION This pattern of familial aggregation, together with the variation of HHV-8 seroprevalence with age, indicate that, in endemic populations, HHV-8 transmission mainly occurs from mother to child and between siblings during childhood and adolescence.
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Affiliation(s)
- S Plancoulaine
- INSERM U436, Unité d'Epidémiologie des Virus Oncogènes, Institut Pasteur, Laboratoire de Génétique Humaine des Maladies Infectieuses, Faculté de Médecine Necker, Paris, France
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