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Fang XT, Raval NR, O’Dell RS, Naganawa M, Mecca AP, Chen MK, van Dyck CH, Carson RE. Synaptic density patterns in early Alzheimer's disease assessed by independent component analysis. Brain Commun 2024; 6:fcae107. [PMID: 38601916 PMCID: PMC11004947 DOI: 10.1093/braincomms/fcae107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 02/23/2024] [Accepted: 03/25/2024] [Indexed: 04/12/2024] Open
Abstract
Synaptic loss is a primary pathology in Alzheimer's disease and correlates best with cognitive impairment as found in post-mortem studies. Previously, we observed in vivo reductions of synaptic density with [11C]UCB-J PET (radiotracer for synaptic vesicle protein 2A) throughout the neocortex and medial temporal brain regions in early Alzheimer's disease. In this study, we applied independent component analysis to synaptic vesicle protein 2A-PET data to identify brain networks associated with cognitive deficits in Alzheimer's disease in a blinded data-driven manner. [11C]UCB-J binding to synaptic vesicle protein 2A was measured in 38 Alzheimer's disease (24 mild Alzheimer's disease dementia and 14 mild cognitive impairment) and 19 cognitively normal participants. [11C]UCB-J distribution volume ratio values were calculated with a whole cerebellum reference region. Principal components analysis was first used to extract 18 independent components to which independent component analysis was then applied. Subject loading weights per pattern were compared between groups using Kruskal-Wallis tests. Spearman's rank correlations were used to assess relationships between loading weights and measures of cognitive and functional performance: Logical Memory II, Rey Auditory Verbal Learning Test-long delay, Clinical Dementia Rating sum of boxes and Mini-Mental State Examination. We observed significant differences in loading weights among cognitively normal, mild cognitive impairment and mild Alzheimer's disease dementia groups in 5 of the 18 independent components, as determined by Kruskal-Wallis tests. Only Patterns 1 and 2 demonstrated significant differences in group loading weights after correction for multiple comparisons. Excluding the cognitively normal group, we observed significant correlations between the loading weights for Pattern 1 (left temporal cortex and the cingulate gyrus) and Clinical Dementia Rating sum of boxes (r = -0.54, P = 0.0019), Mini-Mental State Examination (r = 0.48, P = 0.0055) and Logical Memory II score (r = 0.44, P = 0.013). For Pattern 2 (temporal cortices), significant associations were demonstrated between its loading weights and Logical Memory II score (r = 0.34, P = 0.0384). Following false discovery rate correction, only the relationship between the Pattern 1 loading weights with Clinical Dementia Rating sum of boxes (r = -0.54, P = 0.0019) and Mini-Mental State Examination (r = 0.48, P = 0.0055) remained statistically significant. We demonstrated that independent component analysis could define coherent spatial patterns of synaptic density. Furthermore, commonly used measures of cognitive performance correlated significantly with loading weights for two patterns within only the mild cognitive impairment/mild Alzheimer's disease dementia group. This study leverages data-centric approaches to augment the conventional region-of-interest-based methods, revealing distinct patterns that differentiate between mild cognitive impairment and mild Alzheimer's disease dementia, marking a significant advancement in the field.
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Affiliation(s)
- Xiaotian T Fang
- Yale PET Center, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Nakul R Raval
- Yale PET Center, Yale University School of Medicine, New Haven, CT 06520, USA
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Ryan S O’Dell
- Alzheimer’s Disease Research Unit, Yale University School of Medicine, New Haven, CT 06520, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Mika Naganawa
- Yale PET Center, Yale University School of Medicine, New Haven, CT 06520, USA
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Adam P Mecca
- Alzheimer’s Disease Research Unit, Yale University School of Medicine, New Haven, CT 06520, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Ming-Kai Chen
- Yale PET Center, Yale University School of Medicine, New Haven, CT 06520, USA
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Christopher H van Dyck
- Alzheimer’s Disease Research Unit, Yale University School of Medicine, New Haven, CT 06520, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06520, USA
- Department of Neurology, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Richard E Carson
- Yale PET Center, Yale University School of Medicine, New Haven, CT 06520, USA
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT 06520, USA
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Modi AC, Beal SJ, Becker SP, Boerner KE, Burton ET, Chen D, Crosby LE, Hilliard ME, Hood AM, Kahhan NA, Law E, Long KA, McGrady ME, Sweenie RE, Thurston IB, Valrie C, Wu YP, Duncan CL. Editorial: Recommendations on inclusive language and transparent reporting relating to diversity dimensions for the Journal of Pediatric Psychology and Clinical Practice in Pediatric Psychology. J Pediatr Psychol 2024; 49:1-12. [PMID: 38167955 PMCID: PMC10799720 DOI: 10.1093/jpepsy/jsad094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 12/01/2023] [Accepted: 12/01/2023] [Indexed: 01/05/2024] Open
Affiliation(s)
- Avani C Modi
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Sarah J Beal
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Stephen P Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Katelynn E Boerner
- Department of Pediatrics, BC Children’s Hospital Research Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - E Thomaseo Burton
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
| | - Diane Chen
- Potocsnak Family Division of Adolescent and Young Adult Medicine & Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA
- Departments of Psychiatry & Behavioral Sciences, and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Lori E Crosby
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Marisa E Hilliard
- Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA
| | - Anna M Hood
- Division of Psychology and Mental Health, Manchester Centre for Health Psychology University of Manchester, UK
| | - Nicole A Kahhan
- Division of Psychology & Neuropsychology, Nemours Children’s Health, Jacksonville, FL, USA
| | - Emily Law
- Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Kristin A Long
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Meghan E McGrady
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Rachel E Sweenie
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Idia B Thurston
- Department of Health Sciences and Applied Psychology, Northeastern University, Boston, MA, USA
| | - Cecelia Valrie
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Yelena P Wu
- Department of Dermatology, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA
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Deo R, Dubin RF, Ren Y, Murthy AC, Wang J, Zheng H, Zheng Z, Feldman H, Shou H, Coresh J, Grams M, Surapaneni AL, Bhat Z, Cohen JB, Rahman M, He J, Saraf SL, Go AS, Kimmel PL, Vasan RS, Segal MR, Li H, Ganz P. Proteomic cardiovascular risk assessment in chronic kidney disease. Eur Heart J 2023; 44:2095-2110. [PMID: 37014015 PMCID: PMC10281556 DOI: 10.1093/eurheartj/ehad115] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 01/21/2023] [Accepted: 02/16/2023] [Indexed: 04/05/2023] Open
Abstract
AIMS Chronic kidney disease (CKD) is widely prevalent and independently increases cardiovascular risk. Cardiovascular risk prediction tools derived in the general population perform poorly in CKD. Through large-scale proteomics discovery, this study aimed to create more accurate cardiovascular risk models. METHODS AND RESULTS Elastic net regression was used to derive a proteomic risk model for incident cardiovascular risk in 2182 participants from the Chronic Renal Insufficiency Cohort. The model was then validated in 485 participants from the Atherosclerosis Risk in Communities cohort. All participants had CKD and no history of cardiovascular disease at study baseline when ∼5000 proteins were measured. The proteomic risk model, which consisted of 32 proteins, was superior to both the 2013 ACC/AHA Pooled Cohort Equation and a modified Pooled Cohort Equation that included estimated glomerular filtrate rate. The Chronic Renal Insufficiency Cohort internal validation set demonstrated annualized receiver operating characteristic area under the curve values from 1 to 10 years ranging between 0.84 and 0.89 for the protein and 0.70 and 0.73 for the clinical models. Similar findings were observed in the Atherosclerosis Risk in Communities validation cohort. For nearly half of the individual proteins independently associated with cardiovascular risk, Mendelian randomization suggested a causal link to cardiovascular events or risk factors. Pathway analyses revealed enrichment of proteins involved in immunologic function, vascular and neuronal development, and hepatic fibrosis. CONCLUSION In two sizeable populations with CKD, a proteomic risk model for incident cardiovascular disease surpassed clinical risk models recommended in clinical practice, even after including estimated glomerular filtration rate. New biological insights may prioritize the development of therapeutic strategies for cardiovascular risk reduction in the CKD population.
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Affiliation(s)
- Rajat Deo
- Division of Cardiovascular Medicine, Electrophysiology Section, Perelman School of Medicine at the University of Pennsylvania, One Convention Avenue, Level 2 / City Side, Philadelphia, PA 19104, USA
| | - Ruth F Dubin
- Division of Nephrology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390, USA
| | - Yue Ren
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, 215 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104, USA
| | - Ashwin C Murthy
- Division of Cardiovascular Medicine, Electrophysiology Section, Perelman School of Medicine at the University of Pennsylvania, One Convention Avenue, Level 2 / City Side, Philadelphia, PA 19104, USA
| | - Jianqiao Wang
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, 215 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104, USA
| | - Haotian Zheng
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, 215 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104, USA
| | - Zihe Zheng
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, 215 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104, USA
| | - Harold Feldman
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, 215 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104, USA
| | - Haochang Shou
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, 215 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104, USA
| | - Josef Coresh
- Department of Epidemiology; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA
- Department of Medicine, Johns Hopkins University, 2024 E. Monument Street, Room 2-635, Suite 2-600, Baltimore, MD 21287, USA
| | - Morgan Grams
- Department of Epidemiology; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA
- Department of Medicine, Johns Hopkins University, 2024 E. Monument Street, Room 2-635, Suite 2-600, Baltimore, MD 21287, USA
| | - Aditya L Surapaneni
- Department of Epidemiology; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA
| | - Zeenat Bhat
- Division of Nephrology, University of Michigan, 5100 Brehm Tower, 1000 Wall Street, Ann Arbor, MI 48105, USA
| | - Jordana B Cohen
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, 215 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104, USA
- Renal, Electrolyte and Hypertension Division, Perelman School of Medicine, University of Pennsylvania, 831 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104, USA
| | - Mahboob Rahman
- Department of Medicine, Case Western Reserve University School of Medicine, 11100 Euclid Avenue, Wearn Bldg. 3 Floor. Rm 352, Cleveland, OH 44106, USA
| | - Jiang He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, SL 18, New Orleans, LA 70112, USA
| | - Santosh L Saraf
- Division of Hematology and Oncology, University of Illinois at Chicago, 1740 West Taylor Street, Chicago, IL 60612, USA
| | - Alan S Go
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612, USA
- Departments of Epidemiology, Biostatistics and Medicine, University of California at San Francisco, San Francisco, CA, USA
| | - Paul L Kimmel
- Division of Kidney, Urologic, and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD 20892, USA
| | - Ramachandran S Vasan
- Section of Preventive Medicine and Epidemiology, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
- Section of Cardiology, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Mark R Segal
- Department of Epidemiology and Biostatistics, University of California, 550 16th Street, 2nd Floor, Box #0560, San Francisco, CA 94143, USA
| | - Hongzhe Li
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, 215 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104, USA
| | - Peter Ganz
- Division of Cardiology, Zuckerberg San Francisco General Hospital and Department of Medicine, University of California, San Francisco, 1001 Potrero Avenue, 5G1, San Francisco, CA 94110, USA
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Vega-Fernandez P, De Ranieri D, Oberle E, Clark M, Bukulmez H, Lin C, Shenoi S, Thatayatikom A, Woolnough L, Benham H, Brunner E, Henrickson M, Pratt LR, Proulx-Gauthier JP, Janow G, Cassedy A, Ting TV, Roth J. Comprehensive and reliable sonographic assessment and scoring system for inflammatory lesions of the paediatric ankle. Rheumatology (Oxford) 2023; 62:2239-2246. [PMID: 36308429 PMCID: PMC10234197 DOI: 10.1093/rheumatology/keac622] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 08/30/2022] [Indexed: 11/30/2023] Open
Abstract
OBJECTIVE The clinical decision-making process in paediatric arthritis lacks an objective, reliable bedside imaging tool. The aim of this study was to develop a US scanning protocol and assess the reliability of B-mode and Doppler scoring systems for inflammatory lesions of the paediatric ankle. METHODS As part of the Childhood Arthritis and Rheumatology Research Alliance (CARRA) US group, 19 paediatric rheumatologists through a comprehensive literature review developed a set of standardized views and scoring systems to assess inflammatory lesions of the synovial recesses as well as tendons of the paediatric ankle. Three rounds of scoring of still images were followed by one practical exercise. Agreement among raters was assessed using two-way single score intraclass correlation coefficients (ICC). RESULTS Of the 37 initially identified views to assess the presence of ankle synovitis and tenosynovitis, nine views were chosen for each B-mode and Doppler mode semi-quantitative evaluation. Several scoring exercises and iterative modifications resulted in a final highly reliable scoring system: anterior tibiotalar joint ICC: 0.93 (95% CI 0.92, 0.94), talonavicular joint ICC: 0.86 (95% CI 0.81, 0.90), subtalar joint ICC: 0.91 (95% CI 0.88, 0.93) and tendons ICC: 0.96 (95% CI 0.95, 0.97). CONCLUSION A comprehensive and reliable paediatric ankle US scanning protocol and scoring system for the assessment of synovitis and tenosynovitis were successfully developed. Further validation of this scoring system may allow its use as an outcome measure for both clinical and research applications.
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Affiliation(s)
- Patricia Vega-Fernandez
- Division of Rheumatology, Department of Pediatrics, University of Cincinnati, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Deirdre De Ranieri
- Division of Rheumatology, Department of Pediatrics, Northwestern Feinberg School of Medicine, Ann and Robert H. Lurie Children’s Hospital, Chicago, IL, USA
| | - Edward Oberle
- Department of Pediatrics, Nationwide Children’s Hospital, Columbus, OH, USA
| | - Matthew Clark
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Hulya Bukulmez
- Division of Pediatric Rheumatology, Department of Pediatrics, Metro Health Medical System, Case Western Reserve University, Cleveland, OH, USA
| | - Clara Lin
- Department of Pediatrics, Children’s Hospital Colorado, Aurora, CO, USA
| | - Susan Shenoi
- Seattle Children’s Hospital and Research Center University of Washington, Seattle, WA, USA
| | - Akaluck Thatayatikom
- AdventHealth Medical Group Pediatric Rheumatology and Immunology, Orlando, FL, USA
| | | | - Heather Benham
- Department of Pediatrics, Scottish Rite for Children, Frisco, TX, USA
| | - Emily Brunner
- Department of Pediatrics, Geisinger Medical Center, Danville, PA, USA
| | - Michael Henrickson
- Division of Rheumatology, Department of Pediatrics, University of Cincinnati, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Laura R Pratt
- Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE, USA
| | | | - Ginger Janow
- Joseph M. Sanzari Children’s Hospital, Hackensack, NJ, USA
| | - Amy Cassedy
- Division of Biostatistics and Epidemiology, Department of Pediatrics, University of Cincinnati, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Tracy V Ting
- Division of Rheumatology, Department of Pediatrics, University of Cincinnati, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
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Yang JY, Lund JL, Pate V, Kappelman MD. Utilization of Colonoscopy Following Treatment Initiation in U.S. Commercially Insured Patients With Inflammatory Bowel Disease, 2013-2019. Inflamm Bowel Dis 2023; 29:735-743. [PMID: 35929644 PMCID: PMC10152285 DOI: 10.1093/ibd/izac136] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Indexed: 12/09/2022]
Abstract
BACKGROUND Evaluation of mucosal healing with colonoscopy is recommended for inflammatory bowel disease (IBD) management; however, little is known about real-world use of treat-to-target monitoring following IBD treatment initiation. We aimed to estimate the proportion of U.S. commercially insured IBD patients who receive colonoscopy in the 3 to 15 months after initiating treatment. METHODS We identified IBD patients, 18 to 64 years of age, in the IBM MarketScan Commercial Claims and Encounters database as those with ≥3 IBD diagnoses prior to initiation of biologic, small molecule, or immunomodulatory treatment. We excluded patients with prior colectomy and with rheumatologic and other indications for these therapies. Colonoscopies were identified using International Classification of Diseases-Ninth Revision, International Classification of Diseases-Tenth Revision, and Current Procedural Terminology procedure codes. We used Kaplan-Meier methods to estimate the proportion of newly treated IBD patients who received colonoscopy in the 3 to 6 months, 3 to 12 months, and 3 to 15 months following treatment initiation, and stratified trends by year, patient age and sex, and region. RESULTS From 2013 to 2019, we identified 39 734 initiators of IBD medications (51.9% female, mean age 39.4 years). We observed similar colonoscopy incidence among ulcerative colitis patients (3-6 months: 14.2% [95% confidence interval (CI), 13.6%-14.8%]; 3-12 months: 37.7% [95% CI, 36.8%-38.6%]; 3-15 months: 46.1% [95% CI, 45.2%-47.1%]) and Crohn's disease patients (3-6 months: 11.2% [95% CI, 10.8%-11.6%]; 3-12 months: 32.2% [95% CI, 31.5%-32.9%]; 3-15 months: CD: 40.1% [95% CI, 39.3%-40.8%]). Overall colonoscopy use was slightly higher among women, patients in the Northeast, and those initiating newer biologic therapies. CONCLUSIONS Fewer than half of newly treated IBD patients underwent colonoscopy within 3 to 15 months of initiating new treatment, suggesting low uptake of treat-to-target endoscopic disease monitoring in real-world practice.
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Affiliation(s)
- Jeff Y Yang
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jennifer L Lund
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Virginia Pate
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Michael D Kappelman
- Division of Pediatric Gastroenterology, Department of Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Galderisi A, Moran A, Evans-Molina C, Martino M, Santoro N, Caprio S, Cobelli C. Early Impairment of Insulin Sensitivity, β-Cell Responsiveness, and Insulin Clearance in Youth with Stage 1 Type 1 Diabetes. J Clin Endocrinol Metab 2021; 106:2660-2669. [PMID: 34000022 PMCID: PMC8372628 DOI: 10.1210/clinem/dgab344] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Indexed: 01/10/2023]
Abstract
CONTEXT Clinical onset of type 1 diabetes (Stage 3 T1D) is preceded by a presymptomatic phase characterized by multiple islet autoantibodies with normal glucose tolerance (Stage 1 T1D). OBJECTIVE The aim was to explore the metabolic phenotypes of β-cell function and insulin sensitivity and clearance in normoglycemic youth with Stage 1 T1D and compare them with healthy nonrelated peers during a 3-hour oral glucose tolerance test (OGTT). METHODS Twenty-eight lean youth, 14 with ≥2 islet autoantibodies (cases) and 14 healthy controls underwent a 3-hour 9-point OGTT with measurement of glucose, C-peptide, and insulin. The oral minimal model was used to quantitate β-cell responsiveness (φtotal) and insulin sensitivity (SI), allowing assessment of β-cell function by the disposition index (DI=φtotal×SI). Fasting insulin clearance (CL0) was calculated as the ratio between the fasting insulin secretion rate (ISR) and plasma insulin levels (ISR0/I0), while postload clearance (CL180) was estimated by the ratio of AUC of ISR over the plasma insulin AUC for the 3-hour OGTT (ISRAUC/IAUC). Participants with impaired fasting glucose, impaired glucose tolerance, or any OGTT glucose concentration ≥200 mg/dL were excluded. RESULTS Cases (10.5 years [8, 15]) exhibited reduced DI (P < .001) due to a simultaneous reduction in both φtotal (P < 0.001) and SI (P = .008) compared with controls (11.5 years [10.4, 14.9]). CL0 and CL180 were lower in cases than in controls (P = .005 and P = .019). CONCLUSION Presymptomatic Stage 1 T1D in youth is associated with reduced insulin sensitivity and lower β-cell responsiveness, and the presence of blunted insulin clearance.
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Affiliation(s)
- Alfonso Galderisi
- Department of Woman and Child’s Health, University of Padova, Padova, Italy
- Department of Pediatrics, Yale University, New Haven, CT, USA
- Correspondence: Alfonso Galderisi, MD, PhD, Department of Woman and Child’s Health, University of Padova, Via N. Giustiniani, 3, 35128 Padova, Italy.
| | - Antoinette Moran
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Carmella Evans-Molina
- Center for Diabetes and Metabolic Diseases, Indiana University, Bloomington, IN, USA
| | - Mariangela Martino
- Department of Woman and Child’s Health, University of Padova, Padova, Italy
| | - Nicola Santoro
- Department of Pediatrics, Yale University, New Haven, CT, USA
- Department of Medicine and Health Sciences “V. Tiberio,” University of Molise, Campobasso, Italy
| | - Sonia Caprio
- Department of Pediatrics, Yale University, New Haven, CT, USA
| | - Claudio Cobelli
- Department of Woman and Child’s Health, University of Padova, Padova, Italy
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Li Y, Zhou C, Lei W, Wang K, Zheng J. Roles of aryl hydrocarbon receptor in endothelial angiogenic responses†. Biol Reprod 2020; 103:927-937. [PMID: 32716482 PMCID: PMC7731988 DOI: 10.1093/biolre/ioaa128] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 07/14/2020] [Accepted: 07/20/2020] [Indexed: 12/23/2022] Open
Abstract
Aryl hydrocarbon receptor (AhR) is a transcription factor, which can be activated by a plethora of structure-diverse ligands. Historically, AhR is known for its involvements in regulation of metabolism of xenobiotics. However, normal physiological roles of AhR have been defined in other essential biological processes, including vascular growth and function, reproduction, and immunoresponses. In contrast, aberrant expression and activation of the AhR signaling pathway occur in a variety of human diseases, many of which (e.g., preeclampsia, atherosclerosis, and hypertension) could be associated with endothelial dysfunction. Indeed, emerging evidence has shown that either exogenous or endogenous AhR ligands can induce endothelial dysfunction in either an AhR-dependent or AhR-independent manner, possibly reliant on the blood vessel origin (artery and vein) of endothelial cells. Given that the AhR signaling pathway has broad impacts on endothelial and cardiovascular function, AhR ligands, AhR, and their downstream genes could be considered novel therapeutic targets for those endothelial-related diseases. This review will discuss the current knowledge of AhR's mediation on endothelial function and potential mechanisms underlying these actions with a focus on placental endothelial cells.
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Affiliation(s)
- Yan Li
- Department of Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Chi Zhou
- Department of Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Wei Lei
- Department of Cardiovascular Medicine, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Kai Wang
- Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jing Zheng
- Department of Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Cardiovascular Medicine, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
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Fujiwara O, Prasai A, Perez-Bello D, El Ayadi A, Petrov IY, Esenaliev RO, Petrov Y, Herndon DN, Finnerty CC, Prough DS, Enkhbaatar P. Adipose-derived stem cells improve grafted burn wound healing by promoting wound bed blood flow. Burns Trauma 2020; 8:tkaa009. [PMID: 32346539 PMCID: PMC7175768 DOI: 10.1093/burnst/tkaa009] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 01/22/2020] [Accepted: 01/30/2000] [Indexed: 01/08/2023]
Abstract
BACKGROUND Researchers have explored the use of adipose-derived stem cells (ASCs) as a cell-based therapy to cover wounds in burn patients; however, underlying mechanistic aspects are not completely understood. We hypothesized that ASCs would improve post-burn wound healing after eschar excision and grafting by increasing wound blood flow via induction of angiogenesis-related pathways. METHODS To test the hypothesis, we used an ovine burn model. A 5 cm2 full thickness burn wound was induced on each side of the dorsum. After 24 hours, the burned skin was excised and a 2 cm2 patch of autologous donor skin was grafted. The wound sites were randomly allocated to either topical application of 7 million allogeneic ASCs or placebo treatment (phosphate-buffered saline [PBS]). Effects of ASCs culture media was also compared to those of PBS. Wound healing was assessed at one and two weeks following the application of ASCs. Allogeneic ASCs were isolated, cultured and characterized from non-injured healthy sheep. The identity of the ASCs was confirmed by flow cytometry analysis, differentiation into multiple lineages and gene expression via real-time polymerase chain reaction. Wound blood flow, epithelialization, graft size and take and the expression of vascular endothelial growth factor (VEGF) were determined via enzyme-linked immunosorbent assay and Western blot. RESULTS Treatment with ASCs accelerated the patch graft growth compared to the control (p < 0.05). Topical application of ASCs significantly increased wound blood flow (p < 0.05). Expression of VEGF was significantly higher in the wounds treated with ASCs compared to control (p < 0.05). CONCLUSIONS ASCs accelerated grafted skin growth possibly by increasing the blood flow via angiogenesis induced by a VEGF-dependent pathway.
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Affiliation(s)
- Osamu Fujiwara
- Department of Anesthesiology, University of Texas Medical Branch, Galveston, TX, USA
| | - Anesh Prasai
- Department of Surgery, University of Texas Medical Branch, Galveston, 301 University BLVD TX 77555, USA
- Shriners Hospitals for Children – Galveston, 815 Market Street Galveston, TX 77555, USA
| | - Dannelys Perez-Bello
- Department of Anesthesiology, University of Texas Medical Branch, Galveston, TX, USA
| | - Amina El Ayadi
- Department of Surgery, University of Texas Medical Branch, Galveston, 301 University BLVD TX 77555, USA
- Shriners Hospitals for Children – Galveston, 815 Market Street Galveston, TX 77555, USA
- Sealy Center for Molecular Medicine, and the Institute for Translational Sciences, University of Texas Medical Branch, 301 University BLVD Galveston, TX 77555, USA
| | - Irene Y Petrov
- Center for Biomedical Engineering, University of Texas Medical Branch, 601 Harbor Side Dr. Galveston, TX 77555, USA
| | - Rinat O Esenaliev
- Department of Anesthesiology, University of Texas Medical Branch, Galveston, TX, USA
- Center for Biomedical Engineering, University of Texas Medical Branch, 601 Harbor Side Dr. Galveston, TX 77555, USA
- Department of Neuroscience, Cell Biology, and Anatomy, University of Texas Medical Branch, 301 University BLVD Galveston, TX 77555, USA
| | - Yuriy Petrov
- Center for Biomedical Engineering, University of Texas Medical Branch, 601 Harbor Side Dr. Galveston, TX 77555, USA
| | - David N Herndon
- Department of Surgery, University of Texas Medical Branch, Galveston, 301 University BLVD TX 77555, USA
- Shriners Hospitals for Children – Galveston, 815 Market Street Galveston, TX 77555, USA
| | - Celeste C Finnerty
- Department of Surgery, University of Texas Medical Branch, Galveston, 301 University BLVD TX 77555, USA
- Shriners Hospitals for Children – Galveston, 815 Market Street Galveston, TX 77555, USA
- Sealy Center for Molecular Medicine, and the Institute for Translational Sciences, University of Texas Medical Branch, 301 University BLVD Galveston, TX 77555, USA
| | - Donald S Prough
- Department of Anesthesiology, University of Texas Medical Branch, Galveston, TX, USA
| | - Perenlei Enkhbaatar
- Department of Anesthesiology, University of Texas Medical Branch, Galveston, TX, USA
- Shriners Hospitals for Children – Galveston, 815 Market Street Galveston, TX 77555, USA
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