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Forrer A, Wanji S, Obie ED, Nji TM, Hamill L, Ozano K, Piotrowski H, Dean L, Njouendou AJ, Ekanya R, Ndongmo WPC, Fung EG, Nnamdi DB, Abong RA, Beng AA, Eyong ME, Ndzeshang BL, Nkimbeng DA, Teghen S, Suireng A, Ashu EE, Kah E, Murdoch MM, Thomson R, Theobald S, Enyong P, Turner JD, Taylor MJ. Why onchocerciasis transmission persists after 15 annual ivermectin mass drug administrations in South-West Cameroon. BMJ Glob Health 2021; 6:bmjgh-2020-003248. [PMID: 33431378 PMCID: PMC7802695 DOI: 10.1136/bmjgh-2020-003248] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 11/11/2020] [Accepted: 11/27/2020] [Indexed: 12/11/2022] Open
Abstract
Introduction Onchocerciasis is targeted for elimination mainly with annual community-directed treatment with ivermectin (CDTI). High infection levels have been reported in South-West Cameroon, despite ≥15 years of CDTI. The aim of this study was to assess factors associated with continued onchocerciasis transmission and skin disease. Methods A large-scale cross-sectional study was conducted in 2017 in 20 communities in a loiasis-risk area in South-West Cameroon. A mixed-methods approach was used. Associations between infection levels, skin disease and adherence to CDTI were assessed using mixed regression modelling. Different community members’ perception and acceptability of the CDTI strategy was explored using semi-structured interviews. Results Onchocerciasis prevalence was 44.4% among 9456 participants. 17.5% of adults were systematic non-adherers and 5.9% participated in ≥75% of CDTI rounds. Skin disease affected 1/10 participants, including children. Increasing self-reported adherence to CDTI was associated with lower infection levels in participants aged ≥15 years but not in children. Adherence to CDTI was positively influenced by perceived health benefits, and negatively influenced by fear of adverse events linked with economic loss. Concern of lethal adverse events was a common reason for systematic non-adherence. Conclusion CDTI alone is unlikely to achieve elimination in those high transmission areas where low participation is commonly associated with the fear of adverse events, despite the current quasi absence of high-risk levels of loiasis. Such persisting historical memories and fear of ivermectin might impact adherence to CDTI also in areas with historical presence but current absence of loiasis. Because such issues are unlikely to be tackled by CDTI adaptive measures, alternative strategies are needed for onchocerciasis elimination where negative perception of ivermectin is an entrenched barrier to community participation in programmes.
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Affiliation(s)
- Armelle Forrer
- Centre for Neglected Tropical Diseases, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, Merseyside, UK
| | - Samuel Wanji
- Department of Disease Control, Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon.,Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Elisabeth Dibando Obie
- Department of Disease Control, Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon.,Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Theobald Mue Nji
- Department of Disease Control, Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon.,Department of Sociology and Anthropology, University of Buea, Buea, Cameroon
| | - Louise Hamill
- Centre for Neglected Tropical Diseases, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, Merseyside, UK
| | - Kim Ozano
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, Liverpool, UK
| | - Helen Piotrowski
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, Liverpool, UK
| | - Laura Dean
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, Liverpool, UK
| | - Abdel J Njouendou
- Department of Disease Control, Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon.,Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Relindis Ekanya
- Department of Disease Control, Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon.,Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Winston Patrick Chounna Ndongmo
- Department of Disease Control, Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon.,Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Ebua Gallus Fung
- Department of Disease Control, Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon.,Department of Sociology and Anthropology, University of Buea, Buea, Cameroon
| | - Dum-Buo Nnamdi
- Department of Disease Control, Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon.,Department of Sociology and Anthropology, University of Buea, Buea, Cameroon
| | - Raphael A Abong
- Department of Disease Control, Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon.,Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Amuam Andrew Beng
- Department of Disease Control, Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon.,Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Mathias Esum Eyong
- Department of Disease Control, Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon.,Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Bertrand L Ndzeshang
- Department of Disease Control, Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon.,Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Desmond Akumtoh Nkimbeng
- Department of Disease Control, Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon.,Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Samuel Teghen
- Department of Disease Control, Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon.,Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Anicetus Suireng
- Department of Disease Control, Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Ernerstine Ebot Ashu
- Department of Disease Control, Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Emmanuel Kah
- Department of Disease Control, Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon.,Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Michele M Murdoch
- Watford General Hospital, West Herts Hospitals NHS Trust, Watford, UK
| | - Rachael Thomson
- Centre for Neglected Tropical Diseases, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, Merseyside, UK
| | - Sally Theobald
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, Liverpool, UK
| | - Peter Enyong
- Department of Disease Control, Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon.,Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Joseph D Turner
- Centre for Neglected Tropical Diseases, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, Merseyside, UK
| | - Mark J Taylor
- Centre for Neglected Tropical Diseases, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, Merseyside, UK
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Partridge F, Bataille CJ, Forman R, Marriott AE, Forde-Thomas J, Häberli C, Dinsdale RL, O’Sullivan JD, Willis NJ, Wynne GM, Whiteland H, Archer J, Steven A, Keiser J, Turner JD, Hoffmann KF, Taylor MJ, Else KJ, Russell AJ, Sattelle DB. Structural Requirements for Dihydrobenzoxazepinone Anthelmintics: Actions against Medically Important and Model Parasites: Trichuris muris, Brugia malayi, Heligmosomoides polygyrus, and Schistosoma mansoni. ACS Infect Dis 2021; 7:1260-1274. [PMID: 33797218 PMCID: PMC8154432 DOI: 10.1021/acsinfecdis.1c00025] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Indexed: 02/07/2023]
Abstract
Nine hundred million people are infected with the soil-transmitted helminths Ascaris lumbricoides (roundworm), hookworm, and Trichuris trichiura (whipworm). However, low single-dose cure rates of the benzimidazole drugs, the mainstay of preventative chemotherapy for whipworm, together with parasite drug resistance, mean that current approaches may not be able to eliminate morbidity from trichuriasis. We are seeking to develop new anthelmintic drugs specifically with activity against whipworm as a priority and previously identified a hit series of dihydrobenzoxazepinone (DHB) compounds that block motility of ex vivo Trichuris muris. Here, we report a systematic investigation of the structure-activity relationship of the anthelmintic activity of DHB compounds. We synthesized 47 analogues, which allowed us to define features of the molecules essential for anthelmintic action as well as broadening the chemotype by identification of dihydrobenzoquinolinones (DBQs) with anthelmintic activity. We investigated the activity of these compounds against other parasitic nematodes, identifying DHB compounds with activity against Brugia malayi and Heligmosomoides polygyrus. We also demonstrated activity of DHB compounds against the trematode Schistosoma mansoni, a parasite that causes schistosomiasis. These results demonstrate the potential of DHB and DBQ compounds for further development as broad-spectrum anthelmintics.
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Affiliation(s)
- Frederick
A. Partridge
- Centre
for Respiratory Biology, UCL Respiratory, Division of Medicine, University College London, London WC1E 6JF, United Kingdom
| | - Carole J.R. Bataille
- Department
of Chemistry, Chemistry Research Laboratory, University of Oxford, Oxford OX1 3TA, United Kingdom
| | - Ruth Forman
- Lydia
Becker Institute of Immunology and Inflammation, Faculty of Biology,
Medicine and Health, University of Manchester, Manchester M13 9PT, United Kingdom
| | - Amy E. Marriott
- Centre
for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, United Kingdom
| | - Josephine Forde-Thomas
- Institute
of Biological, Environmental and Rural Sciences (IBERS), Aberystwyth University, Aberystwyth, Wales SY23 3DA, United Kingdom
| | - Cécile Häberli
- Department
of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Socinstrasse 57, Basel CH-4002, Switzerland
- University
of Basel, Petersplatz
1, Basel CH-4001, Switzerland
| | - Ria L. Dinsdale
- Department
of Chemistry, Chemistry Research Laboratory, University of Oxford, Oxford OX1 3TA, United Kingdom
| | - James D.B. O’Sullivan
- Lydia
Becker Institute of Immunology and Inflammation, Faculty of Biology,
Medicine and Health, University of Manchester, Manchester M13 9PT, United Kingdom
- Henry
Royce Institute, The University of Manchester, Oxford Road, Manchester M13 9PL, United
Kingdom
| | - Nicky J. Willis
- Department
of Chemistry, Chemistry Research Laboratory, University of Oxford, Oxford OX1 3TA, United Kingdom
- Alzheimer’s
Research UK UCL Drug Discovery Institute, University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - Graham M. Wynne
- Department
of Chemistry, Chemistry Research Laboratory, University of Oxford, Oxford OX1 3TA, United Kingdom
| | - Helen Whiteland
- Institute
of Biological, Environmental and Rural Sciences (IBERS), Aberystwyth University, Aberystwyth, Wales SY23 3DA, United Kingdom
| | - John Archer
- Centre
for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, United Kingdom
| | - Andrew Steven
- Centre
for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, United Kingdom
| | - Jennifer Keiser
- Department
of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Socinstrasse 57, Basel CH-4002, Switzerland
- University
of Basel, Petersplatz
1, Basel CH-4001, Switzerland
| | - Joseph D. Turner
- Centre
for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, United Kingdom
- Centre
for Neglected Tropical Diseases, Liverpool
School of Tropical Medicine, Liverpool L3 5QA, United Kingdom
| | - Karl F. Hoffmann
- Institute
of Biological, Environmental and Rural Sciences (IBERS), Aberystwyth University, Aberystwyth, Wales SY23 3DA, United Kingdom
| | - Mark J. Taylor
- Centre
for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, United Kingdom
- Centre
for Neglected Tropical Diseases, Liverpool
School of Tropical Medicine, Liverpool L3 5QA, United Kingdom
| | - Kathryn J. Else
- Lydia
Becker Institute of Immunology and Inflammation, Faculty of Biology,
Medicine and Health, University of Manchester, Manchester M13 9PT, United Kingdom
| | - Angela J. Russell
- Department
of Chemistry, Chemistry Research Laboratory, University of Oxford, Oxford OX1 3TA, United Kingdom
- Department
of Pharmacology, University of Oxford, Mansfield Road, Oxford OX1 3QT, United
Kingdom
| | - David B. Sattelle
- Centre
for Respiratory Biology, UCL Respiratory, Division of Medicine, University College London, London WC1E 6JF, United Kingdom
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Badia-Rius X, Betts H, Wanji S, Molyneux D, Taylor MJ, Kelly-Hope LA. Environmental Factors Associated With Loa loa Microfilaria Prevalence and Intensity in Diverse Bioecological Zones of Cameroon. Front Trop Dis 2021. [DOI: 10.3389/fitd.2021.668641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Loiasis (African Eye Worm) is a filarial infection caused by Loa loa and transmitted by Chrysops vectors, which are confined to the tropical rainforests of Central and West Africa. Loiasis is a major impediment to control and elimination programmes that use the drug ivermectin due to the risk of serious adverse events. There is an urgent need to better refine and map high-risk communities. This study aimed to quantify and predict environmental factors associated with loiasis across five bioecological zones in Cameroon. The L. loa microfilaria (mf) prevalence (%) and intensity (mf number/ml) data from 42 villages within an Equatorial Rainforest and Savannah region were examined in relation to climate, topographic and forest-related data derived from satellite remote sensing sources. Differences between zones and regions were examined using nonparametric tests, and the relationship between L. loa mf prevalence, mf intensity, and the environmental factors using polynomial regression models. Overall, the L. loa mf prevalence was 11.6%, L. loa intensity 927.4 mf/ml, mean annual temperature 23.7°C, annual precipitation 2143.2 mm, elevation 790 m, tree canopy cover 46.7%, and canopy height 19.3m. Significant differences between the Equatorial Rainforest and Savannah region were found. Within the Equatorial Rainforest region, no significant differences were found. However, within the Savannah region, significant differences between the three bioecological zones were found, and the regression models indicated that tree canopy cover and elevation were significant predictors, explaining 85.1% of the L. loa mf prevalence (adjusted R2 = 0.851; p<0.001) and tree cover alone was significant, explaining 58.1% of the mf intensity (adjusted R2 = 0.581; p<0.001). The study highlights that environmental analysis can help delineate risk at different geographical scales, which may be practical for developing larger scale operational plans for mapping and implementing safe effective interventions.
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Taylor MJ, Ronald A, Martin J, Lundström S, Hosang GM, Lichtenstein P. Examining the association between childhood autistic traits and adolescent hypomania: a longitudinal twin study. Psychol Med 2021; 52:1-10. [PMID: 33827724 DOI: 10.1017/s0033291721000374] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND There is evidence that autism spectrum disorders (ASDs) co-occur with bipolar disorder (BD) relatively frequently. Individuals with BD often report symptoms of mania and hypomania during adolescence, prior to the age of onset for BD. It is unknown whether these symptoms are associated with ASDs. We examined whether diagnoses of ASDs and autistic traits were associated with hypomania in a large, population-based Swedish twin sample. METHODS Parental structured interviews assessed autistic traits, and were used to assign screening diagnoses of ASDs, when twins were aged 9 or 12 (N = 13 533 pairs). Parents then completed questionnaires assessing hypomania when the twins were aged 15 and 18 (N = 3852 pairs at age 15, and 3013 pairs at age 18). After investigating the phenotypic associations between these measures, we used the classical twin design to test whether genetic and environmental influences on autistic traits influence variation in adolescent hypomania. RESULTS Autistic traits and ASD diagnoses in childhood were associated with elevated scores on the measures of adolescent hypomania. Twin analyses indicated that 6-9% of the variance in hypomania was explained by genetic influences that were shared with autistic traits in childhood. When repeating these analyses for specific autistic trait domains, we found a stronger association between social interaction difficulties and hypomania than for other autistic trait domains. CONCLUSIONS These results indicate a genetic link between autistic traits and hypomania in adolescence. This adds to the growing evidence base of genetic factors associated with ASDs showing links with psychiatric outcomes across childhood and into adulthood.
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Affiliation(s)
- Mark J Taylor
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Angelica Ronald
- Genes Environment Lifespan Laboratory, Department of Psychological Science, Centre for Brain and Cognitive Development, University of London, Birkbeck, UK
| | - Joanna Martin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Sebastian Lundström
- Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg, Sweden
- Centre for Ethics, Law and Mental Health, University of Gothenburg, Gothenburg, Sweden
| | - Georgina M Hosang
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary, University of London, London, UK
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Dinkler L, Taylor MJ, Råstam M, Hadjikhani N, Bulik CM, Lichtenstein P, Gillberg C, Lundström S. Association of etiological factors across the extreme end and continuous variation in disordered eating in female Swedish twins. Psychol Med 2021; 51:750-760. [PMID: 31843035 PMCID: PMC8108395 DOI: 10.1017/s0033291719003672] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 10/17/2019] [Accepted: 11/25/2019] [Indexed: 11/06/2022]
Abstract
BACKGROUND Accumulating evidence suggests that many psychiatric disorders etiologically represent the extreme end of dimensionally distributed features rather than distinct entities. The extent to which this applies to eating disorders (EDs) is unknown. METHODS We investigated if there is similar etiology in (a) the continuous distribution of the Eating Disorder Inventory-2 (EDI-2), (b) the extremes of EDI-2 score, and (c) registered ED diagnoses, in 1481 female twin pairs at age 18 years (born 1992-1999). EDI-2 scores were self-reported at age 18. ED diagnoses were identified through the Swedish National Patient Register, parent-reported treatment and/or self-reported purging behavior of a frequency and duration consistent with DSM-IV criteria. We differentiated between anorexia nervosa (AN) and other EDs. RESULTS The heritability of the EDI-2 score was 0.65 (95% CI 0.61-0.68). The group heritabilities in DeFries-Fulker extremes analyses were consistent over different percentile-based extreme groups [0.59 (95% CI 0.37-0.81) to 0.65 (95% CI 0.55-0.75)]. Similarly, the heritabilities in liability threshold models were consistent over different levels of severity. In joint categorical-continuous models, the twin-based genetic correlation was 0.52 (95% CI 0.39-0.65) between EDI-2 score and diagnoses of other EDs, and 0.26 (95% CI 0.08-0.42) between EDI-2 score and diagnoses of AN. The non-shared environmental correlations were 0.52 (95% CI 0.32-0.70) and 0.60 (95% CI 0.38-0.79), respectively. CONCLUSIONS Our findings suggest that some EDs can partly be conceptualized as the extreme manifestation of continuously distributed ED features. AN, however, might be more distinctly genetically demarcated from ED features in the general population than other EDs.
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Affiliation(s)
- Lisa Dinkler
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Mark J. Taylor
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Maria Råstam
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
- Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Nouchine Hadjikhani
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts, USA
| | - Cynthia M. Bulik
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Sebastian Lundström
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
- Centre for Ethics, Law and Mental Health (CELAM), Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
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Taylor MJ. Specialty Grand Challenge: Embracing the Need for Research and Innovation as Fundamental Enablers for Programmatic Progress for All Neglected Tropical Diseases. Front Trop Dis 2021. [DOI: 10.3389/fitd.2021.669726] [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: 11/13/2022] Open
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Abstract
Autism spectrum disorder is associated with sensory processing alterations, such as sensory hyper- and hypo-responsiveness. Twin studies are scarce in this field, but they are necessary in order to disentangle the genetic and environmental contributions to this association. Furthermore, it is unclear how different neurodevelopmental/psychiatric conditions contribute to altering sensory processing. We investigated the association between autistic traits/autism spectrum disorder diagnosis and sensory processing alterations in twins (N = 269), using the adult/adolescent sensory profile, which differentiates four sub-domains: Low Registration, Sensation Seeking, Sensory Sensitivity, and Sensation Avoiding. While the associations between autistic traits and Low Registration and Sensation Avoiding persisted within monozygotic (genetically identical) twins, Sensory Sensitivity was only associated with autistic traits within dizygotic twins. In multivariate analyses with different neurodevelopmental/psychiatric diagnoses as predictor variables, autism spectrum disorder and attention deficit hyperactivity disorder were the strongest predictors for two adult/adolescent sensory profile sub-domains each. The results suggest that the association between autistic traits and Sensory Sensitivity is influenced by genetics while non-shared environmental factors influence the associations between autistic traits and Low Registration and Sensation Avoiding. They further indicate that altered sensory processing is not specific to autism spectrum disorder, while autism spectrum disorder is a strong predictor of certain sensory processing alterations, even when controlling for other (comorbid) neurodevelopmental/psychiatric conditions.
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Affiliation(s)
| | | | | | - Johan Isaksson
- Karolinska Institutet, Sweden.,Uppsala University, Sweden
| | | | - Sven Bölte
- Karolinska Institutet, Sweden.,Region Stockholm, Sweden.,Curtin University, Australia
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Furlong-Silva J, Cross SD, Marriott AE, Pionnier N, Archer J, Steven A, Merker SS, Mack M, Hong YK, Taylor MJ, Turner JD. Tetracyclines improve experimental lymphatic filariasis pathology by disrupting interleukin-4 receptor-mediated lymphangiogenesis. J Clin Invest 2021; 131:140853. [PMID: 33434186 PMCID: PMC7919730 DOI: 10.1172/jci140853] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 01/06/2021] [Indexed: 12/21/2022] Open
Abstract
Lymphatic filariasis is the major global cause of nonhereditary lymphedema. We demonstrate that the filarial nematode Brugia malayi induced lymphatic remodeling and impaired lymphatic drainage following parasitism of limb lymphatics in a mouse model. Lymphatic insufficiency was associated with elevated circulating lymphangiogenic mediators, including vascular endothelial growth factor C. Lymphatic insufficiency was dependent on type 2 adaptive immunity, the interleukin-4 receptor, and recruitment of C-C chemokine receptor-2–positive monocytes and alternatively activated macrophages with a prolymphangiogenic phenotype. Oral treatments with second-generation tetracyclines improved lymphatic function, while other classes of antibiotic had no significant effect. Second-generation tetracyclines directly targeted lymphatic endothelial cell proliferation and modified type 2 prolymphangiogenic macrophage development. Doxycycline treatment impeded monocyte recruitment, inhibited polarization of alternatively activated macrophages, and suppressed T cell adaptive immune responses following infection. Our results determine a mechanism of action for the antimorbidity effects of doxycycline in filariasis and support clinical evaluation of second-generation tetracyclines as affordable, safe therapeutics for lymphedemas of chronic inflammatory origin.
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Affiliation(s)
- Julio Furlong-Silva
- Centre for Drugs & Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Stephen D Cross
- Centre for Drugs & Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Amy E Marriott
- Centre for Drugs & Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Nicolas Pionnier
- Centre for Drugs & Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - John Archer
- Centre for Drugs & Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Andrew Steven
- Centre for Drugs & Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Stefan Schulte Merker
- Institute for Cardiovascular Organogenesis and Regeneration, Faculty of Medicine, Westfälische Wilhelms-Universität Münster, Münster, Germany
| | - Matthias Mack
- Universitätsklinikum Regensburg, Regensburg, Germany
| | - Young-Kwon Hong
- Department of Surgery, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Mark J Taylor
- Centre for Drugs & Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Joseph D Turner
- Centre for Drugs & Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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Dinkler L, Taylor MJ, Råstam M, Hadjikhani N, Bulik CM, Lichtenstein P, Gillberg C, Lundström S. Anorexia nervosa and autism: a prospective twin cohort study. J Child Psychol Psychiatry 2021; 62:316-326. [PMID: 32496594 DOI: 10.1111/jcpp.13265] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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] [Accepted: 04/27/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Anorexia nervosa (AN) and autism spectrum disorder (ASD) may be phenotypically and etiologically linked. However, due to the absence of prospective studies, it remains unclear whether the elevation of autistic traits in AN is evident in early childhood. Here, we prospectively investigated autistic traits before and after the first diagnosis of AN. METHODS In a population-based sample of 5,987 individuals (52.4% female) from the Child and Adolescent Twin Study in Sweden, parents reported autistic traits at ages 9 and 18. AN and ASD diagnoses were retrieved from the Swedish National Patient Register. In addition, AN diagnoses were ascertained by parent-reported treatment for AN. We compared whether individuals with and without AN differed in autistic traits before the first diagnosis of AN (age 9) and after the first diagnosis of AN (age 18). RESULTS We did not find evidence for elevated autistic traits in 9-year-old children later diagnosed with AN. At age 18, however, there was a marked elevation in restricted/repetitive behavior and interests, but only in the subgroup of individuals with acute AN. A less pronounced elevation was observed for social communication problems. CONCLUSIONS Coping strategies in individuals with ASD and the somewhat different female ASD phenotype may explain why we did not find elevated autistic traits in children who later developed AN. Alternatively, it is possible that elevated autistic traits were not present prior to the onset of AN, thus questioning the previously reported elevated prevalence of ASD in AN. Future studies should use tailored measurements in order to investigate whether autistic traits in individuals with AN are best conceptualized as an epiphenomenon of the acute AN phase or whether these symptoms indeed represent ASD as a clinically verifiable neurodevelopmental disorder.
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Affiliation(s)
- Lisa Dinkler
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Mark J Taylor
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Maria Råstam
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.,Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Nouchine Hadjikhani
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.,Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Cynthia M Bulik
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Sebastian Lundström
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
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Johansson V, Sandin S, Chang Z, Taylor MJ, Lichtenstein P, D'Onofrio BM, Larsson H, Hellner C, Halldner L. Medications for attention-deficit/hyperactivity disorder in individuals with or without coexisting autism spectrum disorder: analysis of data from the Swedish prescribed drug register. J Neurodev Disord 2020; 12:44. [PMID: 33357227 PMCID: PMC7758935 DOI: 10.1186/s11689-020-09352-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 12/14/2020] [Indexed: 01/14/2023] Open
Abstract
Background Clinical studies found that medication for attention-deficit/hyperactivity disorder (ADHD) is effective in coexisting autism spectrum disorder (ASD), but current research is based on small clinical studies mainly performed on children or adolescents. We here use register data to examine if individuals with ADHD and coexisting ASD present differences in the prescribing patterns of ADHD medication when compared to individuals with pure ADHD. Methods Data with information on filled prescriptions and diagnoses was retrieved from the Swedish Prescribed Drug Register and the National Patient Register. We identified 34,374 individuals with pure ADHD and 5012 individuals with ADHD and coexisting ASD, aged between 3 and 80 years. The first treatment episode with ADHD medications (≥ 2 filled prescriptions within 90 days) and daily doses of methylphenidate during a 3-year period was measured. Odds ratios (ORs) were calculated for the likelihood of being prescribed ADHD medication in individuals with and without ASD and Wilcoxon rank-sum test was used to compare group differences in dose per day. Results Individuals with ADHD and coexisting ASD were less likely to start continuous treatment with ADHD medication (ADHD 80.5%; ADHD with ASD 76.2%; OR, 0.80; 95% confidence interval, 0.75-0.86), were less likely to be prescribed methylphenidate, and were more commonly prescribed second line treatments such as dexamphetamine, amphetamine, or modafinil. No group difference was observed for atomoxetine. In adults with ADHD and coexisting ASD, methylphenidate was prescribed in lower daily doses over three years as compared to individuals with pure ADHD. Conclusions The findings indicate that there are differences in the medical treatment of individuals with or without ASD. If these differences are due to different medication responses in ASD or due to other factors such as clinicians’ perceptions of medication effects in patients with ASD, needs to be further studied. Supplementary Information The online version contains supplementary material available at 10.1186/s11689-020-09352-z.
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Affiliation(s)
- Viktoria Johansson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, PO Box 281, SE-171 77, Stockholm, Sweden. .,Centre for Psychiatric Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden.
| | - Sven Sandin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, PO Box 281, SE-171 77, Stockholm, Sweden.,Department of Psychiatry, Icahn Medical School at Mount Sinai, New York, USA.,Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Zheng Chang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, PO Box 281, SE-171 77, Stockholm, Sweden
| | - Mark J Taylor
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, PO Box 281, SE-171 77, Stockholm, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, PO Box 281, SE-171 77, Stockholm, Sweden
| | - Brian M D'Onofrio
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, PO Box 281, SE-171 77, Stockholm, Sweden.,Department of Psychological and Brain Sciences, Indiana University, Bloomington, Indiana, USA
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, PO Box 281, SE-171 77, Stockholm, Sweden.,School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Clara Hellner
- Centre for Psychiatric Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Linda Halldner
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, PO Box 281, SE-171 77, Stockholm, Sweden.,Department of Clinical Science, Child and Adolescent Psychiatry, Umeå University, Umeå, Sweden
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61
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Li L, Taylor MJ, Bälter K, Kuja‐Halkola R, Chen Q, Hegvik T, Tate AE, Chang Z, Arias‐Vásquez A, Hartman CA, Larsson H. Attention-deficit/hyperactivity disorder symptoms and dietary habits in adulthood: A large population-based twin study in Sweden. Am J Med Genet B Neuropsychiatr Genet 2020; 183:475-485. [PMID: 33029947 PMCID: PMC7702140 DOI: 10.1002/ajmg.b.32825] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 09/14/2020] [Accepted: 09/22/2020] [Indexed: 01/28/2023]
Abstract
Associations between adult attention-deficit/hyperactivity disorder (ADHD) symptoms and dietary habits have not been well established and the underlying mechanisms remain unclear. We explored these associations using a Swedish population-based twin study with 17,999 individuals aged 20-47 years. We estimated correlations between inattention and hyperactivity/impulsivity with dietary habits and fitted twin models to determine the genetic and environmental contributions. Dietary habits were defined as (a) consumption of food groups, (b) consumption of food items rich in particular macronutrients, and (c) healthy and unhealthy dietary patterns. At the phenotypic level, inattention was positively correlated with seafood, high-fat, high-sugar, high-protein food consumptions, and unhealthy dietary pattern, with correlation coefficients ranging from 0.03 (95%CI: 0.01, 0.05) to 0.13 (95% CI: 0.11, 0.15). Inattention was negatively correlated with fruits, vegetables consumptions and healthy dietary pattern, with correlation coefficients ranging from -0.06 (95%CI: -0.08, -0.04) to -0.07 (95%CI: -0.09, -0.05). Hyperactivity/impulsivity and dietary habits showed similar but weaker patterns compared to inattention. All associations remained stable across age, sex and socioeconomic status. Nonshared environmental effects contributed substantially to the correlations of inattention (56-60%) and hyperactivity/impulsivity (63-80%) with dietary habits. The highest and lowest genetic correlations were between inattention and high-sugar food (rA = .16, 95% CI: 0.07, 0.25), and between hyperactivity/impulsivity and unhealthy dietary pattern (rA = .05, 95% CI: -0.05, 0.14), respectively. We found phenotypic and etiological overlap between ADHD and dietary habits, although these associations were weak. Our findings contribute to a better understanding of common etiological pathways between ADHD symptoms and various dietary habits.
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Affiliation(s)
- Lin Li
- School of Medical SciencesÖrebro UniversityÖrebroSweden
| | - Mark J. Taylor
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | - Katarina Bälter
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden,Public Health SciencesMälardalen UniversityVästeråsSweden
| | - Ralf Kuja‐Halkola
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | - Qi Chen
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | - Tor‐Arne Hegvik
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden,Department of BiomedicineUniversity of BergenBergenNorway
| | - Ashley E. Tate
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | - Zheng Chang
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | - Alejandro Arias‐Vásquez
- The Department of Psychiatry & Human GeneticsDonders Institute for Brain, Cognition, and Behavior, Radboud University Medical CenterNijmegenNetherlands
| | - Catharina A. Hartman
- Department of PsychiatryUniversity of Groningen, University Medical Center GroningenGroningenNetherlands
| | - Henrik Larsson
- School of Medical SciencesÖrebro UniversityÖrebroSweden,Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
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Abstract
IMPORTANCE The frequency with which autism spectrum disorders (ASDs) are diagnosed has shown a marked increase in recent years. One suggestion is that this is partly because of secular changes in the environment, yet to our knowledge this hypothesis lacks evidence. OBJECTIVE To assess whether the relative importance of genetic and environmental associations with ASD and autistic traits has changed over a 16-year and 26-year period. DESIGN, SETTING, AND PARTICIPANTS A twin design was used to assess whether the heritability of ASD and autistic traits has changed over time. Data from 2 nationwide Swedish twin cohorts was used: the Swedish Twin Registry (STR; participants born between January 1982 and December 2008) and the Child and Adolescent Twin Study in Sweden (CATSS; participants born between January 1992 and December 2008). Autism spectrum disorder diagnoses were identified for twins in the STR, with follow-up to 2013. Questionnaires assigned screening diagnoses of ASD to CATSS participants and assessed autistic traits. Analyses were performed from September 1, 2018, to March 31, 2019. EXPOSURES Each sample was divided into several birth cohorts covering 1982 to 1991 (for the STR only), 1992-1995, 1996-1999, 2000-2003, and 2004-2008. OUTCOMES We assessed whether the genetric and environment variance underlying autistic traits changed across birth cohorts and examined whether the relative contribution of genetics and environment to liability for autism changed across birth cohorts. RESULTS Data were available for 22 678 twin pairs (5922 female same-sex pairs [26.1%], 5563 male same-sex pairs [24.5%], and 11193 opposite-sex pairs [49.4%]) in the STR and 15 280 pairs (4880 female same-sex pairs [31.9%], 5092 male same-sex pairs [33.3%], and 5308 opposite-sex pairs [34.7%]) in CATSS. The heritability of ASD diagnoses in the STR ranged from 0.88 (95% CI, 0.74-0.96) to 0.97 (95% CI, 0.89-0.99). The heritability of screening diagnoses in CATSS varied from 0.75 (95% CI, 0.58-0.87) to 0.93 (95% CI, 0.84-0.98). Autistic traits showed a modest variance increase over time that was associated with increases in genetic and environmental variance, with the total variance increasing from 0.95 (95% CI, 0.92-0.98) to 1.17 (95% CI, 1.13-1.21) over time. CONCLUSIONS AND RELEVANCE Weak evidence was found for changes in the genetic and environmental factors underlying ASD and autistic traits over time. Genetic factors played a consistently larger role than environmental factors. Environmental factors are thus unlikely to explain the increase in the prevalence of ASD.
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Affiliation(s)
- Mark J. Taylor
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Mina A. Rosenqvist
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden,School of Medical Sciences, Örebro University, Örebro, Sweden
| | | | - Brian M. D’Onofrio
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden,Department of Psychological & Brain Science, Indiana University, Bloomington
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Sebastian Lundström
- Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg, Sweden,Centre for Ethics, Law, and Mental Health, University of Gothenburg, Gothenburg, Sweden
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Pionnier N, Sjoberg H, Furlong-Silva J, Marriott A, Halliday A, Archer J, Steven A, Taylor MJ, Turner JD. Eosinophil-Mediated Immune Control of Adult Filarial Nematode Infection Can Proceed in the Absence of IL-4 Receptor Signaling. J Immunol 2020; 205:731-740. [PMID: 32571840 PMCID: PMC7372315 DOI: 10.4049/jimmunol.1901244] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 05/17/2020] [Indexed: 12/19/2022]
Abstract
Immunity to chronic filarial worm infection is apparent in IL-4Rα–deficient mice. Delayed immunity in IL-4Rα−/− mice is due to suboptimal tissue eosinophilia. Eosinophil recruitment in the absence of IL-4R signaling requires CCR3 and IL-5.
Helminth infections are accompanied by eosinophilia in parasitized tissues. Eosinophils are effectors of immunity to tissue helminths. We previously reported that in the context of experimental filarial nematode infection, optimum tissue eosinophil recruitment was coordinated by local macrophage populations following IL-4R–dependent in situ proliferation and alternative activation. However, in the current study, we identify that control of chronic adult filarial worm infection is evident in IL-4Rα–deficient (IL-4Rα−/−) mice, whereby the majority of infections do not achieve patency. An associated residual eosinophilia was apparent in infected IL-4Rα−/− mice. By treating IL-4Rα−/− mice serially with anti-CCR3 Ab or introducing a compound deficiency in CCR3 within IL-4Rα−/− mice, residual eosinophilia was ablated, and susceptibility to chronic adult Brugia malayi infection was established, promoting a functional role for CCR3-dependent eosinophil influx in immune control in the absence of IL-4/IL-13–dependent immune mechanisms. We investigated additional cytokine signals involved in residual eosinophilia in the absence IL-4Rα signaling and defined that IL-4Rα−/−/IL-5−/− double-knockout mice displayed significant eosinophil deficiency compared with IL-4Rα−/− mice and were susceptible to chronic fecund adult filarial infections. Contrastingly, there was no evidence that either IL-4R–dependent or IL-4R–independent/CCR3/IL-5–dependent immunity influenced B. malayi microfilarial loads in the blood. Our data demonstrate multiplicity of Th2-cytokine control of eosinophil tissue recruitment during chronic filarial infection and that IL-4R–independent/IL-5– and CCR3-dependent pathways are sufficient to control filarial adult infection via an eosinophil-dependent effector response prior to patency.
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Affiliation(s)
- Nicolas Pionnier
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, United Kingdom
| | - Hanna Sjoberg
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, United Kingdom
| | - Julio Furlong-Silva
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, United Kingdom
| | - Amy Marriott
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, United Kingdom
| | - Alice Halliday
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, United Kingdom
| | - John Archer
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, United Kingdom
| | - Andrew Steven
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, United Kingdom
| | - Mark J Taylor
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, United Kingdom
| | - Joseph D Turner
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, United Kingdom
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Martin J, Ghirardi L, Chen Q, Hartman CA, Rosenqvist MA, Taylor MJ, Birgegård A, Almqvist C, Lichtenstein P, Larsson H. Investigating gender-specific effects of familial risk for attention-deficit hyperactivity disorder and other neurodevelopmental disorders in the Swedish population. BJPsych Open 2020; 6:e65. [PMID: 32552921 PMCID: PMC7345736 DOI: 10.1192/bjo.2020.47] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Many psychiatric disorders show gender differences in prevalence. Recent studies suggest that female patients diagnosed with anxiety and depression carry more genetic risks related to attention-deficit hyperactivity disorder (ADHD) compared with affected males. AIMS In this register-based study, we aimed to test whether female patients who received clinical diagnoses of anxiety, depressive, bipolar and eating disorders are at higher familial risk for ADHD and other neurodevelopmental disorders, compared with diagnosed male patients. METHOD We analysed data from a record-linkage of several Swedish national registers, including 151 025 sibling pairs from 103 941 unique index individuals diagnosed with anxiety, depressive, bipolar or eating disorders, as well as data from 646 948 cousin pairs. We compared the likelihood of having a relative diagnosed with ADHD/neurodevelopmental disorders in index males and females. RESULTS Female patients with anxiety disorders were more likely than affected males to have a brother with ADHD (odd ratio (OR) = 1.13, 95% CI 1.05-1.22). Results for broader neurodevelopmental disorders were similar and were driven by ADHD diagnoses. Follow-up analyses revealed similar point estimates for several categories of anxiety disorders, with the strongest effect observed for agoraphobia (OR = 1.64, 95% CI 1.12-2.39). No significant associations were found in individuals with depressive, bipolar or eating disorders, or in cousins. CONCLUSIONS These results provide modest support for the possibility that familial/genetic risks for ADHD may show gender-specific phenotypic expression. Alternatively, there could be gender-specific biases in diagnoses of anxiety and ADHD. These factors could play a small role in the observed gender differences in prevalence of ADHD and anxiety.
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Affiliation(s)
- Joanna Martin
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, UK; and Department of Medical Epidemiology & Biostatistics, Karolinska Institutet, Sweden
| | - Laura Ghirardi
- Department of Medical Epidemiology & Biostatistics, Karolinska Institutet, Sweden
| | - Qi Chen
- Department of Medical Epidemiology & Biostatistics, Karolinska Institutet, Sweden
| | - Catharina A Hartman
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, the Netherlands
| | - Mina A Rosenqvist
- Department of Medical Epidemiology & Biostatistics, Karolinska Institutet, Sweden
| | - Mark J Taylor
- Department of Medical Epidemiology & Biostatistics, Karolinska Institutet, Sweden
| | | | - Catarina Almqvist
- Department of Medical Epidemiology & Biostatistics, Karolinska Institutet, Sweden; and Pediatric Allergy and Pulmonology Unit at Astrid Lindgren Children's Hospital, Karolinska University Hospital, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology & Biostatistics, Karolinska Institutet, Sweden
| | - Henrik Larsson
- Department of Medical Epidemiology & Biostatistics, Karolinska Institutet; and School of Medical Sciences, Örebro University, Sweden
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Betts H, Martindale S, Chiphwanya J, Mkwanda SZ, Matipula DE, Ndhlovu P, Mackenzie C, Taylor MJ, Kelly-Hope LA. Significant improvement in quality of life following surgery for hydrocoele caused by lymphatic filariasis in Malawi: A prospective cohort study. PLoS Negl Trop Dis 2020; 14:e0008314. [PMID: 32384094 PMCID: PMC7239494 DOI: 10.1371/journal.pntd.0008314] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 11/21/2019] [Revised: 05/20/2020] [Accepted: 04/21/2020] [Indexed: 12/12/2022] Open
Abstract
Background Lymphatic filariasis (LF) is a mosquito-borne parasitic infection that causes significant disabling and disfiguring clinical manifestations. Hydrocoele (scrotal swelling) is the most common clinical condition, which affects an estimated 25 million men globally. The recommended strategy is surgical intervention, yet little is known about the impact of hydrocoele on men’s lives, and how it may change if they have access to surgery. Methodology/Principal findings We prospectively recruited and followed-up men who underwent surgery for hydrocoele at six hospitals in an LF endemic area of Malawi in December 2015. Men were interviewed at hospitals pre-surgery and followed-up at 3-months and 6-months post-surgery. Data on demographic characteristics, clinical condition, barriers to surgery, post-surgery symptoms/complications and quality of life indicators were collected and analysed pre- and post-surgery, by age group and stage of disease (mild/moderate vs. severe), using chi-square tests and student’s t test (paired). 201 men were interviewed pre-surgery, 152 at 3-months and 137 at 6-months post-surgery. Most men had unilateral hydrocoeles (65.2%), mild/moderate stages (57.7%) with an average duration of 11.4 years. The most reported cause of hydrocoele was it being sexually transmitted (22.4%), and the main barrier to surgery was the cost (36.3%). Pre-surgery, a significant difference in the scrotum side affected was found by age group (X2 = 5.978, p = 0.05), and men with severe stage hydrocoele reported more problems with their quality of life than those with mild/moderate stage (t = 2.793; p = 0.0006). Post-surgery, around half of the men reported some pain/discomfort (55.9%), swelling (8.6%), bleeding (3.3%) and infection (5.9%), most of which had resolved at 3-months when the most significant improvements in their quality of life were found (t = 21.3902; p = 0.000). Post-surgery at 6 months all men reported no physical, social, psychological problems and took no time off work. Conclusion/Significance Surgery had a significant positive impact on many aspects of a patient’s life, and the expansion of this treatment to all those affected in LF endemic areas would greatly improve the quality of men’s and their families’ lives, and greatly contribute to the global goal of providing universal health care. Lymphatic filariasis is a mosquito-borne infection that causes significant disabling and disfiguring clinical conditions. Hydrocoele (scrotal swelling) is the most common condition affecting an estimated 25 million men worldwide. Surgery is the main intervention, however, there is limited information on its impact. This study assessed men before and after surgery in an endemic region of Malawi, to identify potential barriers and determine how surgery may change the quality of their life. Before surgery, 201 men reported to have moderate to severe problems with many aspects of their life including pain, mobility, usual activities, self-care, social issues, psychological health and ability to work. The main barrier to hydrocoele surgery was the cost, including associated transport and accommodation costs. After surgery, follow-up surveys at 3-months and 6- months found that men reported minimal or no physical, social, psychological problems and took no time off work. Surgery had a significant positive and lasting impact on men’s lives. National programmes need to advocate for resources to increase funding to support men and the uptake and demand for quality surgical services.
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Affiliation(s)
- Hannah Betts
- Centre for Neglected Tropical Diseases, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Sarah Martindale
- Centre for Neglected Tropical Diseases, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | | | | | | | | | - Charles Mackenzie
- Centre for Neglected Tropical Diseases, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Mark J. Taylor
- Centre for Neglected Tropical Diseases, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Louise A. Kelly-Hope
- Centre for Neglected Tropical Diseases, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
- * E-mail:
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Taylor MJ, Wilson J. Corrigendum: Reasonable Expectations of Privacy and Disclosure of Health Data. Med Law Rev 2020; 28:442-443. [PMID: 32073618 PMCID: PMC7286746 DOI: 10.1093/medlaw/fwaa004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Mark J Taylor
- Associate Professor in Health Law and Regulation, Melbourne Law School, University of Melbourne, Australia
| | - James Wilson
- Senior Lecturer, Department of Philosophy, UCL, London, UK
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Taylor MJ, von Geldern TW, Ford L, Hübner MP, Marsh K, Johnston KL, Sjoberg HT, Specht S, Pionnier N, Tyrer HE, Clare RH, Cook DAN, Murphy E, Steven A, Archer J, Bloemker D, Lenz F, Koschel M, Ehrens A, Metuge HM, Chunda VC, Ndongmo Chounna PW, Njouendou AJ, Fombad FF, Carr R, Morton HE, Aljayyoussi G, Hoerauf A, Wanji S, Kempf DJ, Turner JD, Ward SA. Preclinical development of an oral anti- Wolbachia macrolide drug for the treatment of lymphatic filariasis and onchocerciasis. Sci Transl Med 2020; 11:11/483/eaau2086. [PMID: 30867321 DOI: 10.1126/scitranslmed.aau2086] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 10/19/2018] [Indexed: 01/04/2023]
Abstract
There is an urgent global need for a safe macrofilaricide drug to accelerate elimination of the neglected tropical diseases onchocerciasis and lymphatic filariasis. From an anti-infective compound library, the macrolide veterinary antibiotic, tylosin A, was identified as a hit against Wolbachia This bacterial endosymbiont is required for filarial worm viability and fertility and is a validated target for macrofilaricidal drugs. Medicinal chemistry was undertaken to develop tylosin A analogs with improved oral bioavailability. Two analogs, A-1535469 and A-1574083, were selected. Their efficacy was tested against the gold-standard second-generation tetracycline antibiotics, doxycycline and minocycline, in mouse and gerbil infection models of lymphatic filariasis (Brugia malayi and Litomosoides sigmodontis) and onchocerciasis (Onchocerca ochengi). A 1- or 2-week course of oral A-1535469 or A-1574083 provided >90% Wolbachia depletion from nematodes in infected animals, resulting in a block in embryogenesis and depletion of microfilarial worm loads. The two analogs delivered comparative or superior efficacy compared to a 3- to 4-week course of doxycycline or minocycline. A-1574083 (now called ABBV-4083) was selected for further preclinical testing. Cardiovascular studies in dogs and toxicology studies in rats and dogs revealed no adverse effects at doses (50 mg/kg) that achieved plasma concentrations >10-fold above the efficacious concentration. A-1574083 (ABBV-4083) shows potential as an anti-Wolbachia macrolide with an efficacy, pharmacology, and safety profile that is compatible with a short-term oral drug course for treating lymphatic filariasis and onchocerciasis.
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Affiliation(s)
- Mark J Taylor
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
| | - Thomas W von Geldern
- Global Pharmaceutical Research and Development, AbbVie, North Chicago, IL, USA.,Franciscan Institute for World Health, Franciscan University, Steubenville, OH, USA
| | - Louise Ford
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
| | - Marc P Hübner
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
| | - Kennan Marsh
- Global Pharmaceutical Research and Development, AbbVie, North Chicago, IL, USA
| | - Kelly L Johnston
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
| | - Hanna T Sjoberg
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
| | - Sabine Specht
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
| | - Nicolas Pionnier
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
| | - Hayley E Tyrer
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
| | - Rachel H Clare
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
| | - Darren A N Cook
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
| | - Emma Murphy
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
| | - Andrew Steven
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
| | - John Archer
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
| | - Dominique Bloemker
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
| | - Franziska Lenz
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
| | - Marianne Koschel
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
| | - Alexandra Ehrens
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
| | - Haelly M Metuge
- Research Foundation for Tropical Diseases and the Environment, Buea, Cameroon.,Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Valerinne C Chunda
- Research Foundation for Tropical Diseases and the Environment, Buea, Cameroon.,Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Patrick W Ndongmo Chounna
- Research Foundation for Tropical Diseases and the Environment, Buea, Cameroon.,Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Abdel J Njouendou
- Research Foundation for Tropical Diseases and the Environment, Buea, Cameroon.,Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Fanny F Fombad
- Research Foundation for Tropical Diseases and the Environment, Buea, Cameroon.,Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Robert Carr
- Global Pharmaceutical Research and Development, AbbVie, North Chicago, IL, USA
| | - Howard E Morton
- Global Pharmaceutical Research and Development, AbbVie, North Chicago, IL, USA
| | - Ghaith Aljayyoussi
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
| | - Achim Hoerauf
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
| | - Samuel Wanji
- Research Foundation for Tropical Diseases and the Environment, Buea, Cameroon.,Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Dale J Kempf
- Global Pharmaceutical Research and Development, AbbVie, North Chicago, IL, USA
| | - Joseph D Turner
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
| | - Stephen A Ward
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK.
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68
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Turner JD, Marriott AE, Hong D, O' Neill P, Ward SA, Taylor MJ. Novel anti-Wolbachia drugs, a new approach in the treatment and prevention of veterinary filariasis? Vet Parasitol 2020; 279:109057. [PMID: 32126342 DOI: 10.1016/j.vetpar.2020.109057] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 02/07/2020] [Accepted: 02/08/2020] [Indexed: 02/09/2023]
Abstract
Filarial nematodes are tissue-dwelling parasitic worms that can cause a range of disfiguring pathologies in humans and potentially lethal infections of companion animals. The bacterial endosymbiont, Wolbachia, is present within most human and veterinary filarial pathogens, including the causative agent of heartworm disease, Dirofilaria immitis. Doxycycline-mediated drug targeting of Wolbachia leads to sterility, clearance of microfilariae and gradual death of adult filariae. This mode of action is attractive in the treatment of filariasis because it avoids severe host inflammatory adverse reactions invoked by rapid-killing anthelmintic agents. However, doxycycline needs to be taken for four weeks to exert curative activity. In this review, we discuss the evidence that Wolbachia drug targeting is efficacious in blocking filarial larval development as well as in the treatment of chronic filarial disease. We present the current portfolio of next-generation anti-Wolbachia candidates discovered through phenotypic screening of chemical libraries and validated in a range of in vitro and in vivo filarial infection models. Several novel chemotypes have been identified with selected narrow-spectrum anti-Wolbachia specificity and superior time-to-kill kinetics compared with doxycycline. We discuss the opportunities of developing these novel anti-Wolbachia agents as either cures, adjunct therapies or new preventatives for the treatment of veterinary filariasis.
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Affiliation(s)
- Joseph D Turner
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, UK.
| | - Amy E Marriott
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - David Hong
- Department of Chemistry, University of Liverpool, UK
| | - Paul O' Neill
- Department of Chemistry, University of Liverpool, UK
| | - Steve A Ward
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Mark J Taylor
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, UK
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69
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Chunda VC, Ritter M, Bate A, Gandjui NVT, Esum ME, Fombad FF, Njouendou AJ, Ndongmo PWC, Taylor MJ, Hoerauf A, Layland LE, Turner JD, Wanji S. Comparison of immune responses to Loa loa stage-specific antigen extracts in Loa loa-exposed BALB/c mice upon clearance of infection. Parasit Vectors 2020; 13:51. [PMID: 32033624 PMCID: PMC7006431 DOI: 10.1186/s13071-020-3921-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 01/31/2020] [Indexed: 01/10/2023] Open
Abstract
Background Different immune mechanisms are capable of killing developmental stages of filarial nematodes and these mechanisms are also likely to vary between the primary and a challenge infection. However, the lack of a detailed analysis of cytokine, chemokine and immunoglobulin levels in human loiasis is still evident. Therefore, detailed analysis of immune responses induced by the different developmental stages of Loa loa in immune-competent BALB/c mice will aid in the characterization of distinct immune responses that are important for the immunity against loiasis. Methods Different developmental stages of L. loa were obtained from human peripheral blood (microfilariae, MF), the transmitting vector, Chrysops (larval stage 3, L3) and infected immune-deficient BALB/cRAG2γc−/− mice (L4, L5, adult worms). Groups of wildtype BALB/c mice were then injected with the isolated stages and after 42 days post-infection (pi), systemic cytokine, chemokine and immunoglobulin levels were determined. These were then compared to L. loa-specific responses from in vitro re-stimulated splenocytes from individual mice. All parameters were determined using Luminex technology. Results In a pilot study, BALB/c mice cleared the different life stages of L. loa within 42 days pi and systemic cytokine, chemokine and immunoglobulin levels were equal between infected and naive mice. Nevertheless, L. loa-specific re-stimulation of splenocytes from mice infected with L5, MF or adult worms led to induction of Th2, Th17 and chemokine secretion patterns. Conclusions This study shows that although host immunity remains comparable to naive mice, clearance of L. loa life-cycle development stages can induce immune cell memory leading to cytokine, chemokine and immunoglobulins secretion patterns which might contribute to immunity and protection against reinfection.![]()
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Affiliation(s)
- Valerine C Chunda
- Parasite and Vector Biology Research Unit, Department of Microbiology and Parasitology, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon.,Research Foundation in Tropical Diseases and the Environment, P.O. Box 474, Buea, Cameroon
| | - Manuel Ritter
- Institute of Medical Microbiology, Immunology and Parasitology (IMMIP), Medical Faculty, University of Bonn, Bonn, Germany.
| | - Ayukenchengamba Bate
- Parasite and Vector Biology Research Unit, Department of Microbiology and Parasitology, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon.,Research Foundation in Tropical Diseases and the Environment, P.O. Box 474, Buea, Cameroon
| | - Narcisse V T Gandjui
- Parasite and Vector Biology Research Unit, Department of Microbiology and Parasitology, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon.,Research Foundation in Tropical Diseases and the Environment, P.O. Box 474, Buea, Cameroon
| | - Mathias E Esum
- Parasite and Vector Biology Research Unit, Department of Microbiology and Parasitology, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon.,Research Foundation in Tropical Diseases and the Environment, P.O. Box 474, Buea, Cameroon
| | - Fanny F Fombad
- Parasite and Vector Biology Research Unit, Department of Microbiology and Parasitology, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon.,Research Foundation in Tropical Diseases and the Environment, P.O. Box 474, Buea, Cameroon
| | - Abdel J Njouendou
- Parasite and Vector Biology Research Unit, Department of Microbiology and Parasitology, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon.,Research Foundation in Tropical Diseases and the Environment, P.O. Box 474, Buea, Cameroon
| | - Patrick W C Ndongmo
- Parasite and Vector Biology Research Unit, Department of Microbiology and Parasitology, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon.,Research Foundation in Tropical Diseases and the Environment, P.O. Box 474, Buea, Cameroon
| | - Mark J Taylor
- Centre for Drugs and Diagnostics Research, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Achim Hoerauf
- Institute of Medical Microbiology, Immunology and Parasitology (IMMIP), Medical Faculty, University of Bonn, Bonn, Germany.,German Centre for Infection Research (DZIF), Bonn-Cologne partner site, Bonn, Germany
| | - Laura E Layland
- Institute of Medical Microbiology, Immunology and Parasitology (IMMIP), Medical Faculty, University of Bonn, Bonn, Germany.,German Centre for Infection Research (DZIF), Bonn-Cologne partner site, Bonn, Germany
| | - Joseph D Turner
- Centre for Drugs and Diagnostics Research, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Samuel Wanji
- Parasite and Vector Biology Research Unit, Department of Microbiology and Parasitology, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon.,Research Foundation in Tropical Diseases and the Environment, P.O. Box 474, Buea, Cameroon
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70
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Ehrens A, Lunde CS, Jacobs RT, Struever D, Koschel M, Frohberger SJ, Lenz F, Fendler M, Turner JD, Ward SA, Taylor MJ, Freund YR, Stefanakis R, Easom E, Li X, Plattner JJ, Hoerauf A, Hübner MP. In vivo efficacy of the boron-pleuromutilin AN11251 against Wolbachia of the rodent filarial nematode Litomosoides sigmodontis. PLoS Negl Trop Dis 2020; 14:e0007957. [PMID: 31986143 PMCID: PMC7004383 DOI: 10.1371/journal.pntd.0007957] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 07/15/2019] [Revised: 02/06/2020] [Accepted: 11/27/2019] [Indexed: 11/19/2022] Open
Abstract
The elimination of filarial diseases such as onchocerciasis and lymphatic filariasis is hampered by the lack of a macrofilaricidal-adult worm killing-drug. In the present study, we tested the in vivo efficacy of AN11251, a boron-pleuromutilin that targets endosymbiotic Wolbachia bacteria from filarial nematodes and compared its efficacy to doxycycline and rifampicin. Doxycycline and rifampicin were previously shown to deplete Wolbachia endosymbionts leading to a permanent sterilization of the female adult filariae and adult worm death in human clinical studies. Twice-daily oral treatment of Litomosoides sigmodontis-infected mice with 200 mg/kg AN11251 for 10 days achieved a Wolbachia depletion > 99.9% in the adult worms, exceeding the Wolbachia reduction by 10-day treatments with bioequivalent human doses of doxycycline and a similar reduction as high-dose rifampicin (35 mg/kg). Wolbachia reductions of > 99% were also accomplished by 14 days of oral AN11251 at a lower twice-daily dose (50 mg/kg) or once-per-day 200 mg/kg AN11251 treatments. The combinations tested of AN11251 with doxycycline had no clear beneficial impact on Wolbachia depletion, achieving a > 97% Wolbachia reduction with 7 days of treatment. These results indicate that AN11251 is superior to doxycycline and comparable to high-dose rifampicin in the L. sigmodontis mouse model, allowing treatment regimens as short as 10-14 days. Therefore, AN11251 represents a promising pre-clinical candidate that was identified in the L. sigmodontis model, and could be further evaluated and developed as potential clinical candidate for human lymphatic filariasis and onchocerciasis.
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Affiliation(s)
- Alexandra Ehrens
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
| | | | - Robert T. Jacobs
- Anacor Pharmaceuticals, Palo Alto, California, United States of America
| | - Dominique Struever
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
| | - Marianne Koschel
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
| | - Stefan J. Frohberger
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
| | - Franziska Lenz
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
| | - Martina Fendler
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
| | - Joseph D. Turner
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Stephen A. Ward
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Mark J. Taylor
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Yvonne R. Freund
- Anacor Pharmaceuticals, Palo Alto, California, United States of America
| | - Rianna Stefanakis
- Anacor Pharmaceuticals, Palo Alto, California, United States of America
| | - Eric Easom
- Anacor Pharmaceuticals, Palo Alto, California, United States of America
| | - Xianfeng Li
- Anacor Pharmaceuticals, Palo Alto, California, United States of America
| | - Jacob J. Plattner
- Anacor Pharmaceuticals, Palo Alto, California, United States of America
| | - Achim Hoerauf
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
- German Center for Infection Research (DZIF), partner site Bonn-Cologne, Bonn, Germany
| | - Marc P. Hübner
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
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71
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Wanji S, Nji TM, Hamill L, Dean L, Ozano K, Njouendou AJ, Abong RA, Obie ED, Amuam A, Ekanya R, Ndongmo WPC, Ndzeshang BL, Fung EG, Nnamdi DB, Nkimbeng DA, Teghen S, Kah E, Piotrowski H, Forrer A, Khan JAM, Woode ME, Niessen L, Watson V, Njoumemi Z, Murdoch ME, Thomson R, Theobald S, Enyong P, Turner JD, Taylor MJ. Implementation of test-and-treat with doxycycline and temephos ground larviciding as alternative strategies for accelerating onchocerciasis elimination in an area of loiasis co-endemicity: the COUNTDOWN consortium multi-disciplinary study protocol. Parasit Vectors 2019; 12:574. [PMID: 31801631 PMCID: PMC6894124 DOI: 10.1186/s13071-019-3826-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 11/25/2019] [Indexed: 12/15/2022] Open
Abstract
Background Onchocerciasis is a priority neglected tropical disease targeted for elimination by 2025. The standard strategy to combat onchocerciasis is annual Community-Directed Treatment with ivermectin (CDTi). Yet, high prevalence rates and transmission persist following > 12 rounds in South-West Cameroon. Challenges include programme coverage, adherence to, and acceptability of ivermectin in an area of Loa loa co-endemicity. Loiasis patients harbouring heavy infections are at risk of potentially fatal serious adverse events following CDTi. Alternative strategies are therefore needed to achieve onchocerciasis elimination where CDTi effectiveness is suboptimal. Methods/design We designed an implementation study to evaluate integrating World Health Organisation-endorsed alternative strategies for the elimination of onchocerciasis, namely test-and-treat with the macrofilaricide, doxycycline (TTd), and ground larviciding for suppression of blackfly vectors with the organophosphate temephos. A community-based controlled before-after intervention study will be conducted among > 2000 participants in 20 intervention (Meme River Basin) and 10 control (Indian River Basin) communities. The primary outcome measure is O. volvulus prevalence at follow-up 18-months post-treatment. The study involves four inter-disciplinary components: parasitology, entomology, applied social sciences and health economics. Onchocerciasis skin infection will be diagnosed by skin biopsy and Loa loa infection will be diagnosed by parasitological examination of finger-prick blood samples. A simultaneous clinical skin disease assessment will be made. Eligible skin-snip-positive individuals will be offered directly-observed treatment for 5 weeks with 100 mg/day doxycycline. Transmission assessments of onchocerciasis in the communities will be collected post-human landing catch of the local biting blackfly vector prior to ground larviciding with temephos every week (0.3 l/m3) until biting rate falls below 5/person/day. Qualitative research, including in-depth interviews and focus-group discussions will be used to assess acceptability and feasibility of the implemented alternative strategies among intervention recipients and providers. Health economics will assess the cost-effectiveness of the implemented interventions. Conclusions Using a multidisciplinary approach, we aim to assess the effectiveness of TTd, alone or in combination with ground larviciding, following a single intervention round and scrutinise the acceptability and feasibility of implementing at scale in similar hotspots of onchocerciasis infection, to accelerate onchocerciasis elimination.
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Affiliation(s)
- Samuel Wanji
- COUNTDOWN, Department of Microbiology and Parasitology, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon. .,COUNTDOWN, Research Foundation for Tropical Diseases and Environment, P.O. Box 474, Buea, Cameroon.
| | - Theobald Mue Nji
- COUNTDOWN, Research Foundation for Tropical Diseases and Environment, P.O. Box 474, Buea, Cameroon.,COUNTDOWN, Department of Sociology and Anthropology, Faculty of Social and Management Sciences, University of Buea, P.O. Box 63, Buea, Cameroon
| | | | - Laura Dean
- COUNTDOWN, Department of International Public Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK
| | - Kim Ozano
- COUNTDOWN, Department of International Public Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK
| | - Abdel J Njouendou
- COUNTDOWN, Research Foundation for Tropical Diseases and Environment, P.O. Box 474, Buea, Cameroon.,COUNTDOWN, Department of Biomedical Sciences, Faculty of Health Sciences, University of Buea, P.O. Box 12, Buea, Cameroon
| | - Raphael A Abong
- COUNTDOWN, Department of Microbiology and Parasitology, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon.,COUNTDOWN, Research Foundation for Tropical Diseases and Environment, P.O. Box 474, Buea, Cameroon
| | - Elisabeth Dibando Obie
- COUNTDOWN, Department of Microbiology and Parasitology, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon.,COUNTDOWN, Research Foundation for Tropical Diseases and Environment, P.O. Box 474, Buea, Cameroon
| | - Andrew Amuam
- COUNTDOWN, Department of Microbiology and Parasitology, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon.,COUNTDOWN, Research Foundation for Tropical Diseases and Environment, P.O. Box 474, Buea, Cameroon
| | - Relindis Ekanya
- COUNTDOWN, Department of Microbiology and Parasitology, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon.,COUNTDOWN, Research Foundation for Tropical Diseases and Environment, P.O. Box 474, Buea, Cameroon
| | - Winston Patrick Chounna Ndongmo
- COUNTDOWN, Department of Microbiology and Parasitology, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon.,COUNTDOWN, Research Foundation for Tropical Diseases and Environment, P.O. Box 474, Buea, Cameroon
| | - Bertrand L Ndzeshang
- COUNTDOWN, Department of Microbiology and Parasitology, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon.,COUNTDOWN, Research Foundation for Tropical Diseases and Environment, P.O. Box 474, Buea, Cameroon
| | - Ebua Gallus Fung
- COUNTDOWN, Research Foundation for Tropical Diseases and Environment, P.O. Box 474, Buea, Cameroon.,COUNTDOWN, Department of Sociology and Anthropology, Faculty of Social and Management Sciences, University of Buea, P.O. Box 63, Buea, Cameroon
| | - Dum-Buo Nnamdi
- COUNTDOWN, Research Foundation for Tropical Diseases and Environment, P.O. Box 474, Buea, Cameroon.,COUNTDOWN, Department of Sociology and Anthropology, Faculty of Social and Management Sciences, University of Buea, P.O. Box 63, Buea, Cameroon
| | - Desmond Akumtoh Nkimbeng
- COUNTDOWN, Department of Microbiology and Parasitology, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon.,COUNTDOWN, Research Foundation for Tropical Diseases and Environment, P.O. Box 474, Buea, Cameroon
| | - Samuel Teghen
- COUNTDOWN, Department of Microbiology and Parasitology, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon.,COUNTDOWN, Research Foundation for Tropical Diseases and Environment, P.O. Box 474, Buea, Cameroon
| | - Emmanuel Kah
- COUNTDOWN, Department of Microbiology and Parasitology, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon.,COUNTDOWN, Research Foundation for Tropical Diseases and Environment, P.O. Box 474, Buea, Cameroon
| | - Helen Piotrowski
- COUNTDOWN, Department of International Public Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK
| | - Armelle Forrer
- COUNTDOWN, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK
| | - Jahangir A M Khan
- COUNTDOWN, Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK
| | - Maame E Woode
- Centre for Health Economics, Monash University, Victoria, Australia
| | - Louis Niessen
- COUNTDOWN, Department of International Public Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK.,Department of International Health, Johns Hopkins School of Public Health, Baltimore, USA
| | - Victoria Watson
- COUNTDOWN, Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK
| | - Zakariaou Njoumemi
- Health Economics Unit, Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, P.O. Box 1364, Yaounde, Cameroon
| | - Michele E Murdoch
- COUNTDOWN, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK.,West Herts Hospitals NHS Trust, Watford General Hospital, Vicarage Road, Watford, UK
| | - Rachael Thomson
- COUNTDOWN, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK
| | - Sally Theobald
- COUNTDOWN, Department of International Public Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK
| | - Peter Enyong
- COUNTDOWN, Department of Microbiology and Parasitology, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon.,COUNTDOWN, Research Foundation for Tropical Diseases and Environment, P.O. Box 474, Buea, Cameroon
| | - Joseph D Turner
- COUNTDOWN, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK.
| | - Mark J Taylor
- COUNTDOWN, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK
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Taylor MJ, Wilson J. Reasonable Expectations of Privacy and Disclosure of Health Data. Med Law Rev 2019; 27:710. [PMID: 31411699 PMCID: PMC6926441 DOI: 10.1093/medlaw/fwz021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Mark J Taylor
- Associate Professor in Health Law and Regulation, Melbourne Law School, University of Melbourne, Australia
| | - James Wilson
- Senior Lecturer, Department of Philosophy, UCL, London, UK
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Hosang GM, Lichtenstein P, Ronald A, Lundström S, Taylor MJ. Association of Genetic and Environmental Risks for Attention-Deficit/Hyperactivity Disorder With Hypomanic Symptoms in Youths. JAMA Psychiatry 2019; 76:1150-1158. [PMID: 31411648 PMCID: PMC6694400 DOI: 10.1001/jamapsychiatry.2019.1949] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
IMPORTANCE Attention-deficit/hyperactivity disorder (ADHD) and bipolar disorder are highly comorbid, with significantly associated symptoms. The mechanisms that account for their co-occurrence are not known. OBJECTIVE To examine the degree to which genetic and environmental risk factors for ADHD traits, across childhood and adolescence, are associated with adolescent hypomanic symptoms. DESIGN, SETTING, AND PARTICIPANTS This study used data on 13 532 twin pairs from the Child and Adolescent Twin Study in Sweden, a prospective, longitudinal twin study. Their parents provided ADHD data when children were 9 or 12 years of age. Of those who reached 15 years of age, 3784 participated. Of those who reached 18 years of age, 3013 participated. The study was performed from December 20, 2017, to December 5, 2018. Data analysis was performed at the Department of Medical Epidemiology & Biostatistics, Karolinska Institutet, Stockholm, Sweden, from March 1, 2018, to October 31, 2018. MAIN OUTCOMES AND MEASURES Attention-deficit/hyperactivity disorder traits and hypomanic symptoms were assessed using parent-rated instruments. Associations between ADHD and adolescent hypomanic symptoms across childhood and adolescence were investigated using generalized estimating equations. Multivariate twin models were used to examine the extent to which genetic and environmental risk factors for ADHD were associated with hypomania. RESULTS Among 3784 15-year-old twin pairs and 3013 18-year-old twin pairs, ADHD and hypomanic symptoms were significantly associated (age 15 years: β = 0.30; 95% CI, 0.24-0.34; P < .001; age 18 years: β = 0.19; 95% CI, 0.16-0.22; P < .001), especially for the hyperactivity-impulsivity ADHD symptom domain (age 15 years: β = 0.53; 95% CI, 0.46-0.60; P < .001; age 18 years: β = 0.36; 95% CI, 0.30-0.42; P < .001) compared with the inattention domain (age 15 years: β = 0.40; 95% CI, 0.34-0.47; P < .001; age 18 years: β = 0.24; 95% CI, 0.19-0.29; P < .001). Between 13% and 29% of the genetic risk factors for hypomania were also associated with ADHD, with higher estimates detected for symptoms of hyperactivity-impulsivity (10%-25%) compared with inattention (6%-16%). Environmental factors played a negligible role in the associations. Genetic factors unique to adolescent hypomania were associated with 25% to 42% of its variance, suggesting some etiologic distinction between these forms of psychopathology. CONCLUSIONS AND RELEVANCE More than a quarter of the genetic risk factors for adolescent hypomanic traits were also associated with ADHD symptoms in childhood and adolescence, with hypomania-specific genetic risk factors detected. These findings suggest that ADHD and hypomanic symptoms are associated with shared genetic factors, which should be the focus of further research.
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Affiliation(s)
- Georgina M. Hosang
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts and the London School of Dentistry and Medicine, Queen Mary, University of London, London, United Kingdom
| | - Paul Lichtenstein
- Department of Medical Epidemiology & Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Angelica Ronald
- Department of Psychological Science, Birkbeck, University of London, London, United Kingdom
| | - Sebastian Lundström
- Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg, Sweden,Sweden Centre for Ethics, Law and Mental Health, University of Gothenburg, Gothenburg, Sweden
| | - Mark J. Taylor
- Department of Medical Epidemiology & Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Hübner MP, Koschel M, Struever D, Nikolov V, Frohberger SJ, Ehrens A, Fendler M, Johannes I, von Geldern TW, Marsh K, Turner JD, Taylor MJ, Ward SA, Pfarr K, Kempf DJ, Hoerauf A. In vivo kinetics of Wolbachia depletion by ABBV-4083 in L. sigmodontis adult worms and microfilariae. PLoS Negl Trop Dis 2019; 13:e0007636. [PMID: 31381563 PMCID: PMC6695197 DOI: 10.1371/journal.pntd.0007636] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 08/15/2019] [Accepted: 07/17/2019] [Indexed: 11/18/2022] Open
Abstract
Depletion of Wolbachia endosymbionts of human pathogenic filariae using 4–6 weeks of doxycycline treatment can lead to permanent sterilization and adult filarial death. We investigated the anti-Wolbachia drug candidate ABBV-4083 in the Litomosoides sigmodontis rodent model to determine Wolbachia depletion kinetics with different regimens. Wolbachia reduction occurred in mice as early as 3 days after the initiation of ABBV-4083 treatment and continued throughout a 10-day treatment period. Importantly, Wolbachia levels continued to decline after a 5-day-treatment from 91.5% to 99.9% during a 3-week washout period. In jirds, two weeks of ABBV-4083 treatment (100mg/kg once-per-day) caused a >99.9% Wolbachia depletion in female adult worms, and the kinetics of Wolbachia depletion were recapitulated in peripheral blood microfilariae. Similar to Wolbachia depletion, inhibition of embryogenesis was time-dependent in ABBV-4083-treated jirds, leading to a complete lack of late embryonic stages (stretched microfilariae) and lack of peripheral microfilariae in 5/6 ABBV-4083-treated jirds by 14 weeks after treatment. Twice daily treatment in comparison to once daily treatment with ABBV-4083 did not significantly improve Wolbachia depletion. Moreover, up to 4 nonconsecutive daily treatments within a 14-dose regimen did not significantly erode Wolbachia depletion. Within the limitations of an animal model that does not fully recapitulate human filarial disease, our studies suggest that Wolbachia depletion should be assessed clinically no earlier than 3–4 weeks after the end of treatment, and that Wolbachia depletion in microfilariae may be a viable surrogate marker for the depletion within adult worms. Furthermore, strict daily adherence to the dosing regimen with anti-Wolbachia candidates may not be required, provided that the full regimen is subsequently completed. Onchocerciasis and lymphatic filariasis represent debilitating neglected tropical diseases that are caused by parasitic filarial nematodes. Current efforts to eliminate onchocerciasis are hampered by the lack of drugs that lead to permanent sterilization of the adult worms or provide a macrofilaricidal effect, i.e. kill the adult worms. In the past, doxycycline has been shown to deplete Wolbachia endosymbionts of filarial nematodes, leading to permanent sterilization and macrofilaricidal efficacy in filariae causing both onchocerciasis and lymphatic filariasis. However, contraindications and a requirement for at least 4 weeks of doxycycline treatment impair its broader use, creating a need for drugs with a shorter treatment regimen and potentially fewer contraindications. ABBV-4083 is such an anti-Wolbachia candidate that was efficacious in several filarial animal models and has recently been tested in a phase 1 clinical trial. The present studies addressed several points that are important for subsequent phase 2 clinical trials, namely the comparison of once vs. twice-per-day treatments, the impact of missed treatments, and a comparison of the kinetics of Wolbachia depletion in adult worms and microfilariae, the latter of which has the potential to be a surrogate indicator to avoid the necessity of surgically removing nodules with adult worms at repeated time points.
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Affiliation(s)
- Marc P. Hübner
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Germany
- * E-mail:
| | - Marianne Koschel
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Germany
| | - Dominique Struever
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Germany
| | - Venelin Nikolov
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Germany
| | - Stefan J. Frohberger
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Germany
| | - Alexandra Ehrens
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Germany
| | - Martina Fendler
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Germany
| | - Iliana Johannes
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Germany
| | - Thomas W. von Geldern
- Global Pharmaceutical Research and Development, AbbVie, North Chicago, Illinois, United States of America
- Franciscan Institute for World Health, Franciscan University, Steubenville, Ohio, United States of America
| | - Kennan Marsh
- Global Pharmaceutical Research and Development, AbbVie, North Chicago, Illinois, United States of America
| | - Joseph D. Turner
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Mark J. Taylor
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Stephen A. Ward
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Kenneth Pfarr
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Germany
- German Center for Infection Research (DZIF), partner site Bonn-Cologne, Bonn, Germany
| | - Dale J. Kempf
- Global Pharmaceutical Research and Development, AbbVie, North Chicago, Illinois, United States of America
| | - Achim Hoerauf
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Germany
- German Center for Infection Research (DZIF), partner site Bonn-Cologne, Bonn, Germany
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Abstract
The law of confidence allows for a range of defined circumstances in which confidential patient information (CPI) can be disclosed without breach of confidence-including statutory gateway and overriding public interest. Outside such circumstances, current guidance to health professionals (the 'standard account') assumes that CPI can only be lawfully disclosed with patient consent. This article argues that the standard account has not yet caught up with judgments, post the Human Rights Act 1998 coming into force, which have reinterpreted the law of confidence in the light of Article 8 of the European Convention on Human Rights. In particular, the article explains the significance of the concept of a 'reasonable expectation of privacy' to an action for breach of confidence and thus to legal liability for disclosure of health data. It argues that conformity with a reasonable expectation of privacy provides an alternative account for the lawful disclosure of CPI, and may provide a more sustainable and authentic approach to meeting obligations under the law of confidence than the standard account. The article concludes with recommendations for an evolution of the standard account in a way that could allow restatement of associated concepts (such as consent) free from particular pressure to bend them out of shape. The evolution proposed continues to bring to the fore the patient perspective and allows protection of their 'reasonable expectations' regarding uses of data collected about them rather than those of the profession.
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Affiliation(s)
- Mark J Taylor
- Associate Professor in Health Law and Regulation, Melbourne Law School, University of Melbourne, Australia
| | - James Wilson
- Senior Lecturer, Department of Philosophy, UCL, London, UK
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Karim MJ, Haq R, Mableson HE, Sultan Mahmood ASM, Rahman M, Chowdhury SM, Rahman AKMF, Hafiz I, Betts H, Mackenzie C, Taylor MJ, Kelly-Hope LA. Developing the first national database and map of lymphatic filariasis clinical cases in Bangladesh: Another step closer to the elimination goals. PLoS Negl Trop Dis 2019; 13:e0007542. [PMID: 31306409 PMCID: PMC6658114 DOI: 10.1371/journal.pntd.0007542] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 01/23/2019] [Revised: 07/25/2019] [Accepted: 06/11/2019] [Indexed: 11/18/2022] Open
Abstract
Background The Bangladesh Lymphatic Filariasis (LF) Elimination Programme has made significant progress in interrupting transmission through mass drug administration (MDA) and has now focussed its efforts on scaling up managing morbidity and preventing disability (MMDP) activities to deliver the minimum package of care to people affected by LF clinical conditions. This paper highlights the Bangladesh LF Programme’s success in conducting a large-scale cross-sectional survey to determine the number of people affected by lymphoedema and hydrocoele, which enabled clinical risk maps to be developed for targeted interventions across the 34 endemic districts (19 high endemic; 15 low endemic). Methodology/Principal findings In the 19 high endemic districts, 8,145 community clinic staff were trained to identify and report patients in their catchment area. In the 15 low endemic districts, a team of 10 trained field assistants conducted active case finding with cases reported via a SMS mHealth tool. Disease burden and prevalence maps were developed, with morbidity hotspots identified at sub-district level based on a combination of the highest prevalence rates per 100,000 and case-density rates per square kilometre (km2). The relationship between morbidity and baseline microfilaria (mf) prevalence was also examined. In total 43,678 cases were identified in the 19 high endemic districts; 30,616 limb lymphoedema (70.1%; female 55.3%), 12,824 hydrocoele (29.4%), and 238 breast/female genital swelling (0.5%). Rangpur Division reported the highest cases numbers and prevalence of lymphoedema (26,781 cases, 195 per 100,000) and hydrocoele (11661 cases, 169.6 per 100,000), with lymphoedema predominately affecting females (n = 21,652). Rangpur and Lalmonirhat Districts reported the highest case numbers (n = 11,199), and prevalence (569 per 100,000) respectively, with five overlapping lymphoedema and hydrocoele sub-district hotspots. In the 15 low endemic districts, 732 cases were identified; 661 lymphoedema (90.2%; female 39.6%), 56 hydrocoele (7.8%), and 15 both conditions (2.0%). Spearman’s correlation analysis found morbidity and mf prevalence significantly positively correlated (r = 0.904; p<0.01). Conclusions/Significance The Bangladesh LF Programme has developed one of the largest, most comprehensive country databases on LF clinical conditions in the world. It provides an essential database for health workers to identify local morbidity hotspots, deliver the minimum package of care, and address the dossier elimination requirements. The Global Programme to Eliminate Lymphatic Filariasis (GPELF) requires lymphatic filariasis (LF) endemic countries, such as Bangladesh, to estimate the number of lymphoedema and hydrocoele cases in order to deliver the minimum package of care required to control morbidity and reduce patient suffering. This paper highlights the Bangladesh LF Elimination Programme’s progress in training more than 8000 community health workers to identify more than 44,000 cases across 34 endemic districts where approximately 70 million people are at risk. The morbidity data collected enabled the creation of a national database and a series of risk maps of lymphoedema and hydrocoele to be developed, which highlighted the significant burden in northern Rangpur Division, especially of lymphoedema among female patients. The Bangladesh LF Elimination Programme’s efforts to identify LF cases across all endemic districts represents one of the most comprehensive national databases on LF clinical cases in the world. It provides an informative database for health workers to use in the delivery of the minimum package of care and a template for other countries to adopt and develop national strategies to manage morbidity and prevent disability as recommended by GPELF.
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Affiliation(s)
- Mohammad J. Karim
- Filariasis Elimination and STH Control Programme, Communicable Disease Control, Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
- * E-mail: (MJK); (LAK)
| | - Rouseli Haq
- Filariasis Elimination and STH Control Programme, Communicable Disease Control, Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Hayley E. Mableson
- Centre for Neglected Tropical Diseases, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - A. S. M. Sultan Mahmood
- Filariasis Elimination and STH Control Programme, Communicable Disease Control, Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Mujibur Rahman
- Filariasis Elimination and STH Control Programme, Communicable Disease Control, Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | | | | | - Israt Hafiz
- Filariasis Elimination and STH Control Programme, Communicable Disease Control, Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Hannah Betts
- Centre for Neglected Tropical Diseases, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Charles Mackenzie
- Centre for Neglected Tropical Diseases, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Mark J. Taylor
- Centre for Neglected Tropical Diseases, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Louise A. Kelly-Hope
- Centre for Neglected Tropical Diseases, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
- * E-mail: (MJK); (LAK)
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Ghirardi L, Pettersson E, Taylor MJ, Freitag CM, Franke B, Asherson P, Larsson H, Kuja-Halkola R. Genetic and environmental contribution to the overlap between ADHD and ASD trait dimensions in young adults: a twin study. Psychol Med 2019; 49:1713-1721. [PMID: 30191778 PMCID: PMC6601357 DOI: 10.1017/s003329171800243x] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 08/02/2018] [Accepted: 08/08/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Traits of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are strongly associated in children and adolescents, largely due to genetic factors. Less is known about the phenotypic and aetiological overlap between ADHD and ASD traits in adults. METHODS We studied 6866 individuals aged 20-28 years from the Swedish Study of Young Adult Twins. Inattention (IA) and hyperactivity/impulsivity (HI) were assessed using the WHO Adult ADHD Self-Report Scale-V1.1. Repetitive and restricted behaviours (RRB) and social interaction and communication (SIC) were assessed using the Autism-Tics, ADHD, and other Comorbidities inventory. We used structural equation modelling to decompose covariance between these ADHD and ASD trait dimensions into genetic and shared/non-shared environmental components. RESULTS At the phenotypic level, IA was similarly correlated with RRB (r = 0.33; 95% Confidence Interval (CI) 0.31-0.36) and with SIC (r = 0.32; 95% CI 0.29-0.34), whereas HI was more strongly associated with RRB (r = 0.38; 95% CI 0.35-0.40) than with SIC (r = 0.24; 95% CI 0.21-0.26). Genetic and non-shared environmental effects accounted for similar proportions of the phenotypic correlations, whereas shared environmental effects were of minimal importance. The highest genetic correlation was between HI and RRB (r = 0.56; 95% 0.46-0.65), and the lowest was between HI and SIC (r = 0.33; 95% CI 0.23-0.43). CONCLUSIONS We found evidence for dimension-specific phenotypic and aetiological overlap between ADHD and ASD traits in adults. Future studies investigating mechanisms underlying comorbidity between ADHD and ASD may benefit from exploring several symptom-dimensions, rather than considering only broad diagnostic categories.
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Affiliation(s)
- Laura Ghirardi
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Erik Pettersson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Mark J. Taylor
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Christine M. Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Barbara Franke
- Department of Human Genetics and Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Philip Asherson
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Ralf Kuja-Halkola
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Havers L, Taylor MJ, Ronald A. Genetic and environmental influences on the stability of psychotic experiences and negative symptoms in adolescence. J Child Psychol Psychiatry 2019; 60:784-792. [PMID: 30957239 PMCID: PMC6619355 DOI: 10.1111/jcpp.13045] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/12/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Psychotic experiences (PEs) such as paranoia and hallucinations, and negative symptoms (NS) such as anhedonia and flat affect are common in adolescence. Psychotic experiences and negative symptoms (PENS) increase risk for later psychiatric outcomes, particularly when they persist. The extent to which genetic and environmental influences contribute to the stability of PENS in mid-to-late adolescence is unknown. METHODS Using the Specific Psychotic Experiences Questionnaire (SPEQ) twice across ~9 months in adolescence, N = 1,448 twin pairs [M = 16.32 (0.68)] reported experiences of paranoia, hallucinations, cognitive disorganization, grandiosity and anhedonia, and their parents reported on a range of NS. Individuals were split into low-scoring, decreasing, increasing and persistent groups for each subscale. Frequencies and mean differences in distress, depression traits and emotional problems were investigated across groups. Longitudinal structural equation modelling was used to estimate the aetiological components underlying the stability of PENS. RESULTS Phenotypic stability was moderate for all PENS (r = .59-.69). Persistent PENS across 9 months were associated with greater levels of distress (V = 0.15-0.46, for PEs only), depression traits (d = 0.47-1.67, except grandiosity) and emotional problems (d = 0.47-1.47, except grandiosity and anhedonia) at baseline compared to groups with transitory or low levels of PENS. At both ages PENS were heritable and influenced by shared and nonshared environment. Genetic influences contributed 38%-62% and shared environment contributed 13%-33% to the stability of PENS. Nonshared environment contributed 34%-41% (12% for parent-rated NS). There was strong overlap of genetic and shared environmental influences across time, and lower overlap for nonshared environment. Imperfect stability of PENS was at least partly due to nonshared environmental influences. CONCLUSIONS When adolescent PENS persist over time, they are often characterized by more distress, and higher levels of other psychopathology. Both genetic and environmental effects influence stability of PENS.
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Affiliation(s)
- Laura Havers
- Department of Psychological SciencesBirkbeck, University of LondonLondonUK
| | - Mark J. Taylor
- Department of Medical Epidemiology & BiostatisticsKarolinska InstitutetStockholmSweden
| | - Angelica Ronald
- Department of Psychological SciencesBirkbeck, University of LondonLondonUK
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Bakowski MA, Shiroodi RK, Liu R, Olejniczak J, Yang B, Gagaring K, Guo H, White PM, Chappell L, Debec A, Landmann F, Dubben B, Lenz F, Struever D, Ehrens A, Frohberger SJ, Sjoberg H, Pionnier N, Murphy E, Archer J, Steven A, Chunda VC, Fombad FF, Chounna PW, Njouendou AJ, Metuge HM, Ndzeshang BL, Gandjui NV, Akumtoh DN, Kwenti TDB, Woods AK, Joseph SB, Hull MV, Xiong W, Kuhen KL, Taylor MJ, Wanji S, Turner JD, Hübner MP, Hoerauf A, Chatterjee AK, Roland J, Tremblay MS, Schultz PG, Sullivan W, Chu XJ, Petrassi HM, McNamara CW. Discovery of short-course antiwolbachial quinazolines for elimination of filarial worm infections. Sci Transl Med 2019; 11:11/491/eaav3523. [DOI: 10.1126/scitranslmed.aav3523] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Accepted: 03/18/2019] [Indexed: 12/21/2022]
Abstract
Parasitic filarial nematodes cause debilitating infections in people in resource-limited countries. A clinically validated approach to eliminating worms uses a 4- to 6-week course of doxycycline that targetsWolbachia, a bacterial endosymbiont required for worm viability and reproduction. However, the prolonged length of therapy and contraindication in children and pregnant women have slowed adoption of this treatment. Here, we describe discovery and optimization of quinazolines CBR417 and CBR490 that, with a single dose, achieve >99% elimination ofWolbachiain the in vivoLitomosoides sigmodontisfilarial infection model. The efficacious quinazoline series was identified by pairing a primary cell-based high-content imaging screen with an orthogonal ex vivo validation assay to rapidly quantifyWolbachiaelimination inBrugia pahangifilarial ovaries. We screened 300,368 small molecules in the primary assay and identified 288 potent and selective hits. Of 134 primary hits tested, only 23.9% were active in the worm-based validation assay, 8 of which contained a quinazoline heterocycle core. Medicinal chemistry optimization generated quinazolines with excellent pharmacokinetic profiles in mice. Potent antiwolbachial activity was confirmed inL. sigmodontis,Brugia malayi, andOnchocerca ochengiin vivo preclinical models of filarial disease and in vitro selectivity againstLoa loa(a safety concern in endemic areas). The favorable efficacy and in vitro safety profiles of CBR490 and CBR417 further support these as clinical candidates for treatment of filarial infections.
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Clare RH, Clark R, Bardelle C, Harper P, Collier M, Johnston KL, Plant H, Plant D, McCall E, Slatko BE, Cantin L, Wu B, Ford L, Murray D, Rich K, Wigglesworth M, Taylor MJ, Ward SA. Development of a High-Throughput Cytometric Screen to Identify Anti- Wolbachia Compounds: The Power of Public-Private Partnership. SLAS Discov 2019; 24:537-547. [PMID: 30958712 PMCID: PMC6537165 DOI: 10.1177/2472555219838341] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The Anti-Wolbachia (A·WOL) consortium at the Liverpool School of
Tropical Medicine (LSTM) has partnered with the Global High-Throughput Screening
(HTS) Centre at AstraZeneca to create the first anthelmintic HTS for neglected
tropical diseases (NTDs). The A·WOL consortium aims to identify novel
macrofilaricidal drugs targeting the essential bacterial symbiont
(Wolbachia) of the filarial nematodes causing
onchocerciasis and lymphatic filariasis. Working in collaboration, we have
validated a robust high-throughput assay capable of identifying compounds that
selectively kill Wolbachia over the host insect cell. We
describe the development and validation process of this complex, phenotypic
high-throughput assay and provide an overview of the primary outputs from
screening the AstraZeneca library of 1.3 million compounds.
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Affiliation(s)
- Rachel H Clare
- 1 Centre for Drugs and Diagnostics Research, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK
| | - Roger Clark
- 2 Hit Discovery, Discovery Sciences, IMED Biotech Unit, AstraZeneca, Macclesfield, UK
| | - Catherine Bardelle
- 2 Hit Discovery, Discovery Sciences, IMED Biotech Unit, AstraZeneca, Macclesfield, UK
| | - Paul Harper
- 2 Hit Discovery, Discovery Sciences, IMED Biotech Unit, AstraZeneca, Macclesfield, UK
| | - Matthew Collier
- 2 Hit Discovery, Discovery Sciences, IMED Biotech Unit, AstraZeneca, Macclesfield, UK
| | - Kelly L Johnston
- 1 Centre for Drugs and Diagnostics Research, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK
| | - Helen Plant
- 2 Hit Discovery, Discovery Sciences, IMED Biotech Unit, AstraZeneca, Macclesfield, UK
| | - Darren Plant
- 2 Hit Discovery, Discovery Sciences, IMED Biotech Unit, AstraZeneca, Macclesfield, UK
| | - Eileen McCall
- 2 Hit Discovery, Discovery Sciences, IMED Biotech Unit, AstraZeneca, Macclesfield, UK
| | - Barton E Slatko
- 3 Genome Biology Division, New England Biolabs, Inc., Ipswich, MA, USA
| | - Lindsey Cantin
- 3 Genome Biology Division, New England Biolabs, Inc., Ipswich, MA, USA
| | - Bo Wu
- 3 Genome Biology Division, New England Biolabs, Inc., Ipswich, MA, USA
| | - Louise Ford
- 1 Centre for Drugs and Diagnostics Research, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK
| | - David Murray
- 2 Hit Discovery, Discovery Sciences, IMED Biotech Unit, AstraZeneca, Macclesfield, UK
| | - Kirsty Rich
- 2 Hit Discovery, Discovery Sciences, IMED Biotech Unit, AstraZeneca, Macclesfield, UK
| | - Mark Wigglesworth
- 2 Hit Discovery, Discovery Sciences, IMED Biotech Unit, AstraZeneca, Macclesfield, UK
| | - Mark J Taylor
- 1 Centre for Drugs and Diagnostics Research, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK
| | - Stephen A Ward
- 1 Centre for Drugs and Diagnostics Research, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK
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81
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Pionnier NP, Sjoberg H, Chunda VC, Fombad FF, Chounna PW, Njouendou AJ, Metuge HM, Ndzeshang BL, Gandjui NV, Akumtoh DN, Tayong DB, Taylor MJ, Wanji S, Turner JD. Mouse models of Loa loa. Nat Commun 2019; 10:1429. [PMID: 30926803 PMCID: PMC6441053 DOI: 10.1038/s41467-019-09442-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 03/07/2019] [Indexed: 12/14/2022] Open
Abstract
Elimination of the helminth disease, river blindness, remains challenging due to ivermectin treatment-associated adverse reactions in loiasis co-infected patients. Here, we address a deficit in preclinical research tools for filarial translational research by developing Loa loa mouse infection models. We demonstrate that adult Loa loa worms in subcutaneous tissues, circulating microfilariae (mf) and presence of filarial biomarkers in sera occur following experimental infections of lymphopenic mice deficient in interleukin (IL)-2/7 gamma-chain signaling. A microfilaraemic infection model is also achievable, utilizing immune-competent or -deficient mice infused with purified Loa mf. Ivermectin but not benzimidazole treatments induce rapid decline (>90%) in parasitaemias in microfilaraemic mice. We identify up-regulation of inflammatory markers associated with allergic type-2 immune responses and eosinophilia post-ivermectin treatment. Thus, we provide validation of murine research models to identify loiasis biomarkers, to counter-screen candidate river blindness cures and to interrogate the inflammatory etiology of loiasis ivermectin-associated adverse reactions. Here, the authors develop a mouse model of Loa loa that reflects human infections, including eosinophilia, and determine effects of ivermectin treatment.
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Affiliation(s)
- Nicolas P Pionnier
- Centre for Drugs and Diagnostics Research, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Hanna Sjoberg
- Centre for Drugs and Diagnostics Research, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Valerine C Chunda
- Research Foundation in Tropical Diseases and the Environment, P.O. Box 474, Buea, Cameroon.,Parasite and Vector Biology Research Unit, Department of Microbiology and Parasitology, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon
| | - Fanny F Fombad
- Research Foundation in Tropical Diseases and the Environment, P.O. Box 474, Buea, Cameroon.,Parasite and Vector Biology Research Unit, Department of Microbiology and Parasitology, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon
| | - Patrick W Chounna
- Research Foundation in Tropical Diseases and the Environment, P.O. Box 474, Buea, Cameroon.,Parasite and Vector Biology Research Unit, Department of Microbiology and Parasitology, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon
| | - Abdel J Njouendou
- Research Foundation in Tropical Diseases and the Environment, P.O. Box 474, Buea, Cameroon.,Parasite and Vector Biology Research Unit, Department of Microbiology and Parasitology, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon
| | - Haelly M Metuge
- Research Foundation in Tropical Diseases and the Environment, P.O. Box 474, Buea, Cameroon.,Parasite and Vector Biology Research Unit, Department of Microbiology and Parasitology, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon
| | - Bertrand L Ndzeshang
- Research Foundation in Tropical Diseases and the Environment, P.O. Box 474, Buea, Cameroon.,Parasite and Vector Biology Research Unit, Department of Microbiology and Parasitology, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon
| | - Narcisse V Gandjui
- Research Foundation in Tropical Diseases and the Environment, P.O. Box 474, Buea, Cameroon.,Parasite and Vector Biology Research Unit, Department of Microbiology and Parasitology, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon
| | - Desmond N Akumtoh
- Research Foundation in Tropical Diseases and the Environment, P.O. Box 474, Buea, Cameroon.,Parasite and Vector Biology Research Unit, Department of Microbiology and Parasitology, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon
| | - Dizzle B Tayong
- Research Foundation in Tropical Diseases and the Environment, P.O. Box 474, Buea, Cameroon.,Parasite and Vector Biology Research Unit, Department of Microbiology and Parasitology, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon
| | - Mark J Taylor
- Centre for Drugs and Diagnostics Research, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Samuel Wanji
- Research Foundation in Tropical Diseases and the Environment, P.O. Box 474, Buea, Cameroon.,Parasite and Vector Biology Research Unit, Department of Microbiology and Parasitology, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon
| | - Joseph D Turner
- Centre for Drugs and Diagnostics Research, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK.
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82
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Abstract
Alterations in social cognition are hypothesized to underlie social communication challenges in autism spectrum disorder. However, the etiologic underpinnings driving this association, as well as the impact of other psychiatric conditions on the association, remain unclear. Using a co-twin control design, we examined n = 308 twins (mean age = 16.63; 46% females) with autism spectrum disorder, attention-deficit/hyperactivity disorder, affective disorders, or typical development using the Reading the Mind in the Eyes Test to operationalize social cognition ability. Clinical diagnosis of autism spectrum disorder, as well as the extent of quantitative autistic traits, as measured by parental reports using the Social Responsiveness Scale-2, predicted fewer expected responses on the Reading the Mind in the Eyes Test across the pairs. The association remained when adjusting for other diagnoses and IQ. In addition, male sex, lower age, and lower IQ predicted poorer performance on the Reading the Mind in the Eyes Test. The associations between autism and social cognition ability were lost within pairs in both the full sample and the monozygotic subsample. We conclude that the association between autism and social cognition across the sample highlights the importance of social cognition alterations in autism spectrum disorder when compared with other conditions. The attenuation of the association in the within-pair models indicate familial confounding, such as genes and shared environment, influencing both autism and social cognition.
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Affiliation(s)
- Johan Isaksson
- Karolinska Institutet, Sweden.,Stockholm County Council, Sweden.,Uppsala University, Sweden
| | | | - Karl Lundin
- Karolinska Institutet, Sweden.,Stockholm County Council, Sweden
| | - Janina Neufeld
- Karolinska Institutet, Sweden.,Stockholm County Council, Sweden
| | - Sven Bölte
- Karolinska Institutet, Sweden.,Stockholm County Council, Sweden.,Curtin University, Western Australia
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83
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Jacobs RT, Lunde CS, Freund YR, Hernandez V, Li X, Xia Y, Carter DS, Berry PW, Halladay J, Rock F, Stefanakis R, Easom E, Plattner JJ, Ford L, Johnston KL, Cook DAN, Clare R, Cassidy A, Myhill L, Tyrer H, Gamble J, Guimaraes AF, Steven A, Lenz F, Ehrens A, Frohberger SJ, Koschel M, Hoerauf A, Hübner MP, McNamara CW, Bakowski MA, Turner JD, Taylor MJ, Ward SA. Boron-Pleuromutilins as Anti- Wolbachia Agents with Potential for Treatment of Onchocerciasis and Lymphatic Filariasis. J Med Chem 2019; 62:2521-2540. [PMID: 30730745 PMCID: PMC6421521 DOI: 10.1021/acs.jmedchem.8b01854] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Indexed: 01/07/2023]
Abstract
A series of pleuromutilins modified by introduction of a boron-containing heterocycle on C(14) of the polycyclic core are described. These analogs were found to be potent anti- Wolbachia antibiotics and, as such, may be useful in the treatment of filarial infections caused by Onchocerca volvulus, resulting in Onchocerciasis or river blindness, or Wuchereria bancrofti and Brugia malayi and related parasitic nematodes resulting in lymphatic filariasis. These two important neglected tropical diseases disproportionately impact patients in the developing world. The lead preclinical candidate compound containing 7-fluoro-6-oxybenzoxaborole (15, AN11251) was shown to have good in vitro anti- Wolbachia activity and physicochemical and pharmacokinetic properties providing high exposure in plasma. The lead was effective in reducing the Wolbachia load in filarial worms following oral administration to mice.
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Affiliation(s)
- Robert T. Jacobs
- Anacor
Pharmaceuticals, 1020
East Meadow Circle, Palo Alto, California 94303, United States
| | - Christopher S. Lunde
- Anacor
Pharmaceuticals, 1020
East Meadow Circle, Palo Alto, California 94303, United States
| | - Yvonne R. Freund
- Anacor
Pharmaceuticals, 1020
East Meadow Circle, Palo Alto, California 94303, United States
| | - Vincent Hernandez
- Anacor
Pharmaceuticals, 1020
East Meadow Circle, Palo Alto, California 94303, United States
| | - Xianfeng Li
- Anacor
Pharmaceuticals, 1020
East Meadow Circle, Palo Alto, California 94303, United States
| | - Yi Xia
- Anacor
Pharmaceuticals, 1020
East Meadow Circle, Palo Alto, California 94303, United States
| | - David S. Carter
- Anacor
Pharmaceuticals, 1020
East Meadow Circle, Palo Alto, California 94303, United States
| | - Pamela W. Berry
- Anacor
Pharmaceuticals, 1020
East Meadow Circle, Palo Alto, California 94303, United States
| | - Jason Halladay
- Anacor
Pharmaceuticals, 1020
East Meadow Circle, Palo Alto, California 94303, United States
| | - Fernando Rock
- Anacor
Pharmaceuticals, 1020
East Meadow Circle, Palo Alto, California 94303, United States
| | - Rianna Stefanakis
- Anacor
Pharmaceuticals, 1020
East Meadow Circle, Palo Alto, California 94303, United States
| | - Eric Easom
- Anacor
Pharmaceuticals, 1020
East Meadow Circle, Palo Alto, California 94303, United States
| | - Jacob J. Plattner
- Anacor
Pharmaceuticals, 1020
East Meadow Circle, Palo Alto, California 94303, United States
| | - Louise Ford
- Centre
for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, U.K.
| | - Kelly L. Johnston
- Centre
for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, U.K.
| | - Darren A. N. Cook
- Centre
for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, U.K.
| | - Rachel Clare
- Centre
for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, U.K.
| | - Andrew Cassidy
- Centre
for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, U.K.
| | - Laura Myhill
- Centre
for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, U.K.
| | - Hayley Tyrer
- Centre
for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, U.K.
| | - Joanne Gamble
- Centre
for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, U.K.
| | - Ana F. Guimaraes
- Centre
for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, U.K.
| | - Andrew Steven
- Centre
for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, U.K.
| | - Franziska Lenz
- Institute
for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Sigmund Freud Str. 25, 53127 Bonn, Germany
| | - Alexandra Ehrens
- Institute
for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Sigmund Freud Str. 25, 53127 Bonn, Germany
| | - Stefan J. Frohberger
- Institute
for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Sigmund Freud Str. 25, 53127 Bonn, Germany
| | - Marianne Koschel
- Institute
for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Sigmund Freud Str. 25, 53127 Bonn, Germany
| | - Achim Hoerauf
- Institute
for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Sigmund Freud Str. 25, 53127 Bonn, Germany
| | - Marc P. Hübner
- Institute
for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Sigmund Freud Str. 25, 53127 Bonn, Germany
| | - Case W. McNamara
- Calibr, 11119 North
Torrey Pines Road, Suite 100, La Jolla, California 92037, United States
| | - Malina A. Bakowski
- Calibr, 11119 North
Torrey Pines Road, Suite 100, La Jolla, California 92037, United States
| | - Joseph D. Turner
- Centre
for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, U.K.
| | - Mark J. Taylor
- Centre
for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, U.K.
| | - Stephen A. Ward
- Centre
for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, U.K.
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84
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Taylor MJ, Larsson H, Gillberg C, Lichtenstein P, Lundström S. Investigating the childhood symptom profile of community-based individuals diagnosed with attention-deficit/hyperactivity disorder as adults. J Child Psychol Psychiatry 2019; 60:259-266. [PMID: 30338854 DOI: 10.1111/jcpp.12988] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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] [Accepted: 08/29/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is currently defined as a disorder with onset during childhood. Although ADHD occurs in adults as well as children, recent debate has focused on whether adult ADHD represents a continuation of a child-onset disorder or if ADHD may, in at least some cases, have an adult onset. We therefore aimed to test the hypothesis of adult-onset ADHD using a sample born relatively recently (1992-1999) in order to minimize confounding by secular changes in diagnostic practices. METHODS We identified 74 individuals with a community diagnosis of ADHD first assigned during adulthood. We also identified individuals with childhood (N = 194) and adolescent (N = 394) community diagnoses of ADHD. These groups were compared with a comparison group (N = 14,474) on their childhood ADHD and neuropsychiatric symptoms, and rate of other psychiatric diagnoses during childhood. RESULTS Having an adulthood community diagnosis of ADHD was associated with a mean increase in childhood ADHD symptoms of approximately three times that of the comparison group. Individuals with an adult community diagnosis of ADHD also displayed more autistic traits, motor problems, learning difficulties, tics, and oppositional behavior. Forty two percent of these individuals, compared with 1% of comparison cases, had a psychiatric diagnosis other than ADHD as children. In post-hoc analyses of 21 ADHD cases showing few or no ADHD symptoms in childhood, we were unable to detect any other childhood symptomatology in only nine cases, of whom six were female. CONCLUSIONS Our results indicate that alternative explanations for data that appear to show adult onset ADHD, such as sex biases in diagnostic practices, need rigorous testing before adult onset ADHD can be accepted as a valid clinical construct.
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Affiliation(s)
- Mark J Taylor
- Department of Medical Epidemiology & Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Henrik Larsson
- Department of Medical Epidemiology & Biostatistics, Karolinska Institutet, Stockholm, Sweden.,School of Medical Sciences, Örebro University, Örebro, Sweden
| | | | - Paul Lichtenstein
- Department of Medical Epidemiology & Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Sebastian Lundström
- Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg, Sweden.,Sweden Centre for Ethics, Law and Mental Health, University of Gothenburg, Gothenburg, Sweden
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85
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Taylor MJ, Martin J, Lu Y, Brikell I, Lundström S, Larsson H, Lichtenstein P. Association of Genetic Risk Factors for Psychiatric Disorders and Traits of These Disorders in a Swedish Population Twin Sample. JAMA Psychiatry 2019; 76:280-289. [PMID: 30566181 PMCID: PMC6439816 DOI: 10.1001/jamapsychiatry.2018.3652] [Citation(s) in RCA: 96] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
IMPORTANCE Psychiatric traits associated with categorically defined psychiatric disorders are heritable and present to varying degrees in the general population. It is commonly assumed that diagnoses represent the extreme end of continuously distributed traits in the population, but this assumption has yet to be robustly tested for many psychiatric phenotypes. OBJECTIVE To assess whether genetic risk factors associated with psychiatric disorders are also associated with continuous variation in milder population traits. DESIGN, SETTING, AND PARTICIPANTS This study combined a novel twin analytic approach with polygenic risk score (PRS) analyses in a large population-based twin sample. Phenotypic and genetic data were available from the Child and Adolescent Twin Study in Sweden. Inpatient data were available for January 1, 1987, to December 31, 2014, and outpatient data for January 1, 2001, to December 31, 2013. The last day of follow-up was December 31, 2014. Data analysis was performed from January 1, 2017, to September 30, 2017. MAIN OUTCOMES AND MEASURES Questionnaires that assessed traits of autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), learning difficulties, tic disorders (TDs), obsessive-compulsive disorder (OCD), anxiety, major depressive disorder (MDD), mania, and psychotic experiences were administered to a large Swedish twin sample. Individuals with clinical psychiatric diagnoses were identified using the Swedish National Patient Register. Joint categorical/continuous twin modeling was used to estimate genetic correlations between psychiatric diagnoses and continuous traits. The PRSs for psychiatric disorders were calculated based on independent discovery genetic data. The association between PRSs for each disorder and associated continuous traits was tested. RESULTS Phenotype data were available for 13 923 twin pairs (35.1% opposite sex and 31.7% same-sex females) at 9 years of age, 5165 pairs (36.9% opposite sex and 34.0% same-sex females) at 15 years of age, and 4273 pairs (36.5% opposite sex and 34.4% same-sex females) at 18 years of age. Genetic data were available for 13 412 individuals (50.2% females). Twin genetic correlations between numerous psychiatric diagnoses and corresponding traits ranged from 0.31 to 0.69. Disorder PRSs were associated with related population traits for ASD (β [SE] = 0.04 [0.01] at 9 years of age), ADHD (β [SE] = 0.27 [0.03] at 9 years of age), TDs (β [SE] = 0.02 [0.004] at 9 years of age), OCD (β [SE] = 0.13 [0.05] at 18 years of age), anxiety (β [SE] = 0.18 [0.08] at 9 years of age; β [SE] = 0.07 [0.02] at 15 years of age; and β [SE] = 0.40 [0.17] at 18 years of age), MDD (β [SE] = 0.10 [0.03] at 9 years of age; β [SE] = 0.11 [0.02] at 15 years of age; and β [SE] = 0.41 [0.10] at 18 years of age), and schizophrenia (β [SE] = 0.02 [0.01] at 18 years of age). Polygenic risk scores for depressive symptoms were associated with MDD diagnoses (odds ratio, 1.16; 95% CI, 1.02-1.32). CONCLUSIONS AND RELEVANCE These results suggest that genetic factors associated with psychiatric disorders are also associated with milder variation in characteristic traits throughout the general population for many psychiatric phenotypes. This study suggests that many psychiatric disorders are likely to be continuous phenotypes rather than the categorical entities currently defined in diagnostic manuals, which has strong implications for genetic research in particular.
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Affiliation(s)
- Mark J. Taylor
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Joanna Martin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden,MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, United Kingdom
| | - Yi Lu
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Isabell Brikell
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Sebastian Lundström
- Institute of Neuroscience and Physiology, Gillberg Neuropsychiatry Centre, Centre for Ethics Law and Mental Health, University of Gothenburg, Gothenburg, Sweden
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden,School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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86
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von Geldern TW, Morton HE, Clark RF, Brown BS, Johnston KL, Ford L, Specht S, Carr RA, Stolarik DF, Ma J, Rieser MJ, Struever D, Frohberger SJ, Koschel M, Ehrens A, Turner JD, Hübner MP, Hoerauf A, Taylor MJ, Ward SA, Marsh K, Kempf DJ. Discovery of ABBV-4083, a novel analog of Tylosin A that has potent anti-Wolbachia and anti-filarial activity. PLoS Negl Trop Dis 2019; 13:e0007159. [PMID: 30818326 PMCID: PMC6413952 DOI: 10.1371/journal.pntd.0007159] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [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: 11/30/2018] [Revised: 03/12/2019] [Accepted: 01/15/2019] [Indexed: 12/02/2022] Open
Abstract
There is a significant need for improved treatments for onchocerciasis and lymphatic filariasis, diseases caused by filarial worm infection. In particular, an agent able to selectively kill adult worms (macrofilaricide) would be expected to substantially augment the benefits of mass drug administration (MDA) with current microfilaricides, and to provide a solution to treatment of onchocerciasis / loiasis co-infection, where MDA is restricted. We have identified a novel macrofilaricidal agent, Tylosin A (TylA), which acts by targeting the worm-symbiont Wolbachia bacterium. Chemical modification of TylA leads to improvements in anti-Wolbachia activity and oral pharmacokinetic properties; an optimized analog (ABBV-4083) has been selected for clinical evaluation.
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Affiliation(s)
- Thomas W. von Geldern
- Global Pharmaceutical Research and Development, AbbVie, North Chicago, Illinois, United States of America
- Franciscan Institute for World Health, Franciscan University, Steubenville, Ohio, United States of America
| | - Howard E. Morton
- Global Pharmaceutical Research and Development, AbbVie, North Chicago, Illinois, United States of America
| | - Rick F. Clark
- Global Pharmaceutical Research and Development, AbbVie, North Chicago, Illinois, United States of America
| | - Brian S. Brown
- Global Pharmaceutical Research and Development, AbbVie, North Chicago, Illinois, United States of America
| | - Kelly L. Johnston
- Centre for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Louise Ford
- Centre for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Sabine Specht
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital, Bonn, Germany
| | - Robert A. Carr
- Global Pharmaceutical Research and Development, AbbVie, North Chicago, Illinois, United States of America
| | - Deanne F. Stolarik
- Global Pharmaceutical Research and Development, AbbVie, North Chicago, Illinois, United States of America
| | - Junli Ma
- Global Pharmaceutical Research and Development, AbbVie, North Chicago, Illinois, United States of America
| | - Matthew J. Rieser
- Global Pharmaceutical Research and Development, AbbVie, North Chicago, Illinois, United States of America
| | - Dominique Struever
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital, Bonn, Germany
| | - Stefan J. Frohberger
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital, Bonn, Germany
| | - Marianne Koschel
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital, Bonn, Germany
| | - Alexandra Ehrens
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital, Bonn, Germany
| | - Joseph D. Turner
- Centre for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Marc P. Hübner
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital, Bonn, Germany
| | - Achim Hoerauf
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital, Bonn, Germany
| | - Mark J. Taylor
- Centre for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Stephen A. Ward
- Centre for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Kennan Marsh
- Global Pharmaceutical Research and Development, AbbVie, North Chicago, Illinois, United States of America
| | - Dale J. Kempf
- Global Pharmaceutical Research and Development, AbbVie, North Chicago, Illinois, United States of America
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87
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Barkhuizen W, Taylor MJ, Freeman D, Ronald A. A Twin Study on the Association Between Psychotic Experiences and Tobacco Use During Adolescence. J Am Acad Child Adolesc Psychiatry 2019; 58:267-276.e8. [PMID: 30738553 PMCID: PMC6374498 DOI: 10.1016/j.jaac.2018.06.037] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 05/27/2018] [Accepted: 07/06/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Psychotic experiences (PE) are dimensional phenomena in the general population that resemble psychotic symptoms, such as paranoia and hallucinations. This is the first twin study to explore the degree to which tobacco use and PE share genetic or environmental influences. Previous studies on the association between adolescent tobacco use and PE have not considered PE dimensionally, included negative symptoms, or accounted for confounding by sleep disturbance and stressful life events. METHOD An unselected adolescent twin sample (N = 3,787 pairs; mean age = 16.16 years) reported on PE (paranoia, hallucinations, cognitive disorganization, grandiosity, and anhedonia) and regularity of tobacco use. Parents rated the twins' negative symptoms. Regression analyses were conducted while adjusted for sociodemographic characteristics, prenatal maternal smoking, cannabis use, sleep disturbance, and stressful life events. Bivariate twin modeling was used to estimate the degree of genetic and common and unique environmental influences shared between tobacco use and PE. RESULTS Regular smokers were significantly more likely to experience paranoia, hallucinations, cognitive disorganization, and negative symptoms (β = 0.17-0.34), but not grandiosity or anhedonia, than nonsmokers, after adjustment for confounders. Paranoia, hallucinations, and cognitive disorganization correlated ≥0.15 with tobacco use (r = 0.15-0.21, all p < .001). Significant genetic correlations (rA=0.37-0.45) were found. Genetic influences accounted for most of the association between tobacco use and paranoia (84%) and cognitive disorganization (81%). Familial influences accounted for 80% of the association between tobacco use and hallucinations. CONCLUSION Tobacco use and PE during adolescence were associated after adjustment for confounders. They appear to co-occur largely because of shared genetic influences.
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Affiliation(s)
- Wikus Barkhuizen
- Centre for Brain and Cognitive Development, University of London, UK
| | | | | | - Angelica Ronald
- Centre for Brain and Cognitive Development, University of London, UK.
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88
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Clare RH, Bardelle C, Harper P, Hong WD, Börjesson U, Johnston KL, Collier M, Myhill L, Cassidy A, Plant D, Plant H, Clark R, Cook DAN, Steven A, Archer J, McGillan P, Charoensutthivarakul S, Bibby J, Sharma R, Nixon GL, Slatko BE, Cantin L, Wu B, Turner J, Ford L, Rich K, Wigglesworth M, Berry NG, O'Neill PM, Taylor MJ, Ward SA. Industrial scale high-throughput screening delivers multiple fast acting macrofilaricides. Nat Commun 2019; 10:11. [PMID: 30602718 PMCID: PMC6315057 DOI: 10.1038/s41467-018-07826-2] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 11/29/2018] [Indexed: 01/22/2023] Open
Abstract
Nematodes causing lymphatic filariasis and onchocerciasis rely on their bacterial endosymbiont, Wolbachia, for survival and fecundity, making Wolbachia a promising therapeutic target. Here we perform a high-throughput screen of AstraZeneca’s 1.3 million in-house compound library and identify 5 novel chemotypes with faster in vitro kill rates (<2 days) than existing anti-Wolbachia drugs that cure onchocerciasis and lymphatic filariasis. This industrial scale anthelmintic neglected tropical disease (NTD) screening campaign is the result of a partnership between the Anti-Wolbachia consortium (A∙WOL) and AstraZeneca. The campaign was informed throughout by rational prioritisation and triage of compounds using cheminformatics to balance chemical diversity and drug like properties reducing the chance of attrition from the outset. Ongoing development of these multiple chemotypes, all with superior time-kill kinetics than registered antibiotics with anti-Wolbachia activity, has the potential to improve upon the current therapeutic options and deliver improved, safer and more selective macrofilaricidal drugs. Parasitic nematodes causing onchocerciasis and lymphatic filariasis rely on a bacterial endosymbiont, Wolbachia, which is a validated therapeutic target. Here, Clare et al. perform a high-throughput screen of 1.3 million compounds and identify 5 chemotypes with faster kill rates than existing anti-Wolbachia drugs.
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Affiliation(s)
- Rachel H Clare
- Centre for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Catherine Bardelle
- Hit Discovery, Discovery Sciences, IMED Biotech Unit, AstraZeneca, Macclesfield, SK10 4TG, UK
| | - Paul Harper
- Hit Discovery, Discovery Sciences, IMED Biotech Unit, AstraZeneca, Macclesfield, SK10 4TG, UK
| | - W David Hong
- Department of Chemistry, University of Liverpool, Liverpool, L69 7ZD, UK
| | - Ulf Börjesson
- Hit Discovery, Discovery Sciences, IMED Biotech Unit, AstraZeneca, Gothenburg, SE-431 83, Sweden
| | - Kelly L Johnston
- Centre for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Matthew Collier
- Hit Discovery, Discovery Sciences, IMED Biotech Unit, AstraZeneca, Macclesfield, SK10 4TG, UK
| | - Laura Myhill
- Centre for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Andrew Cassidy
- Centre for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Darren Plant
- Hit Discovery, Discovery Sciences, IMED Biotech Unit, AstraZeneca, Macclesfield, SK10 4TG, UK
| | - Helen Plant
- Hit Discovery, Discovery Sciences, IMED Biotech Unit, AstraZeneca, Macclesfield, SK10 4TG, UK
| | - Roger Clark
- Hit Discovery, Discovery Sciences, IMED Biotech Unit, AstraZeneca, Macclesfield, SK10 4TG, UK
| | - Darren A N Cook
- Centre for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Andrew Steven
- Centre for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - John Archer
- Centre for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Paul McGillan
- Department of Chemistry, University of Liverpool, Liverpool, L69 7ZD, UK
| | - Sitthivut Charoensutthivarakul
- Centre for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Jaclyn Bibby
- Department of Chemistry, University of Liverpool, Liverpool, L69 7ZD, UK
| | - Raman Sharma
- Centre for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Gemma L Nixon
- Department of Chemistry, University of Liverpool, Liverpool, L69 7ZD, UK
| | - Barton E Slatko
- Genome Biology Division, New England Biolabs, Inc, Ipswich, 01938, MA, USA
| | - Lindsey Cantin
- Genome Biology Division, New England Biolabs, Inc, Ipswich, 01938, MA, USA
| | - Bo Wu
- Genome Biology Division, New England Biolabs, Inc, Ipswich, 01938, MA, USA
| | - Joseph Turner
- Centre for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Louise Ford
- Centre for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Kirsty Rich
- Hit Discovery, Discovery Sciences, IMED Biotech Unit, AstraZeneca, Macclesfield, SK10 4TG, UK
| | - Mark Wigglesworth
- Hit Discovery, Discovery Sciences, IMED Biotech Unit, AstraZeneca, Macclesfield, SK10 4TG, UK
| | - Neil G Berry
- Department of Chemistry, University of Liverpool, Liverpool, L69 7ZD, UK
| | - Paul M O'Neill
- Department of Chemistry, University of Liverpool, Liverpool, L69 7ZD, UK.
| | - Mark J Taylor
- Centre for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Stephen A Ward
- Centre for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK.
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89
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Angelopoulos NV, Harvey JP, Bolland JD, Nunn AD, Noble RAA, Smith MA, Taylor MJ, Masters JEG, Moxon J, Cowx IG. Overcoming the dichotomy of implementing societal flood risk management while conserving instream fish habitat - A long-term study from a highly modified urban river. J Environ Manage 2018; 224:69-76. [PMID: 30031920 DOI: 10.1016/j.jenvman.2018.07.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 07/10/2018] [Accepted: 07/10/2018] [Indexed: 06/08/2023]
Abstract
Flood Risk Management (FRM) is often essential to reduce the risk of flooding to properties and infrastructure in urban landscapes, but typically degrades the habitats required by many aquatic animals for foraging, refuge and reproduction. This conflict between flood risk management and biodiversity is driven by conflicting directives, such as the EU Floods and Water Framework Directives, and has led to a requirement for synergistic solutions for FRM that integrate river restoration actions. Unfortunately, ecological monitoring and appraisal of combined FRM and river restoration works is inadequate. This paper uses a case study from the River Don in Northern England to evaluate the effects of the FRM and subsequent river restoration works on instream habitat and the associated fish assemblage over an 8-year period. Flood risk management created a homogeneous channel but did not negatively affect fish species composition or densities, specifically brown trout. Densities of adult brown trout were comparable pre and post-FRM, while densities of juvenile bullhead and brown trout increased dramatically post FRM. River restoration works created a heterogeneous channel but did not significantly improve species composition or brown trout density. Species composition post-river restoration works returned to that similar to pre-FRM over a short-term period, but with improved numbers of juvenile bullhead. Although habitat complexity increased after river restoration works, long-term changes in species composition and densities were marginal, probably because the river reset habitat complexity within the time framework of the study.
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Affiliation(s)
- N V Angelopoulos
- Hull International Fisheries Institute, School of Environmental Sciences, University of Hull, Hull HU6 7RX, UK.
| | - J P Harvey
- Hull International Fisheries Institute, School of Environmental Sciences, University of Hull, Hull HU6 7RX, UK
| | - J D Bolland
- Hull International Fisheries Institute, School of Environmental Sciences, University of Hull, Hull HU6 7RX, UK
| | - A D Nunn
- Hull International Fisheries Institute, School of Environmental Sciences, University of Hull, Hull HU6 7RX, UK
| | - R A A Noble
- Hull International Fisheries Institute, School of Environmental Sciences, University of Hull, Hull HU6 7RX, UK
| | - M A Smith
- Hull International Fisheries Institute, School of Environmental Sciences, University of Hull, Hull HU6 7RX, UK
| | - M J Taylor
- Hull International Fisheries Institute, School of Environmental Sciences, University of Hull, Hull HU6 7RX, UK
| | - J E G Masters
- Environment Agency, Fisheries, Biodiversity and Geomorphology, Yorkshire Area. Lateral, 8 City Walk. Leeds LS11 9AT, UK
| | - J Moxon
- Environment Agency, Fisheries, Biodiversity and Geomorphology, Yorkshire Area. Lateral, 8 City Walk. Leeds LS11 9AT, UK
| | - I G Cowx
- Hull International Fisheries Institute, School of Environmental Sciences, University of Hull, Hull HU6 7RX, UK
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90
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Taylor MJ, Bordenstein SR, Slatko B. Microbe Profile: Wolbachia: a sex selector, a viral protector and a target to treat filarial nematodes. Microbiology (Reading) 2018; 164:1345-1347. [PMID: 30311871 PMCID: PMC7008210 DOI: 10.1099/mic.0.000724] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Wolbachia is the most widespread genus of endosymbiotic bacteria in the animal world, infecting a diverse range of arthropods and nematodes. A broad spectrum of associations from parasitism to mutualism occur, with a tendency to drive reproductive manipulation or influence host fecundity to spread infection through host populations. These varied effects of Wolbachia are exploited for public health benefits. Notably, the protection of insect hosts from viruses is being tested as a potential control strategy for human arboviruses, and the mutualistic relationship with filarial nematodes makes Wolbachia a target for antibiotic therapy of human and veterinary nematode diseases.
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Affiliation(s)
- Mark J Taylor
- 1Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Seth R Bordenstein
- 2Department of Biological Sciences, Vanderbilt University, Nashville, TN, USA.,3Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, TN, USA.,4Vanderbilt Institute for Infection, Immunology and Inflammation, Vanderbilt University, Nashville, TN, USA.,5Vanderbilt Genetics Institute, Vanderbilt University, Nashville, TN, USA
| | - Barton Slatko
- 6New England Biolabs, Inc., 240 County Road, Ipswich, MA 01938, USA
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91
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Abstract
In the United Kingdom (UK), transfer of genomic data to third countries is regulated by data protection legislation. This is a composite of domestic and European Union (EU) law, with EU law to be adopted as domestic law when Brexit takes place. In this paper we consider the content of data protection legislation and the likely impact of Brexit on transfers of genomic data from the UK to other countries. We examine the advice by regulators not to rely upon consent as a lawful basis for processing under data protection law, at least not when personal data are used for research purposes, and consider some of the other ways in which the research context can qualify an individual's ability to exercise control over processing operations. We explain how the process of pseudonymization is to be understood in the context of transfer of genomic data to third parties, as well as how adequacy of data protection in a third country is to be determined in general terms. We conclude with reflections on the future direction of UK data protection law post Brexit with the reclassification of the UK itself as a third country.
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Affiliation(s)
- M J Taylor
- HeLEX@Melbourne, Melbourne Law School, University of Melbourne, Carlton, Australia.
| | - S E Wallace
- Population and Public Health Sciences, Department of Health Sciences, University of Leicester, Leicester, UK
- Nuffield Department of Population Health, Centre for Health, Law and Emerging Technologies ("HeLEX"), University of Oxford, Oxford, UK
| | - M Prictor
- HeLEX@Melbourne, Melbourne Law School, University of Melbourne, Carlton, Australia
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92
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Martin J, Taylor MJ, Rydell M, Riglin L, Eyre O, Lu Y, Lundström S, Larsson H, Thapar A, Lichtenstein P. Sex-specific manifestation of genetic risk for attention deficit hyperactivity disorder in the general population. J Child Psychol Psychiatry 2018; 59:908-916. [PMID: 29451303 PMCID: PMC6055636 DOI: 10.1111/jcpp.12874] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/08/2018] [Indexed: 01/12/2023]
Abstract
BACKGROUND Attention deficit hyperactivity disorder (ADHD) is more commonly diagnosed in males than in females. A growing body of research suggests that females with ADHD might be underdiagnosed or receive alternative diagnoses, such as anxiety or depression. Other lines of reasoning suggest that females might be protected from developing ADHD, requiring a higher burden of genetic risk to manifest the disorder. METHODS We tested these two hypotheses, using common variant genetic data from two population-based cohorts. First, we tested whether females and males diagnosed with anxiety or depression differ in terms of their genetic risk for ADHD, assessed as polygenic risk scores (PRS). Second, we tested whether females and males with ADHD differed in ADHD genetic risk burden. We used three different diagnostic definitions: registry-based clinical diagnoses, screening-based research diagnoses and algorithm-based research diagnoses, to investigate possible referral biases. RESULTS In individuals with a registry-based clinical diagnosis of anxiety or depression, females had higher ADHD PRS than males [OR(CI) = 1.39 (1.12-1.73)] but there was no sex difference for screening-based [OR(CI) = 1.15 (0.94-1.42)] or algorithm-based [OR(CI) = 1.04 (0.89-1.21)] diagnoses. There was also no sex difference in ADHD PRS in individuals with ADHD diagnoses that were registry-based [OR(CI) = 1.04 (0.84-1.30)], screening-based [OR(CI) = 0.96 (0.85-1.08)] or algorithm-based [OR(CI) = 1.15 (0.78-1.68)]. CONCLUSIONS This study provides genetic evidence that ADHD risk may be more likely to manifest or be diagnosed as anxiety or depression in females than in males. Contrary to some earlier studies, the results do not support increased ADHD genetic risk in females with ADHD as compared to affected males.
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Affiliation(s)
- Joanna Martin
- Department of Medical Epidemiology & BiostatisticsKarolinska InstitutetStockholmSweden
- MRC Centre for Neuropsychiatric Genetics and GenomicsCardiff UniversityCardiffUK
| | - Mark J. Taylor
- Department of Medical Epidemiology & BiostatisticsKarolinska InstitutetStockholmSweden
| | - Mina Rydell
- Department of Medical Epidemiology & BiostatisticsKarolinska InstitutetStockholmSweden
| | - Lucy Riglin
- MRC Centre for Neuropsychiatric Genetics and GenomicsCardiff UniversityCardiffUK
| | - Olga Eyre
- MRC Centre for Neuropsychiatric Genetics and GenomicsCardiff UniversityCardiffUK
| | - Yi Lu
- Department of Medical Epidemiology & BiostatisticsKarolinska InstitutetStockholmSweden
| | - Sebastian Lundström
- Institute of Neuroscience and PhysiologyGillberg Neuropsychiatry CentreCentre for Ethics Law and Mental HealthUniversity of GothenburgGothenburgSweden
| | - Henrik Larsson
- Department of Medical Epidemiology & BiostatisticsKarolinska InstitutetStockholmSweden
- School of Medical SciencesÖrebro UniversityÖrebroSweden
| | - Anita Thapar
- MRC Centre for Neuropsychiatric Genetics and GenomicsCardiff UniversityCardiffUK
| | - Paul Lichtenstein
- Department of Medical Epidemiology & BiostatisticsKarolinska InstitutetStockholmSweden
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93
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Martin J, Taylor MJ, Lichtenstein P. Assessing the evidence for shared genetic risks across psychiatric disorders and traits. Psychol Med 2018; 48:1759-1774. [PMID: 29198204 PMCID: PMC6088770 DOI: 10.1017/s0033291717003440] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 10/26/2017] [Accepted: 10/27/2017] [Indexed: 12/21/2022]
Abstract
Genetic influences play a significant role in risk for psychiatric disorders, prompting numerous endeavors to further understand their underlying genetic architecture. In this paper, we summarize and review evidence from traditional twin studies and more recent genome-wide molecular genetic analyses regarding two important issues that have proven particularly informative for psychiatric genetic research. First, emerging results are beginning to suggest that genetic risk factors for some (but not all) clinically diagnosed psychiatric disorders or extreme manifestations of psychiatric traits in the population share genetic risks with quantitative variation in milder traits of the same disorder throughout the general population. Second, there is now evidence for substantial sharing of genetic risks across different psychiatric disorders. This extends to the level of characteristic traits throughout the population, with which some clinical disorders also share genetic risks. In this review, we summarize and evaluate the evidence for these two issues, for a range of psychiatric disorders. We then critically appraise putative interpretations regarding the potential meaning of genetic correlation across psychiatric phenotypes. We highlight several new methods and studies which are already using these insights into the genetic architecture of psychiatric disorders to gain additional understanding regarding the underlying biology of these disorders. We conclude by outlining opportunities for future research in this area.
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Affiliation(s)
- Joanna Martin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Mark J. Taylor
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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94
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Taylor MJ, Dove ES, Laurie G, Townend D. When can the Child Speak for Herself? The Limits of Parental Consent in Data Protection Law for Health Research. Med Law Rev 2018; 26:369-391. [PMID: 29140477 PMCID: PMC6093478 DOI: 10.1093/medlaw/fwx052] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Draft regulatory guidance suggests that if the processing of a child's personal data begins with the consent of a parent, then there is a need to find and defend an enduring consent through the child's growing capacity and on to their maturity. We consider the implications for health research of the UK Information Commissioner's Office's (ICO) suggestion that the relevant test for maturity is the Gillick test, originally developed in the context of medical treatment. Noting the significance of the welfare principle to this test, we examine the implications for the responsibilities of a parent to act as proxy for their child. We argue, contrary to draft ICO guidance, that a data controller might legitimately continue to rely upon parental consent as a legal basis for processing after a child is old enough to provide her own consent. Nevertheless, we conclude that data controllers should develop strategies to seek fresh consent from children as soon as practicable after the data controller has reason to believe they are mature enough to consent independently. Techniques for effective communication, recommended to address challenges associated with Big Data analytics, might have a role here in addressing the dynamic relationship between data subject and processing. Ultimately, we suggest that fair and lawful processing of a child's data will be dependent upon data controllers taking seriously the truism that consent is ongoing, rather than a one-time event: the core associated responsibility is to continue to communicate with a data subject regarding the processing of personal data.
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Affiliation(s)
| | | | | | - David Townend
- Department of Health, Ethics & Society and CAPHRI Care and Public Health Research School, Maastricht University, The Netherlands
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Cederwall B, Doncel M, Aktas Ö, Ertoprak A, Liotta R, Qi C, Grahn T, Cullen DM, Hodge D, Giles M, Stolze S, Badran H, Braunroth T, Calverley T, Cox DM, Fang YD, Greenlees PT, Hilton J, Ideguchi E, Julin R, Juutinen S, Raju MK, Li H, Liu H, Matta S, Modamio V, Pakarinen J, Papadakis P, Partanen J, Petrache CM, Rahkila P, Ruotsalainen P, Sandzelius M, Sarén J, Scholey C, Sorri J, Subramaniam P, Taylor MJ, Uusitalo J, Valiente-Dobón JJ. Lifetime Measurements of Excited States in ^{172}Pt and the Variation of Quadrupole Transition Strength with Angular Momentum. Phys Rev Lett 2018; 121:022502. [PMID: 30085703 DOI: 10.1103/physrevlett.121.022502] [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] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 04/19/2018] [Indexed: 06/08/2023]
Abstract
Lifetimes of the first excited 2^{+} and 4^{+} states in the extremely neutron-deficient nuclide ^{172}Pt have been measured for the first time using the recoil-distance Doppler shift and recoil-decay tagging techniques. An unusually low value of the ratio B(E2:4_{1}^{+}→2_{1}^{+})/B(E2:2_{1}^{+}→0_{gs}^{+})=0.55(19) was found, similar to a handful of other such anomalous cases observed in the entire Segré chart. The observation adds to a cluster of a few extremely neutron-deficient nuclides of the heavy transition metals with neutron numbers N≈90-94 featuring the effect. No theoretical model calculations reported to date have been able to explain the anomalously low B(E2:4_{1}^{+}→2_{1}^{+})/B(E2:2_{1}^{+}→0_{gs}^{+}) ratios observed in these cases. Such low values cannot, e.g., be explained within the framework of the geometrical collective model or by algebraic approaches within the interacting boson model framework. It is proposed that the group of B(E2:4_{1}^{+}→2_{1}^{+})/B(E2:2_{1}^{+}→0_{gs}^{+}) ratios in the extremely neutron-deficient even-even W, Os, and Pt nuclei around neutron numbers N≈90-94 reveal a quantum phase transition from a seniority-conserving structure to a collective regime as a function of neutron number. Although a system governed by seniority symmetry is the only theoretical framework for which such an effect may naturally occur, the phenomenon is highly unexpected for these nuclei that are not situated near closed shells.
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Affiliation(s)
- B Cederwall
- KTH Royal Institute of Technology, 10691 Stockholm, Sweden
| | - M Doncel
- Department of Physics, Oliver Lodge Laboratory, University of Liverpool, Liverpool L69 7ZE, United Kingdom
| | - Ö Aktas
- KTH Royal Institute of Technology, 10691 Stockholm, Sweden
| | - A Ertoprak
- KTH Royal Institute of Technology, 10691 Stockholm, Sweden
- Department of Physics, Faculty of Science, Istanbul University, Vezneciler/Fatih, 34134 Istanbul, Turkey
| | - R Liotta
- KTH Royal Institute of Technology, 10691 Stockholm, Sweden
| | - C Qi
- KTH Royal Institute of Technology, 10691 Stockholm, Sweden
| | - T Grahn
- epartment of Physics, University of Jyvaskyla, P.O. Box 35, FI-40014 Jyväskylä, Finland
| | - D M Cullen
- Schuster Building, School of Physics and Astronomy, The University of Manchester, Manchester M13 9PL, United Kingdom
| | - D Hodge
- Schuster Building, School of Physics and Astronomy, The University of Manchester, Manchester M13 9PL, United Kingdom
| | - M Giles
- Schuster Building, School of Physics and Astronomy, The University of Manchester, Manchester M13 9PL, United Kingdom
| | - S Stolze
- epartment of Physics, University of Jyvaskyla, P.O. Box 35, FI-40014 Jyväskylä, Finland
| | - H Badran
- epartment of Physics, University of Jyvaskyla, P.O. Box 35, FI-40014 Jyväskylä, Finland
| | - T Braunroth
- Institut für Kernphysik, Universität zu Köln, 50937 Köln, Germany
| | - T Calverley
- epartment of Physics, University of Jyvaskyla, P.O. Box 35, FI-40014 Jyväskylä, Finland
| | - D M Cox
- epartment of Physics, University of Jyvaskyla, P.O. Box 35, FI-40014 Jyväskylä, Finland
| | - Y D Fang
- Research Center for Nuclear Physics, Osaka University, JP-567-0047 Osaka, Japan
| | - P T Greenlees
- epartment of Physics, University of Jyvaskyla, P.O. Box 35, FI-40014 Jyväskylä, Finland
| | - J Hilton
- epartment of Physics, University of Jyvaskyla, P.O. Box 35, FI-40014 Jyväskylä, Finland
| | - E Ideguchi
- Research Center for Nuclear Physics, Osaka University, JP-567-0047 Osaka, Japan
| | - R Julin
- epartment of Physics, University of Jyvaskyla, P.O. Box 35, FI-40014 Jyväskylä, Finland
| | - S Juutinen
- epartment of Physics, University of Jyvaskyla, P.O. Box 35, FI-40014 Jyväskylä, Finland
| | - M Kumar Raju
- Research Center for Nuclear Physics, Osaka University, JP-567-0047 Osaka, Japan
| | - H Li
- Grand Accélérateur National dâIons Lourds (GANIL), CEA/DSMâCNRS/IN2P3, F-14076 Caen Cedex 5, France
| | - H Liu
- KTH Royal Institute of Technology, 10691 Stockholm, Sweden
| | - S Matta
- KTH Royal Institute of Technology, 10691 Stockholm, Sweden
| | - V Modamio
- Department of Physics, University of Oslo, NO-0316 Oslo, Norway
| | - J Pakarinen
- epartment of Physics, University of Jyvaskyla, P.O. Box 35, FI-40014 Jyväskylä, Finland
| | - P Papadakis
- epartment of Physics, University of Jyvaskyla, P.O. Box 35, FI-40014 Jyväskylä, Finland
| | - J Partanen
- epartment of Physics, University of Jyvaskyla, P.O. Box 35, FI-40014 Jyväskylä, Finland
| | - C M Petrache
- Centre de Sciences Nucléaires et Sciences de la Matière, CNRS/IN2P3, Université Paris-Saclay, 91405 Orsay, France
| | - P Rahkila
- epartment of Physics, University of Jyvaskyla, P.O. Box 35, FI-40014 Jyväskylä, Finland
| | - P Ruotsalainen
- epartment of Physics, University of Jyvaskyla, P.O. Box 35, FI-40014 Jyväskylä, Finland
| | - M Sandzelius
- epartment of Physics, University of Jyvaskyla, P.O. Box 35, FI-40014 Jyväskylä, Finland
| | - J Sarén
- epartment of Physics, University of Jyvaskyla, P.O. Box 35, FI-40014 Jyväskylä, Finland
| | - C Scholey
- epartment of Physics, University of Jyvaskyla, P.O. Box 35, FI-40014 Jyväskylä, Finland
| | - J Sorri
- epartment of Physics, University of Jyvaskyla, P.O. Box 35, FI-40014 Jyväskylä, Finland
- Istituto Nazionale di Fisica Nucleare, Laboratori Nazionali di Legnaro, I-35020 Legnaro, Italy
| | - P Subramaniam
- KTH Royal Institute of Technology, 10691 Stockholm, Sweden
| | - M J Taylor
- Division of Cancer Sciences, School of Medical Sciences, The University of Manchester, Manchester, M13 9PL, United Kingdom
| | - J Uusitalo
- epartment of Physics, University of Jyvaskyla, P.O. Box 35, FI-40014 Jyväskylä, Finland
| | - J J Valiente-Dobón
- Istituto Nazionale di Fisica Nucleare, Laboratori Nazionali di Legnaro, I-35020 Legnaro, Italy
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Kelly-Hope LA, Hemingway J, Taylor MJ, Molyneux DH. Increasing evidence of low lymphatic filariasis prevalence in high risk Loa loa areas in Central and West Africa: a literature review. Parasit Vectors 2018; 11:349. [PMID: 29907117 PMCID: PMC6004093 DOI: 10.1186/s13071-018-2900-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 05/14/2018] [Indexed: 11/10/2022] Open
Abstract
In West and Central Africa, there is a need to establish the prevalence of Wuchereria bancrofti in areas that are co-endemic for Loa loa, in order to implement the appropriate strategies to scale-up interventions for the elimination of lymphatic filariasis (LF). Due to the risk of severe adverse events (SAEs) to ivermectin in individuals with high L. loa microfilaraemia, the current strategy recommended by the World Health Organization (WHO) is twice yearly mass drug administration (MDA) with albendazole, supplemented by vector control targeting the Anopheles vectors. Defining W. bancrofti prevalence in areas co-endemic with L. loa is complicated by the cross-reactivity of rapid diagnostic immunochromatographic card tests (ICT), widely used for LF mapping, in individuals with high L. loa microfilaraemia. This has probably resulted in the overestimation of LF prevalence, triggering the implementation of MDA strategies, which may be unnecessary and wasteful of the limited resources for elimination programme implementation. Here we review the literature and present historical evidence, which uniformly highlight low or no prevalence of W. bancrofti infection and/or clinical LF cases across five Central African countries, in more than 30 different geographical areas covering 280 individual sites and > 22,000 individuals tested within high risk L. loa areas. This highlights the very limited information available on LF prevalence in L. loa areas, and potentially has major policy implications, which could shift the focus towards revised mapping criteria to verify low or no W. bancrofti prevalence in high risk L. loa areas. In this situation, revising the current WHO strategy from MDA, to focus more on ensuring high and effective vector control, through insecticide treated/long-lasting impregnated bednets (ITNs/LLINs), integration of point-of-care test-and-treat options into health systems, and consolidating closer links with the malaria control programme may be a more effective and appropriate use of the limited resources and drug donations available for LF elimination.
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Affiliation(s)
| | | | - Mark J. Taylor
- Liverpool School of Tropical Medicine, Liverpool, L3 5QA UK
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97
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Zofou D, Fombad FF, Gandjui NVT, Njouendou AJ, Kengne-Ouafo AJ, Chounna Ndongmo PW, Datchoua-Poutcheu FR, Enyong PA, Bita DT, Taylor MJ, Turner JD, Wanji S. Evaluation of in vitro culture systems for the maintenance of microfilariae and infective larvae of Loa loa. Parasit Vectors 2018; 11:275. [PMID: 29716646 PMCID: PMC5930665 DOI: 10.1186/s13071-018-2852-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 04/16/2018] [Indexed: 01/28/2023] Open
Abstract
Background Suitable and scalable in vitro culture conditions for parasite maintenance are needed to foster drug research for loiasis, one of the neglected tropical diseases which has attracted only limited attention over recent years, despite having important public health impacts. The present work aims to develop adequate in vitro culture systems for drug screening against both microfilariae (mf) and infective third-stage larvae (L3) of Loa loa. Methods In vitro culture conditions were evaluated by varying three basic culture media: Roswell Park Memorial Institute (RPMI-1640), Dulbecco’s modified Eagle’s medium (DMEM) and Iscove’s modified Dulbecco’s medium (IMDM); four sera/proteins: newborn calf serum (NCS), foetal bovine serum (FBS), bovine serum albumin (BSA) and the lipid-enriched BSA (AlbuMax® II, ALB); and co-culture with the Monkey Kidney Epithelial Cell line (LLC-MK2) as a feeder layer. The various culture systems were tested on both mf and L3, using survival (% motile), motility (T90 = mean duration (days) at which at least 90% of parasites were fully active) and moulting rates of L3 as the major criteria. The general linear model regression analysis was performed to assess the contribution of each variable on the viability of Loa loa L3 and microfilarie. All statistical tests were performed at 95% confidence interval. Results Of the three different media tested, DMEM and IMDM were the most suitable sustaining the maintenance of both L. loa L3 and mf. IMDM alone could sustain L3 for more than 5 days (T90 = 6.5 ± 1.1 day). Serum supplements and LLC-MK2 co-cultures significantly improved the survival of parasites in DMEM and IMDM. In co-cultures with LLC-MK2 cells, L. loa mf were maintained in each of the three basic media (T90 of 16.4–19.5 days) without any serum supplement. The most effective culture systems promoting significant moulting rate of L3 into L4 (at least 25%) with substantial maintenance time were: DMEM + BSA, DMEM + NCS, DMEM-AlbuMax®II, DMEM + FBS all in co-culture with LLC-MK2, and IMDM + BSA (1.5%), DMEM + FBS (10%) and DMEM + NCS (5%) without feeder cells. DMEM + 1% BSA in co-culture scored the highest moulting rate of 57 of 81 (70.37%). The factors that promoted L. loa mf viability included feeder cells (β = 0.490), both IMDM (β = 0.256) and DMEM (β = 0.198) media and the protein supplements NCS (β = 0.052) and FBS (β = 0.022); while for L. loa L3, in addition to feeder cells (β = 0.259) and both IMDM (β = 0.401) and DMEM (β = 0.385) media, the protein supplements BSA (β = 0.029) were found important in maintaining the worm motility. Conclusions The findings from this work display a range of culture requirements for the maintenance of Loa loa stages, which are suitable for developing an effective platform for drug screening. Electronic supplementary material The online version of this article (10.1186/s13071-018-2852-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Denis Zofou
- Research Foundation for Tropical Diseases and Environment (REFOTDE), South West Region, Buea, Cameroon.,Biotechnology Unit, Faculty of Science, University of Buea, Buea, Cameroon
| | - Fanny Fri Fombad
- Research Foundation for Tropical Diseases and Environment (REFOTDE), South West Region, Buea, Cameroon.,Parasites and Vectors Biology Research Unit (PAVBRU), Department of Microbiology and Parasitology, Faculty of Science, University of Buea, South West Region, Buea, Cameroon
| | - Narcisse V T Gandjui
- Research Foundation for Tropical Diseases and Environment (REFOTDE), South West Region, Buea, Cameroon.,Parasites and Vectors Biology Research Unit (PAVBRU), Department of Microbiology and Parasitology, Faculty of Science, University of Buea, South West Region, Buea, Cameroon
| | - Abdel Jelil Njouendou
- Research Foundation for Tropical Diseases and Environment (REFOTDE), South West Region, Buea, Cameroon.,Parasites and Vectors Biology Research Unit (PAVBRU), Department of Microbiology and Parasitology, Faculty of Science, University of Buea, South West Region, Buea, Cameroon
| | - Arnaud Jonas Kengne-Ouafo
- Research Foundation for Tropical Diseases and Environment (REFOTDE), South West Region, Buea, Cameroon.,Parasites and Vectors Biology Research Unit (PAVBRU), Department of Microbiology and Parasitology, Faculty of Science, University of Buea, South West Region, Buea, Cameroon
| | - Patrick W Chounna Ndongmo
- Research Foundation for Tropical Diseases and Environment (REFOTDE), South West Region, Buea, Cameroon.,Parasites and Vectors Biology Research Unit (PAVBRU), Department of Microbiology and Parasitology, Faculty of Science, University of Buea, South West Region, Buea, Cameroon
| | | | - Peter A Enyong
- Research Foundation for Tropical Diseases and Environment (REFOTDE), South West Region, Buea, Cameroon
| | - Dizzle Tayong Bita
- Research Foundation for Tropical Diseases and Environment (REFOTDE), South West Region, Buea, Cameroon.,Parasites and Vectors Biology Research Unit (PAVBRU), Department of Microbiology and Parasitology, Faculty of Science, University of Buea, South West Region, Buea, Cameroon
| | - Mark J Taylor
- Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Joseph D Turner
- Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Samuel Wanji
- Research Foundation for Tropical Diseases and Environment (REFOTDE), South West Region, Buea, Cameroon. .,Parasites and Vectors Biology Research Unit (PAVBRU), Department of Microbiology and Parasitology, Faculty of Science, University of Buea, South West Region, Buea, Cameroon.
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98
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Turner JD, Pionnier N, Furlong-Silva J, Sjoberg H, Cross S, Halliday A, Guimaraes AF, Cook DAN, Steven A, Van Rooijen N, Allen JE, Jenkins SJ, Taylor MJ. Interleukin-4 activated macrophages mediate immunity to filarial helminth infection by sustaining CCR3-dependent eosinophilia. PLoS Pathog 2018; 14:e1006949. [PMID: 29547639 PMCID: PMC5874077 DOI: 10.1371/journal.ppat.1006949] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 03/28/2018] [Accepted: 02/26/2018] [Indexed: 12/18/2022] Open
Abstract
Eosinophils are effectors in immunity to tissue helminths but also induce allergic immunopathology. Mechanisms of eosinophilia in non-mucosal tissues during infection remain unresolved. Here we identify a pivotal function of tissue macrophages (Mϕ) in eosinophil anti-helminth immunity using a BALB/c mouse intra-peritoneal Brugia malayi filarial infection model. Eosinophilia, via C-C motif chemokine receptor (CCR)3, was necessary for immunity as CCR3 and eosinophil impairments rendered mice susceptible to chronic filarial infection. Post-infection, peritoneal Mϕ populations proliferated and became alternatively-activated (AAMϕ). Filarial AAMϕ development required adaptive immunity and interleukin-4 receptor-alpha. Depletion of Mϕ prior to infection suppressed eosinophilia and facilitated worm survival. Add back of filarial AAMϕ in Mϕ-depleted mice recapitulated a vigorous eosinophilia. Transfer of filarial AAMϕ into Severe-Combined Immune Deficient mice mediated immunological resistance in an eosinophil-dependent manner. Exogenous IL-4 delivery recapitulated tissue AAMϕ expansions, sustained eosinophilia and mediated immunological resistance in Mϕ-intact SCID mice. Co-culturing Brugia with filarial AAMϕ and/or filarial-recruited eosinophils confirmed eosinophils as the larvicidal cell type. Our data demonstrates that IL-4/IL-4Rα activated AAMϕ orchestrate eosinophil immunity to filarial tissue helminth infection. Helminths parasitize approximately one quarter of the global population. Medically-important helminths, including filariae responsible for elephantiasis and river blindness, are targeted for elimination as a public health problem. Currently there are no vaccines or immunotherapeutics available for filarial worms or other human helminth pathogens. Here we define a cellular mechanism whereby the interlukin-4 dependent activation of tissue macrophages are essential to sustain the recruitment of larvicidal eosinophil granulocytes, leading to immunity against filarial infection at a sterile tissue site of parasitism. This work delineates the relative non-redundant functional roles of both myeloid cell types in ‘type-2’ immunity to helminth infection. The study represents a mechanistic advance in our understanding of how immunity operates against metazoan macroparasites invading sterile tissues and may be used in the rational design of new therapeutics to limit helminth disease.
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Affiliation(s)
- Joseph D. Turner
- Research Centre for Drugs & Diagnostics, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
- * E-mail:
| | - Nicolas Pionnier
- Research Centre for Drugs & Diagnostics, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Julio Furlong-Silva
- Research Centre for Drugs & Diagnostics, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Hanna Sjoberg
- Research Centre for Drugs & Diagnostics, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Stephen Cross
- Research Centre for Drugs & Diagnostics, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Alice Halliday
- Research Centre for Drugs & Diagnostics, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Ana F. Guimaraes
- Research Centre for Drugs & Diagnostics, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Darren A. N. Cook
- Research Centre for Drugs & Diagnostics, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Andrew Steven
- Research Centre for Drugs & Diagnostics, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Nico Van Rooijen
- VU University Medical Center, Department of Molecular Cell Biology and Immunology, Amsterdam, Netherlands
| | - Judith E. Allen
- Faculty of Biology, Medicine & Health, University of Manchester, Manchester, United Kingdom
| | - Stephen J. Jenkins
- MRC Centre for Inflammation Research, University of Edinburgh, Edinburgh, United Kingdom
| | - Mark J. Taylor
- Research Centre for Drugs & Diagnostics, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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99
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Hilderley AJ, Taylor MJ, Fehlings D, Chen JL, Wright FV. Optimization of fMRI methods to determine laterality of cortical activation during ankle movements of children with unilateral cerebral palsy. Int J Dev Neurosci 2018; 66:54-62. [PMID: 29413879 DOI: 10.1016/j.ijdevneu.2018.01.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 01/20/2018] [Accepted: 01/22/2018] [Indexed: 10/18/2022] Open
Abstract
Measurement of laterality of motor cortical activations may provide valuable information about lower limb control in children with unilateral cerebral palsy (UCP). Evidence from upper limb research suggests that increased contralateral activity may accompany functional gains. However, lower limb areas of activation and associated changes have been underexplored due to challenges with imaging motor cortical leg representations. In this study, methods for a task-based functional magnetic resonance imaging (fMRI) ankle dorsiflexion paradigm were refined with three pilot groups of participants: (i) adults (n = 5); (ii) typically developing (TD) children (n = 5) and; (iii) children with UCP (n = 4). Parameters of experimental design, task resistance, reproducibility, and pre-scan procedures were tested/refined using a staged development approach with additions or changes introduced if image quality did not meet pre-defined standards. When image quality was acceptable for two consecutive participants, the next participant group was recruited to test/refine the next parameter. The final paradigm involved an event-related design of a single dorsiflexion movement against individualized resistance, with two runs per leg. It included a pre-scan session to increase child comfort and determine task resistance. This paradigm produced valid data for laterality index (LI) calculations to determine the ratio of activity in each hemisphere. Ventricle and lesion masks were used in non-linear image registration, and individual thresholds were used for extent-based LI calculations. LI of dominant ankle movements were contralateral (LI ≥ +0.2) for TD children (mean LI = +0.89, std = 0.27) and children with UCP (mean LI = +0.86, std = 0.26). For the affected ankle of children with UCP, LI values indicated ipsilateral and/or contralateral activation (mean LI = +0.02, std = 0.71, range -0.92 to +1.00). This fMRI paradigm will support investigations of cortical activation and mechanisms of skill improvement following lower limb interventions.
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Affiliation(s)
- A J Hilderley
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Rd, Toronto, M4K 1E1, Canada; Rehabilitation Sciences Institute, University of Toronto, 500 University Ave, Toronto, M5G 1V7, Canada.
| | - M J Taylor
- Diagnostic Imaging, Hospital for Sick Children, 555 University Avenue, Toronto, M5G 1X8, Canada; Department of Medical Imaging, University of Toronto, 263 McCaul Street, Toronto, M5T 1W7, Canada; Department of Psychology, University of Toronto, 100 St. George Street, Toronto, M5S 3G3, Canada.
| | - D Fehlings
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Rd, Toronto, M4K 1E1, Canada; Rehabilitation Sciences Institute, University of Toronto, 500 University Ave, Toronto, M5G 1V7, Canada; Department of Developmental Paediatrics, University of Toronto, 1 King's College Circle, Toronto, M5S 1A8, Canada.
| | - J L Chen
- Rehabilitation Sciences Institute, University of Toronto, 500 University Ave, Toronto, M5G 1V7, Canada; Hurvitz Brain Sciences Program, Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, 2075 Bayview Ave, Toronto, M4N 3M5, Canada; Department of Physical Therapy, University of Toronto, 500 University Ave, Toronto, M5G 1V7, Canada.
| | - F V Wright
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Rd, Toronto, M4K 1E1, Canada; Rehabilitation Sciences Institute, University of Toronto, 500 University Ave, Toronto, M5G 1V7, Canada; Department of Physical Therapy, University of Toronto, 500 University Ave, Toronto, M5G 1V7, Canada.
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100
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Taylor MJ, Gustafsson P, Larsson H, Gillberg C, Lundström S, Lichstenstein P. Examining the Association Between Autistic Traits and Atypical Sensory Reactivity: A Twin Study. J Am Acad Child Adolesc Psychiatry 2018; 57:96-102. [PMID: 29413155 DOI: 10.1016/j.jaac.2017.11.019] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 10/11/2017] [Accepted: 11/29/2017] [Indexed: 01/21/2023]
Abstract
OBJECTIVE Atypical responses to sensory stimuli are common features of autism spectrum disorders (ASD). Consequently, atypical sensory reactivity (SR) is now a diagnostic feature of ASD. Quantitative genetic research on ASD has overlooked these symptoms, however. We therefore investigated the association between autistic traits and SR using twin methods. METHOD Autistic traits and SR were assessed by 2 separate scales in 12,419 Swedish twin pairs (n = 3,586 monozygotic [MZ], n = 8,833 dizygotic [DZ]) when the twins were 9 or 12 years of age. The classic twin design estimated the degree to which etiological factors associated with autistic traits were also associated with SR, and the degree to which such shared factors explained the covariance between these phenotypes. DeFries-Fulker analysis estimated the genetic correlation between screening diagnoses of ASD, defined broadly and strictly, and SR. RESULTS Autistic traits and SR were both highly heritable (62%-75% and 66%-71%, respectively). There was a moderate phenotypic correlation between autistic traits and SR (r = 0.47). Genetic influences on these phenotypes correlated moderately (genetic correlation = 0.60). These overlapping genetic factors explained most of the correlation between autistic traits and SR. Genetic correlations with SR increased for broad ASD (genetic correlation = 0.72) and strict ASD (genetic correlation = 0.80). CONCLUSION The genetic overlap observed between autistic traits and SR lends quantitative genetic support to the notion that ASD and SR are strongly linked. Such symptoms may thus comprise part of the ASD genotype, as well as phenotype. Associations persisted across all definitions of ASD, indicating a genetic link between the broader ASD phenotype and SR.
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Affiliation(s)
| | | | - Henrik Larsson
- Karolinska Institutet, Stockholm, Sweden; School of Medical Sciences, Örebro University, Örebro, Sweden
| | | | - Sebastian Lundström
- Gillberg Neuropsychiatry Centre, University of Gothenburg, Sweden; Sweden Centre for Ethics, Law and Mental Health, University of Gothenburg, Sweden
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