101
|
Nascimento FF, Mehta SR, Little SJ, Volz EM. Assessing transmission attribution risk from simulated sequencing data in HIV molecular epidemiology. AIDS 2024; 38:865-873. [PMID: 38126363 PMCID: PMC10994139 DOI: 10.1097/qad.0000000000003820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 12/08/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND HIV molecular epidemiology (ME) is the analysis of sequence data together with individual-level clinical, demographic, and behavioral data to understand HIV epidemiology. The use of ME has raised concerns regarding identification of the putative source in direct transmission events. This could result in harm ranging from stigma to criminal prosecution in some jurisdictions. Here we assessed the risks of ME using simulated HIV genetic sequencing data. METHODS We simulated social networks of men-who-have-sex-with-men, calibrating the simulations to data from San Diego. We used these networks to simulate consensus and next-generation sequence (NGS) data to evaluate the risks of identifying direct transmissions using different HIV sequence lengths, and population sampling depths. To identify the source of transmissions, we calculated infector probability and used phyloscanner software for the analysis of consensus and NGS data, respectively. RESULTS Consensus sequence analyses showed that the risk of correctly inferring the source (direct transmission) within identified transmission pairs was very small and independent of sampling depth. Alternatively, NGS analyses showed that identification of the source of a transmission was very accurate, but only for 6.5% of inferred pairs. False positive transmissions were also observed, where one or more unobserved intermediaries were present when compared to the true network. CONCLUSION Source attribution using consensus sequences rarely infers direct transmission pairs with high confidence but is still useful for population studies. In contrast, source attribution using NGS data was much more accurate in identifying direct transmission pairs, but for only a small percentage of transmission pairs analyzed.
Collapse
Affiliation(s)
- Fabrícia F. Nascimento
- MRC Centre for Global Infectious Disease Analysis and the Department of Infectious Disease Epidemiology, Imperial College London, London, UK
| | - Sanjay R. Mehta
- Division of Infectious Diseases, University of California San Diego, San Diego, CA, USA
| | - Susan J. Little
- Division of Infectious Diseases, University of California San Diego, San Diego, CA, USA
| | - Erik M. Volz
- MRC Centre for Global Infectious Disease Analysis and the Department of Infectious Disease Epidemiology, Imperial College London, London, UK
| |
Collapse
|
102
|
Myroniuk TW, Kohler HP, Mwapasa V, Mwera J, Kohler IV. Surprising Gendered Age Differences in Rural Malawians' Early COVID-19 Pandemic Prevention Efforts. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbae031. [PMID: 38457433 PMCID: PMC11000306 DOI: 10.1093/geronb/gbae031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Indexed: 03/10/2024] Open
Abstract
OBJECTIVES We assess how age, the presence of mature adults aged 45+ years, and recent deaths in rural households are associated with coronavirus disease 2019 (COVID-19) preventative actions and the likelihood of getting vaccinated against the virus in Malawi during early stages of the pandemic. METHODS We draw upon data from 2,187 rural Malawians who participated in a 2020 COVID-19 Phone Survey. We estimate the log odds of engaging in "low-cost" and "high-cost" COVID-19 preventative actions based on age, gender, household composition, and recent household deaths. Low-cost prevention efforts were washing hands with soap and water frequently, avoiding close contact with people when going out, and avoiding shaking hands. High-cost actions included staying at home and decreasing time spent close to people not living in their household. We also estimate the chances of acquiring the COVID-19 vaccine in early stages of its availability. RESULTS Mature women (45+ years) in general and younger men (<45 years)-living with at least one mature adult in the household-were less likely than others to comply with low-cost actions. Mature men were more likely than younger men (<45 years) to take on high-cost actions. To some extent, individuals who experienced a recent family death were more likely to engage in high-cost COVID-19 preventative actions as well as getting vaccinated. DISCUSSION Gendered age differences in preventing the transmission of COVID-19 offer hints of larger social norms affecting protective efforts. The analyses also inform future COVID-19 public health outreach efforts in Malawi and other rural SSA contexts.
Collapse
Affiliation(s)
- Tyler W Myroniuk
- Department of Public Health, University of Missouri, Columbia, Missouri, USA
| | - Hans-Peter Kohler
- Population Aging Research Center (PARC), University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Victor Mwapasa
- Department of Community and Environmental Health, Kamuzu University of Health Sciences, Blantyre, Malawi
| | | | - Iliana V Kohler
- Population Studies Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| |
Collapse
|
103
|
Faridi R, Stratton P, Salmeri N, Morell RJ, Khan AA, Usmani MA, Newman WG, Riazuddin S, Friedman TB. Homozygous novel truncating variant of CLPP associated with severe Perrault syndrome. Clin Genet 2024; 105:584-586. [PMID: 38454547 PMCID: PMC10990821 DOI: 10.1111/cge.14514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/12/2024] [Accepted: 02/19/2024] [Indexed: 03/09/2024]
Abstract
A female proband and her affected niece are homozygous for a novel frameshift variant of CLPP. The proband was diagnosed with severe Perrault syndrome encompassing hearing loss, primary ovarian insufficiency, abnormal brain white matter and developmental delay.
Collapse
Affiliation(s)
- Rabia Faridi
- Laboratory of Molecular Genetics, NIDCD, NIH, Bethesda, Maryland, USA
| | - Pamela Stratton
- Office of the Clinical Director, Intramural Research Program, NINDS, NIH, Bethesda, Maryland, USA
| | - Noemi Salmeri
- Rehabilitation Medicine Department, Clinical Center, NIH, Bethesda, Maryland, USA
| | - Robert J. Morell
- Genomics and Computational Biology Core, NIDCD, NIH, Bethesda, Maryland, USA
| | - Asma Ali Khan
- National Centre of Excellence in Molecular Biology, University of the Punjab, Lahore Pakistan
| | - Muhammad A Usmani
- Allama Iqbal Medical Research Center, Jinnah Burn and Reconstructive Surgery Center, University of Health Sciences, Lahore, Pakistan
| | - William G. Newman
- Evolution Infection and Genomics, University of Manchester, Manchester, UK
| | - Sheikh Riazuddin
- Allama Iqbal Medical Research Center, Jinnah Burn and Reconstructive Surgery Center, University of Health Sciences, Lahore, Pakistan
| | | |
Collapse
|
104
|
Boo YY, Bora AK, Chhabra S, Choudhury SS, Deka G, Kakoty S, Kumar P, Mahanta P, Minz B, Rani A, Rao S, Roy I, Solomi V C, Verma A, Zahir F, Deka R, Kurinczuk JJ, Nair M. Maternal and fetal factors associated with stillbirth in singleton pregnancies in 13 hospitals across six states in India: A prospective cohort study. Int J Gynaecol Obstet 2024; 165:462-473. [PMID: 38234106 DOI: 10.1002/ijgo.15367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 12/25/2023] [Accepted: 12/28/2023] [Indexed: 01/19/2024]
Abstract
OBJECTIVE This study aimed to investigate the incidence of and risk factors for stillbirth in an Indian population. METHODS We conducted a secondary data analysis of a hospital-based cohort from the Maternal and Perinatal Health Research collaboration, India (MaatHRI), including pregnant women who gave birth between October 2018-September 2023. Data from 9823 singleton pregnancies recruited from 13 hospitals across six Indian states were included. Univariable and multivariable Poisson regression analysis were performed to examine the relationship between stillbirth and potential risk factors. Model prediction was assessed using the area under the receiver-operating characteristic (AUROC) curve. RESULTS There were 216 stillbirths (48 antepartum and 168 intrapartum) in the study population, representing an overall stillbirth rate of 22.0 per 1000 total births (95% confidence interval [CI]: 19.2-25.1). Modifiable risk factors for stillbirth were: receiving less than four antenatal check-ups (adjusted relative risk [aRR]: 1.75, 95% CI: 1.25-2.47), not taking any iron and folic acid supplementation during pregnancy (aRR: 7.23, 95% CI: 2.12-45.33) and having severe anemia in the third trimester (aRR: 3.37, 95% CI: 1.97-6.11). Having pregnancy/fetal complications such as hypertensive disorders of pregnancy (aRR: 1.59, 95% CI: 1.03-2.36), preterm birth (aRR: 4.41, 95% CI: 3.21-6.08) and birth weight below the 10th percentile for gestational age (aRR: 1.35, 95% CI: 1.02-1.79) were also associated with an increased risk of stillbirth. Identified risk factors explained 78.2% (95% CI: 75.0%-81.4%) of the risk of stillbirth in the population. CONCLUSION Addressing potentially modifiable antenatal factors could reduce the risk of stillbirths in India.
Collapse
Affiliation(s)
- Yebeen Ysabelle Boo
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Amrit K Bora
- Sonapur District Hospital, Guwahati, Assam, India
| | - Shakuntala Chhabra
- Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra, India
| | | | - Gitanjali Deka
- Tezpur Medical College and Hospital, Tezpur, Assam, India
| | - Swapna Kakoty
- Fakhruddin Ali Ahmed Medical College and Hospital, Barpeta, Assam, India
| | - Pramod Kumar
- Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra, India
| | | | - Bina Minz
- Sewa Bhawan Hospital Society, Basna, Chhattisgarh, India
| | - Anjali Rani
- Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Sereesha Rao
- Silchar Medical College and Hospital, Silchar, Assam, India
| | - Indrani Roy
- Nazareth Hospital, Shillong, Meghalaya, India
| | - Carolin Solomi V
- Makunda Christian Leprosy and General Hospital, Karimganj, Assam, India
| | - Ashok Verma
- Dr Rajendra Prasad Government Medical College, Kangra, Himachal Pradesh, India
| | - Farzana Zahir
- Assam Medical College (AMC), Dibrugarh, Assam, India
| | - Rupanjali Deka
- Srimanta Sankaradeva University of Health Sciences, Guwahati, Assam, India
| | - Jennifer J Kurinczuk
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Manisha Nair
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| |
Collapse
|
105
|
Noor NM, Lee JC, Bond S, Dowling F, Brezina B, Patel KV, Ahmad T, Banim PJ, Berrill JW, Cooney R, De La Revilla Negro J, de Silva S, Din S, Durai D, Gordon JN, Irving PM, Johnson M, Kent AJ, Kok KB, Moran GW, Mowat C, Patel P, Probert CS, Raine T, Saich R, Seward A, Sharpstone D, Smith MA, Subramanian S, Upponi SS, Wiles A, Williams HRT, van den Brink GR, Vermeire S, Jairath V, D'Haens GR, McKinney EF, Lyons PA, Lindsay JO, Kennedy NA, Smith KGC, Parkes M. A biomarker-stratified comparison of top-down versus accelerated step-up treatment strategies for patients with newly diagnosed Crohn's disease (PROFILE): a multicentre, open-label randomised controlled trial. Lancet Gastroenterol Hepatol 2024; 9:415-427. [PMID: 38402895 PMCID: PMC11001594 DOI: 10.1016/s2468-1253(24)00034-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 01/31/2024] [Accepted: 01/31/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND Management strategies and clinical outcomes vary substantially in patients newly diagnosed with Crohn's disease. We evaluated the use of a putative prognostic biomarker to guide therapy by assessing outcomes in patients randomised to either top-down (ie, early combined immunosuppression with infliximab and immunomodulator) or accelerated step-up (conventional) treatment strategies. METHODS PROFILE (PRedicting Outcomes For Crohn's disease using a moLecular biomarker) was a multicentre, open-label, biomarker-stratified, randomised controlled trial that enrolled adults with newly diagnosed active Crohn's disease (Harvey-Bradshaw Index ≥7, either elevated C-reactive protein or faecal calprotectin or both, and endoscopic evidence of active inflammation). Potential participants had blood drawn to be tested for a prognostic biomarker derived from T-cell transcriptional signatures (PredictSURE-IBD assay). Following testing, patients were randomly assigned, via a secure online platform, to top-down or accelerated step-up treatment stratified by biomarker subgroup (IBDhi or IBDlo), endoscopic inflammation (mild, moderate, or severe), and extent (colonic or other). Blinding to biomarker status was maintained throughout the trial. The primary endpoint was sustained steroid-free and surgery-free remission to week 48. Remission was defined by a composite of symptoms and inflammatory markers at all visits. Flare required active symptoms (HBI ≥5) plus raised inflammatory markers (CRP >upper limit of normal or faecal calprotectin ≥200 μg/g, or both), while remission was the converse-ie, quiescent symptoms (HBI <5) or resolved inflammatory markers (both CRP ≤ the upper limit of normal and calprotectin <200 μg/g) or both. Analyses were done in the full analysis (intention-to-treat) population. The trial has completed and is registered (ISRCTN11808228). FINDINGS Between Dec 29, 2017, and Jan 5, 2022, 386 patients (mean age 33·6 years [SD 13·2]; 179 [46%] female, 207 [54%] male) were randomised: 193 to the top-down group and 193 to the accelerated step-up group. Median time from diagnosis to trial enrolment was 12 days (range 0-191). Primary outcome data were available for 379 participants (189 in the top-down group; 190 in the accelerated step-up group). There was no biomarker-treatment interaction effect (absolute difference 1 percentage points, 95% CI -15 to 15; p=0·944). Sustained steroid-free and surgery-free remission was significantly more frequent in the top-down group than in the accelerated step-up group (149 [79%] of 189 patients vs 29 [15%] of 190 patients, absolute difference 64 percentage points, 95% CI 57 to 72; p<0·0001). There were fewer adverse events (including disease flares) and serious adverse events in the top-down group than in the accelerated step-up group (adverse events: 168 vs 315; serious adverse events: 15 vs 42), with fewer complications requiring abdominal surgery (one vs ten) and no difference in serious infections (three vs eight). INTERPRETATION Top-down treatment with combination infliximab plus immunomodulator achieved substantially better outcomes at 1 year than accelerated step-up treatment. The biomarker did not show clinical utility. Top-down treatment should be considered standard of care for patients with newly diagnosed active Crohn's disease. FUNDING Wellcome and PredictImmune Ltd.
Collapse
Affiliation(s)
- Nurulamin M Noor
- Department of Gastroenterology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - James C Lee
- Genetic Mechanisms of Disease Laboratory, The Francis Crick Institute, London, UK; Department of Gastroenterology, UCL Institute of Liver and Digestive Diseases, Royal Free Hospital, London, UK
| | - Simon Bond
- Cambridge Clinical Trials Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; Medical Research Council Biostatistics Unit, University of Cambridge, Cambridge, UK
| | - Francis Dowling
- Cambridge Clinical Trials Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Biljana Brezina
- Department of Gastroenterology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Kamal V Patel
- Department of Gastroenterology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Tariq Ahmad
- Department of Gastroenterology, Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK; Exeter Inflammatory Bowel Disease and Pharmacogenetics Research Group, University of Exeter, Exeter, UK
| | - Paul J Banim
- Department of Gastroenterology, James Paget University Hospital, Great Yarmouth, UK
| | - James W Berrill
- Department of Gastroenterology, Royal Glamorgan Hospital, Llantrisant, UK
| | - Rachel Cooney
- GI Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Juan De La Revilla Negro
- Department of Gastroenterology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Shanika de Silva
- Department of Gastroenterology, The Dudley Group NHS Foundation Trust, Dudley, UK
| | - Shahida Din
- Edinburgh IBD Unit, Western General Hospital, Edinburgh, UK
| | - Dharmaraj Durai
- Department of Gastroenterology, Cardiff and Vale University Health Board, University Hospital of Wales, Cardiff, UK
| | - John N Gordon
- Department of Gastroenterology, Royal Hampshire County Hospital, Winchester, UK
| | - Peter M Irving
- Department of Gastroenterology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Matthew Johnson
- Gastroenterology Department, Luton and Dunstable University Hospital, Luton, UK
| | - Alexandra J Kent
- Department of Gastroenterology, King's College Hospital NHS Foundation Trust, London, UK
| | - Klaartje B Kok
- Department of Gastroenterology, Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Gordon W Moran
- National Institute of Health Research Nottingham Biomedical Research Centre, University of Nottingham and Nottingham University Hospitals, Nottingham, UK
| | - Craig Mowat
- Department of Gastroenterology, Ninewells Hospital, Dundee, Scotland, UK
| | - Pritash Patel
- Department of Gastroenterology, Epsom and St Helier University Hospitals, Carshalton, UK
| | - Chris S Probert
- Department of Gastroenterology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK; Department of Molecular and Clinical Cancer Medicine, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| | - Tim Raine
- Department of Gastroenterology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Rebecca Saich
- Department of Gastroenterology, Basingstoke and North Hampshire Hospital, Basingstoke, UK
| | - Abigail Seward
- Department of Gastroenterology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Dan Sharpstone
- Department of Gastroenterology, West Suffolk NHS Foundation Trust, Bury St Edmunds, UK
| | - Melissa A Smith
- Department of Gastroenterology, University Hospitals Sussex NHS Foundation Trust, Brighton, UK
| | - Sreedhar Subramanian
- Department of Gastroenterology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Sara S Upponi
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Alan Wiles
- Department of Gastroenterology, The Queen Elizabeth Hospital King's Lynn NHS Trust, King's Lynn, UK
| | - Horace R T Williams
- Department of Gastroenterology, Imperial College Healthcare NHS Trust, St Mary's Hospital, London, UK
| | | | - Séverine Vermeire
- Department of Gastroenterology and Hepatology, Department of Chronic Diseases and Metabolism, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Vipul Jairath
- Division of Gastroenterology, Department of Medicine, Western University, London, Ontario, Canada
| | - Geert R D'Haens
- Department of Gastroenterology, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Eoin F McKinney
- Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge, UK; PredictImmune Ltd, Babraham Research Campus, Cambridge, UK; Cambridge Institute of Therapeutic Immunology and Infectious Disease, Jeffrey Cheah Biomedical Centre, Cambridge, UK
| | - Paul A Lyons
- Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge, UK; PredictImmune Ltd, Babraham Research Campus, Cambridge, UK; Cambridge Institute of Therapeutic Immunology and Infectious Disease, Jeffrey Cheah Biomedical Centre, Cambridge, UK
| | - James O Lindsay
- Department of Gastroenterology, Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Nicholas A Kennedy
- Department of Gastroenterology, Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK; Exeter Inflammatory Bowel Disease and Pharmacogenetics Research Group, University of Exeter, Exeter, UK
| | - Kenneth G C Smith
- Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge, UK; PredictImmune Ltd, Babraham Research Campus, Cambridge, UK; Cambridge Institute of Therapeutic Immunology and Infectious Disease, Jeffrey Cheah Biomedical Centre, Cambridge, UK
| | - Miles Parkes
- Department of Gastroenterology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge, UK.
| |
Collapse
|
106
|
Murray GM, Griffith N, Sinnappurajar P, Al Julandani DA, Clarke SLN, Hawley DP, Choi J, Guly CM, Ramanan AV. Clinical Efficacy of Biosimilar Switch of Adalimumab for Management of Uveitis. Ocul Immunol Inflamm 2024; 32:442-446. [PMID: 36803373 PMCID: PMC11057845 DOI: 10.1080/09273948.2023.2172591] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 02/23/2023]
Abstract
BACKGROUND Adalimumab has demonstrated efficacy in non-infectious uveitis. With the introduction of biosimilar agents such as Amgevita, we aimed to quantify efficacy and tolerability compared to Humira in a multi-centre UK cohort. METHODS Patients identified from tertiary uveitis clinics in 3 centres, after institution-mandated switching was implemented. RESULTS Data collected for 102 patients, aged 2-75 years, with 185 active eyes. Following switch, rates of uveitis flare were not significantly different (13 events before, 21 after, p = .132). Rates of elevated intraocular pressure were decreased (32 before, 25 afterwards, p = .006) and dosing of oral and intra-ocular steroids was stable. Twenty-four patients (24%) requested to return to Humira, commonly due to pain from injection or technical difficulty with the device. CONCLUSION Amgevita is safe and effective for inflammatory uveitis with non-inferiority to Humira. Significant numbers of patients requested to switch back due to side effects including injection site reactions.
Collapse
Affiliation(s)
- G. M. Murray
- Department of Rheumatology, Bristol Royal Hospital for Children, Bristol, UK
| | - N. Griffith
- Department of Ophthalmology Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK
| | - P. Sinnappurajar
- Department of Rheumatology, Bristol Royal Hospital for Children, Bristol, UK
| | - D. A. Al Julandani
- Department of Rheumatology, Bristol Royal Hospital for Children, Bristol, UK
| | - S. L. N. Clarke
- Department of Rheumatology, Bristol Royal Hospital for Children, Bristol, UK
- MRC Integrative Epidemiology Unit and School of Population Health Sciences, University of Bristol, Bristol, UK
| | - D. P. Hawley
- Department of Rheumatology Sheffield Children’s NHS Foundation Trust, Sheffield, UK
| | - J. Choi
- Department of Ophthalmology Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK
- Department of Rheumatology Sheffield Children’s NHS Foundation Trust, Sheffield, UK
| | - C. M. Guly
- Department of Ophthalmology University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Athimalaipet V. Ramanan
- Department of Rheumatology, Bristol Royal Hospital for Children, Bristol, UK
- Bristol Medical School: Translational Health Sciences, University of Bristol, Bristol, UK
| |
Collapse
|
107
|
Shi D, Zhou Y, He S, Wagner SK, Huang Y, Keane PA, Ting DS, Zhang L, Zheng Y, He M. Cross-modality Labeling Enables Noninvasive Capillary Quantification as a Sensitive Biomarker for Assessing Cardiovascular Risk. Ophthalmol Sci 2024; 4:100441. [PMID: 38420613 PMCID: PMC10899028 DOI: 10.1016/j.xops.2023.100441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 11/26/2023] [Accepted: 11/27/2023] [Indexed: 03/02/2024]
Abstract
Purpose We aim to use fundus fluorescein angiography (FFA) to label the capillaries on color fundus (CF) photographs and train a deep learning model to quantify retinal capillaries noninvasively from CF and apply it to cardiovascular disease (CVD) risk assessment. Design Cross-sectional and longitudinal study. Participants A total of 90732 pairs of CF-FFA images from 3893 participants for segmentation model development, and 49229 participants in the UK Biobank for association analysis. Methods We matched the vessels extracted from FFA and CF, and used vessels from FFA as labels to train a deep learning model (RMHAS-FA) to segment retinal capillaries using CF. We tested the model's accuracy on a manually labeled internal test set (FundusCapi). For external validation, we tested the segmentation model on 7 vessel segmentation datasets, and investigated the clinical value of the segmented vessels in predicting CVD events in the UK Biobank. Main Outcome Measures Area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, and specificity for segmentation. Hazard ratio (HR; 95% confidence interval [CI]) for Cox regression analysis. Results On the FundusCapi dataset, the segmentation performance was AUC = 0.95, accuracy = 0.94, sensitivity = 0.90, and specificity = 0.93. Smaller vessel skeleton density had a stronger correlation with CVD risk factors and incidence (P < 0.01). Reduced density of small vessel skeletons was strongly associated with an increased risk of CVD incidence and mortality for women (HR [95% CI] = 0.91 [0.84-0.98] and 0.68 [0.54-0.86], respectively). Conclusions Using paired CF-FFA images, we automated the laborious manual labeling process and enabled noninvasive capillary quantification from CF, supporting its potential as a sensitive screening method for identifying individuals at high risk of future CVD events. Financial Disclosures Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
Collapse
Affiliation(s)
- Danli Shi
- School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
- Research Centre for SHARP Vision, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yukun Zhou
- Centre for Medical Image Computing, University College London, London, UK
| | - Shuang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Siegfried K. Wagner
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Yu Huang
- Department of Ophthalmology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China
| | - Pearse A. Keane
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Daniel S.W. Ting
- Singapore National Eye Center, Singapore Eye Research Institute, and Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Lei Zhang
- Faculty of Medicine, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Yingfeng Zheng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Mingguang He
- School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
- Research Centre for SHARP Vision, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
- Department of Ophthalmology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China
| |
Collapse
|
108
|
Xu Z, Davies ER, Yao L, Zhou Y, Li J, Alzetani A, Marshall BG, Hancock D, Wallis T, Downward J, Ewing RM, Davies DE, Jones MG, Wang Y. LKB1 depletion-mediated epithelial-mesenchymal transition induces fibroblast activation in lung fibrosis. Genes Dis 2024; 11:101065. [PMID: 38222900 PMCID: PMC7615521 DOI: 10.1016/j.gendis.2023.06.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 05/29/2023] [Accepted: 06/28/2023] [Indexed: 01/16/2024] Open
Abstract
The factors that determine fibrosis progression or normal tissue repair are largely unknown. We previously demonstrated that autophagy inhibition-mediated epithelial-mesenchymal transition (EMT) in human alveolar epithelial type II (ATII) cells augments local myofibroblast differentiation in pulmonary fibrosis by paracrine signalling. Here, we report that liver kinase B1 (LKB1) inactivation in ATII cells inhibits autophagy and induces EMT as a consequence. In IPF lungs, this is caused by downregulation of CAB39L, a key subunit within the LKB1 complex. 3D co-cultures of ATII cells and MRC5 lung fibroblasts coupled with RNA sequencing (RNA-seq) confirmed that paracrine signalling between LKB1-depleted ATII cells and fibroblasts augmented myofibroblast differentiation. Together these data suggest that reduced autophagy caused by LKB1 inhibition can induce EMT in ATII cells and contribute to fibrosis via aberrant epithelial-fibroblast crosstalk.
Collapse
Affiliation(s)
- Zijian Xu
- Biological Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton SO17 1BJ, UK
| | - Elizabeth R. Davies
- Biological Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton SO17 1BJ, UK
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
| | - Liudi Yao
- Biological Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton SO17 1BJ, UK
| | - Yilu Zhou
- Biological Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton SO17 1BJ, UK
- Institute for Life Sciences, University of Southampton, Southampton SO17 1BJ, UK
| | - Juanjuan Li
- Biological Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton SO17 1BJ, UK
| | - Aiman Alzetani
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton SO16 6YD, UK
- University Hospital Southampton, Southampton SO16 6YD, UK
| | - Ben G. Marshall
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton SO16 6YD, UK
- University Hospital Southampton, Southampton SO16 6YD, UK
| | - David Hancock
- Oncogene Biology, The Francis Crick Institute, London NW1 1AT, UK
| | - Tim Wallis
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton SO16 6YD, UK
- University Hospital Southampton, Southampton SO16 6YD, UK
| | - Julian Downward
- Oncogene Biology, The Francis Crick Institute, London NW1 1AT, UK
| | - Rob M. Ewing
- Biological Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton SO17 1BJ, UK
- Institute for Life Sciences, University of Southampton, Southampton SO17 1BJ, UK
| | - Donna E. Davies
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
- Institute for Life Sciences, University of Southampton, Southampton SO17 1BJ, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton SO16 6YD, UK
| | - Mark G. Jones
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
- Institute for Life Sciences, University of Southampton, Southampton SO17 1BJ, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton SO16 6YD, UK
| | - Yihua Wang
- Biological Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton SO17 1BJ, UK
- Institute for Life Sciences, University of Southampton, Southampton SO17 1BJ, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton SO16 6YD, UK
| |
Collapse
|
109
|
Gill SK, Rose HEL, Wilson M, Rodriguez Gutierrez D, Worthington L, Davies NP, MacPherson L, Hargrave DR, Saunders DE, Clark CA, Payne GS, Leach MO, Howe FA, Auer DP, Jaspan T, Morgan PS, Grundy RG, Avula S, Pizer B, Arvanitis TN, Peet AC. Characterisation of paediatric brain tumours by their MRS metabolite profiles. NMR Biomed 2024; 37:e5101. [PMID: 38303627 DOI: 10.1002/nbm.5101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 11/20/2023] [Accepted: 12/04/2023] [Indexed: 02/03/2024]
Abstract
1H-magnetic resonance spectroscopy (MRS) has the potential to improve the noninvasive diagnostic accuracy for paediatric brain tumours. However, studies analysing large, comprehensive, multicentre datasets are lacking, hindering translation to widespread clinical practice. Single-voxel MRS (point-resolved single-voxel spectroscopy sequence, 1.5 T: echo time [TE] 23-37 ms/135-144 ms, repetition time [TR] 1500 ms; 3 T: TE 37-41 ms/135-144 ms, TR 2000 ms) was performed from 2003 to 2012 during routine magnetic resonance imaging for a suspected brain tumour on 340 children from five hospitals with 464 spectra being available for analysis and 281 meeting quality control. Mean spectra were generated for 13 tumour types. Mann-Whitney U-tests and Kruskal-Wallis tests were used to compare mean metabolite concentrations. Receiver operator characteristic curves were used to determine the potential for individual metabolites to discriminate between specific tumour types. Principal component analysis followed by linear discriminant analysis was used to construct a classifier to discriminate the three main central nervous system tumour types in paediatrics. Mean concentrations of metabolites were shown to differ significantly between tumour types. Large variability existed across each tumour type, but individual metabolites were able to aid discrimination between some tumour types of importance. Complete metabolite profiles were found to be strongly characteristic of tumour type and, when combined with the machine learning methods, demonstrated a diagnostic accuracy of 93% for distinguishing between the three main tumour groups (medulloblastoma, pilocytic astrocytoma and ependymoma). The accuracy of this approach was similar even when data of marginal quality were included, greatly reducing the proportion of MRS excluded for poor quality. Children's brain tumours are strongly characterised by MRS metabolite profiles readily acquired during routine clinical practice, and this information can be used to support noninvasive diagnosis. This study provides both key evidence and an important resource for the future use of MRS in the diagnosis of children's brain tumours.
Collapse
Affiliation(s)
- Simrandip K Gill
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
- Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK
| | - Heather E L Rose
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
- Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK
| | - Martin Wilson
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
- Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK
| | | | - Lara Worthington
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
- Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK
- Department of Imaging and Medical Physics, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Nigel P Davies
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
- Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK
- Department of Imaging and Medical Physics, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | | | - Darren R Hargrave
- Paediatric Oncology Unit, Great Ormond Street Hospital For Sick Children, London, UK
| | - Dawn E Saunders
- Paediatric Oncology Unit, Great Ormond Street Hospital For Sick Children, London, UK
| | - Christopher A Clark
- Developmental Imaging and Biophysics Section, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Geoffrey S Payne
- CRUK Cancer Imaging Centre, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - Martin O Leach
- CRUK Cancer Imaging Centre, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - Franklyn A Howe
- Neurosciences Research Section, Molecular and Clinical Sciences Research Institute, St George's, University of London, London, UK
| | - Dorothee P Auer
- The Children's Brain Tumour Research Centre, University of Nottingham, Nottingham, UK
- Radiological Sciences, Department of Clinical Neuroscience, University of Nottingham, Nottingham, UK
- Neuroradiology, Nottingham University Hospital, Queen's Medical Centre, Nottingham, UK
| | - Tim Jaspan
- The Children's Brain Tumour Research Centre, University of Nottingham, Nottingham, UK
- Neuroradiology, Nottingham University Hospital, Queen's Medical Centre, Nottingham, UK
| | - Paul S Morgan
- Medical Physics, Nottingham University Hospital, Queen's Medical Centre, Nottingham, UK
- The Children's Brain Tumour Research Centre, University of Nottingham, Nottingham, UK
| | - Richard G Grundy
- The Children's Brain Tumour Research Centre, University of Nottingham, Nottingham, UK
| | - Shivaram Avula
- Department of Radiology, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Barry Pizer
- Department of Paediatric Oncology, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Theodoros N Arvanitis
- Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK
- Department of Electronic, Electrical and Systems Engineering, University of Birmingham, Birmingham, UK
| | - Andrew C Peet
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
- Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK
| |
Collapse
|
110
|
Qiu Z, Hu S, Zhao W, Sakaie K, Sun JE, Griswold MA, Jones DK, Ma D. Self-calibrated subspace reconstruction for multidimensional MR fingerprinting for simultaneous relaxation and diffusion quantification. Magn Reson Med 2024; 91:1978-1993. [PMID: 38102776 PMCID: PMC10950540 DOI: 10.1002/mrm.29969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 11/22/2023] [Accepted: 11/27/2023] [Indexed: 12/17/2023]
Abstract
PURPOSE To propose a new reconstruction method for multidimensional MR fingerprinting (mdMRF) to address shading artifacts caused by physiological motion-induced measurement errors without navigating or gating. METHODS The proposed method comprises two procedures: self-calibration and subspace reconstruction. The first procedure (self-calibration) applies temporally local matrix completion to reconstruct low-resolution images from a subset of under-sampled data extracted from the k-space center. The second procedure (subspace reconstruction) utilizes temporally global subspace reconstruction with pre-estimated temporal subspace from low-resolution images to reconstruct aliasing-free, high-resolution, and time-resolved images. After reconstruction, a customized outlier detection algorithm was employed to automatically detect and remove images corrupted by measurement errors. Feasibility, robustness, and scan efficiency were evaluated through in vivo human brain imaging experiments. RESULTS The proposed method successfully reconstructed aliasing-free, high-resolution, and time-resolved images, where the measurement errors were accurately represented. The corrupted images were automatically and robustly detected and removed. Artifact-free T1, T2, and ADC maps were generated simultaneously. The proposed reconstruction method demonstrated robustness across different scanners, parameter settings, and subjects. A high scan efficiency of less than 20 s per slice has been achieved. CONCLUSION The proposed reconstruction method can effectively alleviate shading artifacts caused by physiological motion-induced measurement errors. It enables simultaneous and artifact-free quantification of T1, T2, and ADC using mdMRF scans without prospective gating, with robustness and high scan efficiency.
Collapse
Affiliation(s)
- Zhilang Qiu
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, United States
| | - Siyuan Hu
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, United States
| | - Walter Zhao
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, United States
| | - Ken Sakaie
- Imaging Institute, Cleveland Clinic, Cleveland, Ohio, United States
| | - Jessie E.P. Sun
- Department of Radiology, Case Western Reserve University, Cleveland, Ohio, United States
| | - Mark A. Griswold
- Department of Radiology, Case Western Reserve University, Cleveland, Ohio, United States
| | - Derek K. Jones
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, United Kingdom
| | - Dan Ma
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, United States
| |
Collapse
|
111
|
Mclennan NM, Lindsay R, Saravanan P, Sukumar N, White SL, von Dadelszen P, Burden C, Hunt K, George P, Hirst JE, Lattey K, Lee TTM, Murphy HR, Scott EM, Magee LA, Reynolds RM. Impact of COVID-19 on gestational diabetes pregnancy outcomes in the UK: A multicentre retrospective cohort study. BJOG 2024; 131:858-868. [PMID: 37968246 DOI: 10.1111/1471-0528.17716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 10/22/2023] [Accepted: 10/24/2023] [Indexed: 11/17/2023]
Abstract
OBJECTIVE To determine the impact of implementing emergency care pathway(s) for screening, diagnosing and managing women with gestational diabetes (GDM) during COVID-19. DESIGN Retrospective multicentre cohort. SETTING Nine National Health Service (NHS) Hospital Trusts/Health boards in England and Scotland. POPULATION 4915 women with GDM pre-pandemic (1 April 2018 to 31 March 2020), and 3467 women with GDM during the pandemic (1 May 2020 to 31 March 2021). METHODS We examined clinical outcomes for women with GDM prior to and during the pandemic following changes in screening methods, diagnostic testing, glucose thresholds and introduction of virtual care for monitoring of antenatal glycaemia. MAIN OUTCOME MEASURES Intervention at birth, perinatal mortality, large-for-gestational-age infants and neonatal unit admission. RESULTS The new diagnostic criteria more often identified GDM women who were multiparous, had higher body mass index (BMI) and greater deprivation, and less frequently had previous GDM (all p < 0.05). During COVID, these women had no differences in the key outcome measures. Of the women, 3% were identified with pre-existing diabetes at antenatal booking. Where OGTT continued during COVID, but virtual care was introduced, outcomes were also similar pre- and during the pandemic. CONCLUSIONS Using HbA1c and fasting glucose identified a higher risk GDM population during the pandemic but this had minimal impact on pregnancy outcomes. The high prevalence of undiagnosed pre-existing diabetes suggests that women with GDM risk factors should be offered HbA1c screening in early pregnancy.
Collapse
Affiliation(s)
- Niamh-Maire Mclennan
- Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
- MRC Centre for Reproductive Health, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Robert Lindsay
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | | | - Nithya Sukumar
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Sara L White
- Department of Women and Children's Health, King's College London, London, UK
| | - Peter von Dadelszen
- Department of Women and Children's Health, King's College London, London, UK
| | - Christy Burden
- Academic Women's Health Unit, University of Bristol, Bristol, UK
| | - Kathryn Hunt
- Academic Women's Health Unit, University of Bristol, Bristol, UK
| | - Priya George
- Ninewell's Hospital, University of Dundee, Dundee, UK
| | - Jane E Hirst
- Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK
| | - Katherine Lattey
- Academic Women's Health Unit, University of Bristol, Bristol, UK
| | - Tara T M Lee
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Helen R Murphy
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Eleanor M Scott
- Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Laura A Magee
- Department of Women and Children's Health, King's College London, London, UK
| | - Rebecca M Reynolds
- Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
- MRC Centre for Reproductive Health, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| |
Collapse
|
112
|
Choi D, Goodwin G, Stevens EB, Soliman N, Namer B, Denk F. Spontaneous activity in peripheral sensory nerves: a systematic review. Pain 2024; 165:983-996. [PMID: 37991272 PMCID: PMC11017746 DOI: 10.1097/j.pain.0000000000003115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/29/2023] [Accepted: 09/23/2023] [Indexed: 11/23/2023]
Abstract
ABSTRACT In the peripheral nervous system, spontaneous activity in sensory neurons is considered to be one of the 2 main drivers of chronic pain states, alongside neuronal sensitization. Despite this, the precise nature and timing of this spontaneous activity in neuropathic pain is not well-established. Here, we have performed a systematic search and data extraction of existing electrophysiological literature to shed light on which fibre types have been shown to maintain spontaneous activity and over what time frame. We examined both in vivo recordings of preclinical models of neuropathic pain, as well as microneurography recordings in humans. Our analyses reveal that there is broad agreement on the presence of spontaneous activity in neuropathic pain conditions, even months after injury or years after onset of neuropathic symptoms in humans. However, because of the highly specialised nature of the electrophysiological methods used to measure spontaneous activity, there is also a high degree of variability and uncertainty around these results. Specifically, there are very few directly controlled experiments, with less directly comparable data between human and animals. Given that spontaneous peripheral neuron activity is considered to be a key mechanistic feature of chronic pain conditions, it may be beneficial to conduct further experiments in this space.
Collapse
Affiliation(s)
- Dongchan Choi
- Wolfson Centre for Age-Related Diseases, Guy's Campus, King's College London, London, United Kingdom
| | - George Goodwin
- Wolfson Centre for Age-Related Diseases, Guy's Campus, King's College London, London, United Kingdom
| | - Edward B. Stevens
- Metrion Biosciences Ltd, Building 2 Granta Centre, Granta Park, Cambridge, United Kingdom
| | - Nadia Soliman
- Imperial College London, Pain Research Group, Chelsea and Westminster Hospital, London, United Kingdom
| | - Barbara Namer
- Research Group Neuroscience of the Interdisziplinary Center for Clinical Research, University Hospital of the RWTH Aachen, Aachen, Germany
- Institute for Physiology, University Hospital of the RWTH Aachen, Aachen, Germany
| | - Franziska Denk
- Wolfson Centre for Age-Related Diseases, Guy's Campus, King's College London, London, United Kingdom
| |
Collapse
|
113
|
Hezekiah C, Blakemore AI, Bailey DP, Pazoki R. Physical activity alters the effect of genetic determinants of adiposity on hypertension among individuals of European ancestry in the UKB. Scand J Med Sci Sports 2024; 34:e14636. [PMID: 38671551 DOI: 10.1111/sms.14636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 03/30/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024]
Abstract
Hypertension is a leading risk factor for cardiovascular disease and is modulated by genetic variants. This study aimed to assess the effect of obesity genetic liability and physical activity on hypertension among European and African ancestry individuals within the UK Biobank (UKB). Participants were 230 115 individuals of European ancestry and 3239 individuals of African ancestry from UKB. Genetic liability for obesity were estimated using previously published data including genetic variants and effect sizes for body mass index (BMI), waist-hip ratio (WHR) and waist circumference (WC) using Plink software. The outcome was defined as stage 2 hypertension (systolic blood pressure ≥ 140 mmHg, diastolic blood pressure ≥90 mmHg, or the use of anti-hypertensive medications). The association between obesity genetic liability and the outcome was assessed across categories of self-reported physical activity using logistic regression. Among European ancestry participants, there was up to a 1.2 greater odds of hypertension in individuals with high genetic liability and low physical activity compared to individuals with low genetic liability and high physical activity (p < 0.001). In individuals engaging in low levels of physical activity compared with moderate/high physical activity, the effect of BMI genetic liability on hypertension was greater (p interaction = 0.04). There was no evidence of an association between obesity genetic liability and hypertension in individuals of African ancestry in the whole sample or within separate physical activity groups (p > 0.05). This study suggests that higher physical activity levels are associated with lower odds of stage 2 hypertension among European ancestry individuals who carry high genetic liability for obesity. This cannot be inferred for individuals of African ancestry, possibly due to the low African ancestry sample size within the UKB.
Collapse
Affiliation(s)
- Chukwueloka Hezekiah
- Cardiovascular and Metabolic Research Group, Division of Biomedical Sciences, Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, London, UK
- Department of Mental Health, Faculty of Health, Science, Social Care and Education, Kingston University, Surrey, UK
| | - Alexandra I Blakemore
- Department of Life Sciences, Centre for Cognitive Neuroscience, College of Health, Medicine and Life Sciences, Brunel University London, London, UK
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
- School of Medicine, University of Ireland, Galway, Ireland
| | - Daniel P Bailey
- Centre for Physical Activity in Health and Disease, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Uxbridge, UK
| | - Raha Pazoki
- Cardiovascular and Metabolic Research Group, Division of Biomedical Sciences, Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, London, UK
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| |
Collapse
|
114
|
Ouyang X, Reihill JA, Douglas LEJ, Martin SL. Airborne indoor allergen serine proteases and their contribution to sensitisation and activation of innate immunity in allergic airway disease. Eur Respir Rev 2024; 33:230126. [PMID: 38657996 PMCID: PMC11040391 DOI: 10.1183/16000617.0126-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 02/28/2024] [Indexed: 04/26/2024] Open
Abstract
Common airborne allergens (pollen, animal dander and those from fungi and insects) are the main triggers of type I allergic disorder in the respiratory system and are associated with allergic rhinitis, allergic asthma, as well as immunoglobulin E (IgE)-mediated allergic bronchopulmonary aspergillosis. These allergens promote IgE crosslinking, vasodilation, infiltration of inflammatory cells, mucosal barrier dysfunction, extracellular matrix deposition and smooth muscle spasm, which collectively cause remodelling of the airways. Fungus and insect (house dust mite and cockroaches) indoor allergens are particularly rich in proteases. Indeed, more than 40 different types of aeroallergen proteases, which have both IgE-neutralising and tissue-destructive activities, have been documented in the Allergen Nomenclature database. Of all the inhaled protease allergens, 85% are classed as serine protease activities and include trypsin-like, chymotrypsin-like and collagenolytic serine proteases. In this article, we review and compare the allergenicity and proteolytic effect of allergen serine proteases as listed in the Allergen Nomenclature and MEROPS databases and highlight their contribution to allergic sensitisation, disruption of the epithelial barrier and activation of innate immunity in allergic airways disease. The utility of small-molecule inhibitors of allergen serine proteases as a potential treatment strategy for allergic airways disease will also be discussed.
Collapse
Affiliation(s)
- Xuan Ouyang
- School of Pharmacy, Queen's University Belfast, Belfast, UK
| | | | | | | |
Collapse
|
115
|
Farooq S, Fonseka N, Ali MW, Milner A, Hamid S, Sheikh S, Khan MF, Azeemi MMUH, Ariyadasa G, Khan AJ, Ayub M. Early Intervention in Psychosis and Management of First Episode Psychosis in Low- and Lower-Middle-Income Countries: A Systematic Review. Schizophr Bull 2024; 50:521-532. [PMID: 38525604 PMCID: PMC11059814 DOI: 10.1093/schbul/sbae025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Abstract
BACKGROUND AND HYPOTHESIS People with first-episode psychosis (FEP) in low- and lower-middle-income countries (LMIC) experience delays in receiving treatment, resulting in poorer outcomes and higher mortality. There is robust evidence for effective and cost-effective early intervention in psychosis (EIP) services for FEP, but the evidence for EIP in LMIC has not been reviewed. We aim to review the evidence on early intervention for the management of FEP in LMIC. STUDY DESIGN We searched 4 electronic databases (Medline, Embase, PsycINFO, and CINAHL) to identify studies describing EIP services and interventions to treat FEP in LMIC published from 1980 onward. The bibliography of relevant articles was hand-searched. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. STUDY RESULTS The search strategy produced 5074 records; we included 18 studies with 2294 participants from 6 LMIC countries. Thirteen studies (1553 participants) described different approaches for EIP. Pharmacological intervention studies (n = 4; 433 participants) found a high prevalence of metabolic syndrome among FEP receiving antipsychotics (P ≤ .005). One study found a better quality of life in patients using injectables compared to oral antipsychotics (P = .023). Among the non-pharmacological interventions (n = 3; 308 participants), SMS reminders improved treatment engagement (OR = 1.80, CI = 1.02-3.19). The methodological quality of studies evidence was relatively low. CONCLUSIONS The limited evidence showed that EIP can be provided in LMIC with adaptations for cultural factors and limited resources. Adaptations included collaboration with traditional healers, involving nonspecialist healthcare professionals, using mobile technology, considering the optimum use of long-acting antipsychotics, and monitoring antipsychotic side effects.
Collapse
Affiliation(s)
- Saeed Farooq
- School of Medicine, Faculty of Medicine and Health Sciences, Keele University, Staffordshire, UK
- Research and Innovation Department, Midlands Partnership NHS Foundation Trust, St George’s Hospital, Stafford, UK
| | - Nishani Fonseka
- School of Medicine, Faculty of Medicine and Health Sciences, Keele University, Staffordshire, UK
| | - Malik Wajid Ali
- Armed Forces, Institute of Mental Health, Rawalpindi, Pakistan
| | - Abbie Milner
- School of Medicine, Faculty of Medicine and Health Sciences, Keele University, Staffordshire, UK
| | - Shumaila Hamid
- Public Health Department, Institute of Public Health & Social Sciences, Khyber Medical University, Peshawar, Pakistan
| | - Saima Sheikh
- School of Medicine, Faculty of Medicine and Health Sciences, Keele University, Staffordshire, UK
| | - Muhammad Firaz Khan
- Institute of Mental Health & Behavioral Sciences, Khyber Medical University, Peshawar, Pakistan
| | | | - Gayan Ariyadasa
- School of Medicine, Faculty of Medicine and Health Sciences, Keele University, Staffordshire, UK
| | - Abdul Jalil Khan
- Department of Family Medicine, Institute of Public Health and Social Sciences, Khyber Medical University, Peshawar, Pakistan
| | - Muhammad Ayub
- Department of Psychiatry, Queen’s University, Kingston, Canada
- Primary Department of Psychiatry, University College London, London
| |
Collapse
|
116
|
Li Y, Kong Y, Hu Y, Li Y, Asrosa R, Zhang W, Deka Boruah B, Yetisen AK, Davenport A, Lee TC, Li B. A paper-based dual functional biosensor for safe and user-friendly point-of-care urine analysis. Lab Chip 2024; 24:2454-2467. [PMID: 38644805 PMCID: PMC11060138 DOI: 10.1039/d4lc00163j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 04/10/2024] [Indexed: 04/23/2024]
Abstract
Safe, accurate, and reliable analysis of urinary biomarkers is clinically important for early detection and monitoring of the progression of chronic kidney disease (CKD), as it has become one of the world's most prevalent non-communicable diseases. However, current technologies for measuring urinary biomarkers are either time-consuming and limited to well-equipped hospitals or lack the necessary sensitivity for quantitative analysis and post a health risk to frontline practitioners. Here we report a robust paper-based dual functional biosensor, which is integrated with the clinical urine sampling vial, for the simultaneous and quantitative analysis of pH and glucose in urine. The pH sensor was fabricated by electrochemically depositing IrOx onto a paper substrate using optimised parameters, which enabled an ultrahigh sensitivity of 71.58 mV pH-1. Glucose oxidase (GOx) was used in combination with an electrochemically deposited Prussian blue layer for the detection of glucose, and its performance was enhanced by gold nanoparticles (AuNPs), chitosan, and graphite composites, achieving a sensitivity of 1.5 μA mM-1. This dual function biosensor was validated using clinical urine samples, where a correlation coefficient of 0.96 for pH and 0.98 for glucose detection was achieved with commercial methods as references. More importantly, the urine sampling vial was kept sealed throughout the sample-to-result process, which minimised the health risk to frontline practitioners and simplified the diagnostic procedures. This diagnostic platform, therefore, holds high promise as a rapid, accurate, safe, and user-friendly point-of-care (POC) technology for the analysis of urinary biomarkers in frontline clinical settings.
Collapse
Affiliation(s)
- Yujia Li
- Institute for Materials Discovery, University College London, London, WC1E 7JE, UK.
- Department of Chemistry, University College London, London, WC1E 7JE, UK
| | - Yingqi Kong
- Institute for Materials Discovery, University College London, London, WC1E 7JE, UK.
- Department of Chemistry, University College London, London, WC1E 7JE, UK
| | - Yubing Hu
- Department of Chemical Engineering, Imperial College London, London, SW7 2AZ, UK
| | - Yixuan Li
- Institute for Materials Discovery, University College London, London, WC1E 7JE, UK.
- Department of Chemistry, University College London, London, WC1E 7JE, UK
| | - Rica Asrosa
- Institute for Materials Discovery, University College London, London, WC1E 7JE, UK.
- Department of Chemistry, University College London, London, WC1E 7JE, UK
- Department of Physics, Faculty of Mathematics and Natural Science, Universitas Sumatera Utara, Medan 20155, Sumatera Utara, Indonesia
| | - Wenyu Zhang
- Department of Materials, University of Oxford, Parks Road, Oxford, OX1 3PH, UK
| | - Buddha Deka Boruah
- Institute for Materials Discovery, University College London, London, WC1E 7JE, UK.
| | - Ali K Yetisen
- Department of Chemical Engineering, Imperial College London, London, SW7 2AZ, UK
| | - Andrew Davenport
- UCL Department of Renal Medicine, Royal Free Hospital, University College London, Rowland Hill Street, London, NW3 2PF, UK
| | - Tung-Chun Lee
- Institute for Materials Discovery, University College London, London, WC1E 7JE, UK.
| | - Bing Li
- Institute for Materials Discovery, University College London, London, WC1E 7JE, UK.
| |
Collapse
|
117
|
Gobin R, Thomas T, Goberdhan S, Sharma M, Nasiiro R, Emmanuel R, Rambaran M, McFarlane S, Elia C, Van-Veen D, Govia I, Palmer T, Read U, Cruickshank JK, Samuels TA, Wilks R, Harding S. Readiness of primary care centres for a community-based intervention to prevent and control noncommunicable diseases in the Caribbean: A participatory, mixed-methods study. PLoS One 2024; 19:e0301503. [PMID: 38683831 PMCID: PMC11057736 DOI: 10.1371/journal.pone.0301503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 03/15/2024] [Indexed: 05/02/2024] Open
Abstract
INTRODUCTION Epidemiological transition to NCDs is a challenge for fragile health systems in the Caribbean. The Congregations Taking Action against NCDs (CONTACT) Study intervention proposes that trained health advocates (HAs) from places of worship (PoWs), supervised by nurses at nearby primary healthcare centres (PHCs), could facilitate access to primary care among vulnerable communities. Drawing on participatory and systems thinking, we explored the capacity of local PHCs in three Caribbean countries to support this intervention. METHODS Communities in Jamaica (rural, urban), Guyana (rural) and Dominica (Indigenous Kalinago Territory) were selected for CONTACT because of their differing socio-economic, cultural, religious and health system contexts. Through mixed-method concept mapping, we co-developed a list of perceived actionable priorities (possible intervention points ranked highly for feasibility and importance) with 48 policy actors, healthcare practitioners and civic society representatives. Guided in part by the concept mapping findings, we assessed the readiness of 12 purposefully selected PHCs for the intervention, using a staff questionnaire and an observation checklist to identify enablers and constrainers. RESULTS Concept mapping illustrated stakeholder optimism for the intervention, but revealed perceptions of inadequate primary healthcare service capacity, resources and staff training to support implementation. Readiness assessments of PHCs identified potential enablers and constrainers that were consistent with concept mapping results. Staff support was evident. Constraints included under-staffing, which could hinder supervision of HAs; and inadequate essential NCD medicines, training in NCDs and financial and policy support for embedding community interventions. Despite a history of socio-political disadvantage, the most enabling context was found in the Kalinago Territory, where ongoing community engagement activities could support joint development of programmes between churches and PHCs. CONCLUSION Multi-sectoral stakeholder consultation and direct PHC assessments revealed viability of the proposed POW-PHC partnership for NCD prevention and control. However, structural and policy support will be key for implementing change.
Collapse
Affiliation(s)
- Reeta Gobin
- College of Medical Sciences, University of Guyana, Georgetown, Guyana
| | - Troy Thomas
- Faculty of Natural Sciences, University of Guyana, Georgetown, Guyana
| | | | - Manoj Sharma
- College of Medical Sciences, University of Guyana, Georgetown, Guyana
| | | | - Rosana Emmanuel
- School of Life Course and Population Sciences, King’s College London, London, United Kingdom
| | - Madan Rambaran
- Institute of Health Science Education, Georgetown Public Hospital Corporation, Georgetown, Guyana
| | - Shelly McFarlane
- Caribbean Institute for Health Research, University of the West Indies, Kingston, Jamaica
| | | | - Davon Van-Veen
- College of Medical Sciences, University of Guyana, Georgetown, Guyana
| | - Ishtar Govia
- Caribbean Institute for Health Research, University of the West Indies, Kingston, Jamaica
| | - Tiffany Palmer
- Caribbean Institute for Health Research, University of the West Indies, Kingston, Jamaica
| | | | - J. Kennedy Cruickshank
- School of Life Course and Population Sciences, King’s College London, London, United Kingdom
| | - T. Alafia Samuels
- Caribbean Institute for Health Research, University of the West Indies, Kingston, Jamaica
| | - Rainford Wilks
- Caribbean Institute for Health Research, University of the West Indies, Kingston, Jamaica
| | - Seeromanie Harding
- School of Life Course and Population Sciences, King’s College London, London, United Kingdom
| |
Collapse
|
118
|
Huang S, Marsh JW, White JRG, Ha TQ, Twigger SA, Diez-Perez I, Sedgwick AC. A colorimetric approach for monitoring the reduction of platinum(iv) complexes in aqueous solution. NEW J CHEM 2024; 48:7548-7551. [PMID: 38689796 PMCID: PMC11057408 DOI: 10.1039/d4nj00859f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 04/09/2024] [Indexed: 05/02/2024]
Abstract
We report the synthesis of 4-nitrophenyl (4-NP) functionalised Pt(iv) complexes as a colorimetric strategy for monitoring Pt(iv) reduction in aqueous solution. Treatment of each 4-NP functionalised Pt(iv) complex with the biological reductant sodium ascorbate led to a colour change from clear to yellow, which was attributed to the reduction of Pt(iv) to Pt(ii) and simultaneous release of 4-nitroaniline. Trends in reduction profiles and a photocatalysed reduction for each Pt(iv) complex were observed.
Collapse
Affiliation(s)
- Shitong Huang
- Chemistry Research Laboratory, University of Oxford Mansfield Road OX1 3TA UK
| | - Jevon W Marsh
- Chemistry Research Laboratory, University of Oxford Mansfield Road OX1 3TA UK
| | - Jhanelle R G White
- Department of Chemistry, King's College London 7 Trinity Street London SE1 1DB UK
| | - Tracy Q Ha
- Department of Chemistry, King's College London 7 Trinity Street London SE1 1DB UK
| | - Sophie A Twigger
- Department of Oncology, University of Oxford Old Road Campus Research Building Oxford OX3 7DQ UK
| | - Ismael Diez-Perez
- Department of Chemistry, King's College London 7 Trinity Street London SE1 1DB UK
| | - Adam C Sedgwick
- Chemistry Research Laboratory, University of Oxford Mansfield Road OX1 3TA UK
- Department of Chemistry, King's College London 7 Trinity Street London SE1 1DB UK
| |
Collapse
|
119
|
Alix JJP, Plesia M, Dudgeon AP, Kendall CA, Hewamadduma C, Hadjivassiliou M, Gorman GS, Taylor RW, McDermott CJ, Shaw PJ, Mead RJ, Day JC. Conformational fingerprinting with Raman spectroscopy reveals protein structure as a translational biomarker of muscle pathology. Analyst 2024; 149:2738-2746. [PMID: 38533726 PMCID: PMC11056770 DOI: 10.1039/d4an00320a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 03/11/2024] [Indexed: 03/28/2024]
Abstract
Neuromuscular disorders are a group of conditions that can result in weakness of skeletal muscles. Examples include fatal diseases such as amyotrophic lateral sclerosis and conditions associated with high morbidity such as myopathies (muscle diseases). Many of these disorders are known to have abnormal protein folding and protein aggregates. Thus, easy to apply methods for the detection of such changes may prove useful diagnostic biomarkers. Raman spectroscopy has shown early promise in the detection of muscle pathology in neuromuscular disorders and is well suited to characterising the conformational profiles relating to protein secondary structure. In this work, we assess if Raman spectroscopy can detect differences in protein structure in muscle in the setting of neuromuscular disease. We utilise in vivo Raman spectroscopy measurements from preclinical models of amyotrophic lateral sclerosis and the myopathy Duchenne muscular dystrophy, together with ex vivo measurements of human muscle samples from individuals with and without myopathy. Using quantitative conformation profiling and matrix factorisation we demonstrate that quantitative 'conformational fingerprinting' can be used to identify changes in protein folding in muscle. Notably, myopathic conditions in both preclinical models and human samples manifested a significant reduction in α-helix structures, with concomitant increases in β-sheet and, to a lesser extent, nonregular configurations. Spectral patterns derived through non-negative matrix factorisation were able to identify myopathy with a high accuracy (79% in mouse, 78% in human tissue). This work demonstrates the potential of conformational fingerprinting as an interpretable biomarker for neuromuscular disorders.
Collapse
Affiliation(s)
- James J P Alix
- Sheffield Institute for Translational Neuroscience, University of Sheffield, UK.
- Neuroscience Institute, University of Sheffield, Western Bank, Sheffield, UK
- National Institute for Health and Care Research Sheffield Biomedical Research Centre, Sheffield, UK
| | - Maria Plesia
- Sheffield Institute for Translational Neuroscience, University of Sheffield, UK.
| | - Alexander P Dudgeon
- Biophotonics Research Unit, Gloucestershire Hospitals NHS Foundation Trust, UK
- Department of Physics and Astronomy, University of Exeter, UK
| | - Catherine A Kendall
- Biophotonics Research Unit, Gloucestershire Hospitals NHS Foundation Trust, UK
| | - Channa Hewamadduma
- National Institute for Health and Care Research Sheffield Biomedical Research Centre, Sheffield, UK
- Department of Neurology, Academic Directorate of Neurosciences, Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, UK
| | - Marios Hadjivassiliou
- National Institute for Health and Care Research Sheffield Biomedical Research Centre, Sheffield, UK
- Department of Neurology, Academic Directorate of Neurosciences, Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, UK
| | - Gráinne S Gorman
- Wellcome Centre for Mitochondrial Research, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- NHS Highly Specialised Service for Rare Mitochondrial Disorders, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
- National Institute for Health and Care Research Newcastle Biomedical Research Centre, Newcastle upon Tyne, UK
| | - Robert W Taylor
- Wellcome Centre for Mitochondrial Research, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- NHS Highly Specialised Service for Rare Mitochondrial Disorders, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Christopher J McDermott
- Sheffield Institute for Translational Neuroscience, University of Sheffield, UK.
- Neuroscience Institute, University of Sheffield, Western Bank, Sheffield, UK
- National Institute for Health and Care Research Sheffield Biomedical Research Centre, Sheffield, UK
| | - Pamela J Shaw
- Sheffield Institute for Translational Neuroscience, University of Sheffield, UK.
- Neuroscience Institute, University of Sheffield, Western Bank, Sheffield, UK
- National Institute for Health and Care Research Sheffield Biomedical Research Centre, Sheffield, UK
| | - Richard J Mead
- Sheffield Institute for Translational Neuroscience, University of Sheffield, UK.
- Neuroscience Institute, University of Sheffield, Western Bank, Sheffield, UK
| | - John C Day
- Interface Analysis Centre, School of Physics, University of Bristol, UK
| |
Collapse
|
120
|
Bettini A, Patrick PS, Day RM, Stuckey DJ. CT-Visible Microspheres Enable Whole-Body In Vivo Tracking of Injectable Tissue Engineering Scaffolds. Adv Healthc Mater 2024:e2303588. [PMID: 38678393 DOI: 10.1002/adhm.202303588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 02/27/2024] [Indexed: 04/30/2024]
Abstract
Targeted delivery and retention are essential requirements for implantable tissue-engineered products. Non-invasive imaging methods that can confirm location, retention, and biodistribution of transplanted cells attached to implanted tissue engineering scaffolds will be invaluable for the optimization and enhancement of regenerative therapies. To address this need, an injectable tissue engineering scaffold consisting of highly porous microspheres compatible with transplantation of cells is modified to contain the computed tomography (CT) contrast agent barium sulphate (BaSO4). The trackable microspheres show high x-ray absorption, with contrast permitting whole-body tracking. The microspheres are cellularized with GFP+ Luciferase+ mesenchymal stem cells and show in vitro biocompatibility. In vivo, cellularized BaSO4-loaded microspheres are delivered into the hindlimb of mice where they remain viable for 14 days. Co-registration of 3D-bioluminescent imaging and µCT reconstructions enable the assessment of scaffold material and cell co-localization. The trackable microspheres are also compatible with minimally-invasive delivery by ultrasound-guided transthoracic intramyocardial injections in rats. These findings suggest that BaSO4-loaded microspheres can be used as a novel tool for optimizing delivery techniques and tracking persistence and distribution of implanted scaffold materials. Additionally, the microspheres can be cellularized and have the potential to be developed into an injectable tissue-engineered combination product for cardiac regeneration.
Collapse
Affiliation(s)
- Annalisa Bettini
- Centre for Advanced Biomedical Imaging, Division of Medicine, University College London, London, WC1E 6DD, UK
- Centre for Precision Healthcare, Division of Medicine, University College London, London, WC1E 6JF, UK
| | - Peter Stephen Patrick
- Centre for Advanced Biomedical Imaging, Division of Medicine, University College London, London, WC1E 6DD, UK
| | - Richard M Day
- Centre for Precision Healthcare, Division of Medicine, University College London, London, WC1E 6JF, UK
| | - Daniel J Stuckey
- Centre for Advanced Biomedical Imaging, Division of Medicine, University College London, London, WC1E 6DD, UK
| |
Collapse
|
121
|
Alpaslan M, Fastré E, Mestre S, van Haeringen A, Repetto GM, Keymolen K, Boon LM, Belva F, Giacalone G, Revencu N, Sznajer Y, Riches K, Keeley V, Mansour S, Gordon K, Martin-Almedina S, Dobbins S, Ostergaard P, Quere I, Brouillard P, Vikkula M. Pathogenic variants in HGF give rise to childhood-to-late onset primary lymphoedema by loss of function. Hum Mol Genet 2024:ddae060. [PMID: 38676400 DOI: 10.1093/hmg/ddae060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 03/01/2024] [Accepted: 03/19/2024] [Indexed: 04/28/2024] Open
Abstract
Developmental and functional defects in the lymphatic system are responsible for primary lymphoedema (PL). PL is a chronic debilitating disease caused by increased accumulation of interstitial fluid, predisposing to inflammation, infections and fibrosis. There is no cure, only symptomatic treatment is available. Thirty-two genes or loci have been linked to PL, and another 22 are suggested, including Hepatocyte Growth Factor (HGF). We searched for HGF variants in 770 index patients from the Brussels PL cohort. We identified ten variants predicted to cause HGF loss-of-function (six nonsense, two frameshifts, and two splice-site changes; 1.3% of our cohort), and 14 missense variants predicted to be pathogenic in 17 families (2.21%). We studied co-segregation within families, mRNA stability for non-sense variants, and in vitro functional effects of the missense variants. Analyses of the mRNA of patient cells revealed degradation of the nonsense mutant allele. Reduced protein secretion was detected for nine of the 14 missense variants expressed in COS-7 cells. Stimulation of lymphatic endothelial cells with these 14 HGF variant proteins resulted in decreased activation of the downstream targets AKT and ERK1/2 for three of them. Clinically, HGF-associated PL was diverse, but predominantly bilateral in the lower limbs with onset varying from early childhood to adulthood. Finally, aggregation study in a second independent cohort underscored that rare likely pathogenic variants in HGF explain about 2% of PL. Therefore, HGF signalling seems crucial for lymphatic development and/or maintenance in human beings and HGF should be included in diagnostic genetic screens for PL.
Collapse
Affiliation(s)
- Murat Alpaslan
- Human Molecular Genetics, de Duve Institute, University of Louvain, Avenue Hippocrate 74, Brussels 1200, Belgium
| | - Elodie Fastré
- Human Molecular Genetics, de Duve Institute, University of Louvain, Avenue Hippocrate 74, Brussels 1200, Belgium
| | - Sandrine Mestre
- Department of vascular medicine, Hospital Saint-Eloi, University Hospital of Montpellier, Avenue Augustin Fliche 80, Montpellier 34090, France
| | - Arie van Haeringen
- Leiden University Medical Center, Albinusdreef 2, Leiden 2333, the Netherlands
| | - Gabriela M Repetto
- Clinica Alemana Universidad del Desarrollo, Av Plaza 680, Las Condes, Lo Barnechea, Región Metropolitana 7710167, Chile
| | - Kathelijn Keymolen
- Clinical Sciences, Research Group Reproduction and Genetics, Centre for Medical Genetics, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, Brussels 1090, Belgium
| | - Laurence M Boon
- Center for Vascular Anomalies, Division of Plastic Surgery, Cliniques Universitaires Saint-Luc, University of Louvain, Avenue Hippocrate 10, Brussels 1200, Belgium
| | - Florence Belva
- Department of Lymphatic Surgery, AZ Sint-Maarten Hospital, VASCERN PPL European Reference Centre, Liersesteenweg 435, Mechelen 2800, Belgium
| | - Guido Giacalone
- Department of Lymphatic Surgery, AZ Sint-Maarten Hospital, VASCERN PPL European Reference Centre, Liersesteenweg 435, Mechelen 2800, Belgium
| | - Nicole Revencu
- Center for Human Genetics, Cliniques Universitaires Saint-Luc, University of Louvain, Avenue Hippocrate 10, Brussels 1200, Belgium
| | - Yves Sznajer
- Center for Human Genetics, Cliniques Universitaires Saint-Luc, University of Louvain, Avenue Hippocrate 10, Brussels 1200, Belgium
| | - Katie Riches
- University Hospitals of Derby and Burton NHS Foundation Trust, Uttoxeter Rd, Derby DE22 3NE, United Kingdom
| | - Vaughan Keeley
- University Hospitals of Derby and Burton NHS Foundation Trust, Uttoxeter Rd, Derby DE22 3NE, United Kingdom
- University of Nottingham Medical School, Nottingham, East Block, Lenton, Nottingham NG7 2UH, United Kingdom
| | - Sahar Mansour
- Cardiovascular and Genomics Research Institute, St. George's University of London, Blackshaw Rd, London SW17 0QT, United Kingdom
- South West Thames Regional Centre for Genomics, St. George's Universities Hospitals NHS Foundation Trust, Blackshaw Rd, London SW17 0QT, United Kingdom
| | - Kristiana Gordon
- Cardiovascular and Genomics Research Institute, St. George's University of London, Blackshaw Rd, London SW17 0QT, United Kingdom
- Dermatology and Lymphovascular Medicine, St. George's Universities NHS Foundation Trust, Blackshaw Rd, London SW17 0QT, United Kingdom
| | - Silvia Martin-Almedina
- Cardiovascular and Genomics Research Institute, St. George's University of London, Blackshaw Rd, London SW17 0QT, United Kingdom
| | - Sara Dobbins
- Cardiovascular and Genomics Research Institute, St. George's University of London, Blackshaw Rd, London SW17 0QT, United Kingdom
| | - Pia Ostergaard
- Cardiovascular and Genomics Research Institute, St. George's University of London, Blackshaw Rd, London SW17 0QT, United Kingdom
| | - Isabelle Quere
- Department of vascular medicine, Hospital Saint-Eloi, University Hospital of Montpellier, Avenue Augustin Fliche 80, Montpellier 34090, France
| | - Pascal Brouillard
- Human Molecular Genetics, de Duve Institute, University of Louvain, Avenue Hippocrate 74, Brussels 1200, Belgium
| | - Miikka Vikkula
- Human Molecular Genetics, de Duve Institute, University of Louvain, Avenue Hippocrate 74, Brussels 1200, Belgium
- WELBIO Department, WEL Research Institute, Avenue Pasteur, 6, Wavre 1300, Belgium
| |
Collapse
|
122
|
Holland N, Savulich G, Jones PS, Whiteside DJ, Street D, Swann P, Naessens M, Malpetti M, Hong YT, Fryer TD, Rittman T, Mulroy E, Aigbirhio FI, Bhatia KP, O'Brien JT, Rowe JB. Differential Synaptic Loss in β-Amyloid Positive Versus β-Amyloid Negative Corticobasal Syndrome. Mov Disord 2024. [PMID: 38671545 DOI: 10.1002/mds.29814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 03/12/2024] [Accepted: 03/29/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND/OBJECTIVE The corticobasal syndrome (CBS) is a complex asymmetric movement disorder, with cognitive impairment. Although commonly associated with the primary 4-repeat-tauopathy of corticobasal degeneration, clinicopathological correlation is poor, and a significant proportion is due to Alzheimer's disease (AD). Synaptic loss is a pathological feature of many clinical and preclinical tauopathies. We therefore measured the degree of synaptic loss in patients with CBS and tested whether synaptic loss differed according to β-amyloid status. METHODS Twenty-five people with CBS, and 32 age-/sex-/education-matched healthy controls participated. Regional synaptic density was estimated by [11C]UCB-J non-displaceable binding potential (BPND), AD-tau pathology by [18F]AV-1451 BPND, and gray matter volume by T1-weighted magnetic resonance imaging. Participants with CBS had β-amyloid imaging with 11C-labeled Pittsburgh Compound-B ([11C]PiB) positron emission tomography. Symptom severity was assessed with the progressive supranuclear palsy-rating-scale, the cortical basal ganglia functional scale, and the revised Addenbrooke's Cognitive Examination. Regional differences in BPND and gray matter volume between groups were assessed by ANOVA. RESULTS Compared to controls, patients with CBS had higher [18F]AV-1451 uptake, gray matter volume loss, and reduced synaptic density. Synaptic loss was more severe and widespread in the β-amyloid negative group. Asymmetry of synaptic loss was in line with the clinically most affected side. DISCUSSION Distinct patterns of [11C]UCB-J and [18F]AV-1451 binding and gray matter volume loss, indicate differences in the pathogenic mechanisms of CBS according to whether it is associated with the presence of Alzheimer's disease or not. This highlights the potential for different therapeutic strategies in CBSs. © 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
Collapse
Affiliation(s)
- Negin Holland
- Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - George Savulich
- Department of Psychiatry, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - P Simon Jones
- Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - David J Whiteside
- Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Duncan Street
- Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Peter Swann
- Department of Psychiatry, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Michelle Naessens
- Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Maura Malpetti
- Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Young T Hong
- Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Wolfson Brain Imaging Centre, University of Cambridge, Cambridge, United Kingdom
| | - Tim D Fryer
- Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Wolfson Brain Imaging Centre, University of Cambridge, Cambridge, United Kingdom
| | - Timothy Rittman
- Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Eoin Mulroy
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Franklin I Aigbirhio
- Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Kailash P Bhatia
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - John T O'Brien
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
- Department of Psychiatry, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - James B Rowe
- Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom
| |
Collapse
|
123
|
Vignesh V, Castro-Dominguez B, James TD, Gamble-Turner JM, Lightman S, Reis NM. Advancements in Cortisol Detection: From Conventional Methods to Next-Generation Technologies for Enhanced Hormone Monitoring. ACS Sens 2024; 9:1666-1681. [PMID: 38551608 PMCID: PMC11059103 DOI: 10.1021/acssensors.3c01912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 01/22/2024] [Accepted: 03/08/2024] [Indexed: 05/02/2024]
Abstract
The hormone cortisol, released as the end-product of the hypothalamic-pituitary-adrenal (HPA) axis, has a well-characterized circadian rhythm that enables an allostatic response to external stressors. When the pattern of secretion is disrupted, cortisol levels are chronically elevated, contributing to diseases such as heart attacks, strokes, mental health disorders, and diabetes. The diagnosis of chronic stress and stress related disorders depends upon accurate measurement of cortisol levels; currently, it is quantified using mass spectroscopy or immunoassay, in specialized laboratories with trained personnel. However, these methods are time-consuming, expensive and are unable to capture the dynamic biorhythm of the hormone. This critical review traces the path of cortisol detection from traditional laboratory-based methods to decentralised cortisol monitoring biosensors. A complete picture of cortisol biology and pathophysiology is provided, and the importance of precision medicine style monitoring of cortisol is highlighted. Antibody-based immunoassays still dominate the pipeline of development of point-of-care biosensors; new capture molecules such as aptamers and molecularly imprinted polymers (MIPs) combined with technologies such as microfluidics, wearable electronics, and quantum dots offer improvements to limit of detection (LoD), specificity, and a shift toward rapid or continuous measurements. While a variety of different sensors and devices have been proposed, there still exists a need to produce quantitative tests for cortisol ─ using either rapid or continuous monitoring devices that can enable a personalized medicine approach to stress management. This can be addressed by synergistic combinations of technologies that can leverage low sample volumes, relevant limit of detection and rapid testing time, to better account for cortisol's shifting biorhythm. Trends in cortisol diagnostics toward rapid and continuous monitoring of hormones are highlighted, along with insights into choice of sample matrix.
Collapse
Affiliation(s)
- Visesh Vignesh
- Department
of Chemical Engineering and Centre for Bioengineering and Biomedical
Technologies (CBio) University of Bath, BA2 7AY Bath, U.K.
| | - Bernardo Castro-Dominguez
- Department
of Chemical and Engineering and Digital Manufacturing and Design University
of Bath, BA2 7AY Bath, U.K.
| | - Tony D. James
- Department
of Chemistry, University of Bath, BA2 7AY Bath, U.K.
| | | | - Stafford Lightman
- Translational
Health Sciences, Bristol Medical School, University of Bristol, BS1 3NY Bristol, U.K.
| | - Nuno M. Reis
- Department
of Chemical Engineering and Centre for Bioengineering and Biomedical
Technologies (CBio) University of Bath, BA2 7AY Bath, U.K.
| |
Collapse
|
124
|
Doostdar P, Hawley J, Chopra K, Marinopoulou E, Lea R, Arashvand K, Biga V, Papalopulu N, Rodriguez XS. Cell coupling compensates for changes in single-cell Her6 dynamics and provides phenotypic robustness. Development 2024:dev.202640. [PMID: 38682303 DOI: 10.1242/dev.202640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 04/17/2024] [Indexed: 05/01/2024]
Abstract
We investigate the effect of altering the protein expression dynamics of the bHLH transcription factor Her6 at the single-cell level in the embryonic zebrafish telencephalon. Using an homozygote endogenous Her6:Venus reporter and 4D single-cell tracking, we show that Her6 oscillates in neural telencephalic progenitors and that fusion of protein destabilisation domain (PEST) alters its expression dynamics, causing most cells to downregulate Her6 prematurely. However, counterintuitively, oscillatory cells increase with some expressing Her6 at high levels, resulting in increased heterogeneity of Her6 expression in the population. These tissue-levels changes appear to be an emergent property of coupling between single-cells as revealed by experimentally disrupting Notch signalling and by computationally modelling alterations in Her6 protein stability. Despite the profound differences in the single-cell Her6 dynamics, the size of the telencephalon is only transiently altered, and differentiation markers do not exhibit significant differences early on, while a small increase is observed at later developmental stages. Our study suggests that cell coupling provides a compensation strategy, whereby an almost normal phenotype is maintained even though single-cell gene expression dynamics are abnormal, granting phenotypic robustness.
Collapse
Affiliation(s)
- Parnian Doostdar
- Division of Developmental Biology and Medicine, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester, M13 9PT, UK
| | - Joshua Hawley
- Division of Developmental Biology and Medicine, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester, M13 9PT, UK
| | - Kunal Chopra
- Division of Developmental Biology and Medicine, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester, M13 9PT, UK
| | - Elli Marinopoulou
- Division of Developmental Biology and Medicine, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester, M13 9PT, UK
| | - Robert Lea
- Division of Developmental Biology and Medicine, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester, M13 9PT, UK
| | - Kiana Arashvand
- Division of Molecular and Cellular Function, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester, M13 9PT, UK
| | - Veronica Biga
- Division of Developmental Biology and Medicine, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester, M13 9PT, UK
| | - Nancy Papalopulu
- Division of Developmental Biology and Medicine, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester, M13 9PT, UK
| | - Ximena Soto Rodriguez
- Division of Molecular and Cellular Function, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester, M13 9PT, UK
| |
Collapse
|
125
|
Magill N, Shivalli S, Fazzio I, Elbourne D, Keddie S, Reddy P, Nair R, Gopal M, Karnati S, Reddy H, Boone P, Frost C. Statistical analysis plan for a cluster randomised trial in Madhya Pradesh, India: community health promotion and medical provision and impact on neonates (CHAMPION2). Trials 2024; 25:280. [PMID: 38664772 PMCID: PMC11045454 DOI: 10.1186/s13063-024-08056-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 03/11/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Neonatal mortality in India has fallen steadily and was estimated to be 24 per 1000 live births in the year 2017. However, neonatal mortality remains high in rural parts of the country. The Community Health Promotion and Medical Provision and Impact On Neonates (CHAMPION2) trial investigates the effect of a complex health intervention on neonatal mortality in the Satna District of Madhya Pradesh. METHODS/DESIGN The CHAMPION2 trial forms one part of a cluster-randomised controlled trial with villages (clusters) randomised to receive either a health (CHAMPION2) or education (STRIPES2) intervention. Villages receiving the health intervention are controls for the education intervention and vice versa. The primary outcome is neonatal mortality. The effect of the active intervention on the primary outcome (compared to usual care) will be expressed as a risk ratio, estimated using a generalised estimating equation approach with robust standard errors that take account of clustering at village level. Secondary outcomes include maternal mortality, stillbirths, perinatal deaths, causes of death, health care and knowledge, hospital admissions of enrolled women during pregnancy or in the immediate post-natal care period or of their babies (during the neonatal period), maternal blood transfusions, and the cost effectiveness of the intervention. A total of 196 villages have been randomised and over 34,000 women have been recruited in CHAMPION2. DISCUSSION This update to the published trial protocol gives a detailed plan for the statistical analysis of the CHAMPION2 trial. TRIAL REGISTRATION Registry of India: CTRI/2019/05/019296. Registered on 23 May 2019. https://ctri.nic.in/Clinicaltrials/pmaindet2.php?EncHid=MzExOTg=&Enc=&userName=champion2.
Collapse
Affiliation(s)
| | | | | | - Diana Elbourne
- London School of Hygiene and Tropical Medicine, London, UK
| | - Suzanne Keddie
- London School of Hygiene and Tropical Medicine, London, UK
| | | | | | | | | | | | | | - Chris Frost
- London School of Hygiene and Tropical Medicine, London, UK
| |
Collapse
|
126
|
Vilà-González M, Pinte L, Fradique R, Causa E, Kool H, Rodrat M, Morell CM, Al-Thani M, Porter L, Guo W, Maeshima R, Hart SL, McCaughan F, Granata A, Sheppard DN, Floto RA, Rawlins EL, Cicuta P, Vallier L. In vitro platform to model the function of ionocytes in the human airway epithelium. Respir Res 2024; 25:180. [PMID: 38664797 PMCID: PMC11045446 DOI: 10.1186/s12931-024-02800-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 04/01/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Pulmonary ionocytes have been identified in the airway epithelium as a small population of ion transporting cells expressing high levels of CFTR (cystic fibrosis transmembrane conductance regulator), the gene mutated in cystic fibrosis. By providing an infinite source of airway epithelial cells (AECs), the use of human induced pluripotent stem cells (hiPSCs) could overcome some challenges of studying ionocytes. However, the production of AEC epithelia containing ionocytes from hiPSCs has proven difficult. Here, we present a platform to produce hiPSC-derived AECs (hiPSC-AECs) including ionocytes and investigate their role in the airway epithelium. METHODS hiPSCs were differentiated into lung progenitors, which were expanded as 3D organoids and matured by air-liquid interface culture as polarised hiPSC-AEC epithelia. Using CRISPR/Cas9 technology, we generated a hiPSCs knockout (KO) for FOXI1, a transcription factor that is essential for ionocyte specification. Differences between FOXI1 KO hiPSC-AECs and their wild-type (WT) isogenic controls were investigated by assessing gene and protein expression, epithelial composition, cilia coverage and motility, pH and transepithelial barrier properties. RESULTS Mature hiPSC-AEC epithelia contained basal cells, secretory cells, ciliated cells with motile cilia, pulmonary neuroendocrine cells (PNECs) and ionocytes. There was no difference between FOXI1 WT and KO hiPSCs in terms of their capacity to differentiate into airway progenitors. However, FOXI1 KO led to mature hiPSC-AEC epithelia without ionocytes with reduced capacity to produce ciliated cells. CONCLUSION Our results suggest that ionocytes could have role beyond transepithelial ion transport by regulating epithelial properties and homeostasis in the airway epithelium.
Collapse
Affiliation(s)
- Marta Vilà-González
- Wellcome-MRC Cambridge Stem Cell Institute, Jeffrey Cheah Biomedical Centre, University of Cambridge, Puddicombe Way, Cambridge, CB2 0AW, UK.
- Cell Therapy and Tissue Engineering Group, Research Institute of Health Sciences (IUNICS), University of Balearic Islands, Palma, 07122, Spain.
- Health Research Institute of the Balearic Islands (IdISBa), Palma, 07120, Spain.
| | - Laetitia Pinte
- Wellcome-MRC Cambridge Stem Cell Institute, Jeffrey Cheah Biomedical Centre, University of Cambridge, Puddicombe Way, Cambridge, CB2 0AW, UK
| | - Ricardo Fradique
- Department of Physics, Cavendish Laboratory, University of Cambridge, JJ Thomson Avenue, Cambridge, CB3 0HE, UK
| | - Erika Causa
- Department of Physics, Cavendish Laboratory, University of Cambridge, JJ Thomson Avenue, Cambridge, CB3 0HE, UK
| | - Heleen Kool
- Wellcome Trust/CRUK Gurdon Institute, University of Cambridge, Tennis Court Road, Cambridge, CB2 1QN, UK
| | - Mayuree Rodrat
- School of Physiology, Pharmacology and Neuroscience, Biomedical Sciences Building, University of Bristol, University Walk, Bristol, BS8 1TD, UK
- Center of Research and Development for Biomedical Instrumentation, Institute of Molecular Biosciences, Mahidol University, Nakhon Pathom, 73170, Thailand
| | - Carola Maria Morell
- Wellcome-MRC Cambridge Stem Cell Institute, Jeffrey Cheah Biomedical Centre, University of Cambridge, Puddicombe Way, Cambridge, CB2 0AW, UK
- IRCCS Humanitas Research Hospital, via Manzoni 56, Rozzano, Milan, 20089, Italy
| | - Maha Al-Thani
- Department of Clinical Neurosciences, Victor Phillip Dahdaleh Heart & Lung Research Institute, University of Cambridge, Papworth Road, Cambridge, CB2 0BB, UK
| | - Linsey Porter
- Department of Medicine, Victor Phillip Dahdaleh Heart & Lung Research Institute, University of Cambridge, Papworth Road, Cambridge, CB2 0BB, UK
| | - Wenrui Guo
- Department of Medicine, Victor Phillip Dahdaleh Heart & Lung Research Institute, University of Cambridge, Papworth Road, Cambridge, CB2 0BB, UK
| | - Ruhina Maeshima
- Genetics and Genome Medicine Department, UCL Great Ormond Street Institute of Child Health, London, WC1N 1EH, UK
| | - Stephen L Hart
- Genetics and Genome Medicine Department, UCL Great Ormond Street Institute of Child Health, London, WC1N 1EH, UK
| | - Frank McCaughan
- Department of Medicine, Victor Phillip Dahdaleh Heart & Lung Research Institute, University of Cambridge, Papworth Road, Cambridge, CB2 0BB, UK
| | - Alessandra Granata
- Department of Clinical Neurosciences, Victor Phillip Dahdaleh Heart & Lung Research Institute, University of Cambridge, Papworth Road, Cambridge, CB2 0BB, UK
| | - David N Sheppard
- School of Physiology, Pharmacology and Neuroscience, Biomedical Sciences Building, University of Bristol, University Walk, Bristol, BS8 1TD, UK
| | - R Andres Floto
- Molecular Immunity Unit, Department of Medicine, University of Cambridge, Cambridge, CB2 0QH, UK
- Cambridge Centre for Lung Infection, Royal Papworth Hospital NHS Foundation Trust, Cambridge, CB2 0AY, UK
| | - Emma L Rawlins
- Wellcome Trust/CRUK Gurdon Institute, University of Cambridge, Tennis Court Road, Cambridge, CB2 1QN, UK
- Department of Physiology, Development and Neuroscience, University of Cambridge, Tennis Court Road, Cambridge, CB2 1QN, UK
| | - Pietro Cicuta
- Department of Physics, Cavendish Laboratory, University of Cambridge, JJ Thomson Avenue, Cambridge, CB3 0HE, UK
| | - Ludovic Vallier
- Wellcome-MRC Cambridge Stem Cell Institute, Jeffrey Cheah Biomedical Centre, University of Cambridge, Puddicombe Way, Cambridge, CB2 0AW, UK.
- BIH Center for Regenerative Therapies, Berlin Institute of Health at Charité, Augustenburger Platz 1, 13353, Berlin, DE, Germany.
- Max Planck Institute for Molecular Genetics, Ihnestraße 63-73, 14195, Berlin, Germany.
| |
Collapse
|
127
|
Tang H, Spreckley M, van Sluijs E, Ahern AL, Smith AD. The impact of social media interventions on eating behaviours and diet in adolescents and young adults: a mixed methods systematic review protocol. BMJ Open 2024; 14:e083465. [PMID: 38670609 PMCID: PMC11057283 DOI: 10.1136/bmjopen-2023-083465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/12/2024] [Indexed: 04/28/2024] Open
Abstract
INTRODUCTION Adolescents and young adults are susceptible population when it comes to healthy eating and dietary behaviours. The increasing use of social media by this age group presents a unique opportunity to promote healthy eating habits. Social media has become a popular platform for promoting health interventions, particularly among young people. However, there is a lack of consensus on the effectiveness of social media interventions in this population. This mixed-method systematic review aims to synthesise the available evidence on the impact of social media interventions on healthy eating behaviours among young people, their qualitative views and user experiences, and the intervention characteristics, behaviour change theories and techniques used to promote healthy eating. METHODS AND ANALYSIS We will conduct a comprehensive search of seven electronic databases, including ASSIA, Cochrane Library, Embase, MEDLINE, PsycINFO, Scopus and Web of Science. The search strategy will use a combination of Medical Subject Headings terms and keywords covering three domains: social media, eating behaviours and young people. The search will be limited to peer-reviewed published papers in any language, published from 2000. Three independent reviewers will screen studies based on predetermined eligibility criteria. Data will be extracted and analysed using a convergent segregated mixed-method approach. We will use random-effect meta-analysis or Synthesis Without Meta-analysis for quantitative data and thematic synthesis for qualitative data. Finally, narrative synthesis using concurrent triangulation will be used to bring together the results of the mixed-method data analysis to provide a comprehensive and integrated understanding of the impact and other features of social media interventions. This systematic review will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. ETHICS AND DISSEMINATION Ethical approval is not required since this systematic review will not collect original data. The outcomes of this review will be shared through peer-reviewed publications and conference presentations and will contribute to the PhD thesis of the primary author. PROSPERO REGISTRATION NUMBER CRD42023414476.
Collapse
Affiliation(s)
- Hao Tang
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Marie Spreckley
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Esther van Sluijs
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Amy L Ahern
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Andrea D Smith
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| |
Collapse
|
128
|
Russo LX, Powell-Jackson T, Borghi J, Sampaio J, Gurgel Junior GD, Shimizu HE, Bezerra AFB, E Silva KSDB, Barreto JOM, de Carvalho ALB, Kovacs RJ, Gomes LB, Fardousi N, da Silva EN. Does pay-for-performance design matter? Evidence from Brazil. Health Policy Plan 2024:czae025. [PMID: 38661300 DOI: 10.1093/heapol/czae025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 02/14/2024] [Accepted: 04/23/2024] [Indexed: 04/26/2024] Open
Abstract
Pay-for-performance (P4P) schemes have been shown to have mixed effects on health care outcomes. A challenge in interpreting this evidence is that P4P is often considered a homogenous intervention, when in practice schemes vary widely in their design. Our study contributes to this literature by providing a detailed depiction of incentive design across municipalities within a national P4P scheme in Brazil (PMAQ) and exploring the association of alternative design typologies with the performance of primary health /care providers. We carried out a nation-wide survey of municipal health managers to characterize the scheme design, based on the size of the bonus, the providers incentivized, and the frequency of payment. Using OLS regressions and controlling for municipality characteristics, we examined whether each design feature was associated with better family health team performance. To capture potential interactions between design features, we used cluster analysis to group municipalities into five design typologies and then examined associations with quality of care. A majority of the municipalities included in our study used some of the PMAQ funds to provide bonuses to family health team workers, while the remaining municipalities spent the funds in the traditional way using input-based budgets. Frequent bonus payments (monthly) and higher size bonus allocations (share of 20-80%) were strongly associated with better team performance, while who within a team was eligible to receive bonuses did not in isolation appear to influence performance. The cluster analysis showed what combinations of design features were associated with better performance. The PMAQ score in the 'large bonus/many workers/high-frequency' cluster was 8.44 points higher than the 'no bonus' cluster, equivalent to a difference of 21.7% in the mean PMAQ score. Evidence from our study shows how design features can potentially influence health provider performance, informing the design of more effective P4P schemes.
Collapse
Affiliation(s)
- Letícia Xander Russo
- Faculty of Business, Accounting and Economics, Federal University of Grande Dourados, Rodovia Dourados-Itahum, Km 12, Dourados, MS, Brazil
| | - Timothy Powell-Jackson
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Josephine Borghi
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Juliana Sampaio
- Department of Health Promotion, Federal University of Paraiba, João Pessoa, Brazil
| | | | - Helena Eri Shimizu
- Department of Collective Health, University of Brasilia, Brasilia, Brazil
| | | | - Keila Silene de Brito E Silva
- Collective Health Nucleous, Academic Center of Vitória, Federal University of Pernambuco, Vitória de Santo Antão, Brazil
| | | | | | - Roxanne J Kovacs
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Nasser Fardousi
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | |
Collapse
|
129
|
Krishnamoorthy V, Foglizzo M, Dilley RL, Wu A, Datta A, Dutta P, Campbell LJ, Degtjarik O, Musgrove LJ, Calabrese AN, Zeqiraj E, Greenberg RA. The SPATA5-SPATA5L1 ATPase complex directs replisome proteostasis to ensure genome integrity. Cell 2024; 187:2250-2268.e31. [PMID: 38554706 PMCID: PMC11055677 DOI: 10.1016/j.cell.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 12/27/2023] [Accepted: 03/02/2024] [Indexed: 04/02/2024]
Abstract
Ubiquitin-dependent unfolding of the CMG helicase by VCP/p97 is required to terminate DNA replication. Other replisome components are not processed in the same fashion, suggesting that additional mechanisms underlie replication protein turnover. Here, we identify replisome factor interactions with a protein complex composed of AAA+ ATPases SPATA5-SPATA5L1 together with heterodimeric partners C1orf109-CINP (55LCC). An integrative structural biology approach revealed a molecular architecture of SPATA5-SPATA5L1 N-terminal domains interacting with C1orf109-CINP to form a funnel-like structure above a cylindrically shaped ATPase motor. Deficiency in the 55LCC complex elicited ubiquitin-independent proteotoxicity, replication stress, and severe chromosome instability. 55LCC showed ATPase activity that was specifically enhanced by replication fork DNA and was coupled to cysteine protease-dependent cleavage of replisome substrates in response to replication fork damage. These findings define 55LCC-mediated proteostasis as critical for replication fork progression and genome stability and provide a rationale for pathogenic variants seen in associated human neurodevelopmental disorders.
Collapse
Affiliation(s)
- Vidhya Krishnamoorthy
- Department of Cancer Biology, Penn Center for Genome Integrity, Basser Center for BRCA, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104-6160, USA
| | - Martina Foglizzo
- Astbury Centre for Structural Molecular Biology, School of Molecular and Cellular Biology, Faculty of Biological Sciences, University of Leeds, Leeds LS2 9JT, UK
| | - Robert L Dilley
- Department of Cancer Biology, Penn Center for Genome Integrity, Basser Center for BRCA, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104-6160, USA.
| | - Angela Wu
- Department of Cancer Biology, Penn Center for Genome Integrity, Basser Center for BRCA, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104-6160, USA
| | - Arindam Datta
- Department of Cancer Biology, Penn Center for Genome Integrity, Basser Center for BRCA, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104-6160, USA
| | - Parul Dutta
- Department of Cancer Biology, Penn Center for Genome Integrity, Basser Center for BRCA, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104-6160, USA
| | - Lisa J Campbell
- Astbury Centre for Structural Molecular Biology, School of Molecular and Cellular Biology, Faculty of Biological Sciences, University of Leeds, Leeds LS2 9JT, UK
| | - Oksana Degtjarik
- Astbury Centre for Structural Molecular Biology, School of Molecular and Cellular Biology, Faculty of Biological Sciences, University of Leeds, Leeds LS2 9JT, UK
| | - Laura J Musgrove
- Astbury Centre for Structural Molecular Biology, School of Molecular and Cellular Biology, Faculty of Biological Sciences, University of Leeds, Leeds LS2 9JT, UK
| | - Antonio N Calabrese
- Astbury Centre for Structural Molecular Biology, School of Molecular and Cellular Biology, Faculty of Biological Sciences, University of Leeds, Leeds LS2 9JT, UK
| | - Elton Zeqiraj
- Astbury Centre for Structural Molecular Biology, School of Molecular and Cellular Biology, Faculty of Biological Sciences, University of Leeds, Leeds LS2 9JT, UK.
| | - Roger A Greenberg
- Department of Cancer Biology, Penn Center for Genome Integrity, Basser Center for BRCA, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104-6160, USA.
| |
Collapse
|
130
|
Turner HC, Kura K, Roth B, Kuesel AC, Kinrade S, Basáñez MG. An Updated Economic Assessment of Moxidectin Treatment Strategies for Onchocerciasis Elimination. Clin Infect Dis 2024; 78:S138-S145. [PMID: 38662693 PMCID: PMC11045023 DOI: 10.1093/cid/ciae054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Concerns that annual mass administration of ivermectin, the predominant strategy for onchocerciasis control and elimination, may not lead to elimination of parasite transmission (EoT) in all endemic areas have increased interest in alternative treatment strategies. One such strategy is moxidectin. We performed an updated economic assessment of moxidectin- relative to ivermectin-based strategies. METHODS We investigated annual and biannual community-directed treatment with ivermectin (aCDTI, bCDTI) and moxidectin (aCDTM, bCDTM) with minimal or enhanced coverage (65% or 80% of total population taking the drug, respectively) in intervention-naive areas with 30%, 50%, or 70% microfilarial baseline prevalence (representative of hypo-, meso-, and hyperendemic areas). We compared programmatic delivery costs for the number of treatments achieving 90% probability of EoT (EoT90), calculated with the individual-based stochastic transmission model EPIONCHO-IBM. We used the costs for 40 years of program delivery when EoT90 was not reached earlier. The delivery costs do not include drug costs. RESULTS aCDTM and bCDTM achieved EoT90 with lower programmatic delivery costs than aCDTI with 1 exception: aCDTM with minimal coverage did not achieve EoT90 in hyperendemic areas within 40 years. With minimal coverage, bCDTI delivery costs as much or more than aCDTM and bCDTM. With enhanced coverage, programmatic delivery costs for aCDTM and bCDTM were lower than for aCDTI and bCDTI. CONCLUSIONS Moxidectin-based strategies could accelerate progress toward EoT and reduce programmatic delivery costs compared with ivermectin-based strategies. The costs of moxidectin to national programs are needed to quantify whether delivery cost reductions will translate into overall program cost reduction.
Collapse
Affiliation(s)
- Hugo C Turner
- UK Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, United Kingdom
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, United Kingdom
| | - Klodeta Kura
- UK Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, United Kingdom
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, United Kingdom
| | - Barbara Roth
- Medicines Development for Global Health, Melbourne, Victoria, Australia
| | - Annette C Kuesel
- UNICEF/United Nations Development Progamme/World Bank/World Health Organization Special Programme for Research and Training in Tropical Diseases, World Health Organization, Geneva, Switzerland (retired)
| | - Sally Kinrade
- Medicines Development for Global Health, Melbourne, Victoria, Australia
| | - Maria-Gloria Basáñez
- UK Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, United Kingdom
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, United Kingdom
| |
Collapse
|
131
|
Kura K, Mutono N, Basáñez MG, Collyer BS, Coffeng LE, Thumbi SM, Anderson RM. How Does Treatment Coverage and Proportion Never Treated Influence the Success of Schistosoma mansoni Elimination as a Public Health Problem by 2030? Clin Infect Dis 2024; 78:S126-S130. [PMID: 38662698 PMCID: PMC11045018 DOI: 10.1093/cid/ciae074] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND The 2030 target for schistosomiasis is elimination as a public health problem (EPHP), achieved when the prevalence of heavy-intensity infection among school-aged children (SAC) reduces to <1%. To achieve this, the new World Health Organization guidelines recommend a broader target of population to include pre-SAC and adults. However, the probability of achieving EPHP should be expected to depend on patterns in repeated uptake of mass drug administration by individuals. METHODS We employed 2 individual-based stochastic models to evaluate the impact of school-based and community-wide treatment and calculated the number of rounds required to achieve EPHP for Schistosoma mansoni by considering various levels of the population never treated (NT). We also considered 2 age-intensity profiles, corresponding to a low and high burden of infection in adults. RESULTS The number of rounds needed to achieve this target depends on the baseline prevalence and the coverage used. For low- and moderate-transmission areas, EPHP can be achieved within 7 years if NT ≤10% and NT <5%, respectively. In high-transmission areas, community-wide treatment with NT <1% is required to achieve EPHP. CONCLUSIONS The higher the intensity of transmission, and the lower the treatment coverage, the lower the acceptable value of NT becomes. Using more efficacious treatment regimens would permit NT values to be marginally higher. A balance between target treatment coverage and NT values may be an adequate treatment strategy depending on the epidemiological setting, but striving to increase coverage and/or minimize NT can shorten program duration.
Collapse
Affiliation(s)
- Klodeta Kura
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, United Kingdom
- Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Mary's Campus, Imperial College London
- Medical Research Council Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, United Kingdom
| | - Nyamai Mutono
- Centre for Epidemiological Modelling and Analysis, University of Nairobi, Kenya
- Paul G. Allen School for Global Health, Washington State University, Pullman
| | - Maria-Gloria Basáñez
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, United Kingdom
- Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Mary's Campus, Imperial College London
- Medical Research Council Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, United Kingdom
| | - Benjamin S Collyer
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, United Kingdom
- Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Mary's Campus, Imperial College London
- Medical Research Council Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, United Kingdom
| | - Luc E Coffeng
- Department of Public Health, Erasmus University Medical Center, University Medical Center Rotterdam, The Netherlands
| | - S M Thumbi
- Centre for Epidemiological Modelling and Analysis, University of Nairobi, Kenya
- Paul G. Allen School for Global Health, Washington State University, Pullman
- Institute of Immunology and Infection Research, University of Edinburgh, United Kingdom
| | - Roy M Anderson
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, United Kingdom
- Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Mary's Campus, Imperial College London
- Medical Research Council Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, United Kingdom
| |
Collapse
|
132
|
Hoek Spaans R, Mkumbwa A, Nasoni P, Jones CM, Stanton MC. Impact of four years of annually repeated indoor residual spraying (IRS) with Actellic 300CS on routinely reported malaria cases in an agricultural setting in Malawi. PLOS Glob Public Health 2024; 4:e0002264. [PMID: 38656965 PMCID: PMC11042720 DOI: 10.1371/journal.pgph.0002264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 04/01/2024] [Indexed: 04/26/2024]
Abstract
Indoor residual spraying (IRS) is one of the main vector control tools used in malaria prevention. This study evaluates IRS in the context of a privately run campaign conducted across a low-lying, irrigated, sugarcane estate from Illovo Sugar, in the Chikwawa district of Malawi. The effect of Actellic 300CS annual spraying over four years (2015-2018) was assessed using a negative binomial mixed effects model, in an area where pyrethroid resistance has previously been identified. With an unadjusted incidence rate ratio (IRR) of 0.38 (95% CI: 0.32-0.45) and an adjusted IRR of 0.50 (95% CI: 0.42-0.59), IRS has significantly contributed to a reduction in case incidence rates at Illovo, as compared to control clinics and time points outside of the six month protective period. This study shows how the consistency of a privately run IRS campaign can improve the health of employees. More research is needed on the duration of protection and optimal timing of IRS programmes.
Collapse
Affiliation(s)
- Remy Hoek Spaans
- Department of Vector Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | | | | | - Christopher M. Jones
- Illovo Sugar Malawi, Nchalo, Malawi
- Malawi-Liverpool-Wellcome Trust, Blantyre, Malawi
| | | |
Collapse
|
133
|
Ye JH, Chen YL, Ogg G. CD1a and skin T cells: a pathway for therapeutic intervention. Clin Exp Dermatol 2024; 49:450-458. [PMID: 38173286 PMCID: PMC11037390 DOI: 10.1093/ced/llad460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 11/28/2023] [Accepted: 12/22/2023] [Indexed: 01/05/2024]
Abstract
The CD1 and MR1 protein families present lipid antigens and small molecules to T cells, complementing well-studied major histocompatibility complex-peptide mechanisms. The CD1a subtype is highly and continuously expressed within the skin, most notably on Langerhans cells, and has been demonstrated to present self and foreign lipids to T cells, highlighting its cutaneous sentinel role. Alteration of CD1a-dependent T-cell responses has recently been discovered to contribute to the pathogenesis of several inflammatory skin diseases. In this review, we overview the structure and role of CD1a and outline the current evidence implicating CD1a in the development of psoriasis, atopic dermatitis and allergic contact dermatitis.
Collapse
Affiliation(s)
- John H Ye
- MRC Translational Immune Discovery Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - Yi-Ling Chen
- MRC Translational Immune Discovery Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
- Chinese Academy of Medical Sciences Oxford Institute, University of Oxford, Oxford, UK
| | - Graham Ogg
- MRC Translational Immune Discovery Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
- Chinese Academy of Medical Sciences Oxford Institute, University of Oxford, Oxford, UK
| |
Collapse
|
134
|
Avvisati R, Kaufmann AK, Young CJ, Portlock GE, Cancemi S, Costa RP, Magill PJ, Dodson PD. Distributional coding of associative learning in discrete populations of midbrain dopamine neurons. Cell Rep 2024; 43:114080. [PMID: 38581677 DOI: 10.1016/j.celrep.2024.114080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 02/12/2024] [Accepted: 03/24/2024] [Indexed: 04/08/2024] Open
Abstract
Midbrain dopamine neurons are thought to play key roles in learning by conveying the difference between expected and actual outcomes. Recent evidence suggests diversity in dopamine signaling, yet it remains poorly understood how heterogeneous signals might be organized to facilitate the role of downstream circuits mediating distinct aspects of behavior. Here, we investigated the organizational logic of dopaminergic signaling by recording and labeling individual midbrain dopamine neurons during associative behavior. Our findings show that reward information and behavioral parameters are not only heterogeneously encoded but also differentially distributed across populations of dopamine neurons. Retrograde tracing and fiber photometry suggest that populations of dopamine neurons projecting to different striatal regions convey distinct signals. These data, supported by computational modeling, indicate that such distributional coding can maximize dynamic range and tailor dopamine signals to facilitate specialized roles of different striatal regions.
Collapse
Affiliation(s)
- Riccardo Avvisati
- School of Physiology, Pharmacology, and Neuroscience, University of Bristol, Bristol BS8 1TD, UK; Medical Research Council Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford OX1 3TH, UK
| | - Anna-Kristin Kaufmann
- Medical Research Council Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford OX1 3TH, UK
| | - Callum J Young
- School of Physiology, Pharmacology, and Neuroscience, University of Bristol, Bristol BS8 1TD, UK; Computational Neuroscience Unit, Department of Computer Science, SCEEM, Faculty of Engineering, University of Bristol, Bristol BS8 1UB, UK
| | - Gabriella E Portlock
- School of Physiology, Pharmacology, and Neuroscience, University of Bristol, Bristol BS8 1TD, UK
| | - Sophie Cancemi
- School of Physiology, Pharmacology, and Neuroscience, University of Bristol, Bristol BS8 1TD, UK
| | - Rui Ponte Costa
- Computational Neuroscience Unit, Department of Computer Science, SCEEM, Faculty of Engineering, University of Bristol, Bristol BS8 1UB, UK
| | - Peter J Magill
- Medical Research Council Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford OX1 3TH, UK
| | - Paul D Dodson
- School of Physiology, Pharmacology, and Neuroscience, University of Bristol, Bristol BS8 1TD, UK; Medical Research Council Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford OX1 3TH, UK.
| |
Collapse
|
135
|
Liu X, Obacz J, Emanuelli G, Chambers JE, Abreu S, Chen X, Linnane E, Mehta JP, Wheatley AEH, Marciniak SJ, Fairen-Jimenez D. Enhancing Drug Delivery Efficacy Through Bilayer Coating of Zirconium-Based Metal-Organic Frameworks: Sustained Release and Improved Chemical Stability and Cellular Uptake for Cancer Therapy. Chem Mater 2024; 36:3588-3603. [PMID: 38681089 PMCID: PMC11044268 DOI: 10.1021/acs.chemmater.3c02954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 03/19/2024] [Accepted: 03/22/2024] [Indexed: 05/01/2024]
Abstract
The development of nanoparticle (NP)-based drug carriers has presented an exciting opportunity to address challenges in oncology. Among the 100,000 available possibilities, zirconium-based metal-organic frameworks (MOFs) have emerged as promising candidates in biomedical applications. Zr-MOFs can be easily synthesized as small-size NPs compatible with intravenous injection, whereas the ease of decorating their external surfaces with functional groups allows for targeted treatment. Despite these benefits, Zr-MOFs suffer degradation and aggregation in real, in vivo conditions, whereas the loaded drugs will suffer the burst effect-i.e., the fast release of drugs in less than 48 h. To tackle these issues, we developed a simple but effective bilayer coating strategy in a generic, two-step process. In this work, bilayer-coated MOF NU-901 remained well dispersed in biologically relevant fluids such as buffers and cell growth media. Additionally, the coating enhances the long-term stability of drug-loaded MOFs in water by simultaneously preventing sustained leakage of the drug and aggregation of the MOF particles. We evaluated our materials for the encapsulation and transport of pemetrexed, the standard-of-care chemotherapy in mesothelioma. The bilayer coating allowed for a slowed release of pemetrexed over 7 days, superior to the typical 48 h release found in bare MOFs. This slow release and the related performance were studied in vitro using both A549 lung cancer and 3T mesothelioma cells. Using high-resolution microscopy, we found the successful uptake of bilayer-coated MOFs by the cells with an accumulation in the lysosomes. The pemetrex-loaded NU-901 was indeed cytotoxic to 3T and A549 cancer cells. Finally, we demonstrated the general approach by extending the coating strategy using two additional lipids and four surfactants. This research highlights how a simple yet effective bilayer coating provides new insights into the design of promising MOF-based drug delivery systems.
Collapse
Affiliation(s)
- Xiewen Liu
- The
Adsorption & Advanced Materials Laboratory (AML),
Department of Chemical Engineering & Biotechnology, University of Cambridge, Philippa Fawcett Drive, Cambridge CB3 0AS, United
Kingdom
| | - Joanna Obacz
- Cambridge
Institute for Medical Research, Keith Peters Building, Cambridge Biomedical
Campus, University of Cambridge, Cambridge CB2 0XY, United Kingdom
| | - Giulia Emanuelli
- Cambridge
Institute for Medical Research, Keith Peters Building, Cambridge Biomedical
Campus, University of Cambridge, Cambridge CB2 0XY, United Kingdom
| | - Joseph E. Chambers
- Cambridge
Institute for Medical Research, Keith Peters Building, Cambridge Biomedical
Campus, University of Cambridge, Cambridge CB2 0XY, United Kingdom
| | - Susana Abreu
- Cambridge
Institute for Medical Research, Keith Peters Building, Cambridge Biomedical
Campus, University of Cambridge, Cambridge CB2 0XY, United Kingdom
| | - Xu Chen
- The
Adsorption & Advanced Materials Laboratory (AML),
Department of Chemical Engineering & Biotechnology, University of Cambridge, Philippa Fawcett Drive, Cambridge CB3 0AS, United
Kingdom
| | - Emily Linnane
- The
Adsorption & Advanced Materials Laboratory (AML),
Department of Chemical Engineering & Biotechnology, University of Cambridge, Philippa Fawcett Drive, Cambridge CB3 0AS, United
Kingdom
| | - Joshua P. Mehta
- Yusuf
Hamied Department of Chemistry, University
of Cambridge, Lensfield Road, Cambridge CB2 1EW, United Kingdom
| | - Andrew E. H. Wheatley
- Yusuf
Hamied Department of Chemistry, University
of Cambridge, Lensfield Road, Cambridge CB2 1EW, United Kingdom
| | - Stefan J. Marciniak
- Cambridge
Institute for Medical Research, Keith Peters Building, Cambridge Biomedical
Campus, University of Cambridge, Cambridge CB2 0XY, United Kingdom
| | - David Fairen-Jimenez
- The
Adsorption & Advanced Materials Laboratory (AML),
Department of Chemical Engineering & Biotechnology, University of Cambridge, Philippa Fawcett Drive, Cambridge CB3 0AS, United
Kingdom
| |
Collapse
|
136
|
Liu Z, Alexander JL, Yee Eng K, Ibraheim H, Anandabaskaran S, Saifuddin A, Constable L, Castro Seoane R, Bewshea C, Nice R, D’Mello A, Jones GR, Balarajah S, Fiorentino F, Sebastian S, Irving PM, Hicks LC, Williams HRT, Kent AJ, Linger R, Parkes M, Kok K, Patel KV, Teare JP, Altmann DM, Boyton RJ, Hart AL, Lees CW, Goodhand JR, Kennedy NA, Pollock KM, Ahmad T, Powell N. Antibody Responses to Influenza Vaccination are Diminished in Patients With Inflammatory Bowel Disease on Infliximab or Tofacitinib. J Crohns Colitis 2024; 18:560-569. [PMID: 37941436 PMCID: PMC11037107 DOI: 10.1093/ecco-jcc/jjad182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND AND AIMS We sought to determine whether six commonly used immunosuppressive regimens were associated with lower antibody responses after seasonal influenza vaccination in patients with inflammatory bowel disease [IBD]. METHODS We conducted a prospective study including 213 IBD patients and 53 healthy controls: 165 who had received seasonal influenza vaccine and 101 who had not. IBD medications included infliximab, thiopurines, infliximab and thiopurine combination therapy, ustekinumab, vedolizumab, or tofacitinib. The primary outcome was antibody responses against influenza/A H3N2 and A/H1N1, compared to controls, adjusting for age, prior vaccination, and interval between vaccination and sampling. RESULTS Lower antibody responses against influenza A/H3N2 were observed in patients on infliximab (geometric mean ratio 0.35 [95% confidence interval 0.20-0.60], p = 0.0002), combination of infliximab and thiopurine therapy (0.46 [0.27-0.79], p = 0.0050), and tofacitinib (0.28 [0.14-0.57], p = 0.0005) compared to controls. Lower antibody responses against A/H1N1 were observed in patients on infliximab (0.29 [0.15-0.56], p = 0.0003), combination of infliximab and thiopurine therapy (0.34 [0.17-0.66], p = 0.0016), thiopurine monotherapy (0.46 [0.24-0.87], p = 0.017), and tofacitinib (0.23 [0.10-0.56], p = 0.0013). Ustekinumab and vedolizumab were not associated with reduced antibody responses against A/H3N2 or A/H1N1. Vaccination in the previous year was associated with higher antibody responses to A/H3N2. Vaccine-induced anti-SARS-CoV-2 antibody concentration weakly correlated with antibodies against H3N2 [r = 0.27; p = 0.0004] and H1N1 [r = 0.33; p < 0.0001]. CONCLUSIONS Vaccination in both the 2020-2021 and 2021-2022 seasons was associated with significantly higher antibody responses to influenza/A than no vaccination or vaccination in 2021-2022 alone. Infliximab and tofacitinib are associated with lower binding antibody responses to influenza/A, similar to COVID-19 vaccine-induced antibody responses.
Collapse
Affiliation(s)
- Zhigang Liu
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - James L Alexander
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
- Department of Gastroenterology, Imperial College Healthcare NHS Trust, London, UK
- Department of Gastroenterology, St Marks Hospital and Academic Institute, Gastroenterology, London, UK
| | - Kai Yee Eng
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Hajir Ibraheim
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
- Department of Gastroenterology, Imperial College Healthcare NHS Trust, London, UK
| | - Sulak Anandabaskaran
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
- Department of Gastroenterology, St Marks Hospital and Academic Institute, Gastroenterology, London, UK
| | - Aamir Saifuddin
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
- Department of Gastroenterology, St Marks Hospital and Academic Institute, Gastroenterology, London, UK
| | - Laura Constable
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Rocio Castro Seoane
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Claire Bewshea
- Exeter Inflammatory Bowel Disease and Pharmacogenetics Research Group, University of Exeter, Exeter, UK
| | - Rachel Nice
- Exeter Inflammatory Bowel Disease and Pharmacogenetics Research Group, University of Exeter, Exeter, UK
- Department of Clinical Chemistry, Exeter Clinical Laboratory International, Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK
| | - Andrea D’Mello
- Division of Medicine & Integrated Care, Imperial College Healthcare NHS Trust, London, UK
| | - Gareth R Jones
- Department of Gastroenterology, Western General Hospital, NHS Lothian, Edinburgh, UK
- Centre for Inflammation Research, The Queen’s Medical Research Institute, The University of Edinburgh, Edinburgh, UK
| | - Sharmili Balarajah
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
- Department of Gastroenterology, Imperial College Healthcare NHS Trust, London, UK
| | - Francesca Fiorentino
- Department of Surgery and Cancer, Imperial College London, London, UK
- Nightingale-Saunders Clinical Trials & Epidemiology Unit [King’s Clinical Trials Unit], King’s College London, London, UK
| | - Shaji Sebastian
- Department of Gastroenterology, Hull University Teaching Hospitals NHS Trust, Hull, UK
- Hull York Medical School, University of Hull, Hull, UK
| | - Peter M Irving
- Department of Gastroenterology, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
- School of Immunology & Microbial Sciences, King’s College London, London, UK
| | - Lucy C Hicks
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
- Department of Gastroenterology, Imperial College Healthcare NHS Trust, London, UK
| | - Horace R T Williams
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
- Department of Gastroenterology, Imperial College Healthcare NHS Trust, London, UK
| | - Alexandra J Kent
- Department of Gastroenterology, King’s College Hospital, London, UK
| | - Rachel Linger
- The NIHR Bioresource, University of Cambridge, Cambridge, UK
| | - Miles Parkes
- The NIHR Bioresource, University of Cambridge, Cambridge, UK
- Department of Gastroenterology, Cambridge University Hospitals NHS Trust, Cambridge, UK
| | - Klaartje Kok
- Department of Gastroenterology, Bart’s Health NHS Trust, London, UK
| | - Kamal V Patel
- Department of Gastroenterology, St George’s Hospital NHS Trust, London, UK
| | - Julian P Teare
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
- Department of Gastroenterology, Imperial College Healthcare NHS Trust, London, UK
| | - Daniel M Altmann
- Department of Immunology and Inflammation, Imperial College London, London, UK
| | - Rosemary J Boyton
- Department of Infectious Disease, Imperial College London, London, UK
- Lung Division, Royal Brompton and Harefield Hospitals, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - Ailsa L Hart
- Department of Gastroenterology, St Marks Hospital and Academic Institute, Gastroenterology, London, UK
| | - Charlie W Lees
- Department of Gastroenterology, Western General Hospital, NHS Lothian, Edinburgh, UK
- Centre for Inflammation Research, The Queen’s Medical Research Institute, The University of Edinburgh, Edinburgh, UK
| | - James R Goodhand
- Exeter Inflammatory Bowel Disease and Pharmacogenetics Research Group, University of Exeter, Exeter, UK
- Department of Gastroenterology, Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK
| | - Nicholas A Kennedy
- Exeter Inflammatory Bowel Disease and Pharmacogenetics Research Group, University of Exeter, Exeter, UK
- Department of Gastroenterology, Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK
| | - Katrina M Pollock
- Department of Infectious Disease, Imperial College London, London, UK
- NIHR Imperial Clinical Research Facility and NIHR Imperial Biomedical Research Centre, London, UK
| | - Tariq Ahmad
- Exeter Inflammatory Bowel Disease and Pharmacogenetics Research Group, University of Exeter, Exeter, UK
- Department of Gastroenterology, Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK
| | - Nick Powell
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
- Department of Gastroenterology, Imperial College Healthcare NHS Trust, London, UK
| |
Collapse
|
137
|
Comptdaer T, Tardivel M, Schirmer C, Buée L, Galas MC. Cell redistribution of G quadruplex-structured DNA is associated with morphological changes of nuclei and nucleoli in neurons during tau pathology progression. Brain Pathol 2024:e13262. [PMID: 38649330 DOI: 10.1111/bpa.13262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 04/02/2024] [Indexed: 04/25/2024] Open
Abstract
While the double helical structure has long been its iconic representation, DNA is structurally dynamic and can adopt alternative secondary configurations. Specifically, guanine-rich DNA sequences can fold in guanine quadruplexes (G4) structures. These G4 play pivotal roles as regulators of gene expression and genomic stability, and influence protein homeostasis. Despite their significance, the association of G4 with neurodegenerative diseases such as Alzheimer's disease (AD) has been underappreciated. Recent findings have identified DNA sequences predicted to form G4 in sarkosyl-insoluble aggregates from AD brains, questioning the involvement of G4-structured DNA (G4 DNA) in the pathology. Using immunofluorescence coupled to confocal microscopy analysis we investigated the impact of tau pathology, a hallmark of tauopathies including AD, on the distribution of G4 DNA in murine neurons and its relevance to AD brains. In healthy neurons, G4 DNA is detected in nuclei with a notable presence in nucleoli. However, in a transgenic mouse model of tau pathology (THY-Tau22), early stages of the disease exhibit an impairment in the nuclear distribution of G4 DNA. In addition, G4 DNA accumulates in the cytoplasm of neurons exhibiting oligomerized tau and oxidative DNA damage. This altered distribution persists in the later stage of the pathology when larger tau aggregates are present. Still cytoplasmic deposition of G4 DNA does not appear to be a critical factor in the tau aggregation process. Similar patterns are observed in neurons from the AD cortex. Furthermore, the disturbance in G4 DNA distribution is associated with various changes in the size of neuronal nuclei and nucleoli, indicative of responses to stress and the activation of pro-survival mechanisms. Our results shed light on a significant impact of tau pathology on the dynamics of G4 DNA and on nuclear and nucleolar mechanobiology in neurons. These findings reveal new dimensions in the etiopathogenesis of tauopathies.
Collapse
Affiliation(s)
- Thomas Comptdaer
- University of Lille, Inserm, CHU Lille, CNRS, LilNCog-Lille Neuroscience and Cognition, Lille, France
| | - Meryem Tardivel
- University of Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, US41-UAR 2014-PLBS, Lille, France
| | - Claire Schirmer
- University of Lille, Inserm, CHU Lille, CNRS, LilNCog-Lille Neuroscience and Cognition, Lille, France
| | - Luc Buée
- University of Lille, Inserm, CHU Lille, CNRS, LilNCog-Lille Neuroscience and Cognition, Lille, France
| | - Marie-Christine Galas
- University of Lille, Inserm, CHU Lille, CNRS, LilNCog-Lille Neuroscience and Cognition, Lille, France
| |
Collapse
|
138
|
Orimolade BO, Draper ER. Application of quasi solid electrolytes in organic based electrochromic devices: A mini review. Chemistry 2024; 30:e202303880. [PMID: 38224310 DOI: 10.1002/chem.202303880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 01/16/2024]
Abstract
The interest in all solid organic based electrochromic devices (ECDs) is on the increase. This is because these devices offer the applicability of electrochromic materials in products such as smart sensors, smart windows, flexible wearables and energy storage devices. The use of quasi-solid electrolytes for the construction of these ECDs is attractive because of their ease of preparation, availability, low cost, improve electrochromic performance, good ionic conductivity and prevention of leakages in ECDs. Hence, in this review, a detailed discussion is presented on the progress in the development of semi-solid electrolytes for ECDs fabrication. The preparation of the most common electrolytes that have been applied for organic based ECDs are summarized. Particular attention is given to efforts and strategies that have been adopted to improve the efficiency of quasi-solid electrolytes. Importantly, knowledge gaps that warrant further research are clearly identified and recommendations for future works are suggested. This review will be very beneficial for both established and new researchers in the field of electrochromic devices and material science.
Collapse
|
139
|
Hynes T, Fouyssac M, Puaud M, Joshi D, Chernoff C, Stiebahl S, Michaud L, Belin D. Pan-striatal reduction in the expression of the astrocytic dopamine transporter precedes the development of dorsolateral striatum dopamine-dependent incentive heroin seeking habits. Eur J Neurosci 2024. [PMID: 38650303 DOI: 10.1111/ejn.16354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 03/28/2024] [Accepted: 03/31/2024] [Indexed: 04/25/2024]
Abstract
The emergence of compulsive drug-seeking habits, a hallmark feature of substance use disorder, has been shown to be predicated on the engagement of dorsolateral striatal control over behaviour. This process involves the dopamine-dependent functional coupling of the anterior dorsolateral striatum (aDLS) with the nucleus accumbens core, but the mechanisms by which this coupling occurs have not been fully elucidated. The striatum is tiled by a syncytium of astrocytes that express the dopamine transporter (DAT), the level of which is altered in individuals with heroin use disorder. Astrocytes are therefore uniquely placed functionally to bridge dopamine-dependent mechanisms across the striatum. Here we tested the hypothesis that exposure to heroin influences the expression of DAT in striatal astrocytes across the striatum before the development of DLS-dependent incentive heroin seeking habits. Using Western-blot, qPCR, and RNAscope™, we measured DAT protein and mRNA levels in whole tissue, culture and in situ astrocytes from striatal territories of rats with a well-established cue-controlled heroin seeking habit and rats trained to respond for heroin or food under continuous reinforcement. Incentive heroin seeking habits were associated with a reduction in DAT protein levels in the anterior aDLS that was preceded by a heroin-induced reduction in DAT mRNA and protein in astrocytes across the striatum. Striatal astrocytes were also shown to be susceptible to direct dopamine- and opioid-induced downregulation of DAT expression. These results suggest that astrocytes may critically regulate the striatal dopaminergic adaptations that lead to the development of incentive heroin seeking habits.
Collapse
Affiliation(s)
- Tristan Hynes
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - Maxime Fouyssac
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - Mickaël Puaud
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - Dhaval Joshi
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - Chloe Chernoff
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - Sonja Stiebahl
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - Lola Michaud
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - David Belin
- Department of Psychology, University of Cambridge, Cambridge, UK
| |
Collapse
|
140
|
Morris SM, Wiens L, Rose O, Fritz G, Rogers T, Gebhard S. Regulatory interactions between daptomycin- and bacitracin-responsive pathways coordinate the cell envelope antibiotic resistance response of Enterococcus faecalis. Mol Microbiol 2024. [PMID: 38646792 DOI: 10.1111/mmi.15264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 04/02/2024] [Accepted: 04/03/2024] [Indexed: 04/23/2024]
Abstract
Enterococcal infections frequently show high levels of antibiotic resistance, including to cell envelope-acting antibiotics like daptomycin (DAP). While we have a good understanding of the resistance mechanisms, less is known about the control of such resistance genes in enterococci. Previous work unveiled a bacitracin resistance network, comprised of the sensory ABC transporter SapAB, the two-component system (TCS) SapRS and the resistance ABC transporter RapAB. Interestingly, components of this system have recently been implicated in DAP resistance, a role usually regulated by the TCS LiaFSR. To better understand the regulation of DAP resistance and how this relates to mutations observed in DAP-resistant clinical isolates of enterococci, we here explored the interplay between these two regulatory pathways. Our results show that SapR regulates an additional resistance operon, dltXABCD, a known DAP resistance determinant, and show that LiaFSR regulates the expression of sapRS. This regulatory structure places SapRS-target genes under dual control, where expression is directly controlled by SapRS, which itself is up-regulated through LiaFSR. The network structure described here shows how Enterococcus faecalis coordinates its response to cell envelope attack and can explain why clinical DAP resistance often emerges via mutations in regulatory components.
Collapse
Affiliation(s)
- Sali M Morris
- Life Sciences Department, Milner Centre for Evolution, University of Bath, Bath, UK
| | - Laura Wiens
- Institute of Molecular Physiology, Johannes-Gutenberg-University Mainz, Mainz, Germany
| | - Olivia Rose
- Life Sciences Department, Milner Centre for Evolution, University of Bath, Bath, UK
| | - Georg Fritz
- School of Molecular Sciences, The University of Western Australia, Crawley, WA, Australia
| | - Tim Rogers
- Department of Mathematical Sciences, University of Bath, Bath, UK
| | - Susanne Gebhard
- Life Sciences Department, Milner Centre for Evolution, University of Bath, Bath, UK
- Institute of Molecular Physiology, Johannes-Gutenberg-University Mainz, Mainz, Germany
| |
Collapse
|
141
|
Saranholi BH, França FM, Vogler AP, Barlow J, Vaz de Mello FZ, Maldaner ME, Carvalho E, Gestich CC, Howes B, Banks-Leite C, Galetti PM. Testing and optimizing metabarcoding of iDNA from dung beetles to sample mammals in the hyperdiverse Neotropics. Mol Ecol Resour 2024:e13961. [PMID: 38646932 DOI: 10.1111/1755-0998.13961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 03/16/2024] [Accepted: 04/08/2024] [Indexed: 04/25/2024]
Abstract
Over the past few years, insects have been used as samplers of vertebrate diversity by assessing the ingested-derived DNA (iDNA), and dung beetles have been shown to be a good mammal sampler given their broad feeding preference, wide distribution and easy sampling. Here, we tested and optimized the use of iDNA from dung beetles to assess the mammal community by evaluating if some biological and methodological aspects affect the use of dung beetles as mammal species samplers. We collected 403 dung beetles from 60 pitfall traps. iDNA from each dung beetle was sequenced by metabarcoding using two mini-barcodes (12SrRNA and 16SrRNA). We assessed whether dung beetles with different traits related to feeding, nesting and body size differed in the number of mammal species found in their iDNA. We also tested differences among four killing solutions in preserving the iDNA and compared the effectiveness of each mini barcode to recover mammals. We identified a total of 50 mammal OTUs (operational taxonomic unit), including terrestrial and arboreal species from 10 different orders. We found that at least one mammal-matching sequence was obtained from 70% of the dung beetle specimens. The number of mammal OTUs obtained did not vary with dung beetle traits as well as between the killing solutions. The 16SrRNA mini-barcode recovered a higher number of mammal OTUs than 12SrRNA, although both sets were partly non-overlapping. Thus, the complete mammal diversity may not be achieved by using only one of them. This study refines the methodology for routine assessment of tropical mammal communities via dung beetle 'samplers' and its universal applicability independently of the species traits of local beetle communities.
Collapse
Affiliation(s)
- Bruno H Saranholi
- Department of Life Sciences, Imperial College London, Ascot, UK
- Departamento de Genética e Evolução, Universidade Federal de São Carlos, São Carlos, Brazil
| | - Filipe M França
- School of Biological Sciences, University of Bristol, Bristol, UK
- Graduate Program in Ecology, Biological Sciences Institute, Federal University of Pará, Belém, Pará, Brazil
| | - Alfried P Vogler
- Department of Life Sciences, Imperial College London, Ascot, UK
- Department of Life Sciences, Natural History Museum, London, UK
| | - Jos Barlow
- Lancaster Environment Centre, Lancaster University, Lancaster, UK
| | - Fernando Z Vaz de Mello
- Departamento de Biologia e Zoologia, Universidade Federal de Mato Grosso, Instituto de Biociências, Cuiabá, MT, Brazil
| | - Maria E Maldaner
- Programa de Pós-Graduação Em Ecologia e Conservação da Biodiversidade (PPGECB), Universidade Federal de Mato Grosso (UFMT), Cuiabá, Brazil
| | - Edrielly Carvalho
- Programa de Pós-Graduação Em Entomologia, Instituto Nacional de Pesquisas da Amazônia, INPA, Manaus, Amazonas, Brazil
| | - Carla C Gestich
- Departamento de Genética e Evolução, Universidade Federal de São Carlos, São Carlos, Brazil
| | - Benjamin Howes
- Department of Life Sciences, Imperial College London, Ascot, UK
| | | | - Pedro M Galetti
- Departamento de Genética e Evolução, Universidade Federal de São Carlos, São Carlos, Brazil
| |
Collapse
|
142
|
Demou E, Blake C, Tan Llorin C, Salanga MG, Mateo NJ, Lewis R, Mitchell KR. Group-level workplace interventions to improve mental health in low control, high-demand office-based jobs. A scoping review. Ann Work Expo Health 2024; 68:335-350. [PMID: 38489824 PMCID: PMC11033569 DOI: 10.1093/annweh/wxae012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 02/09/2024] [Indexed: 03/17/2024] Open
Abstract
OBJECTIVES Workplace psychosocial risk factors, including low autonomy and high demands, have negative consequences for employee mental health and wellbeing. There is a need to support employees experiencing mental health and well-being problems in these jobs. This scoping review aims to describe group-level workplace interventions and their approaches to improving the mental health and well-being of employees in office-based, low autonomy, and high demands jobs. METHODS Following PRISMA-ScR guidelines, a search was conducted across 4 databases (Medline, PsycINFO, CINAHL, ASSIA). We explored studies presenting group-level interventions, mode of implementation, facilitators and barriers, and intervention effectiveness. The search was restricted to include office-based, low autonomy, and high-demands jobs. Primary outcome of interest was mental health and secondary outcomes were work-related and other well-being outcomes. RESULTS Group-level workplace interventions include an array of organizational, relational, and individual components. Almost all included a training session or workshop for intervention delivery. Several had manuals but theories of change were rare. Most workplace interventions did not use participatory approaches to involve employees in intervention development, implementation and evaluation, and challenges and facilitators were not commonly reported. Key facilitators were shorter intervention duration, flexible delivery modes, and formalized processes (e.g. manuals). A key barrier was the changeable nature of workplace environments. All studies employing behavioural interventions reported significant improvements in mental health outcomes, while no clear pattern of effectiveness was observed for other outcomes or types of interventions employed. CONCLUSIONS Group-based interventions in low-autonomy office settings can be effective but few studies used participatory approaches or conducted process evaluations limiting our knowledge of the determinants for successful group-based workplace interventions. Involving stakeholders in intervention development, implementation, and evaluation is recommended and can be beneficial for better articulation of the acceptability and barriers and facilitators for delivery and engagement.
Collapse
Affiliation(s)
- Evangelia Demou
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Clarice Pears Building, 90 Byres Road, Glasgow G12 8TB, United Kingdom
| | - Carolyn Blake
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Clarice Pears Building, 90 Byres Road, Glasgow G12 8TB, United Kingdom
| | - Charisse Tan Llorin
- Social Development Research Center, De La Salle University, 2401 Taft Avenue, Manila 0922, Philippines
| | - Maria Guadalupe Salanga
- Department of Psychology, De La Salle University, 2401 Taft Avenue, Manila 0922, Philippines
| | - Niño Jose Mateo
- Department of Counseling and Educational Psychology, De La Salle University, 2401 Taft Avenue, Manila 0922, Philippines
| | - Ruth Lewis
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Clarice Pears Building, 90 Byres Road, Glasgow G12 8TB, United Kingdom
| | - Kirstin R Mitchell
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Clarice Pears Building, 90 Byres Road, Glasgow G12 8TB, United Kingdom
| |
Collapse
|
143
|
Somerville TF, Mdala S, Zungu T, Gandiwa M, Herbert R, Everett D, Corless CE, Beare NAV, Neal T, Horsburgh MJ, Darby A, Kaye SB, Kayange PC. Microbial keratitis in Southern Malawi: a microbiological pilot study. BMJ Open Ophthalmol 2024; 9:e001682. [PMID: 38653537 PMCID: PMC11043707 DOI: 10.1136/bmjophth-2024-001682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 04/10/2024] [Indexed: 04/25/2024] Open
Abstract
OBJECTIVE Microbial keratitis (MK) is a significant cause of blindness in sub-Saharan Africa. We investigated the feasibility of using a novel corneal impression membrane (CIM) for obtaining and processing samples by culture, PCR and whole-genome sequencing (WGS) in patients presenting with suspected MK in Malawi. METHODS AND ANALYSIS Samples were collected from patients presenting with suspected MK using a 12 mm diameter polytetrafluoroethylene CIM disc. Samples were processed using culture and PCR for Acanthamoeba, herpes simplex virus type 1 (HSV-1) and the bacterial 16S rRNA gene. Minimum inhibitory concentrations of isolates to eight antimicrobials were measured using susceptibility strips. WGS was used to characterise Staphylococcus aureus isolates. RESULTS 71 eyes of 71 patients were included. The overall CIM isolation rate was 81.7% (58 positive samples from 71 participants). 69 (81.2%) of isolates were Gram-positive cocci. Coagulase-negative Staphylococcus 31.8% and Streptococcus species 14.1% were the most isolated bacteria. Seven (9.9%) participants were positive for HSV-1. Fungi and Acanthamoeba were not detected. Moxifloxacin and chloramphenicol offered the best coverage for both Gram-positive and Gram-negative isolates when susceptibility was determined using known antimicrobial first quartile concentrations and European Committee on Antimicrobial Susceptibility Testing breakpoints, respectively. WGS identified known virulence genes associated with S. aureus keratitis. CONCLUSIONS In a resource-poor setting, a CIM can be used to safely sample the cornea in patients presenting with suspected MK, enabling identification of causative microorganisms by culture and PCR. Although the microbiological spectrum found was limited to the dry season, these preliminary results could be used to guide empirical treatment.
Collapse
Affiliation(s)
- Tobi F Somerville
- Department of Eye and Vision Sciences, University of Liverpool, Liverpool, UK
| | - Shaffi Mdala
- Queen Elizabeth Central Hospital, Blantyre, Southern Region, Malawi
- Ophthalmology Unit, Kamuzu University of Health Sciences, Blantyre, Southern Region, Malawi
| | - Thokozani Zungu
- Queen Elizabeth Central Hospital, Blantyre, Southern Region, Malawi
- Ophthalmology Unit, Kamuzu University of Health Sciences, Blantyre, Southern Region, Malawi
| | - Moira Gandiwa
- Ophthalmology Unit, Kamuzu University of Health Sciences, Blantyre, Southern Region, Malawi
- Kamuzu Central Hospital, Lilongwe, Central Region, Malawi
| | - Rose Herbert
- Department of Eye and Vision Sciences, University of Liverpool, Liverpool, UK
| | - Dean Everett
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi
- College of Medicine and Health Sciences, Infection Research Unit, Khalifa University, Abu Dhabi, UAE
| | - Caroline E Corless
- Medical Microbiology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | | | - Timothy Neal
- Department of Infection and Immunity, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Malcolm J Horsburgh
- Department of Infection Biology and Microbiomes, University of Liverpool, Liverpool, UK
| | - Alistair Darby
- Department of Infection Biology and Microbiomes, University of Liverpool, Liverpool, UK
| | - Stephen B Kaye
- Department of Eye and Vision Sciences, University of Liverpool, Liverpool, UK
| | - Petros C Kayange
- Queen Elizabeth Central Hospital, Blantyre, Southern Region, Malawi
- Ophthalmology Unit, Kamuzu University of Health Sciences, Blantyre, Southern Region, Malawi
| |
Collapse
|
144
|
Dos Santos E, Cochemé HM. How does a fly die? Insights into ageing from the pathophysiology of Drosophila mortality. GeroScience 2024:10.1007/s11357-024-01158-4. [PMID: 38642259 DOI: 10.1007/s11357-024-01158-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 04/05/2024] [Indexed: 04/22/2024] Open
Abstract
The fruit fly Drosophila melanogaster is a common animal model in ageing research. Large populations of flies are used to study the impact of genetic, nutritional and pharmacological interventions on survival. However, the processes through which flies die and their relative prevalence in Drosophila populations are still comparatively unknown. Understanding the causes of death in an animal model is essential to dissect the lifespan-extending interventions that are organism- or disease-specific from those broadly applicable to ageing. Here, we review the pathophysiological processes that can lead to fly death and discuss their relation to ageing.
Collapse
Affiliation(s)
- Eliano Dos Santos
- MRC Laboratory of Medical Sciences (LMS), Hammersmith Hospital Campus, Du Cane Road, London, W12 0HS, UK
- Institute of Clinical Sciences, Hammersmith Hospital Campus, Imperial College London, Du Cane Road, London, W12 0HS, UK
| | - Helena M Cochemé
- MRC Laboratory of Medical Sciences (LMS), Hammersmith Hospital Campus, Du Cane Road, London, W12 0HS, UK.
- Institute of Clinical Sciences, Hammersmith Hospital Campus, Imperial College London, Du Cane Road, London, W12 0HS, UK.
| |
Collapse
|
145
|
Nangaku M, Herrington WG, Goto S, Maruyama S, Kashihara N, Ueki K, Wada J, Watada H, Nakashima E, Lee R, Massey D, Mayne KJ, Tomita A, Haynes R, Hauske SJ, Kadowaki T. Effects of empagliflozin in patients with chronic kidney disease from Japan: exploratory analyses from EMPA-KIDNEY. Clin Exp Nephrol 2024:10.1007/s10157-024-02489-4. [PMID: 38643286 DOI: 10.1007/s10157-024-02489-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 03/18/2024] [Indexed: 04/22/2024]
Abstract
BACKGROUND EMPA-KIDNEY assessed the effects of empagliflozin 10 mg once daily vs. placebo in 6609 patients with chronic kidney disease (CKD) at risk of progression, including 612 participants from Japan. METHODS Eligibility required an estimated glomerular filtration rate (eGFR) of ≥ 20 < 45; or ≥ 45 < 90 ml/min/1.73m2 with a urinary albumin-to-creatinine ratio (uACR) of ≥ 200 mg/g. The primary outcome was a composite of kidney disease progression (end-stage kidney disease, a sustained eGFR decline to < 10 ml/min/1.73m2 or ≥ 40% from randomization, or renal death) or cardiovascular death. In post-hoc analyses, we explored the effects of empagliflozin in participants from Japan vs. non-Japan regions, including additional models assessing whether differences in treatment effects between these regions could result from differences in baseline characteristics. RESULTS Japanese participants had higher levels of albuminuria and eGFR than those from non-Japan regions. During a median of 2.0 year follow-up, a primary outcome occurred in 432 patients (13.1%) in the empagliflozin group and in 558 patients (16.9%) in the placebo group (hazard ratio [HR], 0.72, 95% confidence interval [95%CI] 0.64-0.82; P < 0.0001). Among the participants from non-Japan regions, there were 399 vs. 494 primary outcomes (0.75, 0.66-0.86), and 33 vs. 64 (0.49, 0.32-0.75; heterogeneity p = 0.06) in Japan. Results were similar when models explicitly considered treatment interactions with diabetes status, categories of eGFR/uACR, and recruitment in Japan (heterogeneity p = 0.08). Safety outcomes were broadly comparable between the two groups, and by Japanese status. CONCLUSIONS Empagliflozin safely reduced the risk of "kidney disease progression or cardiovascular death" in patients with CKD, with consistent effects in participants from Japan.
Collapse
Affiliation(s)
- Masaomi Nangaku
- Division of Nephrology and Endocrinology, The University of Tokyo School of Medicine, Tokyo, 113-8655, Japan.
| | - William G Herrington
- Medical Research Council Population Health Research Unit, Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Shinya Goto
- Tokai University School of Medicine, Isehara, Japan
| | - Shoichi Maruyama
- Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | | | - Kohjiro Ueki
- Diabetes Research Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Jun Wada
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Hirotaka Watada
- Department of Metabolism &Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Eitaro Nakashima
- Department of Diabetes and Endocrinology, Chubu Rosai Hospital, Nagoya, Japan
| | - Ryonfa Lee
- Medical Research Council Population Health Research Unit, Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Dan Massey
- Elderbrook Solutions GmbH On Behalf of Boehringer Ingelheim Pharma GmbH & Co.KG, Biberach, Germany
| | - Kaitlin J Mayne
- Medical Research Council Population Health Research Unit, Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Aiko Tomita
- Tokai University School of Medicine, Isehara, Japan
| | - Richard Haynes
- Medical Research Council Population Health Research Unit, Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Sibylle J Hauske
- Boehringer Ingelheim International GmbH, Ingelheim, Germany
- Vth Department of Medicine, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany
| | - Takashi Kadowaki
- The University of Tokyo School of Medicine/Toranomon Hospital, Tokyo, Japan
| |
Collapse
|
146
|
Karlsen TH, Rutter H, Carrieri P, Zelber-Sagi S, Engebretsen E, Hutchinson S, Voigt K, Guha N, Berzigotti A, Schomerus G, Gines P, Buti M, Burra P, Manns MP, Krag A, Kleinert S. The EASL-Lancet Commission on liver health in Europe: prevention, case-finding, and early diagnosis to reduce liver-related mortality. Lancet 2024; 403:1522-1524. [PMID: 38359860 DOI: 10.1016/s0140-6736(24)00204-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 02/01/2024] [Indexed: 02/17/2024]
Affiliation(s)
- Tom H Karlsen
- Department of Transplantation Medicine, Clinic of Surgery, Inflammatory Diseases and Transplantation, Oslo University Hospital and University of Oslo, N-0424 Oslo, Norway; Research Institute of Internal Medicine, Clinic of Surgery, Inflammatory Diseases and Transplantation, Oslo University Hospital and University of Oslo, Oslo, Norway.
| | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath, UK
| | - Patrizia Carrieri
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques, Sociales de la Santé, and Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Shira Zelber-Sagi
- School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Eivind Engebretsen
- Sustainable Health Unit (SUSTAINIT), Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Sharon Hutchinson
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK; Clinical and Protecting Health Directorate, Public Health Scotland, Glasgow, UK
| | - Kristin Voigt
- Department of Equity, Ethics and Policy and Department of Philosophy, McGill University, Quebec, Canada
| | - Neil Guha
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals, NHS Trust and the University of Nottingham, Nottingham, UK
| | - Annalisa Berzigotti
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Georg Schomerus
- Department of Psychiatry, Leipzig University Medical Center, Leipzig, Germany
| | - Pere Gines
- Liver Unit Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Maria Buti
- Liver Unit, Hospital Universitario Valle Hebron, Barcelona, Spain
| | - Patrizia Burra
- Multivisceral Transplant Unit, Gastroenterology, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, Padua, Italy
| | | | - Aleksander Krag
- Centre for Liver Research, Department of Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark; Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | | |
Collapse
|
147
|
Coleman DJ, Keane P, Chin PS, Ames L, Kellaway S, Blair H, Khan N, Griffin J, Holmes E, Maytum A, Potluri S, Strate L, Koscielniak K, Raghavan M, Bushweller J, Heidenreich O, Rabbitts T, Cockerill PN, Bonifer C. Pharmacological inhibition of RAS overcomes FLT3 inhibitor resistance in FLT3-ITD+ AML through AP-1 and RUNX1. iScience 2024; 27:109576. [PMID: 38638836 PMCID: PMC11024925 DOI: 10.1016/j.isci.2024.109576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 02/16/2024] [Accepted: 03/25/2024] [Indexed: 04/20/2024] Open
Abstract
AML is characterized by mutations in genes associated with growth regulation such as internal tandem duplications (ITD) in the receptor kinase FLT3. Inhibitors targeting FLT3 (FLT3i) are being used to treat patients with FLT3-ITD+ but most relapse and become resistant. To elucidate the resistance mechanism, we compared the gene regulatory networks (GRNs) of leukemic cells from patients before and after relapse, which revealed that the GRNs of drug-responsive patients were altered by rewiring their AP-1-RUNX1 axis. Moreover, FLT3i induces the upregulation of signaling genes, and we show that multiple cytokines, including interleukin-3 (IL-3), can overcome FLT3 inhibition and send cells back into cycle. FLT3i leads to loss of AP-1 and RUNX1 chromatin binding, which is counteracted by IL-3. However, cytokine-mediated drug resistance can be overcome by a pan-RAS inhibitor. We show that cytokines instruct AML growth via the transcriptional regulators AP-1 and RUNX1 and that pan-RAS drugs bypass this barrier.
Collapse
Affiliation(s)
- Daniel J.L. Coleman
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Peter Keane
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Paulynn S. Chin
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Luke Ames
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Sophie Kellaway
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Helen Blair
- Wolfson Childhood Cancer Research Centre, University of Newcastle, Newcastle upon Tyne, UK
| | - Naeem Khan
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - James Griffin
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Elizabeth Holmes
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Alexander Maytum
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Sandeep Potluri
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Lara Strate
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Kinga Koscielniak
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Manoj Raghavan
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - John Bushweller
- School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Olaf Heidenreich
- Wolfson Childhood Cancer Research Centre, University of Newcastle, Newcastle upon Tyne, UK
- Princess Máxima Centrum of Pediatric Oncology, Utrecht, the Netherlands
| | - Terry Rabbitts
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, UK
| | - Peter N. Cockerill
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Constanze Bonifer
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| |
Collapse
|
148
|
Tobias JH, Nethander M, Faber BG, Heppenstall SV, Ebsim R, Cootes T, Lindner C, Saunders FR, Gregory JS, Aspden RM, Harvey NC, Kemp JP, Frysz M, Ohlsson C. Femoral neck width genetic risk score is a novel independent risk factor for hip fractures. J Bone Miner Res 2024; 39:241-251. [PMID: 38477772 DOI: 10.1093/jbmr/zjae002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 11/02/2023] [Accepted: 11/09/2023] [Indexed: 03/14/2024]
Abstract
Femoral neck width (FNW) derived from DXA scans may provide a useful adjunct to hip fracture prediction. Therefore, we investigated whether FNW is related to hip fracture risk independently of femoral neck bone mineral density (FN-BMD), using a genetic approach. FNW was derived from points automatically placed on the proximal femur using hip DXA scans from 38 150 individuals (mean age 63.8 yr, 48.0% males) in UK Biobank (UKB). Genome-wide association study (GWAS) identified 71 independent genome-wide significant FNW SNPs, comprising genes involved in cartilage differentiation, hedgehog, skeletal development, in contrast to SNPs identified by FN-BMD GWAS which primarily comprised runx1/Wnt signaling genes (MAGMA gene set analyses). FNW and FN-BMD SNPs were used to generate genetic instruments for multivariable Mendelian randomization. Greater genetically determined FNW increased risk of all hip fractures (odds ratio [OR] 1.53; 95% CI, 1.29-1.82 per SD increase) and femoral neck fractures (OR 1.58;1.30-1.92), but not trochanteric or forearm fractures. In contrast, greater genetically determined FN-BMD decreased fracture risk at all 4 sites. FNW and FN-BMD SNPs were also used to generate genetic risk scores (GRSs), which were examined in relation to incident hip fracture in UKB (excluding the FNW GWAS population; n = 338 742, 3222 cases) using a Cox proportional hazards model. FNW GRS was associated with increased risk of all incident hip fractures (HR 1.08;1.05-1.12) and femoral neck fractures (hazard ratio [HR] 1.10;1.06-1.15), but not trochanteric fractures, whereas FN-BMD GRS was associated with reduced risk of all hip fracture types. We conclude that the underlying biology regulating FNW and FN-BMD differs, and that DXA-derived FNW is causally related to hip fractures independently of FN-BMD, adding information beyond FN-BMD for hip fracture prediction. Hence, FNW derived from DXA analyses or a FNW GRS may contribute clinically useful information beyond FN-BMD for hip fracture prediction.
Collapse
Affiliation(s)
- Jonathan H Tobias
- Musculoskeletal Research Unit, Translational Health Sciences, Southmead Hospital, University of Bristol, Bristol BS10 5NB, United Kingdom
- Medical Research Council Integrative Epidemiology Unit, Population Health Sciences, University of Bristol, Bristol BS8 2BN, United Kingdom
| | - Maria Nethander
- Sahlgrenska Osteoporosis Centre, Centre for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, 41345 Gothenburg, Sweden
- Bioinformatics and Data Center, Sahlgrenska Academy at University of Gothenburg, 40530 Gothenburg, Sweden
| | - Benjamin G Faber
- Musculoskeletal Research Unit, Translational Health Sciences, Southmead Hospital, University of Bristol, Bristol BS10 5NB, United Kingdom
- Medical Research Council Integrative Epidemiology Unit, Population Health Sciences, University of Bristol, Bristol BS8 2BN, United Kingdom
| | - Sophie V Heppenstall
- Musculoskeletal Research Unit, Translational Health Sciences, Southmead Hospital, University of Bristol, Bristol BS10 5NB, United Kingdom
| | - Raja Ebsim
- Division of Informatics, Imaging and Data Sciences, School of Health Sciences, The University of Manchester, Manchester M13 9PT, United Kingdom
| | - Tim Cootes
- Division of Informatics, Imaging and Data Sciences, School of Health Sciences, The University of Manchester, Manchester M13 9PT, United Kingdom
| | - Claudia Lindner
- Division of Informatics, Imaging and Data Sciences, School of Health Sciences, The University of Manchester, Manchester M13 9PT, United Kingdom
| | - Fiona R Saunders
- Centre for Arthritis and Musculoskeletal Health, University of Aberdeen, Aberdeen AB24 3FX, United Kingdom
| | - Jenny S Gregory
- Centre for Arthritis and Musculoskeletal Health, University of Aberdeen, Aberdeen AB24 3FX, United Kingdom
| | - Richard M Aspden
- Centre for Arthritis and Musculoskeletal Health, University of Aberdeen, Aberdeen AB24 3FX, United Kingdom
| | - Nicholas C Harvey
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton SO16 6YD, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, United Kingdom
| | - John P Kemp
- Mater Research Institute, University of Queensland, Brisbane QLD, Australia 4102
| | - Monika Frysz
- Musculoskeletal Research Unit, Translational Health Sciences, Southmead Hospital, University of Bristol, Bristol BS10 5NB, United Kingdom
| | - Claes Ohlsson
- Sahlgrenska Osteoporosis Centre, Centre for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, 41345 Gothenburg, Sweden
- Department of Drug Treatment, Sahlgrenska University Hospital, 41345 Gothenburg, Sweden
| |
Collapse
|
149
|
Bah M, Verhoef H, Okoh E, Bah A, Prentice AM, Cerami C. Haem iron versus ferrous iron salts to treat iron deficiency anaemia in Gambian children: protocol for randomised controlled trial {1}. Trials 2024; 25:270. [PMID: 38641845 PMCID: PMC11027386 DOI: 10.1186/s13063-024-08101-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 04/10/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND The World Health Organization recommends universal iron supplementation for children aged 6-23 months in countries where anaemia is seen in over 40% of the population. Conventional ferrous salts have low efficacy due to low oral absorption in children with inflammation. Haem iron is more bioavailable, and its absorption may not be decreased by inflammation. This study aims to compare daily supplementation with haem iron versus ferrous sulphate on haemoglobin concentration and serum ferritin concentration after 12 weeks of supplementation. METHODS This will be a two-arm, randomised controlled trial. Gambian children aged 6-12 months with anaemia will be recruited within a predefined geographical area and recruited by trained field workers. Eligible participants will be individually randomised using a 1:1 ratio within permuted blocks to daily supplementation for 12 weeks with either 10.0 mg of elemental iron as haem or ferrous sulphate. Safety outcomes such as diarrhoea and infection-related adverse events will be assessed daily by the clinical team (see Bah et al. Additional file 4_Adverse event eCRF). Linear regression will be used to analyse continuous outcomes, with log transformation to normalise residuals as needed. Binary outcomes will be analysed by binomial regression or logistic regression, Primary analysis will be by modified intention-to-treat (i.e., those randomised and who ingested at least one supplement dose of iron), with multiple imputations to replace missing data. Effect estimates will be adjusted for baseline covariates (C-reactive protein, alpha-1-acid glycoprotein, haemoglobin, ferritin, soluble transferrin receptor). DISCUSSION This study will determine if therapeutic supplementation with haem iron is more efficacious than with conventional ferrous sulphate in enhancing haemoglobin and ferritin concentrations in anaemic children aged 6-12 months. TRIAL REGISTRATION Pan African Clinical Trial Registry PACTR202210523178727.
Collapse
Affiliation(s)
- Mamadou Bah
- Medical Research Council (MRC) Unit The Gambia at London School of Hygiene & Tropical Medicine (LSHTM), PO Box 273, Fajara, Banjul, The Gambia
- Division of Human Nutrition and Health, Wageningen University, PO Box 17, 6700, AA, Wageningen, The Netherlands
| | - Hans Verhoef
- Division of Human Nutrition and Health, Wageningen University, PO Box 17, 6700, AA, Wageningen, The Netherlands
| | - Emmanuel Okoh
- Medical Research Council (MRC) Unit The Gambia at London School of Hygiene & Tropical Medicine (LSHTM), PO Box 273, Fajara, Banjul, The Gambia
| | - Abdoulie Bah
- Medical Research Council (MRC) Unit The Gambia at London School of Hygiene & Tropical Medicine (LSHTM), PO Box 273, Fajara, Banjul, The Gambia
| | - Andrew M Prentice
- Medical Research Council (MRC) Unit The Gambia at London School of Hygiene & Tropical Medicine (LSHTM), PO Box 273, Fajara, Banjul, The Gambia
| | - Carla Cerami
- Medical Research Council (MRC) Unit The Gambia at London School of Hygiene & Tropical Medicine (LSHTM), PO Box 273, Fajara, Banjul, The Gambia.
| |
Collapse
|
150
|
Abdullah SM, Huque R, Siddiqi K, Kanaan M, Huque S, Ullah S, Garg S, Singh MM, Deshmukh C, Borle AL, Iqbal R, Mazhar L, Parascandola M, Mehrotra R, Croucher R, Khan Z. Non-compliant packaging and illicit smokeless tobacco in Bangladesh, India and Pakistan: findings of a pack analysis. Tob Control 2024; 33:333-340. [PMID: 36167826 DOI: 10.1136/tc-2021-057228] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 09/13/2022] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Illicit smokeless tobacco (ST) trade has seldom been documented despite ST use in at least 127 countries across the world. Based on non-compliance with packaging regulations, we report the proportion of illicit ST products from samples on sale in Bangladesh, India and Pakistan where 85% of global ST users reside. METHODS We purchased unique ST products from tobacco sellers in two purposively selected administrative areas (division/district) in each of the three countries. The criteria to determine illicit ST products were based on country-specific legal requirements for ST packaging and labelling. These requirements included: 'market retail price disclosure', 'sale statement disclosure', 'pictorial health warning (PHW) pertinence', 'appropriate textual health warning' and 'using misleading descriptors (MDs)'. Non-compliance with even one of the legal requirements was considered to render the ST product illicit. RESULTS Almost all ST products bought in Bangladesh and India were non-compliant with the local packaging requirements and hence potentially illicit, all products in Pakistan lacked desirable features. The most common feature missing was health warnings: 84% packs in Bangladesh, 93% in India, and 100% in Pakistan either did not have PHW or their sizes were too small. In Bangladesh, 61% packs carried MDs. In India and Pakistan, the proportions of such packs were 32% and 42%, respectively. CONCLUSIONS Weak and poorly enforced ST control policies may be slowing the progress of tobacco control in South Asia. Standardised regulations are required for packaging and labelling ST. Improving compliance and reducing sale of cheap illicit products may require business licensing and market surveillance.
Collapse
Affiliation(s)
- S M Abdullah
- Health Sciences, University of York, York, UK
- Department of Economics, University of Dhaka, Dhaka, Dhaka District, Bangladesh
| | - Rumana Huque
- Department of Economics, University of Dhaka, Dhaka, Dhaka District, Bangladesh
- Research and Development, ARK Foundation, Dhaka, Bangladesh
| | | | - Mona Kanaan
- Health Sciences, University of York, York, UK
| | - Samina Huque
- Research and Development, ARK Foundation, Dhaka, Bangladesh
| | - Safat Ullah
- Office of Research Innovation and Commercialization, Khyber Medical University, Pehsawar, Khyber Pakhtunkhwa, Pakistan
| | - Suneela Garg
- Department of Community Medicine, Maulana Azad Medical College and Associated Hospitals, New Delhi, Delhi, India
| | - Mongjam Meghachandra Singh
- Department of Community Medicine, Maulana Azad Medical College and Associated Hospitals, New Delhi, Delhi, India
| | - Chetana Deshmukh
- Department of Community Medicine, Maulana Azad Medical College and Associated Hospitals, New Delhi, Delhi, India
| | - Amod L Borle
- Department of Community Medicine, Maulana Azad Medical College and Associated Hospitals, New Delhi, Delhi, India
| | - Romaina Iqbal
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Laraib Mazhar
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
- Department of Medicine, Aga Khan University, Karachi, Pakistan
| | - Mark Parascandola
- National Cancer Institute, Division of Cancer Control and Population Sciences, Bethesda, Maryland, USA
| | - Ravi Mehrotra
- Indian Council of Medical Research (ICMR) - Indian Cancer Research Consortium, New Delhi, Delhi, India
| | | | - Zohaib Khan
- Office of Research Innovation and Commercialization, Khyber Medical University, Pehsawar, Khyber Pakhtunkhwa, Pakistan
| |
Collapse
|