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Slight-Webb S, Thomas K, Smith M, Wagner CA, Macwana S, Bylinska A, Donato M, Dvorak M, Chang SE, Kuo A, Cheung P, Kalesinskas L, Ganesan A, Dermadi D, Guthridge CJ, DeJager W, Wright C, Foecke MH, Merrill JT, Chakravarty E, Arriens C, Maecker HT, Khatri P, Utz PJ, James JA, Guthridge JM. Ancestry-based differences in the immune phenotype are associated with lupus activity. JCI Insight 2023; 8:e169584. [PMID: 37606045 PMCID: PMC10543734 DOI: 10.1172/jci.insight.169584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 07/10/2023] [Indexed: 08/23/2023] Open
Abstract
Systemic lupus erythematosus (SLE) affects 1 in 537 Black women, which is >2-fold more than White women. Black patients develop the disease at a younger age, have more severe symptoms, and have a greater chance of early mortality. We used a multiomics approach to uncover ancestry-associated immune alterations in patients with SLE and healthy controls that may contribute biologically to disease disparities. Cell composition, signaling, epigenetics, and proteomics were evaluated by mass cytometry; droplet-based single-cell transcriptomics and proteomics; and bead-based multiplex soluble mediator levels in plasma. We observed altered whole blood frequencies and enhanced activity in CD8+ T cells, B cells, monocytes, and DCs in Black patients with more active disease. Epigenetic modifications in CD8+ T cells (H3K27ac) could distinguish disease activity level in Black patients and differentiate Black from White patient samples. TLR3/4/7/8/9-related gene expression was elevated in immune cells from Black patients with SLE, and TLR7/8/9 and IFN-α phospho-signaling and cytokine responses were heightened even in immune cells from healthy Black control patients compared with White individuals. TLR stimulation of healthy immune cells recapitulated the ancestry-associated SLE immunophenotypes. This multiomic resource defines ancestry-associated immune phenotypes that differ between Black and White patients with SLE, which may influence the course and severity of SLE and other diseases.
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Affiliation(s)
- Samantha Slight-Webb
- Department of Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation (OMRF), Oklahoma City, Oklahoma, USA
| | - Kevin Thomas
- Department of Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation (OMRF), Oklahoma City, Oklahoma, USA
- Departments of Medicine and Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Miles Smith
- Department of Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation (OMRF), Oklahoma City, Oklahoma, USA
| | - Catriona A. Wagner
- Department of Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation (OMRF), Oklahoma City, Oklahoma, USA
| | - Susan Macwana
- Department of Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation (OMRF), Oklahoma City, Oklahoma, USA
| | - Aleksandra Bylinska
- Department of Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation (OMRF), Oklahoma City, Oklahoma, USA
- Departments of Medicine and Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Michele Donato
- Institute for Immunity, Transplantation and Infection
- Center for Biomedical Informatics Research, Department of Medicine; and
| | - Mai Dvorak
- Institute for Immunity, Transplantation and Infection
- Center for Biomedical Informatics Research, Department of Medicine; and
| | | | - Alex Kuo
- Division of Immunology and Rheumatology, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Peggie Cheung
- Division of Immunology and Rheumatology, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Laurynas Kalesinskas
- Institute for Immunity, Transplantation and Infection
- Center for Biomedical Informatics Research, Department of Medicine; and
| | - Ananthakrishnan Ganesan
- Institute for Immunity, Transplantation and Infection
- Center for Biomedical Informatics Research, Department of Medicine; and
| | - Denis Dermadi
- Institute for Immunity, Transplantation and Infection
- Center for Biomedical Informatics Research, Department of Medicine; and
| | - Carla J. Guthridge
- Department of Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation (OMRF), Oklahoma City, Oklahoma, USA
| | - Wade DeJager
- Department of Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation (OMRF), Oklahoma City, Oklahoma, USA
| | - Christian Wright
- Department of Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation (OMRF), Oklahoma City, Oklahoma, USA
| | - Mariko H. Foecke
- Division of Immunology and Rheumatology, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Joan T. Merrill
- Department of Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation (OMRF), Oklahoma City, Oklahoma, USA
| | - Eliza Chakravarty
- Department of Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation (OMRF), Oklahoma City, Oklahoma, USA
| | - Cristina Arriens
- Department of Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation (OMRF), Oklahoma City, Oklahoma, USA
- Departments of Medicine and Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | | | - Purvesh Khatri
- Institute for Immunity, Transplantation and Infection
- Center for Biomedical Informatics Research, Department of Medicine; and
| | - Paul J. Utz
- Division of Immunology and Rheumatology, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Judith A. James
- Department of Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation (OMRF), Oklahoma City, Oklahoma, USA
- Departments of Medicine and Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Joel M. Guthridge
- Department of Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation (OMRF), Oklahoma City, Oklahoma, USA
- Departments of Medicine and Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
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Zhou J, Zhou N, Liu Q, Xie ZP, Xu Y, Dai SC, Lu J, Bao ZY, Wu LD. Prevalence of neutropenia in US residents: a population based analysis of NHANES 2011-2018. BMC Public Health 2023; 23:1254. [PMID: 37380948 DOI: 10.1186/s12889-023-16141-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 06/17/2023] [Indexed: 06/30/2023] Open
Abstract
AIMS Neutrophils play a pivotal in immunity and inflammation. We aim to investigate the prevalence of neutropenia in the United States. METHODS In this cross-sectional study, participants from the National Health and Nutrition Examination Survey (NHANES) (2011-2018) were enrolled. Demographic information, hematologic measurements, smoking status of all participants were collected for all participants. All statistical analyses were performed utilizing the NHANES survey weights. Covariate-adjusted linear regression was used to compare hematologic indices in different population grouped by age, sex, ethnicity, and smoking. We also employed multivariate-logistic regression to estimate the weighted odds ratio with a 95% confidence interval and predict the neutropenia risk among. RESULTS 32,102 participants from NHANES survey were included, represented 286.6 million multiracial population in the United States. Black participants had lower mean leukocyte count (mean difference (MD): 0.71 × 109/L; P < 0.001) and lower neutrophil count (MD: 0.83 × 109/L; P < 0.001) compared with white participants after adjusting for age and sex. Furthermore, t a notable observation was the significant downward shift in the distribution curves of leukocyte count and neutrophil count among black participants. Smokers had a higher mean leukocyte count (MD: 1.10 × 109 cells/L; P < 0.001) and a higher mean neutrophil count (MD: 0.75 × 109 cells/L; P < 0.001) comparing with nonsmokers. The estimated prevalence of neutropenia was 1.24% (95% CI: 1.11 - 1.37%), which corresponds to approximately 35.5 million individuals in the United States. The prevalence of neutropenia in black participants was significantly higher than other races. Results of logistic regression analysis showed that black individuals, male individuals, and children younger than 5 years had a higher risk of neutropenia. CONCLUSIONS Neutropenia is more common in the general population than we thought, especially in black individuals and children. More attention should be paid to neutropenia.
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Affiliation(s)
- Jing Zhou
- Department of Infectious Diseases, Affiliated Wuxi Fifth Hospital of Jiangnan University, The Fifth People's Hospital of Wuxi, Wuxi, 214065, China
| | - Nan Zhou
- Department of Nursing, Huadong Sanatorium, Wuxi, 214065, China
| | - Qing Liu
- Department of Nursing, Huadong Sanatorium, Wuxi, 214065, China
| | - Zhi-Ping Xie
- Department of Nursing, Huadong Sanatorium, Wuxi, 214065, China
| | - Yun Xu
- Department of Anesthesiology, Huadong Sanatorium, Wuxi, 214065, China
| | - Si-Cheng Dai
- Department of Nursing, Huadong Sanatorium, Wuxi, 214065, China
| | - Juan Lu
- Department of Nursing, Huadong Sanatorium, Wuxi, 214065, China.
- Department of Anesthesiology, Huadong Sanatorium, Wuxi, 214065, China.
| | - Zheng-Yang Bao
- Department of Internal Medicine, Wuxi Maternity and Child Health Care Hospital, Women's Hospital of Jiangnan University, Jiangnan University, Wuxi, 214002, China.
| | - Li-Da Wu
- Clinical Medical College of Nanjing Medical University, Nanjing, 210029, China.
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3
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Avery EF, Kleynhans JN, Ledergerber B, Schoepf IC, Thorball CW, Kootstra NA, Reiss P, Ryom L, Braun DL, Thurnheer MC, Marzolini C, Seneghini M, Bernasconi E, Cavassini M, Buvelot H, Kouyos RD, Fellay J, Günthard HF, Tarr PE. Leukocyte Count and Coronary Artery Disease Events in People With Human Immunodeficiency Virus: A Longitudinal Study. Clin Infect Dis 2023; 76:1969-1979. [PMID: 36688465 PMCID: PMC10249993 DOI: 10.1093/cid/ciad033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 01/09/2023] [Accepted: 01/19/2023] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND People with human immunodeficiency virus (HIV; PWH) have increased cardiovascular risk. Higher leukocyte count has been associated with coronary artery disease (CAD) events in the general population. It is unknown whether the leukocyte-CAD association also applies to PWH. METHODS In a case-control study nested within the Swiss HIV Cohort Study, we obtained uni- and multivariable odds ratios (OR) for CAD events, based on traditional and HIV-related CAD risk factors, leukocyte count, and confounders previously associated with leukocyte count. RESULTS We included 536 cases with a first CAD event (2000-2021; median age, 56 years; 87% male; 84% with suppressed HIV RNA) and 1464 event-free controls. Cases had higher latest leukocyte count before CAD event than controls (median [interquartile range], 6495 [5300-7995] vs 5900 [4910-7200]; P < .01), but leukocytosis (>11 000/µL) was uncommon (4.3% vs 2.1%; P = .01). In the highest versus lowest leukocyte quintile at latest time point before CAD event, participants had univariable CAD-OR = 2.27 (95% confidence interval, 1.63-3.15) and multivariable adjusted CAD-OR = 1.59 (1.09-2.30). For comparison, univariable CAD-OR for dyslipidemia, diabetes, and recent abacavir exposure were 1.58 (1.29-1.93), 2.19 (1.59-3.03), and 1.73 (1.37-2.17), respectively. Smoking and, to a lesser degree, alcohol and ethnicity attenuated the leukocyte-CAD association. Leukocytes measured up to 8 years before the event were significantly associated with CAD events. CONCLUSIONS PWH in Switzerland with higher leukocyte counts have an independently increased risk of CAD events, to a degree similar to traditional and HIV-related risk factors.
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Affiliation(s)
- Emma F Avery
- University Department of Medicine and Infectious Diseases Service, Kantonsspital Baselland, University of Basel, Bruderholz, Switzerland
| | - Julia N Kleynhans
- University Department of Medicine and Infectious Diseases Service, Kantonsspital Baselland, University of Basel, Bruderholz, Switzerland
| | - Bruno Ledergerber
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Isabella C Schoepf
- University Department of Medicine and Infectious Diseases Service, Kantonsspital Baselland, University of Basel, Bruderholz, Switzerland
- Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland
- Hepatology, Department for Visceral Surgery and Medicine, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Christian W Thorball
- Precision Medicine Unit, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Neeltje A Kootstra
- Department of Experimental Immunology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Peter Reiss
- Department of Global Health and Division of Infectious Disease, Amsterdam University Medical Centers, University of Amsterdam, and Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands
| | - Lene Ryom
- Centre of Excellence for Health, Immunity, and Infections, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Dominique L Braun
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Maria C Thurnheer
- Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Catia Marzolini
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - Marco Seneghini
- Division of Infectious Diseases, Kantonsspital St Gallen, St. Gallen, Switzerland
| | - Enos Bernasconi
- Division of Infectious Diseases, Ospedale Regionale Lugano, University of Geneva and Università della Svizzera italiana, Lugano, Switzerland
| | - Matthias Cavassini
- Infectious Diseases Service, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Hélène Buvelot
- Division of Infectious Disease, Geneva University Hospital, Geneva, Switzerland
| | - Roger D Kouyos
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Jacques Fellay
- Precision Medicine Unit, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Huldrych F Günthard
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Philip E Tarr
- University Department of Medicine and Infectious Diseases Service, Kantonsspital Baselland, University of Basel, Bruderholz, Switzerland
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Kahrizi MS, Patra I, Jalil AT, Achmad H, Alesaeidi S, Al-Gazally ME, Alesaeidi S. Leukocyte telomere length and obesity in children and adolescents: A systematic review and meta-analysis. Front Genet 2022; 13:861101. [PMID: 36160016 PMCID: PMC9490371 DOI: 10.3389/fgene.2022.861101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 07/20/2022] [Indexed: 11/24/2022] Open
Abstract
Background: Several studies have revealed the negative effects of adiposity on telomere length shortening. However, the results of the studies assessing the negative relationship between obesity and leukocyte telomere length (LTL) are not consistent. This systematic review and meta-analysis are aimed to pool the results of articles assessing the relationship between obesity and LTL among children and adolescents. Methods: To retrieve the related studies, four online databases including PubMed, Embase, ProQuest, and Scopus were searched until May 2022. Observational studies evaluating the relationship between obesity and LTL among apparently healthy children and adolescents (aged ≤18 years) were included in the study. We considered the studies that had reported a mean ± standard deviation of LTL. The random-effects model was used to assess the pooled weighted mean difference (WMD) and a 95% confidence interval (CI). Results: The search yielded seven studies from an initial 3,403 records identified. According to the results of seven articles with 4,546 participants, obesity was associated with LTL shortening among children and adolescents (WMD = -0.081; 95% CI: -0.137 to -0.026; p = 0.004; I2 = 99.9%). Also, no publication bias was observed. According to the results of subgrouping, significant results were only attributed to the studies conducted in Europe, with high quality scores, among overweight and obese adolescents, with a baseline LTL lower than 1, and performed in community-based school settings. Also, according to the subgrouping and meta-regression results, the obesity definition criteria and baseline LTL were the possible sources of between-study heterogeneity. Conclusion: We observed shorter LTL among overweight and obese children and adolescents. To obtain more reliable results, further longitudinal prospective studies with large sample sizes and more consistent and accurate definitions of obesity are required.
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Affiliation(s)
| | - Indrajit Patra
- An Independent Researcher, PhD from NIT Durgapur, Durgapur, West Bengal, India
| | | | - Harun Achmad
- Department of Pediatric Dentistry, Faculty of Dentistry, Hasanuddin University, Makassar, Indonesia
| | - Samira Alesaeidi
- Department of Internal Medicine and Rheumatology, Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Sogol Alesaeidi
- Department of Pediatric Medicine, Imam Hossein Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
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Sentana-Lledo D, Sartor O, Balk SP, Einstein DJ. Immune mechanisms behind prostate cancer in men of African ancestry: A review. Prostate 2022; 82:883-893. [PMID: 35254710 PMCID: PMC9875381 DOI: 10.1002/pros.24333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 02/08/2022] [Accepted: 02/21/2022] [Indexed: 01/28/2023]
Abstract
BACKGROUND Men of African ancestry (AA) with prostate cancer suffer from worse outcomes. However, a recent analysis of patients treated with the dendritic cell vaccine sipuleucel-T for prostate cancer suggested that AA patients could have improved outcomes relative to whites. METHODS We conducted a focused literature review of Medline-indexed articles and clinical trials listed on clinicaltrials.gov. RESULTS We identify several studies pointing to enrichment of inflammatory cellular infiltrates and cytokine signaling among AA patients with prostate cancer. We outline potential genomic and transcriptomic alterations that may contribute to immunogenicity. Last, we investigate differences in host immunity and vaccine responsiveness that may be enhanced in AA patients. CONCLUSIONS AA patients with prostate cancer may be enriched for an immunogenic phenotype. Dedicated studies are needed to better understand the immune mechanisms that contribute to existing cancer disparities and test immune-based therapies in this population.
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Affiliation(s)
- Daniel Sentana-Lledo
- Division of Medical Oncology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Oliver Sartor
- Tulane Cancer Center, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Steven P. Balk
- Division of Medical Oncology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - David J. Einstein
- Division of Medical Oncology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
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6
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Salas LA, Peres LC, Thayer ZM, Smith RWA, Guo Y, Chung W, Si J, Liang L. A transdisciplinary approach to understand the epigenetic basis of race/ethnicity health disparities. Epigenomics 2021; 13:1761-1770. [PMID: 33719520 PMCID: PMC8579937 DOI: 10.2217/epi-2020-0080] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 04/07/2020] [Indexed: 11/21/2022] Open
Abstract
Health disparities correspond to differences in disease burden and mortality among socially defined population groups. Such disparities may emerge according to race/ethnicity, socioeconomic status and a variety of other social contexts, and are documented for a wide range of diseases. Here, we provide a transdisciplinary perspective on the contribution of epigenetics to the understanding of health disparities, with a special emphasis on disparities across socially defined racial/ethnic groups. Scientists in the fields of biological anthropology, bioinformatics and molecular epidemiology provide a summary of theoretical, statistical and practical considerations for conducting epigenetic health disparities research, and provide examples of successful applications from cancer research using this approach.
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Affiliation(s)
- Lucas A Salas
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, Lebanon, NH 03756, USA
| | - Lauren C Peres
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA
| | - Zaneta M Thayer
- Department of Anthropology, Dartmouth College, Hanover, NH 03755, USA
| | - Rick WA Smith
- Department of Anthropology, Dartmouth College, Hanover, NH 03755, USA
- The William H. Neukom Institute for Computational Science, Dartmouth College, Hanover, NH 03755, USA
| | | | - Wonil Chung
- Department of Statistics & Actuarial Science, Soongsil University, Seoul, 06478, Korea
- Program in Genetic Epidemiology & Statistical Genetics, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Jiahui Si
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Department of Biostatistics & Epidemiology, Peking University School of Public Health, Beijing, 100191, China
| | - Liming Liang
- Program in Genetic Epidemiology & Statistical Genetics, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
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7
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Hawley JE, Pan S, Kandadi H, Chaimowitz MG, Sheikh N, Drake CG. Analysis of Circulating Immune Biomarkers by Race in Men with Metastatic Castration-Resistant Prostate Cancer Treated with Sipuleucel-T. J Natl Cancer Inst 2021; 114:314-317. [PMID: 34302463 PMCID: PMC8826456 DOI: 10.1093/jnci/djab145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 06/07/2021] [Accepted: 07/19/2021] [Indexed: 11/22/2022] Open
Abstract
Among racial subgroups, Black men have the highest prostate cancer–specific death rate, yet they also exhibit prolonged overall survival compared with White men when treated with standard therapies, including sipuleucel-T. Differential immune responses may play a role in these observations. We compared circulating immune markers from 54 men (18 Black and 36 White) with metastatic castrate-resistant prostate cancer who received sipuleucel-T and were enrolled on an immune monitoring registry. Markers included longitudinal serum cytokine concentrations, humoral responses, and cellular immunity from baseline until 52 weeks after sipuleucel-T administration. Black men had statistically significantly higher median concentrations of TH2-type (interleukin [IL]-4, IL-10, and IL-13) and inflammatory cytokines (IL-2, IL-12, and IL-6) compared with prostate-specific antigen-matched White men both at baseline and 52 weeks after sipuleucel-T (2-sided P < .05). No differences by race were seen in either the antigen-specific T-cell response or the humoral responses to the immunizing antigen PA2024 and select secondary antigens.
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Affiliation(s)
- Jessica E Hawley
- Division of Hematology and Oncology, Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY, USA
| | - Samuel Pan
- Division of Hematology and Oncology, Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY, USA
| | | | - Matthew G Chaimowitz
- Columbia Center for Translational Immunology, Columbia University Irving Medical Center, New York, NY, USA
| | | | - Charles G Drake
- Division of Hematology and Oncology, Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY, USA.,Columbia Center for Translational Immunology, Columbia University Irving Medical Center, New York, NY, USA
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Mangaonkar AA, Tande AJ, Bekele DI. Differential Diagnosis and Workup of Monocytosis: A Systematic Approach to a Common Hematologic Finding. Curr Hematol Malig Rep 2021; 16:267-275. [PMID: 33880680 PMCID: PMC8057007 DOI: 10.1007/s11899-021-00618-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2021] [Indexed: 12/19/2022]
Abstract
Purpose of Review Monocytosis is a frequently encountered clinical condition that needs appropriate investigation due to a broad range of differential diagnoses. This review is meant to summarize the latest literature in the diagnostic testing and interpretation and offer a stepwise diagnostic approach for a patient presenting with monocytosis. Recent Findings Basic studies have highlighted the phenotypic and functional heterogeneity in the monocyte compartment. Studies, both translational and clinical, have provided insights into why monocytosis occurs and how to distinguish the different etiologies. Flow cytometry studies have illustrated that monocyte repartitioning can distinguish chronic myelomonocytic leukemia, a prototypical neoplasm with monocytosis from other reactive or neoplastic causes. Summary In summary, we provide an algorithmic approach to the diagnosis of a patient presenting with monocytosis and expect this document to serve as a reference guide for clinicians.
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Affiliation(s)
| | - Aaron J Tande
- Division of Infectious Diseases, Mayo Clinic, Rochester, MN, USA
| | - Delamo I Bekele
- Division of Rheumatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
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9
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Paximadis M, Picton ACP, Sengupta D, Ramsay M, Puren A, Tiemessen CT. Interleukin-8 genetic diversity, haplotype structure and production differ in two ethnically distinct South African populations. Cytokine 2021; 143:155489. [PMID: 33814271 DOI: 10.1016/j.cyto.2021.155489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 10/14/2020] [Accepted: 02/28/2021] [Indexed: 11/16/2022]
Abstract
A single nucleotide polymorphism (SNP), 251 bases upstream from the IL-8 transcription start (-251A>T, rs4073), has been extensively investigated in cancers and inflammatory and infectious diseases in predominantly European and Asian populations. We sequenced the IL-8 gene of 109 black and 32 white South African (SA) individuals and conducted detailed characterization of gene variation and haplotype structure. IL-8 production in phytohaemagglutinin (PHA)-stimulated peripheral blood mononuclear cells (PBMCs) of a subset (black: N = 22; white: N = 32) of these individuals was measured using ELISA. Select variants were genotyped for additional black individuals (N = 141), and data from the 1000 Genomes Project were used for haplotype analysis and comparative purposes. In white individuals, the -251A>T SNP formed part of a prevalent six-variant haplotype [haplotype frequency (HF): 61%], Hap-1C, involving the following variants: -251A>T; +394T>G (rs2227307); +780C>T (rs2227306); +1240->A (rs2227541); +1635C>T (rs2227543) and +2770A>T (rs2227543). Hap-1C (-251T+394T+780C+1240+A+1635C+2770A) was composed of two three-variant sub-haplotypes [Hap-1Ca: -251T+394T+1240+A; Hap-1Cb: +780C+1635C+2770A) sharing similarities with haplotypes identified in the black population. Hap-1C was found to be present in European, East and South Asian populations. Four haplotypes were identified in the black population with the two prevalent haplotypes each comprised of two variants: Hap-1B [-251A>T and +1240->A; -251T+1240+A; HF: 14%] and Hap-2B [-743T>C (rs2227532) and +2452A>C (rs2227545); -743C+2452C; HF: 13%]. Populations did not differ in unstimulated PBMC IL-8 production. Upon PHA stimulation, PBMCs from white individuals produced more IL-8 (P = 0.04), suggesting the -251T allele is responsible for higher production, however further analysis revealed that Hap-1C (and constituent sub-haplotypes), did not associate with IL-8 production. Populations did however differ in monocyte number with the white population having significantly more monocytes compared to the black population (P = 0.025), and furthermore monocyte number strongly correlated with IL-8 production in both population groups (black: p = 0.0002, r = 0.71; white: P = 0.0005, r = 0.59). Hap-1B, Hap-2B, and a SNP located one base pair upstream of the IL-8 ATG start codon, +100C>T SNP (rs2227538), all associated with higher IL-8 production in the black population - individuals harbouring at least one of these haplotypes/variant associated with higher IL-8 production (P = 0.003) compared to individuals without. The black population was enriched for individuals harbouring Hap-1B and/or Hap-2B compared to the 1000 Genomes project sub-Saharan African population (P = 0.006), suggesting that SA black individuals may be high IL-8 producers. Given the paucity of IL-8-related studies that have been conducted in populations from sub-Saharan Africa, this study has significantly increased our understanding of this important chemokine in the South African population.
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Affiliation(s)
- Maria Paximadis
- Centre for HIV and STIs, National Institute for Communicable Diseases, Johannesburg, South Africa; Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - Anabela C P Picton
- Centre for HIV and STIs, National Institute for Communicable Diseases, Johannesburg, South Africa; Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Dhriti Sengupta
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Michele Ramsay
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Adrian Puren
- Centre for HIV and STIs, National Institute for Communicable Diseases, Johannesburg, South Africa; Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Caroline T Tiemessen
- Centre for HIV and STIs, National Institute for Communicable Diseases, Johannesburg, South Africa; Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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10
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de Sousa E, Ligeiro D, Lérias JR, Zhang C, Agrati C, Osman M, El-Kafrawy SA, Azhar EI, Ippolito G, Wang FS, Zumla A, Maeurer M. Mortality in COVID-19 disease patients: Correlating the association of major histocompatibility complex (MHC) with severe acute respiratory syndrome 2 (SARS-CoV-2) variants. Int J Infect Dis 2020; 98:454-459. [PMID: 32693089 PMCID: PMC7368421 DOI: 10.1016/j.ijid.2020.07.016] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 07/15/2020] [Indexed: 12/14/2022] Open
Abstract
Genetic factors such as the HLA type of patients may play a role in regard to disease severity and clinical outcome of patients with COVID-19. Taking the data deposited in the GISAID database, we made predictions using the IEDB analysis resource (TepiTool) to gauge how variants in the SARS-CoV-2 genome may change peptide binding to the most frequent MHC-class I and -II alleles in Africa, Asia and Europe. We caracterized how a single mutation in the wildtype sequence of of SARS-CoV-2 could influence the peptide binding of SARS-CoV-2 variants to MHC class II, but not to MHC class I alleles. Assuming the ORF8 (L84S) mutation is biologically significant, selective pressure from MHC class II alleles may select for viral varients and subsequently shape the quality and quantity of cellular immune responses aginast SARS-CoV-2. MHC 4-digit typing along with viral sequence analysis should be considered in studies examining clinical outcomes in patients with COVID-19.
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Affiliation(s)
- Eric de Sousa
- ImmunoSurgery Unit, Champalimaud Centre for the Unknown, Avenida Brasília, 1400-038 Lisbon, Portugal.
| | - Dário Ligeiro
- Lisbon Centre for Blood and Transplantation (Instituto Português do Sangue e Transplantação, IPST, Lisbon, Portugal.
| | - Joana R Lérias
- ImmunoSurgery Unit, Champalimaud Centre for the Unknown, Avenida Brasília, 1400-038 Lisbon, Portugal.
| | - Chao Zhang
- Treatment and Research Center for Infectious Diseases, The Fifth Medical Center of PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing 100039, China.
| | - Chiara Agrati
- National Institute for Infectious Diseases, Lazzaro Spallanzani, Rome, Italy.
| | - Mohamed Osman
- York Biomedical Research Institute, University of York, United Kingdom and Emerging and Re-Emerging Diseases, University of Khartoum, Sudan.
| | - Sherif A El-Kafrawy
- Special Infectious Agent Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Esam I Azhar
- Special Infectious Agent Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Giuseppe Ippolito
- National Institute for Infectious Diseases, Lazzaro Spallanzani, Rome, Italy.
| | - Fu-Sheng Wang
- Treatment and Research Center for Infectious Diseases, The Fifth Medical Center of PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing 100039, China.
| | - Alimuddin Zumla
- Division of Infection and Immunity, University College London and NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, UK.
| | - Markus Maeurer
- ImmunoSurgery Unit, Champalimaud Centre for the Unknown, Avenida Brasília, 1400-038 Lisbon, Portugal; I Medical Clinical, University of Mainz, Germany.
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11
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Madan RA, Antonarakis ES, Drake CG, Fong L, Yu EY, McNeel DG, Lin DW, Chang NN, Sheikh NA, Gulley JL. Putting the Pieces Together: Completing the Mechanism of Action Jigsaw for Sipuleucel-T. J Natl Cancer Inst 2020; 112:562-573. [PMID: 32145020 PMCID: PMC7301097 DOI: 10.1093/jnci/djaa021] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 01/23/2020] [Accepted: 01/30/2020] [Indexed: 02/06/2023] Open
Abstract
Sipuleucel-T is an autologous cellular immunotherapy that induces an immune response targeted against prostatic acid phosphatase (PAP) to treat asymptomatic or minimally symptomatic metastatic castration-resistant prostate cancer. In the phase III IMPACT study, sipuleucel-T was associated with a statistically significantly increased overall survival (OS) (median = 4.1 months) vs placebo. Patients with baseline prostate-specific antigen levels in the lowest quartile (≤22.1 ng/mL) exhibited a 13-month improvement in OS with sipuleucel-T. Together, this led sipuleucel-T to be approved and recommended as first-line therapy in various guidelines for treatment of metastatic castration-resistant prostate cancer. This review discusses the varied findings about the mechanisms of action of sipuleucel-T, bringing them together to form a more coherent picture. These pieces include inducing a statistically significant increase in antigen-presenting cell activation; inducing a peripheral immune response specific to the target (PAP) and/or immunizing (PA2024) antigens; stimulating systemic cytotoxic T-lymphocyte activity; and mediating antigen spread (ie, increased antibody responses to secondary proteins in addition to PAP and PA2024). Each of these pieces individually correlates with OS. Sipuleucel-T also traffics T cells to the prostate and is associated with long-term immune memory such that a second course of treatment induces an anamnestic immune response. Prostate cancer does not have a strongly inflamed microenvironment, thus its response to immune checkpoint inhibitors is limited. Because sipuleucel-T is able to traffic T cells to the tumor, it may be an ideal combination partner with immunotherapies including immune checkpoint inhibitors or with radiation therapy.
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Affiliation(s)
- Ravi A Madan
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | | | - Charles G Drake
- Columbia University Herbert Irving Comprehensive Cancer Center, New York, NY, USA
| | - Lawrence Fong
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA
| | - Evan Y Yu
- University of Washington and Seattle Cancer Care Alliance, Seattle, WA, USA
| | | | - Daniel W Lin
- University of Washington and Seattle Cancer Care Alliance, Seattle, WA, USA
| | | | | | - James L Gulley
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
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12
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Gans MD, Gavrilova T. Retrospective Analysis of a New York Newborn Screen Severe Combined Immunodeficiency Referral Center. J Clin Immunol 2020; 40:456-465. [PMID: 31997108 DOI: 10.1007/s10875-020-00757-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 01/21/2020] [Indexed: 12/20/2022]
Abstract
In 2010, the New York State (NYS) Newborn Screen (NBS) Program added the T cell receptor excision circle (TREC) assay to screen for severe combined immunodeficiency disorder (SCID). The objective of this study was to perform a retrospective chart review of 199 infants referred to a single institution for abnormal TREC on NYS NBS between 2010 and 2017. Statistical analysis included analysis of variance, logistic regression models, chi-square, and linear mixed models. One hundred ninety-nine infants were found to have a TREC value of fewer than 200 copies/μL on NYS NBS. Infants were stratified as primary immunodeficiency (PID) (n = 54), immunocompetent (n = 133), lost to follow-up (n = 8), or deceased (n = 4). PID included SCID (n = 3), DiGeorge (n = 6), idiopathic lymphopenia (IL) (n = 44), and other syndromes associated with lymphopenia (n = 3). The 3 SCID cases were identified and brought to treatment, although all experienced significant infections. The study population was found to be predominately non-Hispanic, African American, and male. There was a difference in the average TREC values among those with immunocompetence (83 copies/μL), IL (81 copies/μL), and PID (40 copies/μL) (p < 0.05). On follow-up of 40 patients with IL, patients typically did not have severe infections during first few years of life. This study demonstrates that TREC value can be used to stratify infants for further confirmatory testing to exclude PID. Risk factors, such as stressful prenatal/postnatal conditions, prematurity, race, and sex may affect TREC value but cannot explain all causes of lymphopenia. This study may assist providers in risk stratifying the likelihood of PID with an abnormal TREC and determining the extent of the initial work up that is necessary at the time of a newborn's presentation.
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Affiliation(s)
- Melissa D Gans
- Department of Pediatrics, Division of Allergy and Immunology, Montefiore Medical Center, 1525 Blondell Ave, Bronx, NY, 10461, USA.
| | - Tatyana Gavrilova
- Department of Pediatrics, Division of Allergy and Immunology, Montefiore Medical Center, 1525 Blondell Ave, Bronx, NY, 10461, USA
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13
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Yi JS, Rosa-Bray M, Staats J, Zakroysky P, Chan C, Russo MA, Dumbauld C, White S, Gierman T, Weinhold KJ, Guptill JT. Establishment of normative ranges of the healthy human immune system with comprehensive polychromatic flow cytometry profiling. PLoS One 2019; 14:e0225512. [PMID: 31825961 PMCID: PMC6905525 DOI: 10.1371/journal.pone.0225512] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 11/06/2019] [Indexed: 12/12/2022] Open
Abstract
Existing normative flow cytometry data have several limitations including small sample sizes, incompletely described study populations, variable flow cytometry methodology, and limited depth for defining lymphocyte subpopulations. To overcome these issues, we defined high-dimensional flow cytometry reference ranges for the healthy human immune system using Human Immunology Project Consortium methodologies after carefully screening 127 subjects deemed healthy through clinical and laboratory testing. We enrolled subjects in the following age cohorts: 18–29 years, 30–39, 40–49, and 50–66 and enrolled cohorts to ensure an even gender distribution and at least 30% non-Caucasians. From peripheral blood mononuclear cells, flow cytometry reference ranges were defined for >50 immune subsets including T-cell (activation, maturation, T follicular helper and regulatory T cell), B-cell, and innate cells. We also developed a web tool for visualization of the dataset and download of raw data. This dataset provides the immunology community with a resource to compare and extract data from rigorously characterized healthy subjects across age groups, gender and race.
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Affiliation(s)
- John S Yi
- Department of Surgery, Duke University School of Medicine, Durham, NC, United States of America
| | | | - Janet Staats
- Department of Surgery, Duke University School of Medicine, Durham, NC, United States of America
| | - Pearl Zakroysky
- Duke Clinical Research Institute, Durham, NC, United States of America
| | - Cliburn Chan
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, United States of America
| | - Melissa A Russo
- Department of Neurology, Duke University School of Medicine, Durham, NC, United States of America
| | - Chelsae Dumbauld
- Department of Surgery, Duke University School of Medicine, Durham, NC, United States of America
| | - Scott White
- Department of Surgery, Duke University School of Medicine, Durham, NC, United States of America
| | - Todd Gierman
- Biomat USA-Grifols Plasma Operations, United States of America
| | - Kent J Weinhold
- Department of Surgery, Duke University School of Medicine, Durham, NC, United States of America
| | - Jeffrey T Guptill
- Duke Clinical Research Institute, Durham, NC, United States of America.,Department of Neurology, Duke University School of Medicine, Durham, NC, United States of America
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14
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Needham BL, Salerno S, Roberts E, Boss J, Allgood KL, Mukherjee B. Do black/white differences in telomere length depend on socioeconomic status? BIODEMOGRAPHY AND SOCIAL BIOLOGY 2019; 65:287-312. [PMID: 33243026 PMCID: PMC7703670 DOI: 10.1080/19485565.2020.1765734] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Social and economic disadvantage are hypothesized to increase the risk of disease and death via accelerated biological aging. Given that US blacks are socially and economically disadvantaged relative to whites, health disparities scholars expected that blacks would have shorter telomere length-a biomarker of cell aging-than whites. Yet the majority of studies have found that blacks have longer telomere length than whites. Using data from the National Health and Nutrition Examination Survey (n = 3,761; 28.3% non-Hispanic black, 71.7% non-Hispanic white), we found that leukocyte telomere length was 4.00% (95% CI: 1.12%, 6.87%) longer among blacks compared to whites in the full sample, but differences were greatest among those with lower SES (5.66%; 95% CI: 0.10%, 10.32%), intermediate among those with middle SES (4.14%; 95% CI: 0.05%, 8.24%), and smallest among those with higher SES (2.33%; 95% CI: -3.02%, 7.67%). These results challenge purely genetic explanations for race differences in telomere length and point to a potential social-environmental cause of longer telomere length in US blacks.
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Affiliation(s)
- Belinda L. Needham
- Department of Epidemiology and Center for Social Epidemiology and Population Health, University of Michigan
| | | | | | | | - Kristi L. Allgood
- Department of Epidemiology and Center for Social Epidemiology and Population Health, University of Michigan
| | - Bhramar Mukherjee
- Department of Biostatistics, Department of Epidemiology, University of Michigan
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15
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Gender Dictates the Relationship between Serum Lipids and Leukocyte Counts in the National Health and Nutrition Examination Survey 1999⁻2004. J Clin Med 2019; 8:jcm8030365. [PMID: 30875952 PMCID: PMC6463027 DOI: 10.3390/jcm8030365] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 03/10/2019] [Accepted: 03/12/2019] [Indexed: 12/13/2022] Open
Abstract
Dyslipidemias and leukocytosis are associated with cardiovascular disease and immune disorders. Mechanistic studies have shown lipoprotein metabolism to play a significant role in the regulation of atherosclerosis development and leukocyte activation, whereas lipid-lowering treatments have been shown to exert beneficial anti-inflammatory and immunomodulatory effects in clinical trials. However, the relationship between clinical markers of lipid metabolism and leukocyte counts has not been extensively evaluated at the population level. We aimed to determine whether clinical blood lipid measures are associated with leukocyte counts in the general U.S. population represented in the National Health and Nutrition Examination Survey (NHANES) 1999–2004, and whether differences exist between men and women (n = 5647). We observed a strong positive linear trend between serum triglycerides vs. blood lymphocyte and basophil counts in both men and women, whereas a positive trend between monocytes vs. triglycerides and lymphocytes vs. total cholesterol and LDL-cholesterol (LDL-C) was only detected in women. Conversely, HDL-C was inversely associated with a greater number of leukocyte subsets in men, whereas inverse trends between HDL-C vs. lymphocytes were observed in both men and women. In multiple regression models, a 10% increase in total cholesterol, LDL-C, and triglycerides was associated with a predicted 1.6%, 0.6%, and 1.4% increase in blood lymphocyte counts in women, respectively, whereas no relationship was observed in men. In both men and women, a 10% increase in triglycerides was additionally associated with higher lymphocyte, neutrophil, and basophil counts, whereas 10% increases in HDL-cholesterol were associated with significantly lower lymphocyte, neutrophil, eosinophil, and basophil counts in men, in addition to lower lymphocyte and monocyte counts in women. These findings suggest that clinical lipid markers may be used to predict blood leukocyte distributions, and that a gender-specific relationship exists between distinct classes of serum lipids and immune cell subsets.
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16
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Gielen M, Hageman GJ, Antoniou EE, Nordfjall K, Mangino M, Balasubramanyam M, de Meyer T, Hendricks AE, Giltay EJ, Hunt SC, Nettleton JA, Salpea KD, Diaz VA, Farzaneh-Far R, Atzmon G, Harris SE, Hou L, Gilley D, Hovatta I, Kark JD, Nassar H, Kurz DJ, Mather KA, Willeit P, Zheng YL, Pavanello S, Demerath EW, Rode L, Bunout D, Steptoe A, Boardman L, Marti A, Needham B, Zheng W, Ramsey-Goldman R, Pellatt AJ, Kaprio J, Hofmann JN, Gieger C, Paolisso G, Hjelmborg JBH, Mirabello L, Seeman T, Wong J, van der Harst P, Broer L, Kronenberg F, Kollerits B, Strandberg T, Eisenberg DTA, Duggan C, Verhoeven JE, Schaakxs R, Zannolli R, dos Reis RMR, Charchar FJ, Tomaszewski M, Mons U, Demuth I, Iglesias Molli AE, Cheng G, Krasnienkov D, D'Antono B, Kasielski M, McDonnell BJ, Ebstein RP, Sundquist K, Pare G, Chong M, Zeegers MP. Body mass index is negatively associated with telomere length: a collaborative cross-sectional meta-analysis of 87 observational studies. Am J Clin Nutr 2018; 108:453-475. [PMID: 30535086 PMCID: PMC6454526 DOI: 10.1093/ajcn/nqy107] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 04/27/2018] [Indexed: 12/12/2022] Open
Abstract
Background Even before the onset of age-related diseases, obesity might be a contributing factor to the cumulative burden of oxidative stress and chronic inflammation throughout the life course. Obesity may therefore contribute to accelerated shortening of telomeres. Consequently, obese persons are more likely to have shorter telomeres, but the association between body mass index (BMI) and leukocyte telomere length (TL) might differ across the life span and between ethnicities and sexes. Objective A collaborative cross-sectional meta-analysis of observational studies was conducted to investigate the associations between BMI and TL across the life span. Design Eighty-seven distinct study samples were included in the meta-analysis capturing data from 146,114 individuals. Study-specific age- and sex-adjusted regression coefficients were combined by using a random-effects model in which absolute [base pairs (bp)] and relative telomere to single-copy gene ratio (T/S ratio) TLs were regressed against BMI. Stratified analysis was performed by 3 age categories ("young": 18-60 y; "middle": 61-75 y; and "old": >75 y), sex, and ethnicity. Results Each unit increase in BMI corresponded to a -3.99 bp (95% CI: -5.17, -2.81 bp) difference in TL in the total pooled sample; among young adults, each unit increase in BMI corresponded to a -7.67 bp (95% CI: -10.03, -5.31 bp) difference. Each unit increase in BMI corresponded to a -1.58 × 10(-3) unit T/S ratio (0.16% decrease; 95% CI: -2.14 × 10(-3), -1.01 × 10(-3)) difference in age- and sex-adjusted relative TL in the total pooled sample; among young adults, each unit increase in BMI corresponded to a -2.58 × 10(-3) unit T/S ratio (0.26% decrease; 95% CI: -3.92 × 10(-3), -1.25 × 10(-3)). The associations were predominantly for the white pooled population. No sex differences were observed. Conclusions A higher BMI is associated with shorter telomeres, especially in younger individuals. The presently observed difference is not negligible. Meta-analyses of longitudinal studies evaluating change in body weight alongside change in TL are warranted.
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Affiliation(s)
- Marij Gielen
- Departments of Complex Genetics,Address correspondence to MG (e-mail: )
| | - Geja J Hageman
- Toxicology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht University, Netherlands
| | - Evangelia E Antoniou
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Netherlands
| | | | - Massimo Mangino
- Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom,NIHR Biomedical Research Center at Guy's and St. Thomas’ Foundation Trust, London, United Kingdom
| | | | - Tim de Meyer
- Department of Mathematical Modeling, Statistics, and Bioinformatics, Ghent University, Ghent, Belgium
| | - Audrey E Hendricks
- Population Sciences Branch of the National Heart, Lung, and Blood Institute (NHLBI), NIH, NHLBI's Framingham Heart Study, Framingham, MA,Department of Mathematical and Statistical Sciences, University of Colorado–Denver, Denver, CO
| | - Erik J Giltay
- Department of Psychiatry, Leiden University Medical Center, Leiden, Netherlands
| | - Steven C Hunt
- Cardiovascular Genetics Division, Department of Medicine, University of Utah, Salt Lake City, UT
| | - Jennifer A Nettleton
- Division of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center, Houston, TX
| | - Klelia D Salpea
- Department of Molecular Biology and Genetics, BSRC “Alexander Fleming,” Athens, Greece
| | - Vanessa A Diaz
- Department of Family Medicine, Medical University of South Carolina, Charleston, SC
| | - Ramin Farzaneh-Far
- Division of Cardiology, San Francisco General Hospital, San Francisco, CA
| | - Gil Atzmon
- Department of Medicine and Genetics, Albert Einstein College of Medicine, Bronx, NY, and Department of Biology, Faculty of Natural Science, University of Haifa, Haifa, Israel
| | - Sarah E Harris
- Center for Cognitive Aging and Cognitive Epidemiology and Medical Genetics Section and Center for Genomics and Experimental Medicine and MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Lifang Hou
- Department of Preventive Medicine and Robert H Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - David Gilley
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN
| | - Iiris Hovatta
- Department of Biosciences, University of Helsinki, Helsinki, Finland,Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - Jeremy D Kark
- Epidemiology Unit, Hebrew University–Hadassah School of Public Health and Community Medicine, Jerusalem, Israel
| | - Hisham Nassar
- Department of Cardiology, Hadassah University Medical Center, Jerusalem, Israel
| | - David J Kurz
- Department of Cardiology, Triemli Hospital, Zurich, Switzerland
| | - Karen A Mather
- Centre for Healthy Brain Ageing, Psychiatry, UNSW Australia, Sydney, Australia
| | - Peter Willeit
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria, and Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Yun-Ling Zheng
- Department of Oncology, Georgetown University Medical Center, Georgetown University, Washington, DC
| | - Sofia Pavanello
- Department of Cardiac, Thoracic, and Vascular Sciences, Unit of Occupational Medicine, University of Padova, Padova, Italy
| | - Ellen W Demerath
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN
| | - Line Rode
- The Copenhagen General Population Study, Department of Clinical Biochemistry, Copenhagen University Hospital, Herlev and Gentofte Hospital, Copenhagen, Denmark
| | - Daniel Bunout
- Institute of Nutrition and Food Technology University of Chile, Santiago, Chile
| | - Andrew Steptoe
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Lisa Boardman
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, MN
| | - Amelia Marti
- Department of Nutrition, Food Science, and Physiology, University of Navarra, Pamplona, Spain,Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain,CIBER Fisiopatología de la Obesidad y Nutrición, (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Belinda Needham
- Department of Epidemiology, University of Michigan, Ann Arbor, MI
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN
| | | | | | - Jaakko Kaprio
- Department of Public Health,Institute for Molecular Medicine, University of Helsinki, Helsinki, Finland
| | - Jonathan N Hofmann
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD
| | - Christian Gieger
- Research Unit of Molecular Epidemiology and Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Giuseppe Paolisso
- Department of Medical, Surgical, Neurological, Metabolic, and Geriatric Sciences, Second University of Naples, Naples, Italy
| | - Jacob B H Hjelmborg
- Department of Epidemiology, Biostatistics, and Biodemography, Institute of Public Health, University of Southern Denmark, Odense C, Denmark
| | - Lisa Mirabello
- Department of Medical, Surgical, Neurological, Metabolic, and Geriatric Sciences, Second University of Naples, Naples, Italy
| | - Teresa Seeman
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Jason Wong
- Stanford University School of Medicine, Stanford, CA
| | - Pim van der Harst
- Department of Cardiology, University Medical Center Groningen, Groningen, Netherlands
| | - Linda Broer
- Department of Internal Medicine, Erasmus MC, Rotterdam, Netherlands
| | - Florian Kronenberg
- Division of Genetic Epidemiology, Department of Medical Genetics, Molecular, and Clinical Pharmacology, Medical University of Innsbruck, Innsbruck, Austria
| | - Barbara Kollerits
- Division of Genetic Epidemiology, Department of Medical Genetics, Molecular, and Clinical Pharmacology, Medical University of Innsbruck, Innsbruck, Austria
| | - Timo Strandberg
- University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland; Center for Life Course Epidemiology, University of Oulu, Oulu, Finland
| | - Dan T A Eisenberg
- Department of Anthropology and Center for Studies in Demography and Ecology, University of Washington, Seattle, WA
| | | | - Josine E Verhoeven
- Department of Psychiatry, VU University Medical Center, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Roxanne Schaakxs
- Department of Psychiatry, VU University Medical Center, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Raffaela Zannolli
- Pediatrics Unit, Azienda Ospedaliera Universitaria, Senese/University of Siena, Policlinico Le Scotte, Siena, Italy
| | - Rosana M R dos Reis
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Fadi J Charchar
- School of Science and Technology, Federation University Australia, Department of Physiology, University of Melbourne, Melbourne, Australia, and Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom
| | - Maciej Tomaszewski
- Division of Cardiovascular Sciences, Faculty of Medicine, Biology, and Health, University of Manchester, Manchester, United Kingdom,Division of Medicine, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Ute Mons
- Division of Clinical Epidemiology and Aging Research,Cancer Prevention Unit, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Ilja Demuth
- Charité–Universitätsmedizin Berlin (corporate member of Freie Universität Berlin), Humboldt-Universität zu Berlin, and Berlin Institute of Health, Lipid Clinic at the Interdisciplinary Metabolism Center, Berlin, Germany
| | - Andrea Elena Iglesias Molli
- CONICET-Universidad de Buenos Aires. Instituto de Inmunología, Genética y Metabolismo (INIGEM). Laboratorio de Diabetes y Metabolismo, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
| | - Guo Cheng
- Department of Nutrition, Food Safety, and Toxicology, West China School of Public Health, Sichuan University, Chengdu, China
| | - Dmytro Krasnienkov
- Department of Epigenetics, DF Chebotarev State Institute of Gerontology NAMS of Ukraine, Kyiv, Ukraine
| | - Bianca D'Antono
- Research Center, Montreal Heart Institute, and Psychology Department, University of Montreal, Montreal, Quebec, Canada
| | - Marek Kasielski
- Bases of Clinical Medicine Teaching Center, Medical University of Lodz, Lodz, Poland
| | - Barry J McDonnell
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
| | | | - Kristina Sundquist
- Center for Primary Health Care Research, Lund University, Region Skåne, Lund, Sweden
| | - Guillaume Pare
- Population Health Research Institute and McMaster University, Hamilton, Canada
| | - Michael Chong
- Population Health Research Institute and McMaster University, Hamilton, Canada
| | - Maurice P Zeegers
- Departments of Complex Genetics,CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, Netherlands
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Weber KA, Heaphy CM, Joshu CE, Lu J, Rohrmann S, Bienstock JL, Agurs-Collins T, Meeker AK, Platz EA. Racial differences in maternal and umbilical cord blood leukocyte telomere length and their correlations. Cancer Causes Control 2018; 29:759-767. [PMID: 29980985 DOI: 10.1007/s10552-018-1054-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 06/30/2018] [Indexed: 12/21/2022]
Abstract
PURPOSE Telomere length at birth sets the baseline for telomere shortening and may influence adult disease risk like cancer. Telomere length is heritable, but may also be a marker of exposures in utero, including those influencing racial differences in risk. We examined racial differences in telomere length in maternal and umbilical cord blood from male neonates, and maternal-neonate correlations to generate hypotheses. METHODS Black and white pregnant women were recruited in 2006-2007 and followed to postpartum. Data came from questionnaires and medical records. Relative telomere length was measured by qPCR in leukocyte DNA. We estimated mean telomere length in mothers and neonates (n = 55 pairs) using linear regression and maternal-cord blood Spearman correlations, overall and by race. RESULTS Black mothers had shorter age- and plate-adjusted telomere length (2.49, 95% CI 2.11-2.86) than whites (2.92, 95% CI 2.63-3.22; p = 0.1) and black neonates had shorter telomere length (2.58, 95% CI 2.16-3.01) than whites (3.13, 95% CI 2.79-3.47; p = 0.1), though not statistically significant. Differences were attenuated after further adjustment for maternal factors. Maternal-cord blood correlations were moderate (r = 0.53, p < 0.0001), and did not differ by race. CONCLUSION Telomere length may differ by race at birth due to both inherited and racial differences in maternal factors. This study was for hypothesis generation and results should be followed up in larger studies.
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Affiliation(s)
- Kari A Weber
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Christopher M Heaphy
- Department of Pathology, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD, 21287, USA
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, 401 N Broadway, Baltimore, MD, 21287, USA
| | - Corinne E Joshu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, 401 N Broadway, Baltimore, MD, 21287, USA
| | - Jiayun Lu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Sabine Rohrmann
- Division of Chronic Disease Epidemiology; Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, 8001, Zurich, Switzerland
| | - Jessica L Bienstock
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD, 21287, USA
| | - Tanya Agurs-Collins
- Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892, USA
| | - Alan K Meeker
- Department of Pathology, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD, 21287, USA
- Department of Urology and the James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD, 21287, USA
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, 401 N Broadway, Baltimore, MD, 21287, USA
| | - Elizabeth A Platz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA.
- Department of Urology and the James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD, 21287, USA.
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, 401 N Broadway, Baltimore, MD, 21287, USA.
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Goswami R, Kakkar N, John MJ. Lower Total Leukocyte and Neutrophil Counts in Healthy Young Africans from Uganda. Indian J Hematol Blood Transfus 2017; 34:278-281. [PMID: 29622870 DOI: 10.1007/s12288-017-0866-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 08/18/2017] [Indexed: 12/26/2022] Open
Abstract
The total leukocyte count (TLC) is an important component of the complete blood count and influences many clinical decisions. The effect of race or ethnicity on TLC is not well known. The African population has been reported to have lower than normal TLC and neutrophil counts. In this study, thirty eight African students referred for medical check up to a tertiary care hospital were included. Complete blood count was done on a three part automated hematology analyzer. Blood smear examination and manual differential count was also done. The control group included 38 age and sex matched healthy individuals. Student t test was used to compare the differences between the groups. The mean TLC in African students (4.95 ± 1.09 × 109/l) was significantly lower (p < 0.0001) than that seen in the control group (7.42 ± 1.7 × 109/l). The mean neutrophil percentage was also lower (49 ± 7.5%) in African students compared to the control group (63.6 ± 9.8%) [p < 0.0001] while lymphocyte percentage was higher (45.2 ± 7.5%) in the African students as compared to the control group (31.0 ± 9.3%) [p < 0.0001]. Absolute neutrophil count was also lower (2.45 ± 0.76 × 109/l) in African students compared to the control group (4.76 ± 1.47 × 109/l) while absolute lymphocyte count was comparable (2.21 ± 0.5 × 109/l vs. 2.26 ± 0.72 × 109/l) [p = 0.7212]. This study has shown lower leukocyte and neutrophil counts in apparently healthy African individuals. Knowledge of this variation from normal white cell and neutrophil counts is important in avoiding unnecessary investigations and influencing therapeutic decisions in these individuals.
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Affiliation(s)
- Ritesh Goswami
- 1Department of Clinical Haematology, Hemato-oncology and Bone Marrow (Stem Cell) Transplantation, Christian Medical College & Hospital, Brown Road, Ludhiana, 141 008 Punjab India
| | - Naveen Kakkar
- 2Department of Pathology, Christian Medical College & Hospital, Ludhiana, 141 008 Punjab India
| | - M Joseph John
- 1Department of Clinical Haematology, Hemato-oncology and Bone Marrow (Stem Cell) Transplantation, Christian Medical College & Hospital, Brown Road, Ludhiana, 141 008 Punjab India
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Needham BL, Hicken MT, Govia IO, Mitchell C, Abdou CM. Maternal Social Disadvantage and Newborn Telomere Length in Archived Dried Blood Spots from the Michigan Neonatal Biobank. BIODEMOGRAPHY AND SOCIAL BIOLOGY 2017; 63:221-235. [PMID: 29035107 DOI: 10.1080/19485565.2017.1300520] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Telomeres are the protective caps at the ends of eukaryotic chromosomes. Short telomere length is associated with morbidity and mortality among adults and may mark the biological impact of social experiences. Using archived dried blood spots from the Michigan Neonatal Biobank, this study examined markers of maternal social disadvantage (educational attainment, receipt of public assistance, marital status, and race/ethnicity) from linked birth certificates as predictors of telomere length at birth in a sample of 192 singleton neonates born to non-Hispanic black, non-Hispanic white, and Latina mothers aged 20-35 years. Consistent with two recent studies in newborns, but counter to the idea that maternal social disadvantage is associated with shorter offspring telomere length, we found that infants born to black mothers had longer telomeres than those born to white mothers (b = 0.12, SE = 0.06, p = .05). However, black/white differences in newborn telomere length varied by receipt of public assistance. Among newborns whose mothers received WIC and/or Medicaid, there were no significant black/white differences in telomere length (b = 0.09, SE = 0.08, p = .25). In contrast, among those whose mothers did not receive public assistance-just 6 out of 69 infants born to black mothers versus 41 out of 69 infants born to white mothers-we found that babies born to black mothers had longer telomere length than babies born to white mothers (b = 0.37, SE = 0.16, p = .03). The interaction between black race/ethnicity and receipt of public assistance did not reach the conventional threshold for statistical significance (b = -0.22, SE = 0.15, p = .13), suggesting that this finding may be due to chance. No other markers of maternal social disadvantage were related to infant telomere length. Although replication of these results in a larger sample with more infants born to black mothers with relatively high socioeconomic status is needed, this study offers preliminary support for the hypothesis that race/ethnic differences in newborn telomere length depend on social context.
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Affiliation(s)
- Belinda L Needham
- a Department of Epidemiology , University of Michigan , Ann Arbor , Michigan , USA
| | - Margaret T Hicken
- b Institute for Social Research , University of Michigan , Ann Arbor , Michigan , USA
| | - Ishtar O Govia
- c Epidemiology Research Unit, Tropical Medicine Research Institute , The University of the West Indies , Mona Campus , Kingston , Jamaica
| | - Colter Mitchell
- b Institute for Social Research , University of Michigan , Ann Arbor , Michigan , USA
| | - Cleopatra M Abdou
- d Leonard Davis School of Gerontology and Department of Psychology , University of Southern California , Los Angeles , California , USA
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20
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Rewak M, Buka S, Prescott J, De Vivo I, Loucks EB, Kawachi I, Non AL, Kubzansky LD. Race-related health disparities and biological aging: does rate of telomere shortening differ across blacks and whites? Biol Psychol 2014; 99:92-9. [PMID: 24686071 DOI: 10.1016/j.biopsycho.2014.03.007] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Revised: 03/12/2014] [Accepted: 03/20/2014] [Indexed: 12/20/2022]
Abstract
Recent work suggests that leukocyte telomere length (LTL), a marker of cellular aging, is sensitive to effects of social stress and may also provide early indication of premature aging. Using data from a birth cohort with LTL information at birth and in middle adulthood we examined a potential source of race-based health disparity by testing the hypothesis that Blacks would demonstrate a faster rate of telomere shortening than Whites. Linear regression analyses were conducted and adjusted for pack years, BMI, education and social factors, diet, exercise, marital status, and age. At birth black individuals had LTLs that were longer, on average, than their White counterparts (b=3.85, p<0.01). However, rate of shortening was greater for Blacks, who showed a larger difference in length between birth and adulthood (b=5.10, p=0.01) as compared with Whites, resulting in smaller racial differences in absolute adult LTL.
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Affiliation(s)
| | | | - Jennifer Prescott
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, United States; Program in Molecular and Genetic Epidemiology, Department of Epidemiology, Harvard School of Public Health, United States
| | - Immaculata De Vivo
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, United States; Program in Molecular and Genetic Epidemiology, Department of Epidemiology, Harvard School of Public Health, United States
| | | | | | - Amy L Non
- Department of Anthropology, Vanderbilt University, United States
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21
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Socioeconomic status, health behavior, and leukocyte telomere length in the National Health and Nutrition Examination Survey, 1999-2002. Soc Sci Med 2013; 85:1-8. [PMID: 23540359 DOI: 10.1016/j.socscimed.2013.02.023] [Citation(s) in RCA: 235] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Revised: 02/11/2013] [Accepted: 02/15/2013] [Indexed: 12/11/2022]
Abstract
The purpose of this study was to examine the association between socioeconomic status (SES) and leukocyte telomere length (LTL) - a marker of cell aging that has been linked to stressful life circumstances - in a nationally representative, socioeconomically and ethnically diverse sample of US adults aged 20-84. Using data from the National Health and Nutrition Examination Survey (NHANES), 1999-2002, we found that respondents who completed less than a high school education had significantly shorter telomeres than those who graduated from college. Income was not associated with LTL. African-Americans had significantly longer telomeres than whites, but there were no significant racial/ethnic differences in the association between education and telomere length. Finally, we found that the association between education and LTL was partially mediated by smoking and body mass index but not by drinking or sedentary behavior.
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22
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Padiyar A, Hricik DE. Immune factors influencing ethnic disparities in kidney transplantation outcomes. Expert Rev Clin Immunol 2012; 7:769-78. [PMID: 22014018 DOI: 10.1586/eci.11.32] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
An influence of ethnicity on the outcomes of kidney transplant recipients has been recognized for several decades. Both immune and nonimmune factors have been explored as potential explanations. Most studies have focused on the inferior outcomes of African-Americans. As a group, African-Americans differ from Caucasians with respect to a number of measurable components of the alloimmune response, including the T-cell repertoire and the expression and function of costimulatory molecules and various cytokines and chemokines. In general, these differences suggest that African-Americans may be high immune responders. However, no single difference in any of these components of alloimmunity satisfactorily explains the disparities in outcomes. It seems probable that some combination of immune factors interacts with nonimmune factors, such as socioeconomic resources, to influence transplant outcomes in a complex manner.
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Affiliation(s)
- Aparna Padiyar
- Division of Nephrology and Hypertension and Transplantation Service, Case Western Reserve University and University Hospitals University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA
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23
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Kangelaris KN, Sapru A, Calfee CS, Liu KD, Pawlikowska L, Witte JS, Vittinghoff E, Zhuo H, Auerbach AD, Ziv E, Matthay MA. The association between a Darc gene polymorphism and clinical outcomes in African American patients with acute lung injury. Chest 2011; 141:1160-1169. [PMID: 22207676 DOI: 10.1378/chest.11-1766] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Acute lung injury (ALI) mortality is increased among African Americans compared with Americans of European descent, and genetic factors may be involved. A functional T-46C polymorphism (rs2814778) in the promoter region of Duffy antigen/receptor for chemokines (Darc) gene, present almost exclusively in people of African descent, results in isolated erythrocyte DARC deficiency and has been implicated in ALI pathogenesis in preclinical and murine models, possibly because of an increase in circulating Duffy-binding, proinflammatory chemokines like IL-8. We sought to determine the effect of the functional rs2814778 polymorphism, C/C genotype (Duffy null state), on clinical outcomes in African Americans with acute lung injury. METHODS Clinical data and biologic specimens from African American patients with ALI who enrolled in three randomized controlled trials were analyzed. Multivariate analysis accounted for proportion of African ancestry, sex, cirrhosis, and severity of illness on presentation. RESULTS Among 132 subjects, 88 (67%) were Duffy null (C/C genotype). The Duffy null state was associated with a 17% absolute risk increase (95% CI, 1.4%-33%) in mortality at 60 days, a median of 8 fewer ventilator-free days (95% CI, 1-18.5), and 4.5 fewer organ failure-free days (95% CI, 0-18) compared with individuals with the C/T or T/T genotypes (all P values < .05). Estimates were similar on multivariate analysis. In African Americans without the null variant, clinical outcomes were similar to those in patients of European descent. A subgroup analysis suggested that plasma IL-8 levels are increased in Duffy null individuals. CONCLUSIONS Our results provide evidence that the functional rs2814778 polymorphism in the gene encoding DARC is associated with worse clinical outcomes among African Americans with ALI, possibly via an increase in circulating IL-8.
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Affiliation(s)
- Kirsten Neudoerffer Kangelaris
- Department of Medicine, Division of General Internal Medicine, University of California, San Francisco, San Francisco, CA; Division of Hospital Medicine, University of California, San Francisco, San Francisco, CA.
| | - Anil Sapru
- Department of Pediatrics, Division of Critical Care, University of California, San Francisco, San Francisco, CA
| | - Carolyn S Calfee
- Division of Pulmonary and Critical Care, University of California, San Francisco, San Francisco, CA; Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, CA
| | - Kathleen D Liu
- Division of Nephrology, University of California, San Francisco, San Francisco, CA; Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, CA
| | - Ludmila Pawlikowska
- Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, CA
| | - John S Witte
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA
| | - Eric Vittinghoff
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA
| | - Hanjing Zhuo
- Division of Pulmonary and Critical Care, University of California, San Francisco, San Francisco, CA
| | - Andrew D Auerbach
- Division of Hospital Medicine, University of California, San Francisco, San Francisco, CA
| | - Elad Ziv
- Department of Medicine, Division of General Internal Medicine, University of California, San Francisco, San Francisco, CA
| | - Michael A Matthay
- Division of Pulmonary and Critical Care, University of California, San Francisco, San Francisco, CA; Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, CA
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Tian N, Penman AD, Manning RD, Flessner MF, Mawson AR. Association between circulating specific leukocyte types and incident chronic kidney disease: the Atherosclerosis Risk in Communities (ARIC) study. ACTA ACUST UNITED AC 2011; 6:100-8. [PMID: 22054781 DOI: 10.1016/j.jash.2011.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2011] [Revised: 10/02/2011] [Accepted: 10/03/2011] [Indexed: 12/24/2022]
Abstract
Progressive renal fibrosis is a characteristic of all the diseases that cause renal failure and is invariably accompanied by a prominent leukocyte infiltration in the kidney. The goal of this study was to determine the association between the circulating specific leukocyte types and incident chronic kidney disease (CKD). In a cohort of 10,056 middle-aged white and African American adults, levels of circulating neutrophils, lymphocytes, and monocytes were measured at baseline; blood pressure (BP) and serum creatinine were measured and estimated glomerular filtration rate (eGFR) was calculated at baseline and 3 and 9 years later; and surveillance for first hospitalization or death with CKD was carried out over a mean follow-up of 7.4 years (maximum, 11.9 years). Increased neutrophil levels and decreased lymphocyte levels were significantly associated with greater CKD incidence after adjustment for covariates. African Americans tended to have similar but stronger patterns of association between circulating leukocytes and CKD incidence than whites, although the differences between race groups were not statistically significant. We also found that eGFR and BP were higher at each visit in African Americans than whites between ages 45 and 65. These findings support a potential role for circulating specific leukocytes in the pathogenesis of kidney dysfunction, especially in African Americans, indicating the leukocyte-related renal mechanism of essential hypertension (HT).
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Affiliation(s)
- Niu Tian
- Department of Pediatrics, University of Mississippi Medical Center, Jackson, MS, USA.
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25
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Mendelian randomization: potential use of genetics to enable causal inferences regarding HIV-associated biomarkers and outcomes. Curr Opin HIV AIDS 2011; 5:545-59. [PMID: 20978399 DOI: 10.1097/coh.0b013e32833f2087] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE OF REVIEW It is unknown whether biomarkers simply correlate with or are causal for HIV-associated outcomes. Mendelian randomization is a genetic epidemiologic approach used to disentangle causation from association. Here, we discuss the potential use of Mendelian randomization for differentiating whether biomarkers are correlating with or causal for HIV-associated outcomes. RECENT FINDINGS Mendelian randomization refers to the random allocation of alleles at the time of gamete formation. In observational epidemiology, this refers to the use of genetic variants to estimate a causal effect between a modifiable risk factor and an outcome of interest. A formal Mendelian randomization study using a genetic marker as a proxy for the biomarker has not been conducted in the HIV field. However, in the postgenomic era, this approach is being used increasingly. Examples are evidence for the causal role of BMI in blood pressure and noncausal role of C-reactive protein in coronary heart disease. We discuss the conceptual framework, uses, and limitations of Mendelian randomization in the context of HIV infection as well as specific biomarkers (IL-6, C-reactive protein) and genetic determinants (e.g., in CCR5, chemokine, and DARC genes) that associate with HIV-related outcomes. SUMMARY Making the distinction between correlation and causality has particular relevance when a biomarker (e.g., IL-6) is potentially modifiable, in which case a biomarker-guided targeted treatment strategy may be feasible. Although the tenets of Mendelian randomization rest on strong assumptions, and conducting a Mendelian randomization study in HIV infection presents many challenges, it may offer the potential to identify causal biomarkers for HIV-associated outcomes.
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26
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Lim EM, Cembrowski G, Cembrowski M, Clarke G. Race-specific WBC and neutrophil count reference intervals. Int J Lab Hematol 2011; 32:590-7. [PMID: 20236184 DOI: 10.1111/j.1751-553x.2010.01223.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Healthy African Americans are known to have reduced white blood cell counts (WBC) and absolute neutrophil counts (ANC) compared with European Americans, with little agreement about the levels in reference intervals. The objective is to establish race-specific reference intervals for WBC and ANC using US National Health and Nutrition Examination Survey (NHANES) of 2000-2003. A total of 14,184 civilian noninstitutionalized US citizens participated in NHANES 2000-2003 had complete blood count, red cell distribution width, platelet count and automated WBC differential determined on a Coulter MAXM. The exclusion criteria were used: ferritin <12 ng/ml, pregnancy, body mass index >30, diastolic blood pressure >100 mm Hg, creatinine >2.5 mg/dl, glucose >126 mg/dl. Data were separated into six sex/race categories: female non-Hispanic white, non-Hispanic black (NHBF)], Mexican American; male non-Hispanic white, non-Hispanic black (NHBM), Mexican American and two age groupings (12-18 and >18 years). NHB 2.5-97.5 percentile WBC and (ANC) limits follow (units: × 10⁹ /l): NHBM, ages 12-18: 3.2-9.3 (1.0-6.2); NHBF, ages 12-18: 3.7-10.1 (1.2-6.6); adult NHBM: 3.1-9.9 (1.3-6.6); adult NHBF: 3.4-11 (1.4-7.5). NHB limits are significantly lower than the NHW and MA limits. In most US healthcare organizations, insufficient agreement exists because of large differences in reference intervals for different ethnicities. In areas with peoples of African descent (>10--20%), race-specific WBC and ANC reference intervals must be provided for proper diagnosis and clinical research.
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Affiliation(s)
- E-M Lim
- Department of Laboratory Medicine and Pathology, University Hospital, University of Alberta, Edmonton, AB, Canada
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Martin J, Audrain M, Durant C, Rimbert M, Fromont P, Hamidou M. Neutropénies auto-immunes. Rev Med Interne 2011; 32:26-32. [DOI: 10.1016/j.revmed.2010.04.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2009] [Revised: 03/05/2010] [Accepted: 04/11/2010] [Indexed: 11/30/2022]
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Tian N, Penman AD, Mawson AR, Manning RD, Flessner MF. Association between circulating specific leukocyte types and blood pressure: the atherosclerosis risk in communities (ARIC) study. ACTA ACUST UNITED AC 2010; 4:272-83. [PMID: 20980213 DOI: 10.1016/j.jash.2010.09.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2010] [Revised: 09/07/2010] [Accepted: 09/09/2010] [Indexed: 12/23/2022]
Abstract
Although total white blood cell (WBC) count has been associated with hypertension, the association between specific WBC types and blood pressure (BP) levels has not been studied. In a cohort of 5746 middle-age African-American and white adults free of clinical cardiovascular disease and cancer and not taking hypertension or anti-inflammatory medications, BP was measured at baseline and 3, 6, and 9 years later. Levels of circulating neutrophils, lymphocytes, and monocytes were measured at baseline. In African-Americans, but much less so in whites, increased neutrophil levels and decreased lymphocyte levels were significantly associated with elevation of BP but did not influence the rate of change of BP over time. The mean BP difference between the highest and lowest quartiles of neutrophils was approximately 8 mm Hg for systolic BP (SBP), 4 mm Hg for mean arterial pressure (MAP), and 5 mm Hg for pulse pressure (PP). The mean BP difference between the lowest and highest quartiles of lymphocytes was approximately 6 mm Hg for SBP, 2 mm Hg for diastolic BP (DBP), 3 mm Hg for MAP, and 4 mm Hg for PP. Increased neutrophils and decreased lymphocytes are significantly correlated with the regulation of BP and the development of hypertension, especially in African-Americans.
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Affiliation(s)
- Niu Tian
- Department of Pediatrics, University of Mississippi Medical Center, Jackson, Mississippi 39216, USA.
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Impact of age, gender, and race on circulating γδ T cells. Hum Immunol 2010; 71:968-75. [PMID: 20600446 DOI: 10.1016/j.humimm.2010.06.014] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2010] [Revised: 06/11/2010] [Accepted: 06/22/2010] [Indexed: 11/21/2022]
Abstract
A major subset of human peripheral blood γδ T cells expresses the Vγ2Vδ2 T cell receptor and responds to malignant or infectious diseases. We noted significant differences in the numbers of Vγ2Vδ2 T cells in blood samples from healthy Caucasian CA or African American (AA) donors. On average, CA donors had 3.71% ± 4.37% Vδ2 cells (as a percentage of total lymphocytes) compared with 1.18% ± 2.14% Vδ2 cells for AA donors (p < 0.0001). Age and race had the greatest impact on Vδ2 cell levels; the effect of age was similar for both racial groups. The Vδ2 cell population was dominated, for both donor groups, by cells expressing the Vγ2-Jγ1.2 Vδ2 T cell receptor, an apparent result of strong positive selection and there was substantial overlap in the public Vγ2 clonotypes from both racial groups. Mechanisms for selection and amplification of Vδ2 cells are nearly identical for both groups, despite the significant difference in baseline levels. These data show that appropriate controls, matched for age and race, may be required for clinical studies of Vγ2Vδ2 T cells in infectious disease or cancer and raise important questions about the mechanisms regulating the levels of circulating Vδ2 cells.
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Achhra AC, Zhou J, Dabis F, Pujari S, Thiebaut R, Law MG, Bonnet F. Difference in absolute CD4+ count according to CD4 percentage between Asian and Caucasian HIV-infected patients. ACTA ACUST UNITED AC 2010; 1:1-4. [PMID: 21479149 DOI: 10.4172/2155-6113.1000101] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We compared the absolute CD4+ count, at different CD4+ percentages (CD4%), between Asian (n=442) and Caucasian (n=674) untreated HIV-infected individuals, using linear regression methods. At any given CD4%, Asians had lower CD4+ count than Caucasians (p=0.001). The difference varied from 38.9 cells/mm(3) (95% CI: 3.3-74.5 cells/mm(3)) at CD4% of 15% to 108.7 cells/mm(3) (95% CI: 42.5-174.9 cells/mm(3)) at CD4% of 40%. The impact of these differences on prognosis is uncertain, but it may be that the prognostic thresholds for CD4+ count used in Caucasian populations are inappropriate in Asian populations.
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Affiliation(s)
- Amit C Achhra
- National Centre in HIV Epidemiology and Clinical Research, The University of New South Wales, Sydney, Australia
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The Duffy-null state is associated with a survival advantage in leukopenic HIV-infected persons of African ancestry. Blood 2009; 114:2783-92. [PMID: 19620399 DOI: 10.1182/blood-2009-04-215186] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Persons of African ancestry, on average, have lower white blood cell (WBC) counts than those of European descent (ethnic leukopenia), but whether this impacts negatively on HIV-1 disease course remains unknown. Here, in a large natural history cohort of HIV-infected subjects, we show that, although leukopenia (< 4000 WBC/mm(3) during infection) was associated with an accelerated HIV disease course, this effect was more prominent in leukopenic subjects of European than African ancestry. The African-specific -46C/C genotype of Duffy Antigen Receptor for Chemokines (DARC) confers the malaria-resisting, Duffy-null phenotype, and we found that the recently described association of this genotype with ethnic leukopenia extends to HIV-infected African Americans (AAs). The association of Duffy-null status with HIV disease course differed according to WBC but not CD4(+) T-cell counts, such that leukopenic but not nonleukopenic HIV(+) AAs with DARC -46C/C had a survival advantage compared with all Duffy-positive subjects. This survival advantage became increasingly pronounced in those with progressively lower WBC counts. These data highlight that the interaction between DARC genotype and the cellular milieu defined by WBC counts may influence HIV disease course, and this may provide a partial explanation of why ethnic leukopenia remains benign in HIV-infected AAs, despite immunodeficiency.
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Mayr F, Spiel A, Leitner J, Firbas C, Schnee J, Hilbert J, Derendorf H, Jilma B. Influence of the Duffy Antigen on Pharmacokinetics and Pharmacodynamics of Recombinant Monocyte Chemoattractant Protein (MCP-1, CCL-2) in Vivo. Int J Immunopathol Pharmacol 2009; 22:615-25. [DOI: 10.1177/039463200902200307] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Monocyte chemoattractant protein-1 (MCP-1, CCL-2) binds to the Duffy antigen (DARC) on red blood cells, which act as a sink for several chemokines including MCP-1. In this study it is hypothesized that DARC may alter the pharmacokinetics of infused recombinant human MCP-1 (rhMCP-1). The primary aim of this first in man trial is to compare the pharmacokinetics of rhMCP-1 in Duffy positive and negative individuals. A randomized, double-blinded, placebo-controlled dose escalation trial was conducted on 36 healthy volunteers. Subjects received infusions of 0.02–2.0 μg/kg rhMCP-1 or placebo for one hour. RhMCP-1 displayed linear pharmacokinetics. Duffy negative individuals reached maximal plasma levels significantly earlier, but overall plasma concentration profiles were not altered. rhMCP-1 markedly increased monocyte counts, and estimated EC50 values were 10-fold higher in Duffy positive than in Duffy negative subjects. Increased monocyte counts were associated with decreased surface expression of intercellular adhesion molecule 1 (ICAM-1, CD54). In contrast, neither CCR-2 or CD11b expression, nor markers of platelet or endothelial activation, inflammation and coagulation were altered. RhMCP-1 is a highly selective chemoattractant for monocytes in humans. The Duffy antigen only minimally alters the pharmacokinetics of rhMCP-1 for doses up to 2 μg/kg.
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Affiliation(s)
- F.B. Mayr
- Department of Clinical Pharmacology, Medical University of Vienna, Austria
| | - A.O. Spiel
- Department of Clinical Pharmacology, Medical University of Vienna, Austria
| | - J.M. Leitner
- Department of Clinical Pharmacology, Medical University of Vienna, Austria
| | - C. Firbas
- Department of Clinical Pharmacology, Medical University of Vienna, Austria
| | - J. Schnee
- Boehringer Ingelheim, Ridgefield, USA
| | | | - H. Derendorf
- Department of Pharmaceutics, College of Pharmacy, University of Florida, Gainesville, USA
| | - B. Jilma
- Department of Clinical Pharmacology, Medical University of Vienna, Austria
- Department of Pharmaceutics, College of Pharmacy, University of Florida, Gainesville, USA
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Reduced Relative Lymphocyte Count in African-Americans With Decompensated Heart Failure. Am J Med Sci 2009; 337:156-60. [DOI: 10.1097/maj.0b013e318182198f] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Taylor WRJ, Widjaja H, Basri H, Ohrt C, Taufik T, Tjitra E, Baso S, Fryauff D, Hoffman SL, Richie TL. Changes in the total leukocyte and platelet counts in Papuan and non Papuan adults from northeast Papua infected with acute Plasmodium vivax or uncomplicated Plasmodium falciparum malaria. Malar J 2008; 7:259. [PMID: 19094197 PMCID: PMC2642516 DOI: 10.1186/1475-2875-7-259] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2007] [Accepted: 12/18/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There are limited data on the evolution of the leukocyte and platelet counts in malaria patients. METHODS In a clinical trial of chloroquine vs. chloroquine plus doxycycline vs. doxycycline alone against Plasmodium vivax (n = 64) or Plasmodium falciparum (n = 98) malaria, the total white cell (WCC) and platelet (PLT) counts were measured on Days 0, 3, 7 and 28 in 57 indigenous Papuans with life long malaria exposure and 105 non Papuan immigrants from other parts of Indonesia with limited malaria exposure. RESULTS The mean Day 0 WCC (n = 152) was 6.492 (range 2.1-13.4) x 10(9)/L and was significantly lower in the Papuans compared to the non Papuans: 5.77 x 10(9)/L vs. 6.86 x 10(9)/L, difference = -1.09 [(95% CI -0.42 to -1.79 x 10(9)/L), P = 0.0018]. 14 (9.2%) and 9 (5.9%) patients had leukopaenia (<4.0 x 10(9)/L) and leukocytosis (>10.0 x 10(9)/L), respectively. By Day 28, the mean WCC increased significantly (P = 0.0003) from 6.37 to 7.47 x 10(9)/L (73 paired values) and was similar between the two groups. Ethnicity was the only WCC explanatory factor and only on Day 0.The mean Day 0 platelet count (n = 151) was 113.0 (range 8.0-313.0) x 10(9)/L and rose significantly to 186.308 x 10(9)/L by Day 28 (P < 0.0001). There was a corresponding fall in patient proportions with thrombocytopaenia (<150 x 10(9)/L): 119/151 (78.81%) vs. 16/73 (21.92%, P < 0.00001). Papuan and non Papuan mean platelet counts were similar at all time points. Only malaria species on Day 0 was a significant platelet count explanatory factor. The mean D0 platelet counts were significantly lower (P = 0.025) in vivax (102.022 x 10(9)/L) vs. falciparum (122.125 x 10(9)/L) patients. CONCLUSION Changes in leukocytes and platelets were consistent with other malaria studies. The Papuan non Papuan difference in the mean Day 0 WCC was small but might be related to the difference in malaria exposure.
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Abstract
OBJECTIVE The Duffy receptor is a promiscuous receptor for chemokines and selectively binds CXC and CC chemokines with high affinity. Preclinical data show that presence of the Duffy receptor on red blood cells may influence plasma levels of proinflammatory cytokines and chemokines and be protective during inflammation. This trial was designed to investigate the influence of the Duffy antigen on human inflammation in vivo. DESIGN Prospective, analyst-blinded clinical trial. PATIENTS A total of 32 healthy male volunteers: 16 Duffy-positive white subjects and 16 Duffy-negative subjects of African descent. MEASUREMENTS AND MAIN RESULTS All subjects received an intravenous bolus of 2 ng/kg endotoxin (lipopolysaccharide). Cytokines, chemokines, and their receptors were quantified by enzyme immunoassay, reverse transcriptase-polymerase chain reaction, and flow cytometry. RESULTS Plasma levels of tumor necrosis factor, interleukin-6, interleukin-10, and whole blood growth-related oncogen-alpha, monocyte chemoattractant protein-1, and interleukin-8 messenger RNA increased similarly in both groups after lipopolysaccharide infusion. Monocyte chemoattractant protein-1 peak plasma levels were roughly two-fold higher in Duffy-positive subjects compared with Duffy-negative subjects (16 ng/mL vs. 7 ng/mL, p < .0001). Similarly, growth-related oncogen-alpha levels were 2.5-fold higher in Duffy-positive subjects 2 hrs after lipopolysaccharide infusion (210 pg/mL vs. 85 pg/mL; p < .001). Erythrocyte-bound monocyte chemoattractant protein-1, growth-related oncogen-alpha, and interleukin-8 increased 20- to 50-fold in Duffy-positive subjects (p < .00001 vs. baseline). CONCLUSION The Duffy antigen substantially alters chemokine concentrations in blood, but it does not have a protective effect during human endotoxemia.
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Kaaba SA, Al Fadhli S, Burhamah M, Al Jafar H, Khamis A. Lymphocyte subsets in healthy adult Kuwaiti Arabs with relative benign ethnic neutropenia. Immunol Lett 2004; 91:49-53. [PMID: 14757369 DOI: 10.1016/j.imlet.2003.10.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Relative and absolute neutropenia is frequently seen in the healthy adult Kuwaiti Arab population. Fluorescent monoclonal antibody labelling followed by flow cytometry was used to determine the lymphocyte subsets in 48 normal healthy individuals in the Kuwaiti adult population (24 males and 24 females, age 17-59 years) with relative or absolute neutropenia, and this was compared to age-matched controls (64 males and 63 females). The mean haemoglobin levels were 13.6+/-1.5 and 13.7+/-1.5 g/dl in the neutropenic and control groups, respectively. White blood cell counts, absolute neutrophil and lymphocyte counts in neutropenic individuals with the corresponding reference range, taken from the control subjects (in parenthesis) were: WBC, 6.7+/-1.6 x 10(9)/l (4-10.4 x 10(9)/l), neutrophils, 2.7+/-0.8 x 10(9)/l (1.87-6.63 x 10(9)/l), lymphocytes, 3.3+/-0.9 x 10(9)/l (1.4-3.62 x 10(9)/l). Absolute values of lymphocytes, CD2+, CD3+, CD19+, CD4+, CD8+, HLADR+ and CD45RA+ cells were significantly higher in the neutropenic group. The range of values with the corresponding reference ranges, in parenthesis, were: CD2+, 1.61-4.30 x 10(9)/l (0.95-2.99 x 10(9)/l), CD3+, 1.37-4.16 x 10(9)/l (0.83-2.71 x 10(9)/l), CD19+, 0.16-1.09 x 10(9)/l (0.05-0.61 x 10(9)/l), CD4+, 0.70-2.89 x 10(9)/l (0.45-1.65 x 10(9)/l), CD8+, 0.57-1.80 x 10(9)/l (0.29-1.17 x 10(9)/l), HLADR+ 0.27-1.74 x 10(9)/l (0.02-0.62 x 10(9)/l), CD45RA, 0.90-4.63 x 10(9)/l (0.34-2.05 x 10(9)/l), respectively. The levels of natural killer cells, CD56+ cells were significantly lower compared to controls while the values of memory T lymphocytes, CD45RO+ were comparable to controls. These results indicate that difference in the leukocyte subpopulations may also be indicative of differences in the lymphocyte subpopulations and that reference ranges for these cell types in healthy neutropenic and non-neutropenic individuals should be established.
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Affiliation(s)
- Salim A Kaaba
- Department of Medical Laboratory Sciences, Faculty of Allied Health Sciences, Kuwait University, PO Box 31470, 90805 Sulaibikhat, Kuwait.
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Anthony D, Johnson M, Reynolds T, Russell L. Ethnicity in pressure ulcer risk assessment, with specific relation to the Pakistani ethnic minority in Burton, England. J Adv Nurs 2002; 38:592-7. [PMID: 12067398 DOI: 10.1046/j.1365-2648.2000.02226.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND There has been little work on ethnicity related to pressure ulcers in general and little or nothing specific to South Asians, and the Pakistani ethnic group in particular. AIM To explore the relevance of ethnicity in pressure ulcers. METHODS All admissions over a 5-year period to a District General Hospital in Burton, United Kingdom (UK) were considered where data were present on Waterlow Score, ethnicity and pressure sore status. Logistic regression analysis was conducted using ethnicity and other variables to predict ulcer formation. RESULTS; Age is predictive, but ethnicity was not found to be a significant predictor. CONCLUSION There is no evidence that members of the Pakistani ethnic minority are at higher risk than the majority White population in Burton, with respect to pressure ulcers.
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Affiliation(s)
- Denis Anthony
- Nursing Informatics, Mary Seacole Research Centre, School of Nursing and Midwifery, De Montfort University, Leicester, UK.
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Hutchings A, Purcell WM, Benfield MR. Increased costimulatory responses in African-American kidney allograft recipients. Transplantation 2001; 71:692-5. [PMID: 11292304 DOI: 10.1097/00007890-200103150-00021] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The issue of racial differences in immune responses has been seldom investigated, despite the increased incidence of transplant rejection and inferior allograft outcomes in African-Americans (AA). We previously reported significantly increased expression of costimulatory molecules on peripheral blood cells from healthy adult AA compared with Caucasian (CS) volunteers. This report extends the study to pediatric kidney allograft recipients. METHODS Surface antigen expression by peripheral blood mononuclear cells (MNC) from AA and CS transplant patients was determined by flow cytometry, after staining with specific antibodies. In vitro proliferation, in a one-way mixed lymphocyte response (MLR), was measured after stimulation with allogeneic irradiated mononuclear cells. The concentration of cyclosporine (CsA) achieving 50% inhibition (IC50) of in vitro proliferative responses to PHA and OKT3 was calculated. RESULTS MNC from AA patients were shown to have significantly higher expression of CD80 (CS 5.2% +/- 0.6, AA 9.6% +/- 1.2, P < 0.0001) than cells from CS patients. Additionally, the cells from AA transplant recipients proliferated significantly more in an MLR (stimulation index: CS 8 +/- S2, AA 25 +/- 8, P < 0.05), and the CsA IC50 values, during proliferation to PHA and OKT3, were significantly higher in AA compared to CS patients. CONCLUSIONS Although socioeconomic factors and therapeutic compliance are undoubtedly important issues in long-term allograft survival, our data suggest that AA patients mount more vigorous immune responses to antigens. The increased requirement for immunosuppression may be linked to racial variations in costimulatory molecule expression on antigen-presenting cells.
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Affiliation(s)
- A Hutchings
- Department of Pediatrics, University of Alabama at Birmingham, 35233, USA
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Hutchings A, Purcell WM, Benfield MR. Peripheral blood antigen-presenting cells from African-Americans exhibit increased CD80 and CD86 expression. Clin Exp Immunol 1999; 118:247-52. [PMID: 10540186 PMCID: PMC1905418 DOI: 10.1046/j.1365-2249.1999.01051.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/1999] [Indexed: 11/20/2022] Open
Abstract
Despite the increased incidence and severity of many autoimmune diseases and transplant rejection in African-Americans (AA) compared with Caucasians (CS), very few studies have addressed issues of racial variation during antigen presentation. This investigation was performed as a preliminary exploration of differences in peripheral blood cell costimulatory functions between healthy AA (n = 20) and CS (n = 20) subjects. The expression of surface costimulatory molecules on peripheral blood cells, mononuclear cells enriched by Ficoll density centrifugation, and plastic adherent antigen-presenting cells (APC) was determined by flow cytometry using fluorescent-labelled MoAbs. The expression of both B7 costimulatory molecules was significantly higher on the cells from AA subjects compared with cells from CS subjects (CD80, P < 0.05; CD86, P < 0.05). Also, following 18 h of culture with rhIL-1beta, there was a significant increase in the percentage of APC from AA expressing high levels of the costimulatory molecule CD80 (P < 0.05). Costimulatory function during mitogen and antigen presentation was determined by 3H-thymidine incorporation during T cell proliferation. Purified T cells from AA subjects demonstrated significantly increased proliferation to phytohaemagglutinin (PHA). The differences reported here suggest that racial variations in peripheral blood APC characteristics may exist. Given the importance of costimulation in maintaining long-term immune responses, these data suggest a further direction for the investigation of racial disparity in autoimmune disease pathology and transplant rejection rates.
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Affiliation(s)
- A Hutchings
- University of Alabama at Birmingham, Birmingham, AL 35233, USA.
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Freedman DS, Flanders WD, Barboriak JJ, Malarcher AM, Gates L. Cigarette smoking and leukocyte subpopulations in men. Ann Epidemiol 1996; 6:299-306. [PMID: 8876840 DOI: 10.1016/s1047-2797(96)00024-5] [Citation(s) in RCA: 53] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Because of previously reported associations among the total leukocyte count, cigarette smoking, and risk of cardiovascular disease, we examined the relation of cigarette smoking to various leukocyte subpopulations among 3467 men aged 31 to 45 years. The median total leukocyte count was 36% higher (7840 vs. 5760 cells/mL) among current cigarette smokers than among men who had never smoked, and both stratification and regression analyses were used to examine independent associations with leukocyte subpopulations. At equivalent counts of other subpopulations, CD4+ lymphocytes and neutrophils were the cell types most strongly associated with cigarette smoking; each standard deviation change in counts of these subpopulations increased the odds of current (vs. never) smoking by approximately threefold. Furthermore, whereas 15% of the 238 men with relatively low (< 25 percentile) counts of both neutrophils and CD4+ lymphocytes were cigarette smokers, 96% of the 249 men with relatively high counts of both subpopulations were current smokers. Counts of T lymphocytes also tended to be higher among the 32 men with self-reported ischemic heart disease than among other men. These results, along with previous reports of immunologically active T lymphocytes in atherosclerotic plaques, suggest that this subpopulation may be of particular interest in studies examining the relation of leukocytes to cardiovascular disease.
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Affiliation(s)
- D S Freedman
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341-3724, USA
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