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Yang L, Lu Z, Bian J, Li F, Zou H. Association between chronic viral infection-related hospitalization and risk of cardiovascular disease: A population-based cohort study. J Med Virol 2024; 96:e29350. [PMID: 38180233 DOI: 10.1002/jmv.29350] [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: 09/17/2023] [Revised: 12/12/2023] [Accepted: 12/15/2023] [Indexed: 01/06/2024]
Abstract
Chronic viral infection induces immunosenescence and systemic low-grade inflammation, leading to worsened long-term outcomes. We sought to explore the short- and long-term effects of chronic viral infection on cardiovascular disease (CVD). Based on UK Biobank data, exposed group was identified as individuals who had chronic virus infection-related hospitalization (IRH). Unexposed group was randomly selected, matched by 5-year age interval, sex, and Charlson comorbidity index at a ratio up to 1:10. Restricted cubic splines were used to model time-varying effects of IRH in nonproportional Cox models. A cut-off value of 5 years was recorded and used in piecewise Cox proportional hazards models as we estimated short- and long-term effects of IRH on CVD. A total of 2826 exposed participants and 28 212 matched unexposed participants were included. Chronic viral IRH was associated with increased risk of CVD (0-5 years: hazard ratio, 1.57 [95% confidence interval: 1.32, 1.87] and 5+ years: 1.31 [1.06, 1.61]). Elevated risk of stroke was only observed within the initial 5-year follow-up (0-5 years: 1.91 [1.30, 2.81]). The short- and long-term associations were observed in herpes or hepatitis virus IRH with risk of CVD (all p < 0.05). Subgroup analysis revealed long-term association between chronic viral IRH and CVD among female (5+ years: 1.68 [1.27, 2.22]) but not among male. The association between chronic viral infection and elevated CVD risk appeared to be stronger among individuals who did not take cholesterol-lowering medication, antithrombotic medication, or certain antihypertensive medications (all p for interaction < 0.05). The risk of CVD event remained persistently higher within and over 5 years following chronic viral IRH, especially in individuals infected with herpes and hepatitis virus.
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Affiliation(s)
- Luoyao Yang
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, People's Republic of China
| | - Zhen Lu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, People's Republic of China
| | - Junye Bian
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, People's Republic of China
| | - Feng Li
- Department of Cardiac and Vascular Surgery, The 1st Affiliated Hospital of AnHui Medical University, Hefei, China
| | - Huachun Zou
- School of Public Health, Fudan University, Shanghai, China
- School of Public Health, Southwest Medical University, Luzhou, China
- Kirby Institute, University of New South Wales, Sydney, Australia
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2
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Wang Y, Guo D, Chen X, Wang S, Hu J, Liu X. Trends in asthma among adults in the United States, National Health and Nutrition Examination Survey 2005 to 2018. Ann Allergy Asthma Immunol 2022; 129:71-78.e2. [PMID: 35257870 DOI: 10.1016/j.anai.2022.02.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 02/19/2022] [Accepted: 02/22/2022] [Indexed: 01/13/2023]
Abstract
BACKGROUND Asthma is a common chronic disease in American adults. The prevalence of asthma has varied over time, but there are few studies on the long-term trend of asthma in American adults. OBJECTIVE To describe the prevalence and trend of asthma in American adults from 2005 to 2018 and analyze the risk factors for asthma. METHODS Data collection was performed from National Health and Nutrition Examination Survey 2005 to 2018. The unweighted number and weighted percentages of normal participants and patients with asthma and the trends of asthma were calculated. Weighted univariate logistic regression was used to analyze the risk factors for asthma. RESULTS A total of 39,601 adults were included in this study. From 2005 to 2018, the overall prevalence of asthma in American adults was 8.41%, whereas that in young, middle-aged, and elderly adults was 8.30%, 8.70%, and 7.92%, respectively. The estimated prevalence of asthma in the overall adults and young adults increased with time (P for trend = .03, difference = 0.023 and P for trend = .007, difference = 0.060, respectively), and the estimated prevalence of middle-aged and elderly adults remained stable with time (P for trend = .33, difference = 0.015 and P for trend = .80, difference = -0.024, respectively). CONCLUSION Asthma in American adults was on the rise. Female sex, non-Hispanic Blacks, individuals with low annual household income, active smokers, obese patients, patients with hypertension, patients with diabetes, and individuals with positive asthma family history were associated with a higher risk for developing asthma.
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Affiliation(s)
- Yashan Wang
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, PR China
| | - Dingjie Guo
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, PR China
| | - Xiaofei Chen
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, PR China
| | - Song Wang
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, PR China
| | - Jiayi Hu
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, PR China
| | - Xin Liu
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, PR China.
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3
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Noppert GA, Stebbins RC, Dowd JB, Hummer RA, Aiello AE. Life Course Socioeconomic Disadvantage and the Aging Immune System: Findings From the Health and Retirement Study. J Gerontol B Psychol Sci Soc Sci 2021; 76:1195-1205. [PMID: 32880643 DOI: 10.1093/geronb/gbaa144] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES Previous research has documented a consistent association between current socioeconomic status (SES) and cytomegalovirus (CMV). Early life is likely a critical period for CMV exposure and immune development, but less is known about early-life socioeconomic factors and CMV, particularly in older age populations. Using data from the Health and Retirement Study, we investigated the association between life course socioeconomic disadvantage and immune response to CMV among older adults. METHODS Using ordered logit models, we estimated associations between several measures of socioeconomic disadvantage and the odds of being in a higher CMV Immunoglobulin G (IgG) response category in a sample of 8,168 respondents aged older than 50 years. RESULTS We found a significant association between educational attainment and CMV IgG response. Those with less than a high school education had 2.00 (95% confidence interval [CI]: 1.67-2.40) times the odds of being in a higher CMV category compared to those with a college degree or greater. In addition, we also observed a significant association with parental education and CMV response. Individuals with parents having 8 years or less of schooling had 2.32 (95% CI: 2.00-2.70) times the odds of higher CMV response compared to those whose parents had greater than high school education. DISCUSSION CMV IgG levels in older adults are associated with both early-life and adult SES. Life course socioeconomic disadvantage may contribute to disparities in immunological aging.
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Affiliation(s)
- Grace A Noppert
- Carolina Population Center, University of North Carolina at Chapel Hill
| | | | - Jennifer B Dowd
- Department of Global Health and Social Medicine, King's College London, UK.,CUNY Graduate School of Public Health and Health Policy, City University of New York
| | - Robert A Hummer
- Carolina Population Center, University of North Carolina at Chapel Hill.,Department of Sociology, University of North Carolina at Chapel Hill
| | - Allison E Aiello
- Carolina Population Center, University of North Carolina at Chapel Hill.,Department of Epidemiology, University of North Carolina at Chapel Hill
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4
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Stebbins RC, Noppert GA, Yang YC, Dowd JB, Simanek A, Aiello AE. Association Between Immune Response to Cytomegalovirus and Cognition in the Health and Retirement Study. Am J Epidemiol 2021; 190:786-797. [PMID: 33094810 DOI: 10.1093/aje/kwaa238] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 10/12/2020] [Accepted: 10/20/2020] [Indexed: 12/26/2022] Open
Abstract
Chronic infections and the subsequent immune response have recently been shown to be risk factors for cognitive decline and Alzheimer disease and related dementias (ADRD). While some studies have shown an association between cytomegalovirus (CMV), a chronic and highly prevalent infection, and cognition and/or ADRD, these studies have been limited by nonrepresentative and small samples. Using 2016 data on 5,617 adults aged 65 years or more from the Health and Retirement Study, we investigated the cross-sectional associations of both CMV serostatus and immunoglobulin G (IgG) antibody response with cognitive function using linear regression models adjusting for age, sex, race/ethnicity, and educational attainment. We further investigated potential effect-measure modification by educational attainment. Overall, both CMV seropositivity and higher IgG antibody response were associated with lower cognitive function, though the relationship was not statistically significant in adjusted models. Among participants with less than a high school diploma, CMV seropositivity and being in the first tertile of IgG response, relative to seronegative persons, were associated with lower scores on the Telephone Interview for Cognitive Status (-0.56 points (95% confidence interval: -1.63, 0.52) and -0.89 points (95% confidence interval: -2.07, 0.29), respectively), and the relationship was attenuated among those with higher education. Our results suggest that CMV may be a risk factor for cognitive impairment, particularly among persons with fewer educational resources.
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5
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Bulka CM, Avula V, Fry RC. Associations of exposure to perfluoroalkyl substances individually and in mixtures with persistent infections: Recent findings from NHANES 1999-2016. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 275:116619. [PMID: 33578314 PMCID: PMC7957906 DOI: 10.1016/j.envpol.2021.116619] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 01/06/2021] [Accepted: 01/27/2021] [Indexed: 05/12/2023]
Abstract
Certain viruses and parasites can cause persistent infections that often co-occur and have been associated with substantial morbidity and mortality. Separate lines of research indicate exposures to per- and polyfluoroalkyl substances (PFAS) suppress the immune system. We hypothesized that PFAS exposures might systematically increase susceptibility to persistent infections resulting in a higher pathogen burden. We used data from 8778 individuals (3189 adolescents, 5589 adults) in the nationally-representative U.S. National Health and Nutrition Examination Survey (NHANES) 1999-2016 to examine cross-sectional associations between serum concentrations of four highly detected PFAS (PFOS, PFOA, PFHxS, PFNA) with the presence of antibodies to cytomegalovirus, Epstein Barr virus, hepatitis C and E, herpes simplex 1 and 2, HIV, T. gondii, and Toxocara spp. Seropositivity was summed to calculate a pathogen burden score reflecting the total number of infections. Separate survey-weighted multivariable regression models were fitted to analyze PFAS individually and quantile g-computation was used to analyze PFAS mixtures. Among adolescents, 38.7% had at least one persistent infection while 14.9% had two or more; among adults, these percentages were 48.0% and 19.7%. Each PFAS was individually associated with significantly higher pathogen burdens and the most pronounced associations were observed in adolescents [e.g., among adolescents, a doubling of PFOS was associated with 30% (95% CI: 25-36%) higher pathogen burden]. Quantile g-computation revealed PFAS mixtures as a whole were also associated with higher pathogen burdens. Taken together, these results suggest PFAS exposure may increase susceptibility to and foster the clustering of persistent infections, particularly among adolescents. Since persistent infections are important contributors to long-term health, prospective data are needed to confirm these findings.
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Affiliation(s)
- Catherine M Bulka
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
| | - Vennela Avula
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Rebecca C Fry
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Institute for Environmental Health Solutions, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Curriculum in Toxicology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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6
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Social patterning of acute respiratory illnesses in the Household Influenza Vaccine Evaluation (HIVE) Study 2014-2015. Epidemiol Infect 2020; 147:e185. [PMID: 31063118 PMCID: PMC6518597 DOI: 10.1017/s0950268819000748] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Social patterning of infectious diseases is increasingly recognised. Previous studies of social determinants of acute respiratory illness (ARI) have found that highly educated and lower income families experience more illnesses. Subjective social status (SSS) has also been linked to symptomatic ARI, but the association may be confounded by household composition. We examined SSS and ARI in the Household Influenza Vaccine Evaluation (HIVE) Study in 2014–2015. We used SSS as a marker of social disadvantage and created a workplace disadvantage score for working adults. We examined the association between these measures and ARI incidence using mixed-effects Poisson regression models with random intercepts to account for household clustering. In univariate analyses, mean ARI was higher among children <5 years old (P < 0.001), and females (P = 0.004) at the individual level. At the household level, mean ARI was higher for households with at least one child <5 years than for those without (P = 0.002). In adjusted models, individuals in the lowest tertile of SSS had borderline significantly higher rates of ARI than those in the highest tertile (incidence rate ratio (IRR) 1.34, 95% confidence interval (CI) 0.98–1.92). Households in the lowest tertile of SSS had significantly higher ARI incidence in household-level models (IRR 1.46, 95% CI 1.05–2.03). We observed no association between workplace disadvantage and ARI. We detected an increase in the incidence of ARI for households with low SSS compared with those with high SSS, suggesting that socio-economic position has a meaningful impact on ARI incidence.
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7
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Mansori K, Moradi Y, Naderpour S, Rashti R, Moghaddam AB, Saed L, Mohammadi H. Helicobacter pylori infection as a risk factor for diabetes: a meta-analysis of case-control studies. BMC Gastroenterol 2020; 20:77. [PMID: 32209055 PMCID: PMC7092473 DOI: 10.1186/s12876-020-01223-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 03/17/2020] [Indexed: 02/07/2023] Open
Abstract
Background There are several studies with varied and mixed results about the possible relationship between H. pylori and diabetes. Therefore, this current meta-analysis performed to determine the association between H. pylori infection and the risk of diabetes mellitus. Methods A systematic literature searches of international databases, including Medline (PubMed), Web of Sciences, Scopus, EMBASE, and CINHAL (January 1990–March 2019) was conducted to identify studies investigating the relationship between H. pylori infection and diabetes mellitus. Only case–control studies were analyzed using odds ratio (OR) with 95% confidence intervals (CIs). Stratified and subgroup analyses were performed to explore heterogeneity between studies and assess effects of study quality. Logarithm and standard error logarithm odds ratio (OR) were also used for meta-analysis. Results A total of 41 studies involving 9559 individuals (case; 4327 and control; 5232) were analyzed. The pooled estimate of the association between H. pylori infection with diabetes was OR = 1.27 (95% CI 1.11 to 1.45, P = 0.0001, I2 = 86.6%). The effect of H. pylori infection on diabetes mellitus (both types), type 1 and type 2 diabetes was 1.17 (95% CI 0.94 to 1.45), 1.19 (95% CI 0.98 to 1.45), and 1.43 (95% CI 1.11 to 1.85) respectively. Subgroup analysis by the geographical regions showed in Asian population risk of the effect of H. pylori infection on diabetes was slightly higher than other population, Conclusion In overall a positive association between H. pylori infection and diabetes mellitus was found.
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Affiliation(s)
- Kamyar Mansori
- Department of Biostatistics and Epidemiology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Yousef Moradi
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
| | - Sara Naderpour
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Roya Rashti
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Ali Baradaran Moghaddam
- Research Center of Pediatric Infection Diseases, Institute of Immunology and Infection Diseases, Iran University of Medical Sciences, Tehran, Iran
| | - Lotfolah Saed
- Department of Endocrinology, Faculty of Medicine, Kurdistan University of Medical Science, Sanandaj, Iran
| | - Hedyeh Mohammadi
- Faculty of Medicine, Kurdistan University of Medical Science, Sanandaj, Iran
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8
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Persistent socioeconomic and racial and ethnic disparities in pathogen burden in the United States, 1999-2014. Epidemiol Infect 2019; 147:e301. [PMID: 31709963 PMCID: PMC6873154 DOI: 10.1017/s0950268819001894] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The disproportionate burden of prevalent, persistent pathogens among disadvantaged groups may contribute to socioeconomic and racial/ethnic disparities in long-term health. We assessed if the social patterning of pathogen burden changed over 16 years in a U.S.-representative sample. Data came from 17 660 National Health and Nutrition Examination Survey participants. Pathogen burden was quantified by summing the number of positive serologies for cytomegalovirus, herpes simplex virus-1, HSV-2, human papillomavirus and Toxoplasma gondii and dividing by the number of pathogens tested, giving a percent-seropositive for each participant. We examined sex- and age-adjusted mean pathogen burdens from 1999–2014, stratified by race/ethnicity and SES (poverty-to-income ratio (PIR); educational attainment). Those with a PIR < 1.3 had a mean pathogen burden 1.4–1.8 times those with a PIR > 3.5, with no change over time. Educational disparities were even greater and showed some evidence of increasing over time, with the mean pathogen burden among those with less than a high school education approximately twice that of those who completed more than high school. Non-Hispanic Black, Mexican American and other Hispanic participants had a mean pathogen burden 1.3–1.9 times non-Hispanic Whites. We demonstrate that socioeconomic and racial/ethnic disparities in pathogen burden have persisted across 16 years, with little evidence that the gap is closing.
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9
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Steptoe A, Hiltl TJ, Dowd JB, Hamer M. Socioeconomic status and central adiposity as determinants of stress-related biological responses relevant to cardiovascular disease risk. Brain Behav Immun 2019; 77:16-24. [PMID: 30468859 PMCID: PMC6417991 DOI: 10.1016/j.bbi.2018.11.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 11/14/2018] [Accepted: 11/19/2018] [Indexed: 12/17/2022] Open
Abstract
Stress-related processes have been implicated in the associations between lower socioeconomic status (SES), central adiposity, and cardiovascular disease risk. This study analysed the impact of SES and central adiposity on cardiovascular, inflammatory and neuroendocrine stress responses, and associations with cytomegalovirus (CMV) infection in a sample of 537 men and women aged 53-76 years (mean 62.89 years). SES was defined by grade of employment (higher, intermediate, and lower categories), and central adiposity was indexed by waist-hip ratio (WHR). Cardiovascular, inflammatory and cortisol responses were monitored during administration of a standardized mental stress testing protocol and salivary cortisol was measured repeatedly over the day. Lower SES was associated with raised systolic and diastolic blood pressure (BP), plasma interleukin (IL-6), fibrinogen, C-reactive protein, and salivary cortisol, and a large WHR accentuated SES differences in fibrinogen, C-reactive protein, and likelihood of CMV seropositivity, independently of general adiposity indexed by body mass index. During mental stress testing, return to resting levels (recovery) following behavioural challenge in systolic and diastolic BP and heart rate was impaired among lower SES participants, particularly those with large WHR. Lower SES participants had greater cortisol concentrations across the day, but this pattern did not vary with WHR. These findings extend the evidence relating lower SES to stress-related biological risk factors for cardiovascular disease, and indicate that central adiposity may augment these effects.
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Affiliation(s)
- Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London WC1E 6BT, UK.
| | - Tanja-Julia Hiltl
- Department of Behavioural Science and Health, University College London, London WC1E 6BT, UK
| | - Jennifer Beam Dowd
- Department of Global Health and Social Medicine, King's College London, London WC2R 2LS, UK
| | - Mark Hamer
- Department of Behavioural Science and Health, University College London, London WC1E 6BT, UK; School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire LE11 3TU, UK
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10
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Lee S, Brook E, Affandi J, Howson P, Tanudjaja SA, Dhaliwal S, Irish A, Price P. A high burden of cytomegalovirus marks poor vascular health in transplant recipients more clearly than in the general population. Clin Transl Immunology 2019; 8:e1043. [PMID: 30788107 PMCID: PMC6369563 DOI: 10.1002/cti2.1043] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 01/07/2019] [Accepted: 01/08/2019] [Indexed: 01/22/2023] Open
Abstract
Objectives Meta‐analyses have now confirmed that persistent infections with cytomegalovirus (CMV) can accelerate the onset of diseases of ageing, notably cardiovascular pathologies. We address the circumstances in which the association may be strong enough to warrant intervention to reduce the viral burden. Results We compare markers of the burden of CMV with established indices of vascular pathology in healthy adults (n = 82) and in renal transplant recipients (RTR; n = 81). Levels of all inflammatory and vascular biomarkers and CMV antibodies were higher in RTR, and flow‐mediated dilation (FMD) values were lower indicating inferior endothelial function. In multivariable regression models without adjustment for estimated glomerular filtration rate (eGFR), CMV antibody levels, age and gender were independently associated with FMD in RTR, whilst only CRP associated with FMD in healthy adults. After adjustment for eGFR, associations between CMV antibody and FMD in RTR were reduced. Methods Carotid intima‐media thickness, FMD, eGFR and plasma levels of CMV antibodies (reactive with a lysate, CMV IE‐1 or CMV gB), ICAM‐1, VCAM‐1, P‐selectin, sIFNαR2, sTNFR1, sCD14 and CRP were determined. Conclusion Levels of CMV antibody predict declining endothelial health in RTR and not in healthy adults, presumably by reflecting a high burden of CMV. The levels of CMV antibodies were a poor reflection of plasma biomarkers thought to reflect ‘inflammaging’ or vascular damage.
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Affiliation(s)
- Silvia Lee
- School of Biomedical Science and the Curtin Health Innovation Research Institute Curtin University Bentley WA Australia.,Department of Microbiology Pathwest Laboratory Medicine Perth WA Australia
| | - Emily Brook
- School of Biomedical Science and the Curtin Health Innovation Research Institute Curtin University Bentley WA Australia
| | | | - Prue Howson
- Renal Unit Fiona Stanley Hospital Murdoch WA Australia
| | | | | | - Ashley Irish
- Renal Unit Fiona Stanley Hospital Murdoch WA Australia
| | - Patricia Price
- School of Biomedical Science and the Curtin Health Innovation Research Institute Curtin University Bentley WA Australia
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11
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Investigating pathogen burden in relation to a cumulative deficits index in a representative sample of US adults. Epidemiol Infect 2018; 146:1968-1976. [PMID: 29898795 DOI: 10.1017/s095026881800153x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Pathogen burden is a construct developed to assess the cumulative effects of multiple, persistent pathogens on morbidity and mortality. Despite the likely biological wear and tear on multiple body systems caused by persistent infections, few studies have examined the impact of total pathogen burden on such outcomes and specifically on preclinical markers of dysfunction. Using data from two waves of the National Health and Nutrition Examination Survey, we compared three alternative methods for measuring pathogen burden, composed of mainly persistent viral infections, using a cumulative deficits index (CDI) as an outcome: single pathogen associations, a pathogen burden summary score and latent class analyses. We found significant heterogeneity in the distribution of the CDI by age, sex, race/ethnicity and education. There was an association between pathogen burden and the CDI by all three metrics. The latent class classification of pathogen burden showed particularly strong associations with the CDI; these associations remained after controlling for age, sex, body mass index, smoking, race/ethnicity and education. Our results suggest that pathogen burden may influence early clinical indicators of poor health as measured by the CDI. Our results are salient since we were able to detect these associations in a relatively young population. These findings suggest that reducing pathogen burden and the specific pathogens that drive the CDI may provide a target for preventing the early development of age-related physiological changes.
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12
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Iglesias-Escudero M, Moro-García MA, Marcos-Fernández R, García-Torre A, Álvarez-Argüelles ME, Suárez-Fernández ML, Martínez-Camblor P, Rodríguez M, Alonso-Arias R. Levels of anti-CMV antibodies are modulated by the frequency and intensity of virus reactivations in kidney transplant patients. PLoS One 2018; 13:e0194789. [PMID: 29641536 PMCID: PMC5895001 DOI: 10.1371/journal.pone.0194789] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 03/10/2018] [Indexed: 12/21/2022] Open
Abstract
Anti-CMV (cytomegalovirus) antibody titers are related to immune alterations and increased risk of mortality. To test whether they represent a marker of infection history, we analyzed the effect of viral reactivations on the production of specific antibodies in kidney transplant patients. We quantified CMV-DNAemia and antibody titers in 58 kidney transplant patients before transplantation and during a follow-up of 315 days (standard deviation, SD: 134.5 days). In order to calculate the intensity of the infection, we plotted the follow-up time of the infection on the x-axis and the number of DNA-CMV copies on the y-axis and calculated the area under the curve (CMV-AUC). The degree of T-lymphocyte differentiation was analyzed with flow cytometry, the cells were labelled with different monoclonal antibodies in order to distinguish their differentiation state, from naive T-cells to senescent T-cells. Peak viremia was significantly higher in patients experiencing a primary infection (VI) compared to patients experiencing viral reactivation (VR). Our data indicate that the overall CMV viral load over the course of a primary infection is significantly higher than in a reactivation of a previously established infection. Whereas patients who experienced an episode of CMV reactivation during the course of our observation showed increased levels of CMV-specific antibodies, patients who did not experience CMV reactivation (WVR) showed a drop in CMV antibody levels that corresponds to an overall drop in antibody levels, probably due to the continuing immunosuppression after the renal transplant. We found a positive correlation between the CMV viremia over the course of the infection or reactivation and the CMV-specific antibody titers in the examined patients. We also observed a positive correlation between anti-CMV titers and T-cell differentiation. In conclusion, our data show that anti-CMV antibody titers are related to the course of CMV infection in kidney transplant patients.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Rebeca Alonso-Arias
- Immunology Department, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain
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13
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Aiello AE, Chiu YL, Frasca D. How does cytomegalovirus factor into diseases of aging and vaccine responses, and by what mechanisms? GeroScience 2017. [PMID: 28624868 DOI: 10.1007/s11357-017-9983-9] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Cytomegalovirus (CMV) is an important pathogen for both clinical and population settings. There is a growing body of research implicating CMV in multiple health outcomes across the life course. At the same time, there is mounting evidence that individuals living in poverty are more likely to be exposed to CMV and more likely to experience many of the chronic conditions for which CMV has been implicated. Further research on the causal role of CMV for health and well-being is needed. However, the strong evidence implicating CMV in type 2 diabetes, autoimmunity, cancer, cardiovascular disease, vaccination, and age-related alterations in immune function warrants clinical and public health action. This imperative is even higher among individuals living in socioeconomically disadvantaged settings and those exposed to high levels of chronic psychosocial stress.
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Affiliation(s)
- Allison E Aiello
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Yen-Ling Chiu
- Department of Medicine, Far Eastern Memorial Hospital, Taipei, Taiwan.,Graduate Program of Biomedical Informatics, Yuan Ze University, Taoyuan, Taiwan
| | - Daniela Frasca
- Department of Microbiology and Immunology, University of Miami Miller School of Medicine, Room #3146A, P.O. Box 016960 (R-138), Miami, FL, 33101, USA.
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14
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Rosenberg N, Daviglus ML, DeVon HA, Park CG, Eldeirawi K. Systemic Inflammation and Viral Exposure among Young Mexican American Women: Nativity-Related Differences. Ethn Dis 2017; 27:133-142. [PMID: 28439184 DOI: 10.18865/ed.27.2.133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Factors contributing to elevated inflammation in racial/ethnic minority populations are not well understood. We examined the association of viral exposure with C-reactive protein (CRP) in young Mexican American women. METHODS AND RESULTS Participants (N=1,141) were currently non-pregnant women of Mexican background, aged 18-39 years, from the cross-sectional National Health and Nutrition Examination Survey (NHANES) 1999-2010. Viral exposure was defined as seropositive status for hepatitis B, and herpes simplex types 1 and 2, and classified as seronegative, seropositive for any one agent, and seropositive for 2 or 3 agents. The association of viral exposure with elevated CRP (3.01-10.00 mg/L) varied by country of birth (P=.001). Among Mexico-born women, those seropositive for 2 or 3 agents had 3.79 times (95% CI: 1.28-11.27) and those seropositive for any one agent 2.56 times (95% CI: 1.12-5.86) the odds of elevated CRP compared with seronegative women, after adjustment for age, country of birth, household density, waist circumference, glycated hemoglobin, and total cholesterol. Among US-born women, the corresponding odds were OR: .32, 95% CI: .12-.86 and OR: .71, 95% CI .43-1.17. CONCLUSIONS In Mexico-born Mexican American women, viral exposure is associated with higher odds of elevated CRP.
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Affiliation(s)
- Natalya Rosenberg
- Institute for Minority Health Research, College of Medicine, University of Illinois at Chicago
| | - Martha L Daviglus
- Institute for Minority Health Research, College of Medicine, University of Illinois at Chicago
| | - Holli A DeVon
- College of Nursing, University of Illinois at Chicago
| | - Chang Gi Park
- College of Nursing, University of Illinois at Chicago
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15
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Broadley I, Pera A, Morrow G, Davies KA, Kern F. Expansions of Cytotoxic CD4 +CD28 - T Cells Drive Excess Cardiovascular Mortality in Rheumatoid Arthritis and Other Chronic Inflammatory Conditions and Are Triggered by CMV Infection. Front Immunol 2017; 8:195. [PMID: 28303136 PMCID: PMC5332470 DOI: 10.3389/fimmu.2017.00195] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 02/09/2017] [Indexed: 12/21/2022] Open
Abstract
A large proportion of cardiovascular (CV) pathology results from immune-mediated damage, including systemic inflammation and cellular proliferation, which cause a narrowing of the blood vessels. Expansions of cytotoxic CD4+ T cells characterized by loss of CD28 (“CD4+CD28− T cells” or “CD4+CD28null cells”) are closely associated with cardiovascular disease (CVD), in particular coronary artery damage. Direct involvement of these cells in damaging the vasculature has been demonstrated repeatedly. Moreover, CD4+CD28− T cells are significantly increased in rheumatoid arthritis (RA) and other autoimmune conditions. It is striking that expansions of this subset beyond 1–2% occur exclusively in CMV-infected people. CMV infection itself is known to increase the severity of autoimmune diseases, in particular RA and has also been linked to increased vascular pathology. A review of the recent literature on immunological changes in CVD, RA, and CMV infection provides strong evidence that expansions of cytotoxic CD4+CD28− T cells in RA and other chronic inflammatory conditions are limited to CMV-infected patients and driven by CMV infection. They are likely to be responsible for the excess CV mortality observed in these situations. The CD4+CD28− phenotype convincingly links CMV infection to CV mortality based on a direct cellular-pathological mechanism rather than epidemiological association.
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Affiliation(s)
- Iain Broadley
- Division of Medicine, Brighton and Sussex Medical School , Brighton , UK
| | - Alejandra Pera
- Division of Medicine, Brighton and Sussex Medical School, Brighton, UK; Department of Immunology, Maimonides Institute for Biomedical Research (IMIBIC), Reina Sofía University Hospital, University of Cordoba, Cordoba, Spain
| | - George Morrow
- Division of Medicine, Brighton and Sussex Medical School , Brighton , UK
| | - Kevin A Davies
- Division of Medicine, Brighton and Sussex Medical School , Brighton , UK
| | - Florian Kern
- Division of Medicine, Brighton and Sussex Medical School , Brighton , UK
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16
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Murdock KW, Fagundes CP, Peek MK, Vohra V, Stowe RP. The effect of self-reported health on latent herpesvirus reactivation and inflammation in an ethnically diverse sample. Psychoneuroendocrinology 2016; 72:113-8. [PMID: 27398881 PMCID: PMC5116910 DOI: 10.1016/j.psyneuen.2016.06.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 06/17/2016] [Accepted: 06/20/2016] [Indexed: 02/05/2023]
Abstract
Self-rated health (SRH) is a reliable predictor of health outcomes including morbidity and mortality. Immune dysregulation is one hypothesized mechanism underlying the association between SRH and health outcomes. Indeed, poorer SRH is associated with greater inflammation. The association between SRH and reactivation of latent herpesviruses is unknown, representing an important gap in the literature given that reactivation of latent herpesviruses leads to enhanced inflammation. The present study addressed this important gap in the literature by examining associations between SRH, inflammation (i.e., peripheral cytokines in the blood), and reactivation of latent herpesviruses among a sample of 1208 individuals participating in the Texas City Stress and Health Study. Participants completed a self-report measure of SRH and a blood draw. Results indicated that higher SRH was associated with lower reactivation of latent herpesviruses and inflammation. Moreover, reactivation of latent herpesviruses partially mediated the association between SRH and inflammation. Accordingly, findings add to our growing understanding of the association between SRH and immune dysfunction.
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Affiliation(s)
- Kyle W. Murdock
- Department of Psychology, Rice University, 6500 Main Street, Houston, TX 77005, USA
| | - Christopher P. Fagundes
- Department of Psychology, Rice University, 6500 Main Street, Houston, TX 77005, USA
,Department of Symptoms Research, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1450, Houston, Texas 77030, USA
,Department of Psychiatry, Baylor College of Medicine, One Baylor Plaza - BCM350, Houston, Texas 77030 , USA
| | - M. Kristen Peek
- Department of Preventative Medicine and Community Health, The University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555, USA
| | - Vansh Vohra
- Department of Psychology, Rice University, 6500 Main Street, Houston, TX 77005, USA
| | - Raymond P. Stowe
- Microgen Laboratories, 903 Texas Avenue, La Marque, TX 77568, USA
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17
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Meier HCS, Haan MN, Mendes de Leon CF, Simanek AM, Dowd JB, Aiello AE. Early life socioeconomic position and immune response to persistent infections among elderly Latinos. Soc Sci Med 2016; 166:77-85. [PMID: 27543684 DOI: 10.1016/j.socscimed.2016.07.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 07/01/2016] [Accepted: 07/04/2016] [Indexed: 02/07/2023]
Abstract
Persistent infections, such as cytomegalovirus (CMV), herpes simplex virus-1 (HSV-1), Helicobacter pylori (H. pylori), and Toxoplasma gondii (T. gondii), are common in the U.S. but their prevalence varies by socioeconomic status. It is unclear if early or later life socioeconomic position (SEP) is a more salient driver of disparities in immune control of these infections. Using data from the Sacramento Area Latino Study on Aging, we examined whether early or later life SEP was the strongest predictor of immune control later in life by contrasting two life course models, the critical period model and the chain of risk model. Early life SEP was measured as a latent variable, derived from parental education and occupation, and food availability. Indicators for SEP in later life included education level and occupation. Individuals were categorized by immune response to each pathogen (seronegative, low, medium and high) with increasing immune response representing poorer immune control. Cumulative immune response was estimated using a latent profile analysis with higher total immune response representing poorer immune control. Structural equation models were used to examine direct, indirect and total effects of early life SEP on each infection and cumulative immune response, controlling for age and gender. The direct effect of early life SEP on immune response was not statistically significant for the infections or cumulative immune response. Higher early life SEP was associated with lower immune response for T. gondii, H. pylori and cumulative immune response through pathways mediated by later life SEP. For CMV, higher early life SEP was both directly associated and partially mediated by later life SEP. No association was found between SEP and HSV-1. Findings from this study support a chain of risk model, whereby early life SEP acts through later life SEP to affect immune response to persistent infections in older age.
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Affiliation(s)
- Helen C S Meier
- Epidemiology Branch, National Institute of Environmental Health Sciences, 111 T.W. Alexander Dr., P.O. Box 12233, MD A3-05, Research Triangle Park, NC 27709, United States.
| | - Mary N Haan
- Department of Epidemiology and Biostatistics, University of California San Francisco, 550 15th Street, San Francisco, CA 94158, United States.
| | - Carlos F Mendes de Leon
- Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States.
| | - Amanda M Simanek
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, P.O. Box 413, Milwaukee, WI 53201, United States.
| | - Jennifer B Dowd
- Department of Epidemiology and Biostatistics, CUNY School of Public Health, Hunter College, City University of New York, 2180 Third Ave., New York, NY 10035, United States.
| | - Allison E Aiello
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Dr. 2101B McGavran-Greenberg Hall, CB 7435, Chapel Hill, NC 27599, United States.
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18
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Does cytomegalovirus infection contribute to socioeconomic disparities in all-cause mortality? Mech Ageing Dev 2016; 158:53-61. [PMID: 27268074 DOI: 10.1016/j.mad.2016.06.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 04/16/2016] [Accepted: 06/01/2016] [Indexed: 12/29/2022]
Abstract
The social patterning of cytomegalovirus (CMV) and its implication in aging suggest that the virus may partially contribute to socioeconomic disparities in mortality. We used Cox regression and inverse odds ratio weighting to quantify the proportion of the association between socioeconomic status (SES) and all-cause mortality that was attributable to mediation by CMV seropositivity. Data were from the National Health and Nutrition Examination Survey (NHANES) III (1988-1994), with mortality follow-up through December 2011. SES was assessed as household income (income-to-poverty ratio ≤1.30;>1.30 to≤1.85;>1.85 to≤3.50;>3.50) and education (<high school; high school; >high school). We found strong associations between low SES and increased mortality: hazard ratio (HR) 1.80; 95% confidence interval (CI): 1.57, 2.06 comparing the lowest versus highest income groups and HR 1.29; 95% CI: 1.13, 1.48 comparing <high school versus >high school education. 65% of individuals were CMV seropositive, accounting for 6-15% of the SES-mortality associations. Age modified the associations between SES, CMV, and mortality, with CMV more strongly associated with mortality in older individuals. Our findings suggest that cytomegalovirus may partially contribute to persistent socioeconomic disparities in mortality, particularly among older individuals.
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19
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Spyridopoulos I, Martin-Ruiz C, Hilkens C, Yadegarfar ME, Isaacs J, Jagger C, Kirkwood T, von Zglinicki T. CMV seropositivity and T-cell senescence predict increased cardiovascular mortality in octogenarians: results from the Newcastle 85+ study. Aging Cell 2016; 15:389-92. [PMID: 26696322 PMCID: PMC4783336 DOI: 10.1111/acel.12430] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2015] [Indexed: 12/14/2022] Open
Abstract
Although chronic infection with cytomegalovirus (CMV) is known to drive T lymphocytes toward a senescent phenotype, it remains controversial whether and how CMV can cause coronary heart disease (CHD). To explore whether CMV seropositivity or T-cell populations associated with immunosenescence were informative for adverse cardiovascular outcome in the very old, we prospectively analyzed peripheral blood samples from 751 octogenarians (38% males) from the Newcastle 85+ study for their power to predict survival during a 65-month follow-up (47.3% survival rate). CMV-seropositive participants showed a higher prevalence of CHD (37.7% vs. 26.7%, P = 0.030) compared to CMV-seronegative participants together with lower CD4/CD8 ratio (1.7 vs. 4.1, P < 0.0001) and higher frequencies of senescence-like CD4 memory cells (41.1% vs. 4.5%, P < 0.001) and senescence-like CD8 memory cells (TEMRA, 28.1% vs. 6.7%, P < 0.001). CMV seropositivity was also associated with increased six-year cardiovascular mortality (HR 1.75 [1.09-2.82], P = 0.021) or death from myocardial infarction and stroke (HR 1.89 [107-3.36], P = 0.029). Gender-adjusted multivariate Cox regression analysis revealed that low percentages of senescence-like CD4 T cells (HR 0.48 [0.32-0.72], P < 0.001) and near-senescent (CD27 negative) CD8 T cells (HR 0.60 [0.41-0.88], P = 0.029) reduced the risk of cardiovascular death. For senescence-like CD4, but not near-senescent CD8 T cells, these associations remained robust after additional adjustment for CMV status, comorbidities, and inflammation markers. We conclude that CMV seropositivity is linked to a higher incidence of CHD in octogenarians and that senescence in both the CD4 and CD8 T-cell compartments is a predictor of overall cardiovascular mortality as well as death from myocardial infarction and stroke.
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Affiliation(s)
- Ioakim Spyridopoulos
- Newcastle University Institute for Ageing; Newcastle University; Newcastle upon Tyne NE4 5PL UK
- Institute of Genetic Medicine; Newcastle University; Newcastle upon Tyne NE4 5PL UK
| | - Carmen Martin-Ruiz
- Newcastle University Institute for Ageing; Newcastle University; Newcastle upon Tyne NE4 5PL UK
- Institute of Neuroscience; Newcastle University; Newcastle upon Tyne NE4 5PL UK
| | - Catharien Hilkens
- Institute of Cellular Medicine; Newcastle University; Newcastle upon Tyne NE4 5PL UK
| | - Mohammad E. Yadegarfar
- Newcastle University Institute for Ageing; Newcastle University; Newcastle upon Tyne NE4 5PL UK
- Institute of Health and Society; Newcastle University; Newcastle upon Tyne NE4 5PL UK
| | - John Isaacs
- Newcastle University Institute for Ageing; Newcastle University; Newcastle upon Tyne NE4 5PL UK
- Institute of Cellular Medicine; Newcastle University; Newcastle upon Tyne NE4 5PL UK
| | - Carol Jagger
- Newcastle University Institute for Ageing; Newcastle University; Newcastle upon Tyne NE4 5PL UK
- Institute of Health and Society; Newcastle University; Newcastle upon Tyne NE4 5PL UK
| | - Tom Kirkwood
- Newcastle University Institute for Ageing; Newcastle University; Newcastle upon Tyne NE4 5PL UK
- Institute for Cell and Molecular Biosciences; Newcastle University; Newcastle upon Tyne NE4 5PL UK
| | - Thomas von Zglinicki
- Newcastle University Institute for Ageing; Newcastle University; Newcastle upon Tyne NE4 5PL UK
- Institute for Cell and Molecular Biosciences; Newcastle University; Newcastle upon Tyne NE4 5PL UK
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20
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Han X, Li Y, Wang J, Liu B, Hu H, Li X, Yang K, Yuan J, Yao P, Wei S, Wang Y, Liang Y, Miao X, Zhang X, Guo H, Yang H, Wu T, He M. Helicobacter pylori infection is associated with type 2 diabetes among a middle- and old-age Chinese population. Diabetes Metab Res Rev 2016; 32:95-101. [PMID: 26172433 DOI: 10.1002/dmrr.2677] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 06/11/2015] [Accepted: 07/01/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND Although the association of Helicobacter pylori (H. pylori) infection with diabetes mellitus has been evaluated, findings are controversial. This study investigated the association in a Chinese population. METHODS A cross-sectional study, including a total of 30 810 subjects from the Dongfeng-Tongji Cohort study, was conducted. H. pylori status was measured via (14) C urea breath test. Association analysis was performed by logistic regression, with multivariable adjustment for sex, age, body mass index, smoking, alcohol consumption, family history of diabetes, physical activity and the use of antibiotics. RESULTS Among a middle-age and old-age Chinese population, individuals with H. pylori infection also had a higher prevalence of type 2 diabetes (21.3% versus 20.2%, p = 0.026). H. pylori infection was associated with higher risk of type 2 diabetes [odds ratio, 1.08 (95% confidence interval: 1.02-1.14); p = 0.008] after adjustment for other confounders. The association was significant among women, those who were above 65 years old, not overweight or obese, and those who did not smoke, did not consume alcohol and without family history of diabetes. However, there was no interaction between H. pylori infection and other traditional risk factors on type 2 diabetes risk. Subjects with H. pylori infection had a lower level of high-density lipoprotein cholesterol (p < 0.0001) and higher levels of blood pressure (p < 0.001), total cholesterol, HbA1c and fasting blood glucose (p < 0.0001) than those who did not. CONCLUSIONS These findings suggested that H. pylori infection was associated with the risk of type 2 diabetes in a middle-age and old-age Chinese population. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Xu Han
- Institute of Occupational Medicine and the Ministry of Education Key Lab of Environment and Health, School of Public Health, Huazhong University of Science and Technology, Wuhan, China
| | - Yaru Li
- Institute of Occupational Medicine and the Ministry of Education Key Lab of Environment and Health, School of Public Health, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Wang
- Institute of Occupational Medicine and the Ministry of Education Key Lab of Environment and Health, School of Public Health, Huazhong University of Science and Technology, Wuhan, China
| | - Bing Liu
- Institute of Occupational Medicine and the Ministry of Education Key Lab of Environment and Health, School of Public Health, Huazhong University of Science and Technology, Wuhan, China
| | - Hua Hu
- Institute of Occupational Medicine and the Ministry of Education Key Lab of Environment and Health, School of Public Health, Huazhong University of Science and Technology, Wuhan, China
| | - Xiulou Li
- Dongfeng Central Hospital, Dongfeng Motor Corporation and Hubei University of Medicine, Shiyan, Hubei, China
| | - Kun Yang
- Dongfeng Central Hospital, Dongfeng Motor Corporation and Hubei University of Medicine, Shiyan, Hubei, China
| | - Jing Yuan
- Institute of Occupational Medicine and the Ministry of Education Key Lab of Environment and Health, School of Public Health, Huazhong University of Science and Technology, Wuhan, China
| | - Ping Yao
- Institute of Occupational Medicine and the Ministry of Education Key Lab of Environment and Health, School of Public Health, Huazhong University of Science and Technology, Wuhan, China
| | - Sheng Wei
- Institute of Occupational Medicine and the Ministry of Education Key Lab of Environment and Health, School of Public Health, Huazhong University of Science and Technology, Wuhan, China
| | - Youjie Wang
- Institute of Occupational Medicine and the Ministry of Education Key Lab of Environment and Health, School of Public Health, Huazhong University of Science and Technology, Wuhan, China
| | - Yuan Liang
- Institute of Occupational Medicine and the Ministry of Education Key Lab of Environment and Health, School of Public Health, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoping Miao
- Institute of Occupational Medicine and the Ministry of Education Key Lab of Environment and Health, School of Public Health, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaomin Zhang
- Institute of Occupational Medicine and the Ministry of Education Key Lab of Environment and Health, School of Public Health, Huazhong University of Science and Technology, Wuhan, China
| | - Huan Guo
- Institute of Occupational Medicine and the Ministry of Education Key Lab of Environment and Health, School of Public Health, Huazhong University of Science and Technology, Wuhan, China
| | - Handong Yang
- Dongfeng Central Hospital, Dongfeng Motor Corporation and Hubei University of Medicine, Shiyan, Hubei, China
| | - Tangchun Wu
- Institute of Occupational Medicine and the Ministry of Education Key Lab of Environment and Health, School of Public Health, Huazhong University of Science and Technology, Wuhan, China
| | - Meian He
- Institute of Occupational Medicine and the Ministry of Education Key Lab of Environment and Health, School of Public Health, Huazhong University of Science and Technology, Wuhan, China
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21
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Association Between Prenatal Exposure to Maternal Infection and Offspring Mood Disorders: A Review of the Literature. Curr Probl Pediatr Adolesc Health Care 2015; 45:325-64. [PMID: 26476880 DOI: 10.1016/j.cppeds.2015.06.008] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Accepted: 06/14/2015] [Indexed: 01/19/2023]
Abstract
The purpose of this article is to provide a systematic review of studies that have examined the association between prenatal exposure to maternal infection and development of mood disorders across the life course. Drawing from both human- and animal-based studies, we give an overview of hypothesized biological mechanisms by which exposure to maternal infection during critical periods of gestation may contribute to fetal programming of mood disorders in offspring. We discuss studies examining the association between prenatal exposure to maternal infection with pathogens including influenza as well as other respiratory viruses, herpesviruses, hepatitis viruses, and Toxoplasma gondii and mood disorders in human populations. Moreover, we outline strengths and limitations of the current body of evidence and make recommendations for future research. We also discuss findings in the context of well-documented gender and socioeconomic disparities in the prevalence and severity of mood disorders, particularly major depression, and the role that early exposure to infection may play in explaining the perpetuation of such disparities across generations. Overall, this review of the current knowledge on this topic has important implications for determining future research directions, designing interventions as well as prenatal care guidelines targeted at prevention or treatment of infection during pregnancy, and clinical practice for the identification of individuals that may be at increased risk for mood disorders beginning early in life. Importantly, such efforts may not only lower the overall burden of mood disorders but also serve to address social disparities in these adverse mental health conditions in the U.S.
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22
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Unpacking the 'black box' of total pathogen burden: is number or type of pathogens most predictive of all-cause mortality in the United States? Epidemiol Infect 2014; 143:2624-34. [PMID: 25518978 DOI: 10.1017/s0950268814003215] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
A 'black box' paradigm has prevailed in which researchers have focused on the association between the total number of pathogens for which individuals are seropositive (i.e. total pathogen burden) and various chronic diseases, while largely ignoring the role that seropositivity for specific combinations of pathogens may play in the aetiology of such outcomes and consequently mortality. We examined the association between total pathogen burden as well as specific pathogen combinations and all-cause mortality in the United States. Data were from individuals aged ⩾25 years tested for cytomegalovirus (CMV), herpes simplex virus (HSV)-1, HSV-2 and Helicobacter pylori, with mortality follow-up to 31 December 2006 in the National Health and Nutrition Examination Survey (NHANES) III (N = 6522). We did not observe a statistically significant graded relationship between total pathogen burden level and all-cause mortality. Furthermore, compared to those seronegative for all four pathogens, the greatest statistically significant rate of all-cause mortality was for those CMV+/HSV-2+ (hazard ratio 1·95, 95% confidence interval 1·13-3·35) adjusting for age, gender, race/ethnicity, education level, body mass index (kg/m2) and smoking status. Interventions targeting prevention or treatment of particular pathogens may be more effective for reducing mortality than those focused solely on reducing overall pathogen burden.
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23
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Simanek AM, Cheng C, Yolken R, Uddin M, Galea S, Aiello AE. Herpesviruses, inflammatory markers and incident depression in a longitudinal study of Detroit residents. Psychoneuroendocrinology 2014; 50:139-48. [PMID: 25218654 PMCID: PMC4306348 DOI: 10.1016/j.psyneuen.2014.08.002] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 08/01/2014] [Accepted: 08/01/2014] [Indexed: 01/16/2023]
Abstract
BACKGROUND Depression is predicted to become the leading cause of disability worldwide by 2030 and moreover, socioeconomic inequalities in depression persist. Herpesviruses, which are more prevalent among socioeconomically disadvantaged populations, subject to stress-induced reactivation and are associated with increased levels of pro-inflammatory cytokines implicated in the etiology of depression, may serve as novel risk factors for depression onset. METHODS Data are from individuals in the Detroit Neighborhood Health Study tested for herpes simplex virus-1 (HSV-1) and cytomegalovirus (CMV) seropositivity/immunoglobulin G (IgG) antibody levels (N=263) as well as interleukin-6 (IL-6) (N=245) and C-reactive protein (CRP) (N=236) levels and assessed for incident depression via the Patient Health Questionnaire-9. Linear and logistic regression models were used to examine associations between pathogen seropositivity/IgG antibody levels, pro-inflammatory markers and incident depression over approximately one-year of follow-up. RESULTS For every one unit increase in CMV IgG antibody level, the odds of incident depression increased by 26% and individuals with IgG antibody levels in the highest quartile had over three times greater odds of incident depression (odds ratio 3.87, 95% confidence interval 1.47, 10.19), compared to those in the lower three quartiles. Neither CMV or HSV-1 seropositivity nor HSV-1 IgG antibody level were associated with IL-6 or CRP levels at Wave 1, nor were IL-6 or CRP levels associated with incident depression at Wave 2. CONCLUSIONS Further examination of the biological pathways linking CMV and depression are warranted.
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Affiliation(s)
- Amanda M Simanek
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, USA.
| | - Caroline Cheng
- Department of Epidemiology, University of Michigan-School of Public Health, Ann Arbor, MI, USA; Center for Social Epidemiology & Population Health, University of Michigan-School of Public Health, Ann Arbor, MI, USA
| | - Robert Yolken
- Department of Pediatrics, Stanley Division of Developmental Neurovirology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Monica Uddin
- Department of Psychology, University of Illinois Urbana-Champaign, Champaign, IL, USA; Institute of Genomic Biology, University of Illinois Urbana-Champaign, Urbana IL
| | - Sandro Galea
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Allison E Aiello
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
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24
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Hoffmann J, Shmeleva EV, Boag SE, Fiser K, Bagnall A, Murali S, Dimmick I, Pircher H, Martin-Ruiz C, Egred M, Keavney B, von Zglinicki T, Das R, Todryk S, Spyridopoulos I. Myocardial ischemia and reperfusion leads to transient CD8 immune deficiency and accelerated immunosenescence in CMV-seropositive patients. Circ Res 2014; 116:87-98. [PMID: 25385851 PMCID: PMC4280279 DOI: 10.1161/circresaha.116.304393] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
RATIONALE There is mounting evidence of a higher incidence of coronary heart disease in cytomegalovirus-seropositive individuals. OBJECTIVE The aim of this study was to investigate whether acute myocardial infarction triggers an inflammatory T-cell response that might lead to accelerated immunosenescence in cytomegalovirus-seropositive patients. METHODS AND RESULTS Thirty-four patients with acute myocardial infarction undergoing primary percutaneous coronary intervention were longitudinally studied within 3 months after reperfusion (Cohort A). In addition, 54 patients with acute myocardial infarction and chronic myocardial infarction were analyzed in a cross-sectional study (Cohort B). Cytomegalovirus-seropositive patients demonstrated a greater fall in the concentration of terminally differentiated CD8 effector memory T cells (TEMRA) in peripheral blood during the first 30 minutes of reperfusion compared with cytomegalovirus-seronegative patients (-192 versus -63 cells/μL; P=0.008), correlating with the expression of programmed cell death-1 before primary percutaneous coronary intervention (r=0.8; P=0.0002). A significant proportion of TEMRA cells remained depleted for ≥3 months in cytomegalovirus-seropositive patients. Using high-throughput 13-parameter flow cytometry and human leukocyte antigen class I cytomegalovirus-specific dextramers, we confirmed an acute and persistent depletion of terminally differentiated TEMRA and cytomegalovirus-specific CD8(+) cells in cytomegalovirus-seropositive patients. Long-term reconstitution of the TEMRA pool in chronic cytomegalovirus-seropositive postmyocardial infarction patients was associated with signs of terminal differentiation including an increase in killer cell lectin-like receptor subfamily G member 1 and shorter telomere length in CD8(+) T cells (2225 versus 3397 bp; P<0.001). CONCLUSIONS Myocardial ischemia and reperfusion in cytomegalovirus-seropositive patients undergoing primary percutaneous coronary intervention leads to acute loss of antigen-specific, terminally differentiated CD8 T cells, possibly through programmed cell death-1-dependent programmed cell death. Our results suggest that acute myocardial infarction and reperfusion accelerate immunosenescence in cytomegalovirus-seropositive patients.
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Affiliation(s)
- Jedrzej Hoffmann
- From the Institute of Genetic Medicine (J.H., E.V.S., S.E.B., S.M., B.K., I.S.), Institute of Aging and Health (C.M.-R., T.v.Z.), and Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom (A.B., M.E., R.D., S.T.), Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom (A.B., M.E., R.D., I.S.); Flow Cytometry Core Facility, International Center for Life, Newcastle upon Tyne, United Kingdom (I.D.); Department of Immunology, Institute of Medical Microbiology and Hygiene, Freiburg University, Germany (H.P.); CLIP-Childhood Leukaemia Investigation Prague, Department of Paediatric Haematology and Oncology, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic (K.F.); University Hospital Motol, Prague, Czech Republic (K.F.); Institute of Cardiovascular Sciences, The University of Manchester, United Kingdom (B.K.); and Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom (S.M., S.T.)
| | - Evgeniya V Shmeleva
- From the Institute of Genetic Medicine (J.H., E.V.S., S.E.B., S.M., B.K., I.S.), Institute of Aging and Health (C.M.-R., T.v.Z.), and Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom (A.B., M.E., R.D., S.T.), Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom (A.B., M.E., R.D., I.S.); Flow Cytometry Core Facility, International Center for Life, Newcastle upon Tyne, United Kingdom (I.D.); Department of Immunology, Institute of Medical Microbiology and Hygiene, Freiburg University, Germany (H.P.); CLIP-Childhood Leukaemia Investigation Prague, Department of Paediatric Haematology and Oncology, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic (K.F.); University Hospital Motol, Prague, Czech Republic (K.F.); Institute of Cardiovascular Sciences, The University of Manchester, United Kingdom (B.K.); and Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom (S.M., S.T.)
| | - Stephen E Boag
- From the Institute of Genetic Medicine (J.H., E.V.S., S.E.B., S.M., B.K., I.S.), Institute of Aging and Health (C.M.-R., T.v.Z.), and Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom (A.B., M.E., R.D., S.T.), Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom (A.B., M.E., R.D., I.S.); Flow Cytometry Core Facility, International Center for Life, Newcastle upon Tyne, United Kingdom (I.D.); Department of Immunology, Institute of Medical Microbiology and Hygiene, Freiburg University, Germany (H.P.); CLIP-Childhood Leukaemia Investigation Prague, Department of Paediatric Haematology and Oncology, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic (K.F.); University Hospital Motol, Prague, Czech Republic (K.F.); Institute of Cardiovascular Sciences, The University of Manchester, United Kingdom (B.K.); and Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom (S.M., S.T.)
| | - Karel Fiser
- From the Institute of Genetic Medicine (J.H., E.V.S., S.E.B., S.M., B.K., I.S.), Institute of Aging and Health (C.M.-R., T.v.Z.), and Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom (A.B., M.E., R.D., S.T.), Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom (A.B., M.E., R.D., I.S.); Flow Cytometry Core Facility, International Center for Life, Newcastle upon Tyne, United Kingdom (I.D.); Department of Immunology, Institute of Medical Microbiology and Hygiene, Freiburg University, Germany (H.P.); CLIP-Childhood Leukaemia Investigation Prague, Department of Paediatric Haematology and Oncology, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic (K.F.); University Hospital Motol, Prague, Czech Republic (K.F.); Institute of Cardiovascular Sciences, The University of Manchester, United Kingdom (B.K.); and Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom (S.M., S.T.)
| | - Alan Bagnall
- From the Institute of Genetic Medicine (J.H., E.V.S., S.E.B., S.M., B.K., I.S.), Institute of Aging and Health (C.M.-R., T.v.Z.), and Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom (A.B., M.E., R.D., S.T.), Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom (A.B., M.E., R.D., I.S.); Flow Cytometry Core Facility, International Center for Life, Newcastle upon Tyne, United Kingdom (I.D.); Department of Immunology, Institute of Medical Microbiology and Hygiene, Freiburg University, Germany (H.P.); CLIP-Childhood Leukaemia Investigation Prague, Department of Paediatric Haematology and Oncology, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic (K.F.); University Hospital Motol, Prague, Czech Republic (K.F.); Institute of Cardiovascular Sciences, The University of Manchester, United Kingdom (B.K.); and Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom (S.M., S.T.)
| | - Santosh Murali
- From the Institute of Genetic Medicine (J.H., E.V.S., S.E.B., S.M., B.K., I.S.), Institute of Aging and Health (C.M.-R., T.v.Z.), and Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom (A.B., M.E., R.D., S.T.), Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom (A.B., M.E., R.D., I.S.); Flow Cytometry Core Facility, International Center for Life, Newcastle upon Tyne, United Kingdom (I.D.); Department of Immunology, Institute of Medical Microbiology and Hygiene, Freiburg University, Germany (H.P.); CLIP-Childhood Leukaemia Investigation Prague, Department of Paediatric Haematology and Oncology, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic (K.F.); University Hospital Motol, Prague, Czech Republic (K.F.); Institute of Cardiovascular Sciences, The University of Manchester, United Kingdom (B.K.); and Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom (S.M., S.T.)
| | - Ian Dimmick
- From the Institute of Genetic Medicine (J.H., E.V.S., S.E.B., S.M., B.K., I.S.), Institute of Aging and Health (C.M.-R., T.v.Z.), and Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom (A.B., M.E., R.D., S.T.), Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom (A.B., M.E., R.D., I.S.); Flow Cytometry Core Facility, International Center for Life, Newcastle upon Tyne, United Kingdom (I.D.); Department of Immunology, Institute of Medical Microbiology and Hygiene, Freiburg University, Germany (H.P.); CLIP-Childhood Leukaemia Investigation Prague, Department of Paediatric Haematology and Oncology, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic (K.F.); University Hospital Motol, Prague, Czech Republic (K.F.); Institute of Cardiovascular Sciences, The University of Manchester, United Kingdom (B.K.); and Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom (S.M., S.T.)
| | - Hanspeter Pircher
- From the Institute of Genetic Medicine (J.H., E.V.S., S.E.B., S.M., B.K., I.S.), Institute of Aging and Health (C.M.-R., T.v.Z.), and Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom (A.B., M.E., R.D., S.T.), Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom (A.B., M.E., R.D., I.S.); Flow Cytometry Core Facility, International Center for Life, Newcastle upon Tyne, United Kingdom (I.D.); Department of Immunology, Institute of Medical Microbiology and Hygiene, Freiburg University, Germany (H.P.); CLIP-Childhood Leukaemia Investigation Prague, Department of Paediatric Haematology and Oncology, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic (K.F.); University Hospital Motol, Prague, Czech Republic (K.F.); Institute of Cardiovascular Sciences, The University of Manchester, United Kingdom (B.K.); and Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom (S.M., S.T.)
| | - Carmen Martin-Ruiz
- From the Institute of Genetic Medicine (J.H., E.V.S., S.E.B., S.M., B.K., I.S.), Institute of Aging and Health (C.M.-R., T.v.Z.), and Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom (A.B., M.E., R.D., S.T.), Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom (A.B., M.E., R.D., I.S.); Flow Cytometry Core Facility, International Center for Life, Newcastle upon Tyne, United Kingdom (I.D.); Department of Immunology, Institute of Medical Microbiology and Hygiene, Freiburg University, Germany (H.P.); CLIP-Childhood Leukaemia Investigation Prague, Department of Paediatric Haematology and Oncology, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic (K.F.); University Hospital Motol, Prague, Czech Republic (K.F.); Institute of Cardiovascular Sciences, The University of Manchester, United Kingdom (B.K.); and Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom (S.M., S.T.)
| | - Mohaned Egred
- From the Institute of Genetic Medicine (J.H., E.V.S., S.E.B., S.M., B.K., I.S.), Institute of Aging and Health (C.M.-R., T.v.Z.), and Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom (A.B., M.E., R.D., S.T.), Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom (A.B., M.E., R.D., I.S.); Flow Cytometry Core Facility, International Center for Life, Newcastle upon Tyne, United Kingdom (I.D.); Department of Immunology, Institute of Medical Microbiology and Hygiene, Freiburg University, Germany (H.P.); CLIP-Childhood Leukaemia Investigation Prague, Department of Paediatric Haematology and Oncology, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic (K.F.); University Hospital Motol, Prague, Czech Republic (K.F.); Institute of Cardiovascular Sciences, The University of Manchester, United Kingdom (B.K.); and Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom (S.M., S.T.)
| | - Bernard Keavney
- From the Institute of Genetic Medicine (J.H., E.V.S., S.E.B., S.M., B.K., I.S.), Institute of Aging and Health (C.M.-R., T.v.Z.), and Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom (A.B., M.E., R.D., S.T.), Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom (A.B., M.E., R.D., I.S.); Flow Cytometry Core Facility, International Center for Life, Newcastle upon Tyne, United Kingdom (I.D.); Department of Immunology, Institute of Medical Microbiology and Hygiene, Freiburg University, Germany (H.P.); CLIP-Childhood Leukaemia Investigation Prague, Department of Paediatric Haematology and Oncology, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic (K.F.); University Hospital Motol, Prague, Czech Republic (K.F.); Institute of Cardiovascular Sciences, The University of Manchester, United Kingdom (B.K.); and Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom (S.M., S.T.)
| | - Thomas von Zglinicki
- From the Institute of Genetic Medicine (J.H., E.V.S., S.E.B., S.M., B.K., I.S.), Institute of Aging and Health (C.M.-R., T.v.Z.), and Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom (A.B., M.E., R.D., S.T.), Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom (A.B., M.E., R.D., I.S.); Flow Cytometry Core Facility, International Center for Life, Newcastle upon Tyne, United Kingdom (I.D.); Department of Immunology, Institute of Medical Microbiology and Hygiene, Freiburg University, Germany (H.P.); CLIP-Childhood Leukaemia Investigation Prague, Department of Paediatric Haematology and Oncology, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic (K.F.); University Hospital Motol, Prague, Czech Republic (K.F.); Institute of Cardiovascular Sciences, The University of Manchester, United Kingdom (B.K.); and Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom (S.M., S.T.)
| | - Rajiv Das
- From the Institute of Genetic Medicine (J.H., E.V.S., S.E.B., S.M., B.K., I.S.), Institute of Aging and Health (C.M.-R., T.v.Z.), and Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom (A.B., M.E., R.D., S.T.), Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom (A.B., M.E., R.D., I.S.); Flow Cytometry Core Facility, International Center for Life, Newcastle upon Tyne, United Kingdom (I.D.); Department of Immunology, Institute of Medical Microbiology and Hygiene, Freiburg University, Germany (H.P.); CLIP-Childhood Leukaemia Investigation Prague, Department of Paediatric Haematology and Oncology, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic (K.F.); University Hospital Motol, Prague, Czech Republic (K.F.); Institute of Cardiovascular Sciences, The University of Manchester, United Kingdom (B.K.); and Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom (S.M., S.T.)
| | - Stephen Todryk
- From the Institute of Genetic Medicine (J.H., E.V.S., S.E.B., S.M., B.K., I.S.), Institute of Aging and Health (C.M.-R., T.v.Z.), and Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom (A.B., M.E., R.D., S.T.), Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom (A.B., M.E., R.D., I.S.); Flow Cytometry Core Facility, International Center for Life, Newcastle upon Tyne, United Kingdom (I.D.); Department of Immunology, Institute of Medical Microbiology and Hygiene, Freiburg University, Germany (H.P.); CLIP-Childhood Leukaemia Investigation Prague, Department of Paediatric Haematology and Oncology, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic (K.F.); University Hospital Motol, Prague, Czech Republic (K.F.); Institute of Cardiovascular Sciences, The University of Manchester, United Kingdom (B.K.); and Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom (S.M., S.T.)
| | - Ioakim Spyridopoulos
- From the Institute of Genetic Medicine (J.H., E.V.S., S.E.B., S.M., B.K., I.S.), Institute of Aging and Health (C.M.-R., T.v.Z.), and Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom (A.B., M.E., R.D., S.T.), Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom (A.B., M.E., R.D., I.S.); Flow Cytometry Core Facility, International Center for Life, Newcastle upon Tyne, United Kingdom (I.D.); Department of Immunology, Institute of Medical Microbiology and Hygiene, Freiburg University, Germany (H.P.); CLIP-Childhood Leukaemia Investigation Prague, Department of Paediatric Haematology and Oncology, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic (K.F.); University Hospital Motol, Prague, Czech Republic (K.F.); Institute of Cardiovascular Sciences, The University of Manchester, United Kingdom (B.K.); and Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom (S.M., S.T.).
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25
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Yang GH, Wu JS, Yang YC, Huang YH, Lu FH, Chang CJ. Gastric Helicobacter pylori infection associated with risk of diabetes mellitus, but not prediabetes. J Gastroenterol Hepatol 2014; 29:1794-9. [PMID: 24731067 DOI: 10.1111/jgh.12617] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/29/2014] [Indexed: 12/13/2022]
Abstract
BACKGROUNDS AND AIM The association between Helicobacter pylori infection and diabetes was inconsistent in previous studies. Moreover, there are no studies on the relationship between H. pylori infection and prediabetes in the literature. The aim of this study is thus to assess the association of Helicobacter infection, diagnosed by pathology from gastric biopsy, with diabetes and prediabetes. METHODS This cross-sectional study included 1285 subjects aged 19-85 who underwent esophagogastroduodenoscopy and gastric biopsy during health examinations at National Cheng Kung University Hospital from 2000 to 2009. Subjects were divided into three groups, including normal glucose tolerance, prediabetes, and diabetes. Diabetes and prediabetes were assessed according to the American Diabetes Association diagnostic criteria. Gastric Helicobacter infection was an independent variable. Chi-square tests, analysis of variance, and multinomial logistic regression models were used to analyze the effects of Helicobacter infection on the risk of diabetes and prediabetes while controlling for age, lifestyle, pathological conditions, and laboratory variables. RESULTS There were significant differences in the prevalence of gastric Helicobacter infection among the three groups. The results of multivariate analysis showed that age, obesity, family history of diabetes, hypertension, and hypertriglyceridemia were significantly related to both prediabetes and diabetes. Helicobacter pylori infection was positively associated with diabetes (odds ratio [OR] 1.42, 95% confidence interval [CI] 1.01-2.01), but not prediabetes (OR 1.02, 95% CI 0.77-1.36), in addition to male gender, education level (≤ 9 vs > 12 years), pre-hypertension, and low high-density lipoprotein cholesterol. CONCLUSIONS Gastric H. pylori infection is associated with diabetes, but not prediabetes.
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Affiliation(s)
- Gi-Hua Yang
- Department of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
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26
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Hoffmann J, Spyridopoulos I. Senescent cytotoxic T cells in acute myocardial infarction: innocent bystanders or the horsemen of apocalypse? Cell Mol Immunol 2014; 12:510-2. [PMID: 25242271 DOI: 10.1038/cmi.2014.93] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2014] [Accepted: 09/01/2014] [Indexed: 01/23/2023] Open
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27
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Jonker I, Klein HC, Duivis HE, Yolken RH, Rosmalen JGM, Schoevers RA. Association between exposure to HSV1 and cognitive functioning in a general population of adolescents. The TRAILS study. PLoS One 2014; 9:e101549. [PMID: 24983885 PMCID: PMC4077793 DOI: 10.1371/journal.pone.0101549] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 06/08/2014] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Infections with different herpes viruses have been associated with cognitive functioning in psychiatric patients and healthy adults. The aim of this study was to find out whether antibodies to different herpes viruses are prospectively associated with cognitive functioning in a general adolescent population. METHODS This study was performed in TRAILS, a large prospective general population cohort (N = 1084, 54% female, mean age 16.2 years (SD 0.6)). At age 16, immunoglobulin G antibodies against HSV1, HSV2, CMV and EBV were measured next to high sensitive C-Reactive Protein (hsCRP). Two years later, immediate memory and executive functioning were assessed using the 15 words task and the self ordered pointing task. Multiple linear regression analysis with bootstrapping was performed to study the association between viral infections and cognitive function, adjusting for gender, socioeconomic status, ethnicity, and cannabis use. RESULTS Presence of HSV1 antibodies was associated with memory function ((B = -0.272, 95% CI = -0.556 to -0.016, p = 0.047)), while the association with executive functioning did not reach statistical significance (B = 0.560, 95% CI is -0.053 to 1.184, p = 0.075). The level of HSV1 antibodies was associated with both memory function (B = -0.160, 95% CI = -0.280 to -0.039, p = 0.014) and executive functioning (B = 0.296, 95% CI = 0.011 to 0.578, p = 0.046). Other herpes viruses and hsCRP were not associated with cognitive functioning. CONCLUSIONS Both presence and level of HSV1 antibodies are prospectively associated with reduced cognitive performance in a large cohort of adolescents.
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Affiliation(s)
- Iris Jonker
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center for Psychopathology and Emotion regulation (ICPE), Groningen, The Netherlands
- * E-mail:
| | - Hans C. Klein
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center for Psychopathology and Emotion regulation (ICPE), Groningen, The Netherlands
| | - Hester E. Duivis
- Center of Research on Psychology in Somatic Diseases, Department of Medical and Neuropsychology, Tilburg University, Tilburg, The Netherlands
| | - Robert H. Yolken
- Johns Hopkins Medical School, Baltimore, Maryland, United States of America
| | - Judith G. M. Rosmalen
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center for Psychopathology and Emotion regulation (ICPE), Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Internal Medicine, Groningen, The Netherlands
| | - Robert A. Schoevers
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center for Psychopathology and Emotion regulation (ICPE), Groningen, The Netherlands
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28
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Ancheta IB, Carlson JM, Battie CA, Borja-Hart N, Cobb S, Ancheta CV. One size does not fit all: cardiovascular health disparities as a function of ethnicity in Asian-American women. Appl Nurs Res 2014; 28:99-105. [PMID: 25069635 DOI: 10.1016/j.apnr.2014.06.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 06/03/2014] [Accepted: 06/04/2014] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Although few studies have examined cardiovascular disease in Asian-American subgroups separately, limited data in Asian Americans strongly suggest that some subgroups are at increased risk. The present study examined modifiable cardiovascular risk factor profiles as a function of Asian ethnicity. METHODS This descriptive cross-sectional pilot study recruited Asian-American women (N=147) in northeast Florida including Cambodians (n=39), Chinese (n=36), Filipinos (n=49), and Vietnamese (n=23). Risk factors included blood pressure, body mass index, waist circumference and blood lipids. RESULTS Filipino participants (41%) had ≥4 risk factors compared to 21% Cambodian, 13% Vietnamese and 0% Chinese. The Chinese had significantly more participants (44%) with the absence of CVD risk factors compared to all other subgroups. Obesity rate (18%), mean BMI: 26 ± 5 kg/m(2) and mean triglycerides (173 ± 103 mg/dL) were highest in Filipinas (n=49). The Chinese (n=36) had a low rate (4%) of obesity with a mean BMI of 23 ± 3 kg/m(2) and the least risk factors along with the lowest triglycerides (88 ± 44 mg/dL). Cambodians (n=39; BMI of 24 ± 3 kg/m(2)) and Vietnamese (n=23; BMI: 22 ± 3 kg/m(2)) had low rates of obesity with comparable rates of unhealthy lipids and hypertension as the Filipinas. CONCLUSIONS Modifiable CVD risk factor profiles significantly differed as a function of ethnicity supporting the premise that Asian-American women cannot be categorized as one group and the traditional "one size fits all" prevention or treatment of CVD risk factors should be re-considered.
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Affiliation(s)
| | | | | | | | - Sarah Cobb
- College of Public Health and Florida Mental Health Institute, University of South Florida, USA
| | - Christine V Ancheta
- College of Public Health and Florida Mental Health Institute, University of South Florida, USA
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29
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Rector JL, Dowd JB, Loerbroks A, Burns VE, Moss PA, Jarczok MN, Stalder T, Hoffman K, Fischer JE, Bosch JA. Consistent associations between measures of psychological stress and CMV antibody levels in a large occupational sample. Brain Behav Immun 2014; 38:133-41. [PMID: 24472683 DOI: 10.1016/j.bbi.2014.01.012] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Revised: 01/16/2014] [Accepted: 01/17/2014] [Indexed: 02/06/2023] Open
Abstract
Cytomegalovirus (CMV) is a herpes virus that has been implicated in biological aging and impaired health. Evidence, largely accrued from small-scale studies involving select populations, suggests that stress may promote non-clinical reactivation of this virus. However, absent is evidence from larger studies, which allow better statistical adjustment for confounding and mediating factors, in more representative samples. The present study involved a large occupational cohort (N=887, mean age=44, 88% male). Questionnaires assessed psychological (i.e., depression, anxiety, vital exhaustion, SF-12 mental health), demographic, socioeconomic (SES), and lifestyle variables. Plasma samples were analyzed for both the presence and level of CMV-specific IgG antibodies (CMV-IgG), used as markers for infection status and viral reactivation, respectively. Also assessed were potential biological mediators of stress-induced reactivation, such as inflammation (C-reactive protein) and HPA function (awakening and diurnal cortisol). Predictors of CMV infection and CMV-IgG among the infected individuals were analyzed using logistic and linear regression analyses, respectively. Confirming prior reports, lower SES (education and job status) was positively associated with infection status. Among those infected (N=329), higher CMV-IgG were associated with increased anxiety (β=.14, p<.05), depression (β=.11, p=.06), vital exhaustion (β=.14, p<.05), and decreased SF-12 mental health (β=-.14, p<.05), adjusting for a range of potential confounders. Exploratory analyses showed that these associations were generally stronger in low SES individuals. We found no evidence that elevated inflammation or HPA-function mediated any of the associations. In the largest study to date, we established associations between CMV-IgG levels and multiple indicators of psychological stress. These results demonstrate the robustness of prior findings, and extend these to a general working population. We propose that stress-induced CMV replication warrants further research as a psychobiological mechanism linking stress, aging and health.
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Affiliation(s)
- Jerrald L Rector
- School of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, United Kingdom; Mannheim Institute of Public Health, Social and Preventive Medicine (MIPH), Mannheim Medical Faculty, University of Heidelberg, Ludolf-Krehl-Str. 7-11, D-68167 Mannheim, Germany
| | - Jennifer B Dowd
- CUNY School of Public Health and CUNY Institute for Demographic Research (CIDR), One Bernard Baruch Way, New York, NY 10010, USA
| | - Adrian Loerbroks
- Mannheim Institute of Public Health, Social and Preventive Medicine (MIPH), Mannheim Medical Faculty, University of Heidelberg, Ludolf-Krehl-Str. 7-11, D-68167 Mannheim, Germany; Institute of Occupational and Social Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Universitätsstrasse 1, 40225 Düsseldorf, Germany
| | - Victoria E Burns
- School of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, United Kingdom
| | - Paul A Moss
- Cancer Research UK Centre, University of Birmingham, Edgbaston, Birmingham B152TT, United Kingdom
| | - Marc N Jarczok
- Mannheim Institute of Public Health, Social and Preventive Medicine (MIPH), Mannheim Medical Faculty, University of Heidelberg, Ludolf-Krehl-Str. 7-11, D-68167 Mannheim, Germany
| | - Tobias Stalder
- Department of Psychology, Technische Universität Dresden, 01069 Dresden, Germany
| | - Kristina Hoffman
- Mannheim Institute of Public Health, Social and Preventive Medicine (MIPH), Mannheim Medical Faculty, University of Heidelberg, Ludolf-Krehl-Str. 7-11, D-68167 Mannheim, Germany
| | - Joachim E Fischer
- Mannheim Institute of Public Health, Social and Preventive Medicine (MIPH), Mannheim Medical Faculty, University of Heidelberg, Ludolf-Krehl-Str. 7-11, D-68167 Mannheim, Germany
| | - Jos A Bosch
- Mannheim Institute of Public Health, Social and Preventive Medicine (MIPH), Mannheim Medical Faculty, University of Heidelberg, Ludolf-Krehl-Str. 7-11, D-68167 Mannheim, Germany; Department of Psychology, University of Amsterdam, Weesperplein 4, 1018 XA Amsterdam, The Netherlands; Laboratory of Integrated Physiology, Department of Health and Human Performance, University of Houston, Houston, TX, USA.
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Moro-García MA, Alonso-Arias R, López-Larrea C. When Aging Reaches CD4+ T-Cells: Phenotypic and Functional Changes. Front Immunol 2013; 4:107. [PMID: 23675374 PMCID: PMC3650461 DOI: 10.3389/fimmu.2013.00107] [Citation(s) in RCA: 122] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Accepted: 04/25/2013] [Indexed: 12/30/2022] Open
Abstract
Beyond midlife, the immune system shows aging features and its defensive capability becomes impaired, by a process known as immunosenescence that involves many changes in the innate and adaptive responses. Innate immunity seems to be better preserved globally, while the adaptive immune response exhibits profound age-dependent modifications. Elderly people display a decline in numbers of naïve T-cells in peripheral blood and lymphoid tissues, while, in contrast, their proportion of highly differentiated effector and memory T-cells, such as the CD28null T-cells, increases markedly. Naïve and memory CD4+ T-cells constitute a highly dynamic system with constant homeostatic and antigen-driven proliferation, influx, and loss of T-cells. Thymic activity dwindles with age and essentially ceases in the later decades of life, severely constraining the generation of new T-cells. Homeostatic control mechanisms are very effective at maintaining a large and diverse subset of naïve CD4+ T-cells throughout life, but although later than in CD8 + T-cell compartment, these mechanisms ultimately fail with age.
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Intensity of the humoral response to cytomegalovirus is associated with the phenotypic and functional status of the immune system. J Virol 2013; 87:4486-95. [PMID: 23388717 DOI: 10.1128/jvi.02425-12] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Cytomegalovirus (CMV) infection exerts an enormous effect on human immunity, as it is associated with an immune-impaired response, a variety of chronic diseases, and overall survival in elderly individuals. Levels of anti-CMV antibodies may be associated with the differentiation degree of T cell subsets. Titers are significantly higher in the elderly and positively correlated with specific CD4(+) T cell responses to CMV. In the elderly, antibody titers are associated with the degree of differentiation and the T cell receptor excision circle (TREC) content in CD4(+) T cells, with other features of the immune risk profile, and with a reduced ability to respond to immunization in vivo. Associations may be absent in young subjects because their anti-CMV antibody titers are lower than those of the elderly. However, comparing young and elderly individuals with similar antibody levels reveals differences in their highly differentiated and naïve T cells. These are more marked in individuals with high titers. In parallel with the increase in anti-CMV antibodies, the elderly experience a significant reduction in absolute counts of naïve CD4(+) T cells, which may be a strategy to compensate for the expansion of differentiated cells and to avoid an increase in total T cells. In summary, our results show that titers of anti-CMV antibodies, and not only CMV seropositivity, are related to differentiation status and immunocompetence in the elderly, making this as an important prognostic marker of the status of immune system function.
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Cavigelli SA, Chaudhry HS. Social status, glucocorticoids, immune function, and health: can animal studies help us understand human socioeconomic-status-related health disparities? Horm Behav 2012; 62:295-313. [PMID: 22841799 DOI: 10.1016/j.yhbeh.2012.07.006] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2011] [Revised: 07/15/2012] [Accepted: 07/16/2012] [Indexed: 11/16/2022]
Abstract
For humans in developed nations, socioeconomic status (SES)--relative income, education and occupational position in a society--is a strong predictor of morbidity and mortality rates, with increasing SES predicting longer life span (e.g. Marmot et al., 1991). Mechanisms underlying this relationship have been examined, but the relative role of each mechanism still remains unknown. By understanding the relative role of specific mechanisms that underlie dramatic health disparities between high and low social status individuals we can begin to identify effective, targeted methods to alleviate health disparities. In the current paper, we take advantage of a growing number of animal studies that have quantified biological health-related correlates (glucocorticoid production and immune function) of social status and compare these studies to the current literature on human SES and health to determine if and how animal studies can further our understanding of SES-associated human health disparities. Specifically, we compared social-status related glucocorticoid production and immune function in humans and animals. From the review, we show that our present understanding of the relationships between social status and glucocorticoid production/immune function is still growing, but that there are already identifiable parallels (and non-parallels) between humans and animals. We propose timely areas of future study focused on (1) specific aspects of social status that may influence stress-related physiology, (2) mechanisms underlying long-term influences of social status on physiology and health, and (3) intervention studies to alleviate potentially negative physiological correlates of social status.
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Affiliation(s)
- Sonia A Cavigelli
- Department of Biobehavioral Health, Pennsylvania State University, University Park, PA 16802, USA.
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Masters RK, Hummer RA, Powers DA. Educational Differences in U.S. Adult Mortality: A Cohort Perspective. AMERICAN SOCIOLOGICAL REVIEW 2012; 77:548-572. [PMID: 25346542 PMCID: PMC4208076 DOI: 10.1177/0003122412451019] [Citation(s) in RCA: 97] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
We use hierarchical cross-classified random-effects models to simultaneously measure age, period, and cohort patterns of mortality risk between 1986 and 2006 for non-Hispanic white and non-Hispanic black men and women with less than a high school education, a high school education, and more than a high school education. We examine all-cause mortality risk and mortality risk from heart disease, lung cancer, and unpreventable cancers. Findings reveal that temporal reductions in black and white men's and women's mortality rates were driven entirely by cohort changes in mortality. Findings also demonstrate that disparate cohort effects between education groups widened the education gap in all-cause mortality risk and mortality risk from heart disease and lung cancer across this time period. Educational disparities in mortality risk from unpreventable cancers, however, did not change. This research uncovers widening educational differences in adult mortality and demonstrates that a cohort perspective provides valuable insights for understanding recent temporal changes in U.S. mortality risk.
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Aiello AE, Simanek AM. Cytomegalovirus and immunological aging: the real driver of HIV and heart disease? J Infect Dis 2012; 205:1772-4. [PMID: 22492854 DOI: 10.1093/infdis/jis288] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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West DA, Leung GM, Jiang CQ, Elwell-Sutton TM, Zhang WS, Lam TH, Cheng KK, Schooling CM. Life-course origins of social inequalities in adult immune cell markers of inflammation in a developing southern Chinese population: the Guangzhou Biobank Cohort Study. BMC Public Health 2012; 12:269. [PMID: 22472036 PMCID: PMC3373375 DOI: 10.1186/1471-2458-12-269] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2011] [Accepted: 04/03/2012] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Socioeconomic position (SEP) throughout life is associated with cardiovascular disease, though the mechanisms linking these two are unclear. It is also unclear whether there are critical periods in the life course when exposure to better socioeconomic conditions confers advantages or whether SEP exposures accumulate across the whole life course. Inflammation may be a mechanism linking socioeconomic position (SEP) with cardiovascular disease. In a large sample of older residents of Guangzhou, in southern China, we examined the association of life course SEP with inflammation. METHODS In baseline data on 9,981 adults (≥ 50 years old) from the Guangzhou Biobank Cohort Study (2006-08), we used multivariable linear regression and model fit to assess the associations of life course SEP at four stages (childhood, early adult, late adult and current) with white blood, granulocyte and lymphocyte cell counts. RESULTS A model including SEP at all four life stages best explained the association of life course SEP with white blood and granulocyte cell count for men and women, with early adult SEP (education) making the largest contribution. A critical period model best explained the association of life course SEP with lymphocyte count, with sex-specific associations. Early adult SEP was negatively associated with lymphocytes for women. CONCLUSIONS Low SEP throughout life may negatively impact late adult immune-inflammatory status. However, some aspects of immune-inflammatory status may be sensitive to earlier exposures, with sex-specific associations. The findings were compatible with the hypothesis that in a developing population, upregulation of the gonadotropic axis with economic development may obscure the normally protective effects of social advantage for men.
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Affiliation(s)
- Douglas A West
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong, SAR, China
| | - Gabriel M Leung
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong, SAR, China
| | - Chao Q Jiang
- Guangzhou Occupational Diseases Prevention and Treatment Centre, Guangzhou Number 12 Hospital, Guangzhou, China
| | - Timothy M Elwell-Sutton
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong, SAR, China
| | - Wei S Zhang
- Guangzhou Occupational Diseases Prevention and Treatment Centre, Guangzhou Number 12 Hospital, Guangzhou, China
| | - Tai H Lam
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong, SAR, China
| | - Kar K Cheng
- Department of Public Health and Epidemiology, University of Birmingham, Birmingham, UK
| | - C Mary Schooling
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong, SAR, China
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Jeon CY, Haan MN, Cheng C, Clayton ER, Mayeda ER, Miller JW, Aiello AE. Helicobacter pylori infection is associated with an increased rate of diabetes. Diabetes Care 2012; 35:520-5. [PMID: 22279028 PMCID: PMC3322696 DOI: 10.2337/dc11-1043] [Citation(s) in RCA: 141] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Chronic infections could be contributing to the socioeconomic gradient in chronic diseases. Although chronic infections have been associated with increased levels of inflammatory cytokines and cardiovascular disease, there is limited evidence on how infections affect risk of diabetes. RESEARCH DESIGN AND METHODS We examined the association between serological evidence of chronic viral and bacterial infections and incident diabetes in a prospective cohort of Latino elderly. We analyzed data on 782 individuals aged >60 years and diabetes-free in 1998-1999, whose blood was tested for antibodies to herpes simplex virus 1, varicella virus, cytomegalovirus, Helicobacter pylori, and Toxoplasma gondii and who were followed until June 2008. We used Cox proportional hazards regression to estimate the relative incidence rate of diabetes by serostatus, with adjustment for age, sex, education, cardiovascular disease, smoking, and cholesterol levels. RESULTS Individuals seropositive for herpes simplex virus 1, varicella virus, cytomegalovirus, and T. gondii did not show an increased rate of diabetes, whereas those who were seropositive for H. pylori at enrollment were 2.7 times more likely at any given time to develop diabetes than seronegative individuals (hazard ratio 2.69 [95% CI 1.10-6.60]). Controlling for insulin resistance, C-reactive protein and interleukin-6 did not attenuate the effect of H. pylori infection. CONCLUSIONS We demonstrated for the first time that H. pylori infection leads to an increased rate of incident diabetes in a prospective cohort study. Our findings implicate a potential role for antibiotic and gastrointestinal treatment in preventing diabetes.
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Affiliation(s)
- Christie Y Jeon
- Center for Infectious Diseases Epidemiologic Research, Mailman School of Public Health, Columbia University, New York, New York, USA
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Fagundes CP, Bennett JM, Alfano CM, Glaser R, Povoski SP, Lipari AM, Agnese DM, Yee LD, Carson WE, Farrar WB, Malarkey WB, Chen M, Kiecolt-Glaser JK. Social support and socioeconomic status interact to predict Epstein-Barr virus latency in women awaiting diagnosis or newly diagnosed with breast cancer. Health Psychol 2011; 31:11-9. [PMID: 22004465 DOI: 10.1037/a0025599] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Both higher socioeconomic status (SES) and supportive personal relationships confer health benefits, including better immune function. This study assessed the joint impact of SES and social support on the expression of a latent herpesvirus, Epstein-Barr virus (EBV), in a group of highly stressed women. METHODS Two-hundred and twenty four women either awaiting further evaluation following an abnormal mammogram or newly diagnosed with breast cancer completed questionnaires and provided blood samples to assess EBV viral capsid antigen (VCA) IgG antibody titers. RESULTS More highly educated women with more support from friends had lower EBV VCA antibody titers, reflecting a stronger cellular immune response to the latent virus; however, among less educated women, friend support was not associated with EBV antibody titers. As revealed in an ancillary analysis, more highly educated women with more friend support had lower systolic blood pressure (SBP); however, friend support was not associated with SBP among less educated women. Neither depression nor perceived stress mediated these associations. Neither cancer status nor cancer stage among those diagnosed with cancer was significantly related to these outcomes. CONCLUSION Lower SES women may not reap the same immunological benefits from friend support when experiencing a stressful life event as their higher SES counterparts.
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Affiliation(s)
- Christopher P Fagundes
- Institute for Behavioral Medicine Research, The Ohio State University, College of Medicine, 460 Medical Center Drive, Columbus, OH 43210, USA.
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Seropositivity to cytomegalovirus, inflammation, all-cause and cardiovascular disease-related mortality in the United States. PLoS One 2011; 6:e16103. [PMID: 21379581 PMCID: PMC3040745 DOI: 10.1371/journal.pone.0016103] [Citation(s) in RCA: 281] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2010] [Accepted: 12/10/2010] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Studies have suggested that CMV infection may influence cardiovascular disease (CVD) risk and mortality. However, there have been no large-scale examinations of these relationships among demographically diverse populations. The inflammatory marker C-reactive protein (CRP) is also linked with CVD outcomes and mortality and may play an important role in the pathway between CMV and mortality. We utilized a U.S. nationally representative study to examine whether CMV infection is associated with all-cause and CVD-related mortality. We also assessed whether CRP level mediated or modified these relationships. METHODOLOGY/PRINCIPAL FINDINGS Data come from subjects ≥ 25 years of age who were tested for CMV and CRP level and were eligible for mortality follow-up on December 31(st), 2006 (N = 14153) in the National Health and Nutrition Examination Survey (NHANES) III (1988-1994). Cox proportional hazard models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for all-cause and CVD-related mortality by CMV serostatus. After adjusting for multiple confounders, CMV seropositivity remained statistically significantly associated with all-cause mortality (HR 1.19, 95% CI: 1.01, 1.41). The association between CMV and CVD-related mortality did not achieve statistical significance after confounder adjustment. CRP did not mediate these associations. However, CMV seropositive individuals with high CRP levels showed a 30.1% higher risk for all-cause mortality and 29.5% higher risk for CVD-related mortality compared to CMV seropositive individuals with low CRP levels. CONCLUSIONS/SIGNIFICANCE CMV was associated with a significant increased risk for all-cause mortality and CMV seropositive subjects who also had high CRP levels were at substantially higher risk for both for all-cause and CVD-related mortality than subjects with low CRP levels. Future work should target the mechanisms by which CMV infection and low-level inflammation interact to yield significant impact on mortality.
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Abstract
SummaryAgeing is associated with multiple changes in many different components of the immune system. A healthy immune system exists in a state of balance between efficient effector responses against pathogens and tolerance to self antigens. This balance is changed with age; functions such as antigen recognition, phagocytosis, antigen presentation, chemotaxis, cytokine secretion and killing ability are all compromised. Aberrant cellular responses lead to an altered cytokine network with increases in inflammatory cytokines and decreases in anti-inflammatory cytokines leading to a pro-inflammatory state. Consequently older patients require extra care in diagnosis of infections as symptoms may be perturbed, resulting in unusual presentations of common conditions. The defects in immunity due to immunosenescence also mean that older patients require more care and screening than other patients in the same disease cohort. Though it is generally understood by clinicians that older patients are more at risk from multiple infections, the wider clinical effects of immunosenescence are less understood. The immune system is involved in several neurodegenerative conditions and the inflammatory conditions of immunosenescence may be a key factor in pathogenesis. Similarly, there is reason to believe that immunosenescence might be a key factor explaining the increased incidence of cancer in older age. With increasing understanding of the immune system's involvement in many of these pathological processes, and the contribution that immunosenescence makes to these, more efficient vaccines and novel therapies may be developed to prevent/treat these conditions.
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Roberts ET, Haan MN, Dowd JB, Aiello AE. Roberts et al. respond to "Human CMV, inflammation, and mortality". Am J Epidemiol 2010; 172:375-6. [PMID: 20660118 DOI: 10.1093/aje/kwq176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Eric T Roberts
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48104-2548, USA
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Roberts ET, Haan MN, Dowd JB, Aiello AE. Cytomegalovirus antibody levels, inflammation, and mortality among elderly Latinos over 9 years of follow-up. Am J Epidemiol 2010; 172:363-71. [PMID: 20660122 DOI: 10.1093/aje/kwq177] [Citation(s) in RCA: 198] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This study examined the relation between immune response to cytomegalovirus (CMV) and all-cause and cardiovascular disease (CVD) mortality, and possible mediating mechanisms. Data were derived from the Sacramento Area Latino Study on Aging, a population-based study of older Latinos (aged 60-101 years) in California followed in 1998-2008. CMV immunoglobulin G (IgG), tumor necrosis factor, and interleukin-6 were assayed from baseline blood draws. Data on all-cause and CVD mortality were abstracted from death certificates. Analyses included 1,468 of 1,789 participants. For individuals with CMV IgG antibody titers in the highest quartile compared with lower quartiles, fully adjusted models showed that all-cause mortality was 1.43 times (95% confidence interval: 1.14, 1.79) higher over 9 years. In fully adjusted models, the hazard of CVD mortality was also elevated (hazard ratio = 1.35, 95% confidence interval: 1.01, 1.80). A composite measure of tumor necrosis factor and interleukin-6 mediated a substantial proportion of the association between CMV and all-cause (18.9%, P < 0.001) and CVD (29.0%, P = 0.02) mortality. This study is the first known to show that high CMV IgG antibody levels are significantly related to mortality and that the relation is largely mediated by interleukin-6 and tumor necrosis factor. Further studies investigating methods for reducing IgG antibody response to CMV are warranted.
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Affiliation(s)
- Eric T Roberts
- Department of Epidemiology, 3659 SPH Tower, 109 Observatory, Ann Arbor, MI 48104-2548, USA
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Nieto FJ. Commentary: Understanding the pathophysiology of poverty. Int J Epidemiol 2009; 38:787-90. [PMID: 19376881 DOI: 10.1093/ije/dyp187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Affiliation(s)
- F Javier Nieto
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA.
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McDade TW, Hayward MD. Rationale and methodological options for assessing infectious disease and related measures in social science surveys. BIODEMOGRAPHY AND SOCIAL BIOLOGY 2009; 55:159-177. [PMID: 20183903 DOI: 10.1080/19485560903382478] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Infectious disease is an important, but often overlooked, component of population health in high-income nations. Common, everyday infections exact significant costs, including school and work absenteeism, reduced productivity, and substantial health care expenditures. Infectious disease also shapes trajectories of biological risk and health and may be causally linked to chronic disease risk later in life. The size, diversity, and representativeness of samples typically employed in survey-based studies of health present exceptional opportunities for advancing scientific knowledge on the social and economic determinants of infectious disease in childhood and adulthood and to investigate the long-term consequences of infectious disease for well-being and attainment across multiple domains. A wide range of interview-based, anthropometric, and biomarker measurement options are currently available for assessing infectious exposures, inflammation, and immune function in nonclinical settings. These methods afford opportunities for innovative, transdisciplinary research on the causes and consequences of infectious disease across the life course that can address questions of interest to social, life, and biomedical scientists.
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Affiliation(s)
- Thomas W McDade
- Northwestern University, Department of Anthropology, Cells to Society: The Center on Social Disparities and Health at the Institute for Policy Research, Evanston, Illinois 60208, USA.
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Aiello AE, Kaplan GA. Socioeconomic position and inflammatory and immune biomarkers of cardiovascular disease: applications to the Panel Study of Income Dynamics. BIODEMOGRAPHY AND SOCIAL BIOLOGY 2009; 55:178-205. [PMID: 20183904 PMCID: PMC3319671 DOI: 10.1080/19485560903382304] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Biomarkers are an important aspect of research linking psychosocial stress and health. This article aims to characterize the biological pathways that may mediate the relationship between socioeconomic position (SEP) and cardiovascular disease (CVD) and address opportunities for further research within the Panel Study of Income Dynamics (PSID), with a focus on psychosocial stressors related to SEP. We review the literature on CVD biomarkers, including adhesion and proinflammatory molecules (interleukin-6, other cytokines, C-reactive proteins, fibrinogen, etc.) and microbial pathogens. The impact of socioeconomic determinants and related psychosocial stressors on CVD biomarkers mediated by behavioral and central nervous system pathways are described. We also address measurement and feasibility issues, including specimen collection methods, processing and storage procedures, laboratory error, and within-person variability. In conclusion, we suggest that PSID consider adding important assessments of specific CVD biomarkers and mediating behavioral measures, health, and medications that will ultimately address many of the gaps in the literature regarding the relationship between SEP and cardiovascular health.
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Affiliation(s)
- Allison E Aiello
- Department of Epidemiology, Center for Social Epidemiology and Population Health, University of Michigan, School of Public Health, Ann Arbor, Michigan, USA.
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