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Brognara L, Luna OC, Traina F, Cauli O. Inflammatory Biomarkers and Gait Impairment in Older Adults: A Systematic Review. Int J Mol Sci 2024; 25:1368. [PMID: 38338653 PMCID: PMC10855721 DOI: 10.3390/ijms25031368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 01/15/2024] [Accepted: 01/21/2024] [Indexed: 02/12/2024] Open
Abstract
Peripheral inflammation and gait speed alterations are common in several neurological disorders and in the aging process, but the association between the two is not well established. The aim of this systematic literary review is to determine whether proinflammatory markers are a positive predictor for gait impairments and their complications, such as falls in older adults, and may represent a risk factor for slow gait speed and its complications. The systematic review was performed in line with the Preferred Report Items for Systematic Review and Meta-Analyses (PRISMA). A protocol for literature searches was structured a priori and designed according to the International Perspective Register of Systemic Review (PROSPERO: CRD42023451108). Peer-reviewed original articles were identified by searching seven electronic databases: Excerpta Medica Database (EMBASE), SciVerse (ScienceDirect), Scopus, PubMed, Medline, Web of Science, and the Cochrane Library. The search strategy was formulated based on a combination of controlled descriptors and/or keywords related to the topic and a manual search was conducted of the reference lists from the initially selected studies to identify other eligible studies. The studies were thoroughly screened using the following inclusion criteria: older adults, spatiotemporal gait characteristics, and proinflammatory markers. A meta-analysis was not performed due to the heterogeneity of the studies, and the results were narratively synthesized. Due to the clinical and methodological heterogeneity, the studies were combined in a narrative synthesis, grouped by the type of biomarkers evaluated. A standardized data extraction form was used to collect the following methodological outcome variables from each of the included studies: author, year, population, age, sample size, spatiotemporal gait parameters such as gait velocity, and proinflammatory markers such as TNF-α, high sensitivity C-reactive (CRP) proteins, and IL-6. We included 21 out of 51 studies in our review, which examined the association between inflammatory biomarkers and gait impairment. This review highlights the role of TNF-α, CRP, and IL-6 in gait impairment. Biomarkers play an important role in the decision-making process, and IL-6 can be an effective biomarker in establishing the diagnosis of slow gait speed. Further longitudinal research is needed to establish the use of molecular biomarkers in monitoring gait impairment.
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Affiliation(s)
- Lorenzo Brognara
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, 40123 Bologna, Italy;
| | - Oscar Caballero Luna
- Department of Nursing, University of Valencia, 46010 Valencia, Spain; (O.C.L.); (O.C.)
| | - Francesco Traina
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, 40123 Bologna, Italy;
| | - Omar Cauli
- Department of Nursing, University of Valencia, 46010 Valencia, Spain; (O.C.L.); (O.C.)
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Jaime Garcia D, Chagnot A, Wardlaw JM, Montagne A. A Scoping Review on Biomarkers of Endothelial Dysfunction in Small Vessel Disease: Molecular Insights from Human Studies. Int J Mol Sci 2023; 24:13114. [PMID: 37685924 PMCID: PMC10488088 DOI: 10.3390/ijms241713114] [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: 07/23/2023] [Revised: 08/19/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023] Open
Abstract
Small vessel disease (SVD) is a highly prevalent disorder of the brain's microvessels and a common cause of dementia as well as ischaemic and haemorrhagic strokes. Though much about the underlying pathophysiology of SVD remains poorly understood, a wealth of recently published evidence strongly suggests a key role of microvessel endothelial dysfunction and a compromised blood-brain barrier (BBB) in the development and progression of the disease. Understanding the causes and downstream consequences associated with endothelial dysfunction in this pathological context could aid in the development of effective diagnostic and prognostic tools and provide promising avenues for potential therapeutic interventions. In this scoping review, we aim to summarise the findings from clinical studies examining the role of the molecular mechanisms underlying endothelial dysfunction in SVD, focussing on biochemical markers of endothelial dysfunction detectable in biofluids, including cell adhesion molecules, BBB transporters, cytokines/chemokines, inflammatory markers, coagulation factors, growth factors, and markers involved in the nitric oxide cascade.
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Affiliation(s)
- Daniela Jaime Garcia
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh EH16 4SB, UK; (D.J.G.); (J.M.W.)
- UK Dementia Research Institute, University of Edinburgh, Edinburgh EH16 4SB, UK;
| | - Audrey Chagnot
- UK Dementia Research Institute, University of Edinburgh, Edinburgh EH16 4SB, UK;
| | - Joanna M. Wardlaw
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh EH16 4SB, UK; (D.J.G.); (J.M.W.)
- UK Dementia Research Institute, University of Edinburgh, Edinburgh EH16 4SB, UK;
| | - Axel Montagne
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh EH16 4SB, UK; (D.J.G.); (J.M.W.)
- UK Dementia Research Institute, University of Edinburgh, Edinburgh EH16 4SB, UK;
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Ekenze O, Pinheiro A, Demissie S, Charidimou A, Beiser AS, Vasan RS, Benjamin EJ, DeCarli C, Seshadri S, Romero JR. Inflammatory biomarkers and MRI visible perivascular spaces: The Framingham Heart Study. Neurobiol Aging 2023; 127:12-22. [PMID: 37018882 PMCID: PMC10198814 DOI: 10.1016/j.neurobiolaging.2023.03.001] [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: 10/17/2022] [Revised: 02/27/2023] [Accepted: 03/01/2023] [Indexed: 03/08/2023]
Abstract
We studied the association between inflammatory biomarkers and magnetic resonance imaging (MRI) visible perivascular spaces (PVS) in Framingham Heart Study participants free of stroke and dementia. PVS in the basal ganglia (BG) and centrum semiovale (CSO) were rated with validated methods and categorized based on counts. A mixed score of high PVS burden in neither, one or both regions was also evaluated. We related biomarkers representing various inflammatory mechanisms to PVS burden using multivariable ordinal logistic regression analysis accounting for vascular risk factors and other MRI markers of cerebral small vessel disease. Among 3604 participants (mean age 58±13 years, 47% males), significant associations were observed for intercellular adhesion molecule1, fibrinogen, osteoprotegerin, and P-selectin in relation to BG PVS, P-selectin for CSO PVS, and tumor necrosis factor receptor 2, osteoprotegerin and cluster of differentiation 40 ligand for mixed topography PVS. Therefore, inflammation may have a role in the pathogenesis of cerebral small vessel disease and perivascular drainage dysfunction represented by PVS, with different and shared inflammatory biomarkers depending on PVS topography.
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Affiliation(s)
- Oluchi Ekenze
- Graduate Medical Sciences, Boston University School of Medicine, Boston, MA, USA; NHLBI's Framingham Heart Study, Framingham, MA, USA
| | - Adlin Pinheiro
- NHLBI's Framingham Heart Study, Framingham, MA, USA; Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Serkalem Demissie
- NHLBI's Framingham Heart Study, Framingham, MA, USA; Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Andreas Charidimou
- Department of Neurology, Boston University School of Medicine, Boston, MA
| | - Alexa S Beiser
- NHLBI's Framingham Heart Study, Framingham, MA, USA; Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA; The Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, TX, USA
| | | | | | - Charles DeCarli
- Department of Neurology, University of California at Davis, Davis, CA, USA
| | - Sudha Seshadri
- NHLBI's Framingham Heart Study, Framingham, MA, USA; Boston University School of Medicine, Boston, MA, USA; The Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, TX, USA
| | - Jose R Romero
- NHLBI's Framingham Heart Study, Framingham, MA, USA; Department of Neurology, Boston University School of Medicine, Boston, MA.
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Paolillo EW, You M, Gontrum E, Saloner R, Gaynor LS, Kramer JH, Casaletto KB. Sex Differences in the Relationship between Perceived Stress and Cognitive Trajectories. Am J Geriatr Psychiatry 2023; 31:401-410. [PMID: 36509633 PMCID: PMC10468214 DOI: 10.1016/j.jagp.2022.11.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 11/20/2022] [Accepted: 11/21/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Chronic stress adversely affects cognition, in part due to stress-induced inflammation. Rodent models suggest females are more resilient against stress-related cognitive dysfunction than males; however, few studies have examined this in humans. We examined sex differences in the relationship between perceived stress, cognitive functioning, and peripheral inflammation over time among cognitively normal older adults. DESIGN Longitudinal observational study. SETTING University research center. PARTICIPANTS 274 community-dwelling older adults (baseline age: M=70.7, SD=7.2; 58% women; Clinical Dementia Rating=0) who completed at least two study visits. MEASUREMENTS Neurocognitive functioning and perceived stress (Perceived Stress Scale [PSS]) were assessed at each visit. Plasma was analyzed for interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-α) in a subset of 147 participants. Linear mixed effects models examined the interaction between average PSS (i.e., averaged within persons across visits), sex, and time on cognitive domains and on inflammatory markers. RESULTS The interaction between stress, sex, and time predicted executive functioning (β = 0.26, SE = 0.10, p = 0.01) such that higher average PSS related to steeper declines in men, but not in women. Among the 147 participants with inflammatory data, higher average PSS was associated with steeper increases in IL-6 over time in men, but not in women. CONCLUSION Consistent with animal models, results showed older men were more vulnerable to negative effects of stress on cognitive aging, with domain-specific declines in executive function. Findings also suggest systemic immunological mechanisms may underlie increased risk for cognitive decline in men with higher levels of stress. Future work is needed to examine the potential efficacy of person-specific stress interventions.
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Affiliation(s)
- Emily W Paolillo
- Memory and Aging Center (EWP, MY, EG, RS, LSG, JHK, KBC), Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA.
| | - Michelle You
- Memory and Aging Center (EWP, MY, EG, RS, LSG, JHK, KBC), Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA
| | - Eva Gontrum
- Memory and Aging Center (EWP, MY, EG, RS, LSG, JHK, KBC), Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA
| | - Rowan Saloner
- Memory and Aging Center (EWP, MY, EG, RS, LSG, JHK, KBC), Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA
| | - Leslie S Gaynor
- Memory and Aging Center (EWP, MY, EG, RS, LSG, JHK, KBC), Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA
| | - Joel H Kramer
- Memory and Aging Center (EWP, MY, EG, RS, LSG, JHK, KBC), Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA
| | - Kaitlin B Casaletto
- Memory and Aging Center (EWP, MY, EG, RS, LSG, JHK, KBC), Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA
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Miceli G, Basso MG, Rizzo G, Pintus C, Cocciola E, Pennacchio AR, Tuttolomondo A. Artificial Intelligence in Acute Ischemic Stroke Subtypes According to Toast Classification: A Comprehensive Narrative Review. Biomedicines 2023; 11:biomedicines11041138. [PMID: 37189756 DOI: 10.3390/biomedicines11041138] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/29/2023] [Accepted: 04/06/2023] [Indexed: 05/17/2023] Open
Abstract
The correct recognition of the etiology of ischemic stroke (IS) allows tempestive interventions in therapy with the aim of treating the cause and preventing a new cerebral ischemic event. Nevertheless, the identification of the cause is often challenging and is based on clinical features and data obtained by imaging techniques and other diagnostic exams. TOAST classification system describes the different etiologies of ischemic stroke and includes five subtypes: LAAS (large-artery atherosclerosis), CEI (cardio embolism), SVD (small vessel disease), ODE (stroke of other determined etiology), and UDE (stroke of undetermined etiology). AI models, providing computational methodologies for quantitative and objective evaluations, seem to increase the sensitivity of main IS causes, such as tomographic diagnosis of carotid stenosis, electrocardiographic recognition of atrial fibrillation, and identification of small vessel disease in magnetic resonance images. The aim of this review is to provide overall knowledge about the most effective AI models used in the differential diagnosis of ischemic stroke etiology according to the TOAST classification. According to our results, AI has proven to be a useful tool for identifying predictive factors capable of subtyping acute stroke patients in large heterogeneous populations and, in particular, clarifying the etiology of UDE IS especially detecting cardioembolic sources.
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Affiliation(s)
- Giuseppe Miceli
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), Università Degli Studi di Palermo, Piazza Delle Cliniche 2, 90127 Palermo, Italy
- Internal Medicine and Stroke Care Ward, University Hospital, Policlinico "P. Giaccone", 90141 Palermo, Italy
| | - Maria Grazia Basso
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), Università Degli Studi di Palermo, Piazza Delle Cliniche 2, 90127 Palermo, Italy
- Internal Medicine and Stroke Care Ward, University Hospital, Policlinico "P. Giaccone", 90141 Palermo, Italy
| | - Giuliana Rizzo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), Università Degli Studi di Palermo, Piazza Delle Cliniche 2, 90127 Palermo, Italy
- Internal Medicine and Stroke Care Ward, University Hospital, Policlinico "P. Giaccone", 90141 Palermo, Italy
| | - Chiara Pintus
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), Università Degli Studi di Palermo, Piazza Delle Cliniche 2, 90127 Palermo, Italy
- Internal Medicine and Stroke Care Ward, University Hospital, Policlinico "P. Giaccone", 90141 Palermo, Italy
| | - Elena Cocciola
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), Università Degli Studi di Palermo, Piazza Delle Cliniche 2, 90127 Palermo, Italy
- Internal Medicine and Stroke Care Ward, University Hospital, Policlinico "P. Giaccone", 90141 Palermo, Italy
| | - Andrea Roberta Pennacchio
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), Università Degli Studi di Palermo, Piazza Delle Cliniche 2, 90127 Palermo, Italy
- Internal Medicine and Stroke Care Ward, University Hospital, Policlinico "P. Giaccone", 90141 Palermo, Italy
| | - Antonino Tuttolomondo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), Università Degli Studi di Palermo, Piazza Delle Cliniche 2, 90127 Palermo, Italy
- Internal Medicine and Stroke Care Ward, University Hospital, Policlinico "P. Giaccone", 90141 Palermo, Italy
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Low vitamin D status is associated with inflammatory response in older patients with cerebral small vessel disease. J Neuroimmunol 2023; 377:578057. [PMID: 36921477 DOI: 10.1016/j.jneuroim.2023.578057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 02/18/2023] [Accepted: 02/25/2023] [Indexed: 03/11/2023]
Abstract
OBJECTIVES This study aimed to determine the association of the NF-κB inflammatory signaling pathway with vitamin D status in older cerebral small vessel disease (SVD) patients. METHODS We measured serum 25(OH)D, pro-and anti-inflammatory cytokines, and mRNA levels of the vitamin D-activating enzyme, CYP27B1, as well as NF-kB, COX-2, the chemokine-CCL2, IL-1β, IL-6, TNF-α, TGF-β, and IL-10, in cerebral SVD patients aged ≥60 years presenting with vascular dementia and age and gender-matched healthy controls. RESULTS Low vitamin D status (insufficiency: serum 25(OH)D 12-20 ng/ml; deficiency: ≤12 ng/ml) was more prevalent among patients compared to controls. The mRNA levels of NF-kB, COX-2, CCL2, IL-1β, and IL-6, and serum levels of pro-inflammatory cytokines (IL-1α, IL-1β, IL-6, and TNF-α) were significantly higher in cases compared to controls. There was a significant correlation between CYP27B1 and NF-kB, COX-2, CCL2, and IL-1β gene expression. Serum IL-1α, IL-1β, and IL-6 concentrations and the expression of CCL-2, NF-kB2, and NF-kB3 genes were higher in vitamin D-deficient subjects compared to vitamin D-sufficient subjects. There was a significant negative correlation between serum 25(OH)D and IL-1α, IL-6, and TNF-α, and a positive correlation between 25(OH)D and IL-10. CONCLUSION Low vitamin D is associated with an inflammatory response via NF-kB signaling, which could play a role in the etio-pathogenesis of SVD. Further large-scale studies are required to validate our findings.
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Serum levels of IL-6 are associated with cognitive impairment in the salus in apulia population-based study. Heliyon 2023; 9:e13972. [PMID: 36915478 PMCID: PMC10006470 DOI: 10.1016/j.heliyon.2023.e13972] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 02/09/2023] [Accepted: 02/16/2023] [Indexed: 02/25/2023] Open
Abstract
Growing evidence suggests that inflammation contributes to brain aging and neurodegeneration. This study investigates the relationship between global cognitive as well executive function and the inflammatory markers IL-6, CRP, and TNF-α in a population-based study of older adults. A population-based sample, of older people in Southern Italy, was enrolled. We measured serum levels of IL-6, CRP, and TNF-α. We also administered two neuropsychological tests: Mini-Mental State Examination and Frontal Assessment Battery. Rank-based regression models were performed to investigate the relationship between inflammatory markers and cognitive functions, including major demographic and clinical confounders for adjustment. The sample consisted of 1929 subjects aged between 65 and 95 years. Multivariate linear regression analysis revealed that higher serum levels of IL-6 were associated with lower MMSE and FAB scores even after adjustment for demographic data and cardiovascular risk factors. No significant associations were found between cognitive functioning and serum levels of CRP and TNF-α. Our results suggest that higher levels of IL-6 were associated with cognitive impairment in an older adult population of Southern Italy.
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Fu Y, Sun Y, Wang ZB, Zhang DD, Tan L, Feng JF, Cheng W, Yu JT. Associations of Life's Simple 7 with cerebral white matter hyperintensities and microstructural integrity: UK Biobank cohort study. Eur J Neurol 2023; 30:1200-1208. [PMID: 36794682 DOI: 10.1111/ene.15750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/26/2023] [Accepted: 02/13/2023] [Indexed: 02/17/2023]
Abstract
BACKGROUND AND PURPOSE The American Heart Association Life's Simple 7 (LS7) metric was used to define optimal cardiovascular and brain health, but the associations with macrostructural hyperintensities and microstructural white matter damage are unclear. The objective was to determine the association of LS7 ideal cardiovascular health factors with macrostructural and microstructural integrity. METHOD A total of 37,140 participants with available LS7 and imaging data from UK Biobank were included in this study. Linear associations were implemented to examine the associations of LS7 score and subscores with white matter hyperintensity load (WMH) (WMH volume normalized by total white matter volume and logit-transformed) and diffusion imaging indices (fractional anisotropy [FA], mean diffusivity, orientation dispersion index [OD], intracellular volume fraction, isotropic volume fraction [ISOVF]). RESULTS In individuals (mean age 54.76 years; 19,697 females, 52.4%), higher LS7 score and subscores were strongly associated with lower WMH and microstructural white matter injury, including OD, ISOVF, FA. Both interaction analyses and stratified analyses of LS7 score and subscores with age and sex showed a strong association with microstructural damage markers, with remarkable age and sex differences. The association of OD was pronounced in females and populations younger than 50 years and FA, mean diffusivity and ISOVF were pronounced in males and populations older than 50 years. CONCLUSION These findings suggest that healthier LS7 profiles are associated with better profiles of both macrostructural and microstructural markers of brain health, and indicate that ideal cardiovascular health is associated with improved brain health.
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Affiliation(s)
- Yan Fu
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Yan Sun
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Zhi-Bo Wang
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Dan-Dan Zhang
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Lan Tan
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Jian-Feng Feng
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.,Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), China.,Fudan ISTBI-ZJNU Algorithm Centre for Brain-Inspired Intelligence, Zhejiang Normal University, Jinhua, China.,MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China.,Zhangjiang Fudan International Innovation Center, Shanghai, China
| | - Wei Cheng
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.,Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), China.,Fudan ISTBI-ZJNU Algorithm Centre for Brain-Inspired Intelligence, Zhejiang Normal University, Jinhua, China.,Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, National Center for Neurological Disorders, Shanghai, China
| | - Jin-Tai Yu
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, National Center for Neurological Disorders, Shanghai, China
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Wan S, Dandu C, Han G, Guo Y, Ding Y, Song H, Meng R. Plasma inflammatory biomarkers in cerebral small vessel disease: A review. CNS Neurosci Ther 2022; 29:498-515. [PMID: 36478511 PMCID: PMC9873530 DOI: 10.1111/cns.14047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 10/24/2022] [Accepted: 11/22/2022] [Indexed: 12/12/2022] Open
Abstract
Cerebral small vessel disease (CSVD) is a group of pathological processes affecting small arteries, arterioles, capillaries, and small veins of the brain. It is one of the most common subtypes of cerebrovascular diseases, especially highly prevalent in elderly populations, and is associated with stroke occurrence and recurrence, cognitive impairment, gait disorders, psychological disturbance, and dysuria. Its diagnosis mainly depends on MRI, characterized by recent small subcortical infarcts, lacunes, white matter hyperintensities (WMHs), enlarged perivascular spaces (EPVS), cerebral microbleeds (CMBs), and brain atrophy. While the pathophysiological processes of CSVD are not fully understood at present, inflammation is noticed as playing an important role. Herein, we aimed to review the relationship between plasma inflammatory biomarkers and the MRI features of CSVD, to provide background for further research.
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Affiliation(s)
- Shuling Wan
- Department of Neurology, National Center for Neurological Disorders, Xuanwu HospitalCapital Medical UniversityBeijingChina,Advanced Center of StrokeBeijing Institute for Brain DisordersBeijingChina
| | - Chaitu Dandu
- Department of NeurosurgeryWayne State University School of MedicineDetroitMichiganUSA
| | - Guangyu Han
- Department of Neurology, National Center for Neurological Disorders, Xuanwu HospitalCapital Medical UniversityBeijingChina,Advanced Center of StrokeBeijing Institute for Brain DisordersBeijingChina
| | - Yibing Guo
- Department of Neurology, National Center for Neurological Disorders, Xuanwu HospitalCapital Medical UniversityBeijingChina,Advanced Center of StrokeBeijing Institute for Brain DisordersBeijingChina
| | - Yuchuan Ding
- Department of NeurosurgeryWayne State University School of MedicineDetroitMichiganUSA
| | - Haiqing Song
- Department of Neurology, National Center for Neurological Disorders, Xuanwu HospitalCapital Medical UniversityBeijingChina,Advanced Center of StrokeBeijing Institute for Brain DisordersBeijingChina
| | - Ran Meng
- Department of Neurology, National Center for Neurological Disorders, Xuanwu HospitalCapital Medical UniversityBeijingChina,Advanced Center of StrokeBeijing Institute for Brain DisordersBeijingChina,Department of NeurosurgeryWayne State University School of MedicineDetroitMichiganUSA
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Rascle L, Nighoghossian N, Cho TH, Bochaton T, Paccalet A, Da Silva CC, Buisson M, Amaz C, Fontaine J, Ong E, Derex L, Berthezene Y, Eker OF, Mewton N, Ovize M, Mechtouff L. Inflammatory profile and white matter hyperintensity burden in acute ischemic stroke patients. J Neuroimmunol 2022; 371:577934. [DOI: 10.1016/j.jneuroim.2022.577934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 07/10/2022] [Accepted: 07/21/2022] [Indexed: 10/16/2022]
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11
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Tan YD. Two-sample t α -test for testing hypotheses in small-sample experiments. Int J Biostat 2022:ijb-2021-0047. [PMID: 35749155 DOI: 10.1515/ijb-2021-0047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 05/29/2022] [Indexed: 11/15/2022]
Abstract
It has been reported that about half of biological discoveries are irreproducible. These irreproducible discoveries were partially attributed to poor statistical power. The poor powers are majorly owned to small sample sizes. However, in molecular biology and medicine, due to the limit of biological resources and budget, most molecular biological experiments have been conducted with small samples. Two-sample t-test controls bias by using a degree of freedom. However, this also implicates that t-test has low power in small samples. A discovery found with low statistical power suggests that it has a poor reproducibility. So, promotion of statistical power is not a feasible way to enhance reproducibility in small-sample experiments. An alternative way is to reduce type I error rate. For doing so, a so-called t α -test was developed. Both theoretical analysis and simulation study demonstrate that t α -test much outperforms t-test. However, t α -test is reduced to t-test when sample sizes are over 15. Large-scale simulation studies and real experiment data show that t α -test significantly reduced type I error rate compared to t-test and Wilcoxon test in small-sample experiments. t α -test had almost the same empirical power with t-test. Null p-value density distribution explains why t α -test had so lower type I error rate than t-test. One real experimental dataset provides a typical example to show that t α -test outperforms t-test and a microarray dataset showed that t α -test had the best performance among five statistical methods. In addition, the density distribution and probability cumulative function of t α -statistic were given in mathematics and the theoretical and observed distributions are well matched.
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Affiliation(s)
- Yuan-De Tan
- Statistics core, Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX, USA
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Diker S, Gelener P, Eker A, Kaymakamzade B, Mut S, Erem A, Balyemez U. Association between cerebral microbleeds and inflammatory biomarkers in patients with ischemic stroke. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2022. [DOI: 10.1186/s41983-022-00478-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Host inflammation has been studied in patients with ischemic stroke (IS) due to large vessel occlusions. Inflammatory markers were shown to correlate with large artery atherosclerosis and worse outcomes after ischemic stroke due to large vessel occlusions. However, the association between inflammation and cerebral small vessel disease (SVD) is controversial. Mostly studied are the white matter hyperintensities; however, results regarding association of white matter hyperintensities with inflammatory markers are conflicting. We aimed to investigate the association between cerebral microbleed (CMB) load, as an indicator of SVD, and inflammation indices in patients with IS.
Results
We identified 127 patients with IS admitted within 7 days of symptom onset. CMBs were detected in 37% (n: 47) of patients. Patient’s age and Fazekas score were independently associated with CMB load. Inflammatory biomarkers were not associated with the presence or quantitative burden of CMBs.
Conclusions
White matter damage and patient’s age predicted CMB presence and number, respectively, in IS patients. However, inflammatory markers failed to show any association with such SVD signs. Prospective studies with a higher number of stroke patients are needed in order to justify our findings.
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13
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Characterization of cerebral small vessel disease by neutrophil and platelet activation markers using artificial intelligence. J Neuroimmunol 2022; 367:577863. [DOI: 10.1016/j.jneuroim.2022.577863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 03/17/2022] [Accepted: 04/05/2022] [Indexed: 11/23/2022]
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Jung DH, Park B, Lee YJ. Relationship of the Triglyceride-Glucose Index with Subclinical White Matter Hypersensitivities of Presumed Vascular Origin Among Community-Dwelling Koreans. Int J Gen Med 2022; 15:603-608. [PMID: 35068939 PMCID: PMC8766995 DOI: 10.2147/ijgm.s346997] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 01/07/2022] [Indexed: 12/15/2022] Open
Abstract
Purpose The triglyceride-glucose (TyG) index, a widely accessible measure, has been a surrogate indicator of peripheral insulin resistance, and its clinical importance continues to grow in East Asia. We hypothesized that the TyG index is relevant to subclinical white matter hypersensitivities (WMHs) of presumed vascular origin among community-dwelling Koreans. Methods We investigated the relationship between the TyG index and WMHs on brain magnetic resonance imaging scans in 2417 Koreans over 45 years of age without a history of cancer, stroke, or ischemic heart disease. The study population was divided into four groups according to the TyG index quartiles. Using multiple logistic regression analysis, we assessed the odds ratios (ORs) and 95% confidence intervals (95% CIs) for WMHs across the TyG index quartiles. Results The prevalence of WMHs was significantly higher in the fourth TyG index quartile, with an overall rate of 9.3%. After adjusting for potential confounding variables, the ORs of WMHs for the TyG index quartiles were 1.00, 1.47 (95% CI, 0.91–2.40), 1.76 (95% CI, 1.05–2.97), and 6.79 (95% CI, 3.85–1.54), respectively. Conclusion We found that higher TyG index values were associated with the brain’s WMHs of presumed vascular origin. Our findings suggest that the serum TyG index could be an additional valuable biomarker for assessing the risk of cerebral small vessel disease in the preclinical stage.
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Affiliation(s)
- Dong-Hyuk Jung
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Byoungjin Park
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Yong-Jae Lee
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
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15
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Conole ELS, Stevenson AJ, Muñoz Maniega S, Harris SE, Green C, Valdés Hernández MDC, Harris MA, Bastin ME, Wardlaw JM, Deary IJ, Miron VE, Whalley HC, Marioni RE, Cox SR. DNA Methylation and Protein Markers of Chronic Inflammation and Their Associations With Brain and Cognitive Aging. Neurology 2021; 97:e2340-e2352. [PMID: 34789543 PMCID: PMC8665430 DOI: 10.1212/wnl.0000000000012997] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 10/15/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND AND OBJECTIVES To investigate chronic inflammation in relation to cognitive aging by comparison of an epigenetic and serum biomarker of C-reactive protein and their associations with neuroimaging and cognitive outcomes. METHODS At baseline, participants (n = 521) were cognitively normal, around 73 years of age (mean 72.4, SD 0.716), and had inflammation, vascular risk (cardiovascular disease history, hypertension, diabetes, smoking, alcohol consumption, body mass index), and neuroimaging (structural and diffusion MRI) data available. Baseline inflammatory status was quantified by a traditional measure of peripheral inflammation-serum C-reactive protein (CRP)-and an epigenetic measure (DNA methylation [DNAm] signature of CRP). Linear models were used to examine the inflammation-brain health associations; mediation analyses were performed to interrogate the relationship between chronic inflammation, brain structure, and cognitive functioning. RESULTS We demonstrate that DNAm CRP shows significantly (on average 6.4-fold) stronger associations with brain health outcomes than serum CRP. DNAm CRP is associated with total brain volume (β = -0.197, 95% confidence interval [CI] -0.28 to -0.12, p FDR = 8.42 × 10-6), gray matter volume (β = -0.200, 95% CI -0.28 to -0.12, p FDR = 1.66 × 10-5), and white matter volume (β = -0.150, 95% CI -0.23 to -0.07, p FDR = 0.001) and regional brain atrophy. We also find that DNAm CRP has an inverse association with global and domain-specific (speed, visuospatial, and memory) cognitive functioning and that brain structure partially mediates this CRP-cognitive association (up to 29.7%), dependent on lifestyle and health factors. DISCUSSION These results support the hypothesis that chronic inflammation may contribute to neurodegenerative brain changes that underlie differences in cognitive ability in later life and highlight the potential of DNAm proxies for indexing chronic inflammatory status. CLASSIFICATION OF EVIDENCE This study provides Class II evidence that a DNAm signature of CRP levels is more strongly associated with brain health outcomes than serum CRP levels.
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Affiliation(s)
- Eleanor L S Conole
- From the Lothian Birth Cohorts Group, Department of Psychology (E.L.S.C., S.M.M., S.E.H., M.d.C.V.H., M.A.H., J.M.W., I.J.D., R.E.M., S.R.C.), Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer (E.L.S.C., A.J.S., R.E.M.), Centre for Clinical Brain Sciences (E.L.S.C., S.M.M., M.d.C.V.H., M.E.B., J.M.W., H.C.W.), UK Dementia Research Institute, Edinburgh Medical School (A.J.S., V.E.M.), Division of Psychiatry, Royal Edinburgh Hospital (C.G., M.A.H., H.C.W.), and The Queen's Medical Research Institute, Edinburgh BioQuarter (V.E.M.), University of Edinburgh, UK.
| | - Anna J Stevenson
- From the Lothian Birth Cohorts Group, Department of Psychology (E.L.S.C., S.M.M., S.E.H., M.d.C.V.H., M.A.H., J.M.W., I.J.D., R.E.M., S.R.C.), Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer (E.L.S.C., A.J.S., R.E.M.), Centre for Clinical Brain Sciences (E.L.S.C., S.M.M., M.d.C.V.H., M.E.B., J.M.W., H.C.W.), UK Dementia Research Institute, Edinburgh Medical School (A.J.S., V.E.M.), Division of Psychiatry, Royal Edinburgh Hospital (C.G., M.A.H., H.C.W.), and The Queen's Medical Research Institute, Edinburgh BioQuarter (V.E.M.), University of Edinburgh, UK
| | - Susana Muñoz Maniega
- From the Lothian Birth Cohorts Group, Department of Psychology (E.L.S.C., S.M.M., S.E.H., M.d.C.V.H., M.A.H., J.M.W., I.J.D., R.E.M., S.R.C.), Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer (E.L.S.C., A.J.S., R.E.M.), Centre for Clinical Brain Sciences (E.L.S.C., S.M.M., M.d.C.V.H., M.E.B., J.M.W., H.C.W.), UK Dementia Research Institute, Edinburgh Medical School (A.J.S., V.E.M.), Division of Psychiatry, Royal Edinburgh Hospital (C.G., M.A.H., H.C.W.), and The Queen's Medical Research Institute, Edinburgh BioQuarter (V.E.M.), University of Edinburgh, UK
| | - Sarah E Harris
- From the Lothian Birth Cohorts Group, Department of Psychology (E.L.S.C., S.M.M., S.E.H., M.d.C.V.H., M.A.H., J.M.W., I.J.D., R.E.M., S.R.C.), Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer (E.L.S.C., A.J.S., R.E.M.), Centre for Clinical Brain Sciences (E.L.S.C., S.M.M., M.d.C.V.H., M.E.B., J.M.W., H.C.W.), UK Dementia Research Institute, Edinburgh Medical School (A.J.S., V.E.M.), Division of Psychiatry, Royal Edinburgh Hospital (C.G., M.A.H., H.C.W.), and The Queen's Medical Research Institute, Edinburgh BioQuarter (V.E.M.), University of Edinburgh, UK
| | - Claire Green
- From the Lothian Birth Cohorts Group, Department of Psychology (E.L.S.C., S.M.M., S.E.H., M.d.C.V.H., M.A.H., J.M.W., I.J.D., R.E.M., S.R.C.), Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer (E.L.S.C., A.J.S., R.E.M.), Centre for Clinical Brain Sciences (E.L.S.C., S.M.M., M.d.C.V.H., M.E.B., J.M.W., H.C.W.), UK Dementia Research Institute, Edinburgh Medical School (A.J.S., V.E.M.), Division of Psychiatry, Royal Edinburgh Hospital (C.G., M.A.H., H.C.W.), and The Queen's Medical Research Institute, Edinburgh BioQuarter (V.E.M.), University of Edinburgh, UK
| | - Maria Del C Valdés Hernández
- From the Lothian Birth Cohorts Group, Department of Psychology (E.L.S.C., S.M.M., S.E.H., M.d.C.V.H., M.A.H., J.M.W., I.J.D., R.E.M., S.R.C.), Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer (E.L.S.C., A.J.S., R.E.M.), Centre for Clinical Brain Sciences (E.L.S.C., S.M.M., M.d.C.V.H., M.E.B., J.M.W., H.C.W.), UK Dementia Research Institute, Edinburgh Medical School (A.J.S., V.E.M.), Division of Psychiatry, Royal Edinburgh Hospital (C.G., M.A.H., H.C.W.), and The Queen's Medical Research Institute, Edinburgh BioQuarter (V.E.M.), University of Edinburgh, UK
| | - Mathew A Harris
- From the Lothian Birth Cohorts Group, Department of Psychology (E.L.S.C., S.M.M., S.E.H., M.d.C.V.H., M.A.H., J.M.W., I.J.D., R.E.M., S.R.C.), Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer (E.L.S.C., A.J.S., R.E.M.), Centre for Clinical Brain Sciences (E.L.S.C., S.M.M., M.d.C.V.H., M.E.B., J.M.W., H.C.W.), UK Dementia Research Institute, Edinburgh Medical School (A.J.S., V.E.M.), Division of Psychiatry, Royal Edinburgh Hospital (C.G., M.A.H., H.C.W.), and The Queen's Medical Research Institute, Edinburgh BioQuarter (V.E.M.), University of Edinburgh, UK
| | - Mark E Bastin
- From the Lothian Birth Cohorts Group, Department of Psychology (E.L.S.C., S.M.M., S.E.H., M.d.C.V.H., M.A.H., J.M.W., I.J.D., R.E.M., S.R.C.), Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer (E.L.S.C., A.J.S., R.E.M.), Centre for Clinical Brain Sciences (E.L.S.C., S.M.M., M.d.C.V.H., M.E.B., J.M.W., H.C.W.), UK Dementia Research Institute, Edinburgh Medical School (A.J.S., V.E.M.), Division of Psychiatry, Royal Edinburgh Hospital (C.G., M.A.H., H.C.W.), and The Queen's Medical Research Institute, Edinburgh BioQuarter (V.E.M.), University of Edinburgh, UK
| | - Joanna M Wardlaw
- From the Lothian Birth Cohorts Group, Department of Psychology (E.L.S.C., S.M.M., S.E.H., M.d.C.V.H., M.A.H., J.M.W., I.J.D., R.E.M., S.R.C.), Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer (E.L.S.C., A.J.S., R.E.M.), Centre for Clinical Brain Sciences (E.L.S.C., S.M.M., M.d.C.V.H., M.E.B., J.M.W., H.C.W.), UK Dementia Research Institute, Edinburgh Medical School (A.J.S., V.E.M.), Division of Psychiatry, Royal Edinburgh Hospital (C.G., M.A.H., H.C.W.), and The Queen's Medical Research Institute, Edinburgh BioQuarter (V.E.M.), University of Edinburgh, UK
| | - Ian J Deary
- From the Lothian Birth Cohorts Group, Department of Psychology (E.L.S.C., S.M.M., S.E.H., M.d.C.V.H., M.A.H., J.M.W., I.J.D., R.E.M., S.R.C.), Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer (E.L.S.C., A.J.S., R.E.M.), Centre for Clinical Brain Sciences (E.L.S.C., S.M.M., M.d.C.V.H., M.E.B., J.M.W., H.C.W.), UK Dementia Research Institute, Edinburgh Medical School (A.J.S., V.E.M.), Division of Psychiatry, Royal Edinburgh Hospital (C.G., M.A.H., H.C.W.), and The Queen's Medical Research Institute, Edinburgh BioQuarter (V.E.M.), University of Edinburgh, UK
| | - Veronique E Miron
- From the Lothian Birth Cohorts Group, Department of Psychology (E.L.S.C., S.M.M., S.E.H., M.d.C.V.H., M.A.H., J.M.W., I.J.D., R.E.M., S.R.C.), Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer (E.L.S.C., A.J.S., R.E.M.), Centre for Clinical Brain Sciences (E.L.S.C., S.M.M., M.d.C.V.H., M.E.B., J.M.W., H.C.W.), UK Dementia Research Institute, Edinburgh Medical School (A.J.S., V.E.M.), Division of Psychiatry, Royal Edinburgh Hospital (C.G., M.A.H., H.C.W.), and The Queen's Medical Research Institute, Edinburgh BioQuarter (V.E.M.), University of Edinburgh, UK
| | - Heather C Whalley
- From the Lothian Birth Cohorts Group, Department of Psychology (E.L.S.C., S.M.M., S.E.H., M.d.C.V.H., M.A.H., J.M.W., I.J.D., R.E.M., S.R.C.), Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer (E.L.S.C., A.J.S., R.E.M.), Centre for Clinical Brain Sciences (E.L.S.C., S.M.M., M.d.C.V.H., M.E.B., J.M.W., H.C.W.), UK Dementia Research Institute, Edinburgh Medical School (A.J.S., V.E.M.), Division of Psychiatry, Royal Edinburgh Hospital (C.G., M.A.H., H.C.W.), and The Queen's Medical Research Institute, Edinburgh BioQuarter (V.E.M.), University of Edinburgh, UK
| | - Riccardo E Marioni
- From the Lothian Birth Cohorts Group, Department of Psychology (E.L.S.C., S.M.M., S.E.H., M.d.C.V.H., M.A.H., J.M.W., I.J.D., R.E.M., S.R.C.), Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer (E.L.S.C., A.J.S., R.E.M.), Centre for Clinical Brain Sciences (E.L.S.C., S.M.M., M.d.C.V.H., M.E.B., J.M.W., H.C.W.), UK Dementia Research Institute, Edinburgh Medical School (A.J.S., V.E.M.), Division of Psychiatry, Royal Edinburgh Hospital (C.G., M.A.H., H.C.W.), and The Queen's Medical Research Institute, Edinburgh BioQuarter (V.E.M.), University of Edinburgh, UK
| | - Simon R Cox
- From the Lothian Birth Cohorts Group, Department of Psychology (E.L.S.C., S.M.M., S.E.H., M.d.C.V.H., M.A.H., J.M.W., I.J.D., R.E.M., S.R.C.), Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer (E.L.S.C., A.J.S., R.E.M.), Centre for Clinical Brain Sciences (E.L.S.C., S.M.M., M.d.C.V.H., M.E.B., J.M.W., H.C.W.), UK Dementia Research Institute, Edinburgh Medical School (A.J.S., V.E.M.), Division of Psychiatry, Royal Edinburgh Hospital (C.G., M.A.H., H.C.W.), and The Queen's Medical Research Institute, Edinburgh BioQuarter (V.E.M.), University of Edinburgh, UK
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Prapiadou S, Demel SL, Hyacinth HI. Genetic and Genomic Epidemiology of Stroke in People of African Ancestry. Genes (Basel) 2021; 12:1825. [PMID: 34828431 PMCID: PMC8619587 DOI: 10.3390/genes12111825] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/17/2021] [Accepted: 11/17/2021] [Indexed: 11/16/2022] Open
Abstract
Stroke is one of the leading causes of disability and death worldwide and places a significant burden on healthcare systems. There are significant racial/ethnic differences in the incidence, subtype, and prognosis of stroke, between people of European and African ancestry, of which only about 50% can be explained by traditional stroke risk facts. However, only a small number of genetic studies include individuals of African descent, leaving many gaps in our understanding of stroke genetics among this population. This review article highlights the need for and significance of including African-ancestry individuals in stroke genetic studies and points to the efforts that have been made towards this direction. Additionally, we discuss the caveats, opportunities, and next steps in African stroke genetics-a field still in its infancy but with great potential for expanding our understanding of stroke biology and for developing new therapeutic strategies.
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Affiliation(s)
- Savvina Prapiadou
- Department of Medicine, University of Patras School of Medicine, 26223 Patras, Greece;
| | - Stacie L. Demel
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45221, USA;
| | - Hyacinth I. Hyacinth
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45221, USA;
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17
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Spilling CA, Dhillon MPK, Burrage DR, Ruickbie S, Baker EH, Barrick TR, Jones PW. Factors affecting brain structure in smoking-related diseases: Chronic Obstructive Pulmonary Disease (COPD) and coronary artery disease. PLoS One 2021; 16:e0259375. [PMID: 34739504 PMCID: PMC8570465 DOI: 10.1371/journal.pone.0259375] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 10/18/2021] [Indexed: 11/24/2022] Open
Abstract
Background Changes in brain structure and cognitive decline occur in Chronic Obstructive Pulmonary Disease (COPD). They also occur with smoking and coronary artery disease (CAD), but it is unclear whether a common mechanism is responsible. Methods Brain MRI markers of brain structure were tested for association with disease markers in other organs. Where possible, principal component analysis (PCA) was used to group markers within organ systems into composite markers. Univariate relationships between brain structure and the disease markers were explored using hierarchical regression and then entered into multivariable regression models. Results 100 participants were studied (53 COPD, 47 CAD). PCA identified two brain components: brain tissue volumes and white matter microstructure, and six components from other organ systems: respiratory function, plasma lipids, blood pressure, glucose dysregulation, retinal vessel calibre and retinal vessel tortuosity. Several markers could not be grouped into components and were analysed as single variables, these included brain white matter hyperintense lesion (WMH) volume. Multivariable regression models showed that less well organised white matter microstructure was associated with lower respiratory function (p = 0.028); WMH volume was associated with higher blood pressure (p = 0.036) and higher C-Reactive Protein (p = 0.011) and lower brain tissue volume was associated with lower cerebral blood flow (p<0.001) and higher blood pressure (p = 0.001). Smoking history was not an independent correlate of any brain marker. Conclusions Measures of brain structure were associated with a range of markers of disease, some of which appeared to be common to both COPD and CAD. No single common pathway was identified, but the findings suggest that brain changes associated with smoking-related diseases may be due to vascular, respiratory, and inflammatory changes.
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Affiliation(s)
- Catherine A Spilling
- Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, United Kingdom
| | - Mohani-Preet K Dhillon
- Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, United Kingdom
| | - Daniel R Burrage
- Institute for Infection and Immunity, St George's University of London, London, United Kingdom
| | - Sachelle Ruickbie
- Respiratory Medicine, St George's University Hospitals NHS Foundation Trust, London, United Kingdom
| | - Emma H Baker
- Institute for Infection and Immunity, St George's University of London, London, United Kingdom
| | - Thomas R Barrick
- Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, United Kingdom
| | - Paul W Jones
- Institute for Infection and Immunity, St George's University of London, London, United Kingdom
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18
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Cohen AD, Bruña R, Chang YF, Cheng Y, Doman J, Huppert T, Kim T, Maestu F, Roush RE, Snitz BE, Becker JT. Connectomics in Brain Aging and Dementia - The Background and Design of a Study of a Connectome Related to Human Disease. Front Aging Neurosci 2021; 13:669490. [PMID: 34690734 PMCID: PMC8530182 DOI: 10.3389/fnagi.2021.669490] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 09/06/2021] [Indexed: 11/20/2022] Open
Abstract
The natural history of Alzheimer’s Disease (AD) includes significant alterations in the human connectome, and this disconnection results in the dementia of AD. The organizing principle of our research project is the idea that the expression of cognitive dysfunction in the elderly is the result of two independent processes — the neuropathology associated with AD, and second the neuropathological changes of cerebrovascular disease. Synaptic loss, senile plaques, and neurofibrillary tangles are the functional and diagnostic hallmarks of AD, but it is the structural changes as a consequence of vascular disease that reduce brain reserve and compensation, resulting in an earlier expression of the clinical dementia syndrome. This work is being completed under the auspices of the Human Connectome Project (HCP). We have achieved an equal representation of Black individuals (vs. White individuals) and enrolled 60% Women. Each of the participants contributes demographic, behavioral and laboratory data. We acquire data relative to vascular risk, and the participants also undergo in vivo amyloid imaging, and magnetoencephalography (MEG). All of the data are publicly available under the HCP guidelines using the Connectome Coordinating Facility and the NIMH Data Archive. Locally, we use these data to address specific questions related to structure, function, AD, aging and vascular disease in multi-modality studies leveraging the differential advantages of magnetic resonance imaging (MRI), functional magnetic resonance imaging (fMRI), MEG, and in vivo beta amyloid imaging.
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Affiliation(s)
- Ann D Cohen
- Department of Psychiatry, The University of Pittsburgh, Pittsburgh, PA, United States
| | - Ricardo Bruña
- Department of Experimental Psychology, Universidad Complutense de Madrid, Pozuelo de Alarcón, Madrid, Spain
| | - Yue-Fang Chang
- Department of Neurosurgery, The University of Pittsburgh, Pittsburgh, PA, United States
| | - Yu Cheng
- Department of Statistics, The University of Pittsburgh, Pittsburgh, PA, United States.,Department of Biostatistics, The University of Pittsburgh, Pittsburgh, PA, United States
| | - Jack Doman
- Department of Psychiatry, The University of Pittsburgh, Pittsburgh, PA, United States
| | - Ted Huppert
- Department of Electrical Engineering, The University of Pittsburgh, Pittsburgh, PA, United States
| | - Tae Kim
- Department of Radiology, The University of Pittsburgh, Pittsburgh, PA, United States
| | - Fernando Maestu
- Department of Experimental Psychology, Universidad Complutense de Madrid, Pozuelo de Alarcón, Madrid, Spain
| | - Rebecca E Roush
- Department of Neurology, The University of Pittsburgh, Pittsburgh, PA, United States
| | - Beth E Snitz
- Department of Neurology, The University of Pittsburgh, Pittsburgh, PA, United States
| | - James T Becker
- Department of Psychiatry, The University of Pittsburgh, Pittsburgh, PA, United States.,Department of Neurology, The University of Pittsburgh, Pittsburgh, PA, United States.,Department of Psychology, The University of Pittsburgh, Pittsburgh, PA, United States
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19
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Evans LE, Taylor JL, Smith CJ, Pritchard HAT, Greenstein AS, Allan SM. Cardiovascular co-morbidities, inflammation and cerebral small vessel disease. Cardiovasc Res 2021; 117:2575-2588. [PMID: 34499123 DOI: 10.1093/cvr/cvab284] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Indexed: 12/15/2022] Open
Abstract
Cerebral small vessel disease (cSVD) is the most common cause of vascular cognitive impairment and affects all levels of the brain's vasculature. Features include diverse structural and functional changes affecting small arteries and capillaries that lead to a decline in cerebral perfusion. Due to an aging population, incidence of cerebral small vessel disease (cSVD) is continually rising. Despite its prevalence and its ability to cause multiple debilitating illnesses, such as stroke and dementia, there are currently no therapeutic strategies for the treatment of cSVD. In the healthy brain, interactions between neuronal, vascular and inflammatory cells are required for normal functioning. When these interactions are disturbed, chronic pathological inflammation can ensue. The interplay between cSVD and inflammation has attracted much recent interest and this review discusses chronic cardiovascular diseases, particularly hypertension, and explores how the associated inflammation may impact on the structure and function of the small arteries of the brain in cSVD. Molecular approaches in animal studies are linked to clinical outcomes in patients and novel hypotheses regarding inflammation and cSVD are proposed that will hopefully stimulate further discussion and study in this important area.
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Affiliation(s)
- Lowri E Evans
- Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.,Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre, Northern Care Alliance & University of Manchester, Manchester, UK
| | - Jade L Taylor
- Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.,Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre, Northern Care Alliance & University of Manchester, Manchester, UK
| | - Craig J Smith
- Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.,Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre, Northern Care Alliance & University of Manchester, Manchester, UK.,Manchester Centre for Clinical Neurosciences, Manchester Academic Health Science Centre, Salford Royal Hospital, Manchester Academic Health Sciences Centre (MAHSC)
| | - Harry A T Pritchard
- Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.,Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre, Northern Care Alliance & University of Manchester, Manchester, UK
| | - Adam S Greenstein
- Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.,Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre, Northern Care Alliance & University of Manchester, Manchester, UK
| | - Stuart M Allan
- Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre, Northern Care Alliance & University of Manchester, Manchester, UK.,Division of Neuroscience and Experimental Psychology, The University of Manchester, Manchester, UK
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20
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Phneh KY, Chong ETJ, Lee PC. Role of single nucleotide polymorphisms in susceptibility of stroke: A systemic review. Meta Gene 2021. [DOI: 10.1016/j.mgene.2021.100879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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21
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Ariton DM, Jiménez-Balado J, Maisterra O, Pujadas F, Soler MJ, Delgado P. Diabetes, Albuminuria and the Kidney-Brain Axis. J Clin Med 2021; 10:2364. [PMID: 34072230 PMCID: PMC8198842 DOI: 10.3390/jcm10112364] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/19/2021] [Accepted: 05/24/2021] [Indexed: 01/02/2023] Open
Abstract
Cognitive decline and kidney disease are significant public health problems that share similar characteristics and risk factors. The pathophysiology of the kidney-brain axis is not completely understood, and studies analysing the relationship between the biomarkers of kidney damage and cognitive impairment show different results. This article focuses on the epidemiological and clinical aspects concerning the association of albuminuria, a marker for endothelial dysfunction and microvascular disease, and cognitive impairment in patients with chronic kidney disease, diabetic kidney disease and end-stage kidney disease. Most studies show a positive relationship between albuminuria and cognitive impairment in all groups, but evidence in type 2 diabetes (T2D) patients is limited. We briefly discuss the mechanisms underlying these associations, such as damage to the microvascular circulation, leading to hypoperfusion and blood pressure fluctuations, as well as increased inflammation and oxidative stress, both in the brain and in the kidneys. Further clinical and epidemiological studies developed to understand the interplay between the kidneys and brain diseases will hopefully lead to a reduction in cognitive impairment in these patients.
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Affiliation(s)
- Diana Maria Ariton
- Neurology Department, Hospital Vall d’Hebron, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain; (D.M.A.); (J.J.-B.); (O.M.); (F.P.)
| | - Joan Jiménez-Balado
- Neurology Department, Hospital Vall d’Hebron, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain; (D.M.A.); (J.J.-B.); (O.M.); (F.P.)
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089, USA
| | - Olga Maisterra
- Neurology Department, Hospital Vall d’Hebron, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain; (D.M.A.); (J.J.-B.); (O.M.); (F.P.)
| | - Francesc Pujadas
- Neurology Department, Hospital Vall d’Hebron, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain; (D.M.A.); (J.J.-B.); (O.M.); (F.P.)
| | - María José Soler
- Nephrology Department, Hospital Vall d’Hebron, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain;
| | - Pilar Delgado
- Neurology Department, Hospital Vall d’Hebron, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain; (D.M.A.); (J.J.-B.); (O.M.); (F.P.)
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22
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Wang W, Sun P, Han F, Wang C, Wang Y, Wang X, Cong L, Qu C. Transcriptome Sequencing Identifies Potential Biomarker for White Matter Lesions Diagnosis in the Hypertension Population. Neurochem Res 2021; 46:2079-2088. [PMID: 34037902 DOI: 10.1007/s11064-021-03346-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 04/21/2021] [Accepted: 05/12/2021] [Indexed: 11/29/2022]
Abstract
Hypertension is confirmed to be one of the major risk factors of leukoaraiosis (LA). However, the pathogenesis of LA is not completely understood and there is no reliable indicator for the early diagnosis of LA in the hypertensive population. This study was designed to explore the potential biomarker for LA diagnosis in patients with hypertension. And it serves as the basis for the further study of LA mechanism. In this study, This study included 110 subjects, including 50 in the LA group and 60 in the control group. First, we performed transcriptome sequencing and quantitative PCR (qPCR) in four samples from the LA group, and three from the control group (seven people) to identify relevant long non-coding RNAs (long ncRNAs or lncRNA). The 103 samples were used for qPCR validation of relevant lncRNAs and the results were consistent with the sequencing. In-depth bioinformatics analysis were performed on differentially expressed (DE) lncRNAs and mRNAs. Go-functional enrichment analysis was performed on DE mRNAs. Some DE mRNA were enriched to biological processes associated with LA, And some lncRNAs related to DE mRNAs were traceable through cis/trans analysis, suggesting that they might be regulated in some way. Additionally, potential biomarkers for LA diagnosis in the hypertension population were identified via RT-qPCR and receive operating characteristic curve (ROC) analysis of lncRNA. One lncRNA, AC020928.1, has been demonstrated to be potential biomarkers for LA diagnosis in the hypertension population. The results of the present study indicated that the lncRNA may have an important role in the pathogenesis of LA and may be a novel target for further research. As the relationship between lncRNAs and LA is just beginning to be unraveled, their specific mechanisms require further investigation.
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Affiliation(s)
- Wendi Wang
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, China
| | - Pei Sun
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250021, China
| | - Fengyue Han
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250021, China
| | - Chunjuan Wang
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250021, China
| | - Yongxiang Wang
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250021, China
| | - Xiang Wang
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250021, China
| | - Lin Cong
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250021, China
| | - Chuanqiang Qu
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250021, China.
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23
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Shiga Y, Hosomi N, Nezu T, Nishi H, Aoki S, Nakamori M, Ishikawa K, Kinoshita N, Imamura E, Ueno H, Shintani T, Ohge H, Kawaguchi H, Kurihara H, Wakabayashi S, Maruyama H. Association between periodontal disease due to Campylobacter rectus and cerebral microbleeds in acute stroke patients. PLoS One 2020; 15:e0239773. [PMID: 33031428 PMCID: PMC7544022 DOI: 10.1371/journal.pone.0239773] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 09/11/2020] [Indexed: 12/11/2022] Open
Abstract
Oral health conditions and cerebral small vessel disease, such as white matter lesions or cerebral microbleeds (CMBs), are associated with the incidence of stroke. The purpose of this study was to examine the associations between oral health conditions (serum IgG titers of periodontal pathogens) with the presence or severity of CMBs in acute stroke patients. From January 2013 to April 2016, acute stroke patients were registered in two hospitals. Serum samples were evaluated for antibody titers against 9 periodontal pathogens using the ELISA method. The cut-off points for reactivity (the positive decision point) to each antigen were defined as more than a mean ELISA unit + 1 standard deviation (after logarithmic transformation) in all subjects. CMBs were evaluated on T2*-weighted MRI. In all, 639 patients were evaluated (ischemic, n = 533 and hemorrhagic, n = 106; 73.1 ± 12.9 years old). Among these patients, 627 were available for CMB evaluation. Among the 9 evaluated periodontal pathogens, only Campylobacter rectus (C. rectus) was associated with the presence of CMBs. the prevalence of positive serum antibody titers against C. rectus was higher among patients with CMBs than among those without CMBs (14.6% vs. 8.7%, P = 0.025). In addition, positive serum antibody titers against C. rectus remained one of the factors associated with the presence of CMBs in multivariate logistic analysis (odds ratio 2.03, 95% confidence interval 1.19–3.47, P = 0.010). A positive serum antibody titer against C. rectus was associated with the presence of CMBs in acute stroke patients.
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Affiliation(s)
- Yuji Shiga
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Naohisa Hosomi
- Department of Neurology, Chikamori Hospital, Kochi, Japan
- Department of Disease Model, Research Institute of Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
- * E-mail:
| | - Tomohisa Nezu
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Hiromi Nishi
- Department of General Dentistry, Hiroshima University Hospital, Hiroshima, Japan
| | - Shiro Aoki
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Masahiro Nakamori
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
- Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Kenichi Ishikawa
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
- Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Naoto Kinoshita
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Eiji Imamura
- Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Hiroki Ueno
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Tomoaki Shintani
- Center of Oral Examination, Hiroshima University Hospital, Hiroshima, Japan
| | - Hiroki Ohge
- Department of Infectious Diseases, Hiroshima University Hospital, Hiroshima, Japan
| | - Hiroyuki Kawaguchi
- Department of General Dentistry, Hiroshima University Hospital, Hiroshima, Japan
| | - Hidemi Kurihara
- Department of Periodontal Medicine, Division of Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | | | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
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24
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Kawai VK, Shi M, Feng Q, Chung CP, Liu G, Cox NJ, Jarvik GP, Lee MTM, Hebbring SJ, Harley JB, Kaufman KM, Namjou B, Larson E, Gordon AS, Roden DM, Stein CM, Mosley JD. Pleiotropy in the Genetic Predisposition to Rheumatoid Arthritis: A Phenome-Wide Association Study and Inverse Variance-Weighted Meta-Analysis. Arthritis Rheumatol 2020; 72:1483-1492. [PMID: 32307929 DOI: 10.1002/art.41291] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 04/14/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE This study was undertaken to investigate the hypothesis that a genetic predisposition toward rheumatoid arthritis (RA) increases the risk of 10 cardiometabolic and autoimmune disorders previously associated with RA in epidemiologic studies, and to define new genetic pleiotropy present in RA. METHODS Two approaches were used to test our hypothesis. First, we constructed a weighted genetic risk score (wGRS) and then examined its association with 10 prespecified disorders. Additionally, a phenome-wide association study (PheWAS) was carried out to identify potential new associations. Second, inverse variance-weighted regression (IVWR) meta-analysis was used to characterize the association between genetic susceptibility to RA and the prespecified disorders, with the results expressed as odds ratios (ORs) and 95% confidence intervals (95% CIs). RESULTS The wGRS for RA was significantly associated with type 1 diabetes mellitus (DM) (OR 1.10 [95% CI 1.04-1.16]; P = 9.82 × 10-4 ) and multiple sclerosis (OR 0.82 [95% CI 0.77-0.88]; P = 1.73 × 10-8 ), but not with other cardiometabolic phenotypes. In the PheWAS, wGRS was also associated with an increased risk of several autoimmune phenotypes including RA, thyroiditis, and systemic sclerosis, and with a decreased risk of demyelinating disorders. In the IVWR meta-analyses, RA was significantly associated with an increased risk of type 1 DM (P = 1.15 × 10-14 ), with evidence of horizontal pleiotropy (Mendelian Randomization-Egger intercept estimate P = 0.001) likely driven by rs2476601, a PTPN22 variant. The association between type 1 DM and RA remained significant (P = 9.53 × 10-9 ) after excluding rs2476601, with no evidence of horizontal pleiotropy (intercept estimate P = 0.939). RA was also significantly associated with type 2 DM and C-reactive protein levels. These associations were driven by variation in the major histocompatibility complex region. CONCLUSION This study presents evidence of pleiotropy between the genetic predisposition to RA and associated phenotypes found in other autoimmune and cardiometabolic disorders, including type 1 DM.
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Affiliation(s)
- Vivian K Kawai
- Vanderbilt University Medical Center, Nashville, Tennessee
| | - Mingjian Shi
- Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Qiping Feng
- Vanderbilt University Medical Center, Nashville, Tennessee
| | - Cecilia P Chung
- Vanderbilt University Medical Center, Tennessee Valley Healthcare System Nashville Campus, and Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Ge Liu
- Vanderbilt University Medical Center, Nashville, Tennessee
| | - Nancy J Cox
- Vanderbilt University Medical Center and Vanderbilt University School of Medicine, Nashville, Tennessee
| | | | | | | | - John B Harley
- Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, and Cincinnati VA Medical Center, Cincinnati, Ohio
| | - Kenneth M Kaufman
- Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, and Cincinnati VA Medical Center, Cincinnati, Ohio
| | - Bahram Namjou
- Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Eric Larson
- Kaiser Permanente Washington Health Research Institute, Seattle
| | - Adam S Gordon
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Dan M Roden
- Vanderbilt University Medical Center and Vanderbilt University School of Medicine, Nashville, Tennessee
| | | | - Jonathan D Mosley
- Vanderbilt University Medical Center and Vanderbilt University School of Medicine, Nashville, Tennessee
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25
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Yolk sac-derived Pdcd11-positive cells modulate zebrafish microglia differentiation through the NF-κB-Tgfβ1 pathway. Cell Death Differ 2020; 28:170-183. [PMID: 32709934 PMCID: PMC7853042 DOI: 10.1038/s41418-020-0591-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 07/07/2020] [Accepted: 07/09/2020] [Indexed: 12/22/2022] Open
Abstract
Microglia are the primary immune cells in the central nervous system, which plays a vital role in neuron development and neurodegenerative diseases. Microglial precursors in peripheral hematopoietic tissues colonize the central nervous system during early embryogenesis. However, how intrinsic and extrinsic signals integrate to regulate microglia’s differentiation remains undefined. In this study, we identified the cerebral white matter hyperintensities susceptibility gene, programmed cell death protein 11 (PDCD11), as an essential factor regulating microglia differentiation. In zebrafish, pdcd11 deficiency prevents the differentiation of the precursors to mature brain microglia. Although, the inflammatory featured macrophage brain colonization is augmented. At 22 h post fertilization, the Pdcd11-positive cells on the yolk sac are distinct from macrophages and neutrophils. Mechanistically, PDCD11 exerts its physiological role by differentially regulating the functions of nuclear factor-kappa B family members, P65 and c-Rel, suppressing P65-mediated expression of inflammatory cytokines, such as tnfα, and enhancing the c-Rel-dependent appearance of tgfβ1. The present study provides novel insights in understanding microglia differentiation during zebrafish development.
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26
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Lee J, Park A, Mun S, Kim HJ, Son H, Choi H, Kim D, Lee SJ, Kim JG, Kang HG. Proteomics-Based Identification of Diagnostic Biomarkers Related to Risk Factors and Pathogenesis of Ischemic Stroke. Diagnostics (Basel) 2020; 10:diagnostics10050340. [PMID: 32466277 PMCID: PMC7278009 DOI: 10.3390/diagnostics10050340] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 05/20/2020] [Accepted: 05/22/2020] [Indexed: 12/04/2022] Open
Abstract
Ischemic stroke is caused by blood clot formation and consequent vessel blockage. Proteomic approaches provide a cost-effective alternative to current diagnostic methods, including computerized tomography (CT) scans and magnetic resonance imaging (MRI). To identify diagnostic biomarkers associated with ischemic stroke risk factors, we performed individual proteomic analysis of serum taken from 20 healthy controls and 20 ischemic stroke patients. We then performed SWATH analysis, a data-independent method, to assess quantitative changes in protein expression between the two experimental conditions. Our analysis identified several candidate protein biomarkers, 11 of which were validated by multiple reaction monitoring (MRM) analysis as novel diagnostic biomarkers associated with ischemic stroke risk factors. Our study identifies new biomarkers associated with the risk factors and pathogenesis of ischemic stroke which, to the best of our knowledge, were previously unknown. These markers may be effective in not only the diagnosis but also the prevention and management of ischemic stroke.
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Affiliation(s)
- Jiyeong Lee
- Department of Biomedical Laboratory Science, School of Medicine, Eulji University, Daejeon 34824, Korea;
| | - Arum Park
- Department of Senior Healthcare, BK21 Plus Program, Graduate School, Eulji University, Seongnam 13135, Korea; (A.P.); (S.M.); (H.-J.K.); (H.S.); (H.C.)
| | - Sora Mun
- Department of Senior Healthcare, BK21 Plus Program, Graduate School, Eulji University, Seongnam 13135, Korea; (A.P.); (S.M.); (H.-J.K.); (H.S.); (H.C.)
| | - Hyo-Jin Kim
- Department of Senior Healthcare, BK21 Plus Program, Graduate School, Eulji University, Seongnam 13135, Korea; (A.P.); (S.M.); (H.-J.K.); (H.S.); (H.C.)
| | - Hyunsong Son
- Department of Senior Healthcare, BK21 Plus Program, Graduate School, Eulji University, Seongnam 13135, Korea; (A.P.); (S.M.); (H.-J.K.); (H.S.); (H.C.)
| | - Hyebin Choi
- Department of Senior Healthcare, BK21 Plus Program, Graduate School, Eulji University, Seongnam 13135, Korea; (A.P.); (S.M.); (H.-J.K.); (H.S.); (H.C.)
| | - Doojin Kim
- Department of Laboratory Medicine, Seongnam Central Hospital, Seongnam 13161, Korea;
| | - Soo Joo Lee
- Department of Neurology, Eulji University Hospital, School of Medicine, Eulji University, Daejeon 35233, Korea; (S.J.L.); (J.G.K.)
| | - Jae Guk Kim
- Department of Neurology, Eulji University Hospital, School of Medicine, Eulji University, Daejeon 35233, Korea; (S.J.L.); (J.G.K.)
| | - Hee-Gyoo Kang
- Department of Senior Healthcare, BK21 Plus Program, Graduate School, Eulji University, Seongnam 13135, Korea; (A.P.); (S.M.); (H.-J.K.); (H.S.); (H.C.)
- Department of Biomedical Laboratory Science, School of Medicine, Eulji University, Seongnam 13135, Korea
- Seongnam Senior Industry Innovation Center, Eulji University, Seongnam 13503, Korea
- Correspondence: ; Tel.: +82-31-740-7315; Fax: +82-31-740-7448
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27
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Markousis-Mavrogenis G, Mitsikostas DD, Koutsogeorgopoulou L, Dimitroulas T, Katsifis G, Argyriou P, Apostolou D, Velitsista S, Vartela V, Manolopoulou D, Tektonidou MG, Kolovou G, Kitas GD, Sfikakis PP, Mavrogeni SI. Combined Brain-Heart Magnetic Resonance Imaging in Autoimmune Rheumatic Disease Patients with Cardiac Symptoms: Hypothesis Generating Insights from a Cross-sectional Study. J Clin Med 2020; 9:jcm9020447. [PMID: 32041234 PMCID: PMC7074384 DOI: 10.3390/jcm9020447] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 01/30/2020] [Accepted: 01/31/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Autoimmune rheumatic diseases (ARDs) may affect both the heart and the brain. However, little is known about the interaction between these organs in ARD patients. We asked whether brain lesions are more frequent in ARD patients with cardiac symptoms compared with non-ARD patients with cardiovascular disease (CVD). METHODS 57 ARD patients with mean age of 48 ± 13 years presenting with shortness of breath, chest pain, and/or palpitations, and 30 age-matched disease-controls with non-autoimmune CVD, were evaluated using combined brain-heart magnetic resonance imaging (MRI) in a 1.5T system. RESULTS 52 (91%) ARD patients and 16 (53%) controls had white matter hyperintensities (p < 0.001) in at least one brain area (subcortical/deep/periventricular white matter, basal ganglia, pons, brainstem, or mesial temporal lobe). Only the frequency and number of subcortical and deep white matter lesions were significantly greater in ARD patients (p < 0.001 and 0.014, respectively). ARD vs. control status was the only independent predictor of having any brain lesion. Specifically for deep white matter lesions, each increase in ECV independently predicted a higher number of lesions [odds ratio (95% confidence interval): 1.16 (1.01-1.33), p = 0.031] in ordered logistic regression. Penalized logistic regression selected only ARD vs. control status as the most important feature for predicting whether brain lesions were present on brain MRI (odds ratio: 5.46, marginal false discovery rate = 0.011). CONCLUSIONS Subclinical brain involvement was highly prevalent in this cohort of ARD patients and was mostly independent of the severity of cardiac involvement. However, further research is required to determine the clinical relevance of these findings.
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Affiliation(s)
| | - Dimos D. Mitsikostas
- First Neurology Department, National and Kapodistrian University of Athens, 10679 Athens, Greece;
| | | | - Theodoros Dimitroulas
- Department of Rheumatology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Gikas Katsifis
- Rheumatology Department, Naval Hospital, 11521 Athens, Greece;
| | - Panayiotis Argyriou
- MRI Unit, Mediterraneo Hospital, 16675 Athens, Greece; (P.A.); (D.A.); (S.V.)
| | - Dimitrios Apostolou
- MRI Unit, Mediterraneo Hospital, 16675 Athens, Greece; (P.A.); (D.A.); (S.V.)
| | - Stella Velitsista
- MRI Unit, Mediterraneo Hospital, 16675 Athens, Greece; (P.A.); (D.A.); (S.V.)
| | - Vasiliki Vartela
- Onassis Cardiac Surgery Center, 17674 Athens, Greece; (G.M.-M.); (V.V.); (D.M.); (G.K.)
| | - Dionysia Manolopoulou
- Onassis Cardiac Surgery Center, 17674 Athens, Greece; (G.M.-M.); (V.V.); (D.M.); (G.K.)
| | - Maria G. Tektonidou
- First Department of Propaedeutic and Internal Medicine, Laikon Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.G.T.); (P.P.S.)
| | - Genovefa Kolovou
- Onassis Cardiac Surgery Center, 17674 Athens, Greece; (G.M.-M.); (V.V.); (D.M.); (G.K.)
| | - George D. Kitas
- Arthritis Research UK Epidemiology Unit, Manchester University, Manchester M13 9PT, UK;
| | - Petros P. Sfikakis
- First Department of Propaedeutic and Internal Medicine, Laikon Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.G.T.); (P.P.S.)
| | - Sophie I. Mavrogeni
- Onassis Cardiac Surgery Center, 17674 Athens, Greece; (G.M.-M.); (V.V.); (D.M.); (G.K.)
- Correspondence: ; Tel./Fax: +30-210-98-82-797
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28
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Gong X, Shan W, Yuan K, Lu Z, Zhang M, Lu J, Zhang X, Huang X, Guo H, Peng M, Liu X, Zhao X, Xu G. Dietary Inflammatory Index and Leukoaraiosis in Patients with Ischemic Stroke. J Nutr Health Aging 2020; 24:473-477. [PMID: 32346684 DOI: 10.1007/s12603-020-1351-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Diet may change the chronic levels of systemic inflammation, which in turn influence the development of leukoaraiosis (LA). This study aimed to examine the association between dietary inflammatory index (DII) and LA in patients with ischemic stroke. METHODS Patients with first-ever ischemic stroke were enrolled from two centers. A semi-quantitative food frequency questionnaire (FFQ) was used to evaluate diet contents. The DII score of each patient was calculated based on the reported diet contents. Presence and degree of LA were evaluated with a magnetic resonance imaging (MRI) scan. LA was graded according to Fazekas scale. RESULTS Of the 497 enrolled patients, 337 (67.8%) were detected with LA. Patients with LA had a higher DII score (0.23 vs -0.88, P < 0.001). Logistic regression analysis detected that patients with highest quartile of DII score had an OR of 3.61 (95% CI: 2.05-6.36, P < 0.001) for LA compared with those with lowest quartile of DII. After adjusting for major confounders, the highest DII quartile remained as an independent predictor for LA (OR = 2.66, 95% CI: 1.41-5.00, P = 0.008). CONCLUSIONS A pro-inflammatory diet pattern, as indicated by higher DII values, appears to be associated with a higher risk of LA. This result suggested that dietary-mediated inflammation may involved in the pathogenesis of LA, which warrant further study.
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Affiliation(s)
- X Gong
- Gelin Xu, Department of Neurology, Jinling Hospital, First School of Clinical Medicine, Southern Medical University, 305 East Zhongshan Road, Nanjing, 210002, Jiangsu Province, China. Tel: (+) 86- 18951919349; E-Mail: ; Xiongfei Zhao, Department of Neurology, Cardiovascular and Cerebrovascular Disease Hospital of Meishan, Meishan 620000, Sichuan, China. Tel: (+) 86-13609147368;
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29
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Noz MP, Ter Telgte A, Wiegertjes K, Joosten LAB, Netea MG, de Leeuw FE, Riksen NP. Trained Immunity Characteristics Are Associated With Progressive Cerebral Small Vessel Disease. Stroke 2019; 49:2910-2917. [PMID: 30571420 DOI: 10.1161/strokeaha.118.023192] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Background and Purpose- Cerebral small vessel disease (cSVD) is the major vascular cause of cognitive decline and dementia. The pathogenesis of cSVD remains largely unknown, although several studies suggest a role for systemic inflammation. In certain pathophysiological situations, monocytes can reprogram toward a long-term proinflammatory phenotype, which has been termed trained immunity. We hypothesize that trained immunity contributes to the progression of cSVD. Methods- Individuals with mild-to-severe cSVD participated in the study. Severity of cSVD was determined by the white matter hyperintensities (WMH) volume (mL) on magnetic resonance imaging in 2006, 2015, and the progression between 2006 and 2015 (ΔWMH). Cytokine production was assessed after ex vivo stimulation of peripheral blood mononuclear cells and monocytes. Additionally, monocyte subsets were identified by flow cytometry. Results- Fifty-one subjects (70±6 years, 60% men, 5.1±6.4 mL ΔWMH) were included. Circulating hsIL (high-sensitivity interleukin)-6 correlated with cSVD ( P=0.005, rs=0.40). Cytokine production capacity by monocytes was associated with cSVD progression. Basal IL-8 and IL-17 production ( P=0.08, rs=0.25; P=0.03, rs=0.30) and IL-6 production after Pam3Cys stimulation in monocytes was associated with cSVD (n=35: P=0.008, rs=0.44). Conversely, interferon (IFN)-γ production in Candida albicans stimulated peripheral blood mononuclear cells was negatively correlated with cSVD ( P=0.009, rs=-0.36). Flow cytometry revealed a correlation of the intermediate monocyte subset with cSVD ( P=0.01, rs=0.36). Conclusions- Severity and progression of cSVD are not only correlated with systemic inflammation (hsIL-6) but also with trained immunity characteristics of circulating monocytes, in terms of an altered cytokine production capacity and a shift toward the proinflammatory intermediate monocyte subset.
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Affiliation(s)
- Marlies P Noz
- From the Department of Internal Medicine, Radboud University Medical Center Behaviour, (M.P.N., L.A.B.J., M.G.N., N.P.R.), Nijmegen, the Netherlands
| | - Annemieke Ter Telgte
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour (A.t.T., K.W., F.-E.d.L.), Nijmegen, the Netherlands
| | - Kim Wiegertjes
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour (A.t.T., K.W., F.-E.d.L.), Nijmegen, the Netherlands
| | - Leo A B Joosten
- From the Department of Internal Medicine, Radboud University Medical Center Behaviour, (M.P.N., L.A.B.J., M.G.N., N.P.R.), Nijmegen, the Netherlands
| | - Mihai G Netea
- From the Department of Internal Medicine, Radboud University Medical Center Behaviour, (M.P.N., L.A.B.J., M.G.N., N.P.R.), Nijmegen, the Netherlands.,Department for Genomics and Immunoregulation, Life and Medical Sciences Institute (LIMES), University of Bonn, Germany (M.G.N.)
| | - Frank-Erik de Leeuw
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour (A.t.T., K.W., F.-E.d.L.), Nijmegen, the Netherlands
| | - Niels P Riksen
- From the Department of Internal Medicine, Radboud University Medical Center Behaviour, (M.P.N., L.A.B.J., M.G.N., N.P.R.), Nijmegen, the Netherlands
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30
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Silbert LC, Lahna D, Promjunyakul NO, Boespflug E, Ohya Y, Higashiuesato Y, Nishihira J, Katsumata Y, Tokashiki T, Dodge HH. Risk Factors Associated with Cortical Thickness and White Matter Hyperintensities in Dementia Free Okinawan Elderly. J Alzheimers Dis 2019; 63:365-372. [PMID: 29578488 PMCID: PMC5900560 DOI: 10.3233/jad-171153] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Cortical gray matter (GM) and white matter (WM) deterioration are signals of neurodegeneration and increased dementia risk; however, their specific etiologies in dementia-free aging is unclear. Objective: The objective of this study was to examine potentially modifiable risk factors of GM and WM degeneration in a well-characterized cohort of dementia-free elderly. Methods: 96 Okinawan elderly participants (age 83.6) from the Keys to Optimal Cognitive Aging Project (KOCOA) underwent MRI and cognitive evaluation. Serum markers of inflammation (interleukin-6 (IL-6), high sensitivity C-reactive protein), cerebrovascular disease (systolic blood pressure (SBP) 140+, hemoglobin A1C (HgbA1C), total cholesterol), and essential minerals (copper (Cu), magnesium, and calcium) were examined in relation to mean cortical thickness (MCT) and white matter hyperintensities (WMH), adjusting for age and gender. Voxel-based morphometry (VBM) analyses identified relationships between regional GM density and the above markers. Results: Decreased MCT was associated with SBP 140 + (p = 0.029) and increased serum IL-6 (p = 0.036), HgbA1C (p = 0.002), and Cu (p = 0.025). In VBM analyses, increased IL-6, HgbA1C, and Cu were associated with decreased GM density in temporal lobe regions. HgbA1C (p = 0.004) was associated with greater WMH volume. Conclusions: Peripheral markers of Cu, CVD risk, and inflammation are associated with MRI-markers of decreased brain health in dementia-free Okinawan elderly, with regional cortical thinning in areas involved in early accumulation of Alzheimer’s disease pathology. Results identify potentially modifiable biomarkers as targets in the prevention of dementia in older individuals.
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Affiliation(s)
- Lisa C Silbert
- Department of Neurology, NIA-Layton Aging and Alzheimer's Disease Center, Oregon Health & Science University, Portland, OR, USA.,Portland Veterans Affairs Health Care System, Portland, OR, USA
| | - David Lahna
- Department of Neurology, NIA-Layton Aging and Alzheimer's Disease Center, Oregon Health & Science University, Portland, OR, USA
| | - Nutta-On Promjunyakul
- Department of Neurology, NIA-Layton Aging and Alzheimer's Disease Center, Oregon Health & Science University, Portland, OR, USA
| | - Erin Boespflug
- Department of Neurology, NIA-Layton Aging and Alzheimer's Disease Center, Oregon Health & Science University, Portland, OR, USA
| | - Yusuke Ohya
- Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus, Okinawa, Japan
| | | | - Junko Nishihira
- Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus, Okinawa, Japan
| | - Yuriko Katsumata
- Department of Biostatistics, University of Kentucky, Lexington, KY, USA
| | - Takashi Tokashiki
- Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus, Okinawa, Japan
| | - Hiroko H Dodge
- Department of Neurology, NIA-Layton Aging and Alzheimer's Disease Center, Oregon Health & Science University, Portland, OR, USA.,Department of Neurology, Michigan Alzheimer's Disease Center, University of Michigan, Ann Arbor, MI, USA
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31
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Low A, Mak E, Rowe JB, Markus HS, O'Brien JT. Inflammation and cerebral small vessel disease: A systematic review. Ageing Res Rev 2019; 53:100916. [PMID: 31181331 DOI: 10.1016/j.arr.2019.100916] [Citation(s) in RCA: 195] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 05/23/2019] [Accepted: 06/05/2019] [Indexed: 12/13/2022]
Abstract
Inflammation is increasingly implicated as a risk factor for dementia, stroke, and small vessel disease (SVD). However, the underlying mechanisms and causative pathways remain unclear. We systematically reviewed the existing literature on the associations between markers of inflammation and SVD (i.e., white matter hyperintensities (WMH), lacunes, enlarged perivascular spaces (EPVS), cerebral microbleeds (CMB)) in cohorts of older people with good health, cerebrovascular disease, or cognitive impairment. Based on distinctions made in the literature, markers of inflammation were classified as systemic inflammation (e.g. C-reactive protein, interleukin-6, fibrinogen) or vascular inflammation/endothelial dysfunction (e.g. homocysteine, von Willebrand factor, Lp-PLA2). Evidence from 82 articles revealed relatively robust associations between SVD and markers of vascular inflammation, especially amongst stroke patients, suggesting that alterations to the endothelium and blood-brain barrier may be a driving force behind SVD. Conversely, cross-sectional findings on systemic inflammation were mixed, although longitudinal investigations demonstrated that elevated levels of systemic inflammatory markers at baseline predicted subsequent SVD severity and progression. Importantly, regional analysis revealed that systemic and vascular inflammation were differentially related to two distinct forms of SVD. Specifically, markers of vascular inflammation tended to be associated with SVD in areas typical of hypertensive arteriopathy (e.g., basal ganglia), while systemic inflammation appeared to be involved in CAA-related vascular damage (e.g., centrum semiovale). Nonetheless, there is insufficient data to establish whether inflammation is causal of, or secondary to, SVD. Findings have important implications on interventions, suggesting the potential utility of treatments targeting the brain endothelium and blood brain barrier to combat SVD and associated neurodegenerative diseases.
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Affiliation(s)
- Audrey Low
- Department of Psychiatry, University of Cambridge, United Kingdom
| | - Elijah Mak
- Department of Psychiatry, University of Cambridge, United Kingdom
| | - James B Rowe
- Department of Clinical Neurosciences, University of Cambridge, United Kingdom
| | - Hugh S Markus
- Department of Clinical Neurosciences, University of Cambridge, United Kingdom
| | - John T O'Brien
- Department of Psychiatry, University of Cambridge, United Kingdom.
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32
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Graham LC, Grabowska WA, Chun Y, Risacher SL, Philip VM, Saykin AJ, Sukoff Rizzo SJ, Howell GR. Exercise prevents obesity-induced cognitive decline and white matter damage in mice. Neurobiol Aging 2019; 80:154-172. [PMID: 31170535 PMCID: PMC7846054 DOI: 10.1016/j.neurobiolaging.2019.03.018] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 03/26/2019] [Accepted: 03/27/2019] [Indexed: 01/12/2023]
Abstract
Obesity in the western world has reached epidemic proportions, and yet the long-term effects on brain health are not well understood. To address this, we performed transcriptional profiling of brain regions from a mouse model of western diet (WD)-induced obesity. Both the cortex and hippocampus from C57BL/6J (B6) mice fed either a WD or a control diet from 2 months of age to 12 months of age (equivalent to midlife in a human population) were profiled. Gene set enrichment analyses predicted that genes involved in myelin generation, inflammation, and cerebrovascular health were differentially expressed in brains from WD-fed compared to control diet-fed mice. White matter damage and cerebrovascular decline were evident in brains from WD-fed mice using immunofluorescence and electron microscopy. At the cellular level, the WD caused an increase in the numbers of oligodendrocytes and myeloid cells suggesting that a WD is perturbing myelin turnover. Encouragingly, cerebrovascular damage and white matter damage were prevented by exercising WD-fed mice despite mice still gaining a significant amount of weight. Collectively, these data show that chronic consumption of a WD in B6 mice causes obesity, neuroinflammation, and cerebrovascular and white matter damage, but these potentially damaging effects can be prevented by modifiable risk factors such as exercise.
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Affiliation(s)
- Leah C Graham
- The Jackson Laboratory, Bar Harbor, ME, USA; Sackler School of Graduate Biomedical Sciences, Tufts University School of Medicine, Boston, MA, USA
| | - Weronika A Grabowska
- The Jackson Laboratory, Bar Harbor, ME, USA; College of the Atlantic, Bar Harbor, ME, USA
| | - Yoona Chun
- The Jackson Laboratory, Bar Harbor, ME, USA
| | - Shannon L Risacher
- Center for Neuroimaging, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA; Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA
| | | | - Andrew J Saykin
- Center for Neuroimaging, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA; Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA
| | | | - Gareth R Howell
- The Jackson Laboratory, Bar Harbor, ME, USA; Sackler School of Graduate Biomedical Sciences, Tufts University School of Medicine, Boston, MA, USA.
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33
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Huang WQ, Ye HM, Cai LL, Ma QL, Lu CX, Tong SJ, Tzeng CM, Lin Q. The Associations of PMF1, ICAM1, AGT, TRIM65, FBF1, and ACOX1 Variants With Leukoaraiosis in Chinese Population. Front Genet 2019; 10:615. [PMID: 31396257 PMCID: PMC6664056 DOI: 10.3389/fgene.2019.00615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 06/13/2019] [Indexed: 12/13/2022] Open
Abstract
Background: Leukoaraiosis (LA) is shown as white matter hyperintensities on T2-weighted magnetic resonance imaging brain scans. Together with candidate gene association studies (CGAS), multiple genome-wide association studies (GWAS) have reported large numbers of single nucleotide polymorphisms (SNPs) to be associated with LA in European populations. To date, no replication studies have been reported in independent Chinese samples. Methods: Here, we performed a candidate gene association study comprising 220 Chinese subjects with LA and 50 controls. Thirty-nine polymorphisms on 32 risk genes were selected from previous studies, and they were genotyped through matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). Genetic association analysis was firstly performed in all subjects with LA. Then, the same analysis was conducted in the six random sampling cohorts of 50 LA patients, respectively. Data analyses on the associations of SNPs with LA risk were evaluated through Pearson’s χ2 and multivariate logistic regression tests. Results: We found that eight polymorphisms in six genes (PMF1, ICAM1, TRIM65, AGT, FBF1, and ACOX1) were significantly associated with LA in the genetic association tests. Except for those eight gene variants, 24 other polymorphisms were not found to be significantly associated with LA in general genetic model, dominant model, recessive model, or multiplicative model. Among those eight polymorphisms, rs2984613 in PMF1 showed significant association with LA in the cohort of 220 LA subjects, and such significant association remained in both general genetic model (OR: 0.262, 95% CI: 0.091–0.752, padj = 0.030) and recessive model (OR: 0.323, 95% CI: 0.119–0.881, padj = 0.038) when controlling for clinical variables. Seven other significant variants (rs5498 in ICAM1, rs699 in AGT, rs2305913 in FBF1, rs1135640 in ACOX1, and rs3760128, rs7214628, and rs7222757 in TRIM65) were identified in those six random sampling tests that were conducted in the adjusted cohorts of 50 LA patients. In addition, except for rs699 which showed detrimental effect and represented a risk variant for LA, seven other polymorphisms seemed to exert protective effects on LA and to reduce the risk of LA. It is necessary to confirm these associations in an independent cohort. Conclusions: This first replication study on multiple genes in an independent Chinese population did not replicate any risk polymorphisms for LA other than rs 699 in AGT but revealed the significantly negative associations of PMF1, ICAM1, TRIM65, FBF1, and ACOX1 polymorphisms with LA. It not only supported the strong ethnic differences in the genetics of LA but also indicated that those six identified genes may be involved in Chinese white matter lesions. Larger scales of CGAS and GWAS are necessary to confirm and decipher those ethnic-Han specific risk genes for LA in China.
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Affiliation(s)
- Wen-Qing Huang
- Translational Medicine Research Center (TMRC), School of Pharmaceutical Sciences, Xiamen University, Xiamen, China.,Shanghai Institute of Precision Medicine, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hui-Ming Ye
- Department of Clinical Laboratory, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China
| | - Liang-Liang Cai
- Translational Medicine Research Center (TMRC), School of Pharmaceutical Sciences, Xiamen University, Xiamen, China
| | - Qi-Lin Ma
- Department of Neurology and Center for Brain Research, The First Affiliated Hospital of Xiamen University, Xiamen, China.,School of Medicine, Xiamen University, Xiamen, China
| | - Cong-Xia Lu
- Department of Neurology and Center for Brain Research, The First Affiliated Hospital of Xiamen University, Xiamen, China.,School of Medicine, Xiamen University, Xiamen, China
| | - Sui-Jun Tong
- Department of Neurology and Center for Brain Research, The First Affiliated Hospital of Xiamen University, Xiamen, China.,School of Medicine, Xiamen University, Xiamen, China
| | - Chi-Meng Tzeng
- Translational Medicine Research Center (TMRC), School of Pharmaceutical Sciences, Xiamen University, Xiamen, China.,College of Pharmaceutical Sciences, Nanjing Tech University, Nanjing, China
| | - Qing Lin
- Department of Neurology and Center for Brain Research, The First Affiliated Hospital of Xiamen University, Xiamen, China.,School of Medicine, Xiamen University, Xiamen, China.,Department of Neurology, The First Clinical Medical College and Graduate School of Fujian Medical University, Fuzhou, China
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34
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Macroangiopathy is a positive predictive factor for response to immunotherapy. Sci Rep 2019; 9:9728. [PMID: 31278360 PMCID: PMC6611819 DOI: 10.1038/s41598-019-46189-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 06/18/2019] [Indexed: 01/01/2023] Open
Abstract
Immunotherapies demand for predictive biomarkers to avoid unnecessary adverse effects and costs. Analytic morphomics is the technique to use body composition measures as imaging biomarkers for underlying pathophysiology to predict prognosis or outcome to therapy. We investigated different body composition measures to predict response to immunotherapy. This IRB approved retrospective analysis encompassed 147 patients with ipilimumab therapy. Degree of macroangiopathy was quantified with the newly defined total plaque index (TPI), i.e. the body height corrected sum of the soft and hard plaque volume of the infrarenal aorta on portalvenous CT scans. Furthermore, mean psoas density (MPD), different adipose tissue parameters as well as degree of cerebral microangiopathy were extracted from the imaging data. Subsequent multivariate Cox regression analysis encompassed TPI, MPD, serum LDH, S100B, age, gender, number of immunotherapy cycles as well as extent of distant metastases. TPI and MPD correlated positively with PFS in multivariate analysis (p = 0.03 and p = 0.001, respectively). Furthermore, single visceral organ and/or soft tissue involvement significantly decreased progression risk (p = 0.01), whereas increased S100B level showed a trend towards PFS shortening (p = 0.05). In conclusion, degree of macroangiopathy and sarcopenia were independent predictors for outcome to immunotherapy and of equivalent significance compared to other clinical biomarkers.
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35
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Brown RB, Traylor M, Burgess S, Sawcer S, Markus HS. Do Cerebral Small Vessel Disease and Multiple Sclerosis Share Common Mechanisms of White Matter Injury? Stroke 2019; 50:1968-1972. [PMID: 31221055 PMCID: PMC6661245 DOI: 10.1161/strokeaha.118.023649] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Supplemental Digital Content is available in the text. Background and Purpose— The role of inflammation in ischemic white matter disease is increasingly recognized, and further understanding of the pathophysiology might inform future treatment strategies. Multiple sclerosis (MS) is a chronic autoimmune condition in which inflammation plays a central role that also affects the white matter. We hypothesized that white matter injury might share common mechanisms and used statistical genetics techniques to assess whether having genetically elevated white matter hyperintensity (WMH) volume was associated with increased MS risk. Methods— We investigated the genetic association in 2 cohorts with magnetic resonance imaging-quantified ischemic white matter lesion volume (WMH in stroke; n=2797 and UK Biobank; n=8353) and 14 802 cases of MS and 26 703 controls from the International Multiple Sclerosis Genetics Consortium. We further performed individual-level polygenic risk score calculations for MS and measures of structural white matter disease in UK Biobank. Finally, we looked for evidence of overlapping risk across the whole genome. Results— There was no association of genetic variants influencing MS with WMH volume using summary statistics in the WMH in stroke cohort (relative risk score =1.014; 95% CI, 0.936–1.110) or in the UK Biobank cohort (relative risk score =1.030; 95% CI, 0.932–1.117). Conversely, assessing the contribution of single nucleotide polymorphisms significantly associated with WMH on the risk of MS there was no significant association (relative risk score =0.930; 95% CI, 0.736–1.191). There were no significant associations between polygenic risk scores calculations; these results were robust to the selection of single nucleotide polymorphisms at a range of significance thresholds. Whole genome analysis did not reveal any overlap of risk between the traits. Conclusions— Our results do not provide evidence to suggest a shared mechanism of white matter damage in ischemia and MS. We propose that inflammation acts in distinct pathways because of the differing nature of the primary insult.
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Affiliation(s)
- Robin B Brown
- From the Department of Clinical Neurosciences (R.B.B., M.T., S.S., H.S.M.), University of Cambridge, United Kingdom
| | - Matthew Traylor
- From the Department of Clinical Neurosciences (R.B.B., M.T., S.S., H.S.M.), University of Cambridge, United Kingdom
| | - Stephen Burgess
- Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care (S.B.), University of Cambridge, United Kingdom.,MRC Biostatistics Unit, Cambridge Institute of Public Health, United Kingdom (S.B.)
| | - Stephen Sawcer
- From the Department of Clinical Neurosciences (R.B.B., M.T., S.S., H.S.M.), University of Cambridge, United Kingdom
| | - Hugh S Markus
- From the Department of Clinical Neurosciences (R.B.B., M.T., S.S., H.S.M.), University of Cambridge, United Kingdom
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36
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Carmichael O, Newton R. Brain MRI findings related to Alzheimer's disease in older African American adults. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2019; 165:3-23. [PMID: 31481168 DOI: 10.1016/bs.pmbts.2019.04.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Although a substantial body of research has identified brain MRI measures as important markers of Alzheimer's disease (AD) risk, progression, and treatment response, most of that research has been performed in non-Hispanic white American populations, leading to questions about the utility of the brain MRI measures among individuals of other races or ethnicities. African American individuals in particular are under-represented in AD research, and may exhibit differences in prevalence of AD risk factors, prevalence of AD, incidence of AD, the clinical course of cognitive decline, and AD neuropathology, each of which could influence the utility of brain MRI markers. Unfortunately, while current evidence suggests that African Americans exhibit poorer brain health late in life based on brain MRI measurements, several other aspects of brain MRI markers in this population are unclear, including trajectories of brain MRI markers leading up to old age, relationships between traditional brain health risk factors and brain MRI findings, and the status of brain MRI markers as correlates of cognitive impairment. This unclear state of affairs highlights the urgency of future research in which large numbers of older African American adults contribute longitudinal brain MRI measurements concurrent with clinical, cognitive, and molecular biomarker measurements, ideally in the context of AD preventive or therapeutic trials.
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Affiliation(s)
- Owen Carmichael
- Pennington Biomedical Research Center, Baton Rouge, LA, United States.
| | - Robert Newton
- Pennington Biomedical Research Center, Baton Rouge, LA, United States
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37
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Warren KN, Beason-Held LL, Carlson O, Egan JM, An Y, Doshi J, Davatzikos C, Ferrucci L, Resnick SM. Elevated Markers of Inflammation Are Associated With Longitudinal Changes in Brain Function in Older Adults. J Gerontol A Biol Sci Med Sci 2019; 73:770-778. [PMID: 29304217 DOI: 10.1093/gerona/glx199] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Indexed: 11/14/2022] Open
Abstract
Background Chronic inflammation has been linked to memory and other cognitive impairments, as well as Alzheimer's disease. Here, we investigate the association between inflammatory markers and changes in brain activity measured by regional cerebral blood flow (rCBF) to assess the relationship between inflammation and brain function in older individuals. Methods Annual 15O water resting-state positron emission tomography (PET) scans collected over a 5-year period were assessed in 138 cognitively normal older participants (77 males; mean age at baseline = 71.3; mean scans per participant = 3.5) in the Baltimore Longitudinal Study of Aging. Voxel-wise linear mixed models were used to investigate associations between rCBF and C-reactive protein (CRP) and interleukin-6 (IL-6) at the time of scanning. We examined relationships between baseline CRP and IL-6 levels and baseline rCBF, and relationships between baseline and mean inflammatory levels over time and longitudinal rCBF changes. Results Higher baseline CRP and IL-6 were each associated with lower baseline rCBF primarily in frontal and occipital regions, with only the lingual gyrus surviving atrophy correction. Higher baseline and mean CRP were also associated with greater rCBF declines over time in anterior cingulate and hippocampal regions, whereas higher baseline and mean IL-6 levels were associated with greater rCBF declines in orbitofrontal and hippocampal regions. Conclusions Higher levels of inflammation are associated with longitudinal changes in brain function in regions important for cognition. These results, along with previous studies, suggest that chronic inflammation in older adults may contribute to age-associated declines in cognitive function.
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Affiliation(s)
- Kristen N Warren
- Intramural Research Program, National Institute on Aging, NIH, Baltimore, Maryland
| | - Lori L Beason-Held
- Intramural Research Program, National Institute on Aging, NIH, Baltimore, Maryland
| | - Olga Carlson
- Intramural Research Program, National Institute on Aging, NIH, Baltimore, Maryland
| | - Josephine M Egan
- Intramural Research Program, National Institute on Aging, NIH, Baltimore, Maryland
| | - Yang An
- Intramural Research Program, National Institute on Aging, NIH, Baltimore, Maryland
| | - Jimit Doshi
- Department of Radiology, University of Pennsylvania, Philadelphia
| | | | - Luigi Ferrucci
- Intramural Research Program, National Institute on Aging, NIH, Baltimore, Maryland
| | - Susan M Resnick
- Intramural Research Program, National Institute on Aging, NIH, Baltimore, Maryland
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38
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Li D, Misialek JR, Jack CR, Mielke MM, Knopman D, Gottesman R, Mosley T, Alonso A. Plasma Metabolites Associated with Brain MRI Measures of Neurodegeneration in Older Adults in the Atherosclerosis Risk in Communities⁻Neurocognitive Study (ARIC-NCS). Int J Mol Sci 2019; 20:ijms20071744. [PMID: 30970556 PMCID: PMC6479561 DOI: 10.3390/ijms20071744] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 03/28/2019] [Accepted: 04/01/2019] [Indexed: 12/30/2022] Open
Abstract
Background: Plasma metabolites are associated with cognitive and physical function in the elderly. Because cerebral small vessel disease (SVD) and neurodegeneration are common causes of cognitive and physical function decline, the primary objective of this study was to investigate the associations of six plasma metabolites (two plasma phosphatidylcholines [PCs]: PC aa C36:5 and PC aa 36:6 and four sphingomyelins [SMs]: SM C26:0, SM [OH] C22:1, SM [OH] C22:2, SM [OH] C24:1) with magnetic resonance imaging (MRI) features of cerebral SVD and neurodegeneration in older adults. Methods: This study included 238 older adults in the Atherosclerosis Risk in Communities study at the fifth exam. Multiple linear regression was used to assess the association of each metabolite (log-transformed) in separate models with MRI measures except lacunar infarcts, for which binary logistic regression was used. Results: Higher concentrations of plasma PC aa C36:5 had adverse associations with MRI features of cerebral SVD (odds ratio of 1.69 [95% confidence interval: 1.01, 2.83] with lacunar infarct, and beta of 0.16 log [cm3] [0.02, 0.30] with log [White Matter Hyperintensities (WMH) volume]) while higher concentrations of 3 plasma SM (OH)s were associated with higher total brain volume (beta of 12.0 cm3 [5.5, 18.6], 11.8 cm3 [5.0, 18.6], and 7.3 cm3 [1.2, 13.5] for SM [OH] C22:1, SM [OH] C22:2, and SM [OH] C24:1, respectively). Conclusions: This study identified associations between certain plasma metabolites and brain MRI measures of SVD and neurodegeneration in older adults, particularly higher SM (OH) concentrations with higher total brain volume.
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Affiliation(s)
- Danni Li
- Department of Lab Medicine and Pathology, University of Minnesota, 420 Delaware Street SE, MMC 609, Minneapolis, MN 55455, USA.
| | - Jeffrey R Misialek
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA.
| | - Clifford R Jack
- Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
| | - Michelle M Mielke
- Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MN 55906, USA.
- Department of Neurology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
| | - David Knopman
- Department of Neurology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
| | - Rebecca Gottesman
- Department of Neurology, Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA.
| | - Tom Mosley
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA.
| | - Alvaro Alonso
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
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Huang W, Lv T, Li H, Du S, Yang C, Yuan S. [Correlation of apolipoprotein AI, apolipoprotein B and their ratio with the severity of cerebral white matter lesions]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2019; 38:992-996. [PMID: 30187870 DOI: 10.3969/j.issn.1673-4254.2018.08.15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To investigate the correlation of apolipoprotein AI (ApoAI), ApoB, ApoB/ApoAI and the severity of brain white matter lesions (WML). METHODS A total of 648 patients with WML confirmed by brain magnetic resonance imaging (MRI) were divided into mild WML group (n=386) and moderate to severe WML group (n=262) according to evaluations with the Fazekas scale. The demographic data, blood biochemical parameters and the levels of ApoAI, ApoB and ApoB/AI ratio were compared between the two groups to identify the risk factors of moderate to severe WML. RESULTS Univariate analysis showed that age, gender, hypertension, diabetes, coronary heart disease, previous stroke, homocysteine, HDL-C, ApoAI, and ApoB/AI ratio all differed significantly between the two groups (P < 0.05), but ApoB levels were similar between them (P > 0.05). Multivariate logistic regression analysis revealed that with ApoAI and ApoB/AI ratio as the continuous variables, after adjustment for the compounding factors, ApoB/AI ratio was an independent risk factor (OR=11.456, 95% CI: 3.622-36.229, P < 0.001) and ApoAI was an independent protective factor for moderate to severe WML (OR=0.068, 95% CI: 0.018-0.262, P < 0.001). With the upper quartiles of ApoAI level (1.38 g/L) and ApoB/AI ratio (0.58) as their respective cutoff values, patients with a high ApoAI level and a low ApoB/AI ratio were found to have the lowest incidence of moderate to severe WML (P < 0.001). CONCLUSIONS An increased ApoB/AI ratio is an independent risk factor and an increased ApoAI level is an independent protective factor for moderate to severe WML.
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Affiliation(s)
- Weihua Huang
- Department of Neurology, Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China
| | - Tianming Lv
- Department of Neurology, Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China
| | - Huanmin Li
- Department of Neurology, Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China
| | - Shuhua Du
- Department of Neurology, Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China
| | - Canhong Yang
- Department of Neurology, Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China
| | - Shiqi Yuan
- Department of Neurology, Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China
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Bettcher BM, Neuhaus J, Wynn MJ, Elahi FM, Casaletto KB, Saloner R, Fitch R, Karydas A, Kramer JH. Increases in a Pro-inflammatory Chemokine, MCP-1, Are Related to Decreases in Memory Over Time. Front Aging Neurosci 2019; 11:25. [PMID: 30814948 PMCID: PMC6381047 DOI: 10.3389/fnagi.2019.00025] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 01/29/2019] [Indexed: 12/28/2022] Open
Abstract
Objective: To determine the longitudinal relationship between monocyte chemotactic protein 1 (MCP-1)/CCL2 and memory function in older adults. Methods: We examined longitudinal plasma MCP-1/CCL2 levels and a longitudinal verbal memory measure (CVLT-II 20' recall) in a sample of 399 asymptomatic older adults (mean age = 72.1). Total visits ranged from 1 to 8, with an average time of 2.1 years between each visit, yielding 932 total observations. In order to isolate change over time, we decomposed MCP-1/CCL2 into subject-specific means and longitudinal deviations from the mean. The decomposed MCP-1/CCL2 variables were entered as predictors in linear mixed effects models, with age at baseline, sex, and education entered as covariates and recall as the longitudinal outcome. In follow-up analyses, we controlled for global cognition and APOE genotype, as well as baseline vascular risk factors. We also examined the specificity of findings by examining the longitudinal association between the MCP-1/CCL2 variables and non-memory cognitive tests. Results: Within-subject increases in MCP-1/CCL2 levels were associated with decreases in delayed recall (t = -2.65; p = 0.01) over time. Results were independent of global cognitive function and APOE status (t = -2.30, p = 0.02), and effects remained when controlling for baseline vascular risk factors (t = -1.92, p = 0.05). No associations were noted between within-subject increases in MCP-1/CCL2 levels and other cognitive domains. Conclusions: In an asymptomatic aging adult cohort, longitudinal increases in MCP-1/CCL2 levels were associated with longitudinal decline in memory. Results suggest that "healthy aging" is typified by early remodeling of the immune system, and that the chemokine, MCP-1/CCL2, may be associated with negative memory outcomes.
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Affiliation(s)
- Brianne M Bettcher
- Rocky Mountain Alzheimer's Disease Center, Departments of Neurosurgery and Neurology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - John Neuhaus
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States
| | - Matthew J Wynn
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, United States
| | - Fanny M Elahi
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Kaitlin B Casaletto
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Rowan Saloner
- Department of Psychiatry, San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, United States
- HIV Neurobehavioral Research Program, Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
| | - Ryan Fitch
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Anna Karydas
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Joel H Kramer
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
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Chauhan G, Adams HHH, Satizabal CL, Bis JC, Teumer A, Sargurupremraj M, Hofer E, Trompet S, Hilal S, Smith AV, Jian X, Malik R, Traylor M, Pulit SL, Amouyel P, Mazoyer B, Zhu YC, Kaffashian S, Schilling S, Beecham GW, Montine TJ, Schellenberg GD, Kjartansson O, Guðnason V, Knopman DS, Griswold ME, Windham BG, Gottesman RF, Mosley TH, Schmidt R, Saba Y, Schmidt H, Takeuchi F, Yamaguchi S, Nabika T, Kato N, Rajan KB, Aggarwal NT, De Jager PL, Evans DA, Psaty BM, Rotter JI, Rice K, Lopez OL, Liao J, Chen C, Cheng CY, Wong TY, Ikram MK, van der Lee SJ, Amin N, Chouraki V, DeStefano AL, Aparicio HJ, Romero JR, Maillard P, DeCarli C, Wardlaw JM, Hernández MDCV, Luciano M, Liewald D, Deary IJ, Starr JM, Bastin ME, Muñoz Maniega S, Slagboom PE, Beekman M, Deelen J, Uh HW, Lemmens R, Brodaty H, Wright MJ, Ames D, Boncoraglio GB, Hopewell JC, Beecham AH, Blanton SH, Wright CB, Sacco RL, Wen W, Thalamuthu A, Armstrong NJ, Chong E, Schofield PR, Kwok JB, van der Grond J, Stott DJ, Ford I, Jukema JW, Vernooij MW, Hofman A, Uitterlinden AG, van der Lugt A, Wittfeld K, Grabe HJ, Hosten N, von Sarnowski B, Völker U, Levi C, Jimenez-Conde J, Sharma P, Sudlow CLM, Rosand J, Woo D, Cole JW, Meschia JF, Slowik A, Thijs V, Lindgren A, Melander O, Grewal RP, Rundek T, Rexrode K, Rothwell PM, Arnett DK, Jern C, Johnson JA, Benavente OR, Wasssertheil-Smoller S, Lee JM, Wong Q, Mitchell BD, Rich SS, McArdle PF, Geerlings MI, van der Graaf Y, de Bakker PIW, Asselbergs FW, Srikanth V, Thomson R, McWhirter R, Moran C, Callisaya M, Phan T, Rutten-Jacobs LCA, Bevan S, Tzourio C, Mather KA, Sachdev PS, van Duijn CM, Worrall BB, Dichgans M, Kittner SJ, Markus HS, Ikram MA, Fornage M, Launer LJ, Seshadri S, Longstreth WT, Debette S. Genetic and lifestyle risk factors for MRI-defined brain infarcts in a population-based setting. Neurology 2019; 92:e486-e503. [PMID: 30651383 PMCID: PMC6369905 DOI: 10.1212/wnl.0000000000006851] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 10/01/2018] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To explore genetic and lifestyle risk factors of MRI-defined brain infarcts (BI) in large population-based cohorts. METHODS We performed meta-analyses of genome-wide association studies (GWAS) and examined associations of vascular risk factors and their genetic risk scores (GRS) with MRI-defined BI and a subset of BI, namely, small subcortical BI (SSBI), in 18 population-based cohorts (n = 20,949) from 5 ethnicities (3,726 with BI, 2,021 with SSBI). Top loci were followed up in 7 population-based cohorts (n = 6,862; 1,483 with BI, 630 with SBBI), and we tested associations with related phenotypes including ischemic stroke and pathologically defined BI. RESULTS The mean prevalence was 17.7% for BI and 10.5% for SSBI, steeply rising after age 65. Two loci showed genome-wide significant association with BI: FBN2, p = 1.77 × 10-8; and LINC00539/ZDHHC20, p = 5.82 × 10-9. Both have been associated with blood pressure (BP)-related phenotypes, but did not replicate in the smaller follow-up sample or show associations with related phenotypes. Age- and sex-adjusted associations with BI and SSBI were observed for BP traits (p value for BI, p [BI] = 9.38 × 10-25; p [SSBI] = 5.23 × 10-14 for hypertension), smoking (p [BI] = 4.4 × 10-10; p [SSBI] = 1.2 × 10-4), diabetes (p [BI] = 1.7 × 10-8; p [SSBI] = 2.8 × 10-3), previous cardiovascular disease (p [BI] = 1.0 × 10-18; p [SSBI] = 2.3 × 10-7), stroke (p [BI] = 3.9 × 10-69; p [SSBI] = 3.2 × 10-24), and MRI-defined white matter hyperintensity burden (p [BI] = 1.43 × 10-157; p [SSBI] = 3.16 × 10-106), but not with body mass index or cholesterol. GRS of BP traits were associated with BI and SSBI (p ≤ 0.0022), without indication of directional pleiotropy. CONCLUSION In this multiethnic GWAS meta-analysis, including over 20,000 population-based participants, we identified genetic risk loci for BI requiring validation once additional large datasets become available. High BP, including genetically determined, was the most significant modifiable, causal risk factor for BI.
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Fornage M, Beecham AH. The emerging genetic landscape of cerebral white matter hyperintensities. Neurology 2019; 92:355-356. [PMID: 30659142 DOI: 10.1212/wnl.0000000000006936] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Myriam Fornage
- From the Institute of Molecular Medicine and Human Genetics Center (M.F.), University of Texas Health Science Center at Houston; and John P. Hussman Institute for Human Genomics (A.H.B.), University of Miami, FL.
| | - Ashley H Beecham
- From the Institute of Molecular Medicine and Human Genetics Center (M.F.), University of Texas Health Science Center at Houston; and John P. Hussman Institute for Human Genomics (A.H.B.), University of Miami, FL
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Peng X, Zhao J, Liu J, Li S. Advances in biomarkers of cerebral small vessel disease. JOURNAL OF NEURORESTORATOLOGY 2019. [DOI: 10.26599/jnr.2019.9040021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Cerebral small vessel disease (CSVD) refers to a type of syndrome caused by lesions in perforating arteries, small veins, small arteries, or capillaries, resulting in clinical, imaging, or pathological alterations. The occurrence and development of CSVD are related to various cerebrovascular risk factors, such as metabolism and genetic factors. CSVD is diagnosed based on brain imaging biomarkers; however, biomarkers capable of predicting and diagnosing CSVD early in its progression have not been found. Exploring biomarkers closely related to disease progression is of great significance for early diagnosis, prognosis, prevention, and treatment of CSVD. This article examines the research progress of CSVD biomarkers, from inflammatory biomarkers, coagulation and fibrinolysis markers, biomarkers of endothelial dysfunction, biomarkers related to cerebrospinal fluid, and gene markers.
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Zahodne LB, Kraal AZ, Sharifian N, Zaheed AB, Sol K. Inflammatory mechanisms underlying the effects of everyday discrimination on age-related memory decline. Brain Behav Immun 2019; 75:149-154. [PMID: 30367930 PMCID: PMC6279484 DOI: 10.1016/j.bbi.2018.10.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 09/04/2018] [Accepted: 10/23/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND/OBJECTIVES Previous research suggests that everyday discrimination is associated with worse episodic memory and partially mediates Black-White disparities in memory aging. The biological mechanisms underlying the link between everyday discrimination and memory are unclear but may involve inflammatory processes. This study aimed to determine whether systemic inflammation, indexed by blood levels of C-reactive protein (CRP), mediates associations between everyday discrimination and episodic memory over 6 years. DESIGN A longitudinal mediation model quantified associations between baseline everyday discrimination, 4-year change in CRP, and 6-year change in episodic memory. SETTING The Health and Retirement Study (HRS). PARTICIPANTS 12,624 HRS participants aged 51 and older. MEASUREMENTS Everyday Discrimination Scale, high-sensitivity CRP assays of dried blood spots, composite scores of immediate and delayed recall of a word list. RESULTS Black participants reported greater everyday discrimination. Greater discrimination was associated with lower baseline memory and faster memory decline. Higher CRP at baseline partially mediated the negative association between discrimination and baseline memory, but CRP change did not mediate the association between discrimination and memory decline. CONCLUSION This U.S.-representative longitudinal study provides evidence for deleterious effects of discrimination on subsequent episodic memory. The fact that elevated CRP only partially explained the concurrent association between discrimination and memory highlights the need for more comprehensive investigations of biological mechanisms underlying the link between social stress and age-related memory decline in order to better characterize potential intervention targets to reduce racial inequalities in memory aging.
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Choi J, Choi SA, Kim SY, Kim H, Lim BC, Hwang H, Chae JH, Kim KJ, Oh S, Kim EY, Shin JS. Association Analysis of Interleukin-1β, Interleukin-6, and HMGB1 Variants with Postictal Serum Cytokine Levels in Children with Febrile Seizure and Generalized Epilepsy with Febrile Seizure Plus. J Clin Neurol 2019; 15:555-563. [PMID: 31591845 PMCID: PMC6785474 DOI: 10.3988/jcn.2019.15.4.555] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 08/21/2019] [Accepted: 08/22/2019] [Indexed: 12/12/2022] Open
Abstract
Background and Purpose Febrile seizure (FS) is a unique type of seizure that only occurs during childhood. Genelized epilepsy with febrile seizure plus (GEFS+) is a familial epilepsy syndrome associated with FS and afebrile seizure (AFS). Both seizure types are related to fever, but whether genetic susceptibility to inflammation is implicated in them is still unclear. To analyze the associations between postictal serum cytokine levels and genetic variants in the cytokine genes interleukin (IL)-1β, IL-6, and high mobility group box-1 (HMGB1) in FS and GEFS+. Methods Genotyping was performed in 208 subjects (57 patients with FS, 43 patients with GEFS+, and 108 controls) with the SNaPshot assay for IL-1β-31 (rs1143627), IL-1β-511 (rs16944), IL-6-572 (rs1800796), and HMGB1 3814 (rs2249825). Serum IL-1β, IL-6, and HMGB1 levels were analyzed within 2 hours after seizure attacks using the ELISA in only 68 patients (38 FS, 10 GEFS+, and 20 controls). The allele distribution, genotype distribution, and correlations with serum cytokine levels were analyzed. Results Near-complete linkage disequilibrium exists between IL-1β-31 and IL-1β-511 variants. CT genotypes of these variants were associated with significantly higher postictal serum IL-1β levels than were CC+TT genotypes in FS (both p<0.05). CT genotypes of IL-1β-31 and IL-1β-511 variants were more strongly associated with FS than were CC+TT genotypes (odds ratio=1.691 and 1.731, respectively). For GEFS+, serum IL-1β levels after AFS for CT genotypes of IL-1β-31 and IL-1β-511 were also higher than for CC+TT genotypes. No significant associations were found for IL-6 and HMGB1. Conclusions Genetic variants located in IL-1β-31 and IL-1β-511 promotor regions are correlated with higher postictal IL-1β levels in FS. These results suggest that IL-1 gene cluster variants in IL-1β-31 and IL-1β-511 are a host genetic factor for provoking FS in Korean children.
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Affiliation(s)
- Jieun Choi
- Department of Pediatrics, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.
| | - Sun Ah Choi
- Department of Pediatrics, Dankook University Hospital, Cheonan, Korea
| | - Soo Yeon Kim
- Department of Pediatrics, Pediatric Clinical Neuroscience Center, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Hunmin Kim
- Department of Pediatrics, Seoul National University Bundang Hospital, Seoul, Korea
| | - Byung Chan Lim
- Department of Pediatrics, Pediatric Clinical Neuroscience Center, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Hee Hwang
- Department of Pediatrics, Seoul National University Bundang Hospital, Seoul, Korea
| | - Jong Hee Chae
- Department of Pediatrics, Pediatric Clinical Neuroscience Center, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Ki Joong Kim
- Department of Pediatrics, Pediatric Clinical Neuroscience Center, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Sohee Oh
- Department of Biostatistics, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Eun Young Kim
- Department of Pediatrics, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Jeon Soo Shin
- Department of Microbiology, Brain Korea 21 Plus Project for Medical Science, Severance Biomedical Science Institute and Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Korea.
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Gu Y, Gutierrez J, Meier IB, Guzman VA, Manly JJ, Schupf N, Brickman AM, Mayeux R. Circulating inflammatory biomarkers are related to cerebrovascular disease in older adults. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2018; 6:e521. [PMID: 30568999 PMCID: PMC6278856 DOI: 10.1212/nxi.0000000000000521] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 10/12/2018] [Indexed: 12/17/2022]
Abstract
Objective This investigation aimed at examining whether circulating inflammatory biomarkers C-reactive protein (CRP), interleukin-6 (IL6), and alpha 1-antichymotrypsin (ACT) were related to cerebrovascular disease (CVD) assessed by MRI. Methods The study included nondemented elderly participants of a community-based, multiethnic cohort, who received baseline MRI scans and had CRP (n = 508), ACT (435), and IL6 (N = 357) measured by ELISA. Silent brain infarcts and white matter hyperintensities (WMH) were derived from all available MRI scans at baseline, approximately 4.4 years after blood sample collection for inflammatory biomarkers. Repeated assessments of infarcts and WMH, as well as microbleeds assessment, were performed at follow-up MRI visits around 4.5 years later. Cross-sectional and longitudinal relationship between inflammatory biomarkers and CVD were analyzed using appropriate logistic regression models, generalized linear models, or COX models. Results After adjusting for age, sex, ethnicity, education, APOE genotype, and intracranial volume, 1 SD increase in log10IL6 was associated with infarcts on MRI {odds ratio [OR] (95% confidence interval [CI]) = 1.28 [1.02–1.60], p = 0.033}, and 1 SD increase in log10CRP and log10ACT was associated with microbleeds (OR [95% CI] = 1.46 [1.02–2.09], p = 0.041; and 1.65 [1.11–2.46], p = 0.013; respectively). One SD increase in log10ACT was also associated with larger WMH at the follow-up MRI (b = 0.103, p = 0.012) and increased accumulation of WMH volume (b = 0.062, p = 0.041) during follow-up. The associations remained significant after additional adjustment of vascular risk factors and excluding participants with clinical stroke. Conclusions Among older adults, increased circulating inflammatory biomarkers were associated with the presence of infarcts and microbleeds, WMH burden, and progression of WMH.
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Affiliation(s)
- Yian Gu
- Taub Institute for Research in Alzheimer's Disease and the Aging Brain (Y.G., I.B.M., V.A.G., J.J.M., N.S., A.M.B., R.M.), Columbia University; Department of Neurology (Y.G., J.G., J.J.M., N.S., A.M.B., R.M.), Columbia University and the New York Presbyterian Hospital; Department of Epidemiology (Y.G., N.S., R.M.), Joseph P. Mailman School of Public Health, Columbia University; and the Gertrude H. Sergievsky Center (Y.G., J.J.M., A.M.B., R.M.), Columbia University, New York
| | - Jose Gutierrez
- Taub Institute for Research in Alzheimer's Disease and the Aging Brain (Y.G., I.B.M., V.A.G., J.J.M., N.S., A.M.B., R.M.), Columbia University; Department of Neurology (Y.G., J.G., J.J.M., N.S., A.M.B., R.M.), Columbia University and the New York Presbyterian Hospital; Department of Epidemiology (Y.G., N.S., R.M.), Joseph P. Mailman School of Public Health, Columbia University; and the Gertrude H. Sergievsky Center (Y.G., J.J.M., A.M.B., R.M.), Columbia University, New York
| | - Irene B Meier
- Taub Institute for Research in Alzheimer's Disease and the Aging Brain (Y.G., I.B.M., V.A.G., J.J.M., N.S., A.M.B., R.M.), Columbia University; Department of Neurology (Y.G., J.G., J.J.M., N.S., A.M.B., R.M.), Columbia University and the New York Presbyterian Hospital; Department of Epidemiology (Y.G., N.S., R.M.), Joseph P. Mailman School of Public Health, Columbia University; and the Gertrude H. Sergievsky Center (Y.G., J.J.M., A.M.B., R.M.), Columbia University, New York
| | - Vanessa A Guzman
- Taub Institute for Research in Alzheimer's Disease and the Aging Brain (Y.G., I.B.M., V.A.G., J.J.M., N.S., A.M.B., R.M.), Columbia University; Department of Neurology (Y.G., J.G., J.J.M., N.S., A.M.B., R.M.), Columbia University and the New York Presbyterian Hospital; Department of Epidemiology (Y.G., N.S., R.M.), Joseph P. Mailman School of Public Health, Columbia University; and the Gertrude H. Sergievsky Center (Y.G., J.J.M., A.M.B., R.M.), Columbia University, New York
| | - Jennifer J Manly
- Taub Institute for Research in Alzheimer's Disease and the Aging Brain (Y.G., I.B.M., V.A.G., J.J.M., N.S., A.M.B., R.M.), Columbia University; Department of Neurology (Y.G., J.G., J.J.M., N.S., A.M.B., R.M.), Columbia University and the New York Presbyterian Hospital; Department of Epidemiology (Y.G., N.S., R.M.), Joseph P. Mailman School of Public Health, Columbia University; and the Gertrude H. Sergievsky Center (Y.G., J.J.M., A.M.B., R.M.), Columbia University, New York
| | - Nicole Schupf
- Taub Institute for Research in Alzheimer's Disease and the Aging Brain (Y.G., I.B.M., V.A.G., J.J.M., N.S., A.M.B., R.M.), Columbia University; Department of Neurology (Y.G., J.G., J.J.M., N.S., A.M.B., R.M.), Columbia University and the New York Presbyterian Hospital; Department of Epidemiology (Y.G., N.S., R.M.), Joseph P. Mailman School of Public Health, Columbia University; and the Gertrude H. Sergievsky Center (Y.G., J.J.M., A.M.B., R.M.), Columbia University, New York
| | - Adam M Brickman
- Taub Institute for Research in Alzheimer's Disease and the Aging Brain (Y.G., I.B.M., V.A.G., J.J.M., N.S., A.M.B., R.M.), Columbia University; Department of Neurology (Y.G., J.G., J.J.M., N.S., A.M.B., R.M.), Columbia University and the New York Presbyterian Hospital; Department of Epidemiology (Y.G., N.S., R.M.), Joseph P. Mailman School of Public Health, Columbia University; and the Gertrude H. Sergievsky Center (Y.G., J.J.M., A.M.B., R.M.), Columbia University, New York
| | - Richard Mayeux
- Taub Institute for Research in Alzheimer's Disease and the Aging Brain (Y.G., I.B.M., V.A.G., J.J.M., N.S., A.M.B., R.M.), Columbia University; Department of Neurology (Y.G., J.G., J.J.M., N.S., A.M.B., R.M.), Columbia University and the New York Presbyterian Hospital; Department of Epidemiology (Y.G., N.S., R.M.), Joseph P. Mailman School of Public Health, Columbia University; and the Gertrude H. Sergievsky Center (Y.G., J.J.M., A.M.B., R.M.), Columbia University, New York
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An Q, Chen Z, Huo K, Su H, Qu QM. Risk factors for ischemic stroke post bone fracture. J Clin Neurosci 2018; 59:224-228. [PMID: 30414811 DOI: 10.1016/j.jocn.2018.09.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Revised: 08/11/2018] [Accepted: 09/24/2018] [Indexed: 11/19/2022]
Abstract
Stroke is one of the most devastating complications after bone fracture. However, due to the rarity of the complication, the risk factor for post fracture stroke remains unknown. We retrospectively reviewed 2914 fractured adults referred to the first affiliated hospital of Xi'an Jiaotong University, a regional referral center of China, from January 2008 to May 2013. As a result, among the 2914 patients, 13 of them had newly onset stroke within a median of 4 days after bone fractures (ranging from 1 to 25 days). The overall prevalence of post fracture stroke was 0.446%. The post fracture stroke prevalence in patients older than 68 years old was 3.542%. Compared to patients with vertebral (0.124%) and femur (0.619%) fractures, patients with hip fractures had a higher prevalence of post fracture stroke (2.320%) (P < 0.001). Univariate analysis showed that hyperlipidemia, history of prior fracture, more comorbidities, higher CHADS2 score and higher neutrophil counts at admission were more often observed among patients who had post fracture stroke (P < 0.05). With the multiple logistic regression analysis, we identified that history of prior fracture was an independent risk factor for post fracture ischemic stroke (OR = 6.417, 95% CI = 1.581-26.051, P = 0.009). Our study illustrates that the history of prior fracture is associated with a 6.4-fold increase in the risk of post fracture ischemic stroke.
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Affiliation(s)
- Qi An
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China; Department of Rheumatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Zhe Chen
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Kang Huo
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Hua Su
- Center for Cerebrovascular Research, Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, CA, USA
| | - Qiu-Min Qu
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
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48
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Cuadrado-Godia E, Dwivedi P, Sharma S, Ois Santiago A, Roquer Gonzalez J, Balcells M, Laird J, Turk M, Suri HS, Nicolaides A, Saba L, Khanna NN, Suri JS. Cerebral Small Vessel Disease: A Review Focusing on Pathophysiology, Biomarkers, and Machine Learning Strategies. J Stroke 2018; 20:302-320. [PMID: 30309226 PMCID: PMC6186915 DOI: 10.5853/jos.2017.02922] [Citation(s) in RCA: 152] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 04/02/2018] [Indexed: 12/15/2022] Open
Abstract
Cerebral small vessel disease (cSVD) has a crucial role in lacunar stroke and brain hemorrhages and is a leading cause of cognitive decline and functional loss in elderly patients. Based on underlying pathophysiology, cSVD can be subdivided into amyloidal and non-amyloidal subtypes. Genetic factors of cSVD play a pivotal role in terms of unraveling molecular mechanism. An important pathophysiological mechanism of cSVD is blood-brain barrier leakage and endothelium dysfunction which gives a clue in identification of the disease through circulating biological markers. Detection of cSVD is routinely carried out by key neuroimaging markers including white matter hyperintensities, lacunes, small subcortical infarcts, perivascular spaces, cerebral microbleeds, and brain atrophy. Application of neural networking, machine learning and deep learning in image processing have increased significantly for correct severity of cSVD. A linkage between cSVD and other neurological disorder, such as Alzheimer's and Parkinson's disease and non-cerebral disease, has also been investigated recently. This review draws a broad picture of cSVD, aiming to inculcate new insights into its pathogenesis and biomarkers. It also focuses on the role of deep machine strategies and other dimensions of cSVD by linking it with several cerebral and non-cerebral diseases as well as recent advances in the field to achieve sensitive detection, effective prevention and disease management.
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Affiliation(s)
- Elisa Cuadrado-Godia
- Department of Neurology, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | | | - Sanjiv Sharma
- Department of Computer Science & Engineering and Information Technology, Madhav Institute of Technology and Science, Gwalior, India
| | - Angel Ois Santiago
- Department of Neurology, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Jaume Roquer Gonzalez
- Department of Neurology, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Mercedes Balcells
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA.,Department of Biological Engineering, IQS School of Engineering, Barcelona, Spain
| | - John Laird
- Department of Cardiology, St. Helena Hospital, St. Helena, CA, USA
| | - Monika Turk
- Deparment of Neurology, University Medical Centre Maribor, Maribor, Slovenia
| | | | | | - Luca Saba
- Department of Radiology, Azienda Ospedaliero Universitaria, Cagliari, Italy
| | | | - Jasjit S Suri
- Stroke Monitoring Division, AtheroPoint, Roseville, CA, USA
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49
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Huang WQ, Yi KH, Li Z, Wang H, Li ML, Cai LL, Lin HN, Lin Q, Tzeng CM. DNA Methylation Profiling Reveals the Change of Inflammation-Associated ZC3H12D in Leukoaraiosis. Front Aging Neurosci 2018; 10:143. [PMID: 29875652 PMCID: PMC5974056 DOI: 10.3389/fnagi.2018.00143] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Accepted: 04/27/2018] [Indexed: 01/04/2023] Open
Abstract
Leukoaraiosis (LA) is neuroimaging abnormalities of the cerebral white matter in elderly people. However, the molecular mechanisms underlying the cerebral white matter lesions remain unclear. Here, we reported an epigenetic basis and potential pathogenesis for this complex illness. 317 differentially methylated genes were identified to distinguish the mechanism of occurrence and progression of LA. Gene-Ontology pathway analysis highlighted that those genes with epigenetic changes are mostly involved in four major signaling pathways including inflammation and immune response-associated processes (antigen processing and presentation, T cell costimulation and interferon-γ-mediated signaling pathway), synapse assembly, synaptic transmission and cell adhesion. Moreover, immune response seems to be specific to LA occurrence and subsequent disruption of nervous system functions could drive the progression of LA. The significant change of inflammation-associated ZC3H12D in promoter methylation and mRNA expression was implicated in the occurrence of LA, suggesting its potential functions in the molecular mechanism of LA. Our results suggested that inflammation-associated signaling pathways were involved in the pathogenesis of LA and ZC3H12D may contribute to such inflammatory process underlying LA, and further echoed it as a neuroinflammatory disorder in central nervous system (CNS).
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Affiliation(s)
- Wen-Qing Huang
- Translational Medicine Research Center, School of Pharmaceutical Sciences, Xiamen University, Xiamen, China.,Key Laboratory for Cancer T-Cell Theranostics and Clinical Translation, Xiamen University, Fujian, China.,Department of Physiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Ke-Hui Yi
- Department of Neurology, The First Affiliated Hospital of Xiamen University, Xiamen, China.,Department of Neurology, The First Clinical College of Fujian Medical University, Fuzhou, China
| | - Zhi Li
- Translational Medicine Research Center, School of Pharmaceutical Sciences, Xiamen University, Xiamen, China.,Key Laboratory for Cancer T-Cell Theranostics and Clinical Translation, Xiamen University, Fujian, China
| | - Han Wang
- Translational Medicine Research Center, School of Pharmaceutical Sciences, Xiamen University, Xiamen, China.,Key Laboratory for Cancer T-Cell Theranostics and Clinical Translation, Xiamen University, Fujian, China
| | - Ming-Li Li
- Translational Medicine Research Center, School of Pharmaceutical Sciences, Xiamen University, Xiamen, China.,Key Laboratory for Cancer T-Cell Theranostics and Clinical Translation, Xiamen University, Fujian, China
| | - Liang-Liang Cai
- Translational Medicine Research Center, School of Pharmaceutical Sciences, Xiamen University, Xiamen, China.,Key Laboratory for Cancer T-Cell Theranostics and Clinical Translation, Xiamen University, Fujian, China
| | - Hui-Nuan Lin
- Translational Medicine Research Center, School of Pharmaceutical Sciences, Xiamen University, Xiamen, China.,Key Laboratory for Cancer T-Cell Theranostics and Clinical Translation, Xiamen University, Fujian, China
| | - Qing Lin
- Translational Medicine Research Center, School of Pharmaceutical Sciences, Xiamen University, Xiamen, China.,Department of Neurology, The First Affiliated Hospital of Xiamen University, Xiamen, China.,Department of Neurology, The First Clinical College of Fujian Medical University, Fuzhou, China
| | - Chi-Meng Tzeng
- Translational Medicine Research Center, School of Pharmaceutical Sciences, Xiamen University, Xiamen, China.,Key Laboratory for Cancer T-Cell Theranostics and Clinical Translation, Xiamen University, Fujian, China.,INNOVA Cell: TDx/Clinics and TRANSLA Health Group, Yangzhou, China.,College of Pharmaceutical Sciences, Nanjing Tech University, Nanjing, China.,Jiansu Provincial Institute of Translation Medicine and Women-Child Health Care Hospital, Nanjing Medical University, Nanjing, China
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50
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Katan M, Elkind MSV. The potential role of blood biomarkers in patients with ischemic stroke. CLINICAL AND TRANSLATIONAL NEUROSCIENCE 2018. [DOI: 10.1177/2514183x18768050] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Mira Katan
- Department of Neurology, Universitiy Hospital of Zurich, Zürich, Switzerland
| | - Mitchell SV Elkind
- Department of Neurology, Division of Stroke, Columbia University, New York, NY, USA
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