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Kowo-Nyakoko F, Gregson CL, Madanhire T, Stranix-Chibanda L, Rukuni R, Offiah AC, Micklesfield LK, Cooper C, Ferrand RA, Rehman AM, Ward KA. Evaluation of two methods of bone age assessment in peripubertal children in Zimbabwe. Bone 2023; 170:116725. [PMID: 36871897 DOI: 10.1016/j.bone.2023.116725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 01/27/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023]
Abstract
OBJECTIVES Bone age (BA) measurement in children is used to evaluate skeletal maturity and helps in the diagnosis of growth disorders in children. The two most used methods are Greulich and Pyle (GP), and Tanner and Whitehouse 3 (TW3), both based upon assessment of a hand-wrist radiograph. To our knowledge no study has compared and validated the two methods in sub-Saharan Africa (SSA), and only a few have determined BA despite it being a region where skeletal maturity is often impaired for example by HIV and malnutrition. This study aimed to compare BA as measured by two methods (GP and TW3) against chronological age (CA) and determine which method is most applicable in peripubertal children in Zimbabwe. METHODS We conducted a cross-sectional study of boys and girls who tested negative for HIV. Children and adolescents were recruited by stratified random sampling from six schools in Harare, Zimbabwe. Non-dominant hand-wrist radiographs were taken, and BA assessed manually using both GP and TW3. Paired sample Student t-tests were used to calculate the mean differences between BA and chronological age (CA) in boys and girls. Bland-Altman plots compared CA to BA as determined by both methods, and agreement between GP and TW3 BA. All radiographs were graded by a second radiographer and 20 % of participants of each sex were randomly selected and re-graded by the first observer. Intraclass correlation coefficient assessed intra- and inter-rater reliability and coefficient of variation assessed precision. RESULTS We recruited 252 children (111 [44 %] girls) aged 8.0-16.5 years. The boys and girls were of similar mean ± SD CA (12.2 ± 2.4 and 11.7 ± 1.9 years) and BA whether assessed by GP (11.5 ± 2.8 and 11.5 ± 2.1 years) or TW3 (11.8 ± 2.5 and 11.8 ± 2.1 years). In boys BA was lower than CA by 0.76 years (95 % CI: -0.95, -0.57) when using GP, and by 0.43 years (95 % CI: -0.61, -0.24) when using TW3. Among the girls there was no difference between BA and CA by either GP [-0.19 years (95 % CI: -0.40, 0.03)] or TW3 [0.07 years (95 % CI: -0.16, 0.29)]. In both boys and girls, there were no systematic differences between CA and TW3 BA across age groups whereas agreement improved between CA and GP BA as children got older. Inter-operator precision was 1.5 % for TW3 and 3.7 % for GP (n = 252) and intra-operator precision was 1.5 % for TW3 and 2.4 % for GP (n = 52). CONCLUSION The TW3 BA method had better precision than GP and did not systematically differ from CA, meaning that TW3 is the preferred method of assessment of skeletal maturity in Zimbabwean children and adolescents. TW3 and GP methods do not agree for estimates of BA and therefore cannot be used interchangeably. The systematic differences in GP BA assessments over age means it is not appropriate for use in all age groups or stages of maturity in this population.
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Affiliation(s)
- Farirayi Kowo-Nyakoko
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Tremona Road, SO16 6YD Southampton, UK; Biomedical Research and Training Institute, 10 Seagrave Road, Avondale Harare, Zimbabwe; Department of Medical Physics and Imaging Sciences, University of Zimbabwe- Faculty of Medicine and Health Sciences, Parirenyatwa Group of Hospitals, Mazowe Street, Harare, Zimbabwe.
| | - Celia L Gregson
- Musculoskeletal Research Unit, Bristol Medical School, University of Bristol, Southmead Hospital, Bristol BS10 5NB, UK; SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Tafadzwa Madanhire
- Biomedical Research and Training Institute, 10 Seagrave Road, Avondale Harare, Zimbabwe
| | - Lynda Stranix-Chibanda
- Child and Adolescent Unit, University of Zimbabwe-Faculty of Medicine and Health Sciences, Parirenyatwa Group of Hospitals, Mazowe Street, Harare, Zimbabwe
| | - Ruramayi Rukuni
- Biomedical Research and Training Institute, 10 Seagrave Road, Avondale Harare, Zimbabwe; Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK
| | - Amaka C Offiah
- Department of Oncology & Metabolism, University of Sheffield, Damer Street Building, Sheffield Children's NHS Foundation Trust, Western Bank, Sheffield S10 2TH, UK
| | - Lisa K Micklesfield
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Tremona Road, SO16 6YD Southampton, UK
| | - Rashida A Ferrand
- Biomedical Research and Training Institute, 10 Seagrave Road, Avondale Harare, Zimbabwe; Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK
| | - Andrea M Rehman
- MRC International Statistics and Epidemiology Group, Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Kate A Ward
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Tremona Road, SO16 6YD Southampton, UK; SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
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Elamin F, Mohamed HYH, Abdelazeem N, Elamin A, Liversidge HM. Bone-specific median age of hand-wrist maturation from Sudan. Ann Hum Biol 2023; 50:1-7. [PMID: 36724737 DOI: 10.1080/03014460.2022.2157484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Maturation of bones in the hand-wrist region varies among individuals of the same age and among world groups. Although some studies from Africa report differences to other ethnic groups, the lack of detailed bone-specific maturity data prevents meaningful comparisons. AIM The aim of this study was to describe bone-specific maturity for developing hand-wrist bones in individuals in Khartoum, Sudan. SUBJECTS AND METHODS The sample was selected from healthy patients attending a dental hospital in Khartoum with known age and ancestry (males = 280, females = 330; aged between 3 and 25 years). Bones were assessed from radiographs of the left hand and wrist after the Greulich and Pyle Atlas (1959). Median ages of attainment for bone stages were calculated using probit analysis for each stage in males and females separately. RESULTS Maturity data for stages of the phalanges, metacarpals, carpals and radius and ulna in males and females are presented. Median ages in females were earlier compared to males for all stages. These results are largely earlier than previously published findings or where these could be calculated. CONCLUSION These results of individual maturity stages of phalanges, metacarpals, carpals and the distal epiphyses of the radius and ulna are useful to assess maturity in growing individuals from Sudan.
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Affiliation(s)
- Fadil Elamin
- Institute of Dentistry, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,Khartoum Centre for Research and Medical Training, Khartoum, Sudan.,El Razi Dental School, Khartoum, Sudan
| | | | - Nihal Abdelazeem
- Khartoum Centre for Research and Medical Training, Khartoum, Sudan.,El Razi Dental School, Khartoum, Sudan
| | - Ahmed Elamin
- Khartoum Centre for Research and Medical Training, Khartoum, Sudan
| | - Helen M Liversidge
- Institute of Dentistry, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Barash A, Belmaker M, Bastir M, Soudack M, O'Brien HD, Woodward H, Prendergast A, Barzilai O, Been E. The earliest Pleistocene record of a large-bodied hominin from the Levant supports two out-of-Africa dispersal events. Sci Rep 2022; 12:1721. [PMID: 35110601 PMCID: PMC8810791 DOI: 10.1038/s41598-022-05712-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 01/12/2022] [Indexed: 11/09/2022] Open
Abstract
The paucity of early Pleistocene hominin fossils in Eurasia hinders an in-depth discussion on their paleobiology and paleoecology. Here we report on the earliest large-bodied hominin remains from the Levantine corridor: a juvenile vertebra (UB 10749) from the early Pleistocene site of 'Ubeidiya, Israel, discovered during a reanalysis of the faunal remains. UB 10749 is a complete lower lumbar vertebral body, with morphological characteristics consistent with Homo sp. Our analysis indicates that UB-10749 was a 6- to 12-year-old child at death, displaying delayed ossification pattern compared with modern humans. Its predicted adult size is comparable to other early Pleistocene large-bodied hominins from Africa. Paleobiological differences between UB 10749 and other early Eurasian hominins supports at least two distinct out-of-Africa dispersal events. This observation corresponds with variants of lithic traditions (Oldowan; Acheulian) as well as various ecological niches across early Pleistocene sites in Eurasia.
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Affiliation(s)
- Alon Barash
- Azrieli Faculty of Medicine, Bar Ilan University, POB 1589, 1311502, Safed, Israel.
| | - Miriam Belmaker
- The Department of Anthropology, The University of Tulsa, Tulsa, OK, 74104, USA
| | - Markus Bastir
- Paleoanthropology Group, Department of Paleobiology, Museo Nacional de Ciencias Naturales, CSIC, JG Abascal 2, 28006, Madrid, Spain
| | - Michalle Soudack
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Pediatric Imaging, The Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Haley D O'Brien
- Department of Anatomy and Cell Biology, Oklahoma State University Center for Health Science, Tulsa, USA
| | - Holly Woodward
- Department of Anatomy and Cell Biology, Oklahoma State University Center for Health Science, Tulsa, USA
| | - Amy Prendergast
- School of Geography, Earth and Atmospheric Sciences, University of Melbourne, Melbourne, Australia
| | - Omry Barzilai
- Archaeological Research Department, Israel Antiquities Authority, POB 586, 91004, Jerusalem, Israel
| | - Ella Been
- Department of Sports Therapy, Faculty of Health Professions, Ono Academic College, Kiryat Ono, Israel.,Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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Determination of bone age and evaluating the applicability of Greulich-Pyle standards among the Turkish children. JOURNAL OF SURGERY AND MEDICINE 2022. [DOI: 10.28982/josam.1021045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Li W, Wei C, Xu L, Yu B, Chen Y, Lu D, Zhang L, Song X, Dong L, Zhou S, Xu Z, Zhu J, Chen X, Su C. Schistosome infection promotes osteoclast-mediated bone loss. PLoS Pathog 2021; 17:e1009462. [PMID: 33735306 PMCID: PMC8009420 DOI: 10.1371/journal.ppat.1009462] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 03/30/2021] [Accepted: 03/09/2021] [Indexed: 12/24/2022] Open
Abstract
Infection with schistosome results in immunological changes that might influence the skeletal system by inducing immunological states affecting bone metabolism. We investigated the relationships between chronic schistosome infection and bone metabolism by using a mouse model of chronic schistosomiasis, affecting millions of humans worldwide. Results showed that schistosome infection resulted in aberrant osteoclast-mediated bone loss, which was accompanied with an increased level of receptor activator of nuclear factor-κB (NF-κB) Ligand (RANKL) and decreased level of osteoprotegerin (OPG). The blockade of RANKL by the anti-RANKL antibody could prevent bone loss in the context of schistosome infection. Meanwhile, both B cells and CD4+ T cells, particularly follicular helper T (Tfh) cell subset, were the important cellular sources of RANKL during schistosome infection. These results highlight the risk of bone loss in schistosome-infected patients and the potential benefit of coupling bone therapy with anti-schistosome treatment. Schistosomiasis remains an important public health problem in many countries in tropical and subtropical regions, which affects about 200 million people worldwide, with another 700 million considered at risk of infection. Although the primary cause of pathogenesis of schistosomiasis is the granulomatous inflammatory responses, schistosomiasis patients experience long-term hidden pathologies that remain poorly investigated. Here, we found that schistosome infection resulted in RANKL-associated bone loss. Furthermore, our results indicated that both B cells and CD4+ T cells, particularly Tfh cell subset, in the peripheral lymphoid tissues are likely to be the important contributors to bone loss through releasing soluble RANKL. In addition, Tfh cells played a sufficient but not necessary role in schistosome infection-induced bone loss. Our findings highlight the risk of bone loss in schistosome-infected patients and the potential benefit of coupling bone therapy with anti-schistosome treatment.
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Affiliation(s)
- Wei Li
- Department of Clinical Laboratory, Nanjing First Hospital, Nanjing Medical University, Nanjing, P. R. China
- State Key Lab of Reproductive Medicine, Jiangsu Key Laboratory of Pathogen Biology, Department of Pathogen Biology and Immunology, Center for Global Health, Nanjing Medical University, Nanjing, P. R. China
| | - Chuan Wei
- State Key Lab of Reproductive Medicine, Jiangsu Key Laboratory of Pathogen Biology, Department of Pathogen Biology and Immunology, Center for Global Health, Nanjing Medical University, Nanjing, P. R. China
| | - Lei Xu
- State Key Lab of Reproductive Medicine, Jiangsu Key Laboratory of Pathogen Biology, Department of Pathogen Biology and Immunology, Center for Global Health, Nanjing Medical University, Nanjing, P. R. China
| | - Beibei Yu
- State Key Lab of Reproductive Medicine, Jiangsu Key Laboratory of Pathogen Biology, Department of Pathogen Biology and Immunology, Center for Global Health, Nanjing Medical University, Nanjing, P. R. China
| | - Ying Chen
- State Key Lab of Reproductive Medicine, Jiangsu Key Laboratory of Pathogen Biology, Department of Pathogen Biology and Immunology, Center for Global Health, Nanjing Medical University, Nanjing, P. R. China
| | - Di Lu
- State Key Lab of Reproductive Medicine, Jiangsu Key Laboratory of Pathogen Biology, Department of Pathogen Biology and Immunology, Center for Global Health, Nanjing Medical University, Nanjing, P. R. China
| | - Lina Zhang
- State Key Lab of Reproductive Medicine, Jiangsu Key Laboratory of Pathogen Biology, Department of Pathogen Biology and Immunology, Center for Global Health, Nanjing Medical University, Nanjing, P. R. China
| | - Xian Song
- State Key Lab of Reproductive Medicine, Jiangsu Key Laboratory of Pathogen Biology, Department of Pathogen Biology and Immunology, Center for Global Health, Nanjing Medical University, Nanjing, P. R. China
| | - Liyang Dong
- State Key Lab of Reproductive Medicine, Jiangsu Key Laboratory of Pathogen Biology, Department of Pathogen Biology and Immunology, Center for Global Health, Nanjing Medical University, Nanjing, P. R. China
| | - Sha Zhou
- State Key Lab of Reproductive Medicine, Jiangsu Key Laboratory of Pathogen Biology, Department of Pathogen Biology and Immunology, Center for Global Health, Nanjing Medical University, Nanjing, P. R. China
| | - Zhipeng Xu
- State Key Lab of Reproductive Medicine, Jiangsu Key Laboratory of Pathogen Biology, Department of Pathogen Biology and Immunology, Center for Global Health, Nanjing Medical University, Nanjing, P. R. China
| | - Jifeng Zhu
- State Key Lab of Reproductive Medicine, Jiangsu Key Laboratory of Pathogen Biology, Department of Pathogen Biology and Immunology, Center for Global Health, Nanjing Medical University, Nanjing, P. R. China
| | - Xiaojun Chen
- State Key Lab of Reproductive Medicine, Jiangsu Key Laboratory of Pathogen Biology, Department of Pathogen Biology and Immunology, Center for Global Health, Nanjing Medical University, Nanjing, P. R. China
- * E-mail: (XC); (CS)
| | - Chuan Su
- State Key Lab of Reproductive Medicine, Jiangsu Key Laboratory of Pathogen Biology, Department of Pathogen Biology and Immunology, Center for Global Health, Nanjing Medical University, Nanjing, P. R. China
- * E-mail: (XC); (CS)
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Age estimation in the living: A scoping review of population data for skeletal and dental methods. Forensic Sci Int 2021; 320:110689. [PMID: 33561788 DOI: 10.1016/j.forsciint.2021.110689] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 01/07/2021] [Accepted: 01/11/2021] [Indexed: 11/22/2022]
Abstract
Age estimation of living individuals has become a crucial part of the forensic practice, especially due to the global increase in cross-border migration. The low rate of birth registration in many countries, hence of identification documents of migrants, especially in Africa and Asia, highlights the importance of reliable methods for age estimation of living individuals. Despite the fact that a number of skeletal and dental methods for age estimation have been developed, their main limitation is that they are based on specific reference samples and there is still no consensus among researchers on whether these methods can be applied to all populations. Though this issue remains still unsolved, population information at a glance could be useful for forensic practitioners dealing with such issues. This study aims at presenting a scoping review and mapping of the current situation concerning population data for skeletal (hand-wrist and clavicle) and dental methods (teeth eruption and third molar formation) for age estimation in the living. Two hundred studies on the rate of skeletal maturation and four hundred thirty-nine on the rate of dental maturation were found, covering the period from 1952 and 2020 for a total of ninety-eight countries. For most of the western and central African countries there are currently no data on the rate of skeletal and dental maturation. The same applies to the countries of the Middle East, as well as the eastern European countries, especially as regard the skeletal development.
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A Comparison of 3 Established Skeletal Age Estimation Methods in an African Group From Benin and an Italian Group From Southern Italy. ACTA ACUST UNITED AC 2019; 40:125-128. [DOI: 10.1097/paf.0000000000000472] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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8
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Alshamrani K, Messina F, Offiah AC. Is the Greulich and Pyle atlas applicable to all ethnicities? A systematic review and meta-analysis. Eur Radiol 2019; 29:2910-2923. [PMID: 30617474 PMCID: PMC6510872 DOI: 10.1007/s00330-018-5792-5] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 09/06/2018] [Accepted: 09/21/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To determine whether the Greulich and Pyle (G&P) atlas is applicable when applied to populations of different ethnicity. METHODS A systematic review of studies published between 1959 and 15th February 2017 identified from the Embase, MEDLINE and Cochrane databases was undertaken. Quality of the studies was assessed using the National Institute for Health and Care Excellence tool. Meta-analysis used mean differences and standard deviations as summary statistics for the difference between bone age (BA) and chronological age (CA). RESULTS A total of 49 studies were included of which 27 (55%) were related to Caucasian populations. Of the 49 eligible studies, 35 were appropriate for further meta-analysis. In African females, meta-analysis showed a significant mean difference between BA and CA of 0.37 years (95% CI 0.04, 0.69). In Asian males, meta-analysis showed significant differences between BA and CA of -1.08, -1.35, -1.07, -0.80 and 0.50 years for chronological ages of 6, 7, 8, 9 and 17 years, respectively. Meta-analysis showed no significant differences between BA and CA in African males, Asian females, Caucasians and Hispanics. CONCLUSIONS The G&P standard is imprecise and should be used with caution when applied to Asian male and African female populations, particularly when aiming to determine chronological age for forensic/legal purposes. KEY POINTS • In African females, bone age is significantly advanced when compared to the G&P standard. • In Asian males, bone age is significantly delayed between 6 and 9 years old inclusive and significantly advanced at 17 years old when compared to the G&P standard. • The G&P atlas should be used with caution when applied to Asian and African populations, particularly when aiming to determine chronological age for forensic/legal purposes.
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Affiliation(s)
- Khalaf Alshamrani
- Department of Oncology & Metabolism, University of Sheffield, Sheffield, UK.
- College of Applied Medical Sciences, Najran University, Najran, Saudi Arabia.
- Academic Unit of Child Health, Damer Street Building, Sheffield Children's NHS Foundation Trust, Western Bank, Sheffield, S10 2TH, UK.
| | - Fabrizio Messina
- School of Health and Related Research, University of Sheffield, Sheffield, UK
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - Amaka C Offiah
- Department of Oncology & Metabolism, University of Sheffield, Sheffield, UK
- Academic Unit of Child Health, Damer Street Building, Sheffield Children's NHS Foundation Trust, Western Bank, Sheffield, S10 2TH, UK
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Abstract
BACKGROUND The spatial order of physeal maturation around the distal tibia has been shown to place adolescent patients at risk for certain transitional injuries, such as Tillaux or triplane fractures. Less is known about physeal maturation around the knee. The purpose of this study was to establish the spatial order of physeal maturation in the normal human knee using magnetic resonance imaging (MRI). METHODS We retrospectively collected all knee MRI scans from patients presenting to our institution from January 2004 to January 2014. Patients who were suspected on the basis of clinical or radiographic findings of having abnormal knee physeal development or injury were excluded. We then applied a previously described MRI staging system of knee physeal maturation to the MRI scans of the remaining patients at 8 defined knee locations. Associations between the stage of maturation and mean chronological age were then evaluated across the 8 knee locations. Interrater and intrarater reliabilities were assessed. RESULTS A total of 165 knee MRI scans (from 98 boys, 67 girls) met the inclusion criteria. Significant differences were found between each stage of physeal maturation and the mean chronological ages at all 8 knee locations for both boys and girls (each, P<0.001). Interestingly, within each stage of physeal maturation, no significant difference was found in the mean chronological ages at any of the 8 knee locations, suggesting that physeal development occurs uniformly in the normal human knee for both boys and girls. Interrater and intrarater reliability were nearly perfect at all locations. CONCLUSIONS The spatial order of physeal maturation in the normal human knee was uniform across 8 knee locations for both boys and girls. This uniformity may help to explain why transitional injuries do not follow a recognizable pattern in the knee. Furthermore, the uniformity aids with surgical decision making, because minimal growth modulation or disturbance is likely when early physeal closure is present in a portion of the physis. LEVEL OF EVIDENCE Level III.
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Abstract
Systemic inflammation mediated by Plasmodium parasites is central to malaria disease and its complications. Plasmodium parasites reside in erythrocytes and can theoretically reach all host tissues via the circulation. However, actual interactions between parasitized erythrocytes and host tissues, along with the consequent damage and pathological changes, are limited locally to specific tissue sites. Such tissue specificity of the parasite can alter the outcome of malaria disease, determining whether acute or chronic complications occur. Here, we give an overview of the recent progress that has been made in understanding tissue-specific immunopathology during Plasmodium infection. As knowledge on tissue-specific host-parasite interactions accumulates, better treatment modalities and targets may emerge for intervention in malaria disease.
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Lee MSJ, Maruyama K, Fujita Y, Konishi A, Lelliott PM, Itagaki S, Horii T, Lin JW, Khan SM, Kuroda E, Akira S, Ishii KJ, Coban C. Plasmodium products persist in the bone marrow and promote chronic bone loss. Sci Immunol 2017; 2:2/12/eaam8093. [PMID: 28783657 DOI: 10.1126/sciimmunol.aam8093] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 04/28/2017] [Indexed: 12/18/2022]
Abstract
Although malaria is a life-threatening disease with severe complications, most people develop partial immunity and suffer from mild symptoms. However, incomplete recovery from infection causes chronic illness, and little is known of the potential outcomes of this chronicity. We found that malaria causes bone loss and growth retardation as a result of chronic bone inflammation induced by Plasmodium products. Acute malaria infection severely suppresses bone homeostasis, but sustained accumulation of Plasmodium products in the bone marrow niche induces MyD88-dependent inflammatory responses in osteoclast and osteoblast precursors, leading to increased RANKL expression and overstimulation of osteoclastogenesis, favoring bone resorption. Infection with a mutant parasite with impaired hemoglobin digestion that produces little hemozoin, a major Plasmodium by-product, did not cause bone loss. Supplementation of alfacalcidol, a vitamin D3 analog, could prevent the bone loss. These results highlight the risk of bone loss in malaria-infected patients and the potential benefits of coupling bone therapy with antimalarial treatment.
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Affiliation(s)
- Michelle S J Lee
- Laboratory of Malaria Immunology, Immunology Frontier Research Center (IFReC), Osaka University, 3-1 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Kenta Maruyama
- Laboratory of Host Defense, IFReC, Osaka University, Suita, Osaka 565-0871, Japan
| | - Yukiko Fujita
- Laboratory of Malaria Immunology, Immunology Frontier Research Center (IFReC), Osaka University, 3-1 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Aki Konishi
- Laboratory of Malaria Immunology, Immunology Frontier Research Center (IFReC), Osaka University, 3-1 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Patrick M Lelliott
- Laboratory of Malaria Immunology, Immunology Frontier Research Center (IFReC), Osaka University, 3-1 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Sawako Itagaki
- Department of Molecular Protozoology, Research Institute for Microbial Diseases, Osaka University, Suita, Osaka 565-0871, Japan
| | - Toshihiro Horii
- Department of Molecular Protozoology, Research Institute for Microbial Diseases, Osaka University, Suita, Osaka 565-0871, Japan
| | - Jing-Wen Lin
- Leiden Malaria Research Group, Department of Parasitology, Leiden University Medical Centre, 2333 ZA Leiden, Netherlands.,Division of Pediatric Infectious Diseases, State Key Laboratory of Biotherapy, West China Second Hospital, Sichuan University and Collaboration Innovation Centre, Chengdu 610041, China
| | - Shahid M Khan
- Leiden Malaria Research Group, Department of Parasitology, Leiden University Medical Centre, 2333 ZA Leiden, Netherlands
| | - Etsushi Kuroda
- Laboratory of Vaccine Science, IFReC, Osaka University, Suita, Osaka 565-0871, Japan.,Laboratory of Adjuvant Innovation, National Institutes of Biomedical Innovation, Health and Nutrition, 7-6-8 Saito-Asagi, Ibaraki, Osaka 567-0085, Japan
| | - Shizuo Akira
- Laboratory of Host Defense, IFReC, Osaka University, Suita, Osaka 565-0871, Japan
| | - Ken J Ishii
- Laboratory of Vaccine Science, IFReC, Osaka University, Suita, Osaka 565-0871, Japan.,Laboratory of Adjuvant Innovation, National Institutes of Biomedical Innovation, Health and Nutrition, 7-6-8 Saito-Asagi, Ibaraki, Osaka 567-0085, Japan
| | - Cevayir Coban
- Laboratory of Malaria Immunology, Immunology Frontier Research Center (IFReC), Osaka University, 3-1 Yamadaoka, Suita, Osaka 565-0871, Japan.
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Tisè M, Ferrante L, Mora S, Tagliabracci A. A biochemical approach for assessing cutoffs at the age thresholds of 14 and 18 years: a pilot study on the applicability of bone specific alkaline phosphatase on an Italian sample. Int J Legal Med 2016; 130:1149-1158. [PMID: 27169674 DOI: 10.1007/s00414-016-1382-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 05/02/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND The majority of age estimation methods analyze morphological changes of specific skeletal (or dental) structures reflecting global bone development (biological parameter) in order to estimate a chronological value. This morphological and structural development is the consequence of a very active tissue metabolism and intensive modeling process which involve both bone formation and bone resorption. Several biochemical markers of bone formation and bone resorption are available, and specific biochemical tests can be performed on blood or urine samples, but such markers of bone turnover have never been employed for age estimation in living individuals for forensic purposes. The aim of this study was to ascertain the applicability of serum bone alkaline phosphatase (BALP) concentration in the age estimation for forensic purposes. We focused on the legal age thresholds of 14 and 18 years (LAT) because, in Italy, the former is considered the minimum age for criminal responsibility and the latter defines adult age and the possibility of applying general criminal laws. MATERIALS AND METHODS This study analyzed, from a forensic point of view, BALP and Tanner stages of 202 healthy white individuals (116 females and 86 males) between the ages of 10 and 30 years. We derived a linear logistic model to estimate the probability that an individual was older or younger than LAT using two variables: BALP concentration and Tanner stages. The predictive accuracy of the test was assessed by the determination of the receiver-operating characteristic curve (ROC curve). The test was performed to identify a threshold (cutoff) that could be used to assign an individual to the population of those younger or older than LAT. RESULTS ROC curve showed that the use of both serum BALP concentration and Tanner stages has a very good level of reliability in age assessment (the area under the ROC curve, AUC, ranged from 0.918 to 0.962). Best results were obtained in the assessment of male over 18 years of age (sensibility and specificity respectively of 0.90 and 0.93 with an accuracy of 0.92). Worst results were obtained in the assessment of female over 18 years of age (sensibility and specificity respectively of 0.87 and 0.82 with an accuracy of 0.84). We also calculated the probability of the correctness in the age estimation. CONCLUSION The results showed that the use of serum BALP concentration in the age assessment could be a promising and integrative method to established ones, but more research has to be done to validate the value of the proposed method in the forensic practice.
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Affiliation(s)
- Marco Tisè
- Section of Legal Medicine, Department of Biomedical Sciences and Public Health, Polytechnic University of Marche, 60020, Torrette di Ancona, Italy
| | - Luigi Ferrante
- Center of Epidemiology, Biostatistics, and Medical Information Technology, Department of Biomedical Sciences and Public Health, Polytechnic University of Marche, 60020, Torrette di Ancona, Italy
| | - Stefano Mora
- Laboratory of Pediatric Endocrinology, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy
| | - Adriano Tagliabracci
- Section of Legal Medicine, Department of Biomedical Sciences and Public Health, Polytechnic University of Marche, 60020, Torrette di Ancona, Italy.
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Büken B, Safak AA, Yazici B, Büken E, Mayda AS. Is the assessment of bone age by the Greulich-Pyle method reliable at forensic age estimation for Turkish children? Forensic Sci Int 2007; 173:146-53. [PMID: 17391883 DOI: 10.1016/j.forsciint.2007.02.023] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2005] [Revised: 12/01/2006] [Accepted: 02/22/2007] [Indexed: 10/23/2022]
Abstract
BACKGROUND Estimation of age is an important task for forensic experts especially in developing countries where birth records are often not well maintained. In this study, we investigated whether or not the Greulich-Pyle (G-P) method is sufficient at forensic age estimation for Turkish children. METHODS Plain radiographies of left hands and wrists of 492 (241 (49.0%) female, 251 (51.0%) male) healthy children between 11 and 18 years of age for girls and 11 and 19 years of age for boys were taken. Mean chronological ages (CA) were compared with mean skeletal ages according to G-P atlas for each gender and in the second step the differences those for each age group were determined. The children were Caucasian and had a low-middle socioeconomic status in this study population. The paired sample t test was used to indicate the difference between G-P (mean skeletal age according to G-P atlas) and CA (mean chronological age). In order to indicate the relation Pearson correlation coefficient was used. Modeling the relationship between G-P and CA linear regression was used. The analyses were done under SPSS 11.5. RESULTS The G-P compared to their CA. The CA was 14.52+/-2.18 S.D. years, S.E.: 0.14 (median: 14.47, range: 11.07-18.92 years) whereas G-P was 15.06+/-2.31 S.D. years, S.E.: 0.15 (median: 15.00, range: 10-18 years) for girls. The difference between the two parameters was statistically significant (p<0.001). The CA was 15.28+/-2.41 S.D. years, S.E.: 0.15 (median: 15.09, S.E. range 11.13-19.94 years) and G-P was 15.41+/-2.92 S.D. years, S.E.: 0.18 (median: 15.60, range 9-19 years) for boys. The difference was not statistically significant (p>0.05). There was a high correlation (Pearson r=0.882, p<0.001) for girls and (Pearson r=0.900, p<0.001) for boys. The determination coefficient (R2) is equal to 0.778 for girls and 0.81 for boys. The regression model also tested by ANOVA and it is found significant (p<0.01) for both genders. According to age groups G-P was advanced (0.17-1.1 year) almost for all ages and differences were significant at 11, 12, 14, 16 ages for girls. G-P was delayed at 11-14 ages (0.01-0.58 year) but not significant except for 13 years and G-P were significantly advanced in 15-17 ages (0.88-0.98 years) but then delayed in 18-19 years of age (0.02-0.48) for boys. The difference's standard deviation at 12, 13, 15, 16 years of ages for girls and between 12 and 16 and 18 years of ages for boys were more than 1 year. CONCLUSION When the results of the previous study and this study are compared, the test method could be used technically by pediatricians and other clinicians, but it is even more important for ethically unacceptable errors to disappear, especially in cases involving the possible criminal liability of the supposed minor. So standard deviation at 12, 15 years of ages for girls and 12, 15, 18 years of ages for boys were more than 1 year. But it is not known that the other methods whether more useful or not than this method. For the time being unless any other methods will be proved more useful, we have to use this method cautiously for possible criminal liability cases in forensic age diagnosis.
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Affiliation(s)
- Bora Büken
- Düzce University, Düzce Medical Faculty, Forensics Medicine Department, Turkey.
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Idohou-Dossou N, Wade S, Guiro AT, Sarr CS, Diaham B, Cissé D, Beau JP, Chappuis P, Hoffman D, Lemonnier D. Nutritional status of preschool Senegalese children: long-term effects of early severe malnutrition. Br J Nutr 2007; 90:1123-32. [PMID: 14641972 DOI: 10.1079/bjn2003990] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The prevalence of malnutrition remains high in many developing countries. However, data relating to the long-term effects of severe malnutrition, specifically, serum levels of biochemical indicators of nutritional status, are still scarce in the literature. Hence the present study aimed to investigate the nutritional, biological and growth status of Senegalese preschool children previously hospitalised for severe malnutrition. The study involved twenty-four 7-year-old children who had suffered from marasmus 5 years earlier, twenty-four siblings living in the same household, and nineteen age-matched children living in the centre of Dakar. The siblings were of similar age to the post-marasmic children. Anthropometry, serum biochemical indicators of nutritional status, growth factors, and haematological and mineral parameters were measured. The prevalence of stunting and wasting was the same in the post-marasmic children as in the siblings. Body-fat and fat-free-mass (FFM) deficits in both groups were corroborated by abnormally low concentrations of transthyretin, osteocalcin, insulin-like growth factor (IGF)-1, and insulin-like growth factor-binding protein (IGFBP)-3. FFM was positively and significantly correlated with concentrations of IGF-1 and IGFBP-3. In the post-marasmic children, height for age was also correlated with IGF-1. Of the post-marasmic children, 53 % had Fe-deficiency anaemia, as did 35 % of the siblings and 29 % of the controls. No significant associations were found between the serum concentrations of Ca, Cu, K, Mg, Na, P, Se, Zn and growth retardation. At 5 years after nutritional rehabilitation, the post-marasmic children remained stunted with nutritional indices significantly lower than the control children. However, these children were doing as well as their siblings except for minor infections.
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Affiliation(s)
- Nicole Idohou-Dossou
- Equipe de Nutrition et Alimentation, Laboratoire de Physiologie, Département de Biologie Animale, Faculté des Sciences et Techniques, Université Cheikh Anta Diop de Dakar, Sénégal.
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