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Rakita U, Kaundinya T, Guraya A, Nelson K, Maner B, Manjunath J, Schwartzman G, Lane B, Silverberg JI. Associations between onychomycosis and COVID-19 clinical outcomes: a retrospective cohort study from a US metropolitan center. Arch Dermatol Res 2021. [PMID: 34773138 DOI: 10.1007/s00403-021-02299-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 10/15/2021] [Accepted: 10/26/2021] [Indexed: 12/24/2022]
Abstract
Little is known about the relationship of COVID-19 outcomes with onychomycosis. We investigated the relationship of onychomycosis with COVID-19 outcomes. A retrospective cohort study was performed on SARS-CoV-2 positive adult outpatients or inpatients who had onychomycosis and other skin diseases. Overall, 430 adults were identified with SARS-CoV-2 and a skin disease, including 98 with diagnosed onychomycosis. In bivariable logistic regression models, onychomycosis was associated with increased hospitalization {odds ratio(OR) [95% confidence interval (CI)]: 3.56 [2.18–5.80]}, initial inpatient vs. outpatient visits (OR [95% CI]: 2.24 [1.35–3.74]), use of oxygen therapy (OR [95% CI]: 2.77 [1.60–4.79]), severe-critical vs. asymptomatic-mild severity (OR [95% CI]: 2.28 [1.32–3.94]), and death (OR [95% CI]: 7.48 [1.83–30.47]) from COVID-19, but not prolonged hospitalization (OR [95% CI]: 1.03 [0.47–2.25]). In multivariable models adjusting for socio-demographics, comorbidities, and immunosuppressant medication use, the associations with onychomycosis remained significant for hospitalization, inpatient visits, oxygen therapy, severe-critical COVID-19. Onychomycosis was a significant independent risk factor for COVID-19 severity, hospitalization, and receiving supplemental oxygen therapy.
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2
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Baghad B, Bousfiha AA, Chiheb S, Ailal F. [Genetic predisposition to mucocutaneous fungal infections]. Rev Med Interne 2021; 42:566-570. [PMID: 34052048 DOI: 10.1016/j.revmed.2021.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 03/29/2021] [Accepted: 05/09/2021] [Indexed: 11/15/2022]
Abstract
Mucocutaneous fungal infections are common and usually occur in the presence of certain risk factors. However, these infections can occur in patients with no known risk factors. This indicates the presence of an underlying genetic susceptibility to fungi reflecting an innate or adaptive immune deficiency. In this review, we highlight genetic factors that predispose to mucocutaneous fungal infections specially candidiasis and dermatophytosis.
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Affiliation(s)
- B Baghad
- Service de dermatologie vénéréologie, CHU de Casablanca, Hassan II University of Casablanca, Maroc; Laboratoire d'immunologie clinique, inflammation et allergie, Faculté de médecine et de pharmacie de Casablanca, Hassan II University of Casablanca, Maroc.
| | - A A Bousfiha
- Laboratoire d'immunologie clinique, inflammation et allergie, Faculté de médecine et de pharmacie de Casablanca, Hassan II University of Casablanca, Maroc; Unité d'immunologie clinique, service de pédiatrie infectieuse, CHU Harrouchi, Hassan II University of Casablanca, Maroc
| | - S Chiheb
- Service de dermatologie vénéréologie, CHU de Casablanca, Hassan II University of Casablanca, Maroc
| | - F Ailal
- Laboratoire d'immunologie clinique, inflammation et allergie, Faculté de médecine et de pharmacie de Casablanca, Hassan II University of Casablanca, Maroc; Unité d'immunologie clinique, service de pédiatrie infectieuse, CHU Harrouchi, Hassan II University of Casablanca, Maroc
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3
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Sardana K, Gupta A, Mathachan SR. Immunopathogenesis of Dermatophytoses and Factors Leading to Recalcitrant Infections. Indian Dermatol Online J 2021; 12:389-399. [PMID: 34211904 PMCID: PMC8202482 DOI: 10.4103/idoj.idoj_503_20] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/27/2020] [Accepted: 12/20/2020] [Indexed: 11/11/2022] Open
Abstract
The pathogenesis of dermatophytic infections involves the interplay of three major factors: the dermatophyte, the inherent host defense, and the adaptive host immune response. The fungal virulence factors determine the adhesion and invasion of the skin while the immune response depends on an interaction of the pathogen-associated molecular patterns (PAMPs) and damage-associated molecular patterns (DAMP) with pattern recognition receptors (PRRs) of the host, which lead to a differential Th (T helper) 1, Th2, Th17, and Treg response. While anthropophilic dermatophytes Trichophyton rubrum and now increasingly by T. interdigitale subvert the immune response via mannans, zoophilic species are eliminated due to a brisk immune response. Notably, delayed-type hypersensitivity (Th1) response of T lymphocytes causes the elimination of fungal infection, while chronic disease caused by anthropophilic species corresponds to toll-like receptor 2 mediated IL (interleukin)-10 release and generation of T-regulatory cells with immunosuppressive potential. Major steps that determine the ultimate clinical course and chronicity include genetic susceptibility factors, impaired epidermal and immunological barriers, variations in the composition of sebum and sweat, carbon dioxide tension, skin pH, and topical steroid abuse. It is important to understand these multifarious aspects to surmount the problem of recalcitrant dermatophytosis when the disorder fails conventional therapeutic agents.
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Affiliation(s)
- Kabir Sardana
- Department of Dermatology, Post Graduate Institute of Medical Education and Research Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Aastha Gupta
- Department of Dermatology, Post Graduate Institute of Medical Education and Research Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Sinu Rose Mathachan
- Department of Dermatology, Post Graduate Institute of Medical Education and Research Dr. Ram Manohar Lohia Hospital, New Delhi, India
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4
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Gnat S, Łagowski D, Nowakiewicz A. Genetic Predisposition and its Heredity in the Context of Increased Prevalence of Dermatophytoses. Mycopathologia 2021; 186:163-176. [PMID: 33523393 PMCID: PMC8106586 DOI: 10.1007/s11046-021-00529-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 01/16/2021] [Indexed: 12/12/2022]
Abstract
Dermatophytosis is a widespread disease with high prevalence and a substantial economic burden associated with costs of treatment. The pattern of this infectious disease covers a wide spectrum from exposed individuals without symptoms to those with acutely inflammatory or non-inflammatory, chronic to invasive, and life-threatening symptoms. Moreover, the prevalence of cutaneous fungal infections is not as high as might be expected. This curious disparity in the dermatophyte infection patterns may suggest that there are individual factors that predispose to infection, with genetics as an increasingly well-known determinant. In this review, we describe recent findings about the genetic predisposition to dermatophyte infections, with focus on inheritance in families with a high frequency of dermatophyte infections and specific host-pathogen interactions. The results of studies indicating a hereditary predisposition to dermatophytoses have been challenged by many skeptics suggesting that the varied degree of pathogenicity and the ecological diversity of this group of fungi are more important in increasing sensitivity. Nonetheless, a retrospective analysis of the hereditary propensity to dermatophytoses revealed at least several proven genetic relationships such as races, CARD9 deficiency, HLA-DR4 and HLA-DR8 type and responsible genes encoding interleukin-22, β-defensin 2 and 4 as well as genetic defects in dectin-1, which increased the prevalence of the disease in families and were involved in the inheritance of the proneness in their members. In future, the Human Genome Diversity Project can contribute to elucidation of the genetic predisposition to dermatophytoses and provide more information.
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Affiliation(s)
- Sebastian Gnat
- Faculty of Veterinary Medicine, Institute of Preclinical Veterinary Sciences, Department of Veterinary Microbiology, University of Life Sciences, Akademicka 12, 20-033, Lublin, Poland.
| | - Dominik Łagowski
- Faculty of Veterinary Medicine, Institute of Preclinical Veterinary Sciences, Department of Veterinary Microbiology, University of Life Sciences, Akademicka 12, 20-033, Lublin, Poland
| | - Aneta Nowakiewicz
- Faculty of Veterinary Medicine, Institute of Preclinical Veterinary Sciences, Department of Veterinary Microbiology, University of Life Sciences, Akademicka 12, 20-033, Lublin, Poland
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Rajbanshi B, Shen L, Jiang M, Gao Q, Huang X, Ma J, Wang J, Hu Y, Lv H, Wu X, Zhao J. Comparative Study of Traditional Ablative CO 2 Laser-Assisted Topical Antifungal with only Topical Antifungal for Treating Onychomycosis: A Multicenter Study. Clin Drug Investig 2020; 40:575-82. [PMID: 32314298 DOI: 10.1007/s40261-020-00914-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND The predominance of onychomycosis has been increasing recently. New medications and treatment modalities are being researched for better saturation of the antifungal agents through the nail plate topically because of the low resilience of some patients for the oral antifungal agents. Treatment of onychomycosis, mainly moderate to severe, can be very challenging, expensive, and time consuming. OBJECTIVE The objective of this clinical trial is to compare the efficacy and safety of a manually operated ablative CO2 laser combined with a topical antifungal agent in patients with onychomycosis. STUDY DESIGN We conducted an open-label controlled prospective study of 160 eligible patients randomized into control and treatment groups with a 1:1 allocation in the department of dermatology in five different hospitals in Shanghai. It was a 6-month study where both groups were treated with a topical antifungal agent, with the treatment group also receiving ablation by the traditional CO2 laser once a month for the first 3 months. RESULTS The clinical efficacy and mycological cure rate were significantly higher (p < 0.001) for the treatment group. Three (3.75%) patients from the control group and 18 (25%) patients from the treatment group achieved complete nail clearance along with negative potassium hydroxide and negative culture (primary endpoint) results at 24 weeks. Mycological clearance with at least moderate nail clearance (secondary endpoint) for the treatment group was also significantly higher (p < 0.001) for the laser treatment group. The laser treatment was mildly painful but tolerable by the patients. No drug interactions for both groups were encountered. CONCLUSIONS The ablative CO2 laser is a primitive yet effective modality to be considered for the delivery of topical antifungal agents for the management of mild-to-severe onychomycosis. The laser has good tolerance in patients and is a common equipment found in most dermatology units even those without the latest medical technology.
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Faway É, Lambert de Rouvroit C, Poumay Y. In vitro models of dermatophyte infection to investigate epidermal barrier alterations. Exp Dermatol 2019; 27:915-922. [PMID: 29957851 DOI: 10.1111/exd.13726] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2018] [Indexed: 02/06/2023]
Abstract
Fungal infections of the skin, known as dermatophytoses, are initiated at the epidermal barrier and lead to dysfunctions of the stratum corneum and cornified skin appendages. Dermatophytosis affects a significant part of the human population and, despite the availability of effective treatments, its prevalence is still increasing. Numerous dermatophyte species are able to induce lesions in both animals and humans, with different clinical pictures and host inflammatory responses. The understanding of the infectious process and of tissue responses has been impeded by discrepancies between observations in vivo or in research models. Indeed, cells cultured as monolayers do not undergo the keratinization process required to study the adherence and invasion of dermatophytes. Animal models lack relevance to study human dermatophytosis because of species-specific differences in the development of lesions and inflammatory responses. This review focuses on the recent development of cultured human skin equivalents, which partly overcomes those limitations and allows improved understanding of the pathogenesis of dermatophytosis in human being, especially the impacts of infection on epidermal barrier integrity.
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Affiliation(s)
- Émilie Faway
- URPhyM-NARILIS, University of Namur, Namur, Belgium
| | | | - Yves Poumay
- URPhyM-NARILIS, University of Namur, Namur, Belgium
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7
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Adis Medical Writers. Take a multifaceted approach when treating onychomycosis. Drugs Ther Perspect 2019; 35:321-325. [DOI: 10.1007/s40267-019-00640-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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8
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Gupta AK, Versteeg SG, Shear NH, Piguet V, Tosti A, Piraccini BM. A Practical Guide to Curing Onychomycosis: How to Maximize Cure at the Patient, Organism, Treatment, and Environmental Level. Am J Clin Dermatol 2019; 20:123-33. [PMID: 30456537 DOI: 10.1007/s40257-018-0403-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Onychomycosis is a fungal nail infection caused by dermatophytes, non-dermatophyte molds, and yeasts. Treatment of this infection can be difficult, with relapse likely to occur within 2.5 years of cure. The objective of this article is to review factors that can impact cure and to suggest practical techniques that physicians can use to maximize cure rates. Co-morbidities, as well as disease severity and duration, are among the many patient factors that could influence the efficacy of antifungal therapies. Furthermore, organism, treatment, and environmental factors that may hinder cure include point mutations, biofilms, affinity for non-target enzymes, and exposure to fungal reservoirs. To address patient-related factors, physicians are encouraged to conduct confirmatory testing and treat co-morbidities such as tinea pedis early and completely. To combat organism-focused factors, it is recommended that disruption of biofilms is considered, and drugs with multiple routes of delivery and unique mechanisms of action are prescribed when traditional agents are not effective. Extending follow-up periods, using combination treatments, and considering pulse regimens may also be of benefit. Through these practical techniques, physicians can maximize cure and limit the risk of relapse and re-infection.
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Abstract
Onychomycosis is a chronic fungal infection that is recalcitrant to treatment and often results in relapse. New evidence suggests that disease prognosis may be linked to pathogens manipulating host immune responses. Therefore, individuals with specific mutations, including those affecting pattern recognition receptors or the interleukin (IL)-17 and IL-22 pathways, may be more susceptible to infection. Moreover, it is recommended that those with a family history of immune mutations or predisposition to fungal disease be treated aggressively for onychomycosis prior to symptom progression. In addition, incorporating genetic testing and new investigational therapy such as IL-33 and interferon-γ may improve treatment outcome.
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Affiliation(s)
- Aditya K Gupta
- 1 Department of Medicine, University of Toronto School of Medicine, Toronto, Ontario, Canada.,2 Mediprobe Research, London, Ontario, Canada
| | | | - Neil H Shear
- 3 Division of Dermatology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
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Tirado-sánchez A, Bonifaz A. The Efficacy and Safety of Systemic Antifungals in Children’s Onychomycosis. Curr Fungal Infect Rep 2017; 11:104-109. [DOI: 10.1007/s12281-017-0280-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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11
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Abstract
Onychomycosis is caused by dermatophytes, yeasts or non-dermatophyte molds; when caused by dermatophytes, it is called tinea unguium. The main etiological agents are Trichophyton rubrum and Trichophyton interdigitale. The most frequent types are distal and lateral subungual onychomycosis. Diagnosis usually requires mycological laboratory confirmation. Dermoscopy can be helpful and also biopsy is an excellent diagnostic method in uncommon cases or when mycological test is negative. Treatment must be chosen according to clinical type, number of affected nails and severity. The goal for antifungal therapy is the clearing of clinical signs or mycological cure.
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Affiliation(s)
- Daniel Asz-Sigall
- Mycology Section, "Dr. Manuel Gea Gonzalez" General Hospital, Av. Calzada de Tlalpan 4800, Tlalpan, Sección XVI, 14080, Cuidad de Mexico, D.F., Mexico.
| | - Antonella Tosti
- Department of Dermatology and Cutaneous Surgery, University of Miami Hospital, 1295 NW 14th St, South Bldg, Stes K, L & M, Miami, FL, 33136, USA
| | - Roberto Arenas
- Mycology Section, "Dr. Manuel Gea Gonzalez" General Hospital, Av. Calzada de Tlalpan 4800, Tlalpan, Sección XVI, 14080, Cuidad de Mexico, D.F., Mexico
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13
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Solís-Arias MP, García-Romero MT. Onychomycosis in children. A review. Int J Dermatol 2016; 56:123-130. [DOI: 10.1111/ijd.13392] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 04/04/2016] [Accepted: 05/11/2016] [Indexed: 11/30/2022]
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14
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Abstract
Countless observational studies conducted over the last century reveal that dermatophytes infect humans of every age, race, gender, and socioeconomic status with strikingly high rates. The curious disparity in dermatophyte infection patterns observed within and between populations has led countless investigators to explore whether genetics underlie a susceptibility to, or confer protection against, dermatophyte infections. This paper examines the data that offer a link between genetics and dermatophytoses and discusses the underlying mechanisms that support these observations.
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Affiliation(s)
- Susan M Abdel-Rahman
- UMKC School of Medicine, Kansas City, MO, USA. .,Section of Therapeutic Innovation, Children's Mercy Hospital, Kansas City, MO, USA. .,Division of Pediatric Clinical Pharmacology, Toxicology, and Therapeutic Innovation, Children's Mercy Hospitals and Clinics, 2401 Gillham Rd., Kansas City, MO, 64108, USA.
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15
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Carrillo-Meléndrez H, Ortega-Hernández E, Granados J, Arroyo S, Barquera R, Arenas R. Role of HLA-DR Alleles to Increase Genetic Susceptibility to Onychomycosis in Nail Psoriasis. Skin Appendage Disord 2016; 2:22-25. [PMID: 27843918 DOI: 10.1159/000446444] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 04/25/2016] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Patients with nail psoriasis have an increased risk of onychomycosis. Previous studies suggest it may be due to structural changes of the nails. However, a genetic predisposition seems to be also at play. OBJECTIVE To determine a genetic susceptibility for onychomycosis in nails with changes of psoriasis. METHODS This is a prospective case-control study of patients with suggestive changes of nail psoriasis with onychomycosis (cases) and without onychomycosis (controls) confirmed by mycological tests. HLA typing was performed in all of them by sequence-specific primers. RESULTS Twenty-five patients and 20 controls with a mean age of 50 years (range 37-72 years) were studied. HLA-DRB1*08 was found in 12 cases (48%) and only 3 controls (15%) [p < 0.033, odds ratio (OR) = 3.8, 95% confidence interval (CI): 0.9-19]. HLA-DR1 was found in 9 cases (36%) and only 1 control (5%) (p < 0.023, OR = 8.5, 95% CI: 1-188). CONCLUSION HLA-DR*08 and HLA-DR*01 probably increase the susceptibility to fungal infection in psoriasis-affected nails, but larger studies are required to confirm this observation.
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Affiliation(s)
| | - Esteban Ortega-Hernández
- Department of Transplantation, Inmunogenetics Division, Instituto Nacional de Ciencias Médicas y Nutrición 'Salvador Zubirán', Mexico City, Mexico
| | - Julio Granados
- Department of Transplantation, Inmunogenetics Division, Instituto Nacional de Ciencias Médicas y Nutrición 'Salvador Zubirán', Mexico City, Mexico
| | - Sara Arroyo
- Department of Molecular Biology and Histocompatibility, 'Dr. Manuel Gea González' General Hospital, Mexico City, Mexico
| | - Rodrigo Barquera
- Department of Molecular Biology Department, Escuela Nacional de Antropología e Historia, Mexico City, Mexico
| | - Roberto Arenas
- Department of Dermatology, 'Dr. Manuel Gea González' General Hospital, Mexico City, Mexico
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16
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Mosley JD, Witte JS, Larkin EK, Bastarache L, Shaffer CM, Karnes JH, Stein CM, Phillips E, Hebbring SJ, Brilliant MH, Mayer J, Ye Z, Roden DM, Denny JC. Identifying genetically driven clinical phenotypes using linear mixed models. Nat Commun 2016; 7:11433. [PMID: 27109359 PMCID: PMC4848547 DOI: 10.1038/ncomms11433] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 03/24/2016] [Indexed: 01/06/2023] Open
Abstract
We hypothesized that generalized linear mixed models (GLMMs), which estimate the additive genetic variance underlying phenotype variability, would facilitate rapid characterization of clinical phenotypes from an electronic health record. We evaluated 1,288 phenotypes in 29,349 subjects of European ancestry with single-nucleotide polymorphism (SNP) genotyping on the Illumina Exome Beadchip. We show that genetic liability estimates are primarily driven by SNPs identified by prior genome-wide association studies and SNPs within the human leukocyte antigen (HLA) region. We identify 44 (false discovery rate q<0.05) phenotypes associated with HLA SNP variation and show that hypothyroidism is genetically correlated with Type I diabetes (rG=0.31, s.e. 0.12, P=0.003). We also report novel SNP associations for hypothyroidism near HLA-DQA1/HLA-DQB1 at rs6906021 (combined odds ratio (OR)=1.2 (95% confidence interval (CI): 1.1-1.2), P=9.8 × 10(-11)) and for polymyalgia rheumatica near C6orf10 at rs6910071 (OR=1.5 (95% CI: 1.3-1.6), P=1.3 × 10(-10)). Phenome-wide application of GLMMs identifies phenotypes with important genetic drivers, and focusing on these phenotypes can identify novel genetic associations.
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Affiliation(s)
- Jonathan D Mosley
- Department of Medicine, Vanderbilt University, Nashville, Tennessee 37232, USA
| | - John S Witte
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California 94158, USA
| | - Emma K Larkin
- Department of Medicine, Vanderbilt University, Nashville, Tennessee 37232, USA
| | - Lisa Bastarache
- Biomedical Informatics, Vanderbilt University, Nashville, Tennessee 37203, USA
| | - Christian M Shaffer
- Department of Medicine, Vanderbilt University, Nashville, Tennessee 37232, USA
| | - Jason H Karnes
- Department of Medicine, Vanderbilt University, Nashville, Tennessee 37232, USA
| | - C Michael Stein
- Department of Medicine, Vanderbilt University, Nashville, Tennessee 37232, USA
| | - Elizabeth Phillips
- Department of Medicine, Vanderbilt University, Nashville, Tennessee 37232, USA
| | - Scott J Hebbring
- Center for Human Genetics, Marshfield Clinic Research Foundation, Marshfield, Wisconsin 54449, USA
| | - Murray H Brilliant
- Center for Human Genetics, Marshfield Clinic Research Foundation, Marshfield, Wisconsin 54449, USA
| | - John Mayer
- Biomedical Informatics Research Center, Marshfield Clinic Research Foundation, Marshfield, Wisconsin 54449, USA
| | - Zhan Ye
- Biomedical Informatics Research Center, Marshfield Clinic Research Foundation, Marshfield, Wisconsin 54449, USA
| | - Dan M Roden
- Department of Medicine, Vanderbilt University, Nashville, Tennessee 37232, USA
| | - Joshua C Denny
- Department of Medicine, Vanderbilt University, Nashville, Tennessee 37232, USA.,Biomedical Informatics, Vanderbilt University, Nashville, Tennessee 37203, USA
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Robres P, Aspiroz C, Rezusta A, Gilaberte Y. Utilidad de la terapia fotodinámica en el manejo de la onicomicosis. Actas Dermo-Sifiliográficas 2015; 106:795-805. [DOI: 10.1016/j.ad.2015.08.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 08/13/2015] [Accepted: 08/15/2015] [Indexed: 11/28/2022] Open
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18
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Robres P, Aspiroz C, Rezusta A, Gilaberte Y. Usefulness of Photodynamic Therapy in the Management of Onychomycosis. Actas Dermo-Sifiliográficas (English Edition) 2015; 106:795-805. [DOI: 10.1016/j.adengl.2015.10.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Abstract
Fungal infections in humans are among the most prevalent diseases globally. Superficial invasion by dermatophytes leads to skin, hair, and nail infection. Even though they have usually been associated with extrinsic conditions such as immunosuppression, environmental factors, and contaminated individuals, objects, or surfaces; people are not equally susceptible to dermatophyte infection, even when they have the same risk factors. This commentary summarizes findings that provide evidence of familial or genetic predisposition to fungal infection, mediated by innate and/or adaptive immunity.
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Affiliation(s)
| | - Roberto Arenas
- Section of Mycology, Hospital General Dr. Manuel Gea González, Mexico City, Mexico
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20
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Jaradat SW, Cubillos S, Krieg N, Lehmann K, Issa B, Piehler S, Wehner-Diab S, Hipler UC, Norgauer J. Low DEFB4 copy number and high systemic hBD-2 and IL-22 levels are associated with dermatophytosis. J Invest Dermatol 2015; 135:750-758. [PMID: 25178103 DOI: 10.1038/jid.2014.369] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 07/21/2014] [Accepted: 08/12/2014] [Indexed: 01/22/2023]
Abstract
Dermatophytes initiate dermatophytosis, but susceptibility to infection is dictated by host genetic factors, although the role of some of these-such as human beta-defensin 2 (hBD-2) genomic (DEFB4) copy number (CN) variation and its induction by IL-22-remains unclear. This was investigated in this cross-sectional study in 442 unrelated Caucasian subjects, including 195 healthy controls and 247 dermatophytosis patients who were divided into five subgroups according to clinical presentation. DNA samples were evaluated for DEFB4 CN variation by relative quantification using the comparative CT method, and serum hBD-2 and IL-22 levels were determined by ELISA. DEFB4 CN in patients was significantly lower and, except in the tinea cruris subgroup, serum hBD-2 levels were higher than in controls. The positive correlation between hBD-2 levels and DEFB4 CN observed in controls was not detected in patients, who also had higher serum IL-22 levels that were positively correlated with hBD-2 levels. Moreover, unlike in control subjects, the serum IL-22 level was negatively correlated with DEFB4 CN in patients. Taken together, these findings suggest an association between decreased DEFB4 CN, elevated serum hBD-2 and IL-22 levels, and dermatophytosis, underscoring a gene/cytokine interaction in the occurrence of this infection.
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Affiliation(s)
- Sameh W Jaradat
- Department of Dermatology, Jena University Hospital, Jena, Germany; Department of Conservative Dentistry, Jena University Hospital, Jena, Germany; Jena School for Microbial Communication, Friedrich Schiller University of Jena, Jena, Germany.
| | - Susana Cubillos
- Department of Dermatology, Jena University Hospital, Jena, Germany
| | - Nadine Krieg
- Department of Dermatology, Jena University Hospital, Jena, Germany
| | - Katja Lehmann
- Department of Dermatology, Jena University Hospital, Jena, Germany
| | - Bassam Issa
- Private Dental Practices, Orland Park, Illinois, USA
| | - Susann Piehler
- Department of Dermatology, Jena University Hospital, Jena, Germany
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21
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Gupta AK, Simpson FC, Brintnell WC. Do Genetic Mutations and Genotypes Contribute to Onychomycosis? Dermatology 2014; 228:207-10. [DOI: 10.1159/000358586] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2013] [Accepted: 01/14/2014] [Indexed: 11/19/2022] Open
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22
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Gazes MI, Zeichner J. Onychomycosis in close quarter living review of the literature. Mycoses 2013; 56:610-3. [DOI: 10.1111/myc.12088] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Revised: 04/02/2013] [Accepted: 04/17/2013] [Indexed: 11/26/2022]
Affiliation(s)
- Michael I. Gazes
- New York College of Podiatric Medicine; New York NY USA
- Mount Sinai School of Medicine; New York NY USA
| | - Joshua Zeichner
- Department of Dermatology; Mount Sinai Medical Center; New York NY USA
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