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Zuzek R, Potter M, Talley NJ, Agréus L, Andreasson A, Veits L, Vieth M, Walker MM. Prevalence of Histological Gastritis in a Community Population and Association with Epigastric Pain. Dig Dis Sci 2024; 69:528-537. [PMID: 38091176 PMCID: PMC10861608 DOI: 10.1007/s10620-023-08170-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 10/26/2023] [Indexed: 02/15/2024]
Abstract
BACKGROUND AND AIMS Gastritis is a common histological diagnosis, although the prevalence is decreasing in developed populations, alongside decreasing prevalence of H. pylori infection. We sought to determine the prevalence of the etiology of gastritis in a Swedish population sample and to analyze any associations with symptoms, an area of clinical uncertainty. METHODS Longitudinal population-based study based in Östhammar, Sweden. A randomly sampled adult population completed a validated gastrointestinal symptom questionnaire (Abdominal Symptom Questionnaire, ASQ) in 2011 (N = 1175). Participants < 80 years of age and who were eligible were invited to undergo esophagogastroduodenoscopy (EGD) (N = 947); 402 accepted and 368 underwent EGD with antral and body biopsies (average 54.1 years, range 20-79 years; 47.8% male) with H. pylori serology. RESULTS Gastritis was found in 40.2% (148/368; 95% CI 35.2-45.2%). By rank, the most common histological subtype was reactive (68/148; 45.9%), then H. pylori (44/148; 29.7%), chronic non-H. pylori (29/148; 19.6%), and autoimmune (4/148; 2.7%). Gastritis was significantly associated with older age and H. pylori status (p < 0.01). Gastritis subjects were divided into three histological categories: chronic inactive inflammation, autoimmune gastritis, and active inflammation; there was no difference in the presence of upper gastrointestinal symptoms when categories were compared to cases with no pathological changes. Functional dyspepsia or gastroesophageal reflux were reported in 25.7% (38/148) of those with gastritis (any type or location) versus 34.1% (75/220) with no pathological changes (p = 0.32). Epigastric pain was more common in chronic H. pylori negative gastritis in the gastric body (OR = 3.22, 95% CI 1.08-9.62). CONCLUSION Gastritis is common in the population with a prevalence of 40% and is usually asymptomatic. Chronic body gastritis may be associated with epigastric pain, but independent validation is required to confirm these findings. Clinicians should not generally ascribe symptoms to histological gastritis.
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Affiliation(s)
- Rachael Zuzek
- Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia
- Department of Medicine, Wollongong Hospital, Wollongong, Australia
| | - Michael Potter
- Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia
- Department of Gastroenterology, John Hunter Hospital, Newcastle, Australia
- NHMRC Centre for Research Excellence in Digestive Health, Newcastle, Australia
| | - Nicholas J Talley
- Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia.
- Department of Gastroenterology, John Hunter Hospital, Newcastle, Australia.
- NHMRC Centre for Research Excellence in Digestive Health, Newcastle, Australia.
- Hunter Medical Research Institute, Lot 1, Kookaburra Cct, New Lambton Heights, NSW, 2305, Australia.
| | - L Agréus
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - A Andreasson
- Department of Psychology, Macquarie University, North Ryde, Australia
- Department of Medicine Solna, Karolinska Institutet, Solna, Sweden
- Department of Psychology, Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - L Veits
- Klinikum Bayreuth, Institute of Pathology, Friedrich-Alexander-University Erlangen-Nuremberg, Bayreuth, Germany
| | - M Vieth
- Klinikum Bayreuth, Institute of Pathology, Friedrich-Alexander-University Erlangen-Nuremberg, Bayreuth, Germany
| | - M M Walker
- Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia
- NHMRC Centre for Research Excellence in Digestive Health, Newcastle, Australia
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Wändell P, Andreasson A, Hagström H, Kapetanovic MC, Carlsson AC. The use of anthropometric measures in the prediction of incident gout: results from a Swedish community-based cohort study. Scand J Rheumatol 2019; 48:294-299. [DOI: 10.1080/03009742.2019.1583368] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- P Wändell
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - A Andreasson
- Stress Research Institute, Stockholm University, Stockholm, Sweden
- Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
| | - H Hagström
- Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
| | - MC Kapetanovic
- Department of Clinical Sciences, Lund, Section for Rheumatology, Lund University, Lund, Sweden
- Section for Rheumatology in Lund and Malmö, Skåne University Hospital, Lund, Sweden
| | - AC Carlsson
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
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Wang L, Andreasson A, Straughan C, Sims A, Brennan K, Fisher A, Clark S, Parry G, Booth K, Dark J. Developing DSA Post-Lung Transplant - Identifying Risk Factors. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.1055] [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: 10/27/2022] Open
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Mayes JW, Jiwa K, Leaw B, Tan J, Lau S, Borthwick L, Andreasson A, Dark J, Jenkin G, Lim R, Fisher AJ. S136 Potential therapeutic benefits of the human amniotic epithelium cell secretome during ex-vivo perfusion of donor lungs. Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.142] [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: 11/04/2022]
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Andreasson A, Karamanou D, Gillespie C, Borthwick L, Jiwa K, Henderson P, Özalp F, Butt T, Clark S, Pauli H, Corris P, Ali S, Dark J, Fisher A. Treating Donor Lung Inflammation by Blocking Interleukin-1Β - An In Vitro Therapy Testing Platform for Ex Vivo Lung Perfusion. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.275] [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: 10/22/2022] Open
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Andreasson A, Yonan N, Fildes J, Mascaro J, Marczin N, Tsui S, Simon A, Dark J, Fisher A. Profiling Biomarkers of Inflammation and Tissue Injury during Human Ex Vivo Lung Perfusion in the DEVELOP-UK Study. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.241] [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: 10/22/2022] Open
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Wuttge DM, Andreasson A, Tufvesson E, Johansson ÅCM, Scheja A, Hellmark T, Hesselstrand R, Truedsson L. CD81 and CD48 show different expression on blood eosinophils in systemic sclerosis: new markers for disease and pulmonary inflammation? Scand J Rheumatol 2015; 45:107-13. [PMID: 26926492 DOI: 10.3109/03009742.2015.1054877] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES In systemic sclerosis (SSc)-related interstitial lung disease (ILD), elevated eosinophil counts in bronchoalveolar lavage are associated with a worse outcome. We hypothesized that eosinophils may be activated in the peripheral circulation, thereby increasing their recruitment to affected tissues and contributing to inflammation and fibrosis. The aim of this study was to characterize the blood eosinophils in SSc patients. METHOD Expression levels of surface markers CD11b, CD44, CD48, CD54, CD69, CD81, and HLA-DR on CD16(low)CD9(high)-expressing eosinophils were measured by flow cytometry in whole blood from SSc patients (n = 32) and controls (n = 11). RESULTS Expression levels of CD54, CD69, and HLA-DR were undetectable in all groups. CD44 and CD11b expression levels were similar between groups. CD81 expression was lower in patients compared to controls independent of disease duration (p = 0.001). CD48 expression was increased in patients with a short disease duration (< 2 years) compared to both controls (p = 0.042) and patients with longer disease duration (≥ 2 years; p = 0.027). In patients with short disease duration, increased CD48 expression was associated with alveolar inflammation as measured by an increased concentration of alveolar nitric oxide (r = 0.76, p = 0.003). CONCLUSIONS Blood eosinophils change phenotype during disease evolution in SSc, and CD48 expression may be used as a biomarker for pulmonary inflammation.
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Affiliation(s)
- D M Wuttge
- a Section of Rheumatology, Department of Clinical Sciences, Lund University and Skåne University Hospital , Lund , Sweden
| | - A Andreasson
- b Section of Microbiology, Immunology and Glycobiology, Department of Laboratory Medicine, Lund University and Skåne University Hospital , Lund , Sweden
| | - E Tufvesson
- c Section of Respiratory Medicine and Allergy, Department of Clinical Sciences, Lund University and Skåne University Hospital , Lund , Sweden
| | - Å C M Johansson
- b Section of Microbiology, Immunology and Glycobiology, Department of Laboratory Medicine, Lund University and Skåne University Hospital , Lund , Sweden
| | - A Scheja
- a Section of Rheumatology, Department of Clinical Sciences, Lund University and Skåne University Hospital , Lund , Sweden
| | - T Hellmark
- d Section of Nephrology, Department of Clinical Sciences, Lund, Lund University and Skåne University Hospital , Lund , Sweden
| | - R Hesselstrand
- a Section of Rheumatology, Department of Clinical Sciences, Lund University and Skåne University Hospital , Lund , Sweden
| | - L Truedsson
- b Section of Microbiology, Immunology and Glycobiology, Department of Laboratory Medicine, Lund University and Skåne University Hospital , Lund , Sweden
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Andreasson A, Kiss NB, Juhlin CC, Höög A. Long-term storage of endocrine tissues at - 80°C does not adversely affect RNA quality or overall histomorphology. Biopreserv Biobank 2015; 11:366-70. [PMID: 24475321 DOI: 10.1089/bio.2013.0038] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Today, no consensus exists regarding how human tissues are best preserved for long-term storage. Very low temperature storage in liquid nitrogen is often advocated as the superlative method for extended periods, but storage in -80 degrees Celsius (-80°C) freezers, while sometimes debated, is a possible alternative. RNA is the most easily degradable component of a biological sample in a molecular biology context and the quality can reliably be measured. AIM To investigate to what extent long-term storage of tissues in -80°C affects the RNA quality and overall histomorphology. The tissue storage period represents nearly three decades (1986-2013). METHODS RNA extraction from 153 tissue samples with different storage periods was performed with the mirVana kit (Invitrogen). RNA integrity was assessed using an Agilent bioanalyzer to obtain RNA integrity numbers (RIN). Further, tissue representative testing using light microscopy was performed by two pathologists to assess tissue composition and morphology. RESULTS RIN values were measured in all samples, showing a variability that did not correlate with the storage time of the tissues. Microscopically, all samples displayed acceptable tissue morphology regardless of storage time. CONCLUSION Long-term storage in -80°C does not adversely affect the quality of the RNA extracted from the stored tissues, and the tissue morphology is maintained to a good standard.
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Hultgren K, Andreasson A, Axelsson T, Albertsson P, Lepore V, Jeppsson A. 076-I * ACUTE CORONARY ANGIOGRAPHY FOR MYOCARDIAL ISCHAEMIA AFTER CORONARY ARTERY BYPASS GRAFTING. Interact Cardiovasc Thorac Surg 2014. [DOI: 10.1093/icvts/ivu276.76] [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: 11/13/2022] Open
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Welander J, Andreasson A, Juhlin CC, Wiseman RW, Bäckdahl M, Höög A, Larsson C, Gimm O, Söderkvist P. Rare germline mutations identified by targeted next-generation sequencing of susceptibility genes in pheochromocytoma and paraganglioma. J Clin Endocrinol Metab 2014; 99:E1352-60. [PMID: 24694336 PMCID: PMC5393486 DOI: 10.1210/jc.2013-4375] [Citation(s) in RCA: 124] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
CONTEXT Pheochromocytomas and paragangliomas have a highly diverse genetic background, with a third of the cases carrying a germline mutation in 1 of 14 identified genes. OBJECTIVE This study aimed to evaluate next-generation sequencing for more efficient genetic testing of pheochromocytoma and paraganglioma and to establish germline and somatic mutation frequencies for all known susceptibility genes. DESIGN A targeted next-generation sequencing approach on an Illumina MiSeq instrument was used for a mutation analysis in 86 unselected pheochromocytoma and paraganglioma tumor samples. The study included the genes EGLN1, EPAS1, KIF1Bβ, MAX, MEN1, NF1, RET, SDHA, SDHB, SDHC, SDHD, SDHAF2, TMEM127, and VHL. RESULTS were verified in tumor and constitutional DNA with Sanger sequencing. RESULTS In all cases with clinical syndromes or known germline mutations, a mutation was detected in the expected gene. Among 68 nonfamilial tumors, 32 mutations were identified in 28 of the samples (41%), including germline mutations in EGLN1, KIF1Bβ, SDHA, SDHB, and TMEM127 and somatic mutations in EPAS1, KIF1Bβ, MAX, NF1, RET, and VHL, including one double monoallelic EPAS1 mutation. CONCLUSIONS Targeted next-generation sequencing proved to be fast and cost effective for the genetic analysis of pheochromocytoma and paraganglioma. More than half of the tumors harbored mutations in the investigated genes. Notably, 7% of the apparently sporadic cases carried germline mutations, highlighting the importance of comprehensive genetic testing. KIF1Bβ, which previously has not been investigated in a large cohort, appears to be an equally important tumor suppressor as MAX and TMEM127 and could be considered for genetic testing of these patients.
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Ethier JF, Curcin V, Barton A, McGilchrist MM, Bastiaens H, Andreasson A, Rossiter J, Zhao L, Arvanitis TN, Taweel A, Delaney BC, Burgun A. Clinical data integration model. Core interoperability ontology for research using primary care data. Methods Inf Med 2014; 54:16-23. [PMID: 24954896 DOI: 10.3414/me13-02-0024] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Accepted: 04/23/2014] [Indexed: 12/18/2022]
Abstract
INTRODUCTION This article is part of the Focus Theme of METHODS of Information in Medicine on "Managing Interoperability and Complexity in Health Systems". BACKGROUND Primary care data is the single richest source of routine health care data. However its use, both in research and clinical work, often requires data from multiple clinical sites, clinical trials databases and registries. Data integration and interoperability are therefore of utmost importance. OBJECTIVES TRANSFoRm's general approach relies on a unified interoperability framework, described in a previous paper. We developed a core ontology for an interoperability framework based on data mediation. This article presents how such an ontology, the Clinical Data Integration Model (CDIM), can be designed to support, in conjunction with appropriate terminologies, biomedical data federation within TRANSFoRm, an EU FP7 project that aims to develop the digital infrastructure for a learning healthcare system in European Primary Care. METHODS TRANSFoRm utilizes a unified structural / terminological interoperability framework, based on the local-as-view mediation paradigm. Such an approach mandates the global information model to describe the domain of interest independently of the data sources to be explored. Following a requirement analysis process, no ontology focusing on primary care research was identified and, thus we designed a realist ontology based on Basic Formal Ontology to support our framework in collaboration with various terminologies used in primary care. RESULTS The resulting ontology has 549 classes and 82 object properties and is used to support data integration for TRANSFoRm's use cases. Concepts identified by researchers were successfully expressed in queries using CDIM and pertinent terminologies. As an example, we illustrate how, in TRANSFoRm, the Query Formulation Workbench can capture eligibility criteria in a computable representation, which is based on CDIM. CONCLUSION A unified mediation approach to semantic interoperability provides a flexible and extensible framework for all types of interaction between health record systems and research systems. CDIM, as core ontology of such an approach, enables simplicity and consistency of design across the heterogeneous software landscape and can support the specific needs of EHR-driven phenotyping research using primary care data.
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Affiliation(s)
- J-F Ethier
- Jean-François Ethier, INSERM UMR_S 872 team 22, Information Sciences to support Personalized Medicine, Centre de Recherche des Cordeliers, Rue de l'Ecole de Médecine, 75006 Paris, France, E-mail:
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Welander J, Andreasson A, Brauckhoff M, Bäckdahl M, Larsson C, Gimm O, Söderkvist P. Frequent EPAS1/HIF2α exons 9 and 12 mutations in non-familial pheochromocytoma. Endocr Relat Cancer 2014; 21:495-504. [PMID: 24741025 DOI: 10.1530/erc-13-0384] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Pheochromocytomas are neuroendocrine tumors arising from the adrenal medulla. While heritable mutations are frequently described, less is known about the genetics of sporadic pheochromocytoma. Mutations in genes involved in the cellular hypoxia response have been identified in tumors, and recently EPAS1, encoding HIF2α, has been revealed to be a new gene involved in the pathogenesis of pheochromocytoma and abdominal paraganglioma. The aim of this study was to further characterize EPAS1 alterations in non-familial pheochromocytomas. Tumor DNA from 42 adrenal pheochromocytoma cases with apparently sporadic presentation, without known hereditary mutations in predisposing genes, were analyzed for mutations in EPAS1 by sequencing of exons 9 and 12, which contain the two hydroxylation sites involved in HIF2α degradation, and also exon 2. In addition, the copy number at the EPAS1 locus as well as transcriptome-wide gene expression were studied by DNA and RNA microarray analyses, respectively. We identified six missense EPAS1 mutations, three in exon 9 and three in exon 12, in five of 42 pheochromocytomas (12%). The mutations were both somatic and constitutional, and had no overlap in 11 cases (26%) with somatic mutations in NF1 or RET. One sample had two different EPAS1 mutations, shown by cloning to occur in cis, possibly indicating a novel mechanism of HIF2α stabilization through inactivation of both hydroxylation sites. One of the tumors with an EPAS1 mutation also had a gain in DNA copy number at the EPAS1 locus. All EPAS1-mutated tumors displayed a pseudo-hypoxic gene expression pattern, indicating an oncogenic role of the identified mutations.
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Affiliation(s)
- Jenny Welander
- Department of Clinical and Experimental MedicineFaculty of Health Sciences, Linköping University, Linköping SE-58185, SwedenDepartment of Oncology-PathologyKarolinska Institutet, CCK, Karolinska University Hospital, Stockholm SE-17176, SwedenDepartment of SurgeryHaukeland University Hospital, Bergen, NorwayDepartment of Clinical ScienceUniversity of Bergen, Bergen NO-5021, NorwayDepartment of Molecular Medicine and SurgeryKarolinska Institutet, Karolinska University Hospital, Stockholm SE-17176, SwedenDepartment of SurgeryCounty Council of Östergötland, Linköping SE-58185, Sweden
| | - Adam Andreasson
- Department of Clinical and Experimental MedicineFaculty of Health Sciences, Linköping University, Linköping SE-58185, SwedenDepartment of Oncology-PathologyKarolinska Institutet, CCK, Karolinska University Hospital, Stockholm SE-17176, SwedenDepartment of SurgeryHaukeland University Hospital, Bergen, NorwayDepartment of Clinical ScienceUniversity of Bergen, Bergen NO-5021, NorwayDepartment of Molecular Medicine and SurgeryKarolinska Institutet, Karolinska University Hospital, Stockholm SE-17176, SwedenDepartment of SurgeryCounty Council of Östergötland, Linköping SE-58185, Sweden
| | - Michael Brauckhoff
- Department of Clinical and Experimental MedicineFaculty of Health Sciences, Linköping University, Linköping SE-58185, SwedenDepartment of Oncology-PathologyKarolinska Institutet, CCK, Karolinska University Hospital, Stockholm SE-17176, SwedenDepartment of SurgeryHaukeland University Hospital, Bergen, NorwayDepartment of Clinical ScienceUniversity of Bergen, Bergen NO-5021, NorwayDepartment of Molecular Medicine and SurgeryKarolinska Institutet, Karolinska University Hospital, Stockholm SE-17176, SwedenDepartment of SurgeryCounty Council of Östergötland, Linköping SE-58185, SwedenDepartment of Clinical and Experimental MedicineFaculty of Health Sciences, Linköping University, Linköping SE-58185, SwedenDepartment of Oncology-PathologyKarolinska Institutet, CCK, Karolinska University Hospital, Stockholm SE-17176, SwedenDepartment of SurgeryHaukeland University Hospital, Bergen, NorwayDepartment of Clinical ScienceUniversity of Bergen, Bergen NO-5021, NorwayDepartment of Molecular Medicine and SurgeryKarolinska Institutet, Karolinska University Hospital, Stockholm SE-17176, SwedenDepartment of SurgeryCounty Council of Östergötland, Linköping SE-58185, Sweden
| | - Martin Bäckdahl
- Department of Clinical and Experimental MedicineFaculty of Health Sciences, Linköping University, Linköping SE-58185, SwedenDepartment of Oncology-PathologyKarolinska Institutet, CCK, Karolinska University Hospital, Stockholm SE-17176, SwedenDepartment of SurgeryHaukeland University Hospital, Bergen, NorwayDepartment of Clinical ScienceUniversity of Bergen, Bergen NO-5021, NorwayDepartment of Molecular Medicine and SurgeryKarolinska Institutet, Karolinska University Hospital, Stockholm SE-17176, SwedenDepartment of SurgeryCounty Council of Östergötland, Linköping SE-58185, Sweden
| | - Catharina Larsson
- Department of Clinical and Experimental MedicineFaculty of Health Sciences, Linköping University, Linköping SE-58185, SwedenDepartment of Oncology-PathologyKarolinska Institutet, CCK, Karolinska University Hospital, Stockholm SE-17176, SwedenDepartment of SurgeryHaukeland University Hospital, Bergen, NorwayDepartment of Clinical ScienceUniversity of Bergen, Bergen NO-5021, NorwayDepartment of Molecular Medicine and SurgeryKarolinska Institutet, Karolinska University Hospital, Stockholm SE-17176, SwedenDepartment of SurgeryCounty Council of Östergötland, Linköping SE-58185, Sweden
| | - Oliver Gimm
- Department of Clinical and Experimental MedicineFaculty of Health Sciences, Linköping University, Linköping SE-58185, SwedenDepartment of Oncology-PathologyKarolinska Institutet, CCK, Karolinska University Hospital, Stockholm SE-17176, SwedenDepartment of SurgeryHaukeland University Hospital, Bergen, NorwayDepartment of Clinical ScienceUniversity of Bergen, Bergen NO-5021, NorwayDepartment of Molecular Medicine and SurgeryKarolinska Institutet, Karolinska University Hospital, Stockholm SE-17176, SwedenDepartment of SurgeryCounty Council of Östergötland, Linköping SE-58185, SwedenDepartment of Clinical and Experimental MedicineFaculty of Health Sciences, Linköping University, Linköping SE-58185, SwedenDepartment of Oncology-PathologyKarolinska Institutet, CCK, Karolinska University Hospital, Stockholm SE-17176, SwedenDepartment of SurgeryHaukeland University Hospital, Bergen, NorwayDepartment of Clinical ScienceUniversity of Bergen, Bergen NO-5021, NorwayDepartment of Molecular Medicine and SurgeryKarolinska Institutet, Karolinska University Hospital, Stockholm SE-17176, SwedenDepartment of SurgeryCounty Council of Östergötland, Linköping SE-58185, Sweden
| | - Peter Söderkvist
- Department of Clinical and Experimental MedicineFaculty of Health Sciences, Linköping University, Linköping SE-58185, SwedenDepartment of Oncology-PathologyKarolinska Institutet, CCK, Karolinska University Hospital, Stockholm SE-17176, SwedenDepartment of SurgeryHaukeland University Hospital, Bergen, NorwayDepartment of Clinical ScienceUniversity of Bergen, Bergen NO-5021, NorwayDepartment of Molecular Medicine and SurgeryKarolinska Institutet, Karolinska University Hospital, Stockholm SE-17176, SwedenDepartment of SurgeryCounty Council of Östergötland, Linköping SE-58185, Sweden
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Liu T, Brown TC, Juhlin CC, Andreasson A, Wang N, Bäckdahl M, Healy JM, Prasad ML, Korah R, Carling T, Xu D, Larsson C. The activating TERT promoter mutation C228T is recurrent in subsets of adrenal tumors. Endocr Relat Cancer 2014; 21:427-34. [PMID: 24803525 PMCID: PMC4045219 DOI: 10.1530/erc-14-0016] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The telomerase reverse transcriptase gene (TERT) encodes the reverse transcriptase component of the telomerase complex, which is essential for telomere stabilization and cell immortalization. Recent studies have demonstrated a transcriptional activation role for the TERT promoter mutations C228T and C250T in many human cancers, as well as a role in aggressive disease with potential clinical applications. Although telomerase activation is known in adrenal tumors, the underlying mechanisms are not established. We assessed C228T and C250T TERT mutations by direct Sanger sequencing in tumors of the adrenal gland, and further evaluated potential associations with clinical parameters and telomerase activation. A total of 199 tumors were evaluated, including 34 adrenocortical carcinomas (ACC), 47 adrenocortical adenomas (ACA), 105 pheochromocytomas (PCC; ten malignant and 95 benign), and 13 abdominal paragangliomas (PGL; nine malignant and four benign). TERT expression levels were determined by quantitative RT-PCR. The C228T mutation was detected in 4/34 ACCs (12%), but not in any ACA (P=0.028). C228T was also observed in one benign PCC and in one metastatic PGL. The C250T mutation was not observed in any case. In the ACC and PGL groups, TERT mutation-positive cases exhibited TERT expression, indicating telomerase activation; however, since expression was also revealed in TERT WT cases, this could denote additional mechanisms of TERT activation. To conclude, the TERT promoter mutation C228T is a recurrent event associated with TERT expression in ACCs, but rarely occurs in PGL and PCC. The involvement of the TERT gene in ACC represents a novel mutated gene in this entity.
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Affiliation(s)
| | - Taylor C Brown
- Yale Endocrine Neoplasia Laboratory, Yale School of Medicine333 Cedar Street, FMB130A, PO Box 208062, New Haven, Connecticut, 06520USA
- Department of Surgery, Yale School of MedicineNew Haven, ConnecticutUSA
| | - C Christofer Juhlin
- Yale Endocrine Neoplasia Laboratory, Yale School of Medicine333 Cedar Street, FMB130A, PO Box 208062, New Haven, Connecticut, 06520USA
- Department of Surgery, Yale School of MedicineNew Haven, ConnecticutUSA
- Department of Oncology-Pathology, Karolinska Institutet, Karolinska University Hospital CCKStockholm, SE-171 76Sweden
- Correspondence should be addressed to C C Juhlin,
| | - Adam Andreasson
- Department of Oncology-Pathology, Karolinska Institutet, Karolinska University Hospital CCKStockholm, SE-171 76Sweden
| | - Na Wang
- Department of Oncology-Pathology, Karolinska Institutet, Karolinska University Hospital CCKStockholm, SE-171 76Sweden
| | - Martin Bäckdahl
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University HospitalStockholm, SE-171 76Sweden
| | - James M Healy
- Yale Endocrine Neoplasia Laboratory, Yale School of Medicine333 Cedar Street, FMB130A, PO Box 208062, New Haven, Connecticut, 06520USA
- Department of Surgery, Yale School of MedicineNew Haven, ConnecticutUSA
| | - Manju L Prasad
- Department of Pathology, Yale School of MedicineNew Haven, ConnecticutUSA
| | - Reju Korah
- Yale Endocrine Neoplasia Laboratory, Yale School of Medicine333 Cedar Street, FMB130A, PO Box 208062, New Haven, Connecticut, 06520USA
- Department of Surgery, Yale School of MedicineNew Haven, ConnecticutUSA
| | - Tobias Carling
- Yale Endocrine Neoplasia Laboratory, Yale School of Medicine333 Cedar Street, FMB130A, PO Box 208062, New Haven, Connecticut, 06520USA
- Department of Surgery, Yale School of MedicineNew Haven, ConnecticutUSA
| | | | - Catharina Larsson
- Department of Oncology-Pathology, Karolinska Institutet, Karolinska University Hospital CCKStockholm, SE-171 76Sweden
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Fridegren J, Andreasson A, Wallin C. [Pheochromocytoma can easily be missed in an unusual symptomatology. Hypotension and syncope were interpreted as orthostatism]. Lakartidningen 2014; 111:340-341. [PMID: 24669455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Andreasson A, Kiss NB, Caramuta S, Sulaiman L, Svahn F, Bäckdahl M, Höög A, Juhlin CC, Larsson C. The VHL gene is epigenetically inactivated in pheochromocytomas and abdominal paragangliomas. Epigenetics 2013; 8:1347-54. [PMID: 24149047 PMCID: PMC3933494 DOI: 10.4161/epi.26686] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Pheochromocytoma (PCC) and abdominal paraganglioma (PGL) are neuroendocrine tumors that present with clinical symptoms related to increased catecholamine levels. About a third of the cases are associated with constitutional mutations in pre-disposing genes, of which some may also be somatically mutated in sporadic cases. However, little is known about inactivating epigenetic events through promoter methylation in these very genes. Using bisulphite pyrosequencing we assessed the methylation density of 11 PCC/PGL disease genes in 96 tumors (83 PCCs and 13 PGLs) and 34 normal adrenal references. Gene expression levels were determined by quantitative RT-PCR. Both tumors and normal adrenal samples exhibited low methylation index (MetI) in the EGLN1 (PDH2), MAX, MEN1, NF1, SDHB, SDHC, SDHD, SDHAF2 (SDH5), and TMEM127 promoters, not exceeding 10% in any of the samples investigated. Aberrant RET promoter methylation was observed in two cases only. For the VHL gene we found increased MetI in tumors as compared with normal adrenals (57% vs. 27%; P < 0.001), in malignant vs. benign tumors (63% vs. 55%; P < 0.05), and in PGL vs. PCC (66% vs. 55%; P < 0.0005). Decreased expression of the VHL gene was observed in all tumors compared with normal adrenals (P < 0.001). VHL MetI and gene expressions were inversely correlated (R = −0.359, P < 0.0001). Our results show that the VHL gene promoter has increased methylation compared with normal adrenals (MetI > 50%) in approximately 75% of PCCs and PGLs investigated, highlighting the role of VHL in the development of these tumors.
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Affiliation(s)
- Adam Andreasson
- Department of Oncology-Pathology; Karolinska Institutet; Karolinska University Hospital; Stockholm, Sweden
| | - Nimrod B Kiss
- Department of Oncology-Pathology; Karolinska Institutet; Karolinska University Hospital; Stockholm, Sweden
| | - Stefano Caramuta
- Department of Oncology-Pathology; Karolinska Institutet; Karolinska University Hospital; Stockholm, Sweden
| | - Luqman Sulaiman
- Department of Oncology-Pathology; Karolinska Institutet; Karolinska University Hospital; Stockholm, Sweden
| | - Fredrika Svahn
- Department of Oncology-Pathology; Karolinska Institutet; Karolinska University Hospital; Stockholm, Sweden
| | - Martin Bäckdahl
- Department of Molecular Medicine and Surgery; Karolinska Institutet; Stockholm, Sweden; Department of Breast and Endocrine Surgery; Karolinska University Hospital; Stockholm, Sweden
| | - Anders Höög
- Department of Oncology-Pathology; Karolinska Institutet; Karolinska University Hospital; Stockholm, Sweden; Department of Clinical Pathology and Cytology; Karolinska University Hospital; Stockholm, Sweden
| | - C Christofer Juhlin
- Department of Oncology-Pathology; Karolinska Institutet; Karolinska University Hospital; Stockholm, Sweden; Department of Clinical Pathology and Cytology; Karolinska University Hospital; Stockholm, Sweden
| | - Catharina Larsson
- Department of Oncology-Pathology; Karolinska Institutet; Karolinska University Hospital; Stockholm, Sweden
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Andreasson A, Sulaiman L, do Vale S, Martins JM, Ferreira F, Miltenberger-Miltenyi G, Batista L, Haglund F, Björck E, Nilsson IL, Höög A, Larsson C, Juhlin CC. Molecular characterization of parathyroid tumors from two patients with hereditary colorectal cancer syndromes. Fam Cancer 2013; 11:355-62. [PMID: 22395475 DOI: 10.1007/s10689-012-9520-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The tumor suppressor adenomatous polyposis coli (APC) has recently been implicated in parathyroid development. We here report clinical, histopathological and molecular investigations in parathyroid tumors arising in two patients; one familial adenomatous polyposis (FAP) syndrome patient carrying a constitutional APC mutation, and one Lynch syndrome patient demonstrating a germline MLH1 mutation as well as a non-classified, missense alteration of the APC gene. We sequenced the entire APC gene in tumor and constitutional DNA from both cases, assessed the levels of APC promoter 1A and 1B methylation by bisulfite Pyrosequencing analysis and performed immunohistochemistry for APC and parafibromin. In addition, copy number analysis regarding the APC gene on chromosome 5q21-22 was performed using qRT-PCR. Histopathological workup confirmed both tumors as parathyroid adenomas without signs of malignancy or atypia. No somatic mutations or copy number changes for the APC gene were discovered in the tumors; however, in both cases, the APC promoter 1A was hypermethylated while the APC promoter 1B was unmethylated. APC promoter 1B-specific mRNA and total APC mRNA levels were higher than in normal parathyroid samples. Immunohistochemical analyses revealed strong APC protein immunoreactivity and positive parafibromin expression in both parathyroid tumors. Absence of additional somatic APC mutations and copy number changes in addition to the positive APC immunoreactivity obtained suggest that the tumors arose without biallelic inactivation of the APC tumor suppressor gene. The finding of an unmethylated APC promoter 1B and high APC 1B mRNA levels could explain the maintained APC protein expression. Moreover, the findings of positive parafibromin and APC immunoreactivity as well as a low MIB-1 proliferation index and absence of histopathological features of malignancy/atypical adenoma indicate that the parathyroid adenomas arising in these patients did not harbor malignant potential.
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Affiliation(s)
- Adam Andreasson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
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Kiss NB, Muth A, Andreasson A, Juhlin CC, Geli J, Bäckdahl M, Höög A, Wängberg B, Nilsson O, Ahlman H, Larsson C. Acquired hypermethylation of the P16INK4A promoter in abdominal paraganglioma: relation to adverse tumor phenotype and predisposing mutation. Endocr Relat Cancer 2013; 20:65-78. [PMID: 23154831 PMCID: PMC3573842 DOI: 10.1530/erc-12-0267] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Recurrent alterations in promoter methylation of tumor suppressor genes (TSGs) and LINE1 (L1RE1) repeat elements were previously reported in pheochromocytoma and abdominal paraganglioma. This study was undertaken to explore CpG methylation abnormalities in an extended tumor panel and assess possible relationships between metastatic disease and mutation status. CpG methylation was quantified by bisulfite pyrosequencing for selected TSG promoters and LINE1 repeats. Methylation indices above normal reference were observed for DCR2 (TNFRSF10D), CDH1, P16 (CDKN2A), RARB, and RASSF1A. Z-scores for overall TSG, and individual TSG methylation levels, but not LINE1, were significantly correlated with metastatic disease, paraganglioma, disease predisposition, or outcome. Most strikingly, P16 hypermethylation was strongly associated with SDHB mutation as opposed to RET/MEN2, VHL/VHL, or NF1-related disease. Parallel analyses of constitutional, tumor, and metastasis DNA implicate an order of events where constitutional SDHB mutations are followed by TSG hypermethylation and 1p loss in primary tumors, later transferred to metastatic tissue. In the combined material, P16 hypermethylation was prevalent in SDHB-mutated samples and was associated with short disease-related survival. The findings verify the previously reported importance of P16 and other TSG hypermethylation in an independent tumor series. Furthermore, a constitutional SDHB mutation is proposed to predispose for an epigenetic tumor phenotype occurring before the emanation of clinically recognized malignancy.
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Affiliation(s)
- Nimrod B Kiss
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
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Haglund F, Lu M, Vukojević V, Nilsson IL, Andreasson A, Džabić M, Bränström R, Höög A, Juhlin CC, Larsson C. Prolactin receptor in primary hyperparathyroidism--expression, functionality and clinical correlations. PLoS One 2012; 7:e36448. [PMID: 22606260 PMCID: PMC3350524 DOI: 10.1371/journal.pone.0036448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2012] [Accepted: 04/04/2012] [Indexed: 12/11/2022] Open
Abstract
Background Primary hyperparathyroidism (PHPT) is an endocrine disorder most commonly affecting women, suggesting a role for female hormones and/or their receptors in parathyroid adenomas. We here investigated the prolactin receptor (PRLr) which is associated with tumours of the breast and other organs. Methodology/Principal Findings PRLr expression was investigated in a panel of 37 patients with sporadic parathyroid tumours and its functionality in cultured parathyroid tumour cells. In comparison with other tissues and breast cancer cells, high levels of prolactin receptor gene (PRLR) transcripts were demonstrated in parathyroid tissues. PRLr products of 60/70 kDa were highly expressed in all parathyroid tumours. In addition varying levels of the 80 kDa PRLr isoform, with known proliferative activity, were demonstrated. In parathyroid tumours, PRLr immunoreactivity was observed in the cytoplasm (in all cases, n = 36), cytoplasmic granulae (n = 16), the plasma membrane (n = 12) or enlarged lysosomes (n = 4). In normal parathyroid rim (n = 28), PRLr was uniformly expressed in the cytoplasm and granulae. In in vitro studies of short-term cultured human parathyroid tumour cells, prolactin stimulation was associated with significant transcriptional changes in JAK/STAT, RIG-I like receptor and type II interferon signalling pathways as documented by gene expression profiling. Moreover, PRLR gene expression in parathyroid tumours was inversely correlated with the patients’ plasma calcium levels. Conclusions We demonstrate that the prolactin receptor is highly abundant in human parathyroid tissues and that PRLr isoforms expression and PRLr subcellular localisation are altered in parathyroid tumours. Responsiveness of PRLr to physiological levels of prolactin was observed in the form of increased PTH secretion and altered gene transcription with significant increase of RIG-I like receptor, JAK-STAT and Type II interferon signalling pathways. These data suggest a role of the prolactin receptor in parathyroid adenomas.
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Affiliation(s)
- Felix Haglund
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
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Haglund F, Andreasson A, Nilsson IL, Höög A, Larsson C, Juhlin CC. Lack of S37A CTNNB1/β-catenin mutations in a Swedish cohort of 98 parathyroid adenomas. Clin Endocrinol (Oxf) 2010; 73:552-3. [PMID: 20550535 DOI: 10.1111/j.1365-2265.2010.03830.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Andrén L, Andreasson A, Eggertsen R. Interaction between a commercially available St. John’s wort product (Movina) and atorvastatin in patients with hypercholesterolemia. Eur J Clin Pharmacol 2007; 63:913-6. [PMID: 17701167 DOI: 10.1007/s00228-007-0345-x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [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: 03/29/2007] [Accepted: 07/02/2007] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The aim of this study was to assess the effect of treatment with a St. John's wort product (Movina) on cholesterol [total cholesterol, low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol] and triglyceride levels in patients with hypercholesterolemia on treatment with a stable dose of atorvastatin in a controlled, randomised, open, crossover interaction study. METHODS Sixteen patients with hypercholesterolemia treated with a stable dose of atorvastatin (10-40 mg/daily) for at least 3 months were treated with Movina one tablet (containing 300 mg of hypericum perforatum) twice daily and control (a commercially available multivitamin tablet Vitamineral). After a run-in period of 4 weeks, patients were randomised to treatment with either Movina or control for 4 weeks in a crossover design. The atorvastatin dose was kept unchanged during the study period (12 weeks), and assessments of total cholesterol, HDL cholesterol, LDL cholesterol and triglycerides were performed in the morning with the patients in the fasting condition. The difference between control and active treatment in LDL cholesterol after 4 weeks of treatment was the primary endpoint. RESULTS All patients completed the study. The St. John's wort product significantly increased the serum level of LDL cholesterol compared with control (2.66 mmol/l compared with 2.34 mmol/l, p = 0.004). A significant increase in total cholesterol was also observed (5,10 mmol/l compared with 4.78 mmol/l, p = 0.02). No statistically significant change was observed in HDL cholesterol (1.59 mmol/l and 1.56 mmol/l, p = 0.49) or in triglycerides (1.87 mmol/l and 1.94 mmol/l, p = 0.60). No product-related side effects were reported CONCLUSION An interaction was observed between the studied St.-John's-wort-containing product and atorvastatin. Physicians and patients should be aware of this interaction and if treatment with a St. John's wort product is considered necessary, then there may be a need for increasing the dose of atorvastatin.
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Affiliation(s)
- L Andrén
- Department of Medicine/Clinical Pharmacology, Gothenburg University, Sahlgrenska University Hospital, Vita Stråket 11, S-413 45, Gothenburg, Sweden.
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Klint C, Truedsson L, Andreasson A, Johansson I, Sturfelt G. Toxic effects of SLE serum on normal monocytes in vitro: cell death induced by apoptosis related to complement dysfunction. Lupus 2000; 9:278-87. [PMID: 10866099 DOI: 10.1191/096120300680198999] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The aim of this study was to assess toxic effects of systemic lupus erythematosus (SLE) serum on blood peripheral mononuclear cells from healthy donors and to evaluate if complement activation was involved. Monocytes from a healthy donor were incubated with 20 sera from ten SLE patients in both high and low disease activity states. After incubation non-adherent cells were analysed by flow cytometry. Serum from six SLE patients induced an increased cell death, four in active disease only, one in the inactive state and one in the active and the inactive state. Five of these sera, three with high and two with low disease activity, induced an increased apoptosis in the monocytes. Proportion of apoptotic cells correlated inversely with C1q and C3 concentration in the active disease sera, but not with disease activity as evaluated by SLEDAI. Apoptosis could be induced by addition of active C1s or antigen/antibody complexes to normal serum before incubation. Serum with complexes added induced increased tumour necrosis factor-alpha secretion from mononuclear cells, but SLE patient sera did not. The results demonstrate that the toxic effect of serum from SLE patients on healthy monocytes is explained by induction of apoptosis. The induction process is suggested to be connected with complement activation in the serum.
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Affiliation(s)
- C Klint
- Department of Laboratory Medicine, Lund University, Sweden
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Syk I, Andreasson A, Truedsson L, Risberg B. Postoperative downregulation of MHC class II antigen on monocytes does not differ between open and endovascular repair of aortic aneurysms. Eur J Surg 1999; 165:1035-42. [PMID: 10595606 DOI: 10.1080/110241599750007856] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVES To study immune cell response and histocompability class II (HLA-DR) expression after aortic aneurysm repair. SETTING University hospital, Sweden. SUBJECTS 42 patients operated on for aortic aneurysm, 26 by an endovascular and 16 by an open technique. MAIN OUTCOME MEASURES Analysis of HLA-DR expression and concentrations of blood mononuclear cells by flow cytometry. Splanchnic pH analysed by tonometry and interleukin-6 and tumour necrosis factor-alpha measured by enzyme-linked immunosorbent assay. RESULTS The HLA-DR expression on lymphocytes did not change, whereas total HLA-DR expression on monocytes was downregulated, and more pronounced in five patients who developed severe postoperative complications. There were no differences in cell or HLA-DR responses between the two operations. CONCLUSIONS Both endovascular and open repair of aortic aneurysm produced similar downregulation of monocyte HLA-DR expression and similar responses in circulating mononuclear blood cells. There was pronounced downregulation of monocyte HLA-DR expression in patients with severe postoperative complications.
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Affiliation(s)
- I Syk
- Department of Surgery, Malmö University Hospital, Sweden
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Otto G, Braconier J, Andreasson A, Svanborg C, Walsh PC. Interleukin-6 and Disease Severity in Patients With Bacteremic and Nonbacteremic Febrile Urinary Tract Infection. J Urol 1999. [DOI: 10.1016/s0022-5347(05)68399-1] [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: 11/29/2022]
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Otto G, Braconier J, Andreasson A, Svanborg C. Interleukin-6 and disease severity in patients with bacteremic and nonbacteremic febrile urinary tract infection. J Infect Dis 1999; 179:172-9. [PMID: 9841836 DOI: 10.1086/314534] [Citation(s) in RCA: 94] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
An interleukin-6 (IL-6) response was detected in 81 patients with febrile urinary tract infections (UTIs). Bacteremic patients (n=24) had higher serum IL-6 at inclusion and throughout the first 24 h (P<. 01) and higher urine IL-6 from 6 h after start of therapy (P<.01) than did nonbacteremic patients (n=57). The serum and urine IL-6 responses remained elevated longer in the bacteremic group. Patients with clinical signs of pyelonephritis had higher serum and urine IL-6 concentrations than did other patients in the study population (P=.058, P<.01, respectively). IL-6 high responders had higher temperatures (P<.05) and C-reactive protein levels (P<.05, P<.01) than did low responders. The results demonstrate that IL-6 responses accompany febrile UTIs regardless of bacteremia and that the response reflects disease severity. The results suggest that IL-6 produced in the urinary tract can trigger the systemic host response in the absence of bacteremia.
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Affiliation(s)
- G Otto
- Department of Medical Microbiology, Division of Clinical Immunology, Lund University, Sweden
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Kidney JC, Boulet LP, Hargreave FE, Deschesnes F, Swystun VA, O'Byrne PM, Choudry N, Morris MM, Jennings B, Andersson N, Andreasson A, Cockcroft DW. Evaluation of single-dose inhaled corticosteroid activity with an allergen challenge model. J Allergy Clin Immunol 1997; 100:65-70. [PMID: 9257789 DOI: 10.1016/s0091-6749(97)70196-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Inhaled corticosteroids are the most commonly used antiinflammatory agents for asthma. There is no simple way to compare objectively the relative potency of inhaled corticosteroids. The allergen-induced late asthmatic response (LAR) can be suppressed by a single dose of inhaled corticosteroid. OBJECTIVE This study was undertaken to evaluate LAR as a model for the determination of the relative potency of single doses of inhaled corticosteroids. METHODS We compared doses of 200 and 800 microg of a highly active inhaled corticosteroid (budesonide) with placebo and a marginally active investigational inhaled corticosteroid (D5159). Ten atopic patients with asthma completed a randomized, double-blind, double-dummy, multicenter, four-way, crossover trial. A standardized allergen challenge with the identical dose of allergen was performed 10 minutes after each of four blinded, single-dose treatments: 200 microg of budesonide, 800 microg of budesonide, 8 mg of D5159, and placebo, all administered from Turbuhaler. The LAR was recorded as the maximum percent fall in FEV1 between 4 and 7 hours, and the allergen-induced increase in methacholine airway responsiveness at 24 hours was recorded as the A log PC20 from the day before to the day after allergen challenge. RESULTS There were no significant differences in the early asthmatic responses during the 4 days; the mean maximum percent in FEV1 fall ranged between 19.5% and 22%. D5159 produced a slight inhibition of the LAR with maximum percent fall in FEV1 recorded as 28.8% +/- 5.0% for D5159 versus 34.1% +/- 4.8% for placebo (p < 0.05). There was a greater reduction recorded after administration of the two doses of budesonide. The mean LAR was 15.1% +/- 3.8% for 200 microg of budesonide and 11.2% +/- 2.3% for 800 microg of budesonide (p < 0.01 compared with placebo and D5159). The two doses of budesonide were not statistically different. Airway responsiveness to methacholine increased by 1.07 doubling doses 24 hours after allergen challenge. This increased airway responsiveness was slightly, but not significantly, reduced by the three active treatments (0.6 to 0.91 doubling doses). CONCLUSION The allergen-induced LAR model was able to differentiate a single dose of an active inhaled corticosteroid from placebo and a highly potent inhaled corticosteroid from a weak inhaled corticosteroid. The model did not differentiate between 2 fourfold doses of the highly active inhaled corticosteroid (at the doses used in this study), neither for the fall in FEV1 nor for the increase in airway hyperresponsiveness.
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Affiliation(s)
- J C Kidney
- Asthma Research Group, McMaster University, Hamilton, Ontario, Canada
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Abstract
Serum and urine cytokines were analyzed in children with hemolytic uremic syndrome (HUS) and thrombotic thrombocytopenic purpura (TTP). Interleukin-6 (IL-6) was elevated in the serum of 33 of 35 children with HUS (94%) and in 2 of 2 children with recurrent TTP. Serum IL-6 was higher in children with HUS who developed anuria, extrarenal manifestations during the acute phase of illness and/or chronic renal sequelae. Tumor necrosis factor-alpha (TNF-alpha) was detected in the serum of 7 patients with HUS (20%) and 1 patient with TTP. IL-6 and TNF-alpha were elevated in the urine of 4 of 4 children with HUS and 2 of 2 children with TTP. Urinary levels were higher than serum levels, suggesting local production of cytokines in the urinary tract. Sequential serum and urine samples showed that IL-6 levels varied with disease activity. IL-6 and TNF-alpha were not detected in the serum (n = 25) and urine (n = 15) of healthy children. We conclude that IL-6 in urine may be used to monitor disease activity in HUS and TTP.
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Affiliation(s)
- D Karpman
- Department of Pediatrics, Lund University, Sweden
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Abstract
This study analyzed the interleukin 6 (IL-6) response in 114 children with suspected urinary tract infection (UTI). Urine and serum samples were obtained at the time of enrollment. There were 90 children with UTI, 41 with and 49 without a temperature > or = 38.5 degrees C. The remaining 24 children did not have bacteriuria; 11 were febrile and 13 were not. The urinary IL-6 concentrations were higher in the children with UTI (mean, 129 units/ml) than in the children without bacteriuria (mean, 7 units/ml, P < 0.01). In contrast the serum IL-6 did not differ between children with or without UTI or between children with or without a temperature > or = 38.5 degrees C. The urinary IL-6 response was higher in children who were infected with P fimbriated Escherichia coli than in other children with UTI (P < 0.05). There was a correlation of urinary IL-6 with the degree of proteinuria, hematuria and urinary leukocyte counts (P < 0.001, P < 0.05, P < 0.05, respectively) but not with serum IL-6, CRP or temperature, and of serum IL-6 to C-reactive protein (P = 0.053) and renal concentrating capacity (P < 0.05). The results demonstrate that infections of the urinary tract activate an IL-6 response in children and that the magnitude of the IL-6 response is influenced by the properties of the infecting strain.
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Affiliation(s)
- M Benson
- Department of Pediatrics, Göteborg University, Sweden
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Abstract
Effects of caffeine on ambulatory blood pressure, heart rate, renin-angiotensin system, and ANP were studied in patients treated for mild to moderate hypertension in a randomized, double-blind, placebo-controlled, cross-over trial comparing 2 weeks of caffeine-free diet with 2 weeks of regular coffee use. Twenty-three patients (13 men; aged 28-74 years) with treated, mild to moderate essential hypertension and a regular intake of 3-4 cups of coffee daily completed the study. Mean 24-h, day- or night-time ambulatory blood pressure and heart rate were not different between regimens. Nor were there any effects on the renin-angiotensin system while ANP was significantly increased during caffeine intake. Compliance of the dietary regimen was excellent as assessed by serum caffeine concentration measurements. We conclude that habitual coffee drinking did not influence the 24-h blood pressure profiles or cardiovascular hormones in treated hypertensives.
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Affiliation(s)
- R Eggertsen
- Mölndycke Primary Care Centre, University of Göteborg, Sweden
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Ungell AL, Andreasson A, Lundin K, Utter L. Effects of enzymatic inhibition and increased paracellular shunting on transport of vasopressin analogues in the rat. J Pharm Sci 1992; 81:640-5. [PMID: 1403696 DOI: 10.1002/jps.2600810710] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The Ussing chamber technique was used as an oral absorption model for studies of the relative effects of the inhibition of enzymatic degradation and increased paracellular route on the transport of the poorly absorbed vasopressin analogues lysine vasopressin (LVP) and desmopressin (DDAVP). The rates of transport of LVP or DDAVP at 250 microM across ileum and colon segments were studied in the absence and in the presence of protease inhibitors (aprotinin and bestatin) and cytochalasin-B. During the different treatments, the rates of degradation of the peptides were also studied. Detectable amounts of LVP could only be measured on the serosal side of the intestinal segment in the presence of protease inhibitors or cytochalasin-B. The treatment with cytochalasin-B increased the rates of transport of both peptides severalfold, and the effect was reversible. We suggest that the Ussing chamber technique can be used to evaluate the reasons for low transport rates across intestinal membranes. The results also show that, apart from enzymatic degradation, the vasopressin analogues LVP and DDAVP have additional permeation problems; therefore, it may be necessary to increase the paracellular route to increase the absorption of these peptides.
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Affiliation(s)
- A L Ungell
- Department of Drug Delivery Research, Pharmaceutical R & D, Astra Hässle AB, Mölndal, Sweden
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Andreasson A, Jonasson AL. [Symphysiotomy]. Jordemodern 1981; 94:47-56. [PMID: 6912845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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