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Hazra A, Ullrich A, Nimri O. Disparities in Breast Cancer Characteristics Among Syrian Migrants and Jordanian Women in the Jordan Cancer Registry from 2010 to 2016. JAMA Netw Open 2023; 6:e2325197. [PMID: 37486635 PMCID: PMC10366694 DOI: 10.1001/jamanetworkopen.2023.25197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/25/2023] Open
Abstract
This case series analyzes breast cancer characteristics of women diagnosed with breast ancer in the Jordan Cancer Registry by Syrian migrant status to determine inequities.
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Affiliation(s)
- Aditi Hazra
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Andreas Ullrich
- Department Gynaecology Charité University, Charité Universitätsmedizin, Berlin, Germany
| | - Omar Nimri
- Disease Prevention and Control Directorate, Jordan Center for Disease Control, Amman, Jordan
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2
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Hazra A, Bondarenko I. Clinical trials can adapt for refugees. Science 2023; 380:592. [PMID: 37167395 DOI: 10.1126/science.adh1190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Affiliation(s)
- Aditi Hazra
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Igor Bondarenko
- Oncology and Medical Radiology Department, Dnipropetrovsk Medical Academy, Dnipro State Medical University, Dnipro, Ukraine
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Ray A, Pandithurai G, Mukherjee S, Kumar VA, Hazra A, Patil RD, Waghmare V. Seasonal variability in size-resolved hygroscopicity of sub-micron aerosols over the Western Ghats, India: Closure and parameterization. Sci Total Environ 2023; 869:161753. [PMID: 36690110 DOI: 10.1016/j.scitotenv.2023.161753] [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] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 06/17/2023]
Abstract
Hygroscopicity of atmospheric aerosol primarily depends on the size and chemical composition of the particle and is important for estimating anthropogenic aerosol radiative forcing. There is limited information exists over the Indian region on size segregated aerosol hygroscopicity (κ) in different seasons. This study presents 'κ' as derived from a Humidified Tandem Differential Mobility Analyzer (HTDMA) over a High Altitude Cloud Physics Laboratory (HACPL) in the Western Ghats, India for more than a year (from May 2019 to May 2020). The average hygroscopicity values of aerosol particles of diameters 32, 50, 75, 110, 150, 210 and 260 nm at 90 % RH condition are 0.19, 0.18, 0.16, 0.17, 0.18, 0.20, 0.21 respectively during the entire observation period. κ was observed to decrease with an increase in size in the Aitken mode regime (32-75 nm) and an increase in the accumulation mode (110-260 nm). Seasonal variation of hygroscopicity for a wide range of particle diameters is reported which is highly demanding as there is a change in the air mass flow pattern in each of the seasons. The diurnal cycle of hygroscopicity showed a prominent peak during the midnight to early morning hours followed by a decrease in the forenoon hours and a secondary peak in the afternoon hours. κ is found to be higher in pre-monsoon compared to winter season as Chl is approximately 3 % higher in pre-monsoon and NH4Cl is highly hygroscopic among the assumed chemical composition. Hygroscopicity derived through chemical speciation observations assuming internal and external mixing of aerosols i.e. κinter and κexter are overestimating as compared to κHTDMA. However, the bias between kexter and kHTDMA is relatively lower as external mixing type of aerosol is evident through the growth factor data sets measured by HTDMA. Utilizing the hygroscopicity measurements available for discrete diameters by HTDMA, a parameterization of hygroscopicity with the dry diameter of sub-micron particles is developed.
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Affiliation(s)
- Avishek Ray
- Indian Institute of Tropical Meteorology, Pune, Ministry of Earth Sciences, India; Savitribai Phule Pune University, Pune, India
| | - G Pandithurai
- Indian Institute of Tropical Meteorology, Pune, Ministry of Earth Sciences, India.
| | - S Mukherjee
- Indian Institute of Tropical Meteorology, Pune, Ministry of Earth Sciences, India
| | - V Anil Kumar
- Indian Institute of Tropical Meteorology, Pune, Ministry of Earth Sciences, India
| | - A Hazra
- Indian Institute of Tropical Meteorology, Pune, Ministry of Earth Sciences, India
| | - Rohit D Patil
- Indian Institute of Tropical Meteorology, Pune, Ministry of Earth Sciences, India
| | - V Waghmare
- Indian Institute of Tropical Meteorology, Pune, Ministry of Earth Sciences, India
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Hazra A, O’Hara A, Polyak K, Nakhlis F, Harrison BT, Giordano A, Overmoyer B, Lynce F. Copy Number Variation in Inflammatory Breast Cancer. Cells 2023; 12:cells12071086. [PMID: 37048158 PMCID: PMC10093603 DOI: 10.3390/cells12071086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 03/29/2023] [Accepted: 03/31/2023] [Indexed: 04/08/2023] Open
Abstract
Identification of a unique genomic biomarker in de novo inflammatory breast cancer (IBC) may provide an insight into the biology of this aggressive disease. The goal of our study was to elucidate biomarkers associated with IBC. We examined breast biopsies collected from Dana–Farber Cancer Institute patients with IBC prior to initiating preoperative systemic treatment (30 samples were examined, of which 14 were eligible). Patients without available biopsies (n = 1), with insufficient tumor epithelial cells (n = 10), or insufficient DNA yield (n = 5) were excluded from the analysis. Molecular subtype and tumor grade were abstracted from a medical records’ review. Ten IBC tumors were estrogen-receptor-positive (ER+) and human epidermal growth factor receptor 2 (HER2)-negative (n = 10 out of 14). Sufficient RNA and DNA were simultaneously extracted from 14 biopsy specimens using the Qiagen AllPrep Kit. RNA was amplified using the Sensation kit and profiled using the Affymetrix Human Transcriptome Array 2.0. DNA was profiled for genome-wide copy number variation (CNV) using the Affymetrix OncoScan Array and analyzed using the Nexus Chromosome Analysis Suite. Among the 14 eligible samples, we first confirmed biological concordance and quality control metrics using replicates and gene expression data. Second, we examined CNVs and gene expression change by IBC subtype. We identified significant CNVs in IBC patients after adjusting for multiple comparisons. Next, to assess whether the CNVs were unique to IBC, we compared the IBC CNV data to fresh-frozen non-IBC CNV data from The Cancer Genome Atlas (n = 388). On chromosome 7p11.2, we identified significant CN gain located at position 58,019,983-58,025,423 in 8 ER+ IBC samples compared to 338 non-IBC ER+ samples (region length: 5440 bp gain and 69,039 bp, False Discovery Rate (FDR) p-value = 3.12 × 10−10) and at position 57,950,944–58,025,423 in 3 TN-IBC samples compared to 50 non-IBC TN samples (74,479 base pair, gain, FDR p-value = 4.27 × 10−5; near the EGFR gene). We also observed significant CN loss on chromosome 21, located at position 9,648,315–9,764,385 (p-value = 4.27 × 10−5). Secondarily, differential gene expression in IBC patients with 7p11.2 CN gain compared to SUM149 were explored after FDR correction for multiple testing (p-value = 0.0016), but the results should be interpreted with caution due to the small sample size. Finally, the data presented are hypothesis-generating. Validation of CNVs that contribute to the unique presentation and biological features associated with IBC in larger datasets may lead to the optimization of treatment strategies.
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Affiliation(s)
- Aditi Hazra
- Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02215, USA
- Inflammatory Breast Cancer Program, Dana-Farber Cancer Institute, Boston, MA 02115, USA
| | | | - Kornelia Polyak
- Inflammatory Breast Cancer Program, Dana-Farber Cancer Institute, Boston, MA 02115, USA
- Department of Medical Oncology, Breast Oncology Center, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02115, USA
| | - Faina Nakhlis
- Inflammatory Breast Cancer Program, Dana-Farber Cancer Institute, Boston, MA 02115, USA
- Department of Surgery, Division of Breast Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Beth T. Harrison
- Inflammatory Breast Cancer Program, Dana-Farber Cancer Institute, Boston, MA 02115, USA
- Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Antonio Giordano
- Inflammatory Breast Cancer Program, Dana-Farber Cancer Institute, Boston, MA 02115, USA
- Department of Medical Oncology, Breast Oncology Center, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02115, USA
| | - Beth Overmoyer
- Inflammatory Breast Cancer Program, Dana-Farber Cancer Institute, Boston, MA 02115, USA
- Department of Medical Oncology, Breast Oncology Center, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02115, USA
| | - Filipa Lynce
- Inflammatory Breast Cancer Program, Dana-Farber Cancer Institute, Boston, MA 02115, USA
- Department of Medical Oncology, Breast Oncology Center, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02115, USA
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Zaaimi B, Turnbull M, Hazra A, Wang Y, Gandara C, McLeod F, McDermott EE, Escobedo-Cousin E, Idil AS, Bailey RG, Tardio S, Patel A, Ponon N, Gausden J, Walsh D, Hutchings F, Kaiser M, Cunningham MO, Clowry GJ, LeBeau FEN, Constandinou TG, Baker SN, Donaldson N, Degenaar P, O'Neill A, Trevelyan AJ, Jackson A. Closed-loop optogenetic control of the dynamics of neural activity in non-human primates. Nat Biomed Eng 2023; 7:559-575. [PMID: 36266536 PMCID: PMC7614485 DOI: 10.1038/s41551-022-00945-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 08/14/2022] [Indexed: 11/08/2022]
Abstract
Electrical neurostimulation is effective in the treatment of neurological disorders, but associated recording artefacts generally limit its applications to open-loop stimuli. Real-time and continuous closed-loop control of brain activity can, however, be achieved by pairing concurrent electrical recordings and optogenetics. Here we show that closed-loop optogenetic stimulation with excitatory opsins enables the precise manipulation of neural dynamics in brain slices from transgenic mice and in anaesthetized non-human primates. The approach generates oscillations in quiescent tissue, enhances or suppresses endogenous patterns in active tissue and modulates seizure-like bursts elicited by the convulsant 4-aminopyridine. A nonlinear model of the phase-dependent effects of optical stimulation reproduced the modulation of cycles of local-field potentials associated with seizure oscillations, as evidenced by the systematic changes in the variability and entropy of the phase-space trajectories of seizures, which correlated with changes in their duration and intensity. We also show that closed-loop optogenetic neurostimulation could be delivered using intracortical optrodes incorporating light-emitting diodes. Closed-loop optogenetic approaches may be translatable to therapeutic applications in humans.
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Affiliation(s)
- B Zaaimi
- Biosciences Institute, Newcastle University, Newcastle, UK
- School of Life and Health Sciences, Aston University, Birmingham, UK
| | - M Turnbull
- Biosciences Institute, Newcastle University, Newcastle, UK
| | - A Hazra
- Biosciences Institute, Newcastle University, Newcastle, UK
| | - Y Wang
- School of Computing, Newcastle University, Newcastle, UK
| | - C Gandara
- Biosciences Institute, Newcastle University, Newcastle, UK
| | - F McLeod
- Biosciences Institute, Newcastle University, Newcastle, UK
| | - E E McDermott
- Biosciences Institute, Newcastle University, Newcastle, UK
| | | | - A Shah Idil
- Department of Medical Physics and Biomedical Engineering, University College London, London, UK
| | - R G Bailey
- School of Engineering, Newcastle University, Newcastle, UK
| | - S Tardio
- School of Engineering, Newcastle University, Newcastle, UK
| | - A Patel
- School of Engineering, Newcastle University, Newcastle, UK
| | - N Ponon
- School of Engineering, Newcastle University, Newcastle, UK
| | - J Gausden
- School of Engineering, Newcastle University, Newcastle, UK
| | - D Walsh
- Biosciences Institute, Newcastle University, Newcastle, UK
| | - F Hutchings
- School of Computing, Newcastle University, Newcastle, UK
| | - M Kaiser
- School of Computing, Newcastle University, Newcastle, UK
- NIHR, Nottingham Biomedical Research Centre, School of Medicine, University of Nottingham, Nottingham, UK
- Sir Peter Mansfield Imaging Centre, School of Medicine, University of Nottingham, Nottingham, UK
- Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - M O Cunningham
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - G J Clowry
- Biosciences Institute, Newcastle University, Newcastle, UK
| | - F E N LeBeau
- Biosciences Institute, Newcastle University, Newcastle, UK
| | - T G Constandinou
- Department of Electrical and Electronic Engineering, Imperial College, London, UK
| | - S N Baker
- Biosciences Institute, Newcastle University, Newcastle, UK
| | - N Donaldson
- Department of Medical Physics and Biomedical Engineering, University College London, London, UK
| | - P Degenaar
- School of Engineering, Newcastle University, Newcastle, UK
| | - A O'Neill
- School of Engineering, Newcastle University, Newcastle, UK
| | - A J Trevelyan
- Biosciences Institute, Newcastle University, Newcastle, UK
| | - A Jackson
- Biosciences Institute, Newcastle University, Newcastle, UK.
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Vyas CM, Sadreyev RI, Gatchel JR, Kang JH, Reynolds CF, Mischoulon D, Chang G, Hazra A, Manson JE, Blacker D, Vivo ID, Okereke OI. Pilot Study of Second-Generation DNA Methylation Epigenetic Markers in Relation to Cognitive and Neuropsychiatric Symptoms in Older Adults. J Alzheimers Dis 2023; 93:1563-1575. [PMID: 37212116 PMCID: PMC10336852 DOI: 10.3233/jad-230093] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
BACKGROUND Associations between epigenetic aging with cognitive aging and neuropsychiatric measures are not well-understood. OBJECTIVE 1) To assess cross-sectional correlations between second-generation DNA methylation (DNAm)-based clocks of healthspan and lifespan (i.e., GrimAge, PhenoAge, and DNAm-based estimator of telomere length [DNAmTL]) and cognitive and neuropsychiatric measures; 2) To examine longitudinal associations between change in DNAm markers and change in cognition over 2 years. METHODS Participants were members of VITAL-DEP (VITamin D and OmegA-3 TriaL- Depression Endpoint Prevention) study. From previously ascertained cognitive groups (i.e., cognitively normal and mild cognitive impairment), we randomly selected 45 participants, aged≥60 years, who completed in-person neuropsychiatric assessments at baseline and 2 years. The primary outcome was global cognitive score (averaging z-scores of 9 tests). Neuropsychiatric Inventory severity scores were mapped from neuropsychiatric symptoms (NPS) from psychological scales and structured diagnostic interviews. DNAm was assayed using Illumina MethylationEPIC 850K BeadChip at baseline and 2 years. We calculated baseline partial Spearman correlations between DNAm markers and cognitive and NPS measures. We constructed multivariable linear regression models to examine longitudinal relations between DNAm markers and cognition. RESULTS At baseline, we observed a suggestive negative correlation between GrimAge clock markers and global cognition but no signal between DNAm markers and NPS measures. Over 2 years: each 1-year increase in DNAmGrimAge was significantly associated with faster declines in global cognition; each 100-base pair increase in DNAmTL was significantly associated with better global cognition. CONCLUSION We found preliminary evidence of cross-sectional and longitudinal associations between DNAm markers and global cognition.
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Affiliation(s)
- Chirag M. Vyas
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Ruslan I. Sadreyev
- Department of Molecular Biology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Jennifer R. Gatchel
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Division of Geriatric Psychiatry, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | - Jae H. Kang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Charles F. Reynolds
- Department of Psychiatry, UPMC and University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - David Mischoulon
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Grace Chang
- Department of Psychiatry, VA Boston Healthcare System and Harvard Medical School, Boston, MA, USA
| | - Aditi Hazra
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - JoAnn E. Manson
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Deborah Blacker
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Immaculata De Vivo
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Olivia I. Okereke
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
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7
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Sharma S, Sahu R, Taneja N, Hazra A. Epidemiological investigation of viral hepatitis E outbreak in two colocated training centers. Med J Armed Forces India 2022; 78:S116-S122. [PMID: 36147417 PMCID: PMC9485744 DOI: 10.1016/j.mjafi.2018.09.001] [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: 02/27/2018] [Accepted: 09/02/2018] [Indexed: 10/27/2022] Open
Abstract
Background A high number of jaundice cases were reported from two colocated training centers in North India. This outbreak was investigated to describe the epidemiology, identify risk factors, and recommend preventive and control measures. Methods Initial line list was prepared, and case definition was defined as "the presence of icterus or passage of yellow-colored urine with fever/anorexia/vomiting/abdominal pain in a resident of Military Station A between 03/04/2016 to 06/06/2016". Case search was conducted through surveillance. An unmatched 1:1 case-control study was conducted to evaluate the associated risk factors. All cases were tested for hepatitis markers. Environmental investigation of food and water sources was conducted to identify the source of infection. Results Of 172 cases, all were males from two co-located military training centers (attack rate, 4.7%). Clinical features included icterus (100%), yellowish discoloration of urine (98.9%), anorexia (97.22%), fever (80%), nausea/vomiting (56%), and abdominal pain (52.77%). Only one case (0.6%) had complication of fulminant hepatitis, and there were no deaths (CFR = 0%). Consumption of juice with ice from juice shops was significantly associated with illness (Odds Ratio-14.3 [95%CI 7.4-27.6]). Of 172 cases, 167 (97.1%) tested anti-HEV-IgM positive. Juice shops in training centers were using ice made from contaminated water with positive coliform test. All other water samples tested satisfactory. No cross-contamination of water pipelines with sewage was observed. Conclusion Epidemiological evidence concludes that a large viral hepatitis E outbreak was likely caused by consumption of juice with contaminated ice. Early stoppage of contaminated ice usage led to timely control of the outbreak.
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Affiliation(s)
- Seema Sharma
- Assistant Director (Health), Head Quarters (DB Area), Chennai 600 009, India
| | - Rajesh Sahu
- Classified Specialist (Community Medicine), Command Hospital (Central Command), Lucknow 226010, India
| | - N.S. Taneja
- Classified Specialist (Pathology), Military Hospital Ramgarh Cantt, Jharkhand, India
| | - A. Hazra
- Senior Advisor (Community Medicine), Headquarters Southern Command, Pune, India
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8
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Salvatore M, Purkayastha S, Ganapathi L, Bhattacharyya R, Kundu R, Zimmermann L, Ray D, Hazra A, Kleinsasser M, Solomon S, Subbaraman R, Mukherjee B. Lessons from SARS-CoV-2 in India: A data-driven framework for pandemic resilience. Sci Adv 2022; 8:eabp8621. [PMID: 35714183 PMCID: PMC9205583 DOI: 10.1126/sciadv.abp8621] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
India experienced a massive surge in SARS-CoV-2 infections and deaths during April to June 2021 despite having controlled the epidemic relatively well during 2020. Using counterfactual predictions from epidemiological disease transmission models, we produce evidence in support of how strengthening public health interventions early would have helped control transmission in the country and significantly reduced mortality during the second wave, even without harsh lockdowns. We argue that enhanced surveillance at district, state, and national levels and constant assessment of risk associated with increased transmission are critical for future pandemic responsiveness. Building on our retrospective analysis, we provide a tiered data-driven framework for timely escalation of future interventions as a tool for policy-makers.
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Affiliation(s)
- Maxwell Salvatore
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
- Center for Precision Health Data Science, University of Michigan, Ann Arbor, MI, USA
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
| | | | - Lakshmi Ganapathi
- Division of Infectious Diseases, Boston Children’s Hospital and Harvard Medical School, Boston, MA, USA
| | | | - Ritoban Kundu
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | - Lauren Zimmermann
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
- Center for Precision Health Data Science, University of Michigan, Ann Arbor, MI, USA
| | - Debashree Ray
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Aditi Hazra
- Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | | | - Sunil Solomon
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ramnath Subbaraman
- Department of Public Health and Community Medicine and Center for Global Public Health, Tufts University School of Medicine, Boston, MA, USA
| | - Bhramar Mukherjee
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
- Center for Precision Health Data Science, University of Michigan, Ann Arbor, MI, USA
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
- Corresponding author.
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9
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Rist PM, Sesso HD, Johnson LG, Aragaki AK, Wang L, Rautiainen S, Hazra A, Tobias DK, LeBoff MS, Schroeter H, Friedenberg G, Copeland T, Clar A, Tinker LF, Hunt RP, Bassuk SS, Sarkissian A, Smith DC, Pereira E, Carrick WR, Wion ES, Schoenberg J, Anderson GL, Manson JE. Design and baseline characteristics of participants in the COcoa Supplement and Multivitamin Outcomes Study (COSMOS). Contemp Clin Trials 2022; 116:106728. [PMID: 35288332 PMCID: PMC9133193 DOI: 10.1016/j.cct.2022.106728] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 03/01/2022] [Accepted: 03/02/2022] [Indexed: 11/15/2022]
Abstract
Background Cocoa extract and multivitamins have been proposed to reduce the risk of cardiovascular disease (CVD) and cancer, respectively. However, few randomized clinical trials have tested their long-term effects on these outcomes. Methods The COcoa Supplement and Multivitamin Outcomes Study (COSMOS) is a randomized, double-blind, placebo-controlled, 2 × 2 factorial trial of a cocoa extract supplement and a multivitamin supplement to reduce the risk of CVD and cancer. Here we describe the pragmatic, hybrid design of the trial and baseline characteristics of the trial participants. Results The nationwide study population includes 21,442 U.S. women aged ≥65 years and men aged ≥60 years without baseline myocardial infarction (MI), stroke, or a recent (within the past 2 years) cancer diagnosis. Participants were randomized in a 2 × 2 factorial design to one of four groups: (1) cocoa extract (containing 500 mg/d flavanols, including 80 mg (-)-epicatechin) and a multivitamin (Centrum Silver©); (2) cocoa extract and multivitamin placebo; (3) multivitamin and cocoa extract placebo; or (4) both placebos. Randomization successfully distributed baseline demographic, clinical, behavioral, and dietary characteristics across treatment groups. Baseline biospecimens were collected from 6867 participants, with at least one follow-up biospecimen from 2142 participants. The primary outcome for the cocoa extract intervention is total CVD (a composite of MI, stroke, cardiovascular mortality, coronary revascularization, unstable angina requiring hospitalization, carotid artery surgery, and peripheral artery surgery); the primary outcome for the multivitamin intervention is total invasive cancer. Conclusion COSMOS will provide important information on the health effects of cocoa extract and multivitamin supplementation in older U.S. adults. Clinical Trials Registration: clinicaltrials.gov #NCT02422745.
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Affiliation(s)
- Pamela M Rist
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Howard D Sesso
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Lisa G Johnson
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Aaron K Aragaki
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Lu Wang
- Epidemiology, Janssen Research & Development, LLC, Titusville, NJ, USA
| | - Susanne Rautiainen
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Aditi Hazra
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Deirdre K Tobias
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Meryl S LeBoff
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | | | - Georgina Friedenberg
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Trisha Copeland
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Allison Clar
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Lesley F Tinker
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Rebecca P Hunt
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Shari S Bassuk
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Ara Sarkissian
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Douglas C Smith
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Eduardo Pereira
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - William R Carrick
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Emily S Wion
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Jennifer Schoenberg
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Garnet L Anderson
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - JoAnn E Manson
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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10
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Hazra A, Mandal S, Chakraborty J. W040 Relationship of neutrophil-lymphocyte-ratio and platelet counts with parathormone, and how they are affected by gender, age and sugar levels in maintenance hemodialysis patients in India. Clin Chim Acta 2022. [DOI: 10.1016/j.cca.2022.04.171] [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: 11/03/2022]
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11
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Joshi R, Medhi B, Prakash A, Chandy S, Ranjalkar J, Bright HR, Basker J, Govindraj L, Chugh PK, Tripathi CD, Badyal DK, Balakrishnan S, Jhaj R, Shukla AK, Atal S, Najmi A, Banerjee A, Kamat S, Tripathi RK, Shetty YC, Parmar U, Rege N, Dikshit H, Mishra H, Roy SS, Chatterjee S, Hazra A, Bhattacharya M, Das D, Trivedi N, Shah P, Chauhan J, Desai C, Gandhi AM, Patel PP, Shah S, Sheth S, Raveendran R, Mathaiyan J, Manikandan S, Jeevitha G, Gupta P, Sarangi SC, Yadav HN, Singh S, Kaushal S, Arora S, Gupta K, Jain S, Cherian JJ, Chatterjee NS, Kaul R, Kshirsagar NA. Assessment of prescribing pattern of drugs and completeness of prescriptions as per the World Health Organization prescribing indicators in various Indian tertiary care centers: A multicentric study by Rational Use of Medicines Centers-Indian Council of Medical Research network under National Virtual Centre Clinical Pharmacology activity. Indian J Pharmacol 2022; 54:321-328. [PMID: 36537400 PMCID: PMC9846909 DOI: 10.4103/ijp.ijp_976_21] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE The rational use of medicines as per the World Health Organization (WHO) should be practiced globally. However, data regarding the completeness of the prescriptions and their rational use is lacking from developing countries like India. Thus, the aim of this study was to assess the prescribing patterns of drugs and completeness of prescriptions as per WHO core drug use and complementary indicators to provide real-life examples for the Indian Council of Medical Research (ICMR) online prescribing skill course for medical graduates. METHODS Prescriptions of the patients, fulfilling inclusion criteria, attending Outpatient Departments of various specialties of tertiary care hospitals, were collected by thirteen ICMR Rational use of medicines centers located in tertiary care hospitals, throughout India. Prescriptions were evaluated for rational use of medicines according to the WHO guidelines and for appropriateness as per standard treatment guidelines using a common protocol approved by local Ethics committees. RESULTS Among 4838 prescriptions, an average of about three drugs (3.34) was prescribed to the patients per prescription. Polypharmacy was noted in 83.05% of prescriptions. Generic drugs were prescribed in 47.58% of the prescriptions. Further, antimicrobials were prescribed in 17.63% of the prescriptions and only 4.98% of prescriptions were with injectables. During the prescription evaluation, 38.65% of the prescriptions were incomplete due to multiple omissions such as dose, duration, and formulation. CONCLUSION Most of the parameters in the present study were out of the range of WHO-recommended prescribing indicators. Therefore, effective intervention program, like training, for the promotion of rational drug use practice was recommended to improve the prescribing pattern of drugs and the quality of prescriptions all over the country.
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Affiliation(s)
- R Joshi
- Department of Pharmacology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - B Medhi
- Department of Pharmacology, Post Graduate Institute of Medical Education and Research, Chandigarh, India,Address for correspondence: Dr. Medhi B, Department of Pharmacology, Post Graduate Institute of Medical Education and Research, Chandigarh, India. E-mail:
| | - A Prakash
- Department of Pharmacology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - S Chandy
- Department of Pharmacology and Clinical Pharmacology, Christian Medical College, Vellore, Tamil Nadu, India
| | - J Ranjalkar
- Department of Pharmacology and Clinical Pharmacology, Christian Medical College, Vellore, Tamil Nadu, India
| | - HR Bright
- Department of Pharmacology and Clinical Pharmacology, Christian Medical College, Vellore, Tamil Nadu, India
| | - J Basker
- Department of Pharmacology and Clinical Pharmacology, Christian Medical College, Vellore, Tamil Nadu, India
| | - L Govindraj
- Department of Pharmacology and Clinical Pharmacology, Christian Medical College, Vellore, Tamil Nadu, India
| | - PK Chugh
- Vardhman Mahavir Medical College, New Delhi, India
| | - CD Tripathi
- Vardhman Mahavir Medical College, New Delhi, India
| | - DK Badyal
- Department of Pharmacology, Christian Medical College, Ludhiana, Punjab, India
| | - S Balakrishnan
- Department of Pharmacology, All India Institute of Medical Sciences, Bhopal, India
| | - R Jhaj
- Department of Pharmacology, All India Institute of Medical Sciences, Bhopal, India
| | - AK Shukla
- Department of Pharmacology, All India Institute of Medical Sciences, Bhopal, India
| | - S Atal
- Department of Pharmacology, All India Institute of Medical Sciences, Bhopal, India
| | - A Najmi
- Department of Pharmacology, All India Institute of Medical Sciences, Bhopal, India
| | - A Banerjee
- Department of Pharmacology, All India Institute of Medical Sciences, Bhopal, India
| | - S Kamat
- Department of Pharmacology and Therapeutics, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - RK Tripathi
- Department of Pharmacology and Therapeutics, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - YC Shetty
- Department of Pharmacology and Therapeutics, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - U Parmar
- Department of Pharmacology and Therapeutics, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - N Rege
- Department of Pharmacology and Therapeutics, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - H Dikshit
- Department of Pharmacology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - H Mishra
- Department of Pharmacology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - SS Roy
- Department of Pharmacology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - S Chatterjee
- Department of Pharmacology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - A Hazra
- Department of Pharmacology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - M Bhattacharya
- Department of Pharmacology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - D Das
- Department of Pharmacology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - N Trivedi
- Department of Pharmacology, Government Medical College, Baroda, Gujarat, India
| | - P Shah
- Department of Pharmacology, Government Medical College, Baroda, Gujarat, India
| | - J Chauhan
- Department of Pharmacology, Government Medical College, Baroda, Gujarat, India
| | - C Desai
- Department of Pharmacology, B.J. Medical College, Ahmedabad, Gujarat, India
| | - AM Gandhi
- Department of Pharmacology, B.J. Medical College, Ahmedabad, Gujarat, India
| | - PP Patel
- Department of Pharmacology, B.J. Medical College, Ahmedabad, Gujarat, India
| | - S Shah
- Department of Pharmacology, B.J. Medical College, Ahmedabad, Gujarat, India
| | - S Sheth
- Department of Pharmacology, B.J. Medical College, Ahmedabad, Gujarat, India
| | - R Raveendran
- Department of Pharmacology, Jawaharlal Institute of Post Medical Education and Research, Puducherry, India
| | - J Mathaiyan
- Department of Pharmacology, Jawaharlal Institute of Post Medical Education and Research, Puducherry, India
| | - S Manikandan
- Department of Pharmacology, Jawaharlal Institute of Post Medical Education and Research, Puducherry, India
| | - G Jeevitha
- Department of Pharmacology, Jawaharlal Institute of Post Medical Education and Research, Puducherry, India
| | - P Gupta
- Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, India
| | - SC Sarangi
- Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, India
| | - HN Yadav
- Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, India
| | - S Singh
- Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, India
| | - S Kaushal
- Department of Pharmacology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - S Arora
- Department of Pharmacology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - K Gupta
- Department of Pharmacology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - S Jain
- Department of Pharmacology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - JJ Cherian
- Indian Council of Medical Research, New Delhi, India
| | - NS Chatterjee
- Indian Council of Medical Research, New Delhi, India
| | - R Kaul
- Indian Council of Medical Research, New Delhi, India
| | - NA Kshirsagar
- Indian Council of Medical Research, New Delhi, India
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12
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Trombetta BA, Kandigian SE, Kitchen RR, Grauwet K, Webb PK, Miller GA, Jennings CG, Jain S, Miller S, Kuo Y, Sweeney T, Gilboa T, Norman M, Simmons DP, Ramirez CE, Bedard M, Fink C, Ko J, De León Peralta EJ, Watts G, Gomez-Rivas E, Davis V, Barilla RM, Wang J, Cunin P, Bates S, Morrison-Smith C, Nicholson B, Wong E, El-Mufti L, Kann M, Bolling A, Fortin B, Ventresca H, Zhou W, Pardo S, Kwock M, Hazra A, Cheng L, Ahmad QR, Toombs JA, Larson R, Pleskow H, Luo NM, Samaha C, Pandya UM, De Silva P, Zhou S, Ganhadeiro Z, Yohannes S, Gay R, Slavik J, Mukerji SS, Jarolim P, Walt DR, Carlyle BC, Ritterhouse LL, Suliman S. Correction to: Evaluation of serological lateral flow assays for severe acute respiratory syndrome coronavirus-2. BMC Infect Dis 2021; 21:628. [PMID: 34210278 PMCID: PMC8246132 DOI: 10.1186/s12879-021-06333-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Bianca A Trombetta
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
| | - Savannah E Kandigian
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
| | - Robert R Kitchen
- Department of Medicine, Harvard Medical School, Boston, MA, USA.,Mass General Brigham Innovation, Boston, MA, USA
| | - Korneel Grauwet
- Cardiology Division, Massachusetts General Hospital, Charlestown, MA, USA
| | - Pia Kivisäkk Webb
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA
| | | | - Charles G Jennings
- Cardiology Division, Massachusetts General Hospital, Charlestown, MA, USA.,Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Sejal Jain
- Department of Medical Oncology and Center for Cancer-Genome Discovery, Dana-Farber Cancer Institute, Boston, MA, USA.,Department of Pathology, Harvard Medical School, Boston, MA, USA
| | - Samara Miller
- Department of Medicine, Harvard Medical School, Boston, MA, USA.,Center for Regenerative Medicine, Massachusetts General Hospital, Boston, MA, USA.,Harvard Stem Cell Institute, Cambridge, MA, USA.,Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Yikai Kuo
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA.,Cardiology Division, Massachusetts General Hospital, Charlestown, MA, USA
| | - Thadryan Sweeney
- Cardiology Division, Massachusetts General Hospital, Charlestown, MA, USA
| | - Tal Gilboa
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA.,Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Maia Norman
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA.,Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Sackler School of Biomedical Sciences, Tufts University School of Medicine, Boston, MA, USA
| | - Daimon P Simmons
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, MA, USA
| | - Christopher E Ramirez
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
| | - Melissa Bedard
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, MA, USA
| | - Catherine Fink
- Medical Diagnostic Technology Evaluation, LLC, Carlisle, MA, USA
| | - Jina Ko
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA.,Center for Systems Biology, Massachusetts General Hospital, Boston, MA, USA
| | - Esmarline J De León Peralta
- Department of Pathology, Massachusetts General Hospital, Boston, MA, USA.,Wellman Center for Photomedicine, Massachusetts General Research Institute, Boston, MA, USA.,Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA
| | - Gerald Watts
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, MA, USA
| | - Emma Gomez-Rivas
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, MA, USA
| | - Vannessa Davis
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Rocky M Barilla
- Evergrande Center for Immunologic Diseases, Brigham and Women's Hospital, Boston, MA, USA
| | - Jianing Wang
- Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Pierre Cunin
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, MA, USA
| | - Samuel Bates
- Functional Genomics Laboratory, Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Chevaun Morrison-Smith
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Benjamin Nicholson
- Center for Cancer Research, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Edmond Wong
- Center for Cancer Research, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Leena El-Mufti
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
| | - Michael Kann
- Center for Cancer Research, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Anna Bolling
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
| | - Brooke Fortin
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
| | - Hayden Ventresca
- Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Wen Zhou
- Division of Nephrology and Endocrine Unit Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Santiago Pardo
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
| | - Megan Kwock
- Cancer Center Protocol Office, Massachusetts General Hospital, Boston, MA, USA
| | - Aditi Hazra
- Department of Medicine, Harvard Medical School, Boston, MA, USA.,Division of Preventative Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Leo Cheng
- Radiology and pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Q Rushdy Ahmad
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA
| | - James A Toombs
- Brigham Research Institute, Brigham and Women's Hospital, Boston, MA, USA
| | - Rebecca Larson
- Immunology Program, Harvard Medical School, Boston, MA, USA.,Cellular Immunotherapy Program, Cancer Center, Massachusetts General Hospital, Boston, MA, USA
| | - Haley Pleskow
- Center for Cancer Research, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.,Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | | | - Unnati M Pandya
- Department of Medicine, Harvard Medical School, Boston, MA, USA.,Vincent Center for Reproductive Biology, Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA, USA
| | - Pushpamali De Silva
- Wellman Center for Photomedicine, Massachusetts General Research Institute, Boston, MA, USA
| | - Sally Zhou
- Department of Biology, Northeastern University, Boston, MA, USA.,College of Science, Northeastern University, Boston, MA, USA
| | - Zakary Ganhadeiro
- Department of Biology, Northeastern University, Boston, MA, USA.,College of Science, Northeastern University, Boston, MA, USA
| | - Sara Yohannes
- Brigham Research Institute, Brigham and Women's Hospital, Boston, MA, USA
| | - Rakiesha Gay
- Brigham Research Institute, Brigham and Women's Hospital, Boston, MA, USA.,College of Science, Northeastern University, Boston, MA, USA
| | - Jacqueline Slavik
- Brigham Research Institute, Brigham and Women's Hospital, Boston, MA, USA
| | - Shibani S Mukerji
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
| | - Petr Jarolim
- Department of Pathology, Harvard Medical School, Boston, MA, USA.,Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - David R Walt
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA.,Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Mass General Brigham COVID Center for Innovation, Diagnostics Accelerator, Boston, MA, USA
| | - Becky C Carlyle
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Lauren L Ritterhouse
- Department of Pathology, Massachusetts General Hospital, Boston, MA, USA.,Mass General Brigham COVID Center for Innovation, Diagnostics Accelerator, Boston, MA, USA
| | - Sara Suliman
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, MA, USA. .,Mass General Brigham COVID Center for Innovation, Diagnostics Accelerator, Boston, MA, USA.
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13
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Trombetta BA, Kandigian SE, Kitchen RR, Grauwet K, Webb PK, Miller GA, Jennings CG, Jain S, Miller S, Kuo Y, Sweeney T, Gilboa T, Norman M, Simmons DP, Ramirez CE, Bedard M, Fink C, Ko J, De León Peralta EJ, Watts G, Gomez-Rivas E, Davis V, Barilla RM, Wang J, Cunin P, Bates S, Morrison-Smith C, Nicholson B, Wong E, El-Mufti L, Kann M, Bolling A, Fortin B, Ventresca H, Zhou W, Pardo S, Kwock M, Hazra A, Cheng L, Ahmad QR, Toombs JA, Larson R, Pleskow H, Luo NM, Samaha C, Pandya UM, De Silva P, Zhou S, Ganhadeiro Z, Yohannes S, Gay R, Slavik J, Mukerji SS, Jarolim P, Walt DR, Carlyle BC, Ritterhouse LL, Suliman S. Evaluation of serological lateral flow assays for severe acute respiratory syndrome coronavirus-2. BMC Infect Dis 2021; 21:580. [PMID: 34134647 PMCID: PMC8206878 DOI: 10.1186/s12879-021-06257-7] [Citation(s) in RCA: 8] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 05/25/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND COVID-19 has resulted in significant morbidity and mortality worldwide. Lateral flow assays can detect anti-Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) antibodies to monitor transmission. However, standardized evaluation of their accuracy and tools to aid in interpreting results are needed. METHODS We evaluated 20 IgG and IgM assays selected from available tests in April 2020. We evaluated the assays' performance using 56 pre-pandemic negative and 56 SARS-CoV-2-positive plasma samples, collected 10-40 days after symptom onset, confirmed by a molecular test and analyzed by an ultra-sensitive immunoassay. Finally, we developed a user-friendly web app to extrapolate the positive predictive values based on their accuracy and local prevalence. RESULTS Combined IgG + IgM sensitivities ranged from 33.9 to 94.6%, while combined specificities ranged from 92.6 to 100%. The highest sensitivities were detected in Lumiquick for IgG (98.2%), BioHit for both IgM (96.4%), and combined IgG + IgM sensitivity (94.6%). Furthermore, 11 LFAs and 8 LFAs showed perfect specificity for IgG and IgM, respectively, with 15 LFAs showing perfect combined IgG + IgM specificity. Lumiquick had the lowest estimated limit-of-detection (LOD) (0.1 μg/mL), followed by a similar LOD of 1.5 μg/mL for CareHealth, Cellex, KHB, and Vivachek. CONCLUSION We provide a public resource of the accuracy of select lateral flow assays with potential for home testing. The cost-effectiveness, scalable manufacturing process, and suitability for self-testing makes LFAs an attractive option for monitoring disease prevalence and assessing vaccine responsiveness. Our web tool provides an easy-to-use interface to demonstrate the impact of prevalence and test accuracy on the positive predictive values.
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Affiliation(s)
- Bianca A Trombetta
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
| | - Savannah E Kandigian
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
| | - Robert R Kitchen
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Mass General Brigham Innovation, Boston, MA, USA
| | - Korneel Grauwet
- Cardiology Division, Massachusetts General Hospital, Charlestown, MA, USA
| | - Pia Kivisäkk Webb
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | | | - Charles G Jennings
- Cardiology Division, Massachusetts General Hospital, Charlestown, MA, USA
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Sejal Jain
- Department of Medical Oncology and Center for Cancer-Genome Discovery, Dana-Farber Cancer Institute, Boston, MA, USA
- Department of Pathology, Harvard Medical School, Boston, MA, USA
| | - Samara Miller
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Center for Regenerative Medicine, Massachusetts General Hospital, Boston, MA, USA
- Harvard Stem Cell Institute, Cambridge, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Yikai Kuo
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
- Cardiology Division, Massachusetts General Hospital, Charlestown, MA, USA
| | - Thadryan Sweeney
- Cardiology Division, Massachusetts General Hospital, Charlestown, MA, USA
| | - Tal Gilboa
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Maia Norman
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Sackler School of Biomedical Sciences, Tufts University School of Medicine, Boston, MA, USA
| | - Daimon P Simmons
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, MA, USA
| | - Christopher E Ramirez
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
| | - Melissa Bedard
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, MA, USA
| | - Catherine Fink
- Medical Diagnostic Technology Evaluation, LLC, Carlisle, MA, USA
| | - Jina Ko
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA
- Center for Systems Biology, Massachusetts General Hospital, Boston, MA, USA
| | - Esmarline J De León Peralta
- Department of Pathology, Massachusetts General Hospital, Boston, MA, USA
- Wellman Center for Photomedicine, Massachusetts General Research Institute, Boston, MA, USA
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA
| | - Gerald Watts
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, MA, USA
| | - Emma Gomez-Rivas
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, MA, USA
| | - Vannessa Davis
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Rocky M Barilla
- Evergrande Center for Immunologic Diseases, Brigham and Women's Hospital, Boston, MA, USA
| | - Jianing Wang
- Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Pierre Cunin
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, MA, USA
| | - Samuel Bates
- Functional Genomics Laboratory, Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Chevaun Morrison-Smith
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Benjamin Nicholson
- Center for Cancer Research, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Edmond Wong
- Center for Cancer Research, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Leena El-Mufti
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
| | - Michael Kann
- Center for Cancer Research, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Anna Bolling
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
| | - Brooke Fortin
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
| | - Hayden Ventresca
- Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Wen Zhou
- Division of Nephrology and Endocrine Unit Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Santiago Pardo
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
| | - Megan Kwock
- Cancer Center Protocol Office, Massachusetts General Hospital, Boston, MA, USA
| | - Aditi Hazra
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Division of Preventative Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Leo Cheng
- Radiology and pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Q Rushdy Ahmad
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA
| | - James A Toombs
- Brigham Research Institute, Brigham and Women's Hospital, Boston, MA, USA
| | - Rebecca Larson
- Immunology Program, Harvard Medical School, Boston, MA, USA
- Cellular Immunotherapy Program, Cancer Center, Massachusetts General Hospital, Boston, MA, USA
| | - Haley Pleskow
- Center for Cancer Research, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | | | - Unnati M Pandya
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Vincent Center for Reproductive Biology, Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA, USA
| | - Pushpamali De Silva
- Wellman Center for Photomedicine, Massachusetts General Research Institute, Boston, MA, USA
| | - Sally Zhou
- Department of Biology, Northeastern University, Boston, MA, USA
- College of Science, Northeastern University, Boston, MA, USA
| | - Zakary Ganhadeiro
- Department of Biology, Northeastern University, Boston, MA, USA
- College of Science, Northeastern University, Boston, MA, USA
| | - Sara Yohannes
- Brigham Research Institute, Brigham and Women's Hospital, Boston, MA, USA
| | - Rakiesha Gay
- Brigham Research Institute, Brigham and Women's Hospital, Boston, MA, USA
- College of Science, Northeastern University, Boston, MA, USA
| | - Jacqueline Slavik
- Brigham Research Institute, Brigham and Women's Hospital, Boston, MA, USA
| | - Shibani S Mukerji
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
| | - Petr Jarolim
- Department of Pathology, Harvard Medical School, Boston, MA, USA
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - David R Walt
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Mass General Brigham COVID Center for Innovation, Diagnostics Accelerator, Boston, MA, USA
| | - Becky C Carlyle
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Lauren L Ritterhouse
- Department of Pathology, Massachusetts General Hospital, Boston, MA, USA
- Mass General Brigham COVID Center for Innovation, Diagnostics Accelerator, Boston, MA, USA
| | - Sara Suliman
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, MA, USA.
- Mass General Brigham COVID Center for Innovation, Diagnostics Accelerator, Boston, MA, USA.
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14
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Wang R, DeGruttola V, Lei Q, Mayer KH, Redline S, Hazra A, Mora S, Willett WC, Ganmaa D, Manson JE. The vitamin D for COVID-19 (VIVID) trial: A pragmatic cluster-randomized design. Contemp Clin Trials 2021; 100:106176. [PMID: 33045402 PMCID: PMC7547023 DOI: 10.1016/j.cct.2020.106176] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [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: 07/21/2020] [Revised: 10/03/2020] [Accepted: 10/06/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVES To determine the effect of vitamin D supplementation on disease progression and post-exposure prophylaxis for COVID-19 infection. We hypothesize that high-dose vitamin D3 supplementation will reduce risk of hospitalization/death among those with recently diagnosed COVID-19 infection and will reduce risk of COVID-19 infection among their close household contacts. METHODS We report the rationale and design of a planned pragmatic, cluster randomized, double-blinded trial (N = 2700 in total nationwide), with 1500 newly diagnosed individuals with COVID-19 infection, together with up to one close household contact each (~1200 contacts), randomized to either vitamin D3 (loading dose, then 3200 IU/day) or placebo in a 1:1 ratio and a household cluster design. The study duration is 4 weeks. The primary outcome for newly diagnosed individuals is the occurrence of hospitalization and/or mortality. Key secondary outcomes include symptom severity scores among cases and changes in the infection (seroconversion) status for their close household contacts. Changes in vitamin D 25(OH)D levels will be assessed and their relation to study outcomes will be explored. CONCLUSIONS The proposed pragmatic trial will allow parallel testing of vitamin D3 supplementation for early treatment and post-exposure prophylaxis of COVID-19. The household cluster design provides a cost-efficient approach to testing an intervention for reducing rates of hospitalization and/or mortality in newly diagnosed cases and preventing infection among their close household contacts.
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Affiliation(s)
- Rui Wang
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA; Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
| | - Victor DeGruttola
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | | | - Kenneth H Mayer
- Fenway Health, and Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Susan Redline
- Division of Sleep Medicine and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Aditi Hazra
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Samia Mora
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Division of Cardiovascular Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Walter C Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Davaasambuu Ganmaa
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - JoAnn E Manson
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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15
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Chandler PD, Chen WY, Ajala ON, Hazra A, Cook N, Bubes V, Lee IM, Giovannucci EL, Willett W, Buring JE, Manson JE. Effect of Vitamin D3 Supplements on Development of Advanced Cancer: A Secondary Analysis of the VITAL Randomized Clinical Trial. JAMA Netw Open 2020; 3:e2025850. [PMID: 33206192 PMCID: PMC7675103 DOI: 10.1001/jamanetworkopen.2020.25850] [Citation(s) in RCA: 120] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
IMPORTANCE Epidemiologic and trial data suggest that vitamin D supplementation may reduce metastatic cancer and cancer mortality, reflecting shared biological pathways. OBJECTIVE To follow up on the possible reduction in cancer death in the Vitamin D and Omega-3 Trial (VITAL) with an evaluation of whether vitamin D reduces the incidence of advanced (metastatic or fatal) cancer and an examination possible effect modification by body mass index. DESIGN, SETTING, AND PARTICIPANTS VITAL is a randomized, double-blind, placebo-controlled, 2 × 2 factorial clinical trial of vitamin D3 (cholecalciferol, 2000 IU/d) and marine omega-3 fatty acids (1 g/d). This multicenter clinical trial was conducted in the United States; participants included men aged 50 years or older and women aged 55 years or older who were free of cancer and cardiovascular disease at baseline. Randomization took place from November 2011 through March 2014, and study medication ended on December 31, 2017. Data for this secondary analysis were analyzed from November 1, 2011, to December 31, 2017. INTERVENTIONS Vitamin D3 (cholecalciferol, 2000 IU/d) and marine omega-3 fatty acids (1 g/d) supplements. MAIN OUTCOMES AND MEASURES For the present analysis, the primary outcome was a composite incidence of metastatic and fatal invasive total cancer, because the main VITAL study showed a possible reduction in fatal cancer with vitamin D supplementation and effect modification by body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) for total cancer incidence reduction for individuals with normal BMI, but not for individuals with overweight or obesity. Secondary analyses included examination of BMI (<25, 25 to < 30, and ≥30) as effect modifiers of the observed associations. RESULTS Among 25 871 randomized VITAL participants (51% female; mean [SD] age, 67.1 [7.1] years), 1617 were diagnosed with invasive cancer over a median intervention period of 5.3 years (range, 3.8-6.1 years). As previously reported, no significant differences for cancer incidence by treatment arm were observed. However, a significant reduction in advanced cancers (metastatic or fatal) was found for those randomized to vitamin D compared with placebo (226 of 12 927 assigned to vitamin D [1.7%] and 274 of 12 944 assigned to placebo [2.1%]; HR, 0.83 [95% CI, 0.69-0.99]; P = .04). When stratified by BMI, there was a significant reduction for the vitamin D arm in incident metastatic or fatal cancer among those with normal BMI (BMI<25: HR, 0.62 [95% CI, 0.45-0.86]) but not among those with overweight or obesity (BMI 25-<30: HR, 0.89 [95% CI, 0.68-1.17]; BMI≥30: HR, 1.05 [95% CI, 0.74-1.49]) (P = .03 for interaction by BMI). CONCLUSIONS AND RELEVANCE In this randomized clinical trial, supplementation with vitamin D reduced the incidence of advanced (metastatic or fatal) cancer in the overall cohort, with the strongest risk reduction seen in individuals with normal weight. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01169259.
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Affiliation(s)
- Paulette D. Chandler
- Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Wendy Y. Chen
- Department of Medical Oncology, Dana Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Oluremi N. Ajala
- Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Aditi Hazra
- Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Nancy Cook
- Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Vadim Bubes
- Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - I-Min Lee
- Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Edward L. Giovannucci
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Walter Willett
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Julie E. Buring
- Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - JoAnn E. Manson
- Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
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16
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Tobias DK, Hazra A, Lawler PR, Chandler PD, Chasman DI, Buring JE, Lee IM, Cheng S, Manson JE, Mora S. Circulating branched-chain amino acids and long-term risk of obesity-related cancers in women. Sci Rep 2020; 10:16534. [PMID: 33024201 PMCID: PMC7539150 DOI: 10.1038/s41598-020-73499-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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: 06/15/2020] [Accepted: 08/28/2020] [Indexed: 02/07/2023] Open
Abstract
Obesity is a risk factor for > 13 cancer sites, although it is unknown whether there is a common mechanism across sites. Evidence suggests a role for impaired branched-chain amino acid (BCAAs; isoleucine, leucine, valine) metabolism in obesity, insulin resistance, and immunity; thus, we hypothesized circulating BCAAs may be associated with incident obesity-related cancers. We analyzed participants in the prospective Women’s Health Study without a history of cancer at baseline blood collection (N = 26,711, mean age = 54.6 years [SD = 7.1]). BCAAs were quantified via NMR spectroscopy, log-transformed, and standardized. We used Cox proportional regression models adjusted for age, race, smoking, diet, alcohol, physical activity, menopausal hormone use, Body Mass Index (BMI), diabetes, and other risk factors. The endpoint was a composite of obesity-related cancers, defined per the International Agency for Research on Cancer 2016 report, over a median 24 years follow-up. Baseline BMI ≥ 30 kg/m2 compared with BMI 18.5–25.0 kg/m2 was associated with 23% greater risk of obesity-related cancers (n = 2751 events; multivariable HR 1.23, 95% CI 1.11–1.37). However, BCAAs were not associated with obesity-related cancers (multivariable HR per SD = 1.01 [0.97–1.05]). Results for individual BCAA metabolites suggested a modest association for leucine with obesity-related cancers (1.04 [1.00–1.08]), and no association for isoleucine or valine (0.99 [0.95–1.03] and 1.00 [0.96–1.04], respectively). Exploratory analyses of BCAAs with individual sites included positive associations between leucine and postmenopausal breast cancer, and isoleucine with pancreatic cancer. Total circulating BCAAs were unrelated to obesity-related cancer incidence although an association was observed for leucine with incident obesity-related cancer.
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Affiliation(s)
- Deirdre K Tobias
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 900 Commonwealth Avenue, Boston, MA, 02215, USA. .,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Aditi Hazra
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 900 Commonwealth Avenue, Boston, MA, 02215, USA
| | - Patrick R Lawler
- Peter Munk Cardiac Centre, University Health Network, and Heart and Stroke Richard Lewar Centre of Excellence in Cardiovascular Research, University of Toronto, Toronto, ON, Canada
| | - Paulette D Chandler
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 900 Commonwealth Avenue, Boston, MA, 02215, USA
| | - Daniel I Chasman
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 900 Commonwealth Avenue, Boston, MA, 02215, USA
| | - Julie E Buring
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 900 Commonwealth Avenue, Boston, MA, 02215, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - I-Min Lee
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 900 Commonwealth Avenue, Boston, MA, 02215, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Susan Cheng
- Division of Cardiovascular Medicine, Department of Medicine, Center for Lipid Metabolomics, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.,Barbra Streisand Women's Heart Center and Smidt Heart Institute at Cedars-Sinai, Los Angeles, CA, USA
| | - JoAnn E Manson
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 900 Commonwealth Avenue, Boston, MA, 02215, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Mary Horrigan Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Samia Mora
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 900 Commonwealth Avenue, Boston, MA, 02215, USA.,Division of Cardiovascular Medicine, Department of Medicine, Center for Lipid Metabolomics, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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17
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Kensler KH, Poole EM, Heng YJ, Collins LC, Glass B, Beck AH, Hazra A, Rosner BA, Eliassen AH, Hankinson SE, Winer EP, Brown M, Tamimi RM. Androgen Receptor Expression and Breast Cancer Survival: Results From the Nurses' Health Studies. J Natl Cancer Inst 2020; 111:700-708. [PMID: 30445651 DOI: 10.1093/jnci/djy173] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 08/10/2018] [Accepted: 08/24/2018] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Hormone receptor signaling is critical in the progression of breast cancers, although the role of the androgen receptor (AR) remains unclear, particularly for estrogen receptor (ER)-negative tumors. This study assessed AR protein expression as a prognostic marker for breast cancer mortality. METHODS This study included 4147 pre- and postmenopausal women with invasive breast cancer from the Nurses' Health Study (diagnosed 1976-2008) and Nurses' Health Study II (1989-2008) cohorts. AR protein expression was evaluated by immunohistochemistry and scored through pathologist review and as a digitally quantified continuous measure. Hazard ratios (HR) and 95% confidence intervals (CI) of breast cancer mortality were estimated from Cox proportional hazards models, adjusting for patient, tumor, and treatment covariates. RESULTS Over a median 16.5 years of follow-up, there were 806 deaths due to breast cancer. In the 7 years following diagnosis, AR expression was associated with a 27% reduction in breast cancer mortality overall (multivariable HR = 0.73, 95% CI = 0.58 to 0.91) a 47% reduction for ER+ cancers (HR = 0.53, 95% CI = 0.41 to 0.69), and a 62% increase for ER- cancers (HR = 1.62, 95% CI = 1.18 to 2.22) (P heterogeneity < .001). A log-linear association was observed between AR expression and breast cancer mortality among ER- cancers (HR = 1.14, 95% CI = 1.02 to 1.26 per each 10% increase in AR), although no log-linear association was observed among ER+ cancers. CONCLUSIONS AR expression was associated with improved prognosis in ER+ tumors and worse prognosis in ER- tumors in the first 5-10 years postdiagnosis. These findings support the continued evaluation of AR-targeted therapies for AR+/ER- breast cancers.
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Affiliation(s)
- Kevin H Kensler
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | | | - Yujing J Heng
- Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA.,Harvard Medical School, Boston, MA
| | - Laura C Collins
- Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA.,Harvard Medical School, Boston, MA
| | | | | | - Aditi Hazra
- Harvard Medical School, Boston, MA.,Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA
| | - Bernard A Rosner
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.,Harvard Medical School, Boston, MA.,Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA
| | - A Heather Eliassen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.,Harvard Medical School, Boston, MA
| | - Susan E Hankinson
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.,Harvard Medical School, Boston, MA.,Department of Biostatistics and Epidemiology, University of Massachusetts School of Public Health and Health Sciences, Amherst, MA
| | - Eric P Winer
- Harvard Medical School, Boston, MA.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Myles Brown
- Harvard Medical School, Boston, MA.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Rulla M Tamimi
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.,Harvard Medical School, Boston, MA
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18
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Vong C, Wang X, Hazra A, Mukherjee A, Nicholas T, Chang C. FRI0465 TOFACITINIB POPULATION PHARMACOKINETICS IN CHILDREN WITH JUVENILE IDIOPATHIC ARTHRITIS: A POOLED ANALYSIS OF DATA FROM THREE CLINICAL STUDIES. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Tofacitinib is an oral JAK inhibitor that is being investigated for juvenile idiopathic arthritis (JIA).Objectives:To describe tofacitinib pharmacokinetics (PK) in patients with JIA, identify potential covariates accounting for variability in exposure, assess the formulation effect of oral solution vs tablet and propose a simplified dosing regimen.Methods:This was a pooled analysis of data from 3 tofacitinib clinical studies in patients with JIA aged 2−<18 years: a Phase 1, open-label (OL), non-randomised study (NCT01513902); a Phase 3, randomised, double-blind, placebo-controlled, withdrawal study (NCT02592434); and an OL long-term extension study (NCT01500551). Tofacitinib was dosed at 5 mg twice daily (BID) in patients ≥40 kg or at body weight (BW)-based lower doses BID in patients <40 kg, to achieve average concentrations (Cavg) comparable with those in patients receiving 5 mg BID. A sparse PK sampling scheme was applied, and the plasma samples were assayed using a validated, sensitive and specific high-performance liquid chromatography tandem mass spectrometric method (lower limit of quantification = 0.100 ng/mL). A nonlinear mixed-effects modelling approach was used for the population PK model, and population parameter variability was assumed to be log-normally distributed. Covariates relating to patient demographics, disease characteristics, concomitant medications and formulation (oral solution vs tablet) were selected using a stepwise covariate modelling approach, and parameter-covariate relationships were evaluated using stepwise forward-inclusion (p<0.05) backward-deletion (p<0.001) procedures. The effect of time-varying BW on oral clearance (CL/F) and apparent volume of distribution (V/F) was characterised using an allometric model. Final model quality was assessed by Visual Predictive Checks (VPCs).Results:Of 246 patients in the analysis, 74.0% were female; 87.8% were white, 2% were black, 10.2% were ‘other’ races and no patients were Asian. Median (range) BW was 46.3 (11.1−121.8) kg. Initially, 100 patients received oral solution and 146 patients received tablets; 11 patients switched formulations during the studies. A one compartment disposition model with first-order absorption and a lag time sufficiently described the data. Final estimates for CL/F, V/F and the first-order absorption rate constant (ka) for tablets were 26.1 L/hr, 89.2 L and 2.78 hr-1, respectively. The only statistically significant covariate was a formulation effect on ka. All parameters were estimated adequately. Estimated allometric exponents were 0.310 for CL/F and 0.537 for V/F. Absorption was described with an estimated lag time of 0.186 hr, and the oral solution had a 1.64-fold faster absorption rate vs the tablet. VPCs sufficiently described the observed data over time, across BWs and ages. Given the PK characterisation and variability in patients with JIA, a simplified dosing scheme was proposed, targeting Cavgvalues equivalent to those in patients receiving 5 mg BID: 3.2 mg BID solution in patients 10−<20 kg; 4 mg BID solution in patients 20−<40 kg; and 5 mg BID tablet or solution in patients ≥40 kg.Conclusion:Tofacitinib population PK in patients with JIA were adequately described by a one compartment model parameterised in terms of CL/F, V/F and first-order absorption with a lag time. Drug absorption from the oral solution was faster than from the tablet. Tofacitinib does not require dose modification or restrictions for any covariates, except BW, to account for differences in Cavg. Based on the results of this analysis, a simplified BW-based dosing regimen was proposed.Acknowledgments:Study sponsored by Pfizer Inc. Medical writing support was provided by Sarah Piggott of CMC Connect and funded by Pfizer Inc.Disclosure of Interests:Camille Vong Shareholder of: Pfizer Inc, at time of analysis, Employee of: Pfizer Inc, at time of analysis, Xiaoxing Wang Shareholder of: Pfizer Inc, Employee of: Pfizer Inc, Anasuya Hazra Shareholder of: Pfizer Inc, at time of analysis, Employee of: Pfizer Inc, at time of analysis, Arnab Mukherjee Shareholder of: Pfizer Inc, Employee of: Pfizer Inc, Timothy Nicholas Shareholder of: Pfizer Inc, Employee of: Pfizer Inc, Cheng Chang Shareholder of: Pfizer Inc, Employee of: Pfizer Inc
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19
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Chandler P, Chen WY, Ajala O, Hazra A, Cook N, Bubes V, Lee IM, Giovannucci EL, Buring J, Manson JE. Vitamin D supplements and marine omega-3 fatty acids and development of advanced cancer. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.1510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
1510 Background: Epidemiologic data suggest that vitamin D supplementation may reduce cancer mortality. We tested whether vitamin D and/or omega-3 supplementation reduces the incidence of advanced stage cancer at diagnosis or lethal cancer, and whether body mass index (BMI) modifies these associations. Methods: The VITamin D and OmegA-3 TriaL (VITAL) is a randomized, placebo-controlled, 2x2 factorial trial of vitamin D3 (cholecalciferol, 2000 IU/day) and marine omega-3 fatty acids (1 g/day) that enrolled men aged ≥50 years and women aged ≥55 years free of cancer and cardiovascular disease at baseline. For this particular analysis, the primary outcome is a composite of metastatic and fatal invasive total cancer. Secondary analyses included examination of BMI (<25, 25-<30, and >= 30 kg/m2) as effect modifiers of the observed associations. Results: VITAL randomized 25,871 participants, among whom 1,617 were diagnosed with invasive cancer over a median 5.3 year intervention period. No significant differences by treatment arm (vitamin D vs placebo: hazard ratio [HR]=0.96; 95% confidence interval, 0.88-1.06; p=0.47; omega-3 vs placebo; HR 1.03 [0.93-1.13]; p=0.56) were observed. However, a significant reduction in advanced cancers (metastatic or fatal) was found for those randomized to vitamin D, compared to placebo (226 assigned to vitamin D and 274 to placebo; HR 0.83 [0.69-0.99]; p=0.036). There was no difference by omega-3 assignment (246 assigned to omega-3 and 254 to placebo: HR 0.97 [0.81-1.15], p=0.72). When stratified by BMI, there was a significant reduction for the vitamin D arm in incident metastatic or fatal cancer among those with normal BMI (BMI<25: HR 0.62 [0.45-0.86], but not among those who were overweight or obese (BMI 25-<30: HR 0.89 [0.68-1.17]; BMI >=30: HR 1.05 [0.74-1.49]); p for interaction by BMI =0.03. There was no effect modification by BMI noted for the omega 3 arm. Conclusions: In a randomized clinical trial, supplementation with vitamin D, but not omega-3s, reduced incidence of advanced (metastatic or fatal) cancer in the overall cohort, with strongest risk reduction in normal weight individuals. Further research is needed to understand these findings. Clinical trial information: NCT01169259.
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Affiliation(s)
| | | | | | | | - Nancy Cook
- Brigham and Women's Hospital/Harvard Medical School, Boston, MA
| | | | | | - Edward L. Giovannucci
- Harvard T.H. Chan School of Public Health, Harvard Medical School, Brigham and Women's Hospital, Boston, MA
| | - Julie Buring
- Brigham and Women's Hospital/Harvard T.H. Chan School of Public Health/Harvard Medical School, Boston, MA
| | - JoAnn E Manson
- Brigham and Women's Hospital/Harvard Medical School, Boston, MA
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20
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Banerjee TK, Saha M, Ghosh E, Hazra A, Das A, Choudhury D, Ojha S, Haldar A, Mukherjee A, Nandi SS, Ghosh A, Mukherjee A, Chatterjee A, Datta A, Purakayastha S. Conversion of clinically isolated syndrome to multiple sclerosis: a prospective multi-center study in Eastern India. Mult Scler J Exp Transl Clin 2019; 5:2055217319849721. [PMID: 31236283 PMCID: PMC6572895 DOI: 10.1177/2055217319849721] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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] [Received: 12/24/2018] [Revised: 04/05/2019] [Accepted: 04/16/2019] [Indexed: 11/17/2022] Open
Abstract
Background In White populations more than 60% of clinically isolated syndrome (CIS) convert to multiple sclerosis (MS) on a long-term follow-up; several predictors for conversion have been identified. Objective This study aimed to determine the conversion rate and the predictors of conversion from CIS to MS (McDonald 2010) among Indians. The other objective was to evaluate the diagnostic accuracy of the new McDonald 2017 criteria in prediction of a second clinical attack. Methods Clinical and demographic data of CIS cohorts were collected. Baseline investigations included cerebrospinal magnetic resonance imaging (MRI) with contrast and cerebrospinal fluid (CSF) testing for oligoclonal band (OCB). Follow-up clinical and MRI examinations were performed annually for at least 24 months. Results Of the 82 subjects (age range 15-58 years), 36 (43.9%) converted to MS; 31/82 (37.8%) converted in 24 months. The predictors for conversion were earlier age of onset, CSF-OCB, cerebral MRI T2 lesion count, and periventricular and juxtacortical location of lesions. Twenty-two (26.83%) CIS fulfilled the McDonald MS 2017 criteria at baseline. Conclusion In this first prospective study of CIS in India, the risk factors for conversion are similar but the conversion rate to MS is lower than that in the western nations.
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Affiliation(s)
- T K Banerjee
- National Neurosciences Centre Calcutta, Kolkata, India
| | - M Saha
- Apollo Gleneagles Hospital, Kolkata, India
| | - E Ghosh
- National Neurosciences Centre Calcutta, Kolkata, India
| | - A Hazra
- Institute of Postgraduate Medical Education & Research, Kolkata, India
| | - A Das
- National Neurosciences Centre Calcutta, Kolkata, India
| | - D Choudhury
- National Neurosciences Centre Calcutta, Kolkata, India
| | - S Ojha
- National Neurosciences Centre Calcutta, Kolkata, India
| | | | - A Mukherjee
- Vivekananda Institute of Medical Sciences, Kolkata, India
| | - S S Nandi
- Calcutta Medical Research Institute, Kolkata, India
| | - A Ghosh
- Apollo Gleneagles Hospital, Kolkata, India
| | - A Mukherjee
- Calcutta Medical Research Institute, Kolkata, India
| | - A Chatterjee
- Calcutta Medical Research Institute, Kolkata, India
| | - A Datta
- Institute of Neuroscience Kolkata, Kolkata, India
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Chandrashekar S, Saha S, Varghese B, Mohan L, Shetty G, Porwal A, Hazra A, Mondal S, Das R. Cost and cost-effectiveness of health behavior change interventions implemented with self-help groups in Bihar, India. PLoS One 2019; 14:e0213723. [PMID: 30921334 PMCID: PMC6438566 DOI: 10.1371/journal.pone.0213723] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 02/27/2019] [Indexed: 01/09/2023] Open
Abstract
Introduction Health interventions implemented with self-help groups (SHGs) enhance the relevance and acceptability of the health services. The Parivartan program was implemented in eight districts of Bihar with women’s self-help groups to increase adoption of maternal and newborn health behaviors through layering health behavior change communication. This study estimates the cost and cost-effectiveness of a health behavior change program with SHGs in Bihar. Methods Cost analysis was conducted from a provider’s perspective. All costs have been presented in US dollars for the purpose of international comparisons and converted to constant values. The effectiveness estimate was based on the reported changes in select newborn care practices. A decision model approach was used to estimate the potential number of neonatal deaths averted based on adoption of key newborn care practices. Using India’s life expectancy of 65 years, cost per life year saved was calculated. A one-way sensitivity analysis was conducted using the upper and lower estimates for various variables in the model, and functionality of SHGs. Results The cost of forming an SHG group was US$254 and that of reaching a woman within the group was US$19. The unit cost for delivering health interventions through the Parivartan program was US$148 per group and US$11 per woman reached. During an 18 months period, Parivartan program reached around 17,120 SHGs and an estimated 20,544 pregnant women resulting in an estimated prevention of 23 neonatal deaths at a cost of US$3,825 per life year saved. Conclusion SHGs can be an effective platform to increase uptake of women’s health interventions and follow-up care, and also to broaden their utility beyond microfinance, particularly when they operate at a larger scale.
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Affiliation(s)
| | - S. Saha
- Public Health Foundation of India, New Delhi, India
- Indian Institute of Public Health, Gandhinagar, India
| | - B. Varghese
- Public Health Foundation of India, New Delhi, India
| | - L. Mohan
- Karnataka Health Promotion Trust, Bangalore, India
| | - G. Shetty
- Karnataka Health Promotion Trust, Bangalore, India
| | - A. Porwal
- Population Council, New Delhi, India
| | - A. Hazra
- Population Council, New Delhi, India
| | - S. Mondal
- Project Concern International, New Delhi, India
| | - R. Das
- Project Concern International, New Delhi, India
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Kensler KH, Regan MM, Heng YJ, Baker GM, Pyle ME, Schnitt SJ, Hazra A, Kammler R, Thürlimann B, Colleoni M, Viale G, Brown M, Tamimi RM. Prognostic and predictive value of androgen receptor expression in postmenopausal women with estrogen receptor-positive breast cancer: results from the Breast International Group Trial 1-98. Breast Cancer Res 2019; 21:30. [PMID: 30795773 PMCID: PMC6387478 DOI: 10.1186/s13058-019-1118-z] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 02/10/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The androgen receptor (AR) is an emerging prognostic marker and therapeutic target in breast cancer. AR is expressed in 60-80% of breast cancers, with higher prevalence among estrogen receptor-positive (ER+) tumors. Androgen treatment inhibits ER signaling in ER+/AR+ breast cancer cell lines, and AR expression is associated with improved survival for this subtype in epidemiologic studies. However, whether AR expression modifies the efficacy of selective ER modulators or aromatase inhibitors for ER+ cancers remains unclear. METHODS We evaluated the prognostic and predictive value of AR expression among 3021 postmenopausal ER+ breast cancer patients in the Breast International Group (BIG) trial 1-98. The BIG 1-98 study was a four-armed, double-blind, phase III randomized clinical trial that compared 5 years of tamoxifen or letrozole monotherapy, or sequences of 2 years and 3 years treatment with one drug and then the other. AR expression was measured by immunohistochemistry and the percentage of AR-positive nuclei was quantified. The association between AR expression and prognosis was evaluated using Cox proportional hazards models. Continuous AR-by-treatment interactions were assessed using Subpopulation Treatment Effect Pattern Plots (STEPP). RESULTS Eighty-two percent of patients had AR+ (≥ 1%) tumors. Patients with AR+ cancers were more likely to have smaller, lower-grade tumors, with higher expression of ER and PR. AR expression was not associated with breast cancer-free interval (BCFI) (415 events) over a median 8.0 years of follow-up (p = 0.12, log-rank test). In multivariable-adjusted models, AR expression was not associated with BCFI (HR = 1.07, 95% CI 0.83-1.36, p = 0.60). The letrozole versus tamoxifen monotherapy treatment effect did not significantly differ for AR+ tumors (HR = 0.63, 95% CI 0.44-0.75, p = 0.003) and AR- tumors (HR = 0.39, 95% CI 0.21-0.72, p = 0.002) (p-heterogeneity = 0.16). STEPP analysis also suggested no heterogeneity of the treatment effect across the continuum of AR expression. CONCLUSIONS AR expression was not associated with prognosis, nor was there heterogeneity of the letrozole versus tamoxifen treatment effect by AR expression. These findings suggest that AR expression may not be an informative biomarker for the selection of adjuvant endocrine therapy for postmenopausal women with ER+ breast cancers. TRIAL REGISTRATION ClinicalTrials.gov , NCT00004205, Registered 27 January 2003-Retrospectively registered, https://clinicaltrials.gov/ct2/show/study/NCT00004205 .
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Affiliation(s)
- Kevin H. Kensler
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA USA
| | - Meredith M. Regan
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA USA
| | - Yujing J. Heng
- Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA USA
| | - Gabrielle M. Baker
- Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA USA
| | - Michael E. Pyle
- Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA USA
| | - Stuart J. Schnitt
- Department of Pathology, Brigham and Women’s Hospital, Boston, MA USA
| | - Aditi Hazra
- Department of Medicine, Brigham and Women’s Hospital, Boston, MA USA
| | - Roswitha Kammler
- International Breast Cancer Study Group Coordinating Center, Central Pathology Office, Bern, Switzerland
| | - Beat Thürlimann
- Breast Center, Cantonal Hospital, St. Gallen and SAKK, Berne, Switzerland
| | - Marco Colleoni
- Division of Medical Senology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Giuseppe Viale
- Department of Pathology, IEO, European Institute of Oncology IRCCS, University of Milan, Milan, Italy
| | - Myles Brown
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA USA
| | - Rulla M. Tamimi
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA USA
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA USA
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Okereke O, Ogata S, Mischoulon D, Chang G, Hazra A, Manson J, Reynolds C, De Vivo I. VARIATIONS BY RACE, ETHNICITY AND SEX IN RELATIONS OF BEHAVIORAL FACTORS TO BIOLOGICAL AGING. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- O Okereke
- Massachusetts General Hospital, Department of Psychiatry
| | - S Ogata
- Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center
| | - D Mischoulon
- Massachusetts General Hospital, Department of Psychiatry
| | | | - A Hazra
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital
| | - J Manson
- Brigham and Women’s Hospital and Harvard Medical School
| | - C Reynolds
- University of Pittsburgh School of Medicine
| | - I De Vivo
- Brigham and Women’s Hospital and Harvard Medical School
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24
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Kensler KH, Beca F, Baker GM, Heng YJ, Beck AH, Schnitt SJ, Hazra A, Rosner BA, Eliassen AH, Hankinson SE, Brown M, Tamimi RM. Androgen receptor expression in normal breast tissue and subsequent breast cancer risk. NPJ Breast Cancer 2018; 4:33. [PMID: 30276234 PMCID: PMC6155011 DOI: 10.1038/s41523-018-0085-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [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: 06/26/2018] [Revised: 09/05/2018] [Accepted: 09/06/2018] [Indexed: 01/09/2023] Open
Abstract
Sex steroid hormone signaling is critical in the development of breast cancers, although the role of the androgen receptor remains unclear. This study evaluated androgen receptor (AR) expression in normal breast tissue as a potential marker of breast cancer risk. We conducted a nested case-control study of women with benign breast disease (BBD) within the Nurses' Health Studies. Epithelial AR expression was assessed by immunohistochemistry in normal tissue from the BBD biopsy and the percent of positive nuclei was estimated in ordinal categories of 10% for 78 breast cancer cases and 276 controls. Logistic regression models adjusting for the matching factors and BBD lesion type were used to calculate odds ratios (ORs) for the association between AR expression (tertiles: ≤10%, 11-30%, and >30%) and breast cancer risk. AR expression in normal breast tissue was not associated with subsequent breast cancer risk (ORT3vsT1 = 0.9, 95% CI = 0.4-1.8, p trend = 0.68). In comparison with low AR/low ER women, ORs of 0.4 (95% CI = 0.1-1.2) for high AR/high ER women, 1.8 (95% CI = 0.4-7.8) for low AR/high ER women, and 0.7 (95% CI = 0.3-1.6) for high AR/low ER women were observed (p interaction = 0.21). Ki67 did not modify the association between AR expression and breast cancer risk (p interaction = 0.75). There was little evidence for an overall association between AR expression in normal breast tissue and breast cancer risk. These findings did not show that the AR association varied by Ki67 expression in normal breast tissue, though there was suggestive heterogeneity by ER expression.
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Affiliation(s)
- Kevin H Kensler
- 1Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215 USA.,2Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115 USA
| | - Francisco Beca
- 3Department of Pathology, Stanford University School of Medicine, Stanford, CA 94035 USA
| | - Gabrielle M Baker
- 4Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA 02215 USA.,5Harvard Medical School, Boston, MA 02215 USA
| | - Yujing J Heng
- 4Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA 02215 USA.,5Harvard Medical School, Boston, MA 02215 USA
| | | | - Stuart J Schnitt
- 5Harvard Medical School, Boston, MA 02215 USA.,7Department of Pathology, Brigham and Women's Hospital, Boston, MA 02115 USA
| | - Aditi Hazra
- 5Harvard Medical School, Boston, MA 02215 USA.,8Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115 USA
| | - Bernard A Rosner
- 5Harvard Medical School, Boston, MA 02215 USA.,9Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115 USA.,10Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA 02115 USA
| | - A Heather Eliassen
- 2Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115 USA.,9Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115 USA
| | - Susan E Hankinson
- 2Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115 USA.,5Harvard Medical School, Boston, MA 02215 USA.,9Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115 USA.,11Department of Biostatistics and Epidemiology, University of Massachusetts School of Public Health and Health Sciences, Amherst, MA 01003 USA
| | - Myles Brown
- 1Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215 USA.,5Harvard Medical School, Boston, MA 02215 USA
| | - Rulla M Tamimi
- 2Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115 USA.,9Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115 USA
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25
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Wang J, Heng YJ, Eliassen AH, Tamimi RM, Hazra A, Carey VJ, Ambrosone CB, de Andrade VP, Brufsky A, Couch FJ, King TA, Modugno F, Vachon CM, Hunter DJ, Beck AH, Hankinson SE. Alcohol consumption and breast tumor gene expression. Breast Cancer Res 2017; 19:108. [PMID: 28899409 PMCID: PMC5596493 DOI: 10.1186/s13058-017-0901-y] [Citation(s) in RCA: 17] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 08/31/2017] [Indexed: 02/07/2023] Open
Abstract
Background Alcohol consumption is an established risk factor for breast cancer and the association generally appears stronger among estrogen receptor (ER)-positive tumors. However, the biological mechanisms underlying this association are not completely understood. Methods We analyzed messenger RNA (mRNA) microarray data from both invasive breast tumors (N = 602) and tumor-adjacent normal tissues (N = 508) from participants diagnosed with breast cancer in the Nurses’ Health Study (NHS) and NHSII. Multivariable linear regression, controlling for other known breast cancer risk factors, was used to identify differentially expressed genes by pre-diagnostic alcohol intake. For pathway analysis, we performed gene set enrichment analysis (GSEA). Differentially expressed genes or enriched pathway-defined gene sets with false discovery rate (FDR) <0.1 identified in tumors were validated in RNA sequencing data of invasive breast tumors (N = 166) from The Cancer Genome Atlas. Results No individual genes were significantly differentially expressed by alcohol consumption in the NHS/NHSII. However, GSEA identified 33 and 68 pathway-defined gene sets at FDR <0.1 among 471 ER+ and 127 ER- tumors, respectively, all of which were validated. Among ER+ tumors, consuming 10+ grams of alcohol per day (vs. 0) was associated with upregulation in RNA metabolism and transport, cell cycle regulation, and DNA repair, and downregulation in lipid metabolism. Among ER- tumors, in addition to upregulation in RNA processing and cell cycle, alcohol intake was linked to overexpression of genes involved in cytokine signaling, including interferon and transforming growth factor (TGF)-β signaling pathways, and translation and post-translational modifications. Lower lipid metabolism was observed in both ER+ tumors and ER+ tumor-adjacent normal samples. Most of the significantly enriched gene sets identified in ER- tumors showed a similar enrichment pattern among ER- tumor-adjacent normal tissues. Conclusions Our data suggest that moderate alcohol consumption (i.e. 10+ grams/day, equivalent to one or more drinks/day) is associated with several specific and reproducible biological processes and pathways, which adds potential new insight into alcohol-related breast carcinogenesis. Electronic supplementary material The online version of this article (doi:10.1186/s13058-017-0901-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jun Wang
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, 715 N Pleasant Street, Amherst, MA, 01003, USA. .,Present address: Department of Preventive Medicine, University of Southern California, Harlyne J. Norris Research Tower, 1450 Biggy Street, Los Angeles, CA, 90033, USA.
| | - Yujing J Heng
- Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, 02215, USA
| | - A Heather Eliassen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Rulla M Tamimi
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Aditi Hazra
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 900 Commonwealth Ave, Boston, MA, 02115, USA
| | - Vincent J Carey
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA
| | - Christine B Ambrosone
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Elm & Carlton Streets, Buffalo, NY, 14263, USA
| | - Victor P de Andrade
- Departamento de Patologia, A.C. Camargo Cancer Center, São Paulo, SP, 01509-900, Brazil
| | - Adam Brufsky
- Department of Medicine, University of Pittsburgh Medical Center, 300 Halket Street, Pittsburgh, PA, 15213, USA
| | - Fergus J Couch
- Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Tari A King
- Dana-Farber Cancer Institute and Brigham and Women's Cancer Center, 450 Brookline Avenue, Boston, MA, 02215, USA
| | - Francesmary Modugno
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, 300 Halket Street, Pittsburgh, PA, 15213, USA
| | - Celine M Vachon
- Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - David J Hunter
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.,Department of Nutrition, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Andrew H Beck
- Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, 02215, USA
| | - Susan E Hankinson
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, 715 N Pleasant Street, Amherst, MA, 01003, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
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26
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Healey MA, Hirko KA, Beck AH, Collins LC, Schnitt SJ, Eliassen AH, Holmes MD, Tamimi RM, Hazra A. Assessment of Ki67 expression for breast cancer subtype classification and prognosis in the Nurses' Health Study. Breast Cancer Res Treat 2017; 166:613-622. [PMID: 28791482 DOI: 10.1007/s10549-017-4421-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 07/24/2017] [Indexed: 12/14/2022]
Abstract
PURPOSE Ki67 is a proliferation marker commonly assessed by immunohistochemistry in breast cancer, and it has been proposed as a clinical marker for subtype classification, prognosis, and prediction of therapeutic response. However, the clinical utility of Ki67 is limited by the lack of consensus on the optimal cut point for each application. METHODS We assessed Ki67 by immunohistochemistry using Definiens digital image analysis (DIA) in 2653 cases of incident invasive breast cancer diagnosed in the Nurses' Health Study from 1976 to 2006. Ki67 was scored as continuous percentage of positive tumor cells, and dichotomized at various cut points. Multivariable hazard ratios (HR) and 95% confidence intervals (CI) were calculated using Cox regression models for distant recurrence, breast cancer-specific mortality and overall mortality in relation to luminal subtypes defined with various Ki67 cut points, adjusting for breast cancer prognostic factors, clinico-pathologic features and treatment. RESULTS DIA was highly correlated with manual scoring of Ki67 (Spearman correlation ρ = 0.86). Mean Ki67 score was higher in grade-defined luminal B (12.6%), HER2-enriched (17.9%) and basal-like (20.6%) subtypes compared to luminal A (8.9%). In multivariable-adjusted models, luminal B tumors had higher breast cancer-specific mortality compared to luminal A cancer classified using various cut points for Ki67 positivity including the 14% cut point routinely reported in the literature (HR 1.38, 95% CI 1.11-1.72, p = 0.004). There was no significant difference in clinical outcomes for ER- tumors according to Ki67 positivity defined at various cut points. CONCLUSIONS Assessment of Ki67 in breast tumors by DIA was a robust and quantitative method. Results from this large prospective cohort study provide support for the clinical relevance of using Ki67 at the 14% cut point for luminal subtype classification and breast cancer prognosis.
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Affiliation(s)
- Megan A Healey
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Kelly A Hirko
- Department of Epidemiology and Biostatistics, College of Human Medicine, Traverse City Campus, Michigan State University, East Lansing, MI, USA
| | | | - Laura C Collins
- Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Stuart J Schnitt
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - A Heather Eliassen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Michelle D Holmes
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Rulla M Tamimi
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Aditi Hazra
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA.
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
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Toth R, Scherer D, Kelemen LE, Risch A, Hazra A, Balavarca Y, Issa JPJ, Moreno V, Eeles RA, Ogino S, Wu X, Ye Y, Hung RJ, Goode EL, Ulrich CM. Genetic Variants in Epigenetic Pathways and Risks of Multiple Cancers in the GAME-ON Consortium. Cancer Epidemiol Biomarkers Prev 2017; 26:816-825. [PMID: 28115406 PMCID: PMC6054308 DOI: 10.1158/1055-9965.epi-16-0728] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 12/16/2016] [Accepted: 12/19/2016] [Indexed: 11/16/2022] Open
Abstract
Background: Epigenetic disturbances are crucial in cancer initiation, potentially with pleiotropic effects, and may be influenced by the genetic background.Methods: In a subsets (ASSET) meta-analytic approach, we investigated associations of genetic variants related to epigenetic mechanisms with risks of breast, lung, colorectal, ovarian and prostate carcinomas using 51,724 cases and 52,001 controls. False discovery rate-corrected P values (q values < 0.05) were considered statistically significant.Results: Among 162,887 imputed or genotyped variants in 555 candidate genes, SNPs in eight genes were associated with risk of more than one cancer type. For example, variants in BABAM1 were confirmed as a susceptibility locus for squamous cell lung, overall breast, estrogen receptor (ER)-negative breast, and overall prostate, and overall serous ovarian cancer; the most significant variant was rs4808076 [OR = 1.14; 95% confidence interval (CI) = 1.10-1.19; q = 6.87 × 10-5]. DPF1 rs12611084 was inversely associated with ER-negative breast, endometrioid ovarian, and overall and aggressive prostate cancer risk (OR = 0.93; 95% CI = 0.91-0.96; q = 0.005). Variants in L3MBTL3 were associated with colorectal, overall breast, ER-negative breast, clear cell ovarian, and overall and aggressive prostate cancer risk (e.g., rs9388766: OR = 1.06; 95% CI = 1.03-1.08; q = 0.02). Variants in TET2 were significantly associated with overall breast, overall prostate, overall ovarian, and endometrioid ovarian cancer risk, with rs62331150 showing bidirectional effects. Analyses of subpathways did not reveal gene subsets that contributed disproportionately to susceptibility.Conclusions: Functional and correlative studies are now needed to elucidate the potential links between germline genotype, epigenetic function, and cancer etiology.Impact: This approach provides novel insight into possible pleiotropic effects of genes involved in epigenetic processes. Cancer Epidemiol Biomarkers Prev; 26(6); 816-25. ©2017 AACR.
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Affiliation(s)
- Reka Toth
- National Center for Tumor Diseases and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Epigenomics and Cancer Risk Factors, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Dominique Scherer
- National Center for Tumor Diseases and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
| | - Linda E Kelemen
- Medical University of South Carolina and Hollings Cancer Center, Charleston, South Carolina
| | - Angela Risch
- Division of Epigenomics and Cancer Risk Factors, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Cancer Research and Epigenetics, Department of Molecular Biology, University of Salzburg, Salzburg, Austria
- Cancer Cluster Salzburg, Salzburg, Austria
- Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research (DZL), Heidelberg, Germany
| | - Aditi Hazra
- Brigham and Women's Hospital, Harvard Medical School, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Yesilda Balavarca
- National Center for Tumor Diseases and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Victor Moreno
- Catalan Institute of Oncology, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Catalonia, Spain
| | | | - Shuji Ogino
- Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Xifeng Wu
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Yuanqing Ye
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Rayjean J Hung
- Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Toronto, Ontario, Canada
- University of Toronto, Toronto, Canada
| | - Ellen L Goode
- Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Cornelia M Ulrich
- National Center for Tumor Diseases and German Cancer Research Center (DKFZ), Heidelberg, Germany.
- Fred Hutchinson Cancer Research Center, Seattle, Washington
- Huntsman Cancer Institute, Salt Lake City, Utah
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Quiroz-Zárate A, Harshfield BJ, Hu R, Knoblauch N, Beck AH, Hankinson SE, Carey V, Tamimi RM, Hunter DJ, Quackenbush J, Hazra A. Expression Quantitative Trait loci (QTL) in tumor adjacent normal breast tissue and breast tumor tissue. PLoS One 2017; 12:e0170181. [PMID: 28152060 PMCID: PMC5289428 DOI: 10.1371/journal.pone.0170181] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 12/30/2016] [Indexed: 12/31/2022] Open
Abstract
We investigate 71 single nucleotide polymorphisms (SNPs) identified in meta-analytic studies of genome-wide association studies (GWAS) of breast cancer, the majority of which are located in intergenic or intronic regions. To explore regulatory impacts of these variants we conducted expression quantitative loci (eQTL) analyses on tissue samples from 376 invasive postmenopausal breast cancer cases in the Nurses' Health Study (NHS) diagnosed from 1990-2004. Expression analysis was conducted on all formalin-fixed paraffin-embedded (FFPE) tissue samples (and on 264 adjacent normal samples) using the Affymetrix Human Transcriptome Array. Significance and ranking of associations between tumor receptor status and expression variation was preserved between NHS FFPE and TCGA fresh-frozen sample sets (Spearman r = 0.85, p<10^-10 for 17 of the 21 Oncotype DX recurrence signature genes). At an FDR threshold of 10%, we identified 27 trans-eQTLs associated with expression variation in 217 distinct genes. SNP-gene associations can be explored using an open-source interactive browser distributed in a Bioconductor package. Using a new a procedure for testing hypotheses relating SNP content to expression patterns in gene sets, defined as molecular function pathways, we find that loci on 6q14 and 6q25 affect various gene sets and molecular pathways (FDR < 10%). Although the ultimate biological interpretation of the GWAS-identified variants remains to be uncovered, this study validates the utility of expression analysis of this FFPE expression set for more detailed integrative analyses.
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Affiliation(s)
| | - Benjamin J. Harshfield
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Rong Hu
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Nick Knoblauch
- Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Andrew H. Beck
- Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Susan E. Hankinson
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
- Division of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, Massachusetts, United States of America
| | - Vincent Carey
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Rulla M. Tamimi
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - David J. Hunter
- Program in Genetic Epidemiology and Statistical Genetics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts, United States of America
| | - John Quackenbush
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Biostatistics and Computational Biology and Center for Cancer Computational Biology, Dana-Farber Cancer Institute, Boston, Massachusetts, United States of America
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Aditi Hazra
- Program in Genetic Epidemiology and Statistical Genetics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts, United States of America
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
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Ghude SD, Bhat GS, Prabhakaran T, Jenamani RK, Chate DM, Safai PD, Karipot AK, Konwar M, Pithani P, Sinha V, Rao PSP, Dixit SA, Tiwari S, Todekar K, Varpe S, Srivastava AK, Bisht DS, Murugavel P, Ali K, Mina U, Dharua M, Rao J, Padmakumari B, Hazra A, Nigam N, Shende U, Lal DM, Chandra BP, Mishra AK, Kumar A, Hakkim H, Pawar H, Acharja P, Kulkarni R, Subharthi C, Balaji B, Varghese M, Bera S, Rajeevan M. Winter Fog Experiment Over the Indo-Gangetic Plains of India. CURR SCI INDIA 2017. [DOI: 10.18520/cs/v112/i04/767-784] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Abstract
Medication nonadherence is a known problem after renal transplantation and can vary from one setting to another. Since it can lead to negative outcomes, it is important to develop intervention strategies to enhance adherence in a given setting using determinants identified through exploratory studies. We explored nonadherence in renal transplant recipients. A longitudinal survey was done with adult renal transplant recipients at a tertiary care public and two private hospitals of Kolkata. Subjects were followed-up for 1 year. After screening for medication adherence status by the four-item Morisky Medication Adherence Scale, those admitting to potential nonadherence were probed further. A patient was deemed to be nonadherent if failing to take medicines on appointed time (doses missed or delayed by more than 2 h) more than three times in any month during the observation period. A pretested questionnaire was used to explore potential determinants of nonadherence. Data of 153 patients recruited over a 2-year were analyzed. The extent of nonadherence with immunosuppressant regimens was about 31% overall; 44% in the public sector and 19% in the private sector (P < 0.001). Nonadherence with other medication was around 19% in both the sectors. Several potential demographic, socioeconomic and psychosocial determinants of nonadherence were identified on univariate analysis. However, logistic regression analysis singled out only the economic status. This study had updated the issue of nonadherence in renal transplant recipients in the Indian setting. Strategies to improve medication adherence can be planned by relevant stakeholders on the basis of these findings.
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Affiliation(s)
| | - A Taraphder
- Department of Nephrology, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India
| | - A Hazra
- Department of Pharmacology, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India
| | - T Das
- Department of Medicine, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India
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Roy R, Kundu R, Sengupta M, Hazra A. Assessment of 2nd and 4th digit length ratio as an anatomical marker for predicting the risk of developing polycystic ovarian syndrome. J ANAT SOC INDIA 2016. [DOI: 10.1016/j.jasi.2016.08.064] [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: 10/20/2022]
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Fehringer G, Kraft P, Pharoah PD, Eeles RA, Chatterjee N, Schumacher FR, Schildkraut JM, Lindström S, Brennan P, Bickeböller H, Houlston RS, Landi MT, Caporaso N, Risch A, Amin Al Olama A, Berndt SI, Giovannucci EL, Grönberg H, Kote-Jarai Z, Ma J, Muir K, Stampfer MJ, Stevens VL, Wiklund F, Willett WC, Goode EL, Permuth JB, Risch HA, Reid BM, Bezieau S, Brenner H, Chan AT, Chang-Claude J, Hudson TJ, Kocarnik JK, Newcomb PA, Schoen RE, Slattery ML, White E, Adank MA, Ahsan H, Aittomäki K, Baglietto L, Blomquist C, Canzian F, Czene K, Dos-Santos-Silva I, Eliassen AH, Figueroa JD, Flesch-Janys D, Fletcher O, Garcia-Closas M, Gaudet MM, Johnson N, Hall P, Hazra A, Hein R, Hofman A, Hopper JL, Irwanto A, Johansson M, Kaaks R, Kibriya MG, Lichtner P, Liu J, Lund E, Makalic E, Meindl A, Müller-Myhsok B, Muranen TA, Nevanlinna H, Peeters PH, Peto J, Prentice RL, Rahman N, Sanchez MJ, Schmidt DF, Schmutzler RK, Southey MC, Tamimi R, Travis RC, Turnbull C, Uitterlinden AG, Wang Z, Whittemore AS, Yang XR, Zheng W, Buchanan DD, Casey G, Conti DV, Edlund CK, Gallinger S, Haile RW, Jenkins M, Le Marchand L, Li L, Lindor NM, Schmit SL, Thibodeau SN, Woods MO, Rafnar T, Gudmundsson J, Stacey SN, Stefansson K, Sulem P, Chen YA, Tyrer JP, Christiani DC, Wei Y, Shen H, Hu Z, Shu XO, Shiraishi K, Takahashi A, Bossé Y, Obeidat M, Nickle D, Timens W, Freedman ML, Li Q, Seminara D, Chanock SJ, Gong J, Peters U, Gruber SB, Amos CI, Sellers TA, Easton DF, Hunter DJ, Haiman CA, Henderson BE, Hung RJ. Cross-Cancer Genome-Wide Analysis of Lung, Ovary, Breast, Prostate, and Colorectal Cancer Reveals Novel Pleiotropic Associations. Cancer Res 2016; 76:5103-14. [PMID: 27197191 PMCID: PMC5010493 DOI: 10.1158/0008-5472.can-15-2980] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 04/05/2016] [Indexed: 01/26/2023]
Abstract
Identifying genetic variants with pleiotropic associations can uncover common pathways influencing multiple cancers. We took a two-stage approach to conduct genome-wide association studies for lung, ovary, breast, prostate, and colorectal cancer from the GAME-ON/GECCO Network (61,851 cases, 61,820 controls) to identify pleiotropic loci. Findings were replicated in independent association studies (55,789 cases, 330,490 controls). We identified a novel pleiotropic association at 1q22 involving breast and lung squamous cell carcinoma, with eQTL analysis showing an association with ADAM15/THBS3 gene expression in lung. We also identified a known breast cancer locus CASP8/ALS2CR12 associated with prostate cancer, a known cancer locus at CDKN2B-AS1 with different variants associated with lung adenocarcinoma and prostate cancer, and confirmed the associations of a breast BRCA2 locus with lung and serous ovarian cancer. This is the largest study to date examining pleiotropy across multiple cancer-associated loci, identifying common mechanisms of cancer development and progression. Cancer Res; 76(17); 5103-14. ©2016 AACR.
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Affiliation(s)
- Gordon Fehringer
- Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Toronto, Canada
| | - Peter Kraft
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | | | | | | | | | | | - Sara Lindström
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Paul Brennan
- International Agency for Research on Cancer, Lyon, France
| | | | | | | | | | - Angela Risch
- Division of Cancer Genetics/Epigenetics, Department of Molecular Biology, University of Salzburg, Salzburg, Austria. Division of Epigenomics and Cancer Risk Factors, DKFZ - German Cancer Research Center, Heidelberg, Germany. Translational Lung Research Center Heidelberg (TLRC-H), German Center for Lung Research (DZL), Heidelberg, Germany
| | | | | | | | | | | | - Jing Ma
- Harvard Medical School, Boston Massachusetts. Brigham and Women's Hospital, Boston, Massachusetts
| | - Kenneth Muir
- University of Manchester, Manchester, United Kingdom. The University of Warwick, Coventry, United Kingdom
| | | | - Victoria L Stevens
- Epidemiology Research Program, American Cancer Society, Atlanta, Georgia
| | | | - Walter C Willett
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | | | | | | | | | | | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany. Division of Preventive Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany. German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Andrew T Chan
- Massachusetts General Hospital, Boston, Massachusetts
| | - Jenny Chang-Claude
- National Center for Tumor Diseases and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | | | | | - Robert E Schoen
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | | | - Emily White
- Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Muriel A Adank
- VU University Medical Center, Amsterdam, the Netherlands
| | | | - Kristiina Aittomäki
- University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | | | - Carl Blomquist
- University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Federico Canzian
- Genomic Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Isabel Dos-Santos-Silva
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - A Heather Eliassen
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts. Harvard Medical School, Boston Massachusetts
| | | | | | - Olivia Fletcher
- Breakthrough Research Centre, The Institute of Cancer Research, London, United Kingdom
| | | | - Mia M Gaudet
- Epidemiology Research Program, American Cancer Society, Atlanta, Georgia
| | - Nichola Johnson
- Breakthrough Research Centre, The Institute of Cancer Research, London, United Kingdom
| | - Per Hall
- Karolinska Institutet, Stockholm, Sweden
| | - Aditi Hazra
- Harvard Medical School, Boston Massachusetts
| | - Rebecca Hein
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ) Heidelberg, Germany. Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Cologne, Germany
| | - Albert Hofman
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - John L Hopper
- Melbourne School of Population Health, University of Melbourne, Melbourne, Victoria, Australia
| | | | - Mattias Johansson
- International Agency for Research on Cancer, Lyon, France. Department of Biobank Research, Umea University, Umea, Sweden
| | - Rudolf Kaaks
- National Center for Tumor Diseases and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Peter Lichtner
- German Research Center for Environmental Health, Neuherberg, Germany
| | | | - Eiliv Lund
- Institute of Community Medicine, UiT The Arctic University of Norway, Tromso, Norway
| | - Enes Makalic
- Melbourne School of Population Health, University of Melbourne, Melbourne, Victoria, Australia
| | | | | | - Taru A Muranen
- University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Heli Nevanlinna
- University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Petra H Peeters
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands
| | - Julian Peto
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | | | - Maria Jose Sanchez
- Escuela Andaluza de Salud Publica, Instituto de Investigacion Biosanitaria ibs. GRANADA, Granada, Spain. Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain. CIBER de Epidemiología y Salud Pública CIBERESP, Madrid, Spain
| | - Daniel F Schmidt
- Melbourne School of Population Health, University of Melbourne, Melbourne, Victoria, Australia
| | | | | | | | - Ruth C Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | | | - Andre G Uitterlinden
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands. Department of Internal Medicine, Erasmus MC, Rotterdam, the Netherlands
| | | | | | | | - Wei Zheng
- Vanderbilt University, Nashville, Tennessee
| | | | - Graham Casey
- University of Southern California, Los Angeles, California
| | - David V Conti
- University of Southern California, Los Angeles, California
| | | | - Steven Gallinger
- Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Toronto, Canada
| | | | - Mark Jenkins
- The University of Melbourne, Melbourne, Victoria, Australia
| | - Loïc Le Marchand
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii
| | - Li Li
- Case Comprehensive Cancer Center and Mary Ann Swetland Center for Environmental Health, Case Western Reserve University, Cleveland, Ohio
| | | | | | | | - Michael O Woods
- Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | | | | | | | | | | | | | | | | | - Yongyue Wei
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Hongbing Shen
- Nanjing Medical University School of Public Health, Nanjing, China
| | - Zhibin Hu
- Nanjing Medical University School of Public Health, Nanjing, China
| | | | - Kouya Shiraishi
- Division of Genome Biology, National Cancer Center Research Institute, Tokyo, Japan
| | - Atsushi Takahashi
- Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Yohan Bossé
- Department of Molecular Medicine, Institut universitaire de cardiologie et de pneumologie de Québec, Laval University, Québec, Canada
| | - Ma'en Obeidat
- University of British Columbia Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, Canada
| | - David Nickle
- Merck & Co, Merck Research Laboratories, Seattle, Washington
| | - Wim Timens
- University of Groningen, University Medical Center Groningen, GRIAC Research Institute, Groningen, the Netherlands
| | | | | | | | | | - Jian Gong
- Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Ulrike Peters
- Fred Hutchinson Cancer Research Center, Seattle, Washington
| | | | | | | | | | - David J Hunter
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | | | | | - Rayjean J Hung
- Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Toronto, Canada.
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Heng YJJ, Wang J, Hazra A, Hunter DJ, Eliassen AH, Tamimi RM, Hankinson SE, Beck AH. Abstract 805: The molecular mechanisms of obesity driving breast cancer etiology and prognosis in post-menopausal women. Cancer Res 2016. [DOI: 10.1158/1538-7445.am2016-805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
This study aims to gain insights into the molecular mechanisms of obesity driving breast cancer etiology and prognosis as post-menopausal women with high body mass index (BMI) have increased breast cancer risk and poorer prognosis.
We examined the differential gene expression of breast tumors from 441 post-menopausal women part of the Nurses’ Health Studies. Primary analysis was performed between women with BMI of <25, ≥25 to <30, ≥30 to 35 and ≥35 while secondary analysis was performed using BMI as a continuous variable. Analyses were adjusted for age of diagnosis, year of diagnosis, post-menopausal hormone therapy, alcohol consumption, microarray batch and ER status.
In the primary analysis, differentially expressed genes associated with BMI were identified in pairwise analyses comparing women with BMI ≥35 with women in lower BMI categories (<25 vs. ≥35, n = 58 significant genes; ≥25 to <30 vs. ≥35, n = 29; ≥30 to 35 vs. ≥35, n = 12; FDR<0.05); no significant genes were identified in the other pairwise comparisons. In the secondary analysis which considered BMI as a continuous value, two genes, NCOA3 and PTPN1, were significantly up-regulated in breast tumors with increasing BMI (FDR<0.05). Gene set enrichment analyses suggested that tumors from post-menopausal women with increasing BMI have increased inflammation and decreased carcinogen/anti-cancer drug metabolism.
These molecular insights have further elucidated breast cancer etiology in post-menopausal women with high BMI.
Citation Format: Yu Jing Jan Heng, Jun Wang, Aditi Hazra, David J. Hunter, A. Heather Eliassen, Rulla M. Tamimi, Susan E. Hankinson, Andrew H. Beck. The molecular mechanisms of obesity driving breast cancer etiology and prognosis in post-menopausal women. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 805.
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Affiliation(s)
- Yu Jing Jan Heng
- 1Beth Israel Deaconess Medical Center Harvard Medical School, Boston, MA
| | - Jun Wang
- 2University of Massachusetts Amherst, Amherst, MA
| | - Aditi Hazra
- 3Harvard T.H. Chan School of Public Health, Boston, MA
| | | | | | | | | | - Andrew H. Beck
- 1Beth Israel Deaconess Medical Center Harvard Medical School, Boston, MA
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Kensler K, Beck A, Beca F, Collins L, Schnitt S, Hazra A, Hankinson S, Brown M, Tamimi R. Abstract 4295: Androgen receptor expression in normal breast TDLUs and subsequent breast cancer risk. Cancer Res 2016. [DOI: 10.1158/1538-7445.am2016-4295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
Sex steroid hormone signaling is critical in the development and progression of breast cancers, though the role of androgens remains unspecified. Large epidemiologic studies have found a consistent association between circulating androgens and increased breast cancer risk, though it is unknown whether circulating androgens reflect the androgenic milieu in the breast. An interaction between androgen receptor (AR) and estrogen receptor (ER) signaling in the breast has been postulated, wherein AR signaling antagonizes ER signaling in estrogen-rich environments, and AR signaling induces proliferative effects in estrogen-deplete environments.
Methods
We evaluated the association between AR expression and subsequent breast cancer risk in a nested case-control study of women with benign breast disease (BBD) within the Nurses’ Health Studies. Cases were women with BBD that subsequently developed breast cancer (median 9 years later) while controls had BBD but did not develop breast cancer. Tissue microarrays were constructed containing normal terminal ductal lobular unit (TDLU) tissue from the BBD biopsy. AR expression was assessed by immunohistochemistry and the percent of positive-staining nuclei was digitally quantified for 61 breast cancer cases and 184 controls. Logistic regression models adjusting for the year of BBD biopsy, age at cancer diagnosis, years since BBD biopsy, and BBD lesion type were used to calculate odds ratios and 95% confidence intervals for the association between the tertile of AR expression and breast cancer risk. We further evaluated the impact of AR and ER co-expression, each dichotomized at the median, in a sub-analysis of 31 cases and 82 controls. Finally, we assessed AR expression as a predictor of subsequent ER tumor status using polytomous logistic regression.
Results
Overall, women in the highest tertile of AR expression experienced non-significant 1.32-fold increased odds of breast cancer (95% CI: 0.64-1.73, p-trend = 0.559) compared to the lowest tertile. A significant interaction was detected between AR and ER co-expression in normal breast TDLUs and subsequent breast cancer risk (p-interaction = 0.003). Among women with low ER expression, increased AR expression was associated with 2.52-fold increased odds (95% CI: 0.68-9.34) of developing breast cancer. In contrast, among women with high ER expression, high AR expression was associated with a 91% decrease in the odds (OR = 0.09, 95% CI: 0.01-0.62) of breast cancer. AR expression was not predictive of subsequent ER tumor status.
Conclusions
There was little evidence for an overall association between AR expression in normal breast tissue and breast cancer risk, though we observed a significant interaction between AR and ER expression. Our findings support the hypothesis that AR interacts with ER to promote cell proliferation in estrogen-deprived environments and inhibit growth in estrogen-rich environments.
Citation Format: Kevin Kensler, Andrew Beck, Francisco Beca, Laura Collins, Stuart Schnitt, Aditi Hazra, Susan Hankinson, Myles Brown, Rulla Tamimi. Androgen receptor expression in normal breast TDLUs and subsequent breast cancer risk. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 4295.
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Affiliation(s)
- Kevin Kensler
- 1Harvard T.H. Chan School of Public Health, Boston, MA
| | - Andrew Beck
- 2Beth Israel Deaconess Medical Center, Boston, MA
| | | | | | | | | | - Susan Hankinson
- 4University of Massachusetts School of Public Health and Health Sciences, Amherst, MA
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Wang J, Heng YJ, Hazra A, Eliassen AH, Tamimi R, Hunter D, Beck A, Hankinson S. Abstract LB-380: Alcohol consumption and transcriptomic differences in breast tumor. Cancer Res 2016. [DOI: 10.1158/1538-7445.am2016-lb-380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Objective: Alcohol consumption is consistently positively associated with breast cancer risk in epidemiologic studies and the association generally appears stronger among estrogen receptor (ER) positive tumors. However, the underlying biologic mechanism is not completely understood.
Methods: We evaluated pre-diagnostic alcohol intake in relation to transcriptome profiles of invasive breast cancers diagnosed 1990-2009 in the Nurses’ Health Studies using a custom Affymetrix Human Transcriptome array. RNA was extracted from formalin fixed paraffin embedded breast tumor and tumor adjacent normal tissue. Cumulative average and recent alcohol intake were used in the analysis (defined as categorical: 0, >0 - <10, 10+ g/d or continuous: per 10 g/d). Multivariable linear regression was used to identify differentially expressed genes in tumor (n = 602) and adjacent normal (n = 508) samples, respectively. We further conducted gene set enrichment analysis (GSEA) to assess biological pathways. Differentially expressed genes or gene sets were considered statistically significant if false discovery rate < 0.1.
Results: When comparing cumulative average or recent alcohol intake 10+ g/d vs. 0, no significantly differentially expressed genes were identified in all tumors combined or in stratified analyses by ER or human epidermal growth factor receptor 2(HER2) status. However, when recent alcohol assessed as per 10 g/d, SUSD2 was significantly up-regulated and GTPBP6 significantly down-regulated in HER2+ and ER- tumors, respectively. No genes were significantly differentially expressed according to alcohol intake in tumor adjacent normal tissue. When evaluating recent alcohol intake 10+ g/d vs 0, differentially expressed gene sets identified through GSEA suggest that translation, cell cycle, and response to DNA damage and DNA repair were up-regulated while lipid metabolism and signaling and retinol metabolism were down-regulated in ER+ tumors; in ER- tumors, immune function/inflammatory response was up-regulated in addition to the up-regulation of genes involved in translation and cell-cycle. We further verified these gene sets (n = 32 and 4 up- and down- regulated, respectively in ER+ tumors; n = 89 and 2 up- and down-, respectively in ER- tumors) in The Cancer Genome Atlas data set. However, such differentially expressed gene sets were not observed in the analysis of cumulative average alcohol. In tumor adjacent normal samples, in addition to the down-regulation in lipid metabolism and signaling (consistent with ER+ tumors), alcohol metabolism (particularly in mitochondria), DNA damage response and apoptosis were significantly down-regulated (contrary to ER+ tumors), when comparing recent alcohol 10+ g/d vs. 0.
Conclusion: To the best of our knowledge, this is the first study to evaluate pre-diagnostic alcohol consumption and breast tumor transcriptomic profiles. Assessment of transcriptomic differences with alcohol intake in tumor and/or adjacent normal tissue may help provide insights into the biologic mechanism underlying the alcohol and breast cancer association.
Citation Format: Jun Wang, Yujing J. Heng, Aditi Hazra, A. Heather Eliassen, Rulla Tamimi, David Hunter, Andrew Beck, Susan Hankinson. Alcohol consumption and transcriptomic differences in breast tumor. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr LB-380.
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Affiliation(s)
- Jun Wang
- 1University of Massachusetts Amherst, Amherst, MA
| | | | | | | | | | - David Hunter
- 4Harvard T.H. Chan School Of Public Health, Boston, MA
| | - Andrew Beck
- 2Beth Israel Deaconess Medical Center, Boston, MA
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van Vollenhoven R, Choy E, Lee E, Hazra A, Anisfeld A, Lazariciu I, Biswas P, Lamba M, Menon S, Hodge J, Clark J, Wang L, Krishnaswami S. THU0199 Tofacitinib, An Oral Janus Kinase Inhibitor, in The Treatment of Rheumatoid Arthritis: Changes in Lymphocytes and Lymphocyte Subset Counts and Reversibility after Up To 8 Years of Tofacitinib Treatment. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2134] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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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Ruperto N, Brunner H, Hazra A, Wang R, Mebus C, Alvey C, Lamba M, Krishnaswami S, Conte U, Wang M, Tzaribachev N, Foeldvari I, Horneff G, Kingsbury D, Koskova E, Smolewska E, Vehe R, Zuber Z, Martini A, Lovell D. AB0879 Pharmacokinetics, Safety, and Tolerability of Tofacitinib in Paediatric Patients from Two To Less than Eighteen Years of Age with Juvenile Idiopathic Arthritis. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2640] [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: 11/04/2022]
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Bhadra R, Choudhuri AR, Hazra A, Mukhopadhyay JD. Serum vitamin D level and its relation with carotid intima-media thickness in type 2 diabetic patients: a cross-sectional observational study. Diabetes Metab Syndr 2016; 10:S55-S59. [PMID: 26818693 DOI: 10.1016/j.dsx.2016.01.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 01/09/2016] [Indexed: 12/29/2022]
Affiliation(s)
- R Bhadra
- Department of Pharmacology, IPGMER & SSKM Hospital, Kolkata.
| | - A R Choudhuri
- Department of Biochemistry, IPGME&R & SSKM Hospital, Kolkata
| | - A Hazra
- Department of Pharmacology, IPGMER & SSKM Hospital, Kolkata
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Hazra A, Warren L, Nakhlis F, Bellon JR, Hirshfield-Bartek J, Jacene H, Yeh ED, Dominici L, Schlosnagle E, Hirko K, Overmoyer B. Abstract P6-18-03: Tumor profiling of inflammatory breast cancer: Advancing the tools needed for precision medicine. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p6-18-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Inflammatory breast cancer (IBC) is a rare and highly lethal form of breast cancer, accounting for approximately 10% of breast cancer mortality in the US. The clinical presentation of IBC includes rapid onset of symptoms, erythema > 1/3 of the breast, and edema. The genomic changes underlying the clincopathologic manifestations of IBC are yet unknown. Identification of a unique molecular signature in de novo IBC may provide insight into the biology of this disease, allowing further investigation into the etiology and treatment of this aggressive disease. In previous studies, supervised analysis of gene expression data from surgical tissue specimens identified a molecular-subtype independent 79-gene signature associated with IBC compared to locally-advanced non-IBC. In this study, we propose to identify a gene expression signature associated with IBC using breast specimens collected from patients with non-metastatic IBC prior to initiating preoperative systemic treatment.
Methods: Formalin fixed paraffin embedded (FFPE) core biopsy specimens were collected from patients with inflammatory breast cancer prior to initiating systemic therapy. All specimens underwent centralized pathology review at Brigham and Women's Hospital, and the clinical diagnosis was confirmed through evaluation by the Dana Farber Cancer Institute Inflammatory Breast Cancer Program. Sufficient RNA and DNA were simultaneously extracted from 14 biopsy specimens using the Qiagen AllPrep Kit. The RNA was amplified using the Sensation kit and profiled using the Affymetrix Human Transcriptome Array (HTA) 2.0. DNA was profiled for druggable somatic mutations and genome-wide copy number variations using the Affymetrix OncoScan Array.
Results: Pearson correlation coefficients for overall gene expression for 4 technical replicates included in the HTA ranged from r=0.993 - 0.994 and suggest excellent reproducibility in archival biopsy tissue. In preliminary analyses, 765 mRNA transcripts and 335 non-coding transcripts were differentially expressed based on clinical presentation features. The strongest differential association for rapid onset of disease was observed for alternately spliced variants in the TSPAN1 gene. Somatic mutations in PIK3CA were detected in 3 of the IBC patients. Additional paired assays as well as single-gene and pathway analyses, and integrated analyses of the genome and transcriptome using the R/Bioconductor packages are ongoing.
Conclusion: An understanding of the genomic changes that contribute to the unique presentation and biologic features associated with IBC should lead to a significant impact on identifying etiologic risk factors and in optimizing treatment strategies. Our findings to date suggest a robust and reproducible method for genomic investigation using standard diagnostic breast core biopsies among IBC patients, and may inform profiling of biopsy specimens for other cancer types. The completion of this study will provide biological insights into the molecular mechanisms driving IBC and may identify clinically actionable targets for novel IBC therapies that warrant further exploration.
Citation Format: Hazra A, Warren L, Nakhlis F, Bellon JR, Hirshfield-Bartek J, Jacene H, Yeh ED, Dominici L, Schlosnagle E, Hirko K, Overmoyer B. Tumor profiling of inflammatory breast cancer: Advancing the tools needed for precision medicine. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P6-18-03.
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Affiliation(s)
- A Hazra
- Brigham and Women's Hospital, Boston, MA; Harvard T.H. Chan School of Public Health, Boston, MA; Dana Farber Cancer Institute, Boston, MA
| | - L Warren
- Brigham and Women's Hospital, Boston, MA; Harvard T.H. Chan School of Public Health, Boston, MA; Dana Farber Cancer Institute, Boston, MA
| | - F Nakhlis
- Brigham and Women's Hospital, Boston, MA; Harvard T.H. Chan School of Public Health, Boston, MA; Dana Farber Cancer Institute, Boston, MA
| | - JR Bellon
- Brigham and Women's Hospital, Boston, MA; Harvard T.H. Chan School of Public Health, Boston, MA; Dana Farber Cancer Institute, Boston, MA
| | - J Hirshfield-Bartek
- Brigham and Women's Hospital, Boston, MA; Harvard T.H. Chan School of Public Health, Boston, MA; Dana Farber Cancer Institute, Boston, MA
| | - H Jacene
- Brigham and Women's Hospital, Boston, MA; Harvard T.H. Chan School of Public Health, Boston, MA; Dana Farber Cancer Institute, Boston, MA
| | - ED Yeh
- Brigham and Women's Hospital, Boston, MA; Harvard T.H. Chan School of Public Health, Boston, MA; Dana Farber Cancer Institute, Boston, MA
| | - L Dominici
- Brigham and Women's Hospital, Boston, MA; Harvard T.H. Chan School of Public Health, Boston, MA; Dana Farber Cancer Institute, Boston, MA
| | - E Schlosnagle
- Brigham and Women's Hospital, Boston, MA; Harvard T.H. Chan School of Public Health, Boston, MA; Dana Farber Cancer Institute, Boston, MA
| | - K Hirko
- Brigham and Women's Hospital, Boston, MA; Harvard T.H. Chan School of Public Health, Boston, MA; Dana Farber Cancer Institute, Boston, MA
| | - B Overmoyer
- Brigham and Women's Hospital, Boston, MA; Harvard T.H. Chan School of Public Health, Boston, MA; Dana Farber Cancer Institute, Boston, MA
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Vilhjálmsson B, Yang J, Finucane H, Gusev A, Lindström S, Ripke S, Genovese G, Loh PR, Bhatia G, Do R, Hayeck T, Won HH, Kathiresan S, Pato M, Pato C, Tamimi R, Stahl E, Zaitlen N, Pasaniuc B, Belbin G, Kenny EE, Schierup MH, De Jager P, Patsopoulos NA, McCarroll S, Daly M, Purcell S, Chasman D, Neale B, Goddard M, Visscher PM, Kraft P, Patterson N, Price AL, Ripke S, Neale B, Corvin A, Walters J, Farh KH, Holmans P, Lee P, Bulik-Sullivan B, Collier D, Huang H, Pers T, Agartz I, Agerbo E, Albus M, Alexander M, Amin F, Bacanu S, Begemann M, Belliveau R, Bene J, Bergen S, Bevilacqua E, Bigdeli T, Black D, Bruggeman R, Buccola N, Buckner R, Byerley W, Cahn W, Cai G, Campion D, Cantor R, Carr V, Carrera N, Catts S, Chambert K, Chan R, Chen R, Chen E, Cheng W, Cheung E, Chong S, Cloninger C, Cohen D, Cohen N, Cormican P, Craddock N, Crowley J, Curtis D, Davidson M, Davis K, Degenhardt F, Del Favero J, DeLisi L, Demontis D, Dikeos D, Dinan T, Djurovic S, Donohoe G, Drapeau E, Duan J, Dudbridge F, Durmishi N, Eichhammer P, Eriksson J, Escott-Price V, Essioux L, Fanous A, Farrell M, Frank J, Franke L, Freedman R, Freimer N, Friedl M, Friedman J, Fromer M, Genovese G, Georgieva L, Gershon E, Giegling I, Giusti-Rodrguez P, Godard S, Goldstein J, Golimbet V, Gopal S, Gratten J, Grove J, de Haan L, Hammer C, Hamshere M, Hansen M, Hansen T, Haroutunian V, Hartmann A, Henskens F, Herms S, Hirschhorn J, Hoffmann P, Hofman A, Hollegaard M, Hougaard D, Ikeda M, Joa I, Julia A, Kahn R, Kalaydjieva L, Karachanak-Yankova S, Karjalainen J, Kavanagh D, Keller M, Kelly B, Kennedy J, Khrunin A, Kim Y, Klovins J, Knowles J, Konte B, Kucinskas V, Kucinskiene Z, Kuzelova-Ptackova H, Kahler A, Laurent C, Keong J, Lee S, Legge S, Lerer B, Li M, Li T, Liang KY, Lieberman J, Limborska S, Loughland C, Lubinski J, Lnnqvist J, Macek M, Magnusson P, Maher B, Maier W, Mallet J, Marsal S, Mattheisen M, Mattingsdal M, McCarley R, McDonald C, McIntosh A, Meier S, Meijer C, Melegh B, Melle I, Mesholam-Gately R, Metspalu A, Michie P, Milani L, Milanova V, Mokrab Y, Morris D, Mors O, Mortensen P, Murphy K, Murray R, Myin-Germeys I, Mller-Myhsok B, Nelis M, Nenadic I, Nertney D, Nestadt G, Nicodemus K, Nikitina-Zake L, Nisenbaum L, Nordin A, O’Callaghan E, O’Dushlaine C, O’Neill F, Oh SY, Olincy A, Olsen L, Van Os J, Pantelis C, Papadimitriou G, Papiol S, Parkhomenko E, Pato M, Paunio T, Pejovic-Milovancevic M, Perkins D, Pietilinen O, Pimm J, Pocklington A, Powell J, Price A, Pulver A, Purcell S, Quested D, Rasmussen H, Reichenberg A, Reimers M, Richards A, Roffman J, Roussos P, Ruderfer D, Salomaa V, Sanders A, Schall U, Schubert C, Schulze T, Schwab S, Scolnick E, Scott R, Seidman L, Shi J, Sigurdsson E, Silagadze T, Silverman J, Sim K, Slominsky P, Smoller J, So HC, Spencer C, Stahl E, Stefansson H, Steinberg S, Stogmann E, Straub R, Strengman E, Strohmaier J, Stroup T, Subramaniam M, Suvisaari J, Svrakic D, Szatkiewicz J, Sderman E, Thirumalai S, Toncheva D, Tooney P, Tosato S, Veijola J, Waddington J, Walsh D, Wang D, Wang Q, Webb B, Weiser M, Wildenauer D, Williams N, Williams S, Witt S, Wolen A, Wong E, Wormley B, Wu J, Xi H, Zai C, Zheng X, Zimprich F, Wray N, Stefansson K, Visscher P, Adolfsson R, Andreassen O, Blackwood D, Bramon E, Buxbaum J, Børglum A, Cichon S, Darvasi A, Domenici E, Ehrenreich H, Esko T, Gejman P, Gill M, Gurling H, Hultman C, Iwata N, Jablensky A, Jonsson E, Kendler K, Kirov G, Knight J, Lencz T, Levinson D, Li Q, Liu J, Malhotra A, McCarroll S, McQuillin A, Moran J, Mortensen P, Mowry B, Nthen M, Ophoff R, Owen M, Palotie A, Pato C, Petryshen T, Posthuma D, Rietschel M, Riley B, Rujescu D, Sham P, Sklar P, St. Clair D, Weinberger D, Wendland J, Werge T, Daly M, Sullivan P, O’Donovan M, Kraft P, Hunter DJ, Adank M, Ahsan H, Aittomäki K, Baglietto L, Berndt S, Blomquist C, Canzian F, Chang-Claude J, Chanock SJ, Crisponi L, Czene K, Dahmen N, Silva IDS, Easton D, Eliassen AH, Figueroa J, Fletcher O, Garcia-Closas M, Gaudet MM, Gibson L, Haiman CA, Hall P, Hazra A, Hein R, Henderson BE, Hofman A, Hopper JL, Irwanto A, Johansson M, Kaaks R, Kibriya MG, Lichtner P, Lindström S, Liu J, Lund E, Makalic E, Meindl A, Meijers-Heijboer H, Müller-Myhsok B, Muranen TA, Nevanlinna H, Peeters PH, Peto J, Prentice RL, Rahman N, Sánchez MJ, Schmidt DF, Schmutzler RK, Southey MC, Tamimi R, Travis R, Turnbull C, Uitterlinden AG, van der Luijt RB, Waisfisz Q, Wang Z, Whittemore AS, Yang R, Zheng W. Modeling Linkage Disequilibrium Increases Accuracy of Polygenic Risk Scores. Am J Hum Genet 2015; 97:576-92. [PMID: 26430803 DOI: 10.1016/j.ajhg.2015.09.001] [Citation(s) in RCA: 773] [Impact Index Per Article: 85.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Accepted: 09/01/2015] [Indexed: 11/24/2022] Open
Abstract
Polygenic risk scores have shown great promise in predicting complex disease risk and will become more accurate as training sample sizes increase. The standard approach for calculating risk scores involves linkage disequilibrium (LD)-based marker pruning and applying a p value threshold to association statistics, but this discards information and can reduce predictive accuracy. We introduce LDpred, a method that infers the posterior mean effect size of each marker by using a prior on effect sizes and LD information from an external reference panel. Theory and simulations show that LDpred outperforms the approach of pruning followed by thresholding, particularly at large sample sizes. Accordingly, predicted R(2) increased from 20.1% to 25.3% in a large schizophrenia dataset and from 9.8% to 12.0% in a large multiple sclerosis dataset. A similar relative improvement in accuracy was observed for three additional large disease datasets and for non-European schizophrenia samples. The advantage of LDpred over existing methods will grow as sample sizes increase.
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Wang J, Zhang X, Beck AH, Collins LC, Chen WY, Tamimi RM, Hazra A, Brown M, Rosner B, Hankinson SE. Alcohol Consumption and Risk of Breast Cancer by Tumor Receptor Expression. Discov Oncol 2015; 6:237-46. [PMID: 26385458 DOI: 10.1007/s12672-015-0235-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Accepted: 09/08/2015] [Indexed: 01/05/2023] Open
Abstract
In epidemiologic studies, alcohol consumption appears more strongly associated with risk of estrogen receptor (ER)-positive than ER-negative breast cancer. However, this association has not been assessed by other potentially relevant tumor markers, such as androgen receptor (AR) or insulin receptor (IR). In the prospective Nurses' Health Study cohort, we evaluated alcohol consumption and breast cancer risk by individual tumor marker expression (i.e., ER, progesterone receptor [PR], AR, and IR) while controlling for other markers and also assessed the joint effect of these receptors. During 26 years follow-up of 106,037 women, 2552 invasive breast cancers contributed to the analysis. When all four markers were considered simultaneously, no significant heterogeneity of the alcohol and breast cancer association was observed by any of the markers. However, each increment in one drink per day was associated with 10% (95% confidence interval [CI] = 4%, 15%) and 9% (95% CI = 4%, 15%) increased risk of AR-positive and ER-positive breast cancer, respectively, while no increased risk was observed among AR-negative or ER-negative tumors. The association was independent of PR and IR expression. Assessment of the joint expression of hormone receptors revealed a significantly increased risk among AR+/ER+/PR+ (hazard ratio [HR] per drink/day = 1.11, 95% CI = 1.06, 1.17) but not in other subgroups (e.g. , AR-/ER-/PR-: HR = 0.99; 95% CI = 0.88, 1.12). Our data suggest that the alcohol and breast cancer association may be more pronounced among ER-positive and/or AR-positive breast tumors. However, our data do not support an important role of IR in the association.
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Affiliation(s)
- Jun Wang
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, 715 N Pleasant Street, Amherst, MA, 01003, USA.
| | - Xuehong Zhang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA
| | - Andrew H Beck
- Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, 02215, USA
| | - Laura C Collins
- Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, 02215, USA
| | - Wendy Y Chen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA.,Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA, 02115, USA
| | - Rulla M Tamimi
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Aditi Hazra
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Myles Brown
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA, 02115, USA
| | - Bernard Rosner
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA.,Department of Biostatistics, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Susan E Hankinson
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, 715 N Pleasant Street, Amherst, MA, 01003, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
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Lindström S, Thompson DJ, Paterson AD, Li J, Gierach GL, Scott C, Stone J, Douglas JA, Dos-Santos-Silva I, Fernandez-Navarro P, Verghase J, Smith P, Brown J, Luben R, Wareham NJ, Loos RJF, Heit JA, Pankratz VS, Norman A, Goode EL, Cunningham JM, deAndrade M, Vierkant RA, Czene K, Fasching PA, Baglietto L, Southey MC, Giles GG, Shah KP, Chan HP, Helvie MA, Beck AH, Knoblauch NW, Hazra A, Hunter DJ, Kraft P, Pollan M, Figueroa JD, Couch FJ, Hopper JL, Hall P, Easton DF, Boyd NF, Vachon CM, Tamimi RM. Corrigendum: genome-wide association study identifies multiple loci associated with both mammographic density and breast cancer risk. Nat Commun 2015; 6:8358. [PMID: 26349435 DOI: 10.1038/ncomms9358] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Banerjee TK, Dutta S, Ray BK, Ghosal M, Hazra A, Chaudhuri A, Das SK. Epidemiology of epilepsy and its burden in Kolkata, India. Acta Neurol Scand 2015; 132:203-11. [PMID: 25689886 DOI: 10.1111/ane.12384] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Disability-adjusted life year (DALY) is a time-based measure of disease burden incorporating both disability and mortality. Our study aimed to determine the DALY lost from epilepsy in an Indian metropolis. METHODS A population-based prospective study on epilepsy was conducted over 5 years (2003-8) in Kolkata, India, on randomly selected 100,802 subjects (males 53,209, females 47,593) to assess prevalence as well as to capture incident cases of epilepsy and those incident cases that died. Standard case definitions were used. The data were used to estimate years of life lost (YLL) due to premature mortality, years of life lived with disability (YLD), and DALY, utilizing the prevalence-based Global Burden of Disease (GBD) 2010 approach. Age- and gender-specific figures were computed. RESULTS During 2003-2004, a total of 476 subjects with active epilepsy were detected and the age-adjusted prevalence rate was 4.71 per 1000. Over 5 years, there were 197 incident cases of epilepsy of whom 26 died. The age-adjusted annual incidence rate of epilepsy was 38.3 per 100,000. The all-cause standardized mortality rate (SMR) of epilepsy was 2.4. The burden of epilepsy in the year 2007-8 revealed the overall YLL was 755 per 100,000, and the overall YLD ranged from 14.45 to 31.0 per 100,000 persons depending on the clinical severity of the epilepsy. Both YLL and YLD values were higher in males than in females. The overall DALY lost due to epilepsy in 2007-8 was found to be 846.96 (males 1183.04, females 463.81) per 100,000. CONCLUSIONS This is the first study in India to determine the DALY of epilepsy using GBD 2010. The results reveal a substantial burden of epilepsy in our setting. Similar such studies are needed in other parts of India in both urban and rural settings.
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Affiliation(s)
- T. K. Banerjee
- Department of Neurology; National Neuroscience Centre; Kolkata India
| | - S. Dutta
- Department of Statistics; Ballygunje Science College; University of Calcutta; Kolkata India
| | - B. K. Ray
- Department of Neurology; BIN and IPGME&R; Kolkata India
| | - M. Ghosal
- Department of Psychiatry; Medical College Kolkata; Kolkata India
| | - A. Hazra
- Department of Pharmacology; IPGME&R; Kolkata India
| | - A. Chaudhuri
- Sampling Unit; Indian Statistical Institute; Kolkata India
| | - S. K. Das
- Department of Neurology; BIN and IPGME&R; Kolkata India
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Scherer D, Toth R, Kelemen L, Risch A, Hazra A, Issa JP, Moreno V, Eeles RA, Quackenbush J, Goode EL, Ogino S, Hung R, Ulrich CM. Abstract 4612: Genetic variants in epigenetic pathways and risk of multiple cancer types in the GAME-ON consortium. Cancer Res 2015. [DOI: 10.1158/1538-7445.am2015-4612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction
Epigenetic changes are reversible features of the genome that regulate gene transcription and protein expression on several levels including DNA methylation, histone modification or miRNA expression. We investigated the association between inherited variation in genes of key epigenetic processes and risk of multiple cancers within the GAME-ON consortium.
Methods
We performed a pathway based meta-analysis using genotypes from more than 50,000 cases of breast, lung, prostate, ovarian and colorectal cancer cases and more than 60,000 controls from various genome wide association studies participating in the GAME-ON consortium to estimate associations with cancer risk. Using the 1000GenomeProject database, we selected 505,702 genotyped and imputed single nucleotide polymorphisms in 551 genes (flanking region +/- 250kb) related to DNA methylation, histone modification or chromatin remodeling based on GO and GeneCard databases. In order to allow variants to be associated with only a subset of traits we used subset based meta-analysis. False-discovery rate (FDR) corrected p-values (q-values) lower than 0.05 were considered significant.
Results and Discussion 582 SNPs were significantly associated with risk of at least one cancer. We identified nine major regions that showed significant associations with more than one cancer type.
Among the most interesting regions was the region around PHC3 (3q36), which showed associations with prostate and colorectal cancer and clear cell ovarian carcinomas. PHC3 is involved in chromatin remodeling and plays a role in epithelial neoplasms. Significant Odds ratios (ORs) ranged from 0.80 to 1.31. The number of risk and protective alleles in this region was similarly distributed (19 and 18, respectively). One of the strongest associations was observed for rs76925190 (intronic in PRKC1), which increased the risk of colorectal and prostate cancer (q-value 4.28*10-10). Variants in this region were previously associated with prostate cancer.
Polymorphisms in the region (19q13) around BABAM1 (RISC and BRCA1 A complex member 1), were associated with lung, breast, ovarian and prostate cancer. BABAM1 is associated with the BRCA1-complex. Its function in histone modification and DNA repair emphasizes its importance in carcinogenesis. Significant ORs ranged from 0.88 to 1.14 with similar distribution of risk and protective alleles in this region (19 and 17, respectively). The strongest association was observed for rs4808076 (intronic in ANKLE1), which increased the risk of squamous lung, serous ovarian and ER- -breast cancer (q-value 2.40*10-6). Variants in this region were previously associated with risk of breast and ovarian cancer.
Conclusions
This study emphasizes the importance of variants in genes of epigenetic processes on cancer risk and further provides insights into novel, pleiotropic epigenetic mechanisms of cancer development.
Citation Format: Dominique Scherer, Reka Toth, Linda Kelemen, Angela Risch, Aditi Hazra, Jean Pierre Issa, Victor Moreno, Rosalind A. Eeles, John Quackenbush, Ellen L. Goode, Shuji Ogino, Rayjean Hung, Cornelia M. Ulrich. Genetic variants in epigenetic pathways and risk of multiple cancer types in the GAME-ON consortium. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 4612. doi:10.1158/1538-7445.AM2015-4612
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Affiliation(s)
| | - Reka Toth
- 1German Cancer Research Center, Heidelberg, Germany
| | - Linda Kelemen
- 2Medical University of South Carolina, Charleston, SC
| | | | - Aditi Hazra
- 4Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | | | | | | | | | | | | | - Rayjean Hung
- 10University of Toronto, Toronto, Ontario, Canada
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Stone J, Thompson DJ, Dos Santos Silva I, Scott C, Tamimi RM, Lindstrom S, Kraft P, Hazra A, Li J, Eriksson L, Czene K, Hall P, Jensen M, Cunningham J, Olson JE, Purrington K, Couch FJ, Brown J, Leyland J, Warren RML, Luben RN, Khaw KT, Smith P, Wareham NJ, Jud SM, Heusinger K, Beckmann MW, Douglas JA, Shah KP, Chan HP, Helvie MA, Le Marchand L, Kolonel LN, Woolcott C, Maskarinec G, Haiman C, Giles GG, Baglietto L, Krishnan K, Southey MC, Apicella C, Andrulis IL, Knight JA, Ursin G, Alnaes GIG, Kristensen VN, Borresen-Dale AL, Gram IT, Bolla MK, Wang Q, Michailidou K, Dennis J, Simard J, Pharoah P, Dunning AM, Easton DF, Fasching PA, Pankratz VS, Hopper JL, Vachon CM. Novel Associations between Common Breast Cancer Susceptibility Variants and Risk-Predicting Mammographic Density Measures. Cancer Res 2015; 75:2457-67. [PMID: 25862352 PMCID: PMC4470785 DOI: 10.1158/0008-5472.can-14-2012] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Accepted: 03/10/2015] [Indexed: 12/30/2022]
Abstract
Mammographic density measures adjusted for age and body mass index (BMI) are heritable predictors of breast cancer risk, but few mammographic density-associated genetic variants have been identified. Using data for 10,727 women from two international consortia, we estimated associations between 77 common breast cancer susceptibility variants and absolute dense area, percent dense area and absolute nondense area adjusted for study, age, and BMI using mixed linear modeling. We found strong support for established associations between rs10995190 (in the region of ZNF365), rs2046210 (ESR1), and rs3817198 (LSP1) and adjusted absolute and percent dense areas (all P < 10(-5)). Of 41 recently discovered breast cancer susceptibility variants, associations were found between rs1432679 (EBF1), rs17817449 (MIR1972-2: FTO), rs12710696 (2p24.1), and rs3757318 (ESR1) and adjusted absolute and percent dense areas, respectively. There were associations between rs6001930 (MKL1) and both adjusted absolute dense and nondense areas, and between rs17356907 (NTN4) and adjusted absolute nondense area. Trends in all but two associations were consistent with those for breast cancer risk. Results suggested that 18% of breast cancer susceptibility variants were associated with at least one mammographic density measure. Genetic variants at multiple loci were associated with both breast cancer risk and the mammographic density measures. Further understanding of the underlying mechanisms at these loci could help identify etiologic pathways implicated in how mammographic density predicts breast cancer risk.
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Affiliation(s)
- Jennifer Stone
- Centre for Genetic Origins of Health and Disease, University of Western Australia, Crawley, Western Australia, Australia
| | - Deborah J Thompson
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Isabel Dos Santos Silva
- Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Christopher Scott
- Department of Health Sciences Research, Division of Biostatistics, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Rulla M Tamimi
- Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Sara Lindstrom
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts. Program in Genetic Epidemiology and Statistical Genetics, Harvard School of Public Health, Boston, Massachusetts
| | - Peter Kraft
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts. Program in Genetic Epidemiology and Statistical Genetics, Harvard School of Public Health, Boston, Massachusetts. Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Aditi Hazra
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Jingmei Li
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. Human Genetics, Genome Institute of Singapore, Singapore, Singapore
| | - Louise Eriksson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Kamila Czene
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Per Hall
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Matt Jensen
- Department of Health Sciences Research, Division of Biostatistics, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Julie Cunningham
- Department of Laboratory Medicine and Pathology, Division of Experimental Pathology, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Janet E Olson
- Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic, Rochester, Minnesota
| | - Kristen Purrington
- Department of Oncology, Wayne State University School of Medicine and Karmanos Cancer Institute, Detroit, Michigan
| | - Fergus J Couch
- Department of Laboratory Medicine and Pathology, Division of Experimental Pathology, Mayo Clinic College of Medicine, Rochester, Minnesota. Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic, Rochester, Minnesota
| | - Judith Brown
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Jean Leyland
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Ruth M L Warren
- Department of Radiology, University of Cambridge, Addenbrooke's NHS Foundation Trust, Cambridge, United Kingdom
| | - Robert N Luben
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Kay-Tee Khaw
- MRC Centre for Nutritional Epidemiology in Cancer Prevention and Survival (CNC), University of Cambridge, Cambridge, United Kingdom
| | - Paula Smith
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Nicholas J Wareham
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Sebastian M Jud
- University Breast Center Franconia, Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-Nuremberg, Erlangen-Nuremberg, Germany
| | - Katharina Heusinger
- University Breast Center Franconia, Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-Nuremberg, Erlangen-Nuremberg, Germany
| | - Matthias W Beckmann
- University Breast Center Franconia, Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-Nuremberg, Erlangen-Nuremberg, Germany
| | - Julie A Douglas
- Department of Human Genetics, University of Michigan Medical School, Ann Arbor, Michigan
| | - Kaanan P Shah
- Department of Human Genetics, University of Michigan Medical School, Ann Arbor, Michigan
| | - Heang-Ping Chan
- Department of Radiology, University of Michigan Medical School, Ann Arbor, Michigan
| | - Mark A Helvie
- Department of Radiology, University of Michigan Medical School, Ann Arbor, Michigan
| | | | | | - Christy Woolcott
- Department of Obstetrics and Genecology, IWK Health Centre, Halifax, Canada
| | | | - Christopher Haiman
- Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Graham G Giles
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Australia. Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Laura Baglietto
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Australia. Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia. Centre for Research in Epidemiology and Population Health, Gustave Roussy Institute, Villejuif Cedex, France. Paris-South University, Villejuif, France
| | - Kavitha Krishnan
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Melissa C Southey
- Department of Pathology, University of Melbourne, Melbourne, Australia
| | - Carmel Apicella
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Irene L Andrulis
- Center for Cancer Genetics, Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada. Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Julia A Knight
- Prosserman Centre for Health Research, Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada. Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Giske Ursin
- Institute of Basic Medical Sciences, University of Oslo, Norway. Department of Preventive Medicine, University of Southern California, California
| | - Grethe I Grenaker Alnaes
- Department of Genetics, Institute for Cancer Research, The Norwegian Radium Hospital, Montebello, Oslo, Norway
| | - Vessela N Kristensen
- Department of Genetics, Institute for Cancer Research, The Norwegian Radium Hospital, Montebello, Oslo, Norway
| | - Anne-Lise Borresen-Dale
- Department of Genetics, Institute for Cancer Research, The Norwegian Radium Hospital, Montebello, Oslo, Norway
| | - Inger Torhild Gram
- Faculty of Health Sciences, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Manjeet K Bolla
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Qin Wang
- Faculty of Health Sciences, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Kyriaki Michailidou
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Joe Dennis
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Jacques Simard
- Centre Hospitalier Universitaire de Québec Research Center and Laval University, Quebec, Canada
| | - Paul Pharoah
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom. Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, United Kingdom
| | - Alison M Dunning
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, United Kingdom
| | - Douglas F Easton
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom. Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, United Kingdom
| | - Peter A Fasching
- University Breast Center Franconia, Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-Nuremberg, Erlangen-Nuremberg, Germany. Department of Medicine, Division of Hematology and Oncology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California
| | - V Shane Pankratz
- Department of Health Sciences Research, Division of Biostatistics, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - John L Hopper
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Celine M Vachon
- Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic, Rochester, Minnesota.
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46
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Campa D, Barrdahl M, Gaudet MM, Black A, Chanock SJ, Diver WR, Gapstur SM, Haiman C, Hankinson S, Hazra A, Henderson B, Hoover RN, Hunter DJ, Joshi AD, Kraft P, Le Marchand L, Lindström S, Willett W, Travis RC, Amiano P, Siddiq A, Trichopoulos D, Sund M, Tjønneland A, Weiderpass E, Peeters PH, Panico S, Dossus L, Ziegler RG, Canzian F, Kaaks R. Genetic risk variants associated with in situ breast cancer. Breast Cancer Res 2015; 17:82. [PMID: 26070784 PMCID: PMC4487950 DOI: 10.1186/s13058-015-0596-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 06/04/2015] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Breast cancer in situ (BCIS) diagnoses, a precursor lesion for invasive breast cancer, comprise about 20 % of all breast cancers (BC) in countries with screening programs. Family history of BC is considered one of the strongest risk factors for BCIS. METHODS To evaluate the association of BC susceptibility loci with BCIS risk, we genotyped 39 single nucleotide polymorphisms (SNPs), associated with risk of invasive BC, in 1317 BCIS cases, 10,645 invasive BC cases, and 14,006 healthy controls in the National Cancer Institute's Breast and Prostate Cancer Cohort Consortium (BPC3). Using unconditional logistic regression models adjusted for age and study, we estimated the association of SNPs with BCIS using two different comparison groups: healthy controls and invasive BC subjects to investigate whether BCIS and BC share a common genetic profile. RESULTS We found that five SNPs (CDKN2BAS-rs1011970, FGFR2-rs3750817, FGFR2-rs2981582, TNRC9-rs3803662, 5p12-rs10941679) were significantly associated with BCIS risk (P value adjusted for multiple comparisons <0.0016). Comparing invasive BC and BCIS, the largest difference was for CDKN2BAS-rs1011970, which showed a positive association with BCIS (OR = 1.24, 95 % CI: 1.11-1.38, P = 1.27 x 10(-4)) and no association with invasive BC (OR = 1.03, 95 % CI: 0.99-1.07, P = 0.06), with a P value for case-case comparison of 0.006. Subgroup analyses investigating associations with ductal carcinoma in situ (DCIS) found similar associations, albeit less significant (OR = 1.25, 95 % CI: 1.09-1.42, P = 1.07 x 10(-3)). Additional risk analyses showed significant associations with invasive disease at the 0.05 level for 28 of the alleles and the OR estimates were consistent with those reported by other studies. CONCLUSIONS Our study adds to the knowledge that several of the known BC susceptibility loci are risk factors for both BCIS and invasive BC, with the possible exception of rs1011970, a putatively functional SNP situated in the CDKN2BAS gene that may be a specific BCIS susceptibility locus.
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Affiliation(s)
- Daniele Campa
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany.
| | - Myrto Barrdahl
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany.
| | - Mia M Gaudet
- Epidemiology Research Program, American Cancer Society, 250 Williams Street NW, Atlanta, GA, 30303, USA.
| | - Amanda Black
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9000 Rockville Pike, Bethesda, MD, 20892, USA.
| | - Stephen J Chanock
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9000 Rockville Pike, Bethesda, MD, 20892, USA.
- Core Genotyping Facility, Frederick National Laboratory for Cancer Research, 8717 Grovemont Circle, Gaithersburg, MD, 20877, USA.
| | - W Ryan Diver
- Epidemiology Research Program, American Cancer Society, 250 Williams Street NW, Atlanta, GA, 30303, USA.
| | - Susan M Gapstur
- Epidemiology Research Program, American Cancer Society, 250 Williams Street NW, Atlanta, GA, 30303, USA.
| | - Christopher Haiman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 1975 Zonal Avenue, Los Angeles, CA, 90033, USA.
| | - Susan Hankinson
- Department of Epidemiology, University of Massachusetts-Amherst School of Public Health and Health Sciences, 715 North Pleasant Street, Amherst, MA, 01003, USA.
- Cancer Research Center, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA.
- Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.
| | - Aditi Hazra
- Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.
- Department of Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA, 02115, USA.
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA.
| | - Brian Henderson
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 1975 Zonal Avenue, Los Angeles, CA, 90033, USA.
| | - Robert N Hoover
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9000 Rockville Pike, Bethesda, MD, 20892, USA.
| | - David J Hunter
- Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.
| | - Amit D Joshi
- Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.
| | - Peter Kraft
- Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.
| | - Loic Le Marchand
- Cancer Research Center of Hawaii, University of Hawaii, 701 Ilalo Street, Honolulu, HI, 96813, USA.
| | - Sara Lindström
- Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.
| | - Walter Willett
- Department of Nutrition, Harvard School of Public Health, 655 Huntington Avenue, Boston, MA, 02115, USA.
| | - Ruth C Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Roosevelt Drive, Oxford, OX3 7LF, UK.
| | - Pilar Amiano
- Public Health Division of Gipuzkoa, BIODonostia Research Institute, Basque Health Department, Avenida Navarra 4, 20013, San Sebastian, Spain.
- CIBER of Epidemiology and Public Health (CIBERESP), Calle del Arzobispo Morcillo 2, 28029, Madrid, Spain.
| | - Afshan Siddiq
- School of Public Health, Imperial College, Norfolk Place, London, W2 1PG, UK.
| | - Dimitrios Trichopoulos
- Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.
- Bureau of Epidemiologic Research, Academy of Athens, 23 Alexandroupoleos Street, 115 27, Athens, Greece.
- Hellenic Health Foundation, 13 Kaisareias and Alexandroupoleos Street, 11527, Athens, Greece.
| | - Malin Sund
- Department of Surgical and Perioperative Sciences, Umeå University, 901 87, Umeå, Sweden.
| | - Anne Tjønneland
- Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark.
| | - Elisabete Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Hansine Hansens veg 18, 9037, Tromsø, Norway.
- Cancer Registry of Norway, Fridtjof Nansens vei 19, 0304, Oslo, Norway.
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solnavägen 1, 171 77, Stockholm, Sweden.
- Department of Genetic Epidemiology, Folkhälsan Research Center, Haarmaninkatu 8, 00014, Helsinki, Finland.
| | - Petra H Peeters
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center, Universiteitsweg 100, 3584 CG, Utrecht, The Netherlands.
| | - Salvatore Panico
- Dipartimento di Medicina Clinica e Chirurgia Federico II University, via Sergio Pansini 5, Naples, 80131, Italy.
| | - Laure Dossus
- Inserm, Centre for research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health Team, 16 avenue Paul Vaillant Couturier, 94805, Villejuif, France.
- University Paris Sud, UMRS 1018, 16 avenue Paul Vaillant Couturier, 94805, Villejuif, France.
- IGR, 114 rue Edouard Vaillant, 94805, Villejuif, France.
| | - Regina G Ziegler
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9000 Rockville Pike, Bethesda, MD, 20892, USA.
| | - Federico Canzian
- Genomic Epidemiology Group, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany.
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany.
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47
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Khalili H, Gong J, Brenner H, Austin TR, Hutter CM, Baba Y, Baron JA, Berndt SI, Bézieau S, Caan B, Campbell PT, Chang-Claude J, Chanock SJ, Chen C, Hsu L, Jiao S, Conti DV, Duggan D, Fuchs CS, Gala M, Gallinger S, Haile RW, Harrison TA, Hayes R, Hazra A, Henderson B, Haiman C, Hoffmeister M, Hopper JL, Jenkins MA, Kolonel LN, Küry S, LaCroix A, Marchand LL, Lemire M, Lindor NM, Ma J, Manson JE, Morikawa T, Nan H, Ng K, Newcomb PA, Nishihara R, Potter JD, Qu C, Schoen RE, Schumacher FR, Seminara D, Taverna D, Thibodeau S, Wactawski-Wende J, White E, Wu K, Zanke BW, Casey G, Hudson TJ, Kraft P, Peters U, Slattery ML, Ogino S, Chan AT. Identification of a common variant with potential pleiotropic effect on risk of inflammatory bowel disease and colorectal cancer. Carcinogenesis 2015; 36:999-1007. [PMID: 26071399 DOI: 10.1093/carcin/bgv086] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2015] [Accepted: 06/06/2015] [Indexed: 12/12/2022] Open
Abstract
Although genome-wide association studies (GWAS) have separately identified many genetic susceptibility loci for ulcerative colitis (UC), Crohn's disease (CD) and colorectal cancer (CRC), there has been no large-scale examination for pleiotropy, or shared genetic susceptibility, for these conditions. We used logistic regression modeling to examine the associations of 181 UC and CD susceptibility variants previously identified by GWAS with risk of CRC using data from the Genetics and Epidemiology of Colorectal Cancer Consortium and the Colon Cancer Family Registry. We also examined associations of significant variants with clinical and molecular characteristics in a subset of the studies. Among 11794 CRC cases and 14190 controls, rs11676348, the susceptibility single nucleotide polymorphism (SNP) for UC, was significantly associated with reduced risk of CRC (P = 7E-05). The multivariate-adjusted odds ratio of CRC with each copy of the T allele was 0.93 (95% CI 0.89-0.96). The association of the SNP with risk of CRC differed according to mucinous histological features (P heterogeneity = 0.008). In addition, the (T) allele was associated with lower risk of tumors with Crohn's-like reaction but not tumors without such immune infiltrate (P heterogeneity = 0.02) and microsatellite instability-high (MSI-high) but not microsatellite stable or MSI-low tumors (P heterogeneity = 0.03). The minor allele (T) in SNP rs11676348, located downstream from CXCR2 that has been implicated in CRC progression, is associated with a lower risk of CRC, particularly tumors with a mucinous component, Crohn's-like reaction and MSI-high. Our findings offer the promise of risk stratification of inflammatory bowel disease patients for complications such as CRC.
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Affiliation(s)
- Hamed Khalili
- Gastrointestinal Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Jian Gong
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany, German Cancer Cosortium (DKTK), Heidelberg, Germany
| | | | - Carolyn M Hutter
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| | - Yoshifumi Baba
- Department of Gastroenterological Surgery, Kumamoto University, Kumamoto, Japan
| | - John A Baron
- Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Sonja I Berndt
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | | | - Bette Caan
- Division of Hematology, Faculty of Medicine, The University of Ottawa, Ottawa, ON, Canada
| | - Peter T Campbell
- Epidemiology Research Program, American Cancer Society, Atlanta, GA, USA
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Stephen J Chanock
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Constance Chen
- Program in Molecular and Genetic Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Li Hsu
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Shuo Jiao
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - David V Conti
- Keck School of Medicine, University of Southern California, Los Angles, CA, USA
| | - David Duggan
- Systems Imagination, Computational Biology, Pheonix, AZ, USA
| | - Charles S Fuchs
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA, Department of Epidemiology, Indiana University School of Public Health, Indianapolis, IN, USA
| | - Manish Gala
- Gastrointestinal Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Steven Gallinger
- Department of Surgery, University Health Network Toronto General Hospital, Toronto, ON, Canada
| | | | - Tabitha A Harrison
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Richard Hayes
- Division of Epidemiology, New York University School of Medicine, New York, NY, USA
| | - Aditi Hazra
- Department of Epidemiology, Indiana University School of Public Health, Indianapolis, IN, USA
| | - Brian Henderson
- Keck School of Medicine, University of Southern California, Los Angles, CA, USA
| | - Chris Haiman
- Keck School of Medicine, University of Southern California, Los Angles, CA, USA
| | - Michael Hoffmeister
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
| | - John L Hopper
- Melbourne School of Population Health, The University of Melbourne, Melbourne, Australia
| | - Mark A Jenkins
- Division of Epidemiology, New York University School of Medicine, New York, NY, USA
| | - Laurence N Kolonel
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Sébastien Küry
- CHU Nantes, Service de Génétique Médicale, Nantes, France
| | - Andrea LaCroix
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Loic Le Marchand
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Mathieu Lemire
- Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - Noralane M Lindor
- Department of Health Science Services, Mayo Clinic, Scottsdale, AZ, USA
| | - Jing Ma
- Department of Epidemiology, Indiana University School of Public Health, Indianapolis, IN, USA
| | - JoAnn E Manson
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Teppei Morikawa
- Department of Pathology, The University of Tokyo Hospital, Tokyo, Japan
| | - Hongmei Nan
- Department of Epidemiology, Indiana University School of Public Health, Indianapolis, IN, USA
| | - Kimmie Ng
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Polly A Newcomb
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Reiko Nishihara
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA, Department of Nutrition, Harvard School of Public Health, Boston, MA, USA
| | - John D Potter
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA, Department of Epidemiology, University of Washington, Seattle, WA, USA, Center for Public Health Research, Massey University, Wellington, New Zealand
| | - Conghui Qu
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Robert E Schoen
- Department of Medicine and Epidemiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | | | - Daniela Seminara
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| | - Darin Taverna
- Systems Imagination, Computational Biology, Pheonix, AZ, USA
| | - Stephen Thibodeau
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Jean Wactawski-Wende
- Department of Social and Preventive Medicine, University of Buffalo, Buffalo, NY, USA
| | - Emily White
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Kana Wu
- Department of Nutrition, Harvard School of Public Health, Boston, MA, USA
| | - Brent W Zanke
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, USA
| | - Graham Casey
- Keck School of Medicine, University of Southern California, Los Angles, CA, USA
| | - Thomas J Hudson
- Ontario Institute for Cancer Research, Toronto, ON, Canada, Department of Medical Biophysics, University of Toronto, Toronto, ON, USA
| | - Peter Kraft
- Program in Molecular and Genetic Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA, Department of Epidemiology, Indiana University School of Public Health, Indianapolis, IN, USA
| | - Ulrike Peters
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Martha L Slattery
- Department of Internal Medicine, University of Utah Health Sciences Center, Salt Lake City, UT, USA
| | - Shuji Ogino
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA, Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Andrew T Chan
- Gastrointestinal Unit, Massachusetts General Hospital, Boston, MA, USA, Department of Epidemiology, Indiana University School of Public Health, Indianapolis, IN, USA,
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van Vollenhoven R, Tanaka Y, Lamba M, Collinge M, Hendrikx T, Hirose T, Toyoizumi S, Hazra A, Krishnaswami S. THU0178 Relationship Between NK Cell Count and Important Safety Events in Rheumatoid Arthritis Patients Treated with Tofacitinib. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3674] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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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Zhang X, Eliassen AH, Tamimi RM, Hazra A, Beck AH, Brown M, Collins LC, Rosner B, Hankinson SE. Adult body size and physical activity in relation to risk of breast cancer according to tumor androgen receptor status. Cancer Epidemiol Biomarkers Prev 2015; 24:962-8. [PMID: 25855627 PMCID: PMC4452447 DOI: 10.1158/1055-9965.epi-14-1429] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Accepted: 03/23/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Obesity and physical activity have been hypothesized to affect breast cancer risk partly via the androgen signaling pathway. We conducted the first study to evaluate these associations by tumor androgen receptor (AR) status. METHODS Height, weight, and physical activity were assessed using questionnaires in the Nurses' Health Study. AR, estrogen receptor (ER), and progesterone receptor (PR) status were determined using immunohistochemistry on tumor tissue and medical/pathology reports. RESULTS A total of 1,701 AR(+) and 497 AR(-) cases were documented during 26 years of follow-up of 103,577 women. After adjusting for ER/PR status and other risk factors, the relative risks (RR) and 95% confidence intervals (95% CI) for every 5 kg/m(2) increase in body mass index (BMI) were 1.07 (1.01-1.13) for AR(+) and 1.16 (1.05-1.29) for AR(-) tumors (P-heterogeneity = 0.17). The RRs (95% CIs) per 5 hours of brisk walking/week were 0.87 (0.73-1.04) for AR(+) and 0.67 (0.45-0.99) for AR(-) tumors (P-heterogeneity = 0.22). Further, BMI, but not physical activity, associations differed significantly across ER/PR/AR subtypes (P-heterogeneity = 0.04 and 0.63, respectively). The RRs (95% CIs) for 5 kg/m(2) increase in BMI were 1.23 (1.04-1.45) for ER(+)PR(+)AR(-), 1.19 (1.01-1.39) for ER(-)PR(-)AR(-), 1.15 (1.08-1.23) for ER(+)PR(+)AR(+), and 0.88 (0.75-1.03) for ER(+)PR(-)AR(+) tumors. CONCLUSIONS Higher BMI was associated with an increased risk of both AR(+) and AR(-) breast tumors in postmenopausal women, whereas physical activity, including brisk walking, was associated with a reduced risk of both subtypes. In addition, a significant positive association was observed between higher BMI and ER(-)PR(-)AR(-) tumors. IMPACT The similar associations observed by AR status suggest that mechanisms other than androgen signaling underlie these two breast cancer risk factors.
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Affiliation(s)
- Xuehong Zhang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
| | - A Heather Eliassen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
| | - Rulla M Tamimi
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
| | - Aditi Hazra
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
| | - Andrew H Beck
- Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
| | - Myles Brown
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
| | - Laura C Collins
- Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
| | - Bernard Rosner
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
| | - Susan E Hankinson
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts. Division of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, Massachusetts
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Hazra A, Bhowmik B, Dutta K, Chattopadhyay PP, Bhattacharyya P. Stoichiometry, Length, and Wall Thickness Optimization of TiO2 Nanotube Array for Efficient Alcohol Sensing. ACS Appl Mater Interfaces 2015; 7:9336-9348. [PMID: 25918822 DOI: 10.1021/acsami.5b01785] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The present study concerns development of an efficient alcohol sensor by controlling the stoichiometry, length, and wall thickness of electrochemically grown TiO2 nanotube array for its use as the sensing layer. Judicious variation of H2O content (0, 2, 10 and 100% by volume) in the mixed electrolyte comprising ethylene glycol and NH4F resulted into the desired variation of stoichiometry. The sensor study was performed within the temperature range of 27 to 250 °C for detecting the alcohols in the concentration range of 10-1000 ppm. The nanotubes grown with the electrolyte containing 2 vol % H2O offered the maximum response magnitude. For this stoichiometry, variation of corresponding length (1.25-2.4 μm) and wall thickness (19.8-9 nm) of the nanotubes was achieved by varying the anodization time (4-16 h) and temperatures (42-87 °C), respectively. While the variation of length influenced the sensing parameters insignificantly, the best response magnitude was achieved for ∼13 nm wall thickness. The underlying sensing mechanism was correlated with the experimental findings on the basis of structural parameters of the nanotubes.
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Affiliation(s)
- A Hazra
- †Nano-Thin Films and Solid State Gas sensor Devices Laboratory, Department of Electronics and Telecommunication Engineering and ‡Department of Metallurgy and Materials Engineering, Indian Institute of Engineering Science and Technology (IIEST), Shibpur, Howrah-711103, India
| | - B Bhowmik
- †Nano-Thin Films and Solid State Gas sensor Devices Laboratory, Department of Electronics and Telecommunication Engineering and ‡Department of Metallurgy and Materials Engineering, Indian Institute of Engineering Science and Technology (IIEST), Shibpur, Howrah-711103, India
| | - K Dutta
- †Nano-Thin Films and Solid State Gas sensor Devices Laboratory, Department of Electronics and Telecommunication Engineering and ‡Department of Metallurgy and Materials Engineering, Indian Institute of Engineering Science and Technology (IIEST), Shibpur, Howrah-711103, India
| | - P P Chattopadhyay
- †Nano-Thin Films and Solid State Gas sensor Devices Laboratory, Department of Electronics and Telecommunication Engineering and ‡Department of Metallurgy and Materials Engineering, Indian Institute of Engineering Science and Technology (IIEST), Shibpur, Howrah-711103, India
| | - P Bhattacharyya
- †Nano-Thin Films and Solid State Gas sensor Devices Laboratory, Department of Electronics and Telecommunication Engineering and ‡Department of Metallurgy and Materials Engineering, Indian Institute of Engineering Science and Technology (IIEST), Shibpur, Howrah-711103, India
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