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Bussi C, Mangiarotti A, Vanhille-Campos C, Aylan B, Pellegrino E, Athanasiadi N, Fearns A, Rodgers A, Franzmann TM, Šarić A, Dimova R, Gutierrez MG. Publisher Correction: Stress granules plug and stabilize damaged endolysosomal membranes. Nature 2023; 624:E3. [PMID: 37993723 DOI: 10.1038/s41586-023-06882-z] [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: 11/24/2023]
Affiliation(s)
| | | | - Christian Vanhille-Campos
- Institute of Science and Technology Austria, Klosterneuburg, Austria
- Department of Physics and Astronomy, Institute for the Physics of Living Systems, University College London, London, UK
| | | | | | | | | | | | - Titus M Franzmann
- Center for Molecular and Cellular Bioengineering, Biotechnology Center, Technische Universität Dresden, Dresden, Germany
| | - Anđela Šarić
- Institute of Science and Technology Austria, Klosterneuburg, Austria
| | - Rumiana Dimova
- Max Planck Institute of Colloids and Interfaces, Potsdam, Germany
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2
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Bussi C, Mangiarotti A, Vanhille-Campos C, Aylan B, Pellegrino E, Athanasiadi N, Fearns A, Rodgers A, Franzmann TM, Šarić A, Dimova R, Gutierrez MG. Stress granules plug and stabilize damaged endolysosomal membranes. Nature 2023; 623:1062-1069. [PMID: 37968398 PMCID: PMC10686833 DOI: 10.1038/s41586-023-06726-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 01/12/2023] [Accepted: 10/09/2023] [Indexed: 11/17/2023]
Abstract
Endomembrane damage represents a form of stress that is detrimental for eukaryotic cells1,2. To cope with this threat, cells possess mechanisms that repair the damage and restore cellular homeostasis3-7. Endomembrane damage also results in organelle instability and the mechanisms by which cells stabilize damaged endomembranes to enable membrane repair remains unknown. Here, by combining in vitro and in cellulo studies with computational modelling we uncover a biological function for stress granules whereby these biomolecular condensates form rapidly at endomembrane damage sites and act as a plug that stabilizes the ruptured membrane. Functionally, we demonstrate that stress granule formation and membrane stabilization enable efficient repair of damaged endolysosomes, through both ESCRT (endosomal sorting complex required for transport)-dependent and independent mechanisms. We also show that blocking stress granule formation in human macrophages creates a permissive environment for Mycobacterium tuberculosis, a human pathogen that exploits endomembrane damage to survive within the host.
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Affiliation(s)
| | | | - Christian Vanhille-Campos
- Institute of Science and Technology Austria, Klosterneuburg, Austria
- Department of Physics and Astronomy, Institute for the Physics of Living Systems, University College London, London, UK
| | | | | | | | | | | | - Titus M Franzmann
- Center for Molecular and Cellular Bioengineering, Biotechnology Center, Technische Universität Dresden, Dresden, Germany
| | - Anđela Šarić
- Institute of Science and Technology Austria, Klosterneuburg, Austria
| | - Rumiana Dimova
- Max Planck Institute of Colloids and Interfaces, Potsdam, Germany
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3
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Bussi C, Heunis T, Pellegrino E, Bernard EM, Bah N, Dos Santos MS, Santucci P, Aylan B, Rodgers A, Fearns A, Mitschke J, Moore C, MacRae JI, Greco M, Reinheckel T, Trost M, Gutierrez MG. Lysosomal damage drives mitochondrial proteome remodelling and reprograms macrophage immunometabolism. Nat Commun 2022; 13:7338. [PMID: 36443305 PMCID: PMC9705561 DOI: 10.1038/s41467-022-34632-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 10/31/2022] [Indexed: 11/29/2022] Open
Abstract
Transient lysosomal damage after infection with cytosolic pathogens or silica crystals uptake results in protease leakage. Whether limited leakage of lysosomal contents into the cytosol affects the function of cytoplasmic organelles is unknown. Here, we show that sterile and non-sterile lysosomal damage triggers a cell death independent proteolytic remodelling of the mitochondrial proteome in macrophages. Mitochondrial metabolic reprogramming required leakage of lysosomal cathepsins and was independent of mitophagy, mitoproteases and proteasome degradation. In an in vivo mouse model of endomembrane damage, live lung macrophages that internalised crystals displayed impaired mitochondrial function. Single-cell RNA-sequencing revealed that lysosomal damage skewed metabolic and immune responses in alveolar macrophages subsets with increased lysosomal content. Functionally, drug modulation of macrophage metabolism impacted host responses to Mycobacterium tuberculosis infection in an endomembrane damage dependent way. This work uncovers an inter-organelle communication pathway, providing a general mechanism by which macrophages undergo mitochondrial metabolic reprograming after endomembrane damage.
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Affiliation(s)
- Claudio Bussi
- grid.451388.30000 0004 1795 1830The Francis Crick Institute, London, UK
| | - Tiaan Heunis
- grid.1006.70000 0001 0462 7212Biosciences Institute, Newcastle University, Newcastle, UK ,grid.4991.50000 0004 1936 8948Present Address: Sir William Dunn School of Pathology, University of Oxford, Oxford, UK
| | - Enrica Pellegrino
- grid.451388.30000 0004 1795 1830The Francis Crick Institute, London, UK
| | - Elliott M. Bernard
- grid.451388.30000 0004 1795 1830The Francis Crick Institute, London, UK ,grid.9851.50000 0001 2165 4204Present Address: Department of Biochemistry, University of Lausanne, Epalinges, Switzerland
| | - Nourdine Bah
- grid.451388.30000 0004 1795 1830The Francis Crick Institute, London, UK
| | | | - Pierre Santucci
- grid.451388.30000 0004 1795 1830The Francis Crick Institute, London, UK ,grid.5399.60000 0001 2176 4817Present Address: Aix-Marseille Univ, CNRS, LISM, IMM FR3479, Marseille, France
| | - Beren Aylan
- grid.451388.30000 0004 1795 1830The Francis Crick Institute, London, UK
| | - Angela Rodgers
- grid.451388.30000 0004 1795 1830The Francis Crick Institute, London, UK
| | - Antony Fearns
- grid.451388.30000 0004 1795 1830The Francis Crick Institute, London, UK
| | - Julia Mitschke
- grid.5963.9Institute for Molecular Medicine and Cell Research, Medical Faculty, Albert-Ludwigs-University Freiburg, Freiburg, Germany ,grid.7497.d0000 0004 0492 0584German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Christopher Moore
- grid.451388.30000 0004 1795 1830The Francis Crick Institute, London, UK
| | - James I. MacRae
- grid.451388.30000 0004 1795 1830The Francis Crick Institute, London, UK
| | - Maria Greco
- grid.451388.30000 0004 1795 1830The Francis Crick Institute, London, UK ,grid.4991.50000 0004 1936 8948Present Address: Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Thomas Reinheckel
- grid.5963.9Institute for Molecular Medicine and Cell Research, Medical Faculty, Albert-Ludwigs-University Freiburg, Freiburg, Germany ,grid.7497.d0000 0004 0492 0584German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany ,grid.5963.9Signalling Research Centres BIOSS and CIBSS, Albert-Ludwigs-University Freiburg, Freiburg, Germany
| | - Matthias Trost
- grid.1006.70000 0001 0462 7212Biosciences Institute, Newcastle University, Newcastle, UK
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4
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Stott D, Santos FD, Rodgers A, Holgado E, Pandya P. Antenatal findings and early postnatal outcomes in pregnancies with trisomy 21: A 10‐year retrospective review at a tertiary centre. Prenat Diagn 2022; 42:1273-1280. [DOI: 10.1002/pd.6215] [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] [Received: 02/14/2022] [Revised: 05/30/2022] [Accepted: 06/27/2022] [Indexed: 11/07/2022]
Affiliation(s)
- D Stott
- University College Hospital Department of Obstetrics and Gynaecology Elizabeth Garrett Anderson Wing 25 Grafton Way LondonWC1E 6DB United Kingdom
| | - F Dos Santos
- Obstetrics and Gynaecology, Health Education England University College Hospital – Department of Obstetrics and Gynaecology Elizabeth Garrett Anderson Wing 25 Grafton Way LondonWC1E 6DB United Kingdom
| | - A Rodgers
- Neonatology, University College Hospital – Department of Neonatology, Elizabeth Garrett Anderson Wing, 25 Grafton Way LondonWC1E 6DB United Kingdom
| | - E Holgado
- Health Services Laboratories The Halo Building1 Mabledon Place LondonWC1H 9AX United Kingdom
| | - P Pandya
- University College Hospital – Fetal Medicine Unit Elizabeth Garrett Anderson Wing, 25 Grafton Way LondonWC1E 6DB United Kingdom
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5
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Wang N, Rueter P, Harris K, Woodward M, Chalmers J, Rodgers A. Cumulative Systolic Blood Pressure Load and Risk of Cardiovascular Outcomes in Patients With Diabetes. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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6
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Rodgers A, Edwards W, Garrity J, Latimer D, Wilson D, Connolly S. Delivering a dietetic intervention to cardiovascular patients in the Covid era. Eur J Prev Cardiol 2021. [DOI: 10.1093/eurjpc/zwab061.420] [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: 11/15/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): Department of Health
Introduction
Healthy diet and body composition are core components of cardiac rehabilitation. Following the COVID outbreak in March 2020, our face-to-face cardiac rehabilitation programme (Our Hearts Our Minds) was suspended. The programme was then quickly moved to a virtual platform to continue to deliver the programme.
Purpose
Here we describe how the OHOM programme adapted our service to deliver the dietetic assessment and intervention on a virtual platform.
Methods
Pre-Covid the dietary component of OHOM consisted of a face-to-face Initial Assessment (IA) with a dietitian, group education sessions and an End of Programme assessment (EOP). Anthropometric measures and dietary habits were assessed including adherence to the Mediterranean diet via the Mediterranean Diet Score (MDS) toolkit. Using behaviour change techniques, tailored dietary advice was provided and goals agreed to educate on healthier food choices, increase adherence to Mediterranean diet and (if appropriate) promote weight loss and reduce central obesity. The assessment and intervention is now delivered virtually via telephone or video. Anthropometrics are self-reported with tape-measures supplied to assess waist circumference and advice provided on home-weighing. MDS is still assessed. The programme includes fortnightly coaching telephone consultations to review and reset goals, the option to attend a dietitian-led virtual group education session, access to a filmed educational video and submission of food diaries via the Fitbit app.
Results
From April to November 2020, 114 patients completed the virtual programme (65 telephone, 39 video). Dietetic outcomes are outlined in Table 1 with inclusion of data for a similar period one year previously (face-to-face) for comparison. Reductions in anthropometric measures and increased adherence to a cardio-protective diet were noted and the results for the two time periods are remarkably similar.
Conclusion
Delivery of a virtual dietetic component in cardiac rehabilitation is feasible, acceptable and just as effective as face-to-face based on preliminary data.
Table 1: Dietary outcomes at IA and EOP Face-to-face assessments (April - March 2019) Virtual assessments (April - November 2020) IA EOP Change IA EOP Change Mean weight (in those with BMI >25kg/m2) 86.5 85.2 -1.3 91.4 88.6 -2.8 Waist circumference (cm) 104.3 103 -1.3 107 102 -5 Mean MDS (Range 1-14) 4.4 7.5 +3.1 4.8 7.8 +3 % Consuming oily fish once per week 20 57 +37 25 68 +43 Achieving fruit and vegetable target 16 61 +45 21 57 +36
Abstract Figure. Dietitian waist circumference tutorial
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Affiliation(s)
- A Rodgers
- Western Health and Social Care Trust, Londonderry, United Kingdom of Great Britain & Northern Ireland
| | - W Edwards
- Western Health and Social Care Trust, Londonderry, United Kingdom of Great Britain & Northern Ireland
| | - J Garrity
- Western Health and Social Care Trust, Londonderry, United Kingdom of Great Britain & Northern Ireland
| | - D Latimer
- Western Health and Social Care Trust, Londonderry, United Kingdom of Great Britain & Northern Ireland
| | - D Wilson
- Western Health and Social Care Trust, Londonderry, United Kingdom of Great Britain & Northern Ireland
| | - S Connolly
- Western Health and Social Care Trust, Londonderry, United Kingdom of Great Britain & Northern Ireland
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7
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Kovoor J, Chow C, Rodgers A, Atkins E. Patient Acceptability of Polypill Treatment for Hypertension: A Qualitative Study From the QUARTET Trial. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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8
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Gnanenthiran S, Wang N, Salam A, Webster R, de Silva A, Schutte A, Patel A, Rodgers A. Effects of Low-dose Triple Combination Therapy on Time at Target Blood Pressure – Results From the TRIUMPH Randomized Controlled Trial. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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9
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Canoy D, Tran J, Norton R, Ayala Solares R, Conrad N, Nazarzadeh M, Raimondi F, Salimi-Khorshidi G, Rodgers A, Rahimi K. Association between comorbidities and blood pressure trajectories in patients with hypertension. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2726] [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: 11/12/2022] Open
Abstract
Abstract
Background
Our knowledge of how to better manage elevated blood pressure in presence of comorbidities is limited; in part due to exclusion or underrepresentation of multimorbid patients from major clinical trials.
Purpose
To investigate the burden and types of comorbidities in patients with hypertension, to assess how such comorbidities and other variables affect blood pressure levels over time.
Methods
The study was conducted using linked electronic health records from the UK Clinical Practice Research Datalink study from its inception on 1 January 1985 to 30 September 2015. Using linked electronic health records, we compared systolic blood pressure levels among 295,487 patients with diagnosed hypertension by type and numbers of major comorbidities from at least 5 years before to up to 10 years after hypertension diagnosis. We used a multiple landmark cohort design in order to investigate associations prospectively with time-updated information that takes advantage of the dynamic nature of electronic health records.
Results
Time-updated multivariable linear regression analyses showed that the presence of more comorbidities was independently associated with lower blood pressure during follow-up. This negative association was not specific to particular types of comorbidities; although associations were stronger in those with pre-existing cardiovascular disease. Tracking patients backwards to years prior to hypertension diagnosis revealed that the association between comorbidities and blood pressure were even more pronounced in years before hypertension diagnosis. Despite substantial declines in blood pressure in the first year after diagnosis, subsequent changes were modest, with no evidence of a more rapid decline in those with more or specific types of comorbidities.
Conclusions
Blood pressure levels at which patients were diagnosed with hypertension varied substantially and were lower when patients had more comorbidities. This early selection bias was a key determinant of long-term differences in blood pressure by comorbidity status and provides an additional explanation for the lower blood pressure in multimorbid patients.
Mean SBP (mmHg) over time
Funding Acknowledgement
Type of funding source: Public Institution(s). Main funding source(s): National Institute for Health Research Oxford Biomedical Research Centre, Rhodes Trust and Clarendon Fund
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Affiliation(s)
- D Canoy
- University of Oxford, Oxford, United Kingdom
| | - J Tran
- University of Oxford, Oxford, United Kingdom
| | - R Norton
- University of Oxford, The George Institute for Global Health (UK), Oxford, United Kingdom
| | | | - N Conrad
- University of Oxford, Oxford, United Kingdom
| | | | - F Raimondi
- University of Oxford, Oxford, United Kingdom
| | | | - A Rodgers
- The George Institute for Global Health, Sydney, Australia
| | - K Rahimi
- University of Oxford, Oxford, United Kingdom
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10
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Wang N, Harris K, Woodward M, Chalmers J, Rodgers A. 060 The Effects of Combination Blood Pressure Lowering in the Presence or Absence of Background Statin and Aspirin Therapy – a Combined Analysis of PROGRESS and ADVANCE. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.067] [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: 11/24/2022]
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11
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Wang N, Salam A, Webster R, De Silva A, Guggilla R, Stepien S, Mysore J, Billot L, Jan S, Maulik P, Naik N, Selak V, Thom S, Prabhakaran D, Patel A, Rodgers A. 021 Effects of Low-dose Triple Combination Therapy on Therapeutic Inertia and Prescribing Patterns in Hypertension – Results from the TRIUMPH Trial. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.028] [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: 11/24/2022]
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12
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Eggermont A, Carlino M, Hauschild A, Ascierto P, Arance A, Daud A, O’Day S, Taylor M, Smith A, Rodgers A, Moreno BH, Diede S, Kluger H. Pembrolizumab (pembro) plus lenvatinib (len) for first-line treatment of patients (pts) with advanced melanoma: Phase III LEAP-003 study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz255.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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13
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Mohammad A, Wang N, Atkins E, Kanukula R, Huffman MD, Rodgers A. P1587Comparison of effects of lowering blood pressure in individuals with blood pressure <140/90 mmHg and hypertension guideline recommendations: a systematic review and meta-analysis of randomised trials. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0347] [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: 11/15/2022] Open
Abstract
Abstract
Background
Implementation of evidence-based medicine requires minimising delays between data generation and guideline creation. We examined the temporal relationship between accumulating evidence from randomized controlled trials (RCTs) of blood pressure (BP) lowering drug therapy among individuals with SBP<140 mmHg, DBP<90 mmHg, or both, and hypertension guideline recommendations over time.
Methods
A systematic review was conducted by searching MEDLINE for RCTs between January 1966 and February 2018. Included trials randomized patients to BP lowering drug(s) vs placebo/no treatment or to more vs less BP lowering with at least 1000 patient-years of follow-up per treatment group, and provided data relevant to BP lowering in patients with SBP<140 mmHg, DBP<90 mmHg, or both (hereafter <140/90 mmHg). Included trials were classified according to major patient groups and whether all patients had baseline BP <140/90 mmHg, or most control group patients had BP <140/90 mmHg during follow-up, which was selected because this is the BP against which interventions were compared. Two reviewers independently extracted relevant data from included RCTs and hypertension guidelines. Cumulative meta-analyses of cardiovascular events were conducted and were compared to hypertension guideline recommendations. The primary outcome was major cardiovascular events.
Results
A total of 73 trials (n=300,805) were included, including 16 trials/subgroups with all participants baseline BP <140/90mmHg. Benefits of BP lowering in individuals with usual BP <140/90 mmHg began to emerge in the 1970s (Figure). Most evidence was from trials that included some or all patients with hypertension at baseline, but most patients had BP <140/90 mmHg during follow-up due to regression to the mean and background treatment. Starting from 1992, 22 trials reported results by baseline hypertension status with no difference in cardiovascular event relative risk reduction among those with and without hypertension (relative risk 0.87 [95% CI 0.84–0.90] vs 0.86 [0.83–0.90], respectively. Until 2017, no major guidelines recommended treatment initiation or intensification for patients with baseline BP <140/90 mmHg, apart from the periods during which some guidelines recommended treatment at lower thresholds for patients with diabetes and chronic kidney disease (Joint National Committee 1997 to 2014; European Society of Hypertension 2007 to 2009).
Cumulative meta-analyses of trials
Conclusions
Evidence of benefits of BP lowering among individuals with usual BP <140/90 mmHg have been demonstrated for decades. However, there has been a substantial delay between data generation and guideline recommendations. This delay was may be due to the inappropriate emphasis on baseline rather than usual BP levels, and relatively narrow evidence synthesis, which does not fully account for evidence generated across various major patient groups.
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Affiliation(s)
- A Mohammad
- The George Institute for Global Health, Hyderabad, India
| | - N Wang
- University of Sydney, Sydney, Australia
| | - E Atkins
- The George Institute for Global Health, Sydney, Australia
| | - R Kanukula
- The George Institute for Global Health, Hyderabad, India
| | - M D Huffman
- Northwestern University, Department of Preventive Medicine, Chicago, United States of America
| | - A Rodgers
- The George Institute for Global Health, Sydney, Australia
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14
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Abstract
Abstract
Background
There is evidence that blood pressure (BP) levels vary considerably from season to season, due principally to variation in ambient temperature. This gives the potential for both under- and over-treatment if BP lowering medications are not varied seasonally, but is not acknowledged in clinical guidelines. We will describe the seasonal variation in BP and assess the association between systolic blood pressure (SBP) and outdoor maximum ambient temperature in Australia.
Methods
The primary care data is an extract from MedicineInsight, a national general practice data program developed and managed by NPS MedicineWise, which extracts deidentified data from almost 10% of all Australian general practices. We included patients aged 30–90 years with at least one BP measure recorded from 1 Jan 2010 to 1 Aug 2017. Australian Bureau of Meteorology daily max temperature is linked by matching observation dates and location to nearest weather station. Decomposition of the mean will determine seasonal variation. Multiple linear regression was used to estimate the associations between max temperature and SBP with adjustment for age, sex, socioeconomic index, current smoking, comorbidities, BP lowering medication use, lipid lowering medication use and year of BP measurement.
Results
The study population includes 2.6 million people, mean age 55 years (standard deviation [SD] 16.3). Fifty-five percent are female, over a third of the cohort reside in New South Wales, and 62.4% reside in major Australian cities. The mean (SD) temperature was 23°C (6.6).
There was a mean (SD) of 7 (11.4) BP measurements per person over the study period, median 3 measures (interquartile range 1–8). A quarter had a history of hypertension, 8% had a history of cardiovascular disease, and 8% had a history of diabetes. Twenty-six percent had at least one prescription for BP lowering therapy.
The average monthly SBP for the cohort demonstrated strong seasonal variation with higher values in winter. The population mean varies by 3mmHg SBP between seasons across Australia, ranging from 1.7mmHg in the Northern Territory to 3.5mmHg in South Australia (range of mean maximum temperature 3°C [30–33] and 14°C [15–29] for the capital cities respectively). Each 10°C increase in max outdoor temperature was associated with a 1.8mmHg [95% CI 1.80–1.83] lower mean SBP. The proportion of people with SBP>140mmHg varied by season, irrespective of age, sex and use of BP lowering treatment. For example, among those treated control rates varied between 70 and 81%, and among those not treated between 78 and 85% (Figure).
Blood pressure seasonality in Australia
Conclusions
BP control rates vary considerably by season. These findings have implications for the reliable diagnosis of hypertension, and suggest seasonal adjustments in treatment should be considered for some patients. The clinical and public health relevance of this phenomenon is expected to increase with increasing climate variability.
Acknowledgement/Funding
National Health and Medical Research Council Australia, National Heart Foundation Australia
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Affiliation(s)
- E Atkins
- The George Institute for Global Health, Sydney, Australia
| | - Q Pilard
- The George Institute for Global Health, Sydney, Australia
| | - K Rogers
- The George Institute for Global Health, Sydney, Australia
| | - A Salam
- The George Institute for Global Health, Hyderabad, India
| | - A Rodgers
- The George Institute for Global Health, Sydney, Australia
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15
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Pinho-Gomes AC, Azevedo L, Bidel Z, Nazarzadeh M, Copland E, Canoy D, Salam A, Rodgers A, Kotecha D, Rahimi K. P5732Effects of blood pressure lowering drugs in heart failure: a systematic review and meta-analysis of randomised controlled trials. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0672] [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: 11/12/2022] Open
Abstract
Abstract
Background
Observational studies have reported a J-shaped relationship between blood pressure (BP) and all-cause and cardiovascular mortality in patients with heart failure (HF). Although decreasing BP significantly reduces the risk of fatal and non-fatal cardiovascular outcomes in the general population across a range of baseline BP categories, the extent to which those findings are applicable to HF patients and whether the relationship holds true when baseline BP is very low remain unclear. Therefore, it is yet to be established whether the observed J-shaped relationship between BP and clinical outcomes in patients with HF is causal and/or modified by antihypertensive treatment.
Purpose
We aimed to combine evidence from all HF trials that have investigated the effects of drugs with BP-lowering properties to assess (1) the extent to which such drugs reduce BP in HF, (2) the association between the net change in BP between treatment arms and cause-specific outcomes, and (3) whether treatment effects (including benefits and potential harms) vary according to baseline BP.
Methods
We conducted a systematic review and meta-analysis including randomised clinical trials of drugs with BP-lowering properties conducted in patients with chronic HF with at least 300 patient-years follow-up.
Results
We included a total of 37 trials (91,950 patients) and showed that treatment with drugs with BP-lowering properties significantly reduced SBP by 2.0 mmHg in all trials and by 2.4 mmHg in placebo-controlled trials (Figure 1). There was no evidence that BP reduction in placebo-controlled trials varied across strata of baseline BP, but there was suggestive evidence for differential effects by drug class, with renin-angiotensin-aldosterone system inhibitors reducing SBP by 3.2 mmHg (95% CI [−4.0, −2.4]), whilst BB appeared to have a neutral effect on BP. There was no evidence that the relative risk reduction afforded by treatment with BP-lowering drugs on all-cause mortality, cardiovascular mortality and HF hospitalisation was significantly different across categories of baseline BP. There was also no strong evidence for heterogeneity of treatment effect on adverse events leading to treatment discontinuation by baseline BP. Meta-regression did not show significant associations between the magnitude of BP reduction achieved in each trial and risk of those clinical outcomes.
Figure 1
Conclusions
Treatment with drugs with BP-lowering properties resulted in a small but significant decrease in SBP in patients with HF irrespective of baseline BP. There was no evidence that the effects of those drugs differed across the range of baseline SBP, thus supporting the efficacy and safety of those drugs in patients with low baseline BP. Data from published reports was insufficient to adequately investigate whether BP-dependent mechanisms contribute to the effect of BP-lowering drugs on clinical outcomes in patients with HF.
Acknowledgement/Funding
None
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Affiliation(s)
| | - L Azevedo
- University of Porto, Faculty of Medicine, Porto, Portugal
| | - Z Bidel
- University of Oxford, The George Institute for Global Health, Oxford, United Kingdom
| | - M Nazarzadeh
- University of Oxford, The George Institute for Global Health, Oxford, United Kingdom
| | - E Copland
- University of Oxford, The George Institute for Global Health, Oxford, United Kingdom
| | - D Canoy
- University of Oxford, The George Institute for Global Health, Oxford, United Kingdom
| | - A Salam
- The George Institute for Global Health, Telangana, India
| | - A Rodgers
- The George Institute for Global Health, University of New South Wales, Sidney, Australia
| | - D Kotecha
- University of Birmingham, Institute of Cardiovascular Sciences, Birmingham, United Kingdom
| | - K Rahimi
- University of Oxford, The George Institute for Global Health, Oxford, United Kingdom
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Hodgson H, Davidson D, Duncan A, Guthrie J, Henderson E, MacDiarmid M, McGown K, Pollard V, Potter R, Rodgers A, Wilson A, Horner J, Doran M, Simm S, Taylor R, Rogers A, Rippon MG, Colgrave M. A multicentre, clinical evaluation of a hydro-responsive wound dressing: the Glasgow experience. J Wound Care 2019; 26:642-650. [PMID: 29131748 DOI: 10.12968/jowc.2017.26.11.642] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Our aim was to assess the effectiveness of hydro-responsive wound dressing (HRWD) in debridement and wound bed preparation of a variety of acute and chronic wounds that presented with devitalised tissue needing removal so that healing may proceed. METHOD This was a non-comparative evaluation of acute and chronic wounds that required debridement as part of their normal treatment regimen. Clinicians recorded wound changes including a subjective assessment level of devitalised tissue and wound bed preparation, presence of pain, wound status (e.g., wound size) and periwound skin condition. Data was also collected from clinicians and patients to provide information on clinical performance of the dressing. RESULTS We recruited 100 patients with a variety of wound types into the study. Over 90% of the clinicians reported removal of devitalised tissue to enable a healing response in both chronic and acute wounds. Specifically, over the course of the evaluation period, levels of devitalised tissue (necrosis and slough) reduced from 85.5% to 26.3%, and this was accompanied by an increase in wound bed granulation from 12.0% to 33.7%. Correspondingly, there was a 40% reduction in wound area, hence a clinically relevant healing response was seen upon treatment with HRWD. It is also noteworthy that this patient population included a significant proportion of chronic wounds (51.4%) that showed no signs of wound progression within <4 weeks before study inclusion. Of these chronic wounds, 93% demonstrated wound progression upon treatment with HRWD. Despite reported pain levels being low pre- and post-dressing change, overall wound pain improved (reduced) in 48% of patients. Periwound skin condition showed a tendency towards improvement, and the fluid management capabilities of the HRWD was reported as good to excellent in the majority of cases. Wound infections were reduced by at least 60% over the evaluation period. A simple cost-effective analysis demonstrated significant savings using HRWD (£6.33) over current standard practice regimens of a four-step debridement process (£8.05), larval therapy (£306.39) and mechanical pad debridement (£11.46). CONCLUSION HRWD was well tolerated and was demonstrated to be an efficient debridement tool providing rapid, effective and pain free debridement in a variety of wound types.
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Affiliation(s)
- H Hodgson
- Lead Investigator, Lead Nurse Tissue Viability, Tissue Viability Acute and Partnerships, Glasgow
| | - D Davidson
- Vascular Nurse Specialist, Inverclyde Royal Hospital, Greenock
| | - A Duncan
- Vascular Nurse Specialist, Queen Elizabeth University Hospital, Glasgow
| | - J Guthrie
- Tissue Viability Specialist Nurse, Tissue Viability Acute and Partnerships, Glasgow
| | - E Henderson
- Tissue Viability Nurse Specialist, Glasgow Royal Infirmary, Glasgow
| | - M MacDiarmid
- Tissue Viability Clinical Nurse Specialist, Queen Elizabeth University Hospital, Glasgow
| | - K McGown
- Tissue Viability Nurse, Queen Elizabeth University Hospital, Glasgow
| | - V Pollard
- Tissue Viability Nurse, Inverclyde Royal Hospital, Greenock
| | - R Potter
- Tissue Viability Clinical Nurse Specialist, Tissue Viability Specialist Nurses (Partnerships Glasgow)
| | - A Rodgers
- Paediatric Tissue Viability Nurse, Royal Hospital for Children, Glasgow
| | - A Wilson
- Tissue Viability Nurse Specialist, Royal Alexandra Hospital, Paisley
| | - J Horner
- Tissue Viability Personal Assistant, Tissue Viability Acute and Partnerships, Glasgow
| | - M Doran
- Tissue Viability Personal Assistant, Tissue Viability Acute and Partnerships, Glasgow
| | - S Simm
- Clinical Development Manager, Hartmann Wound Care, Haywood, Lancashire
| | - R Taylor
- Nurse Advisor (North), Hartmann Wound Care, Haywood, Lancashire
| | - A Rogers
- Medical Communications, Flintshire, North Wales
| | - M G Rippon
- Visiting Clinical Research Fellow, Huddersfield University, Queensgate, Huddesfield
| | - M Colgrave
- Freelance Medical Writer, Molecular Cell Research, Lincoln
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Wang N, Fulcher J, Abeysuriya N, Kumar S, Wilcox I, Rodgers A, Lal S. More Intensive LDL-C Lowering Reduces Major Vascular Events Beyond Current Recommendations: Systematic Review and Meta-Analysis. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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18
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Kanukula R, Salam A, Atkins E, Rogers K, Rodgers A. PO263 Choice In Blood Pressure Lowering Drug Therapy – An Analysis of the Availability of Different Drugs and Doses Over the Last 40 Years. Glob Heart 2018. [DOI: 10.1016/j.gheart.2018.09.217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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19
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Browning P, Beeckman D, White R, Connolly R, Rodgers A, Maclean G, Fumarola S, Harker J, Murray V, Foster S. Report of the proceedings of a UK skin safety advisory group. ACTA ACUST UNITED AC 2018; 27:S34-S40. [DOI: 10.12968/bjon.2018.27.sup20.s34] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Dimitri Beeckman
- Professor of Skin Integrity and Clinical Nursing, Skin Integrity Research Group, Department of Public Health and Primary Care, Ghent University, Belgium
| | - Richard White
- Professor of Tissue Viability, University of Worcester
| | - Roisin Connolly
- Continence Lead Nurse, King's College Hospital NHS Foundation Trust
| | - Angela Rodgers
- Paediatric Tissue Viability Nurse Specialist, NHS Royal Hospital for Children, Glasgow
| | - Gillian Maclean
- Senior Staff Nurse, Intensive Care, Royal Infirmary of Edinburgh, UK
| | - Sian Fumarola
- Senior Clinical Nurse Specialist, Tissue Viability and Continence, University Hospitals of North Midlands NHS Trust
| | - Judy Harker
- Nurse Consultant Tissue Viability, Pennine Acute Hospitals NHS Trust
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20
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Gnatiuc L, Herrington WG, Halsey J, Tuomilehto J, Fang X, Kim HC, De Bacquer D, Dobson AJ, Criqui MH, Jacobs DR, Leon DA, Peters SAE, Ueshima H, Sherliker P, Peto R, Collins R, Huxley RR, Emberson JR, Woodward M, Lewington S, Aoki N, Arima H, Arnesen E, Aromaa A, Assmann G, Bachman DL, Baigent C, Bartholomew H, Benetos A, Bengtsson C, Bennett D, Björkelund C, Blackburn H, Bonaa K, Boyle E, Broadhurst R, Carstensen J, Chambless L, Chen Z, Chew SK, Clarke R, Cox C, Curb JD, D'Agostino R, Date C, Davey Smith G, De Backer G, Dhaliwal SS, Duan XF, Ducimetiere P, Duffy S, Eliassen H, Elwood P, Empana J, Garcia-Palmieri MH, Gazes P, Giles GG, Gillis C, Goldbourt U, Gu DF, Guasch-Ferre M, Guize L, Haheim L, Hart C, Hashimoto S, Hashimoto T, Heng D, Hjermann I, Ho SC, Hobbs M, Hole D, Holme I, Horibe H, Hozawa A, Hu F, Hughes K, Iida M, Imai K, Imai Y, Iso H, Jackson R, Jamrozik K, Jee SH, Jensen G, Jiang CQ, Johansen NB, Jorgensen T, Jousilahti P, Kagaya M, Keil J, Keller J, Kim IS, Kita Y, Kitamura A, Kiyohara Y, Knekt P, Knuiman M, Kornitzer M, Kromhout D, Kronmal R, Lam TH, Law M, Lee J, Leren P, Levy D, Li YH, Lissner L, Luepker R, Luszcz M, MacMahon S, Maegawa H, Marmot M, Matsutani Y, Meade T, Morris J, Morris R, Murayama T, Naito Y, Nakachi K, Nakamura M, Nakayama T, Neaton J, Nietert PJ, Nishimoto Y, Norton R, Nozaki A, Ohkubo T, Okayama A, Pan WH, Puska P, Qizilbash N, Reunanen A, Rimm E, Rodgers A, Saitoh S, Sakata K, Sato S, Schnohr P, Schulte H, Selmer R, Sharp D, Shifu X, Shimamoto K, Shipley M, Silbershatz H, Sorlie P, Sritara P, Suh I, Sutherland SE, Sweetnam P, Tamakoshi A, Tanaka H, Thomsen T, Tominaga S, Tomita M, Törnberg S, Tunstall-Pedoe H, Tverdal A, Ueshima H, Vartiainen E, Wald N, Wannamethee SG, Welborn TA, Whincup P, Whitlock G, Willett W, Woo J, Wu ZL, Yao SX, Yarnell J, Yokoyama T, Yoshiike N, Zhang XH. Sex-specific relevance of diabetes to occlusive vascular and other mortality: a collaborative meta-analysis of individual data from 980 793 adults from 68 prospective studies. Lancet Diabetes Endocrinol 2018; 6:538-546. [PMID: 29752194 PMCID: PMC6008496 DOI: 10.1016/s2213-8587(18)30079-2] [Citation(s) in RCA: 129] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 02/20/2018] [Accepted: 02/26/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND Several studies have shown that diabetes confers a higher relative risk of vascular mortality among women than among men, but whether this increased relative risk in women exists across age groups and within defined levels of other risk factors is uncertain. We aimed to determine whether differences in established risk factors, such as blood pressure, BMI, smoking, and cholesterol, explain the higher relative risks of vascular mortality among women than among men. METHODS In our meta-analysis, we obtained individual participant-level data from studies included in the Prospective Studies Collaboration and the Asia Pacific Cohort Studies Collaboration that had obtained baseline information on age, sex, diabetes, total cholesterol, blood pressure, tobacco use, height, and weight. Data on causes of death were obtained from medical death certificates. We used Cox regression models to assess the relevance of diabetes (any type) to occlusive vascular mortality (ischaemic heart disease, ischaemic stroke, or other atherosclerotic deaths) by age, sex, and other major vascular risk factors, and to assess whether the associations of blood pressure, total cholesterol, and body-mass index (BMI) to occlusive vascular mortality are modified by diabetes. RESULTS Individual participant-level data were analysed from 980 793 adults. During 9·8 million person-years of follow-up, among participants aged between 35 and 89 years, 19 686 (25·6%) of 76 965 deaths were attributed to occlusive vascular disease. After controlling for major vascular risk factors, diabetes roughly doubled occlusive vascular mortality risk among men (death rate ratio [RR] 2·10, 95% CI 1·97-2·24) and tripled risk among women (3·00, 2·71-3·33; χ2 test for heterogeneity p<0·0001). For both sexes combined, the occlusive vascular death RRs were higher in younger individuals (aged 35-59 years: 2·60, 2·30-2·94) than in older individuals (aged 70-89 years: 2·01, 1·85-2·19; p=0·0001 for trend across age groups), and, across age groups, the death RRs were higher among women than among men. Therefore, women aged 35-59 years had the highest death RR across all age and sex groups (5·55, 4·15-7·44). However, since underlying confounder-adjusted occlusive vascular mortality rates at any age were higher in men than in women, the adjusted absolute excess occlusive vascular mortality associated with diabetes was similar for men and women. At ages 35-59 years, the excess absolute risk was 0·05% (95% CI 0·03-0·07) per year in women compared with 0·08% (0·05-0·10) per year in men; the corresponding excess at ages 70-89 years was 1·08% (0·84-1·32) per year in women and 0·91% (0·77-1·05) per year in men. Total cholesterol, blood pressure, and BMI each showed continuous log-linear associations with occlusive vascular mortality that were similar among individuals with and without diabetes across both sexes. INTERPRETATION Independent of other major vascular risk factors, diabetes substantially increased vascular risk in both men and women. Lifestyle changes to reduce smoking and obesity and use of cost-effective drugs that target major vascular risks (eg, statins and antihypertensive drugs) are important in both men and women with diabetes, but might not reduce the relative excess risk of occlusive vascular disease in women with diabetes, which remains unexplained. FUNDING UK Medical Research Council, British Heart Foundation, Cancer Research UK, European Union BIOMED programme, and National Institute on Aging (US National Institutes of Health).
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21
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Härtlova A, Herbst S, Peltier J, Rodgers A, Bilkei-Gorzo O, Fearns A, Dill BD, Lee H, Flynn R, Cowley SA, Davies P, Lewis PA, Ganley IG, Martinez J, Alessi DR, Reith AD, Trost M, Gutierrez MG. LRRK2 is a negative regulator of Mycobacterium tuberculosis phagosome maturation in macrophages. EMBO J 2018; 37:e98694. [PMID: 29789389 PMCID: PMC6003659 DOI: 10.15252/embj.201798694] [Citation(s) in RCA: 112] [Impact Index Per Article: 18.7] [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: 11/21/2017] [Revised: 04/05/2018] [Accepted: 04/24/2018] [Indexed: 12/18/2022] Open
Abstract
Mutations in the leucine-rich repeat kinase 2 (LRRK2) are associated with Parkinson's disease, chronic inflammation and mycobacterial infections. Although there is evidence supporting the idea that LRRK2 has an immune function, the cellular function of this kinase is still largely unknown. By using genetic, pharmacological and proteomics approaches, we show that LRRK2 kinase activity negatively regulates phagosome maturation via the recruitment of the Class III phosphatidylinositol-3 kinase complex and Rubicon to the phagosome in macrophages. Moreover, inhibition of LRRK2 kinase activity in mouse and human macrophages enhanced Mycobacterium tuberculosis phagosome maturation and mycobacterial control independently of autophagy. In vivo, LRRK2 deficiency in mice resulted in a significant decrease in M. tuberculosis burdens early during the infection. Collectively, our findings provide a molecular mechanism explaining genetic evidence linking LRRK2 to mycobacterial diseases and establish an LRRK2-dependent cellular pathway that controls M. tuberculosis replication by regulating phagosome maturation.
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Affiliation(s)
- Anetta Härtlova
- MRC Protein Phosphorylation and Ubiquitylation Unit, University of Dundee, Dundee, UK
- Newcastle University, Newcastle-upon-Tyne, UK
| | - Susanne Herbst
- Host-Pathogen Interactions in Tuberculosis Laboratory, The Francis Crick Institute, London, UK
- Crick-GSK Biomedical LinkLabs, GlaxoSmithKline Pharmaceuticals R&D, Stevenage, UK
| | - Julien Peltier
- MRC Protein Phosphorylation and Ubiquitylation Unit, University of Dundee, Dundee, UK
- Newcastle University, Newcastle-upon-Tyne, UK
| | - Angela Rodgers
- Host-Pathogen Interactions in Tuberculosis Laboratory, The Francis Crick Institute, London, UK
| | - Orsolya Bilkei-Gorzo
- MRC Protein Phosphorylation and Ubiquitylation Unit, University of Dundee, Dundee, UK
| | - Antony Fearns
- Host-Pathogen Interactions in Tuberculosis Laboratory, The Francis Crick Institute, London, UK
| | - Brian D Dill
- MRC Protein Phosphorylation and Ubiquitylation Unit, University of Dundee, Dundee, UK
| | - Heyne Lee
- Sir William Dunn School of Pathology, University of Oxford, Oxford, UK
| | - Rowan Flynn
- Sir William Dunn School of Pathology, University of Oxford, Oxford, UK
| | - Sally A Cowley
- Sir William Dunn School of Pathology, University of Oxford, Oxford, UK
| | - Paul Davies
- MRC Protein Phosphorylation and Ubiquitylation Unit, University of Dundee, Dundee, UK
| | - Patrick A Lewis
- University of Reading, Reading, UK
- UCL Institute of Neurology, Queen Square, London, UK
| | - Ian G Ganley
- MRC Protein Phosphorylation and Ubiquitylation Unit, University of Dundee, Dundee, UK
| | | | - Dario R Alessi
- MRC Protein Phosphorylation and Ubiquitylation Unit, University of Dundee, Dundee, UK
| | - Alastair D Reith
- Neurodegeneration Discovery Performance Unit, RD Neurosciences, GlaxoSmithKline Pharmaceuticals R&D, Stevenage, UK
| | - Matthias Trost
- MRC Protein Phosphorylation and Ubiquitylation Unit, University of Dundee, Dundee, UK
- Newcastle University, Newcastle-upon-Tyne, UK
| | - Maximiliano G Gutierrez
- Host-Pathogen Interactions in Tuberculosis Laboratory, The Francis Crick Institute, London, UK
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22
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Schnettger L, Rodgers A, Repnik U, Lai RP, Pei G, Verdoes M, Wilkinson RJ, Young DB, Gutierrez MG. A Rab20-Dependent Membrane Trafficking Pathway Controls M. tuberculosis Replication by Regulating Phagosome Spaciousness and Integrity. Cell Host Microbe 2017; 21:619-628.e5. [PMID: 28494243 PMCID: PMC5432432 DOI: 10.1016/j.chom.2017.04.004] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 01/19/2017] [Accepted: 04/20/2017] [Indexed: 12/01/2022]
Abstract
The intracellular pathogen Mycobacterium tuberculosis (Mtb) lives within phagosomes and also disrupts these organelles to access the cytosol. The host pathways and mechanisms that contribute to maintaining Mtb phagosome integrity have not been investigated. Here, we examined the spatiotemporal dynamics of Mtb-containing phagosomes and identified an interferon-gamma-stimulated and Rab20-dependent membrane trafficking pathway in macrophages that maintains Mtb in spacious proteolytic phagolysosomes. This pathway functions to promote endosomal membrane influx in infected macrophages, and is required to preserve Mtb phagosome integrity and control Mtb replication. Rab20 is specifically and significantly upregulated in the sputum of human patients with active tuberculosis. Altogether, we uncover an immune-regulated cellular pathway of defense that promotes maintenance of Mtb within intact membrane-bound compartments for efficient elimination. The spatiotemporal dynamics of the M. tuberculosis (Mtb) phagosome were investigated A Rab20-dependent pathway regulates endocytic influx into Mtb phagosomes Mtb avoids targeting to Rab20-positive phagosomes through its ESX-1 system Rab20 is required to maintain Mtb phagosome integrity and for control of Mtb replication
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Affiliation(s)
- Laura Schnettger
- Host-Pathogen Interactions In Tuberculosis Laboratory, The Francis Crick Institute, 1 Midland Road, London NW1 1AT, UK
| | - Angela Rodgers
- Mycobacterial Systems Biology Laboratory, The Francis Crick Institute, 1 Midland Road, London NW1 1AT, UK
| | - Urska Repnik
- Department of Biosciences, University of Oslo, Blindernveien 31, 0371 Oslo, Norway
| | - Rachel P Lai
- Tuberculosis Laboratory, The Francis Crick Institute, 1 Midland Road, London NW1 1AT, UK
| | - Gang Pei
- Department of Immunology, Max Planck Institute for Infection Biology, Charitéplatz 1, 10117 Berlin, Germany
| | - Martijn Verdoes
- Radboud Institute for Molecular Life Sciences (RIMLS), Geert Grooteplein 26/28, Nijmegen 6525 GA, the Netherlands
| | - Robert J Wilkinson
- Tuberculosis Laboratory, The Francis Crick Institute, 1 Midland Road, London NW1 1AT, UK
| | - Douglas B Young
- Mycobacterial Systems Biology Laboratory, The Francis Crick Institute, 1 Midland Road, London NW1 1AT, UK
| | - Maximiliano G Gutierrez
- Host-Pathogen Interactions In Tuberculosis Laboratory, The Francis Crick Institute, 1 Midland Road, London NW1 1AT, UK.
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23
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Smith LJ, Bochkareva A, Rolfe MD, Hunt DM, Kahramanoglou C, Braun Y, Rodgers A, Blockley A, Coade S, Lougheed KEA, Hafneh NA, Glenn SM, Crack JC, Le Brun NE, Saldanha JW, Makarov V, Nobeli I, Arnvig K, Mukamolova GV, Buxton RS, Green J. Cmr is a redox-responsive regulator of DosR that contributes to M. tuberculosis virulence. Nucleic Acids Res 2017; 45:6600-6612. [PMID: 28482027 PMCID: PMC5499769 DOI: 10.1093/nar/gkx406] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [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: 09/12/2016] [Accepted: 04/28/2017] [Indexed: 12/05/2022] Open
Abstract
Mycobacterium tuberculosis (MTb) is the causative agent of pulmonary tuberculosis (TB). MTb colonizes the human lung, often entering a non-replicating state before progressing to life-threatening active infections. Transcriptional reprogramming is essential for TB pathogenesis. In vitro, Cmr (a member of the CRP/FNR super-family of transcription regulators) bound at a single DNA site to act as a dual regulator of cmr transcription and an activator of the divergent rv1676 gene. Transcriptional profiling and DNA-binding assays suggested that Cmr directly represses dosR expression. The DosR regulon is thought to be involved in establishing latent tuberculosis infections in response to hypoxia and nitric oxide. Accordingly, DNA-binding by Cmr was severely impaired by nitrosation. A cmr mutant was better able to survive a nitrosative stress challenge but was attenuated in a mouse aerosol infection model. The complemented mutant exhibited a ∼2-fold increase in cmr expression, which led to increased sensitivity to nitrosative stress. This, and the inability to restore wild-type behaviour in the infection model, suggests that precise regulation of the cmr locus, which is associated with Region of Difference 150 in hypervirulent Beijing strains of Mtb, is important for TB pathogenesis.
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Affiliation(s)
- Laura J Smith
- Molecular Biology and Biotechnology, University of Sheffield, Sheffield S10 2TN, UK.,School of Pharmacy, De Montfort University, Leicester LE1 9BH, UK
| | | | - Matthew D Rolfe
- Molecular Biology and Biotechnology, University of Sheffield, Sheffield S10 2TN, UK
| | - Debbie M Hunt
- Division of Mycobacterial Research, MRC National Institute for Medical Research, Mill Hill, London NW7 1AA, UK
| | - Christina Kahramanoglou
- Division of Mycobacterial Research, MRC National Institute for Medical Research, Mill Hill, London NW7 1AA, UK
| | - Yvonne Braun
- Division of Mycobacterial Research, MRC National Institute for Medical Research, Mill Hill, London NW7 1AA, UK
| | - Angela Rodgers
- Division of Mycobacterial Research, MRC National Institute for Medical Research, Mill Hill, London NW7 1AA, UK
| | - Alix Blockley
- Division of Mycobacterial Research, MRC National Institute for Medical Research, Mill Hill, London NW7 1AA, UK
| | - Stephen Coade
- Division of Mycobacterial Research, MRC National Institute for Medical Research, Mill Hill, London NW7 1AA, UK
| | - Kathryn E A Lougheed
- Division of Mycobacterial Research, MRC National Institute for Medical Research, Mill Hill, London NW7 1AA, UK
| | - Nor Azian Hafneh
- Department of Infection, Immunity and Inflammation, University of Leicester, University Road, Leicester LE1 9HN, UK
| | - Sarah M Glenn
- Department of Infection, Immunity and Inflammation, University of Leicester, University Road, Leicester LE1 9HN, UK
| | - Jason C Crack
- Centre for Molecular and Structural Biochemistry, School of Chemistry, University of East Anglia, Norwich NR4 7TJ, UK
| | - Nick E Le Brun
- Centre for Molecular and Structural Biochemistry, School of Chemistry, University of East Anglia, Norwich NR4 7TJ, UK
| | - José W Saldanha
- Division of Mathematical Biology, MRC National Institute for Medical Research, Mill Hill, London NW7 1AA, UK
| | - Vadim Makarov
- A.N. Bach Institute of Biochemistry, Russian Academy of Sciences, Moscow, Russia
| | - Irene Nobeli
- Institute of Structural and Molecular Biology, Department of Biological Sciences, Birkbeck, University of London, Malet Street, London WC1E 7HX, UK
| | - Kristine Arnvig
- Institute for Structural and Molecular Biology, University College London, London WC1E 6BT, UK
| | - Galina V Mukamolova
- Department of Infection, Immunity and Inflammation, University of Leicester, University Road, Leicester LE1 9HN, UK
| | - Roger S Buxton
- Division of Mycobacterial Research, MRC National Institute for Medical Research, Mill Hill, London NW7 1AA, UK
| | - Jeffrey Green
- Molecular Biology and Biotechnology, University of Sheffield, Sheffield S10 2TN, UK
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24
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Hinton A, Perea-Ortiz M, Winch J, Briggs J, Freer S, Moustoukas D, Powell-Gill S, Squire C, Lamb A, Rammeloo C, Stray B, Voulazeris G, Zhu L, Kaushik A, Lien YH, Niggebaum A, Rodgers A, Stabrawa A, Boddice D, Plant SR, Tuckwell GW, Bongs K, Metje N, Holynski M. A portable magneto-optical trap with prospects for atom interferometry in civil engineering. Philos Trans A Math Phys Eng Sci 2017; 375:rsta.2016.0238. [PMID: 28652493 PMCID: PMC5487716 DOI: 10.1098/rsta.2016.0238] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/12/2016] [Indexed: 05/13/2023]
Abstract
The high precision and scalable technology offered by atom interferometry has the opportunity to profoundly affect gravity surveys, enabling the detection of features of either smaller size or greater depth. While such systems are already starting to enter into the commercial market, significant reductions are required in order to reach the size, weight and power of conventional devices. In this article, the potential for atom interferometry based gravimetry is assessed, suggesting that the key opportunity resides within the development of gravity gradiometry sensors to enable drastic improvements in measurement time. To push forward in realizing more compact systems, techniques have been pursued to realize a highly portable magneto-optical trap system, which represents the core package of an atom interferometry system. This can create clouds of 107 atoms within a system package of 20 l and 10 kg, consuming 80 W of power.This article is part of the themed issue 'Quantum technology for the 21st century'.
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Affiliation(s)
- A Hinton
- School of Physics and Astronomy, Metallurgy and Materials Building, University of Birmingham, Birmingham B15 2TT, UK
| | - M Perea-Ortiz
- School of Physics and Astronomy, Metallurgy and Materials Building, University of Birmingham, Birmingham B15 2TT, UK
| | - J Winch
- School of Physics and Astronomy, Metallurgy and Materials Building, University of Birmingham, Birmingham B15 2TT, UK
| | - J Briggs
- School of Physics and Astronomy, Metallurgy and Materials Building, University of Birmingham, Birmingham B15 2TT, UK
| | - S Freer
- School of Physics and Astronomy, Metallurgy and Materials Building, University of Birmingham, Birmingham B15 2TT, UK
| | - D Moustoukas
- School of Physics and Astronomy, Metallurgy and Materials Building, University of Birmingham, Birmingham B15 2TT, UK
| | - S Powell-Gill
- School of Physics and Astronomy, Metallurgy and Materials Building, University of Birmingham, Birmingham B15 2TT, UK
| | - C Squire
- School of Physics and Astronomy, Metallurgy and Materials Building, University of Birmingham, Birmingham B15 2TT, UK
| | - A Lamb
- School of Physics and Astronomy, Metallurgy and Materials Building, University of Birmingham, Birmingham B15 2TT, UK
| | - C Rammeloo
- School of Physics and Astronomy, Metallurgy and Materials Building, University of Birmingham, Birmingham B15 2TT, UK
| | - B Stray
- School of Physics and Astronomy, Metallurgy and Materials Building, University of Birmingham, Birmingham B15 2TT, UK
| | - G Voulazeris
- School of Physics and Astronomy, Metallurgy and Materials Building, University of Birmingham, Birmingham B15 2TT, UK
| | - L Zhu
- School of Physics and Astronomy, Metallurgy and Materials Building, University of Birmingham, Birmingham B15 2TT, UK
| | - A Kaushik
- School of Physics and Astronomy, Metallurgy and Materials Building, University of Birmingham, Birmingham B15 2TT, UK
| | - Y-H Lien
- School of Physics and Astronomy, Metallurgy and Materials Building, University of Birmingham, Birmingham B15 2TT, UK
| | - A Niggebaum
- School of Physics and Astronomy, Metallurgy and Materials Building, University of Birmingham, Birmingham B15 2TT, UK
| | - A Rodgers
- School of Physics and Astronomy, Metallurgy and Materials Building, University of Birmingham, Birmingham B15 2TT, UK
| | - A Stabrawa
- School of Physics and Astronomy, Metallurgy and Materials Building, University of Birmingham, Birmingham B15 2TT, UK
| | - D Boddice
- School of Engineering, Department of Civil Engineering, University of Birmingham, Birmingham B15 2TT, UK
| | - S R Plant
- School of Physics and Astronomy, Metallurgy and Materials Building, University of Birmingham, Birmingham B15 2TT, UK
| | - G W Tuckwell
- RSK, 18 Frogmore Road, Hemel Hempstead, Hertfordshire HP3 9RT, UK
| | - K Bongs
- School of Physics and Astronomy, Metallurgy and Materials Building, University of Birmingham, Birmingham B15 2TT, UK
| | - N Metje
- School of Engineering, Department of Civil Engineering, University of Birmingham, Birmingham B15 2TT, UK
| | - M Holynski
- School of Physics and Astronomy, Metallurgy and Materials Building, University of Birmingham, Birmingham B15 2TT, UK
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Vázquez CL, Rodgers A, Herbst S, Coade S, Gronow A, Guzman CA, Wilson MS, Kanzaki M, Nykjaer A, Gutierrez MG. The proneurotrophin receptor sortilin is required for Mycobacterium tuberculosis control by macrophages. Sci Rep 2016; 6:29332. [PMID: 27389464 PMCID: PMC4937236 DOI: 10.1038/srep29332] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [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: 02/15/2016] [Accepted: 06/16/2016] [Indexed: 02/05/2023] Open
Abstract
Sorting of luminal and membrane proteins into phagosomes is critical for the immune function of this organelle. However, little is known about the mechanisms that contribute to the spatiotemporal regulation of this process. Here, we investigated the role of the proneurotrophin receptor sortilin during phagosome maturation and mycobacterial killing. We show that this receptor is acquired by mycobacteria-containing phagosomes via interactions with the adaptor proteins AP-1 and GGAs. Interestingly, the phagosomal association of sortilin is critical for the delivery of acid sphingomyelinase (ASMase) and required for efficient phagosome maturation. Macrophages from Sort1(-/-) mice are less efficient in restricting the growth of Mycobacterium bovis BCG and M. tuberculosis. In vivo, Sort1(-/-) mice showed a substantial increase in cellular infiltration of neutrophils in their lungs and higher bacterial burden after infection with M. tuberculosis. Altogether, sortilin defines a pathway required for optimal intracellular mycobacteria control and lung inflammation in vivo.
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Affiliation(s)
- Cristina L Vázquez
- Research Group Phagosome Biology, Helmholtz Centre for Infection Research, Inhoffenstrasse 7, 38124 Braunschweig, Germany
| | - Angela Rodgers
- Host-pathogen interactions in tuberculosis laboratory, The Francis Crick Institute, Mill Hill Laboratory, The Ridgeway, London, NW7 1AA, UK
| | - Susanne Herbst
- Host-pathogen interactions in tuberculosis laboratory, The Francis Crick Institute, Mill Hill Laboratory, The Ridgeway, London, NW7 1AA, UK
| | - Stephen Coade
- Host-pathogen interactions in tuberculosis laboratory, The Francis Crick Institute, Mill Hill Laboratory, The Ridgeway, London, NW7 1AA, UK
| | - Achim Gronow
- Research Group Phagosome Biology, Helmholtz Centre for Infection Research, Inhoffenstrasse 7, 38124 Braunschweig, Germany
| | - Carlos A Guzman
- Department of Vaccinology and Applied Microbiology, Helmholtz Centre for Infection Research, Inhoffenstrasse 7, 38124 Braunschweig, Germany
| | - Mark S Wilson
- Allergy and Anti-Helminth Immunity Laboratory, The Francis Crick Institute, Mill Hill Laboratory, The Ridgeway, London, NW7 1AA, UK
| | - Makoto Kanzaki
- Graduate School of Biomedical Engineering, Tohoku University, Sendai, Miyagi, Japan
| | - Anders Nykjaer
- The Lundbeck Foundation Research Center MIND, Department of Medical Biochemistry, Aarhus University, DK-8000 Aarhus, Denmark
| | - Maximiliano G Gutierrez
- Host-pathogen interactions in tuberculosis laboratory, The Francis Crick Institute, Mill Hill Laboratory, The Ridgeway, London, NW7 1AA, UK
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Mannix LK, Loder E, Nett R, Mueller L, Rodgers A, Hustad CM, Ramsey KE, Skobieranda F. Rizatriptan for the Acute Treatment of ICHD-II Proposed Menstrual Migraine: Two Prospective, Randomized, Placebo-Controlled, Double-Blind Studies. Cephalalgia 2016; 27:414-21. [PMID: 17448179 DOI: 10.1111/j.1468-2982.2007.01313.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
These are the first prospective studies to use criteria for menstrual migraine proposed in the 2004 revision of the International Classification of Headache Disorders (ICHD-II) to examine the efficacy of rizatriptan for treatment of a menstrual attack. Two identical protocols (MM1 and MM2) were randomized, parallel, placebo-controlled, double-blind studies. Adult women with ICHD-II menstrual migraine were assigned to either rizatriptan 10-mg tablet or placebo in a 2 : 1 ratio. Patients treated a single menstrual migraine attack of moderate or severe pain intensity. The primary end-point was 2-h pain relief and the secondary end-point was 24-h sustained pain relief. A total of 707 patients (MM1 357, MM2 350) treated a menstrual migraine attack. The percentage of patients reporting 2-h pain relief was significantly greater for rizatriptan than for placebo (MM1 70% vs. 53%, MM2 73% vs. 50%), as was the percentage of patients reporting 24-h sustained pain relief (MM1 46% vs. 33%; MM2 46% vs. 33%). Rizatriptan 10 mg was effective for the treatment of ICHD-II menstrual migraine, as measured by 2-h pain relief and 24-h sustained pain relief.
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Affiliation(s)
- L K Mannix
- Headache Associates and ClinExcel Research, West Chester, OH 45069, USA.
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Lafeber M, Grobbee DE, Schrover IM, Thom S, Webster R, Rodgers A, Visseren FLJ, Bots ML, Spiering W. Comparison of a morning polypill, evening polypill and individual pills on LDL-cholesterol, ambulatory blood pressure and adherence in high-risk patients; a randomized crossover trial. Int J Cardiol 2014; 181:193-9. [PMID: 25528311 DOI: 10.1016/j.ijcard.2014.11.176] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 11/23/2014] [Indexed: 11/30/2022]
Abstract
AIMS Cardiovascular polypills are a novel strategy in the prevention of cardiovascular disease. Based on considerations about the effectiveness, the individual pills of a polypill are taken at different times of the day. This study aimed therefore to compare the use of a polypill in the morning, in the evening or the individual components taken at their usual times on cardiovascular risk factors and patient acceptability. METHODS The study was a randomized three-period crossover trial. Seventy-eight patients with established cardiovascular disease were randomly allocated to the use of polypill (aspirin 75 mg, simvastatin 40 mg, lisinopril 10mg and hydrochlorothiazide 12.5mg) in the morning, in the evening or use of the individual agents taken at different time points (Trial: NCT01506505). RESULTS Using the polypill in the evening resulted in a 0.2 mmol/L (95%-confidence interval (CI): 0.1 to 0.3) lower fasting LDL-cholesterol compared to the use in the morning, and not statistically significantly different mean 24-hour systolic BP (mean difference: 0.7 mmHg; 95%-CI; -2.1 to 3.4). Compared to the use of the individual agents, the mean LDL-cholesterol was 0.2 mmol/L (95%-CI: 0.1 to 0.3) higher when using the polypill in the morning, but not statistically significantly different when used in the evening (mean difference: -0.1 mmol/L; 95%-CI: -0.1 to 0.0). Furthermore, there were no differences in mean 24-hour systolic BP with morning use (mean difference: 0.4 mmHg; 95%-CI; -1.5 to 2.3) or evening use (mean difference: 1.0mmHg; 95%-CI; -0.8 to 2.8) of the polypill compared to the individual agents. The adherence was 5.2% (95%-CI: 1.4 to 9.1) higher with morning use of the polypill and 5.0% (95%-CI: 1.5 to 8.5) higher with evening use compared to the individual agents. Treatment with the polypill was preferred by 92% of the participants. CONCLUSION The use of a polypill in the evening was more effective in lowering LDL-cholesterol, and resulted in not statistically significantly different ambulatory BP levels compared to the use of a polypill in the morning. Therapy with a polypill was associated with an increased adherence. The polypill is highly preferred by patients, demonstrating a potential role for the polypill in the prevention of cardiovascular disease.
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Affiliation(s)
- M Lafeber
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - D E Grobbee
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - I M Schrover
- Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - S Thom
- International Centre for Circulatory Health, Imperial College, London, UK
| | - R Webster
- George Institute for Global Health, Sydney, Australia
| | - A Rodgers
- George Institute for Global Health, Sydney, Australia
| | - F L J Visseren
- Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - M L Bots
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - W Spiering
- Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
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Ware M, Weiner R, Friedlander P, Gordon C, Saenger Y, Mahmood T, Rodgers A, Bastian G, Urien S, Lee, Morgan R. DD-08 * PHASE I CANCER CLINICAL TRIAL FOR 4-DEMETHYL-4-CHOLESTERYLOXYCARBONYLPENCLOMEDINE (DM-CHOC-PEN). Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou246.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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29
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Laba TL, Hayes A, Jan S, Rodgers A, Patel A, Cass A, Reid C, Tonkin A, Usherwood T, Webster R. Can A Cvd Polypill Save Money In The 'Real World'? Value Health 2014; 17:A482. [PMID: 27201410 DOI: 10.1016/j.jval.2014.08.1398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- T L Laba
- George Institute for Global Health, University of Sydney, Camperdown, Australia
| | - A Hayes
- University of Sydney, Camperdown, Australia
| | - S Jan
- George Institute for Global Health, University of Sydney, Camperdown, Australia
| | - A Rodgers
- George Institute for Global Health, University of Sydney, Camperdown, Australia
| | - A Patel
- George Institute for Global Health, University of Sydney, Camperdown, Australia
| | - A Cass
- Menzies School of Health Research, Darwin, Australia
| | - C Reid
- Monash University, Melbourne, Australia
| | - A Tonkin
- Monash University, Melbourne, Australia
| | | | - R Webster
- George Institute for Global Health, University of Sydney, Camperdown, Australia
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Abstract
The impact of pressure ulcers is psychologically, physically and clinically challenging for both patients and NHS staff. NHS Greater Glasgow and Clyde (NHS GGC), in line with the Scottish Best Practice Statement for the Prevention and Management of Pressure Ulcers ( Quality Improvement Scotland, 2009 ), and the NHS Health Improvement Scotland (2011) Preventing Pressure Ulcers Change Package, launched an awareness campaign throughout the organisation in April 2012 and has more recently adopted a 'zero-tolerance' approach to pressure damage. The tissue viability service in NHS GGC recognised that in order to achieve this aim, education of front-line staff is essential. An educational framework for pressure ulcer prevention was developed for all levels of healthcare staff involved in the delivery of patient care. As a means to support the framework, an initiative to develop web-based eLearning modules has been taken forward. This has resulted in the creation of an accessible, cost-effective, stimulating, relevant, and evidence-based education programme designed around the educational needs of all healthcare staff. In conjunction with the organisation's 'top ten tools' for pressure ulcer prevention and management, the modular online education programme addresses the aims of quality improvement and zero tolerance by supporting the provision of safe and effective person-centered care.
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31
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Rodgers A, Beltsos A, Jasulaitis S, Kaplan B, Wagner-Coughlin C, Liebermann J. Elective single versus double blastocyst transfers in gestational carriers using fresh anonymous donor oocytes. Fertil Steril 2014. [DOI: 10.1016/j.fertnstert.2014.07.1152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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32
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Kennedy NA, Rodgers A, Altus R, McCormick R, Wundke R, Wigg AJ. Optimisation of hepatocellular carcinoma surveillance in patients with viral hepatitis: a quality improvement study. Intern Med J 2014; 43:772-7. [PMID: 23611607 DOI: 10.1111/imj.12166] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [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: 12/05/2012] [Accepted: 04/06/2013] [Indexed: 12/31/2022]
Abstract
BACKGROUND Surveillance for hepatocellular carcinoma (HCC) with 6-monthly ultrasound is a standard of care for higher-risk patients with viral hepatitis. Adherence to screening guidelines is an important quality indicator in hepatology, but multiple studies have demonstrated poor HCC surveillance practices in real-world settings. AIMS The aim of this project was to audit and then optimise HCC surveillance of viral hepatitis patients, who fulfilled criteria for screening, associated with a large tertiary hospital. METHODS Clinical practice improvement principles were utilised. A baseline audit of 22 consecutive viral hepatitis patients was performed. Major barriers preventing adequate surveillance were identified and three interventions to improve adherence to guidelines were introduced. These included: improved doctor education, system redesign and improved patient education. The effects of interventions were measured by serial random audits of patients. A final audit occurred over 3 years after the initial baseline audit. RESULTS At baseline, 46% and 0% of patients had appropriate surveillance performed during the prior 6 months (one surveillance cycle) and 2 years (four surveillance cycles) respectively. Three years after initiation of these strategies, a final audit revealed 92% (vs 46% at baseline) and 64% (vs 0% at baseline) of patients had appropriate HCC surveillance performed during the preceding 6 months and 2 years intervals respectively (P < 0.001 in each case). CONCLUSIONS Simple and low-cost interventions can considerably improve the clinical effectiveness of HCC screening programmes in real world settings. Clinical practice improvement principles appear to be a valid methodology for achieving this positive change.
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Affiliation(s)
- N A Kennedy
- Hepatology and Liver Transplant Medicine Unit, Flinders Medical Centre, Adelaide, South Australia, Australia
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33
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Redfern J, Usherwood T, Harris MF, Rodgers A, Hayman N, Panaretto K, Chow C, Lau AYS, Neubeck L, Coorey G, Hersch F, Heeley E, Patel A, Jan S, Zwar N, Peiris D. A randomised controlled trial of a consumer-focused e-health strategy for cardiovascular risk management in primary care: the Consumer Navigation of Electronic Cardiovascular Tools (CONNECT) study protocol. BMJ Open 2014; 4:e004523. [PMID: 24486732 PMCID: PMC3918991 DOI: 10.1136/bmjopen-2013-004523] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Fewer than half of all people at highest risk of a cardiovascular event are receiving and adhering to best practice recommendations to lower their risk. In this project, we examine the role of an e-health-assisted consumer-focused strategy as a means of overcoming these gaps between evidence and practice. Consumer Navigation of Electronic Cardiovascular Tools (CONNECT) aims to test whether a consumer-focused e-health strategy provided to Aboriginal and Torres Strait Islander and non-indigenous adults, recruited through primary care, at moderate-to-high risk of a cardiovascular disease event will improve risk factor control when compared with usual care. METHODS AND ANALYSIS Randomised controlled trial of 2000 participants with an average of 18 months of follow-up to evaluate the effectiveness of an integrated consumer-directed e-health portal on cardiovascular risk compared with usual care in patients with cardiovascular disease or who are at moderate-to-high cardiovascular disease risk. The trial will be augmented by formal economic and process evaluations to assess acceptability, equity and cost-effectiveness of the intervention. The intervention group will participate in a consumer-directed e-health strategy for cardiovascular risk management. The programme is electronically integrated with the primary care provider's software and will include interactive smart phone and Internet platforms. The primary outcome is a composite endpoint of the proportion of people meeting the Australian guideline-recommended blood pressure (BP) and cholesterol targets. Secondary outcomes include change in mean BP and fasting cholesterol levels, proportion meeting BP and cholesterol targets separately, self-efficacy, health literacy, self-reported point prevalence abstinence in smoking, body mass index and waist circumference, self-reported physical activity and self-reported medication adherence. ETHICS AND DISSEMINATION Primary ethics approval was received from the University of Sydney Human Research Ethics Committee and the Aboriginal Health and Medical Research Council. Results will be disseminated via the usual scientific forums including peer-reviewed publications and presentations at international conferences CLINICAL TRIALS REGISTRATION NUMBER ACTRN12613000715774.
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Affiliation(s)
- Julie Redfern
- The George Institute for Global Health, Sydney Medical School, University of Sydney, Sydney, Australia
| | - T Usherwood
- Sydney Medical School (Westmead), University of Sydney, Sydney, Australia
| | - M F Harris
- University of New South Wales, Sydney, Australia
| | - A Rodgers
- The George Institute for Global Health, Sydney Medical School, University of Sydney, Sydney, Australia
| | - N Hayman
- Inala Indigenous Health Service, School of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - K Panaretto
- University of Queensland, Brisbane, Queensland, Australia
| | - C Chow
- The George Institute for Global Health, Sydney Medical School, University of Sydney, Sydney, Australia
| | - A Y S Lau
- Centre for Health Informatics, Australian Institute of Health Innovation, University of New South Wales, Sydney, New South Wales, Australia
| | - L Neubeck
- The George Institute for Global Health, Sydney Nursing School, University of Sydney, Sydney, Australia
| | - G Coorey
- The George Institute for Global Health, Sydney, Australia
| | - F Hersch
- Nuffied Department for Population Health, The George Institute for Global Health, Oxford University, Oxford, UK
| | - E Heeley
- The George Institute for Global Health, Sydney Medical School, University of Sydney, Sydney, Australia
| | - A Patel
- The George Institute for Global Health, Sydney Medical School, University of Sydney, Sydney, Australia
| | - S Jan
- The George Institute for Global Health, Sydney Medical School, University of Sydney, Sydney, Australia
| | - N Zwar
- Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - D Peiris
- The George Institute for Global Health, Sydney Medical School, University of Sydney, Sydney, Australia
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Houghton J, Cortes T, Schubert O, Rose G, Rodgers A, De Ste Croix M, Aebersold R, Young DB, Arnvig KB. A small RNA encoded in the Rv2660c locus of Mycobacterium tuberculosis is induced during starvation and infection. PLoS One 2013; 8:e80047. [PMID: 24348997 PMCID: PMC3861185 DOI: 10.1371/journal.pone.0080047] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [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: 08/14/2013] [Accepted: 09/27/2013] [Indexed: 01/21/2023] Open
Abstract
Enhanced transcription of the Rv2660c locus in response to starvation of Mycobacterium tuberculosis H37Rv encouraged addition of the predicted Rv2660c protein to an improved vaccine formulation. Using strand-specific RNA sequencing, we show that the up-regulated transcript is in fact a small RNA encoded on the opposite strand to the annotated Rv2660c. The transcript originates within a prophage and is expressed only in strains that carry PhiRv2. The small RNA contains both host and phage sequences and provides a useful biomarker to monitor bacterial starvation during infection and/or non-replicating persistence. Using different approaches we do not find any evidence of Rv2660c at the level of mRNA or protein. Further efforts to understand the mechanism by which Rv2660c improves efficacy of the H56 vaccine are likely to provide insights into the pathology and immunology of tuberculosis.
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Affiliation(s)
- Joanna Houghton
- Division of Mycobacterial Research, MRC National Institute for Medical Research, London, United Kingdom
| | - Teresa Cortes
- Division of Mycobacterial Research, MRC National Institute for Medical Research, London, United Kingdom
| | - Olga Schubert
- ETH Zurich, Institute of Molecular Systems Biology, Zurich, Switzerland
| | - Graham Rose
- Division of Mycobacterial Research, MRC National Institute for Medical Research, London, United Kingdom
| | - Angela Rodgers
- Division of Mycobacterial Research, MRC National Institute for Medical Research, London, United Kingdom
| | - Megan De Ste Croix
- Division of Mycobacterial Research, MRC National Institute for Medical Research, London, United Kingdom
| | - Rudolf Aebersold
- ETH Zurich, Institute of Molecular Systems Biology, Zurich, Switzerland
| | - Douglas B. Young
- Division of Mycobacterial Research, MRC National Institute for Medical Research, London, United Kingdom
| | - Kristine B. Arnvig
- Division of Mycobacterial Research, MRC National Institute for Medical Research, London, United Kingdom
- * E-mail:
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35
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Everitt AR, Clare S, McDonald JU, Kane L, Harcourt K, Ahras M, Lall A, Hale C, Rodgers A, Young DB, Haque A, Billker O, Tregoning JS, Dougan G, Kellam P. Defining the range of pathogens susceptible to Ifitm3 restriction using a knockout mouse model. PLoS One 2013; 8:e80723. [PMID: 24278312 PMCID: PMC3836756 DOI: 10.1371/journal.pone.0080723] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [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: 08/01/2013] [Accepted: 10/16/2013] [Indexed: 12/22/2022] Open
Abstract
The interferon-inducible transmembrane (IFITM) family of proteins has been shown to restrict a broad range of viruses in vitro and in vivo by halting progress through the late endosomal pathway. Further, single nucleotide polymorphisms (SNPs) in its sequence have been linked with risk of developing severe influenza virus infections in humans. The number of viruses restricted by this host protein has continued to grow since it was first demonstrated as playing an antiviral role; all of which enter cells via the endosomal pathway. We therefore sought to test the limits of antimicrobial restriction by Ifitm3 using a knockout mouse model. We showed that Ifitm3 does not impact on the restriction or pathogenesis of bacterial (Salmonella typhimurium, Citrobacter rodentium, Mycobacterium tuberculosis) or protozoan (Plasmodium berghei) pathogens, despite in vitro evidence. However, Ifitm3 is capable of restricting respiratory syncytial virus (RSV) in vivo either through directly restricting RSV cell infection, or by exerting a previously uncharacterised function controlling disease pathogenesis. This represents the first demonstration of a virus that enters directly through the plasma membrane, without the need for the endosomal pathway, being restricted by the IFITM family; therefore further defining the role of these antiviral proteins.
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Affiliation(s)
- Aaron R. Everitt
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, United Kingdom
- * E-mail:
| | - Simon Clare
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, United Kingdom
| | - Jacqueline U. McDonald
- Mucosal Infection and Immunity Group, Section of Infectious Diseases, Department of Medicine, Imperial College London, London, United Kingdom
| | - Leanne Kane
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, United Kingdom
| | - Katherine Harcourt
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, United Kingdom
| | - Malika Ahras
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, United Kingdom
| | - Amar Lall
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | - Christine Hale
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, United Kingdom
| | - Angela Rodgers
- Medical Research Council National Institute for Medical Research, London, United Kingdom
| | - Douglas B. Young
- Medical Research Council National Institute for Medical Research, London, United Kingdom
| | - Ashraful Haque
- Malaria Immunology Laboratory, Queensland Institute of Medical Research and The Australian Centre for Vaccine Development, Herston, Brisbane, Queensland, Australia
| | - Oliver Billker
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, United Kingdom
| | - John S. Tregoning
- Mucosal Infection and Immunity Group, Section of Infectious Diseases, Department of Medicine, Imperial College London, London, United Kingdom
| | - Gordon Dougan
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, United Kingdom
| | - Paul Kellam
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, United Kingdom
- Department of Infection, University College London, London, United Kingdom
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Muller K, Rodgers A, Wundke R, Waddell V, Altus R, Gordon DL, Wigg A. Single centre experience with pegylated interferon and ribavirin for hepatitis C: looking back before moving forward. Intern Med J 2012; 42:765-72. [DOI: 10.1111/j.1445-5994.2012.02798.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Magwira CA, Kullin B, Lewandowski S, Rodgers A, Reid SJ, Abratt VR. Diversity of faecal oxalate-degrading bacteria in black and white South African study groups: insights into understanding the rarity of urolithiasis in the black group. J Appl Microbiol 2012; 113:418-28. [PMID: 22616725 DOI: 10.1111/j.1365-2672.2012.05346.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2012] [Revised: 05/02/2012] [Accepted: 05/14/2012] [Indexed: 12/13/2022]
Abstract
AIM To examine whether enhanced diversity or numbers of oxalate-degrading bacteria in the gastrointestinal tracts of black South Africans play a role in determining the rarity of urolithiasis in this group. METHODS AND RESULTS Fresh faecal samples collected from healthy black and white South African male volunteers were analysed in terms of bacterial oxalate-degrading activity, bacterial diversity and relative species abundance. Varied bacterial populations prepared from samples from the low-risk black group showed a significantly higher level of oxalate degradation. Denaturing gradient gel electrophoresis analyses of Lactobacillus and related spp. and Bifidobacterium spp. 16S rRNA PCR products revealed a significantly higher faecal Lactobacillus diversity for the low-risk black group relative to the higher-risk white group. Quantitative real-time PCR experiments did not show any significant differences between the study groups for Lactobacillus and related spp.. However, Bifidobacterium spp. were present at a significantly higher relative abundance in the black group. Oxalobacter formigenes was present only at very low levels in either group. CONCLUSIONS The low abundance of O. formigenes and increased diversity and abundance of oxalate-degrading Lactobacillus and Bifidobacterium spp. in the black South African population suggest that these strains rather than O. formigenes may protect this group against calcium oxalate kidney stone disease. SIGNIFICANCE AND IMPACT OF THE STUDY The South African black population harbours a pool of potential oxalate-degrading lactic acid bacteria, which is more abundant and diverse than that of white South Africans. This may be useful in developing probiotics for calcium oxalate kidney stone prophylaxis.
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Affiliation(s)
- C A Magwira
- Department of Molecular and Cell Biology, University of Cape Town, Cape Town, South Africa
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39
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Hillis GS, Woodward M, Rodgers A, Chow CK, Li Q, Zoungas S, Patel A, Webster R, Batty GD, Ninomiya T, Mancia G, Poulter NR, Chalmers J. Resting heart rate and the risk of death and cardiovascular complications in patients with type 2 diabetes mellitus. Diabetologia 2012; 55:1283-90. [PMID: 22286552 PMCID: PMC4170780 DOI: 10.1007/s00125-012-2471-y] [Citation(s) in RCA: 77] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2011] [Accepted: 01/09/2012] [Indexed: 02/02/2023]
Abstract
AIMS/HYPOTHESIS An association between resting heart rate and mortality has been described in the general population and in patients with cardiovascular disease. There are, however, few data exploring this relationship in patients with type 2 diabetes mellitus. The current study addresses this issue. METHODS The relationship between baseline resting heart rate and all-cause mortality, cardiovascular death and major cardiovascular events (cardiovascular death, non-fatal myocardial infarction or non-fatal stroke) was examined in 11,140 patients who participated in the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) Study. RESULTS A higher resting heart rate was associated with a significantly increased risk of all-cause mortality (fully adjusted HR 1.15 per 10 bpm [95% CI 1.08, 1.21], p<0.001), cardiovascular death and major cardiovascular outcomes without adjustment and after adjusting for age and sex and multiple covariates. The increased risk associated with a higher baseline resting heart rate was most obvious in patients with previous macrovascular complications (fully adjusted HR for death 1.79 for upper [mean 91 bpm] vs lowest [mean 58 bpm] fifth of resting heart rate in this subgroup [95% CI 1.28, 2.50], p = .001). CONCLUSIONS/INTERPRETATION Among patients with type 2 diabetes, a higher resting heart rate is associated with an increased risk of death and cardiovascular complications. It remains unclear whether a higher heart rate directly mediates the increased risk or is a marker for other factors that determine a poor outcome.
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Affiliation(s)
- G S Hillis
- The George Institute for Global Health, King George V Building, Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia.
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Snelgrove RJ, Cornere MM, Edwards L, Dagg B, Keeble J, Rodgers A, Lyonga DE, Stewart GR, Young DB, Walker B, Hussell T. OX40 ligand fusion protein delivered simultaneously with the BCG vaccine provides superior protection against murine Mycobacterium tuberculosis infection. J Infect Dis 2012; 205:975-83. [PMID: 22315280 DOI: 10.1093/infdis/jir868] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Mycobacterium tuberculosis infection claims approximately 2 million lives per year, and improved efficacy of the BCG vaccine remains a World Health Organization priority. Successful vaccination against M. tuberculosis requires the induction and maintenance of T cells. Targeting molecules that promote T-cell survival may therefore provide an alternative strategy to classic adjuvants. We show that the interaction between T-cell-expressed OX40 and OX40L on antigen-presenting cells is critical for effective immunity to BCG. However, because OX40L is lost rapidly from antigen-presenting cells following BCG vaccination, maintenance of OX40-expressing vaccine-activated T cells may not be optimal. Delivering an OX40L:Ig fusion protein simultaneously with BCG provided superior immunity to intravenous and aerosol M. tuberculosis challenge even 6 months after vaccination, an effect that depends on natural killer 1.1(+) cells. Attenuated vaccines may therefore lack sufficient innate stimulation to maintain vaccine-specific T cells, which can be replaced by reagents binding inducible T-cell costimulators.
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Morgan L, Benes E, Rodgers A, Jursic B, Struck R, Waud W, Weiner R, Ware M, Friedlander P. PP 57 Interaction of 4-demethyl-4-cholesteryloxycarbonylpenclomedine (DM-CHOC-PEN) with melanoma melanin metabolism and cell death. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)72681-8] [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: 11/28/2022]
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Spivey VL, Molle V, Whalan RH, Rodgers A, Leiba J, Stach L, Walker KB, Smerdon SJ, Buxton RS. Forkhead-associated (FHA) domain containing ABC transporter Rv1747 is positively regulated by Ser/Thr phosphorylation in Mycobacterium tuberculosis. J Biol Chem 2011; 286:26198-209. [PMID: 21622570 PMCID: PMC3138270 DOI: 10.1074/jbc.m111.246132] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [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: 03/31/2011] [Revised: 05/24/2011] [Indexed: 12/22/2022] Open
Abstract
One major signaling method employed by Mycobacterium tuberculosis, the causative agent of tuberculosis, is through reversible phosphorylation of proteins mediated by protein kinases and phosphatases. This study concerns one of these enzymes, the serine/threonine protein kinase PknF, that is encoded in an operon with Rv1747, an ABC transporter that is necessary for growth of M. tuberculosis in vivo and contains two forkhead-associated (FHA) domains. FHA domains are phosphopeptide recognition motifs that specifically recognize phosphothreonine-containing epitopes. Experiments to determine how PknF regulates the function of Rv1747 demonstrated that phosphorylation occurs on two specific threonine residues, Thr-150 and Thr-208. To determine the in vivo consequences of phosphorylation, infection experiments were performed in bone marrow-derived macrophages and in mice using threonine-to-alanine mutants of Rv1747 that prevent specific phosphorylation and revealed that phosphorylation positively modulates Rv1747 function in vivo. The role of the FHA domains in this regulation was further demonstrated by isothermal titration calorimetry, using peptides containing both phosphothreonine residues. FHA-1 domain mutation resulted in attenuation in macrophages highlighting the critical role of this domain in Rv1747 function. A mutant deleted for pknF did not, however, have a growth phenotype in an infection, suggesting that other kinases can fulfill its role when it is absent. This study provides the first information on the molecular mechanism(s) regulating Rv1747 through PknF-dependent phosphorylation but also indicates that phosphorylation activates Rv1747, which may have important consequences in regulating growth of M. tuberculosis.
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Affiliation(s)
- Vicky L. Spivey
- From the Division of Mycobacterial Research, Medical Research Council National Institute for Medical Research, Mill Hill, London NW7 1AA, United Kingdom
| | - Virginie Molle
- the Laboratoire de Dynamique des Interactions Membranaires Normales et Pathologiques, Universités de Montpellier II et I, CNRS, UMR 5235, Case 107, Place Eugène Bataillon, 34095 Montpellier Cedex 05, France
| | - Rachael H. Whalan
- From the Division of Mycobacterial Research, Medical Research Council National Institute for Medical Research, Mill Hill, London NW7 1AA, United Kingdom
| | - Angela Rodgers
- the Immunology and Cellular Immunity Section, Bacteriology Division, National Institute of Biological Standards and Control (A Centre of the Health Protection Agency), Blanche Lane, South Mimms, Potters Bar, Hertfordshire EN6 3QG, United Kingdom, and
| | - Jade Leiba
- the Laboratoire de Dynamique des Interactions Membranaires Normales et Pathologiques, Universités de Montpellier II et I, CNRS, UMR 5235, Case 107, Place Eugène Bataillon, 34095 Montpellier Cedex 05, France
| | - Lasse Stach
- the Division of Molecular Structure, Medical Research Council National Institute for Medical Research, Mill Hill, London NW7 1AA, United Kingdom
| | - K. Barry Walker
- the Immunology and Cellular Immunity Section, Bacteriology Division, National Institute of Biological Standards and Control (A Centre of the Health Protection Agency), Blanche Lane, South Mimms, Potters Bar, Hertfordshire EN6 3QG, United Kingdom, and
| | - Stephen J. Smerdon
- the Division of Molecular Structure, Medical Research Council National Institute for Medical Research, Mill Hill, London NW7 1AA, United Kingdom
| | - Roger S. Buxton
- From the Division of Mycobacterial Research, Medical Research Council National Institute for Medical Research, Mill Hill, London NW7 1AA, United Kingdom
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Bach S, Bombinski T, Daniels M, Gross D, Hogg T, Martin T, McMurray D, Naber E, Perez N, Schulman A, Tucker S, Andera‐Cato S, Arnold A, Blumberg A, Bord M, Feiertag A, Greaves M, Her A, Kennedy E, Orozco C, Rice C, Rodgers A, Sauer A, Schubert J, Tubbs C, Wray T, Vogt G, Shrestha L, Hillard C. Of Mice and MAGL (Monoacylglycerol Lipase). FASEB J 2011. [DOI: 10.1096/fasebj.25.1_supplement.lb158] [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: 11/11/2022]
Affiliation(s)
- S. Bach
- Brown Deer High SchoolMilwaukeeWI
| | | | | | - D. Gross
- Brown Deer High SchoolMilwaukeeWI
| | - T. Hogg
- Brown Deer High SchoolMilwaukeeWI
| | | | | | - E. Naber
- Brown Deer High SchoolMilwaukeeWI
| | - N. Perez
- Brown Deer High SchoolMilwaukeeWI
| | | | | | | | | | | | - M. Bord
- Brown Deer High SchoolMilwaukeeWI
| | | | | | - A. Her
- Brown Deer High SchoolMilwaukeeWI
| | | | | | - C. Rice
- Brown Deer High SchoolMilwaukeeWI
| | | | - A. Sauer
- Brown Deer High SchoolMilwaukeeWI
| | | | - C. Tubbs
- Brown Deer High SchoolMilwaukeeWI
| | - T. Wray
- Brown Deer High SchoolMilwaukeeWI
| | - G. Vogt
- Brown Deer High SchoolMilwaukeeWI
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Blakely T, Ni Mhurchu C, Jiang Y, Matoe L, Funaki-Tahifote M, Eyles HC, Foster RH, McKenzie S, Rodgers A. Do effects of price discounts and nutrition education on food purchases vary by ethnicity, income and education? Results from a randomised, controlled trial. J Epidemiol Community Health 2011; 65:902-8. [DOI: 10.1136/jech.2010.118588] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [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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Rockstroh J, Eron J, Cooper D, Steigbigel R, Nguyen BY, Xu X, Wan H, Rodgers A, Miller M, Leavitt R, Sklar P, Teppler H. Analysis of BENCHMRK 1 & 2 using PhenoSense® assay for darunavir (DRV/r) resistance and exploration of functional monotherapy with RAL vs DRV. J Int AIDS Soc 2010. [PMCID: PMC3112906 DOI: 10.1186/1758-2652-13-s4-p130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Abstract
BACKGROUND Nutrition education may be most effective when personally tailored. Individualised electronic supermarket sales data offer opportunities to tailor nutrition education using shopper's usual food purchases. The present study aimed to use individualised electronic supermarket sales data to tailor nutrition resources for an ethnically diverse population in a large supermarket intervention trial in New Zealand. METHODS Culturally appropriate nutrition education resources (i.e. messages and shopping lists) were developed with the target population (through two sets of focus groups) and ethnic researchers. A nutrient database of supermarket products was developed using retrospective sales data and linked to participant sales to allow tailoring by usual food purchases. Modified Heart Foundation Tick criteria were used to identify 'healthier' products in the database suitable for promotion in the resources. Rules were developed to create a monthly report listing the tailored and culturally targeted messages to be sent to each participant, and to produce automated, tailored shopping lists. RESULTS Culturally targeted nutrition messages (n = 864) and shopping lists (n = 3 formats) were developed. The food and nutrient database (n = 3000 top-selling products) was created using 12 months of retrospective sales data, and comprised 60%'healthier' products. Three months of baseline sales data were used to determine usual food purchases. Tailored resources were successfully mailed to 123 Māori, 52 Pacific and 346 non-Māori non-Pacific participants over the 6-month trial intervention period. CONCLUSIONS Electronic supermarket sales data can be used to tailor nutrition education resources for a large number of ethnically diverse supermarket shoppers.
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Affiliation(s)
- H Eyles
- Clinical Trials Research Unit, School of Population Health, University of Auckland, Auckland, New Zealand.
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Andera‐Cato S, Arnold A, Bach S, Faught A, Frisch E, Her A, Keller A, Kennedy E, Martin T, McMurray D, Mitch C, Orozco C, Rice C, Roberts B, Rodgers A, Sauer A, Schulman A, Suggs A, Surfus K, Tucker S, Wray T, Vogt G, St. Maurice M. I'm a PC (Pyruvate Carboxylase)…and diabetes was not my idea! FASEB J 2010. [DOI: 10.1096/fasebj.24.1_supplement.lb116] [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: 11/11/2022]
Affiliation(s)
| | | | - S. Bach
- Brown Deer High SchoolBrown DeerWI
| | | | | | - A. Her
- Brown Deer High SchoolBrown DeerWI
| | | | | | | | | | - C. Mitch
- Brown Deer High SchoolBrown DeerWI
| | | | - C. Rice
- Brown Deer High SchoolBrown DeerWI
| | | | | | - A. Sauer
- Brown Deer High SchoolBrown DeerWI
| | | | - A. Suggs
- Brown Deer High SchoolBrown DeerWI
| | | | | | - T. Wray
- Brown Deer High SchoolBrown DeerWI
| | - G. Vogt
- Brown Deer High SchoolBrown DeerWI
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48
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Free C, Whittaker R, Knight R, Abramsky T, Rodgers A, Roberts IG. Txt2stop: a pilot randomised controlled trial of mobile phone-based smoking cessation support. Tob Control 2010; 18:88-91. [PMID: 19318534 DOI: 10.1136/tc.2008.026146] [Citation(s) in RCA: 141] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIM To conduct a pilot randomised controlled trial of mobile phone-based smoking cessation support intervention for the UK population. DESIGN Randomised controlled trial (txt2stop). SETTING Community. PARTICIPANTS 200 participants responding to radio, poster and leaflet-based promotions regarding the trial. MAIN OUTCOME MEASURES The response rate for the outcome measures planned for the main trial. Participants' qualitative responses to open-ended questions about the intervention content. Secondary outcomes were the outcomes planned for the main trial including the point prevalence of self-reported smoking at 4 weeks and pooled effect estimate for the short-term results for the STOMP and txt2stop trials. RESULTS The response rate at 4 weeks was 96% and at 6 months was 92%. The results at 4 weeks show a doubling of self-reported quitting relative risk (RR) 2.08 (95% CI 1.11 to 3.89), 26% vs 12%. The pooled effect estimate combining txt2stop and a previous New Zealand trial in the short term is RR 2.18 (95% CI 1.79 to 2.65). CONCLUSIONS Mobile phone-based smoking cessation is an innovative means of delivering smoking cessation support, which doubles the self-reported quit rate in the short term. It could represent an important, but as yet largely unused, medium to deliver age-appropriate public health measures. The long-term effect of this mobile phone-based smoking cessation support will be established by a large randomised controlled trial currently in recruitment.
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Affiliation(s)
- C Free
- Nutrition and Public Health Intervention Research Unit, Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London WC1E7HT, UK.
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Ho TW, Fan X, Rodgers A, Lines CR, Winner P, Shapiro RE. Age Effects on Placebo Response Rates in Clinical Trials of Acute Agents for Migraine: Pooled Analysis of Rizatriptan Trials in Adults. Cephalalgia 2009; 29:711-8. [DOI: 10.1111/j.1468-2982.2008.01788.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This study examined the effect of age on placebo response rates in rizatriptan trials in adults. Data from eight rizatriptan adult trials involving patients treating moderate/severe migraine attacks with rizatriptan 5 mg ( N = 1819), rizatriptan 10 mg ( N = 2046) or placebo ( N = 1322) were pooled for post hoc analysis. Logistic regression was used to model 2-h pain relief (reduction to mild or none) and 2-h pain freedom rates by treatment groups. Older patients had lower placebo response rates than younger patients; the estimated odds ratio (older vs. younger) for a 10-year age increase was 0.83 for pain relief [95% confidence interval (CI) 0.75, 0.93] and 0.81 for pain freedom (95% CI 0.68, 0.97). The response proportion vs. age trend was flat for rizatriptan 5 mg and slightly increased for rizatriptan 10 mg. The treatment-by-age interaction was significant for pain relief ( P < 0.001) and pain freedom ( P = 0.001), suggesting an increasing trend of treatment advantage of rizatriptan over placebo as age increased. Age appeared to be an important predictor of placebo response rate in rizatriptan trials, with older patients being less likely to respond to placebo and more likely to respond to rizatriptan.
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Affiliation(s)
- TW Ho
- Merck Research Laboratories, North Wales, PA
| | - X Fan
- Merck Research Laboratories, North Wales, PA
| | - A Rodgers
- Merck Research Laboratories, North Wales, PA
| | - CR Lines
- Merck Research Laboratories, North Wales, PA
| | - P Winner
- Palm Beach Headache Center, West Palm Beach, FL
| | - RE Shapiro
- University of Vermont College of Medicine, Burlington, VT, USA
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50
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Rodgers A, Bungane N, Allie-Hamdulay S, Lewandowski S, Webber D. Calciuria, oxaluria and phosphaturia after ingestion of glucose, xylitol and sorbitol in two population groups with different stone-risk profiles. ACTA ACUST UNITED AC 2009; 37:121-5. [DOI: 10.1007/s00240-009-0184-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2008] [Accepted: 02/19/2009] [Indexed: 11/29/2022]
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