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Huang DQ, Chan KE, Tan C, Zeng RW, Koh B, Ong EYH, Ong CCH, Ong CEY, Tan DJH, Lim WH, Cho E, Tan EXX, Teng MLP, Ng CH, Nah B, Lim MC, Muthiah M, Clark VC, Loomba R. Meta-analysis: Prevalence of significant or advanced fibrosis in adults with alpha-1-antitrypsin deficiency. Aliment Pharmacol Ther 2023; 58:152-158. [PMID: 37089038 PMCID: PMC10330074 DOI: 10.1111/apt.17516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/19/2023] [Accepted: 04/02/2023] [Indexed: 04/25/2023]
Abstract
BACKGROUND The prevalence of liver fibrosis detected by non-invasive imaging in alpha-1-antitrypsin (AAT) deficiency has not been systematically assessed. AIMS We conducted a systematic review and meta-analysis to determine the prevalence of significant fibrosis and advanced fibrosis in AAT deficiency based on non-invasive imaging. METHODS Medline and Embase electronic databases were searched for studies from inception to 13 November 2022 that provided data for the prevalence of fibrosis in adults with AAT deficiency. A generalised linear mixed model with Clopper-Pearson intervals was used to pool single-arm outcomes. RESULTS Of the 214 records identified, 8 studies were included. Five studies assessed fibrosis using vibration-controlled transient elastography. The prevalence of significant fibrosis (defined as ≥7.1 kPA) in Z homozygosity, Z heterozygosity and non-carrier status was 22.10% (five studies, 95% CI: 17.07-28.12), 9.24% (three studies, 95% CI: 4.68-17.45) and 5.38% (one study, 95% CI: 3.27-8.73), respectively, p < 0.0001, and the prevalence of advanced fibrosis (defined as ≥9.5 kPa) was 8.13% (five studies, 95% CI: 4.60-13.96), 2.96% (three studies, 95% CI: 1.49-5.81) and 1.08% (one study, 95% CI: 0.35-3.28), respectively, p = 0.003. There were limited data regarding the use of magnetic resonance elastography or acoustic radiation force impulse to assess for fibrosis. CONCLUSION More than one in five adult individuals with AAT deficiency and Z homozygosity harbour significant fibrosis, and nearly 1 in 10 harbours advanced fibrosis. The risk of fibrosis increases incrementally with the frequency of Pi*Z mutations.
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Affiliation(s)
- Daniel Q Huang
- NAFLD Research Center, Division of Gastroenterology. University of California at San Diego, La Jolla, CA, United States
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore
| | - Kai En Chan
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Caitlyn Tan
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Rebecca Wenling Zeng
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Benjamin Koh
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Elden Yen Hng Ong
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Charlotte Chung Hui Ong
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Christen En Ya Ong
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Darren JH Tan
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Wen Hui Lim
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Elina Cho
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore
| | - Eunice XX Tan
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore
| | - Margaret LP Teng
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore
| | - Cheng Han Ng
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Benjamin Nah
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Mei Chin Lim
- Department of Diagnostic Imaging, National University Health System, Singapore
| | - Mark Muthiah
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore
| | - Virginia C Clark
- Division of Gastroenterology, Hepatology, and Nutrition, University of Florida, United States
| | - Rohit Loomba
- NAFLD Research Center, Division of Gastroenterology. University of California at San Diego, La Jolla, CA, United States
- Division of Epidemiology, Department of Family Medicine and Public Health, University of California at San Diego, San Diego, CA, United States
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Lee A, Patterson KA, Tan DJ, Wilson ME, Proudman SM, Stevens W, Nikpour M, Sahhar J, Ngian GS, Roddy J, Roberts-Thomson PJ, Walker JG. Anti-Ro52/TRIM21 is independently associated with pulmonary arterial hypertension and mortality in a cohort of systemic sclerosis patients. Scand J Rheumatol 2021; 50:469-474. [PMID: 33851896 DOI: 10.1080/03009742.2021.1887927] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objective: We undertook a comprehensive cross-sectional analysis of a multicentred Australian cohort of systemic sclerosis (SSc) patients to evaluate the associations of anti-Ro52/TRIM21 with SSc pulmonary involvement.Method: The study included 596 patients from the Australian Scleroderma Cohort Study database whose anti-Ro52/TRIM21 status was known. Anti-Ro52/TRIM21 was measured via line immunoassay. Data on demographic variables, autoantibody profiles, presence of interstitial lung disease (ILD), presence of pulmonary arterial hypertension (PAH), oxygen saturation, Six-Minute Walk Test distance, Borg dyspnoea score, and lung function tests were extracted. SPSS software was used to examine associations using univariate and multivariate analyses.Results: Anti-Ro52/TRIM21 was present in 34.4% of SSc patients. In the cross-sectional analysis, anti-Ro52/TRIM21 was independently associated with PAH [odds ratio 1.75, 95% confidence interval (CI) 1.05-2.90], but not ILD or other surrogate measures of pulmonary involvement such as average patient oxygen saturation. The antibody, however, was also associated with a higher forced vital capacity/diffusing capacity of the lung for carbon monoxide ratio. Prospectively, anti-Ro52/TRIM21 was also associated with an increased risk of death in patients with SSc (hazard ratio 1.62, 95% CI 1.11-2.35), independent of confounding factors. The primary cause of death appeared to be related to PAH and/or ILD, and anti-Ro52/TRIM21 was associated with PAH-related complications.Conclusion: Anti-Ro52/TRIM21 was independently associated with PAH and mortality in SSc patients. Future longitudinal studies are recommended to investigate the timing and pathogenic mechanisms of this autoantibody in PAH.
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Affiliation(s)
- Ays Lee
- Departments of Rheumatology and Immunology, Flinders Medical Centre, Bedford Park, Australia.,College of Medicine and Public Health, Flinders University, Bedford Park, Australia.,Department of Immunology, SA Pathology, Flinders Medical Centre, Bedford Park, Australia
| | - K A Patterson
- College of Medicine and Public Health, Flinders University, Bedford Park, Australia
| | - D J Tan
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - M E Wilson
- Department of Rheumatology, St Vincent's Hospital (Melbourne), Fitzroy, Australia
| | - S M Proudman
- Rheumatology Unit, Royal Adelaide Hospital, Adelaide, Australia.,Discipline of Medicine, University of Adelaide, Adelaide, Australia
| | - W Stevens
- Department of Rheumatology, St Vincent's Hospital (Melbourne), Fitzroy, Australia
| | - M Nikpour
- Department of Rheumatology, St Vincent's Hospital (Melbourne), Fitzroy, Australia.,Department of Medicine, The University of Melbourne, Fitzroy, Australia
| | - J Sahhar
- Department of Rheumatology, Monash Health, Clayton, Australia.,Department of Medicine, Monash University, Clayton, Australia
| | - G-S Ngian
- Department of Rheumatology, Monash Health, Clayton, Australia.,Department of Medicine, Monash University, Clayton, Australia
| | - J Roddy
- Department of Rheumatology, Fiona Stanley Hospital, Murdoch, Australia
| | - P J Roberts-Thomson
- Departments of Rheumatology and Immunology, Flinders Medical Centre, Bedford Park, Australia.,College of Medicine and Public Health, Flinders University, Bedford Park, Australia.,Department of Immunology, SA Pathology, Flinders Medical Centre, Bedford Park, Australia
| | - J G Walker
- Departments of Rheumatology and Immunology, Flinders Medical Centre, Bedford Park, Australia.,College of Medicine and Public Health, Flinders University, Bedford Park, Australia
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Bowatte G, Tham R, Allen KJ, Tan DJ, Lau MXZ, Dai X, Lodge CJ. Breastfeeding and childhood acute otitis media: a systematic review and meta-analysis. Acta Paediatr 2015; 104:85-95. [PMID: 26265016 DOI: 10.1111/apa.13151] [Citation(s) in RCA: 157] [Impact Index Per Article: 17.4] [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: 05/13/2015] [Revised: 07/03/2015] [Accepted: 08/05/2015] [Indexed: 12/28/2022]
Abstract
AIM To synthesise the evidence on the association between duration and exclusivity of breastfeeding and the risk of acute otitis media (AOM). METHODS Systematic review and meta-analysis following searching of PubMed, CINAHL and EMBASE electronic databases. RESULTS Twenty-four studies, all from the USA or Europe, met the inclusion criteria. In the pooled analyses, any form of breastfeeding was found to be protective for AOM in the first 2 years of life. Exclusive breastfeeding for the first 6 months was associated with the greatest protection (OR 0.57 95% CI 0.44, 0.75), followed by 'more vs less' breastfeeding (OR 0.67; 0.59, 0.76) and 'ever vs never' breastfeeding (OR 0.67; 0.56, 0.80). CONCLUSION This systematic review and meta-analysis provides evidence that breastfeeding protects against AOM until 2 years of age, but protection is greater for exclusive breastfeeding and breastfeeding of longer duration. Exclusive breastfeeding during the first 6 months was associated with around a 43% reduction in ever having AOM in the first 2 years of life. After 2 years of age, there is no evidence that breastfeeding protects against AOM; however, there were few studies and the evidence quality was low.
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Affiliation(s)
- G Bowatte
- Allergy and Lung Health Unit; Centre of Epidemiology and Biostatistics; School of Population and Global Health; The University of Melbourne; Carlton Vic. Australia
| | - R Tham
- Allergy and Lung Health Unit; Centre of Epidemiology and Biostatistics; School of Population and Global Health; The University of Melbourne; Carlton Vic. Australia
| | - KJ Allen
- Murdoch Childrens Research Institute and University of Melbourne Department of Paediatrics; Royal Children's Hospital; Parkville Vic. Australia
- Institute of Inflammation and Repair; University of Manchester; Manchester UK
| | - DJ Tan
- Allergy and Lung Health Unit; Centre of Epidemiology and Biostatistics; School of Population and Global Health; The University of Melbourne; Carlton Vic. Australia
- NHMRC Centre of Research Excellence for Chronic Respiratory Disease; School of Medicine; University of Tasmania; Hobart TAS Australia
| | - MXZ Lau
- Allergy and Lung Health Unit; Centre of Epidemiology and Biostatistics; School of Population and Global Health; The University of Melbourne; Carlton Vic. Australia
| | - X Dai
- Allergy and Lung Health Unit; Centre of Epidemiology and Biostatistics; School of Population and Global Health; The University of Melbourne; Carlton Vic. Australia
| | - CJ Lodge
- Allergy and Lung Health Unit; Centre of Epidemiology and Biostatistics; School of Population and Global Health; The University of Melbourne; Carlton Vic. Australia
- Murdoch Childrens Research Institute and University of Melbourne Department of Paediatrics; Royal Children's Hospital; Parkville Vic. Australia
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Lodge CJ, Tan DJ, Lau MXZ, Dai X, Tham R, Lowe AJ, Bowatte G, Allen KJ, Dharmage SC. Breastfeeding and asthma and allergies: a systematic review and meta-analysis. Acta Paediatr 2015; 104:38-53. [PMID: 26192405 DOI: 10.1111/apa.13132] [Citation(s) in RCA: 315] [Impact Index Per Article: 35.0] [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: 05/13/2015] [Revised: 06/29/2015] [Accepted: 07/14/2015] [Indexed: 02/06/2023]
Abstract
AIM To systematically review the association between breastfeeding and childhood allergic disease. METHODS Predetermined inclusion/exclusion criteria identified 89 articles from PubMed, CINAHL and EMBASE databases. Meta-analyses performed for categories of breastfeeding and allergic outcomes. Meta-regression explored heterogeneity. RESULTS More vs. less breastfeeding (duration) was associated with reduced risk of asthma for children (5-18 years), particularly in medium-/low-income countries and with reduced risk of allergic rhinitis ≤5 years, but this estimate had high heterogeneity and low quality. Exclusive breastfeeding for 3-4 months was associated with reduced risk of eczema ≤2 years (estimate principally from cross-sectional studies of low methodological quality). No association found between breastfeeding and food allergy (estimate had high heterogeneity and low quality). Meta-regression found differences between study outcomes may be attributable to length of breastfeeding recall, study design, country income and date of study inception. Some of the protective effect of breastfeeding for asthma may be related to recall bias in studies of lesser methodological quality. CONCLUSION There is some evidence that breastfeeding is protective for asthma (5-18 years). There is weaker evidence for a protective effect for eczema ≤2 years and allergic rhinitis ≤5 years of age, with greater protection for asthma and eczema in low-income countries.
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Affiliation(s)
- CJ Lodge
- Allergy and Lung Health Unit; Centre for Epidemiology and Biostatistics; Melbourne School of Population and Global Health; The University of Melbourne; Carlton Victoria Australia
- Murdoch Childrens Research Institute and University of Melbourne Department of Paediatrics; Royal Children's Hospital; Parkville Victoria Australia
| | - DJ Tan
- Allergy and Lung Health Unit; Centre for Epidemiology and Biostatistics; Melbourne School of Population and Global Health; The University of Melbourne; Carlton Victoria Australia
- NHMRC Centre of Research Excellence for Chronic Respiratory Disease; School of Medicine; University of Tasmania; Hobart Tasmania Australia
| | - MXZ Lau
- Allergy and Lung Health Unit; Centre for Epidemiology and Biostatistics; Melbourne School of Population and Global Health; The University of Melbourne; Carlton Victoria Australia
| | - X Dai
- Allergy and Lung Health Unit; Centre for Epidemiology and Biostatistics; Melbourne School of Population and Global Health; The University of Melbourne; Carlton Victoria Australia
| | - R Tham
- Allergy and Lung Health Unit; Centre for Epidemiology and Biostatistics; Melbourne School of Population and Global Health; The University of Melbourne; Carlton Victoria Australia
| | - AJ Lowe
- Allergy and Lung Health Unit; Centre for Epidemiology and Biostatistics; Melbourne School of Population and Global Health; The University of Melbourne; Carlton Victoria Australia
- Murdoch Childrens Research Institute and University of Melbourne Department of Paediatrics; Royal Children's Hospital; Parkville Victoria Australia
| | - G Bowatte
- Allergy and Lung Health Unit; Centre for Epidemiology and Biostatistics; Melbourne School of Population and Global Health; The University of Melbourne; Carlton Victoria Australia
| | - KJ Allen
- Murdoch Childrens Research Institute and University of Melbourne Department of Paediatrics; Royal Children's Hospital; Parkville Victoria Australia
- Institute of Inflammation and Repair; University of Manchester; UK
| | - SC Dharmage
- Allergy and Lung Health Unit; Centre for Epidemiology and Biostatistics; Melbourne School of Population and Global Health; The University of Melbourne; Carlton Victoria Australia
- Murdoch Childrens Research Institute and University of Melbourne Department of Paediatrics; Royal Children's Hospital; Parkville Victoria Australia
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Abstract
AIM To synthesise the current evidence for the associations between breastfeeding and dental caries, with respect to specific windows of early childhood caries risk. METHODS Systematic review, meta-analyses and narrative synthesis following searches of PubMed, CINAHL and EMBASE databases. RESULTS Sixty-three papers included. Children exposed to longer versus shorter duration of breastfeeding up to age 12 months (more versus less breastfeeding), had a reduced risk of caries (OR 0.50; 95%CI 0.25, 0.99, I(2) 86.8%). Children breastfed >12 months had an increased risk of caries when compared with children breastfed <12 months (seven studies (OR 1.99; 1.35, 2.95, I(2) 69.3%). Amongst children breastfed >12 months, those fed nocturnally or more frequently had a further increased caries risk (five studies, OR 7.14; 3.14, 16.23, I(2) 77.1%). There was a lack of studies on children aged >12 months simultaneously assessing caries risk in breastfed, bottle-fed and children not bottle or breastfed, alongside specific breastfeeding practices, consuming sweet drinks and foods, and oral hygiene practices limiting our ability to tease out the risks attributable to each. CONCLUSION Breastfeeding in infancy may protect against dental caries. Further research needed to understand the increased risk of caries in children breastfed after 12 months.
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Affiliation(s)
- R Tham
- Allergy and Lung Health Unit; Centre for Epidemiology and Biostatistics; Melbourne School of Population and Global Health; The University of Melbourne; Carlton Vic. Australia
| | - G Bowatte
- Allergy and Lung Health Unit; Centre for Epidemiology and Biostatistics; Melbourne School of Population and Global Health; The University of Melbourne; Carlton Vic. Australia
| | - SC Dharmage
- Allergy and Lung Health Unit; Centre for Epidemiology and Biostatistics; Melbourne School of Population and Global Health; The University of Melbourne; Carlton Vic. Australia
- Murdoch Childrens Research Institute and University of Melbourne Department of Paediatrics, Royal Children's Hospital; Parkville Vic. Australia
| | - DJ Tan
- Allergy and Lung Health Unit; Centre for Epidemiology and Biostatistics; Melbourne School of Population and Global Health; The University of Melbourne; Carlton Vic. Australia
- NHMRC Centre of Research Excellence for Chronic Respiratory Disease; School of Medicine; University of Tasmania; Hobart TAS Australia
| | - MXZ Lau
- Allergy and Lung Health Unit; Centre for Epidemiology and Biostatistics; Melbourne School of Population and Global Health; The University of Melbourne; Carlton Vic. Australia
| | - X Dai
- Allergy and Lung Health Unit; Centre for Epidemiology and Biostatistics; Melbourne School of Population and Global Health; The University of Melbourne; Carlton Vic. Australia
| | - KJ Allen
- Murdoch Childrens Research Institute and University of Melbourne Department of Paediatrics, Royal Children's Hospital; Parkville Vic. Australia
- Institute of Inflammation and Repair; University of Manchester; UK
| | - CJ Lodge
- Allergy and Lung Health Unit; Centre for Epidemiology and Biostatistics; Melbourne School of Population and Global Health; The University of Melbourne; Carlton Vic. Australia
- Murdoch Childrens Research Institute and University of Melbourne Department of Paediatrics, Royal Children's Hospital; Parkville Vic. Australia
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Yuan HN, Tan DJ, Zhang SC, Li SZ, Gao XC. [A review of the literature concerning the adverse effects of Chinese herbal drugs published in major medical and pharmaceutical periodicals in China in 1992]. Zhongguo Zhong Yao Za Zhi 1993; 18:643-7, 674. [PMID: 8003223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Zhang SC, Li SZ, Gao XC, Qian LH, Yang MZ, Yuan HN, Tan DJ. [The adverse effects of the preparations of the active principles of Chinese herbal drugs]. Zhongguo Zhong Yao Za Zhi 1993; 18:387-91. [PMID: 8267848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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