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Djekic D, Carlsson F, Landberg R, Sarnqvist C, Cao Y, Tremaroli V, Backhed F, Frobert O. P6208VEgetaRian Diet in patients with Ischemic heart disease (VERDI): an open-label, randomized, prospective, cross-over study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0813] [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: 11/13/2022] Open
Abstract
Abstract
Background
A vegetarian diet (VD) in patients diagnosed with ischemic heart disease (IHD) may reduce future cardiovascular risk.
Purpose
The study hypothesis was that patients diagnosed with IHD can benefit from a VD assessed by multiple risk markers for this type of disease.
Methods
In a crossover study patients diagnosed with IHD, treated by percutaneous coronary intervention and on optimal medical therapy were randomly allocated to a 4-week intervention with ready-made (lunch and dinner) isocaloric VD or meat diet (MD). The primary outcome was change in oxidized low-density lipoprotein cholesterol (LDL-C) levels. Secondary outcomes were difference in changes of blood lipids, weight, body mass index (BMI), blood pressure, heart rate, glycated haemoglobin (HbA1c), number of participants reaching guideline target values, quality of life, gut microbiota, and trimethylamine N-oxide between the two interventions.
Results
31 participants were recruited (median age: 67 years, male sex: 93.5%). Significant between-intervention differences (VD vs MD) were found in oxidized LDL-C (−2.73 U/L; p=0.015), total cholesterol (TC) (−0.13 mmol/L, p=0.01), LDL-C (−0.10 mmol/L; p=0.02), weight (−0.67 kg, p=0.008) and BMI (−0.21 kg/m2, p=0.009). After VD, numerically more subjects reached guideline LDL-C target values (87% vs 77%) but this did not reach statistical significance (p=0.07). During VD intervention the diet led to a significant reduction in oxidized LDL-C, TC, LDL-C, HDL-C, ApoB, and ApoB/ApoA1 ratio.
Conclusions
Our results suggest that in patients with IHD a VD compared to a MD, lowers oxidative stress, improves lipid profile and lowers BMI.
Acknowledgement/Funding
This study is partially funded by ALF and the Swedish Heart and Lung Foundation.
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Affiliation(s)
- D Djekic
- Orebro University Hospital, Orebro University, Department of Cardiology, Orebro, Sweden
| | - F Carlsson
- Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - R Landberg
- Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - C Sarnqvist
- Orebro University Hospital, Orebro University, Department of Cardiology, Orebro, Sweden
| | - Y Cao
- Karolinska Institute, Unit of Biostatistics, Institute of Environmental Medicine, Stockholm, Sweden
| | - V Tremaroli
- Sahlgrenska Academy, Department of Molecular and Clinical Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - F Backhed
- Sahlgrenska Academy, Department of Molecular and Clinical Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - O Frobert
- Orebro University Hospital, Orebro University, Department of Cardiology, Orebro, Sweden
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Levin M, Davies AM, Liljekvist M, Carlsson F, Gould HJ, Sutton BJ, Ohlin M. Human IgE against the major allergen Bet v 1--defining an epitope with limited cross-reactivity between different PR-10 family proteins. Clin Exp Allergy 2014; 44:288-99. [PMID: 24447087 PMCID: PMC4215112 DOI: 10.1111/cea.12230] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 09/24/2013] [Accepted: 10/25/2013] [Indexed: 02/05/2023]
Abstract
Background The interaction between IgE and allergen is a key event at the initiation of an allergic response, and its characteristics have substantial effects on the clinical manifestation. Despite this, the molecular details of the interaction between human IgE and the major birch allergen Bet v 1, one of the most potent tree allergens, still remain poorly investigated. Objective To isolate Bet v 1-specific human monoclonal IgE and characterize their interaction with the allergen. Methods Recombinant human IgE were isolated from a combinatorial antibody fragment library and their interaction with Bet v 1 assessed using various immunological assays. The structure of one such IgE in the single-chain fragment variable format was determined using X-ray crystallography. Results We present four novel Bet v 1-specific IgE, for one of which we solve the structure, all with their genetic origin in the IGHV5 germline gene, and demonstrate that they target two non-overlapping epitopes on the surface of Bet v 1, thereby fulfilling the basic criteria for FcεRI cross-linkage. We further define these epitopes and for one epitope pinpoint single amino acid residues important for the interaction with human IgE. This provides a potential explanation, at the molecular level, for the differences in recognition of isoforms of Bet v 1 and other allergens in the PR-10 protein family displayed by IgE targeting this epitope. Finally, we present the first high-resolution structure of a human allergen-specific IgE fragment in the single-chain fragment variable (scFv) format. Conclusions and Clinical Relevance We here display the usefulness of allergen-specific human monoclonal IgE as a tool in studies of the crucial molecular interaction taking place at the initiation of an allergic response. Such studies may aid us in development of better diagnostic tools and guide us in the development of new therapeutic compounds.
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Affiliation(s)
- M Levin
- Department of Immunotechnology, Lund University, Lund, Sweden
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Brunkwall J, Kasprzak P, Verhoeven E, Heijmen R, Taylor P, Alric P, Canaud L, Janotta M, Raithel D, Malina W, Resch T, Eckstein HH, Ockert S, Larzon T, Carlsson F, Schumacher H, Classen S, Schaub P, Lammer J, Lönn L, Clough RE, Rampoldi V, Trimarchi S, Fabiani JN, Böckler D, Kotelis D, Böckler D, Kotelis D, von Tenng-Kobligk H, Mangialardi N, Ronchey S, Dialetto G, Matoussevitch V. Endovascular repair of acute uncomplicated aortic type B dissection promotes aortic remodelling: 1 year results of the ADSORB trial. Eur J Vasc Endovasc Surg 2014; 48:285-91. [PMID: 24962744 DOI: 10.1016/j.ejvs.2014.05.012] [Citation(s) in RCA: 250] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Accepted: 05/12/2014] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Uncomplicated acute type B aortic dissection (AD) treated conservatively has a 10% 30-day mortality and up to 25% need intervention within 4 years. In complicated AD, stent grafts have been encouraging. The aim of the present prospective randomised trial was to compare best medical treatment (BMT) with BMT and Gore TAG stent graft in patients with uncomplicated AD. The primary endpoint was a combination of incomplete/no false lumen thrombosis, aortic dilatation, or aortic rupture at 1 year. METHODS The AD history had to be less than 14 days, and exclusion criteria were rupture, impending rupture, malperfusion. Of the 61 patients randomised, 80% were DeBakey type IIIB. RESULTS Thirty-one patients were randomised to the BMT group and 30 to the BMT+TAG group. Mean age was 63 years for both groups. The left subclavian artery was completely covered in 47% and in part in 17% of the cases. During the first 30 days, no deaths occurred in either group, but there were three crossovers from the BMT to the BMT+TAG group, all due to progression of disease within 1 week. There were two withdrawals from the BMT+TAG group. At the 1-year follow up there had been another two failures in the BMT group: one malperfusion and one aneurysm formation (p = .056 for all). One death occurred in the BMT+TAG group. For the overall endpoint BMT+TAG was significantly different from BMT only (p < .001). Incomplete false lumen thrombosis, was found in 13 (43%) of the TAG+BMT group and 30 (97%) of the BMT group (p < .001). The false lumen reduced in size in the BMT+TAG group (p < .001) whereas in the BMT group it increased. The true lumen increased in the BMT+TAG (p < .001) whereas in the BMT group it remained unchanged. The overall transverse diameter was the same at the beginning and after 1 year in the BMT group (42.1 mm), but in the BMT+TAG it decreased (38.8 mm; p = .062). CONCLUSIONS Uncomplicated AD can be safely treated with the Gore TAG device. Remodelling with thrombosis of the false lumen and reduction of its diameter is induced by the stent graft, but long term results are needed.
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Affiliation(s)
- J Brunkwall
- Department of Vascular and Endovascular Surgery, University Clinics, University of Cologne, Cologne, Germany.
| | - P Kasprzak
- Section of Vascular Surgery, Department of Surgery, University of Regensburg, Department of Vascular Surgery, Klinikum Nuernberg, Nuremberg, Germany
| | - E Verhoeven
- Department of Cardiovasc Surgery Antonius Hospital, Nieuwegein, The Netherlands
| | - R Heijmen
- Department of Vascular Surgery, St Guys Hospital, London, UK
| | - P Taylor
- Department of Vascular Surgery, St Guys Hospital, London, UK
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Carlsson F, Getahun A, Rutemark C, Heyman B. Impaired Antibody Responses but Normal Proliferation of Specific CD4+T Cells in Mice Lacking Complement Receptors 1 and 2. Scand J Immunol 2009; 70:77-84. [DOI: 10.1111/j.1365-3083.2009.02274.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Craft D, Carlsson F, Bortfeld T, Rehbinder H. SU-GG-T-527: Multi-Objective IMRT Planning Which Produces Deliverable Plans. Med Phys 2008. [DOI: 10.1118/1.2962276] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Abstract
IgE administered with its specific antigen in vivo induces enhanced proliferation of specific T cells as well as enhanced production of specific antibodies. Both effects are dependent on the low-affinity receptor for IgE (CD23) and the underlying mechanism is thought to be increased antigen presentation following uptake of IgE/antigen complexes via CD23(+) B cells. By contrast, CD23 negatively regulates antibody responses to antigens administered with alum, i.e. without IgE. This effect has been observed as low IgG1 and IgE responses in transgenic mice overexpressing CD23 (CD23Tg). The present study was designed to test whether IgE could enhance antibody and T-cell responses in CD23Tg animals or whether CD23's downregulatory effect precludes IgE-mediated enhancement. IgE-anti-TNP administered with OVA-TNP enhances the OVA-specific antibody responses in wild-type (wt) and CD23Tg mice equally well. Interestingly, the total magnitude of antibody responses to IgE + OVA-TNP and to uncomplexed OVA-TNP, as well as to sheep erythrocytes and keyhole limpet haemocyanine, were lower in the CD23Tg mice. IgE induced proliferation of OVA-specific CD4(+) T cells to the same degree in wt and CD23Tg mice. The effect on T cells was dependent on CD23(+) B cells as demonstrated in in vitro proliferation assays. In conclusion, CD23 does indeed have dual immunoregulatory effects in the same animal. The receptor mediates enhancement of antibody and T-cell responses to IgE-complexed antigen, most likely via increased presentation of complexed antigen, while it negatively regulates the total antibody response to a variety of antigens.
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Affiliation(s)
- F Carlsson
- Department of Genetics and Pathology, Uppsala University, Uppsala, Sweden
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Abstract
Antibodies administered in vivo together with the antigen they are specific for can regulate the immune response to that antigen. This phenomenon is called antibody-mediated feedback regulation and has been known for over 100 years. Both passively administered and actively produced antibodies exert immunoregulatory functions. Feedback regulation can be either positive or negative, resulting in >1000-fold enhancement or >99% suppression of the specific antibody response. Usually, the response to the entire antigen is up- or downregulated, regardless of which epitope the regulating antibody recognizes. IgG of all isotypes can suppress responses to large particulate antigens like erythrocytes, a phenomenon used clinically in Rhesus prophylaxis. IgG suppression works in mice lacking the known Fc-gamma receptors (FcgammaR) and a likely mechanism of action is epitope masking. IgG1, IgG2a and IgG2b administered together with soluble protein antigens will enhance antibody and CD4+ T-cell responses via activating FcgammaR, probably via increased antigen presentation by dendritic cells. IgG3 as well as IgM also enhance antibody responses but their effects are dependent on their ability to activate complement. A possible mechanism is increased B-cell activation caused by immune complexes co-crosslinking the B-cell receptor with the complement-receptor 2/CD19 receptor complex, known to lower the threshold for B-cell activation. IgE-antibodies enhance antibody and CD4+ T-cell responses to small soluble proteins. This effect is entirely dependent on the low-affinity receptor for IgE, CD23, the mechanism probably being increased antigen presentation by CD23+ B cells.
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Affiliation(s)
- F Hjelm
- Department of Genetics and Pathology, Uppsala University, SE-751 85 Uppsala, Sweden
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Gustavsson P, Schoumans J, Staaf J, Jönsson G, Carlsson F, Kristoffersson U, Borg A, Nordenskjöld M, Dahl N. Hemizygosity for chromosome 2q14.2-q22.1 spanning the GLI2 and PROC genes associated with growth hormone deficiency, polydactyly, deep vein thrombosis and urogenital abnormalities. Clin Genet 2006; 69:441-3. [PMID: 16650085 DOI: 10.1111/j.1399-0004.2006.00601.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Antibodies, administered together with their specific antigen, can feedback-regulate antibody responses to this antigen. IgG1, IgG2a and IgG2b enhance antibody responses to soluble protein antigens. This effect is primarily mediated by FcRs as enhancement is impaired in FcR gamma-/- mice, reported to lack Fc gammaRI and Fc gammaRIII because of deletion of the common FcR gamma chain. Also IgG3 can enhance antibody responses. However, this effect is unperturbed in FcR gamma-/- mice but severely impaired in complement-depleted animals and in animals lacking complement receptor 1 and 2. Although this argues against involvement of Fc gammaRs, FcR gamma-/- mice may express one-fifth of the normal levels of Fc gammaRI and, in addition, Fc gammaRI has been suggested to bind IgG3. We re-investigated the dependence of IgG3-mediated enhancement on Fc gammaRs using a mouse strain selectively lacking Fc gammaRI and found that IgG3-mediated enhancement is completely normal. Unlike IgE and IgG2a, which are both thought to enhance T-cell proliferation via FcR-mediated antigen presentation, IgG3 was a poor enhancer of T-cell proliferation both in vivo and in vitro. These findings argue against a significant involvement of Fc gammaRs in IgG3-mediated enhancement of antibody responses and support our previous conclusion that complement plays a major role.
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Affiliation(s)
- F Hjelm
- Department of Genetics and Pathology, Uppsala University, Uppsala, Sweden
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Carlsson F, Karlson B, Ørbaek P, Osterberg K, Ostergren PO. Prevalence of annoyance attributed to electrical equipment and smells in a Swedish population, and relationship with subjective health and daily functioning. Public Health 2005; 119:568-77. [PMID: 15925670 DOI: 10.1016/j.puhe.2004.07.011] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2003] [Revised: 07/05/2004] [Accepted: 07/29/2004] [Indexed: 10/25/2022]
Abstract
BACKGROUND Self-reported annoyance from electrical equipment has been in evidence since the mid-1980s, and the first reports of illness from everyday chemicals arose in the 1960s. However, the extent of the problem has not yet been fully established. AIMS The aim of this study was to estimate the prevalence of annoyance related to electrical and chemical factors in a Swedish general population, and to assess possible relationships with subjective health and daily functioning. METHODS In total, 13,604 subjects, representative of the population of Scania, Sweden, answered a survey containing five questions regarding annoyance from five environmental factors: fluorescent tube lighting, visual display units, other electrical equipment, air that smells of chemicals, and other smells. The survey also obtained data on self-reported health (SRH-7), mental well-being [General Health Questionnaire (GHQ)-12], work situation and daily functioning. RESULTS Almost one-third of the respondents reported annoyance from at least one environmental factor. Annoyance was more frequent among women, subjects of working age and immigrants. Subjects who reported environmental annoyance scored higher on GHQ-12 and lower on SRH-7, indicating impaired subjective physical and mental well-being. They were also more likely to report deteriorated daily functioning. CONCLUSIONS Annoyance related to electrical and/or chemical factors was common in a Swedish population. Subjects reporting environmental annoyance rated their overall health significantly poorer than the general population. The association with subjective health and functional capacity increased with severity of annoyance, which suggests that there is some connection between environmental annoyance, well-being and functional capacity.
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Affiliation(s)
- F Carlsson
- Department of Occupational and Environmental Medicine, Lund University Hospital, Lund University, Bamgatan 2, Lund, Sweden.
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Carlsson F, Forsgren A. WE-D-T-6E-08: Iterative Regularization of the IMRT Optimization Problem. Med Phys 2005. [DOI: 10.1118/1.1998577] [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: 11/07/2022] Open
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Carlsson F, Elofsson U, Arnebrant T, Malmsten M. Interactions between Local Anaesthetic Agents and Poly(N-isopropyl acrylamide) through Phase Behavior, Surface Tension, and Adsorption Measurement. J Colloid Interface Sci 2001; 233:320-328. [PMID: 11121282 DOI: 10.1006/jcis.2000.7253] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The interaction between the local anaesthetic agents prilocaine and lidocaine, on one hand, and poly(N-isopropyl acrylamide) (pNIPAM), on the other, is investigated through studies of the polymer phase behavior and through surface tension and adsorption measurements. In particular, the cloud points (CP) for pNIPAM in the presence of lidocaine and prilocaine under different conditions were compared to the effects of electrolytes and alcohols. It was found that the electrolytes affect the CP of pNIPAM in a lyotropic manner, whereas alcohols depress the CP of pNIPAM in an alkyl chain length dependent way; i.e., the longer the chain, the larger the decrease in CP. Lidocaine and prilocaine affect the CP of pNIPAM in a pH-dependent manner. Below the pK(a) of lidocaine and prilocaine, these cosolutes do not substantially affect the CP in the concentration range investigated, but rather behave analogous to simpler electrolytes. Above the pK(a), on the other hand, they strongly depress the CP already at low concentrations. In parallel, at low pH, the surface tension reduction due to lidocaine or prilocaine is marginal, whereas at high pH the surface tension is reduced considerably. Thus, the poor solubility of prilocaine and lidocaine at high pH causes these to become more surface active and simultaneously interact in a more pronounced way with pNIPAM. Furthermore, it was found from ellipsometry that an adsorbed pNIPAM layer contracts when lidocaine is added, presumably due to a lidocaine-pNIPAM interaction similar to that causing pNIPAM to phase separate. Analogous to this, it was demonstrated that an adsorbed pNIPAM layer shrinks and swells reversibly when the temperature is cycled above and beneath the CP. Copyright 2001 Academic Press.
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Affiliation(s)
- F Carlsson
- Institute for Surface Chemistry, Stockholm, SE-114 86, Sweden
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Brattgård SO, Carlsson F, Sandin A. [Housing and care for severely handicapped]. Rehabilitation (Stuttg) 1972; 11:223-33. [PMID: 4267326] [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: 01/09/2023]
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Brattgård SO, Carlsson F, Sandin A. [Responsibility of society for housing and service to handicapped persons]. Lakartidningen 1972; 69:2607-9. [PMID: 4262604] [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: 01/09/2023]
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Brattgård SO, Carlsson F, Juhlin IM. [Uncomplete school visit for the severely handicapped]. Lakartidningen 1969; 66:4515-8. [PMID: 4246329] [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: 01/09/2023]
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