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Das S, Pandey AK, Morris DE, Anderson R, Lim V, Wie CC, Yap IKS, Alattraqchi AG, Simin H, Abdullah R, Yeo CC, Clarke SC, Cleary DW. Respiratory carriage of hypervirulent Klebsiella pneumoniae by indigenous populations of Malaysia. BMC Genomics 2024; 25:381. [PMID: 38632538 PMCID: PMC11025145 DOI: 10.1186/s12864-024-10276-4] [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] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 04/01/2024] [Indexed: 04/19/2024] Open
Abstract
Klebsiella pneumoniae is a Gram-negative Enterobacteriaceae that is classified by the World Health Organisation (WHO) as a Priority One ESKAPE pathogen. South and Southeast Asian countries are regions where both healthcare associated infections (HAI) and community acquired infections (CAI) due to extended-spectrum β-lactamase (ESBL)-producing and carbapenem-resistant K. pneumoniae (CRKp) are of concern. As K. pneumoniae can also exist as a harmless commensal, the spread of resistance genotypes requires epidemiological vigilance. However there has been no significant study of carriage isolates from healthy individuals, particularly in Southeast Asia, and specially Malaysia. Here we describe the genomic analysis of respiratory isolates of K. pneumoniae obtained from Orang Ulu and Orang Asli communities in Malaysian Borneo and Peninsular Malaysia respectively. The majority of isolates were K. pneumoniae species complex (KpSC) 1 K. pneumoniae (n = 53, 89.8%). Four Klebsiella variicola subsp. variicola (KpSC3) and two Klebsiella quasipneumoniae subsp. similipneumoniae (KpSC4) were also found. It was discovered that 30.2% (n = 16) of the KpSC1 isolates were ST23, 11.3% (n = 6) were of ST65, 7.5% (n = 4) were ST13, and 13.2% (n = 7) were ST86. Only eight of the KpSC1 isolates encoded ESBL, but importantly not carbapenemase. Thirteen of the KpSC1 isolates carried yersiniabactin, colibactin and aerobactin, all of which harboured the rmpADC locus and are therefore characterised as hypervirulent. Co-carriage of multiple strains was minimal. In conclusion, most isolates were KpSC1, ST23, one of the most common sequence types and previously found in cases of K. pneumoniae infection. A proportion were hypervirulent (hvKp) however antibiotic resistance was low.
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Affiliation(s)
- Souradeep Das
- Faculty of Medicine, Institute for Life Sciences, University of Southampton, Southampton, UK
| | - Anish K Pandey
- Faculty of Medicine, Institute for Life Sciences, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton Foundation NHS Trust, Southampton, UK
| | - Denise E Morris
- Faculty of Medicine, Institute for Life Sciences, University of Southampton, Southampton, UK
| | - Rebecca Anderson
- Faculty of Medicine, Institute for Life Sciences, University of Southampton, Southampton, UK
| | - Victor Lim
- School of Medicine, International Medical University, Kuala Lumpur, Malaysia
| | - Chong Chun Wie
- Institute for Research, Development and Innovation, International Medical University, Kuala Lumpur, Malaysia
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - Ivan Kok Seng Yap
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - Ahmed Ghazi Alattraqchi
- Centre for Research in Infectious Diseases and Biotechnology (CeRIDB), Faculty of Medicine, Universiti Sultan Zainal Abidin, Medical Campus, 20400, Kuala Terengganu, Terengganu, Malaysia
| | - Hafis Simin
- Faculty of Applied Social Sciences, Universiti Sultan Zainal Abidin, Gong Badak Campus, 21300, Kuala Nerus, Terengganu, Malaysia
| | - Ramle Abdullah
- Centre of Excellence in National Indigenous Pedagogy, Institute of Teacher Education Tengku, Ampuan Afzan Campus, Pahang, Malaysia
| | - Chew Chieng Yeo
- Centre for Research in Infectious Diseases and Biotechnology (CeRIDB), Faculty of Medicine, Universiti Sultan Zainal Abidin, Medical Campus, 20400, Kuala Terengganu, Terengganu, Malaysia
| | - Stuart C Clarke
- Faculty of Medicine, Institute for Life Sciences, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton Foundation NHS Trust, Southampton, UK
- Institute for Research, Development and Innovation, International Medical University, Kuala Lumpur, Malaysia
- Global Health Research Institute, University of Southampton, Southampton, UK
| | - David W Cleary
- Institute of Microbiology and Infection, College of Medical and Dental Sciences, University of Birmingham, University of Birmingham, UK.
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Yeo JJP, Yeo LS, Tan SSN, Delailah DDRA, Lee SWH, Hu ATH, Foo DHP, Sahiran F, Yap IKS, Fong AYY. Prevalence of true resistant hypertension in those referred for uncontrolled hypertension in Malaysia: A comparison using different definitions. Hypertens Res 2024; 47:352-357. [PMID: 37673957 DOI: 10.1038/s41440-023-01418-4] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 07/31/2023] [Accepted: 08/07/2023] [Indexed: 09/08/2023]
Abstract
Resistant hypertension is a well-recognised clinical challenge. However, the definition and epidemiology of true resistant hypertension (RH) are less understood, especially in Asia. This cross-sectional study examined the prevalence of RH referred from primary care clinics based on various guidelines. RH was defined as blood pressure (BP) being above the threshold using ambulatory blood pressure monitoring despite adequate lifestyle measures and optimal treatment with ≥3 medications at maximally tolerated doses. Between one in four (n = 94, 24.0% using Malaysian guidelines) and up to two-thirds (n = 249, 63.7% using 2018 American guidelines) of adults referred for uncontrolled hypertension met the criteria of true RH. Of those with RH, a further one-quarter (n = 26, 26.6%) were deemed to have refractory hypertension (elevated BP despite treatment with at least 5 antihypertensive medications). Adults with RH were generally younger, more likely to be male, had a higher BMI and were more likely to have gout, CKD, and angina compared to those with controlled hypertension. The prevalence of RH amongst Asian adults with poor hypertension control is high. A concerted effort is needed to reduce the high burden of RH, especially among this population.
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Affiliation(s)
- John Jui Ping Yeo
- Clinical Research Center, Institute for Clinical Research, Sarawak General Hospital, Kuching, Malaysia
| | - Leh Siang Yeo
- Clinical Research Center, Institute for Clinical Research, Sarawak General Hospital, Kuching, Malaysia
| | - Shirley Siang Ning Tan
- Clinical Research Center, Institute for Clinical Research, Sarawak General Hospital, Kuching, Malaysia
| | | | | | - Anna Ting Huey Hu
- Clinical Research Center, Institute for Clinical Research, Sarawak General Hospital, Kuching, Malaysia
| | - Diana Hui Ping Foo
- Clinical Research Center, Institute for Clinical Research, Sarawak General Hospital, Kuching, Malaysia
| | - Faiz Sahiran
- Klinik Kesihatan Petra Jaya, Ministry of Health Malaysia, Sarawak, Malaysia
| | | | - Alan Yean Yip Fong
- Clinical Research Center, Institute for Clinical Research, Sarawak General Hospital, Kuching, Malaysia.
- Department of Cardiology, Sarawak Heart Center, Kota Samarahan, Malaysia.
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Zulkefli NJ, Teh CSJ, Mariappan V, Ngoi ST, Vadivelu J, Ponnampalavanar S, Chai LC, Chong CW, Yap IKS, Vellasamy KM. Genomic comparison and phenotypic profiling of small colony variants of Burkholderia pseudomallei. PLoS One 2021; 16:e0261382. [PMID: 34910764 PMCID: PMC8673655 DOI: 10.1371/journal.pone.0261382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 11/30/2021] [Indexed: 11/18/2022] Open
Abstract
Burkholderia pseudomallei (B. pseudomallei) is an intracellular pathogen that causes melioidosis, a life-threatening infection in humans. The bacterium is able to form small colony variants (SCVs) as part of the adaptive features in response to environmental stress. In this study, we characterize the genomic characteristics, antimicrobial resistance (AMR), and metabolic phenotypes of B. pseudomallei SCV and wild type (WT) strains. Whole-genome sequence analysis was performed to characterize the genomic features of two SCVs (CS and OS) and their respective parental WT strains (CB and OB). Phylogenetic relationship between the four draft genomes in this study and 19 publicly available genomes from various countries was determined. The four draft genomes showed a close phylogenetic relationship with other genomes from Southeast Asia. Broth microdilution and phenotype microarray were conducted to determine the AMR profiles and metabolic features (carbon utilization, osmolytes sensitivity, and pH conditions) of all strains. The SCV strains exhibited identical AMR phenotype with their parental WT strains. A limited number of AMR-conferring genes were identified in the B. pseudomallei genomes. The SCVs and their respective parental WT strains generally shared similar carbon-utilization profiles, except for D,L-carnitine (CS), g-hydroxybutyric acid (OS), and succinamic acid (OS) which were utilized by the SCVs only. No difference was observed in the osmolytes sensitivity of all strains. In comparison, WT strains were more resistant to alkaline condition, while SCVs showed variable growth responses at higher acidity. Overall, the genomes of the colony morphology variants of B. pseudomallei were largely identical, and the phenotypic variations observed among the different morphotypes were strain-specific.
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Affiliation(s)
- Noorfatin Jihan Zulkefli
- Faculty of Medicine, Department of Medical Microbiology, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Cindy Shuan Ju Teh
- Faculty of Medicine, Department of Medical Microbiology, Universiti Malaya, Kuala Lumpur, Malaysia
- * E-mail: (CSJT); (KMV)
| | - Vanitha Mariappan
- Faculty of Health Sciences, Centre of Toxicology and Health Risk Studies (CORE), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Soo Tein Ngoi
- Faculty of Medicine, Department of Medical Microbiology, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Jamuna Vadivelu
- Faculty of Medicine, Department of Medical Microbiology, Universiti Malaya, Kuala Lumpur, Malaysia
| | | | - Lay Ching Chai
- Faculty of Science, Institute of Biological Sciences, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Chun Wie Chong
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
- Institute for Research, Development & Innovation, International Medical University, Kuala Lumpur, Malaysia
| | - Ivan Kok Seng Yap
- Sarawak Research and Development Council, Kuching, Sarawak, Malaysia
| | - Kumutha Malar Vellasamy
- Faculty of Medicine, Department of Medical Microbiology, Universiti Malaya, Kuala Lumpur, Malaysia
- * E-mail: (CSJT); (KMV)
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Morris DE, McNeil H, Hocknell RE, Anderson R, Tuck AC, Tricarico S, Norazmi MN, Lim V, Siang TC, Lim PKC, Wie CC, Cleary DW, Yap IKS, Clarke SC. Carriage of upper respiratory tract pathogens in rural communities of Sarawak, Malaysian Borneo. Pneumonia (Nathan) 2021; 13:6. [PMID: 33894778 PMCID: PMC8070298 DOI: 10.1186/s41479-021-00084-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/22/2021] [Indexed: 11/10/2022] Open
Abstract
Introduction Pneumonia is a leading cause of death in Malaysia. Whilst many studies have reported the aetiology of pneumonia in Western countries, the epidemiology of pneumonia in Malaysia remains poorly understood. As carriage is a prerequisite for disease, we sought to improve our understanding of the carriage and antimicrobial resistance (AMR) of respiratory tract pathogens in Malaysia. The rural communities of Sarawak are an understudied part of the Malaysian population and were the focus of this study, allowing us to gain a better understanding of bacterial epidemiology in this population. Methods A population-based survey of bacterial carriage was undertaken in participants of all ages from rural communities in Sarawak, Malaysia. Nasopharyngeal, nasal, mouth and oropharyngeal swabs were taken. Bacteria were isolated from each swab and identified by culture-based methods and antimicrobial susceptibility testing conducted by disk diffusion or E test. Results 140 participants were recruited from five rural communities. Klebsiella pneumoniae was most commonly isolated from participants (30.0%), followed by Staphylococcus aureus (20.7%), Streptococcus pneumoniae (10.7%), Haemophilus influenzae (9.3%), Moraxella catarrhalis (6.4%), Pseudomonas aeruginosa (6.4%) and Neisseria meningitidis (5.0%). Of the 21 S. pneumoniae isolated, 33.3 and 14.3% were serotypes included in the 13 valent PCV (PCV13) and 10 valent PCV (PCV10) respectively. 33.8% of all species were resistant to at least one antibiotic, however all bacterial species except S. pneumoniae were susceptible to at least one type of antibiotic. Conclusion To our knowledge, this is the first bacterial carriage study undertaken in East Malaysia. We provide valuable and timely data regarding the epidemiology and AMR of respiratory pathogens commonly associated with pneumonia. Further surveillance in Malaysia is necessary to monitor changes in the carriage prevalence of upper respiratory tract pathogens and the emergence of AMR, particularly as PCV is added to the National Immunisation Programme (NIP). Supplementary Information The online version contains supplementary material available at 10.1186/s41479-021-00084-9.
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Affiliation(s)
- Denise E Morris
- Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK
| | - Hannah McNeil
- Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK
| | - Rebecca E Hocknell
- Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK
| | - Rebecca Anderson
- Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK
| | - Andrew C Tuck
- Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK
| | - Serena Tricarico
- Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK
| | - Mohd Nor Norazmi
- School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Victor Lim
- School of Medicine, International Medical University, Kuala Lumpur, Malaysia
| | - Tan Cheng Siang
- Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Kota Samarahan, Sarawak, Malaysia
| | - Patricia Kim Chooi Lim
- School of Medicine, International Medical University, Kuala Lumpur, Malaysia.,Institute for Research, Development and Innovation, International Medical University, Kuala Lumpur, Malaysia
| | - Chong Chun Wie
- Institute for Research, Development and Innovation, International Medical University, Kuala Lumpur, Malaysia.,School of Pharmacy, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - David W Cleary
- Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University Hospital Southampton Foundation NHS Trust, Southampton, UK
| | - Ivan Kok Seng Yap
- Institute for Research, Development and Innovation, International Medical University, Kuala Lumpur, Malaysia.,Sarawak Research and Development Council, Kuching, Sarawak, Malaysia
| | - Stuart C Clarke
- Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK. .,Institute for Research, Development and Innovation, International Medical University, Kuala Lumpur, Malaysia. .,NIHR Southampton Biomedical Research Centre, University Hospital Southampton Foundation NHS Trust, Southampton, UK. .,Global Health Research Institute, University of Southampton, Southampton, UK.
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5
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Tan AH, Chong CW, Lim SY, Yap IKS, Teh CSJ, Loke MF, Song SL, Tan JY, Ang BH, Tan YQ, Kho MT, Bowman J, Mahadeva S, Yong HS, Lang AE. Gut Microbial Ecosystem in Parkinson Disease: New Clinicobiological Insights from Multi-Omics. Ann Neurol 2021; 89:546-559. [PMID: 33274480 DOI: 10.1002/ana.25982] [Citation(s) in RCA: 90] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 11/26/2020] [Accepted: 11/29/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Gut microbiome alterations in Parkinson disease (PD) have been reported repeatedly, but their functional relevance remains unclear. Fecal metabolomics, which provide a functional readout of microbial activity, have scarcely been investigated. We investigated fecal microbiome and metabolome alterations in PD, and their clinical relevance. METHODS Two hundred subjects (104 patients, 96 controls) underwent extensive clinical phenotyping. Stool samples were analyzed using 16S rRNA gene sequencing. Fecal metabolomics were performed using two platforms, nuclear magnetic resonance (NMR) spectroscopy and liquid chromatography-mass spectrometry. RESULTS Fecal microbiome and metabolome composition in PD was significantly different from controls, with the largest effect size seen in NMR-based metabolome. Microbiome and NMR-based metabolome compositional differences remained significant after comprehensive confounder analyses. Differentially abundant fecal metabolite features and predicted functional changes in PD versus controls included bioactive molecules with putative neuroprotective effects (eg, short chain fatty acids [SCFAs], ubiquinones, and salicylate) and other compounds increasingly implicated in neurodegeneration (eg, ceramides, sphingosine, and trimethylamine N-oxide). In the PD group, cognitive impairment, low body mass index (BMI), frailty, constipation, and low physical activity were associated with fecal metabolome compositional differences. Notably, low SCFAs in PD were significantly associated with poorer cognition and low BMI. Lower butyrate levels correlated with worse postural instability-gait disorder scores. INTERPRETATION Gut microbial function is altered in PD, characterized by differentially abundant metabolic features that provide important biological insights into gut-brain pathophysiology. Their clinical relevance further supports a role for microbial metabolites as potential targets for the development of new biomarkers and therapies in PD. ANN NEUROL 2021;89:546-559.
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Affiliation(s)
- Ai Huey Tan
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Mah Pooi Soo and Tan Chin Nam Center for Parkinson's and Related Disorders, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Chun Wie Chong
- School of Pharmacy, Monash University Malaysia, Subang Jaya, Malaysia.,Center of Translational Research, Institute of Research, Development, and Innovation, International Medical University, Kuala Lumpur, Malaysia
| | - Shen-Yang Lim
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Mah Pooi Soo and Tan Chin Nam Center for Parkinson's and Related Disorders, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Cindy Shuan Ju Teh
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Mun Fai Loke
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Sze-Looi Song
- China-ASEAN College of Marine Sciences, Xiamen University Malaysia, Sepang, Malaysia
| | - Jiun Yan Tan
- Mah Pooi Soo and Tan Chin Nam Center for Parkinson's and Related Disorders, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Ban Hong Ang
- Mah Pooi Soo and Tan Chin Nam Center for Parkinson's and Related Disorders, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Yong Qi Tan
- Mah Pooi Soo and Tan Chin Nam Center for Parkinson's and Related Disorders, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Mee Teck Kho
- School of Postgraduate Studies, International Medical University, Kuala Lumpur, Malaysia
| | - Jeff Bowman
- Integrative Oceanography Division, Scripps Institution of Oceanography, University of California, La Jolla, CA, USA.,Center for Microbiome Innovation, University of California, San Diego, San Diego, CA, USA
| | - Sanjiv Mahadeva
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Hoi Sen Yong
- Institute of Biological Sciences, University of Malaya, Kuala Lumpur, Malaysia
| | - Anthony E Lang
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, ON, Canada
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Tan SC, Chong CW, Yap IKS, Thong KL, Teh CSJ. Comparative assessment of faecal microbial composition and metabonome of swine, farmers and human control. Sci Rep 2020; 10:8997. [PMID: 32488118 PMCID: PMC7265441 DOI: 10.1038/s41598-020-65891-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 05/11/2020] [Indexed: 12/12/2022] Open
Abstract
The gastrointestinal tract of humans and swine consist of a wide range of bacteria which interact with hosts metabolism. Due to the differences in co-evolution and co-adaptation, a large fraction of the gut microbiome is host-specific. In this study, we evaluated the effect of close human-animal interaction to the faecal metagenome and metabonome of swine, farmer and human control. Three distinct clusters were observed based on T-RFLP-derived faecal microbial composition. However, 16S-inferred faecal microbiota and metabolic profiles showed that only human control was significantly different from the swine (P < 0.05). The metabonome of farmers and human controls were highly similar. Notably, higher trimethylamine N-oxide (TMAO) and butyrate were detected in human control and swine, respectively. The relative abundance of TMAO was positively correlated with Prevotella copri. Overall, we compared and established the relationship between the metabolites and microbiota composition of swine, farmers and human control. Based on the data obtained, we deduced that long term occupational exposure to swine and farm environment had affected the gut bacterial composition of farmers. Nonetheless, the effect was less prominent in the metabolite profiles, suggesting the gut bacteria expressed high functional plasticity and are therefore resilience to the level of community shift detected.
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Affiliation(s)
- Shiang Chiet Tan
- Institute of Biological Science, Faculty of Science, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Chun Wie Chong
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Malaysia
- Centre for Translational Research, Institute for Research, Development and Innovation (IRDI), International Medical University, 57000, Kuala Lumpur, Malaysia
| | - Ivan Kok Seng Yap
- Sarawak Research and Development Council, 11th Floor LCDA Tower, The Isthmus, Off Jalan Bako, 93050, Kuching, Sarawak, Malaysia
| | - Kwai Lin Thong
- NANOCAT Research Centre, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Cindy Shuan Ju Teh
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
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Wan Yusoff WSY, Abdullah M, Sekawi Z, Amran F, Yuhana MY, Mohd Taib N, Yap IKS, Than LTL, Md Shah A, van Belkum A, Amin Nordin S. Raised levels of Il-6, Il-17a, and Il-22 in fatal leptospirosis. Eur J Clin Microbiol Infect Dis 2019; 38:2349-2353. [PMID: 31529307 DOI: 10.1007/s10096-019-03699-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 08/19/2019] [Indexed: 12/13/2022]
Abstract
Clinical manifestations of leptospirosis range from mild, common cold-like illness, to a life-threatening condition. The host immune response has been hypothesized to play a major role in leptospirosis outcome. Increased levels of inflammatory mediators, such as cytokines, may promote tissue damage that lead to increased disease severity. The question is whether cytokines levels may predict the outcome of leptospirosis and guide patient management. This study aimed to assess the association between Th1-, Th2-, and Th17-related cytokines with the clinical outcome of patients with leptospirosis. Different cytokine levels were measured in fifty-two plasma samples of hospitalized patients diagnosed with leptospirosis in Malaysia (January 2016-December 2017). Patients were divided into two separate categories: survived (n = 40) and fatal outcome (n = 12). Nineteen plasma samples from healthy individuals were obtained as controls. Cytokine quantification was performed using Simple Plex™ assays from ProteinSimple (San Jose, CA, USA). Measurements were done in triplicate and statistical analysis was performed using GraphPad software and SPSS v20. IL-6 (p = 0.033), IL-17A (p = 0.022), and IL-22 (p = 0.046) were significantly elevated in fatal cases. IL-17A concentration (OR 1.115; 95% CI 1.010-1.231) appeared to be an independent predictor of fatality of leptospirosis. Significantly higher levels of TNF-α (p ≤ 0.0001), IL-6 (p ≤ 0.0001), IL-10 (p ≤ 0.0001), IL-12 (p ≤ 0.0001), IL17A (p ≤ 0.0001), and IL-18 (p ≤ 0.0001) were observed among leptospirosis patients in comparison with healthy controls. Our study shows that certain cytokine levels may serve as possible prognostic biomarkers in leptospirosis patients.
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Affiliation(s)
- Wan Shahriman Yushdie Wan Yusoff
- Department of Medical Laboratory Technology, Faculty of Health Sciences, Universiti Teknologi MARA Cawangan Selangor, Kampus Puncak Alam, 42300, Bandar Puncak Alam, Selangor, Malaysia
- Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (UPM), 43400, Serdang, Selangor, Malaysia
| | - Maha Abdullah
- Department of Pathology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (UPM), 43400, Serdang, Selangor, Malaysia
| | - Zamberi Sekawi
- Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (UPM), 43400, Serdang, Selangor, Malaysia
| | - Fairuz Amran
- Infectious Disease Research Centre, Bacteriology Unit, Institute for Medical Research, Ministry of Health Malaysia, 50588, Kuala Lumpur, Malaysia
| | - Muhammad Yazli Yuhana
- Infectious Diseases Unit, Internal Medicine Department, Universiti Teknologi MARA, 47000, Sungai Buloh, Malaysia
| | - Niazlin Mohd Taib
- Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (UPM), 43400, Serdang, Selangor, Malaysia
| | - Ivan Kok Seng Yap
- Department of Life Sciences, International Medical University, Jalan Jalil Perkasa 19, Taman Esplanade, 57000, Kuala Lumpur, Malaysia
| | - Leslie Thian Lung Than
- Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (UPM), 43400, Serdang, Selangor, Malaysia
| | - Anim Md Shah
- Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia
| | - Alex van Belkum
- Clinical Unit, bioMérieux, 3 route de Port Michaud, 38390, La Balme-les-Grottes, France
| | - Syafinaz Amin Nordin
- Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (UPM), 43400, Serdang, Selangor, Malaysia.
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Johari NA, Voon K, Toh SY, Sulaiman LH, Yap IKS, Lim PKC. Sylvatic dengue virus type 4 in Aedes aegypti and Aedes albopictus mosquitoes in an urban setting in Peninsular Malaysia. PLoS Negl Trop Dis 2019; 13:e0007889. [PMID: 31730672 PMCID: PMC6881067 DOI: 10.1371/journal.pntd.0007889] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [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: 04/16/2019] [Revised: 11/27/2019] [Accepted: 10/28/2019] [Indexed: 12/03/2022] Open
Abstract
Dengue fever is endemic in Malaysia, contributing to significant economic and health burden in the country. Aedes aegypti and Ae. albopictus are the main vectors of the dengue virus (DENV), which circulates in sylvatic and human transmission cycles and has been present in Malaysia for decades. The study investigated the presence and distribution of DENV in urban localities in the Klang Valley, Peninsular Malaysia. A total of 364 Ae. aegypti and 1,025 Ae. albopictus larvae, and 10 Ae. aegypti and 42 Ae. albopictus adult mosquitoes were screened for the presence of DENV. In total, 31 (2.2%) samples were positive, of which 2 Ae. albopictus larvae were co-infected with two serotypes, one with DENV-2 and DENV-3 and the other with DENV-3 and DENV-4. Phylogenetic analysis determined that the isolates belonged to DENV-1 genotype I (1 Ae. aegypti adult), DENV-2 (1 Ae. albopictus larva), DENV-3 genotype V (3 Ae. aegypti larvae and 10 Ae. albopictus larvae) and DENV-4 genotype IV (6 Ae. aegypti larvae and 12 Ae. albopictus larvae), a sylvatic strain of DENV-4 which was most closely related with sylvatic strains isolated from arboreal mosquitoes and sentinel monkeys in Peninsular Malaysia in the 1970s. All four DENV serotypes were co-circulating throughout the study period. The detection of a sylvatic strain of DENV-4 in Ae. aegypti and Ae. albopictus mosquitoes in urban areas in Peninsular Malaysia highlights the susceptibility of these vectors to infection with sylvatic DENV. The infectivity and vector competence of these urban mosquitoes to this strain of the virus needs further investigation, as well as the possibility of the emergence of sylvatic virus into the human transmission cycle.
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Affiliation(s)
- Nur Alia Johari
- Institute for Research, Development and Innovation (IRDI), International Medical University, Kuala Lumpur, Malaysia
| | - Kenny Voon
- Pathology Division, School of Medicine, International Medical University, Kuala Lumpur, Malaysia
| | - Shen Yung Toh
- Pathology Division, School of Medicine, International Medical University, Kuala Lumpur, Malaysia
| | - Lokman Hakim Sulaiman
- Institute for Research, Development and Innovation (IRDI), International Medical University, Kuala Lumpur, Malaysia
- Department of Community Medicine, School of Medicine, International Medical University, Kuala Lumpur, Malaysia
| | - Ivan Kok Seng Yap
- Sarawak Research and Development Council, Ministry of Education, Science and Technological Research, Sarawak, Malaysia
| | - Patricia Kim Chooi Lim
- Pathology Division, School of Medicine, International Medical University, Kuala Lumpur, Malaysia
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9
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Low YM, Chong CW, Yap IKS, Chai LC, Clarke SC, Ponnampalavanar S, Abdul Jabar K, Md Yusof MY, Teh CSJ. Elucidating the survival and response of carbapenem resistant Klebsiella pneumoniae after exposure to imipenem at sub-lethal concentrations. Pathog Glob Health 2018; 112:378-386. [PMID: 30380366 DOI: 10.1080/20477724.2018.1538281] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 12/19/2022] Open
Abstract
The increasing prevalence of antibiotic resistant pathogens poses a serious threat to global health. However, less emphasis has been placed to co-relate the gene expression and metabolism of antibiotic resistant pathogens. This study aims to elucidate gene expression and variations in metabolism of multidrug resistant Klebsiella pneumoniae after exposure to antibiotics. Phenotypic responses of three genotypically distinct carbapenem resistant Klebsiella pneumoniae (CRKP) strains untreated and treated with sub-lethal concentrations of imipenem were investigated via phenotype microarrays (PM). The gene expression and metabolism of the strain harboring blaNDM-1 before and after exposure to sub-lethal concentration of imipenem were further investigated by RNA-sequencing (RNA-Seq) and 1H NMR spectroscopy respectively. Most genes related to cell division, central carbon metabolism and nucleotide metabolism were downregulated after imipenem treatment. Similarly, 1H NMR spectra obtained from treated CRKP showed decrease in levels of bacterial end products (acetate, pyruvate, succinate, formate) and metabolites involved in nucleotide metabolism (uracil, xanthine, hypoxanthine) but elevated levels of glycerophosphocholine. The presence of anserine was also observed for the treated CRKP while FAPγ-adenine and methyladenine were only present in untreated bacterial cells. As a conclusion, the studied CRKP strain exhibited decrease in central carbon metabolism, cell division and nucleotide metabolism after exposure to sub-lethal concentrations of imipenem. The understanding of the complex biological system of this multidrug resistant bacterium may help in the development of novel strategies and potential targets for the management of the infections.
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Affiliation(s)
- Ye Mun Low
- a Department of Medical Microbiology, Faculty of Medicine , University of Malaya , Kuala Lumpur , Malaysia
| | - Chun Wie Chong
- b Department of Life Sciences, School of Pharmacy , International Medical University , Bukit Jalil , Kuala Lumpur , Malaysia.,c Centre for Translational Research, Institute for Research, Development and Innovation , International Medical University , Kuala Lumpur , Malaysia
| | - Ivan Kok Seng Yap
- d Clinical Research Centre, Sarawak General Hospital , Jalan Hospital , Kuching , Malaysia
| | - Lay Ching Chai
- e Institute of Biological Sciences , University of Malaya , Kuala Lumpur , Malaysia
| | - Stuart C Clarke
- f Faculty of Medicine and Institute for Life Sciences and Global Health Research Institute , University of Southampton , Southampton , UK.,g NIHR Southampton Biomedical Research Centre , Southampton , UK.,h School of Postgraduate Studies , International Medical University , Kuala Lumpur , Malaysia
| | | | - Kartini Abdul Jabar
- a Department of Medical Microbiology, Faculty of Medicine , University of Malaya , Kuala Lumpur , Malaysia
| | - Mohd Yasim Md Yusof
- a Department of Medical Microbiology, Faculty of Medicine , University of Malaya , Kuala Lumpur , Malaysia
| | - Cindy Shuan Ju Teh
- a Department of Medical Microbiology, Faculty of Medicine , University of Malaya , Kuala Lumpur , Malaysia
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10
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Tan YF, Lim CY, Chong CW, Lim PKC, Yap IKS, Leong PP, Voon K. Isolation and Quantification of Mimivirus-Like and Marseillevirus-Like Viruses from Soil Samples in An Aboriginal (Orang asli) Village in Peninsular Malaysia. Intervirology 2018; 61:92-95. [PMID: 30121676 DOI: 10.1159/000491602] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 03/19/2018] [Accepted: 06/24/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The giant amoebal viruses of Mimivirus and Marseillevirus are large DNA viruses and have been documented in water, soil, and sewage samples. The trend of discovering these giant amoebal viruses has been increasing throughout Asia with Japan, India, and Saudi Arabia being the latest countries to document the presence of these viruses. To date, there have been no reports of large amoebal viruses being isolated in South East Asia. OBJECTIVE In this study, we aim to discover these viruses from soil samples in an aboriginal village (Serendah village) in Peninsular -Malaysia. METHOD AND RESULTS We successfully detected and isolated both Mimivirus-like and Marseillevirus-like viruses using Acanthamoeba castellanii. Phylogeny analysis identified them as Mimivirus and Marseillevirus, respectively. CONCLUSION The ubiquitous nature of both Mimivirus and Marseillevirus is further confirmed in our study as they are detected in higher quantity in soil that is near to water vicinities in an aboriginal village in Peninsular Malaysia. However, this study is limited by our inability to investigate the impact of Mimivirus and Marseillevirus on the aboriginal villagers. More studies on the potential impact of these viruses on human health, especially on the aborigines, are warranted.
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Affiliation(s)
- Yeh Fong Tan
- International Medical University, Bukit Jalil, Malaysia
| | - Chai Ying Lim
- International Medical University, Bukit Jalil, Malaysia
| | | | | | | | | | - Kenny Voon
- International Medical University, Bukit Jalil, Malaysia
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11
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Tan AH, Chong CW, Song SL, Teh CSJ, Yap IKS, Loke MF, Tan YQ, Yong HS, Mahadeva S, Lang AE, Lim SY. Altered gut microbiome and metabolome in patients with multiple system atrophy. Mov Disord 2017; 33:174-176. [DOI: 10.1002/mds.27203] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Revised: 09/11/2017] [Accepted: 09/17/2017] [Indexed: 12/31/2022] Open
Affiliation(s)
- Ai Huey Tan
- Division of Neurology and the Mah Pooi Soo & Tan Chin Nam Centre for Parkinson's & Related Disorders, Faculty of Medicine; University of Malaya; Kuala Lumpur Malaysia
| | - Chun Wie Chong
- Centre for Translational Research, Institute for Research, Development and Innovation; International Medical University; Kuala Lumpur Malaysia
- Department of Life Sciences, School of Pharmacy; International Medical University; Kuala Lumpur Malaysia
| | - Sze Looi Song
- Institute of Ocean and Earth Sciences; University of Malaya; Kuala Lumpur Malaysia
| | - Cindy Shuan Ju Teh
- Department of Medical Microbiology, Faculty of Medicine; University of Malaya; Kuala Lumpur Malaysia
| | - Ivan Kok Seng Yap
- Centre for Translational Research, Institute for Research, Development and Innovation; International Medical University; Kuala Lumpur Malaysia
- Department of Life Sciences, School of Pharmacy; International Medical University; Kuala Lumpur Malaysia
| | - Mun Fai Loke
- Department of Medical Microbiology, Faculty of Medicine; University of Malaya; Kuala Lumpur Malaysia
| | - Yong Qi Tan
- Division of Neurology and the Mah Pooi Soo & Tan Chin Nam Centre for Parkinson's & Related Disorders, Faculty of Medicine; University of Malaya; Kuala Lumpur Malaysia
| | - Hoi Sen Yong
- Institute of Biological Sciences; University of Malaya; Kuala Lumpur Malaysia
| | - Sanjiv Mahadeva
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine; University of Malaya; Kuala Lumpur Malaysia
| | - Anthony E. Lang
- Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital; Division of Neurology, Department of Medicine; University of Toronto; Toronto Canada
| | - Shen-Yang Lim
- Division of Neurology and the Mah Pooi Soo & Tan Chin Nam Centre for Parkinson's & Related Disorders, Faculty of Medicine; University of Malaya; Kuala Lumpur Malaysia
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12
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Tricarico S, McNeil HC, Cleary DW, Head MG, Lim V, Yap IKS, Wie CC, Tan CS, Norazmi MN, Aziah I, Cheah ESG, Faust SN, Jefferies JMC, Roderick PJ, Moore M, Yuen HM, Newell ML, McGrath N, Doncaster CP, Kraaijeveld AR, Webb JS, Clarke SC. Pneumococcal conjugate vaccine implementation in middle-income countries. Pneumonia (Nathan) 2017; 9:6. [PMID: 28702308 PMCID: PMC5471880 DOI: 10.1186/s41479-017-0030-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 02/15/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Since 2000, the widespread adoption of pneumococcal conjugate vaccines (PCVs) has had a major impact in the prevention of pneumonia. Limited access to international financial support means some middle-income countries (MICs) are trailing in the widespread use of PCVs. We review the status of PCV implementation, and discuss any needs and gaps related to low levels of PCV implementation in MICs, with analysis of possible solutions to strengthen the PCV implementation process in MICs. MAIN BODY We searched PubMed, PubMed Central, Ovid MEDLINE, and SCOPUS databases using search terms related to pneumococcal immunization, governmental health policy or programmes, and MICs. Two authors independently reviewed the full text of the references, which were assessed for eligibility using pre-defined inclusion and exclusion criteria. The search terms identified 1,165 articles and the full texts of 21 were assessed for suitability, with eight articles included in the systematic review. MICs are implementing PCVs at a slower rate than donor-funded low-income countries and wealthier developed countries. A significant difference in the uptake of PCV in lower middle-income countries (LMICs) (71%) and upper middle-income countries (UMICs) (48%) is largely due to an unsuccessful process of "graduation" of MICs from GAVI assistance, an issue that arises as countries cross the income eligibility threshold and are no longer eligible to receive the same levels of financial assistance. A lack of country-specific data on disease burden, a lack of local expertise in economic evaluation, and the cost of PCV were identified as the leading causes of the slow uptake of PCVs in MICs. Potential solutions mentioned in the reviewed papers include the use of vaccine cost-effectiveness analysis and the provision of economic evidence to strengthen decision-making, the evaluation of the burden of disease, and post-introduction surveillance to monitor vaccine impact. CONCLUSION The global community needs to recognise the impediments to vaccine introduction into MICs. Improving PCV access could help decrease the incidence of pneumonia and reduce the selection pressure for pneumococcal antimicrobial resistance.
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Affiliation(s)
- Serena Tricarico
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom.,Institute for Life Sciences, University of Southampton, Southampton, United Kingdom.,University of Southampton Malaysia Campus, Johor, Malaysia
| | - Hannah C McNeil
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom.,Institute for Life Sciences, University of Southampton, Southampton, United Kingdom.,University of Southampton Malaysia Campus, Johor, Malaysia
| | - David W Cleary
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom.,Institute for Life Sciences, University of Southampton, Southampton, United Kingdom
| | - Michael G Head
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom.,Institute for Life Sciences, University of Southampton, Southampton, United Kingdom.,Global Health Research Institute, University of Southampton, Southampton, United Kingdom
| | - Victor Lim
- International Medical University, Kuala Lumpur, Malaysia
| | | | - Chong Chun Wie
- International Medical University, Kuala Lumpur, Malaysia
| | - Cheng Siang Tan
- Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Kota Samarahan, Sarawak Malaysia
| | | | - Ismail Aziah
- Universiti Sains Malaysia Health Campus, Kelantan, Malaysia
| | | | - Saul N Faust
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom.,Institute for Life Sciences, University of Southampton, Southampton, United Kingdom.,NIHR Southampton Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom.,NIHR Wellcome Trust Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Johanna M C Jefferies
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom.,Institute for Life Sciences, University of Southampton, Southampton, United Kingdom.,NIHR Southampton Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Paul J Roderick
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Michael Moore
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom.,Institute for Life Sciences, University of Southampton, Southampton, United Kingdom
| | - Ho Ming Yuen
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom.,Institute for Life Sciences, University of Southampton, Southampton, United Kingdom
| | - Marie-Louise Newell
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom.,Global Health Research Institute, University of Southampton, Southampton, United Kingdom
| | - Nuala McGrath
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom.,Institute for Life Sciences, University of Southampton, Southampton, United Kingdom.,Faculty of Social, Human and Mathematical Sciences, University of Southampton, Southampton, United Kingdom
| | - C Patrick Doncaster
- Centre for Biological Sciences, Faculty of Natural and Environmental Sciences, University of Southampton, Southampton, United Kingdom
| | - Alex R Kraaijeveld
- Centre for Biological Sciences, Faculty of Natural and Environmental Sciences, University of Southampton, Southampton, United Kingdom
| | - Jeremy S Webb
- Centre for Biological Sciences, Faculty of Natural and Environmental Sciences, University of Southampton, Southampton, United Kingdom
| | - Stuart C Clarke
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom.,Institute for Life Sciences, University of Southampton, Southampton, United Kingdom.,University of Southampton Malaysia Campus, Johor, Malaysia.,Global Health Research Institute, University of Southampton, Southampton, United Kingdom.,International Medical University, Kuala Lumpur, Malaysia.,Postal address: Infectious Disease Epidemiology Group, Mailpoint 814, Level C, Sir Henry Wellcome Laboratories, South Block, University Hospital Southampton NHS Foundation Trust, Southampton, UK SO16 6YD
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13
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Yap PSX, Ahmad Kamar A, Chong CW, Yap IKS, Thong KL, Choo YM, Md Yusof MY, Teh CSJ. Intestinal carriage of multidrug-resistant gram-negative bacteria in preterm-infants during hospitalization in neonatal intensive care unit (NICU). Pathog Glob Health 2016; 110:238-246. [PMID: 27650884 DOI: 10.1080/20477724.2016.1229884] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [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: 10/21/2022] Open
Abstract
The prevalence and antibiotic susceptibility of intestinal carriage of Gram-negative bacteria among preterm infants admitted to the neonatal intensive care unit (NICU) in a tertiary teaching hospital in Malaysia were determined. A total of 34 stool specimens were obtained from preterm infants upon admission and once weekly up to two weeks during hospitalization. The presumptive colonies of Escherichia coli and Klebsiella pneumoniae were selected for identification, antibiotic susceptibility testing, and subtyping by using pulsed-field gel electrophoresis (PFGE). Out of 76 Gram-negative isolates, highest resistance was detected for amoxicillin/clavulanate (30.8%, n = 16), ceftriaxone (42.3%, n = 22), ceftazidime (28.8%, n = 15), cefoxitin (28.8%, n = 15), aztreonam (36.5%, n = 19), and polymyxin B (23.1%, n = 12). Three colistin resistant K. pneumoniae have also been detected based on E-test analysis. Thirty-nine isolates of K. pneumoniae and 20 isolates of E. coli were resistant to more than three antimicrobial classes and were categorized as multidrug resistant (MDR). PFGE analysis revealed a higher diversity in pulsotypes for K. pneumoniae (18 pulsotypes) in comparison to E. coli (four pulsotypes). In addition, a total of fifteen pulsotypes was observed from 39 MDR K. pneumoniae. The risk factors for antibiotic resistance were assessed using random forest analysis. Gender was found to be the most important predictor for colistin resistant while length, OFC, and delivery mode were showing greater predictive power in the polymyxin B resistance. This study revealed worrying prevalence rates of intestinal carriage of multidrug-resistant K. pneumoniae and E. coli of hospitalized preterm infants in Malaysia, particularly high resistance to polymyxins.
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Affiliation(s)
- Polly Soo Xi Yap
- a Department of Medical Microbiology, Faculty of Medicine , University of Malaya , 50603 Kuala Lumpur , Malaysia
| | - Azanna Ahmad Kamar
- b Department of Paediatrics, Faculty of Medicine , University of Malaya , 50603 Kuala Lumpur , Malaysia
| | - Chun Wie Chong
- c Department of Life Sciences, School of Pharmacy , International Medical University , 57000 Kuala Lumpur , Malaysia
| | - Ivan Kok Seng Yap
- c Department of Life Sciences, School of Pharmacy , International Medical University , 57000 Kuala Lumpur , Malaysia
| | - Kwai Lin Thong
- d Institute of Biological Sciences, Faculty of Science , University of Malaya , 50603 Kuala Lumpur , Malaysia
| | - Yao Mun Choo
- b Department of Paediatrics, Faculty of Medicine , University of Malaya , 50603 Kuala Lumpur , Malaysia
| | - Mohd Yasim Md Yusof
- a Department of Medical Microbiology, Faculty of Medicine , University of Malaya , 50603 Kuala Lumpur , Malaysia
| | - Cindy Shuan Ju Teh
- a Department of Medical Microbiology, Faculty of Medicine , University of Malaya , 50603 Kuala Lumpur , Malaysia
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14
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Chin YT, Lim YAL, Chong CW, Teh CSJ, Yap IKS, Lee SC, Tee MZ, Siow VWY, Chua KH. Prevalence and risk factors of intestinal parasitism among two indigenous sub-ethnic groups in Peninsular Malaysia. Infect Dis Poverty 2016; 5:77. [PMID: 27430215 PMCID: PMC4950084 DOI: 10.1186/s40249-016-0168-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 07/06/2016] [Indexed: 12/30/2022] Open
Abstract
Background Intestinal parasitic infections (IPIs) among indigenous people have been widely documented in Malaysia, however, the prevalence of these infections remains high. In the past, most studies have focused on specific species of parasites but polyparasitism has received limited attention. In addition, epidemiology studies on indigenous people tend to consider them as a homogenous group, whereas in reality different sub-ethnic groups have different cultural and living practices. Variations in living habits such as personal hygiene practices may predispose different groups to different parasitic infections. To better understand prevalence and risk factors of intestinal parasitism among different sub-ethnic groups, the present study was conducted among two sub-ethnic groups of indigenous people (Temuan and Mah Meri) residing in Selangor state, Malaysia. Methods A cross-sectional study that focused on two distinct sub-ethnic groups was carried out from February to September 2014. Faecal samples were collected from 186 participants and examined using the formalin-ether sedimentation technique. A molecular approach was adopted to conduct a genetic characterisation of the parasites. Additionally, questionnaires were administered to obtain information on the demographics, socio-economic backgrounds and behavioural risks relating to the participants, as well as information about their environments. Statistical analyses (i.e. binary and multivariate logistic regression analyses) were performed to measure risk factors. Results For Temuan communities, trichuriasis (64.2 %) was the most common infection found, preceding hookworm infection (34 %), ascariasis (7.5 %), giardiasis (14.2 %) and amoebiasis (7.5 %). As for the Mah Meri communities, trichuriasis (77.5 %) prevailed over ascariasis (21.3 %), hookworm (15 %), giardiasis (7.5 %) and amoebiasis (3.8 %). Significant differences in proportions of trichuriasis, ascariasis and hookworm infections were observed between the Temuan and Mah Meri sub-ethnic groups. Polyparasitism was more common among the Temuan sub-ethnic group (41.5 %) compared to the Mah Meri sub-ethnic group (32.5 %), with the majority of participants harbouring two parasites concurrently (Temuan: 33 %, Mah Meri: 20 %). Trichuris trichiura and Ascaris lumbricoides co-infections were most prevalent (10 %) among the Mah Meri communities, while a co-infection of T. trichiura with hookworm (19.8 %) was most common among the Temuan communities. Multivariate analyses showed that being unemployed, having a large family and drinking unboiled water were found to be significantly associated with intestinal parasitism. Conclusion The present study highlights substantial polyparasitism and risk factors for infections in the Temuan and Mah Meri sub-ethnic groups. The high prevalence of IPIs among these two sub-ethnic groups indicates that parasitic infections are important health issues in these communities. Hence, it is imperative to implement sound intervention strategies such as periodic preventive chemotherapy coupled with health education in order to reduce and eradicate these infections. Electronic supplementary material The online version of this article (doi:10.1186/s40249-016-0168-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yuee Teng Chin
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Yvonne Ai Lian Lim
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Chun Wie Chong
- Department of Life Sciences, School of Pharmacy, International Medical University, 57000, Kuala Lumpur, Malaysia
| | - Cindy Shuan Ju Teh
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Ivan Kok Seng Yap
- Department of Life Sciences, School of Pharmacy, International Medical University, 57000, Kuala Lumpur, Malaysia
| | - Soo Ching Lee
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Mian Zi Tee
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Vinnie Wei Yin Siow
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Kek Heng Chua
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
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15
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Chong CW, Ahmad AF, Lim YAL, Teh CSJ, Yap IKS, Lee SC, Chin YT, Loke P, Chua KH. Effect of ethnicity and socioeconomic variation to the gut microbiota composition among pre-adolescent in Malaysia. Sci Rep 2015; 5:13338. [PMID: 26290472 PMCID: PMC4542465 DOI: 10.1038/srep13338] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2015] [Accepted: 07/15/2015] [Indexed: 01/09/2023] Open
Abstract
Gut microbiota plays an important role in mammalian host metabolism and physiological functions. The functions are particularly important in young children where rapid mental and physical developments are taking place. Nevertheless, little is known about the gut microbiome and the factors that contribute to microbial variation in the gut of South East Asian children. Here, we compared the gut bacterial richness and composition of pre-adolescence in Northern Malaysia. Our subjects covered three distinct ethnic groups with relatively narrow range of socioeconomic discrepancy. These included the Malays (n = 24), Chinese (n = 17) and the Orang Asli (indigenous) (n = 20). Our results suggested a strong ethnicity and socioeconomic-linked bacterial diversity. Highest bacterial diversity was detected from the economically deprived indigenous children while the lowest diversity was recorded from the relatively wealthy Chinese children. In addition, predicted functional metagenome profiling suggested an over-representation of pathways pertinent to bacterial colonisation and chemotaxis in the former while the latter exhibited enriched gene pathways related to sugar metabolism.
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Affiliation(s)
- Chun Wie Chong
- Department of Life Sciences, School of Pharmacy, International Medical University, 57000 Kuala Lumpur, Malaysia
| | - Arine Fadzlun Ahmad
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Yvonne Ai Lian Lim
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Cindy Shuan Ju Teh
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Ivan Kok Seng Yap
- Department of Life Sciences, School of Pharmacy, International Medical University, 57000 Kuala Lumpur, Malaysia
| | - Soo Ching Lee
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Yuee Teng Chin
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - P'ng Loke
- Department of Microbiology, New York University School of Medicine, 10010 New York, United States of America
| | - Kek Heng Chua
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
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16
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Lim PKC, Yamasaki H, Mak JW, Wong SF, Chong CW, Yap IKS, Ambu S, Kumarasamy V. Field evaluation of a rapid diagnostic test to detect antibodies in human toxocariasis. Acta Trop 2015; 148:32-7. [PMID: 25910623 DOI: 10.1016/j.actatropica.2015.04.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 03/23/2015] [Accepted: 04/13/2015] [Indexed: 11/16/2022]
Abstract
Human toxocariasis which is caused mainly by the larvae of Toxocara canis and Toxocara cati, is a worldwide zoonotic disease that can be a potentially serious human infection. The enzyme-linked immunosorbent assay (ELISA) using T. canis excretory-secretory (TES) antigens harvested from T. canis larvae is currently the serological test for confirming toxocariasis. An alternative to producing large amounts of Toxocara TES and improved diagnosis for toxocariasis is through the development of highly specific recombinant antigens such as the T. canis second stage larva excretory-secretory 30 kDa protein (recTES-30). The aim of this study was to evaluate the sensitivity and specificity of a rapid diagnostic kit (RDT, named as iToxocara kit) in comparison to recTES-30 ELISA in Serendah Orang Asli village in Selangor, Malaysia. A total of 133 subjects were included in the study. The overall prevalence rates by ELISA and RDT were 29.3% and 33.1%, respectively, with more positive cases detected in males than females. However, no association was found between toxocariasis and gender or age. The percentage sensitivity, specificity, positive predictive value and negative predictive value of RDT were 85.7%, 90.1%, 80% and 93.2%, respectively. The prevalence for toxocariasis in this population using both ELISA and RDT was 27.1% (36/133) and the K-concordance test suggested good agreement of the two tests with a Cohen's kappa of 0.722, P<0.01. In addition, the followed-up Spearman rank correlation showed a moderately high correlation at R=0.704 and P<0.01. In conclusion, the RDT kit was faster and easier to use than an ELISA and is useful for the laboratory diagnosis of hospitalized cases of toxocariasis.
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Affiliation(s)
- P K C Lim
- School of Medical Sciences, International Medical University, 126 Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, Malaysia.
| | - H Yamasaki
- Department of Parasitology, National Institute of Infectious Diseases, Tokyo 162-8640, Japan.
| | - J W Mak
- School of Medical Sciences, International Medical University, 126 Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, Malaysia.
| | - S F Wong
- School of Medical Sciences, International Medical University, 126 Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, Malaysia.
| | - C W Chong
- School of Pharmacy, International Medical University, 126 Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, Malaysia.
| | - I K S Yap
- School of Pharmacy, International Medical University, 126 Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, Malaysia.
| | - S Ambu
- School of Medical Sciences, International Medical University, 126 Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, Malaysia.
| | - V Kumarasamy
- School of Medical Sciences, International Medical University, 126 Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, Malaysia.
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17
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Tan BS, Tiong KH, Choo HL, Chung FFL, Hii LW, Tan SH, Yap IKS, Pani S, Khor NTW, Wong SF, Rosli R, Cheong SK, Leong CO. Mutant p53-R273H mediates cancer cell survival and anoikis resistance through AKT-dependent suppression of BCL2-modifying factor (BMF). Cell Death Dis 2015; 6:e1826. [PMID: 26181206 PMCID: PMC4650736 DOI: 10.1038/cddis.2015.191] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [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: 04/15/2015] [Revised: 05/25/2015] [Accepted: 06/09/2015] [Indexed: 12/31/2022]
Abstract
p53 is the most frequently mutated tumor-suppressor gene in human cancers. Unlike other tumor-suppressor genes, p53 mutations mainly occur as missense mutations within the DNA-binding domain, leading to the expression of full-length mutant p53 protein. Mutant p53 proteins not only lose their tumor-suppressor function, but may also gain new oncogenic functions and promote tumorigenesis. Here, we showed that silencing of endogenous p53-R273H contact mutant, but not p53-R175H conformational mutant, reduced AKT phosphorylation, induced BCL2-modifying factor (BMF) expression, sensitized BIM dissociation from BCL-XL and induced mitochondria-dependent apoptosis in cancer cells. Importantly, cancer cells harboring endogenous p53-R273H mutant were also found to be inherently resistant to anoikis and lack BMF induction following culture in suspension. Underlying these activities is the ability of p53-R273H mutant to suppress BMF expression that is dependent on constitutively active PI3K/AKT signaling. Collectively, these findings suggest that p53-R273H can specifically drive AKT signaling and suppress BMF expression, resulting in enhanced cell survivability and anoikis resistance. These findings open the possibility that blocking of PI3K/AKT will have therapeutic benefit in mutant p53-R273H expressing cancers.
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Affiliation(s)
- B S Tan
- 1] School of Postgraduate Studies, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia [2] Center for Cancer and Stem Cell Research, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia
| | - K H Tiong
- 1] School of Postgraduate Studies, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia [2] Oral Cancer Research and Co-ordinating Center (OCRCC), Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia [3] Cancer Research Initiatives Foundation, Sime Darby Medical Centre, Subang Jaya, Malaysia
| | - H L Choo
- 1] School of Postgraduate Studies, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia [2] Center for Cancer and Stem Cell Research, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia
| | - F Fei-Lei Chung
- Center for Cancer and Stem Cell Research, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia
| | - L-W Hii
- 1] School of Postgraduate Studies, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia [2] Center for Cancer and Stem Cell Research, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia
| | - S H Tan
- 1] School of Postgraduate Studies, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia [2] Center for Cancer and Stem Cell Research, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia
| | - I K S Yap
- School of Pharmacy, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia
| | - S Pani
- ANU Medical School, Canberra Hospital Campus, The Canberra Hospital Building 4, Garran, Australia
| | - N T W Khor
- School of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - S F Wong
- School of Medicine, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia
| | - R Rosli
- UPM-MAKNA Cancer Research Laboratory, Institute of Bioscience, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia
| | - S-K Cheong
- Faculty of Medicine and Health Sciences, University Tunku Abdul Rahman, Bandar Sungai Long, Selangor, Malaysia
| | - C-O Leong
- 1] School of Postgraduate Studies, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia [2] Center for Cancer and Stem Cell Research, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia [3] School of Pharmacy, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia
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18
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Tan BS, Tiong KH, Yap IKS, Rosli R, Cheong SK, Leong CO. Abstract 1551: p53 mutant regulates a network of cellular anoikis through activation of AKT and suppression of BMF. Cancer Res 2014. [DOI: 10.1158/1538-7445.am2014-1551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
p53 is the most frequently mutated tumor suppressor gene in human cancers. Unlike other tumor-suppressor genes, p53 mutations mainly occur as missense mutations within the DNA-binding domain, leading to the expression of full-length mutant p53 protein. Mutant p53 proteins not only lose their tumor suppressor function, but may also gain new oncogenic function and promote tumorigenesis through transactivation of new target genes. By using an RNA interference (RNAi) approach, we show that silencing of endogenous p53 R273H contact mutant in MDA-MB-468 cells induced massive apoptosis while no apoptosis was observed in the silencing of the p53 R175H structural mutant in SKBR3 cells. Further analysis shows that the apoptotic effects of mutant p53 knock-down involved activation of caspase-9 and mitochondria depolarisation, suggesting a role for mutant p53 in suppressing the intrinsic apoptotic pathway. Indeed, a BCL-2 family member, BCL-2 modifying factor (BMF), was reproducibly up-regulated following knock-down of mutant p53 in MDA-MB-468 cells while no significant changes was observed in other BCL2 family members. Furthermore, we show that p53 R273H contact mutant, but not p53 R175H conformation mutant, suppressed anoikis by down-regulation of BMF expression. Anoikis is a form of apoptosis induced by cell detachment and is a major mechanism to prevent metastasis. Further analyses using microarray gene profiling and connectivity map analysis show that silencing of mutant p53 in MDA-MB-468 cells generates gene expression signatures characteristic of PI3K inhibitors, suggesting that apoptotic effects of mutant p53 knock-down involved dephosphorylation of AKT, a direct substrate of PI3K. Ectopic expression of the activated form of AKT in MDA-MB-468 completely abrogated the apoptotic effects of mutant p53 knock-down. In summary, our results demonstrate that R273H mutant p53 promotes anoikis resistance in breast cancer cells that express it through suppression of BMF expression by the constitutively activated AKT pathway.
Citation Format: Boon Shing Tan, Kai Hung Tiong, Ivan Kok Seng Yap, Rozita Rosli, Soon-Keng Cheong, Chee-Onn Leong. p53 mutant regulates a network of cellular anoikis through activation of AKT and suppression of BMF. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 1551. doi:10.1158/1538-7445.AM2014-1551
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Affiliation(s)
- Boon Shing Tan
- 1International Medical University, Kuala Lumpur, Malaysia
| | - Kai Hung Tiong
- 2Cancer Research Initiatives Foundation, Kuala Lumpur, Malaysia
| | | | - Rozita Rosli
- 3Universiti Putra Malaysia, Kuala Lumpur, Malaysia
| | | | - Chee-Onn Leong
- 1International Medical University, Kuala Lumpur, Malaysia
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