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Bradfield JP, Kember RL, Ulrich A, Balkiyarova Z, Alyass A, Aris IM, Bell JA, Broadaway KA, Chen Z, Chai JF, Davies NM, Fernandez-Orth D, Bustamante M, Fore R, Ganguli A, Heiskala A, Hottenga JJ, Íñiguez C, Kobes S, Leinonen J, Lowry E, Lyytikainen LP, Mahajan A, Pitkänen N, Schnurr TM, Have CT, Strachan DP, Thiering E, Vogelezang S, Wade KH, Wang CA, Wong A, Holm LA, Chesi A, Choong C, Cruz M, Elliott P, Franks S, Frithioff-Bøjsøe C, Gauderman WJ, Glessner JT, Gilsanz V, Griesman K, Hanson RL, Kaakinen M, Kalkwarf H, Kelly A, Kindler J, Kähönen M, Lanca C, Lappe J, Lee NR, McCormack S, Mentch FD, Mitchell JA, Mononen N, Niinikoski H, Oken E, Pahkala K, Sim X, Teo YY, Baier LJ, van Beijsterveldt T, Adair LS, Boomsma DI, de Geus E, Guxens M, Eriksson JG, Felix JF, Gilliland FD, Biobank PM, Hansen T, Hardy R, Hivert MF, Holm JC, Jaddoe VWV, Järvelin MR, Lehtimäki T, Mackey DA, Meyre D, Mohlke KL, Mykkänen J, Oberfield S, Pennell CE, Perry JRB, Raitakari O, Rivadeneira F, Saw SM, Sebert S, Shepherd JA, Standl M, Sørensen TIA, Timpson NJ, Torrent M, Willemsen G, Hypponen E, Power C, McCarthy MI, Freathy RM, Widén E, Hakonarson H, Prokopenko I, Voight BF, Zemel BS, Grant SFA, Cousminer DL. Trans-ancestral genome-wide association study of longitudinal pubertal height growth and shared heritability with adult health outcomes. Genome Biol 2024; 25:22. [PMID: 38229171 PMCID: PMC10790528 DOI: 10.1186/s13059-023-03136-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 11/30/2023] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Pubertal growth patterns correlate with future health outcomes. However, the genetic mechanisms mediating growth trajectories remain largely unknown. Here, we modeled longitudinal height growth with Super-Imposition by Translation And Rotation (SITAR) growth curve analysis on ~ 56,000 trans-ancestry samples with repeated height measurements from age 5 years to adulthood. We performed genetic analysis on six phenotypes representing the magnitude, timing, and intensity of the pubertal growth spurt. To investigate the lifelong impact of genetic variants associated with pubertal growth trajectories, we performed genetic correlation analyses and phenome-wide association studies in the Penn Medicine BioBank and the UK Biobank. RESULTS Large-scale growth modeling enables an unprecedented view of adolescent growth across contemporary and 20th-century pediatric cohorts. We identify 26 genome-wide significant loci and leverage trans-ancestry data to perform fine-mapping. Our data reveals genetic relationships between pediatric height growth and health across the life course, with different growth trajectories correlated with different outcomes. For instance, a faster tempo of pubertal growth correlates with higher bone mineral density, HOMA-IR, fasting insulin, type 2 diabetes, and lung cancer, whereas being taller at early puberty, taller across puberty, and having quicker pubertal growth were associated with higher risk for atrial fibrillation. CONCLUSION We report novel genetic associations with the tempo of pubertal growth and find that genetic determinants of growth are correlated with reproductive, glycemic, respiratory, and cardiac traits in adulthood. These results aid in identifying specific growth trajectories impacting lifelong health and show that there may not be a single "optimal" pubertal growth pattern.
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Affiliation(s)
- Jonathan P Bradfield
- Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
- Center for Spatial and Functional Genomics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Rachel L Kember
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Anna Ulrich
- Department of Clinical & Experimental Medicine, University of Surrey, Guildford, UK
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Zhanna Balkiyarova
- Department of Clinical & Experimental Medicine, University of Surrey, Guildford, UK
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
- People-Centred Artificial Intelligence Institute, University of Surrey, Guildford, UK
| | - Akram Alyass
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Izzuddin M Aris
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, 02215, USA
| | - Joshua A Bell
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - K Alaine Broadaway
- Department of Genetics, University of North Carolina, Chapel Hill, NC, USA
| | - Zhanghua Chen
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, 90032, USA
| | - Jin-Fang Chai
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Neil M Davies
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | | | | | - Ruby Fore
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, 02215, USA
| | - Amitavo Ganguli
- Center for Spatial and Functional Genomics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Anni Heiskala
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Jouke-Jan Hottenga
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Carmen Íñiguez
- Department of Statistics and Computational Research, Universitat de València, Valencia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
| | - Sayuko Kobes
- Phoenix Epidemiology and Clinical Research Center, NIDDK, NIH, Bethesda, USA
| | - Jaakko Leinonen
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Estelle Lowry
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Leo-Pekka Lyytikainen
- Department of Clinical Physiology, Finnish Cardiovascular Research Center - Tampere, Faculty of Medicine and Health Technology, Tampere University, 33014, Tampere, Finland
- Department of Clinical Physiology, Tampere University Hospital, 33521, Tampere, Finland
| | - Anubha Mahajan
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, OX3 7BN, UK
| | - Niina Pitkänen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Theresia M Schnurr
- Faculty of Health and Medical Sciences, Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Christian Theil Have
- Faculty of Health and Medical Sciences, Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - David P Strachan
- Population Health Research Institute, St George's, University of London, Cranmer Terrace, London, SW17 0RE, UK
| | - Elisabeth Thiering
- Institute of Epidemiology, Helmholtz Zentrum München- German Research Center for Environmental Health, Neuherberg, Germany
- Division of Metabolic and Nutritional Medicine, Dr. Von Hauner Children's Hospital, University of Munich Medical Center, Munich, Germany
| | - Suzanne Vogelezang
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Kaitlin H Wade
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
| | - Carol A Wang
- School of Medicine and Public Health, Faculty of Medicine and Health, University of Newcastle, Callaghan, NSW, 2308, Australia
- Hunter Medical Research Institute, Newcastle, NSW, 2305, Australia
| | - Andrew Wong
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
| | - Louise Aas Holm
- Faculty of Health and Medical Sciences, Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
- Department of Pediatrics, The Children's Obesity Clinic, Copenhagen University Hospital Holbæk, Holbæk, Denmark
| | - Alessandra Chesi
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Catherine Choong
- Faculty of Health and Medical Sciences, University of Western Australia, Perth, WA, Australia
| | - Miguel Cruz
- Unidad de Investigación Médica en Bioquímica, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Paul Elliott
- MRC Centre for Environment and Health, School of Public Health, Faculty of Medicine, Imperial College London, St Mary's Campus, Norfolk Place, London, W2 1PG, UK
| | - Steve Franks
- Institute of Reproductive & Developmental Biology, Imperial College London, London, UK
| | - Christine Frithioff-Bøjsøe
- Faculty of Health and Medical Sciences, Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
- Department of Pediatrics, The Children's Obesity Clinic, Copenhagen University Hospital Holbæk, Holbæk, Denmark
| | - W James Gauderman
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, 90032, USA
| | - Joseph T Glessner
- Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Vicente Gilsanz
- Center for Endocrinology, Diabetes & Metabolism, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | | | - Robert L Hanson
- Phoenix Epidemiology and Clinical Research Center, NIDDK, NIH, Bethesda, USA
| | - Marika Kaakinen
- Department of Clinical & Experimental Medicine, University of Surrey, Guildford, UK
- Institute of Reproductive & Developmental Biology, Imperial College London, London, UK
| | - Heidi Kalkwarf
- Department of Pediatrics, Cincinnati Children's Hospital, University of Cincinnati, Cincinnati, OH, USA
| | - Andrea Kelly
- Department of Pediatrics, The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, 19104, USA
- Division of Endocrinology & Diabetes, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Joseph Kindler
- College of Family and Consumer Sciences, University of Georgia, Athens, GA, USA
| | - Mika Kähönen
- Department of Clinical Physiology, Finnish Cardiovascular Research Center - Tampere, Faculty of Medicine and Health Technology, Tampere University, 33014, Tampere, Finland
- Department of Clinical Physiology, Tampere University Hospital, 33521, Tampere, Finland
| | - Carla Lanca
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Joan Lappe
- Department of Medicine and College of Nursing, Creighton University School of Medicine, Omaha, NB, USA
| | - Nanette R Lee
- USC-Office of Population Studies Foundation, Inc, University of San Carlos, Cebu, Philippines
| | - Shana McCormack
- Department of Pediatrics, The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, 19104, USA
- Division of Endocrinology & Diabetes, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Frank D Mentch
- Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Jonathan A Mitchell
- Department of Pediatrics, The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, 19104, USA
- Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Nina Mononen
- Department of Clinical Chemistry, Faculty of Medicine and Health Technology, Finnish Cardiovascular Research Center - Tampere, Tampere University, 33014, Tampere, Finland
- Department of Clinical Chemistry, Fimlab Laboratories, 33520, Tampere, Finland
| | - Harri Niinikoski
- Department of Pediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, Turku, Finland
- Department of Physiology, University of Turku, Turku, Finland
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, 02215, USA
- Department of Nutrition, Harvard T.H Chan School of Public Health, Boston, MA, 02115, USA
| | - Katja Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Paavo Nurmi Centre, Unit for Health and Physical Activity, University of Turku, Turku, Finland
| | - Xueling Sim
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Yik-Ying Teo
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Leslie J Baier
- Phoenix Epidemiology and Clinical Research Center, NIDDK, NIH, Bethesda, USA
| | - Toos van Beijsterveldt
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Linda S Adair
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Dorret I Boomsma
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction & Development (AR&D) Research Institute, Amsterdam, the Netherlands
| | - Eco de Geus
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Mònica Guxens
- ISGlobal, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Johan G Eriksson
- Institute of Clinical Medicine Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
- Department of Obstetrics & Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Janine F Felix
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Frank D Gilliland
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, 90032, USA
| | | | - Torben Hansen
- Faculty of Health and Medical Sciences, Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Rebecca Hardy
- Cohort and Longitudinal Studies Enhancement Resources (CLOSER), UCL Institute of Education, London, UK
| | - Marie-France Hivert
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, 02215, USA
| | - Jens-Christian Holm
- Faculty of Health and Medical Sciences, Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
- Department of Pediatrics, The Children's Obesity Clinic, Copenhagen University Hospital Holbæk, Holbæk, Denmark
- The Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Vincent W V Jaddoe
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Marjo-Riitta Järvelin
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Department of Epidemiology and Biostatistics, School of Public Health, MRC-PHE Centre for Environment and Health, Imperial College London, London, W2 1PG, UK
- Unit of Primary Health Care, Oulu University Hospital, OYS, Kajaanintie 50, 90220, Oulu, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Faculty of Medicine and Health Technology, Finnish Cardiovascular Research Center - Tampere, Tampere University, 33014, Tampere, Finland
- Department of Clinical Chemistry, Fimlab Laboratories, 33520, Tampere, Finland
| | - David A Mackey
- Lions Eye Institute, Centre for Ophthalmology and Visual Science, Centre for Eye Research Australia, University of Western Australia, Perth, WA, Australia
| | - David Meyre
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Canada
- Inserm UMR_S1256 Nutrition-Genetics-Environmental Risk Exposure, University of Lorraine, Nancy, France
- Department of Biochemistry-Molecular Biology-Nutrition, University Hospital Centre of Nancy, Nancy, France
| | - Karen L Mohlke
- Department of Genetics, University of North Carolina, Chapel Hill, NC, USA
| | - Juha Mykkänen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Sharon Oberfield
- Division of Pediatric Endocrinology, Columbia University Medical Center, New York, NY, USA
| | - Craig E Pennell
- School of Medicine and Public Health, Faculty of Medicine and Health, University of Newcastle, Callaghan, NSW, 2308, Australia
- Hunter Medical Research Institute, Newcastle, NSW, 2305, Australia
- Department of Maternity and Gynaecology, John Hunter Hospital, Newcastle, NSW, 2305, Australia
| | - John R B Perry
- Metabolic Research Laboratory, School of Clinical Medicine, Wellcome-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, CB2 0QQ, UK
- MRC Epidemiology Unit, School of Clinical Medicine, Wellcome-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Olli Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Fernando Rivadeneira
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Seang-Mei Saw
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Sylvain Sebert
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Department of Epidemiology and Biostatistics, School of Public Health, MRC-PHE Centre for Environment and Health, Imperial College London, London, W2 1PG, UK
| | - John A Shepherd
- Department of Epidemiology and Population Science, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Marie Standl
- Institute of Epidemiology, Helmholtz Zentrum München- German Research Center for Environmental Health, Neuherberg, Germany
| | - Thorkild I A Sørensen
- Faculty of Health and Medical Sciences, Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Nicholas J Timpson
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - Maties Torrent
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Fundació Institut d'Investigació Sanitària Illes Balears - IdISBa, Palma, Spain
| | - Gonneke Willemsen
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Elina Hypponen
- UCL Great Ormond Street Institute of Child Health, London, UK
- Australian Centre for Precision Health, Unit of Clinical and Health Sciences, University of South Australia, Adelaide, Australia
- South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Chris Power
- UCL Great Ormond Street Institute of Child Health, London, UK
| | - Mark I McCarthy
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, OX3 7BN, UK
- Current Address: Genentech, 1 DNA Way, San Francisco, CA, 94080, USA
| | - Rachel M Freathy
- Department of Clinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, EX2 5DW, UK
| | - Elisabeth Widén
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Hakon Hakonarson
- Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
- Department of Pediatrics, The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, 19104, USA
| | - Inga Prokopenko
- Department of Clinical & Experimental Medicine, University of Surrey, Guildford, UK
- People-Centred Artificial Intelligence Institute, University of Surrey, Guildford, UK
- UMR 8199 - EGID, Institut Pasteur de Lille, CNRS, University of Lille, 59000, Lille, France
| | - Benjamin F Voight
- Department of Genetics, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Institute of Translational Medicine and Therapeutics, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Babette S Zemel
- Department of Pediatrics, The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, 19104, USA
- Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Struan F A Grant
- Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA.
- Center for Spatial and Functional Genomics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA.
- Department of Pediatrics, The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, 19104, USA.
- Division of Endocrinology & Diabetes, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA.
- Department of Genetics, University of Pennsylvania, Philadelphia, PA, 19104, USA.
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA.
| | - Diana L Cousminer
- Center for Spatial and Functional Genomics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA.
- Department of Genetics, University of Pennsylvania, Philadelphia, PA, 19104, USA.
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA.
- Currently Employed By GlaxoSmithKline, 1250 S Collegeville Rd, Collegeville, PA, 19426, USA.
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Kankuri E, Finckenberg P, Leinonen J, Tarkia M, Björk S, Purhonen J, Kallijärvi J, Kankainen M, Soliymani R, Lalowski M, Mervaala E. Altered acylcarnitine metabolism and inflexible mitochondrial fuel utilization characterize the loss of neonatal myocardial regeneration capacity. Exp Mol Med 2023; 55:806-817. [PMID: 37009793 PMCID: PMC10167339 DOI: 10.1038/s12276-023-00967-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 11/29/2022] [Accepted: 12/23/2022] [Indexed: 04/04/2023] Open
Abstract
Myocardial regeneration capacity declines during the first week after birth, and this decline is linked to adaptation to oxidative metabolism. Utilizing this regenerative window, we characterized the metabolic changes in myocardial injury in 1-day-old regeneration-competent and 7-day-old regeneration-compromised mice. The mice were either sham-operated or received left anterior descending coronary artery ligation to induce myocardial infarction (MI) and acute ischemic heart failure. Myocardial samples were collected 21 days after operations for metabolomic, transcriptomic and proteomic analyses. Phenotypic characterizations were carried out using echocardiography, histology and mitochondrial structural and functional assessments. In both groups, MI induced an early decline in cardiac function that persisted in the regeneration-compromised mice over time. By integrating the findings from metabolomic, transcriptomic and proteomic examinations, we linked regeneration failure to the accumulation of long-chain acylcarnitines and insufficient metabolic capacity for fatty acid beta-oxidation. Decreased expression of the redox-sensitive mitochondrial Slc25a20 carnitine-acylcarnitine translocase together with a decreased reduced:oxidized glutathione ratio in the myocardium in the regeneration-compromised mice pointed to a defect in the redox-sensitive acylcarnitine transport to the mitochondrial matrix. Rather than a forced shift from the preferred adult myocardial oxidative fuel source, our results suggest the facilitation of mitochondrial fatty acid transport and improvement of the beta-oxidation pathway as a means to overcome the metabolic barrier for repair and regeneration in adult mammals after MI and heart failure.
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Affiliation(s)
- E Kankuri
- Department of Pharmacology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - P Finckenberg
- Department of Pharmacology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - J Leinonen
- Department of Pharmacology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - M Tarkia
- Department of Pharmacology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - S Björk
- Department of Pharmacology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - J Purhonen
- Folkhälsan Research Center, Helsinki, Finland
- Stem Cells and Metabolism Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - J Kallijärvi
- Folkhälsan Research Center, Helsinki, Finland
- Stem Cells and Metabolism Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - M Kankainen
- Medical and Clinical Genetics, Faculty of Medicine, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
- Translational Immunology Research Program and Department of Clinical Chemistry, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - R Soliymani
- Helsinki Institute of Life Science (HiLIFE), Meilahti Clinical Proteomics Core Facility, Department of Biochemistry and Developmental Biology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - M Lalowski
- Helsinki Institute of Life Science (HiLIFE), Meilahti Clinical Proteomics Core Facility, Department of Biochemistry and Developmental Biology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Gene Expression, Institute of Molecular Biology and Biotechnology, Faculty of Biology, Adam Mickiewicz University, Poznań, Poland
| | - E Mervaala
- Department of Pharmacology, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
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3
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Voisin C, Linden M, Dyke SO, Bowers SR, Alper P, Barkley MP, Bernick D, Chao J, Courtot M, Jeanson F, Konopko MA, Kuba M, Lawson J, Leinonen J, Li S, Ota Wang V, Philippakis AA, Reinold K, Rushton GA, Spalding JD, Törnroos J, Tulchinsky I, Guidry Auvil JM, Nyrönen TH. GA4GH Passport standard for digital identity and access permissions. Cell Genom 2021; 1:None. [PMID: 34820660 PMCID: PMC8591913 DOI: 10.1016/j.xgen.2021.100030] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 07/08/2021] [Accepted: 09/02/2021] [Indexed: 12/21/2022]
Abstract
The Global Alliance for Genomics and Health (GA4GH) supports international standards that enable a federated data sharing model for the research community while respecting data security, ethical and regulatory frameworks, and data authorization and access processes for sensitive data. The GA4GH Passport standard (Passport) defines a machine-readable digital identity that conveys roles and data access permissions (called "visas") for individual users. Visas are issued by data stewards, including data access committees (DACs) working with public databases, the entities responsible for the quality, integrity, and access arrangements for the datasets in the management of human biomedical data. Passports streamline management of data access rights across data systems by using visas that present a data user's digital identity and permissions across organizations, tools, environments, and services. We describe real-world implementations of the GA4GH Passport standard in use cases from ELIXIR Europe, National Institutes of Health, and the Autism Sharing Initiative. These implementations demonstrate that the Passport standard has provided transparent mechanisms for establishing permissions and authorizing data access across platforms.
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Affiliation(s)
- Craig Voisin
- Google LLC, Kitchener, ON N2H 5G5, Canada,Corresponding author
| | - Mikael Linden
- CSC–IT Center for Science, Espoo 02101, Finland,ELIXIR Finland, Espoo 02101, Finland
| | - Stephanie O.M. Dyke
- McGill Centre for Integrative Neuroscience, McGill University, Montreal, QC H3A 2B4, Canada
| | | | - Pinar Alper
- ELIXIR Luxembourg, Luxembourg Centre for Systems Biomedicine, University of Luxembourg, 4367 Belvaux, Luxembourg
| | | | - David Bernick
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | | | - Mélanie Courtot
- European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Hinxton, Cambridgeshire CB10 1SD, UK
| | | | - Melissa A. Konopko
- Wellcome Sanger Institute, Hinxton, Cambridgeshire CB10 1SA, UK,Global Alliance for Genomics and Health, Toronto, ON M5G 0A3, Canada
| | - Martin Kuba
- Masaryk University, Brno 602 00, Czech Republic
| | - Jonathan Lawson
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | | | - Stephanie Li
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA,Global Alliance for Genomics and Health, Toronto, ON M5G 0A3, Canada
| | - Vivian Ota Wang
- National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | | | - Kathy Reinold
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | | | - J. Dylan Spalding
- CSC–IT Center for Science, Espoo 02101, Finland,ELIXIR Finland, Espoo 02101, Finland
| | - Juha Törnroos
- CSC–IT Center for Science, Espoo 02101, Finland,ELIXIR Finland, Espoo 02101, Finland
| | | | | | - Tommi H. Nyrönen
- CSC–IT Center for Science, Espoo 02101, Finland,ELIXIR Finland, Espoo 02101, Finland,Corresponding author
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4
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Emanuelov A, Bouaziz P, Leinonen J, Ankri R, Hoss S, Lotan C, Fixler D, Beeri R. P1573The left atrial appendagea -biological band aid for cardiac tissue regeneration. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1573] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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5
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Amarouch MY, Leinonen J, Marjamaa A, M. Lahtinen A, Kontula K, Toivonen L, Widen E, Swan H, Abriel H. 0012 : Antiarrhythmic action of flecainide in polymorphic ventricular arrhythmias caused by a gain-of-function mutation in the Nav1.5 sodium channel. Archives of Cardiovascular Diseases Supplements 2016. [DOI: 10.1016/s1878-6480(16)30436-0] [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: 11/12/2022]
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6
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Amarouch MY, Swan H, Leinonen J, Marjamaa A, Lahtinen AM, Kontula K, Toivonen L, Widen E, Abriel H. Antiarrhythmic Action of Flecainide in Polymorphic Ventricular Arrhythmias Caused by a Gain-of-Function Mutation in the Nav 1.5 Sodium Channel. Ann Noninvasive Electrocardiol 2015; 21:343-51. [PMID: 26965448 DOI: 10.1111/anec.12312] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 07/04/2015] [Accepted: 07/15/2015] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND The cardiac sodium channel Nav 1.5, encoded by the gene SCN5A, is associated with a wide spectrum of hereditary arrhythmias. The gain-of-function mutation p.I141V in SCN5A was identified in a large multigenerational family with exercise-induced polymorphic ventricular arrhythmias. The purpose of this study was to evaluate the molecular and clinical effects of flecainide administration on patients with this syndrome. METHODS Eleven p.I141V carriers who exhibited frequent multiformic premature ventricular complexes (PVCs) during exercise were subjected to exercise stress tests, both before and after intravenous infusion of 2 mg/kg flecainide. The in vitro effects of flecainide were evaluated using the patch-clamp technique with HEK293 cells expressing the Nav 1.5 channel. RESULTS The flecainide treatment significantly reduced the frequency of PVCs during and after exercise. Next, the sensitivity of the p.I141V mutant channel to flecainide was compared to that of the wild type channel. Perfusion of flecainide inhibited the peak and window currents in both groups. CONCLUSION The clinical investigations of the affected patients, as well as the molecular and pharmacological characterization of the SCN5A p.I141V mutation, provide new evidence supporting the association of this mutation with exercise-induced polymorphic ventricular arrhythmias. These data also demonstrate that flecainide may serve as an effective treatment for the defect in Nav 1.5 that leads to an increased sodium window current.
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Affiliation(s)
| | - Heikki Swan
- Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland
| | - Jaakko Leinonen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Annukka Marjamaa
- Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland
| | - Annukka M Lahtinen
- Department of Medicine, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Kimmo Kontula
- Department of Medicine, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Lauri Toivonen
- Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland
| | - Elisabeth Widen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Hugues Abriel
- Department of Clinical Research, University of Bern, Bern, Switzerland
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7
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Swan H, Amarouch MY, Leinonen J, Marjamaa A, Kucera JP, Laitinen-Forsblom PJ, Lahtinen AM, Palotie A, Kontula K, Toivonen L, Abriel H, Widen E. Gain-of-Function Mutation of the
SCN5A
Gene Causes Exercise-Induced Polymorphic Ventricular Arrhythmias. ACTA ACUST UNITED AC 2014; 7:771-81. [DOI: 10.1161/circgenetics.114.000703] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background—
Over the past 15 years, a myriad of mutations in genes encoding cardiac ion channels and ion channel interacting proteins have been linked to a long list of inherited atrial and ventricular arrhythmias. The purpose of this study was to identify the genetic and functional determinants underlying exercise-induced polymorphic ventricular arrhythmia present in a large multigenerational family.
Methods and Results—
A large 4-generation family presenting with exercise-induced polymorphic ventricular arrhythmia, which was followed for 10 years, was clinically characterized. A novel
SCN5A
mutation was identified via whole exome sequencing and further functionally evaluated by patch-clamp studies using human embryonic kidney 293 cells. Of 37 living family members, a total of 13 individuals demonstrated ≥50 multiformic premature ventricular complexes or ventricular tachycardia upon exercise stress tests when sinus rate exceeded 99±17 beats per minute. Sudden cardiac arrest occurred in 1 individual during follow-up. Exome sequencing identified a novel missense mutation (p.I141V) in a highly conserved region of the
SCN5A
gene, encoding the Na
v
1.5 sodium channel protein that cosegregated with the arrhythmia phenotype. The mutation p.I141V shifted the activation curve toward more negative potentials and increased the window current, whereas action potential simulations suggested that it lowered the excitability threshold of cardiac cells.
Conclusions—
Gain-of-function of Na
v
1.5 may cause familial forms of exercise-induced polymorphic ventricular arrhythmias.
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Affiliation(s)
- Heikki Swan
- From the Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland (H.S., A.M., L.T.); Department of Clinical Research (M.Y.A., H.A), and Department of Physiology (J.P.K), University of Bern, Bern, Switzerland. and Institute for Molecular Medicine Finland (FIMM), University of Helsinki (J.L., A.P., E.W.), and Department of Medicine, University of Helsinki and Helsinki University Central Hospital (P.J.L.-F., A.M.L., K.K.), Helsinki, Finland
| | - Mohamed Yassine Amarouch
- From the Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland (H.S., A.M., L.T.); Department of Clinical Research (M.Y.A., H.A), and Department of Physiology (J.P.K), University of Bern, Bern, Switzerland. and Institute for Molecular Medicine Finland (FIMM), University of Helsinki (J.L., A.P., E.W.), and Department of Medicine, University of Helsinki and Helsinki University Central Hospital (P.J.L.-F., A.M.L., K.K.), Helsinki, Finland
| | - Jaakko Leinonen
- From the Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland (H.S., A.M., L.T.); Department of Clinical Research (M.Y.A., H.A), and Department of Physiology (J.P.K), University of Bern, Bern, Switzerland. and Institute for Molecular Medicine Finland (FIMM), University of Helsinki (J.L., A.P., E.W.), and Department of Medicine, University of Helsinki and Helsinki University Central Hospital (P.J.L.-F., A.M.L., K.K.), Helsinki, Finland
| | - Annukka Marjamaa
- From the Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland (H.S., A.M., L.T.); Department of Clinical Research (M.Y.A., H.A), and Department of Physiology (J.P.K), University of Bern, Bern, Switzerland. and Institute for Molecular Medicine Finland (FIMM), University of Helsinki (J.L., A.P., E.W.), and Department of Medicine, University of Helsinki and Helsinki University Central Hospital (P.J.L.-F., A.M.L., K.K.), Helsinki, Finland
| | - Jan P. Kucera
- From the Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland (H.S., A.M., L.T.); Department of Clinical Research (M.Y.A., H.A), and Department of Physiology (J.P.K), University of Bern, Bern, Switzerland. and Institute for Molecular Medicine Finland (FIMM), University of Helsinki (J.L., A.P., E.W.), and Department of Medicine, University of Helsinki and Helsinki University Central Hospital (P.J.L.-F., A.M.L., K.K.), Helsinki, Finland
| | - Päivi J. Laitinen-Forsblom
- From the Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland (H.S., A.M., L.T.); Department of Clinical Research (M.Y.A., H.A), and Department of Physiology (J.P.K), University of Bern, Bern, Switzerland. and Institute for Molecular Medicine Finland (FIMM), University of Helsinki (J.L., A.P., E.W.), and Department of Medicine, University of Helsinki and Helsinki University Central Hospital (P.J.L.-F., A.M.L., K.K.), Helsinki, Finland
| | - Annukka M. Lahtinen
- From the Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland (H.S., A.M., L.T.); Department of Clinical Research (M.Y.A., H.A), and Department of Physiology (J.P.K), University of Bern, Bern, Switzerland. and Institute for Molecular Medicine Finland (FIMM), University of Helsinki (J.L., A.P., E.W.), and Department of Medicine, University of Helsinki and Helsinki University Central Hospital (P.J.L.-F., A.M.L., K.K.), Helsinki, Finland
| | - Aarno Palotie
- From the Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland (H.S., A.M., L.T.); Department of Clinical Research (M.Y.A., H.A), and Department of Physiology (J.P.K), University of Bern, Bern, Switzerland. and Institute for Molecular Medicine Finland (FIMM), University of Helsinki (J.L., A.P., E.W.), and Department of Medicine, University of Helsinki and Helsinki University Central Hospital (P.J.L.-F., A.M.L., K.K.), Helsinki, Finland
| | - Kimmo Kontula
- From the Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland (H.S., A.M., L.T.); Department of Clinical Research (M.Y.A., H.A), and Department of Physiology (J.P.K), University of Bern, Bern, Switzerland. and Institute for Molecular Medicine Finland (FIMM), University of Helsinki (J.L., A.P., E.W.), and Department of Medicine, University of Helsinki and Helsinki University Central Hospital (P.J.L.-F., A.M.L., K.K.), Helsinki, Finland
| | - Lauri Toivonen
- From the Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland (H.S., A.M., L.T.); Department of Clinical Research (M.Y.A., H.A), and Department of Physiology (J.P.K), University of Bern, Bern, Switzerland. and Institute for Molecular Medicine Finland (FIMM), University of Helsinki (J.L., A.P., E.W.), and Department of Medicine, University of Helsinki and Helsinki University Central Hospital (P.J.L.-F., A.M.L., K.K.), Helsinki, Finland
| | - Hugues Abriel
- From the Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland (H.S., A.M., L.T.); Department of Clinical Research (M.Y.A., H.A), and Department of Physiology (J.P.K), University of Bern, Bern, Switzerland. and Institute for Molecular Medicine Finland (FIMM), University of Helsinki (J.L., A.P., E.W.), and Department of Medicine, University of Helsinki and Helsinki University Central Hospital (P.J.L.-F., A.M.L., K.K.), Helsinki, Finland
| | - Elisabeth Widen
- From the Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland (H.S., A.M., L.T.); Department of Clinical Research (M.Y.A., H.A), and Department of Physiology (J.P.K), University of Bern, Bern, Switzerland. and Institute for Molecular Medicine Finland (FIMM), University of Helsinki (J.L., A.P., E.W.), and Department of Medicine, University of Helsinki and Helsinki University Central Hospital (P.J.L.-F., A.M.L., K.K.), Helsinki, Finland
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8
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Amarouch MY, Leinonen J, Marjamaa A, Kucera JP, Laitinen-Forsblom PJ, Lahtinen AM, Palotie A, Kontula K, Toivonen L, Abriel H, Widen E, Swan H. 0265: A novel SCN5A mutation associated with exercise-induced polymorphic ventricular arrhythmias resembling CPVT. Archives of Cardiovascular Diseases Supplements 2014. [DOI: 10.1016/s1878-6480(14)71376-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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9
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Leinonen J, Korkus-Emanuelov A, Milgrom-Hoffman M, Hoss S, Lotan C, Tzahor E, Beeri R. Cardiac progenitor cells from the left atrial appendage may originate from a resident non-hematopoietic myeloid progenitor population. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p1464] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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10
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Abstract
To study the effect of prolonged irrigation in the treatment of chemical eye injuries we reviewed the case records of 172 patients. Most of the patients were men in working age. The injury was caused by acid in 57 patients (33%). Of the acid burns, 28 were due to AIV solution commonly used in agriculture in Finland, and 27 were due to inorganic acids. Alkaline burns occurred in 64 (37%) patients including 33 cases with natrium hydroxide and 20 cases with mortar and cement burns. Other chemicals including organic solvents and surfactants caused the eye burn in 51 (30%) cases. Fifty three patients mostly with alkaline and acid burns were treated with prolonged irrigation with one liter of physiological saline using intravenous delivery system during 1-2 hours. The extent of damage was smaller, the visual outcome better, and the duration of treatment at the hospital and absence from work were shorter in patients treated with prolonged irrigation than without such treatment.
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11
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Abstract
PURPOSE To estimate the repeatability of refractive error measurement (REM) in a clinical environment in cataractous, pseudophakic and healthy eyes. METHODS The refractive error of patients referred for cataract surgery or consultation measured by ophthalmic professionals was re-examined and the measurement results were compared. A total of 99 eyes from 99 persons (41 cataractous, 36 pseudophakic and 22 healthy eyes) with visual acuity (VA) of 0.3-1.3 (logMAR 0.52 to - 0.11) were included. The differences between measurements 1 and 2 were calculated as 3-dimensional vector values and spherical equivalents (SEs) and expressed as the coefficient of repeatability (CR). The mean time interval between the first and second examinations was 45 days. RESULTS The CRs for all eyes for vertical (V), torsional (T) and horizontal (H) vectors were 0.74 D, 0.34 D and 0.93 D, respectively. The CR of SE for all eyes was 0.74 D. Eyes with lower VA (0.3-0.45) had larger variability in vector and SE values but the differences between VA groups were not statistically significant. The difference in the mean defocus equivalent (DE) between measurements 1 and 2 was, however, significantly greater in the group with lower VA. In all VA groups the mean difference vector was very close to the zero vector, which means that there was no systematic difference. CONCLUSIONS Repeatability of refractive error measurements in clinical settings has a certain degree of variability. In this series, the variability in eyes with better VA was not great and was in accordance with earlier findings in healthy eyes. Eyes with lower VA had greater variability due to greater tolerance to defocus. Thus, conclusions concerning changes in the refractive state and the need to make changes in the refractive correction of eyes with poorer vision should be made with caution.
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Affiliation(s)
- Jaakko Leinonen
- Department of Ophthalmology, Vaasa Central Hospital, Vaasa, Finland.
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12
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Timonen M, Kankaanranta L, Lundbom N, Collan J, Kangasmäki A, Kortesniemi M, Häkkinen AM, Lönngren A, Karjalainen S, Rasilainen M, Leinonen J, Huitti T, Jääskeläinen J, Kouri M, Savolainen S, Heikkinen S. 1H MRS studies in the Finnish boron neutron capture therapy project: detection of 10B-carrier, L-p-boronophenylalanine-fructose. Eur J Radiol 2006; 56:154-9. [PMID: 16233888 DOI: 10.1016/j.ejrad.2005.03.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [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: 03/02/2005] [Revised: 03/05/2005] [Accepted: 03/08/2005] [Indexed: 11/26/2022]
Abstract
This article summarizes the current status of 1H MRS in detecting and quantifying a boron neutron capture therapy (BNCT) boron carrier, L-p-boronophenylalanine-fructose (BPA-F) in vivo in the Finnish BNCT project. The applicability of 1H MRS to detect BPA-F is evaluated and discussed in a typical situation with a blood containing resection cavity within the gross tumour volume (GTV). 1H MRS is not an ideal method to study BPA concentration in GTV with blood in recent resection cavity. For an optimal identification of BPA signals in the in vivo 1H MR spectrum, both pre- and post-infusion 1H MRS should be performed. The post-infusion spectroscopy studies should be scheduled either prior to or, less optimally, immediately after the BNCT. The pre-BNCT MRS is necessary in order to utilise the MRS results in the actual dose planning.
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Affiliation(s)
- M Timonen
- Department of Physical Sciences, University of Helsinki, POB 64, FIN-00014, Helsinki, Finland
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13
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Sinikumpu JJ, Leinonen J. [Not Available]. Duodecim 2006; 122:3029, 3031. [PMID: 17330428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
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14
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Abstract
PURPOSE To estimate the random measurement error in visual acuity (VA) determination in the clinical environment in cataractous, pseudophakic and healthy eyes. METHODS The VAs of patients referred for cataract surgery or consultation by ophthalmic professionals were re-examined and the VA results for distance using projector acuity charts were compared. Refractive errors were also remeasured. A total of 99 eyes (41 cataractous, 36 pseudophakic and 22 healthy eyes) were examined. The healthy comparison group consisted of hospital staff. Only one eye of each person and eyes with Snellen VAs of 0.3-1.3 (logMAR 0.52 to - 0.11) were included. The mean time interval between the first and second examinations was 45 days. RESULTS The estimated standard deviation of measurement error (SDME) of repeated VA measurements of all eyes was logMAR 0.06. Eyes with the lowest VA (0.3-0.45) had the largest variability (SDME logMAR 0.09), and eyes with VA > or = 0.7 had the smallest (SDME logMAR 0.04). The variability may be partly explained by the line size progression in lower VAs, partly by the difference in the remeasurement of the refractive error. The difference in the average VA between examinations 1 and 2 (logMAR 0.15 versus 0.12) was considered to be of some interest because it indicates that some learning effect is possible. CONCLUSION Visual acuity results in clinical settings have a certain degree of inherent variability. In this series variability ranged from SDME logMAR 0.04 (eyes with good vision) to logMAR 0.09 (in the lower vision group) in the Snellen VA range of 0.3-1.3. Changes should be judged with caution, especially in cases of decreased VA.
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Affiliation(s)
- Jaakko Leinonen
- Department of Ophthalmology, Vaasa Central Hospital, Vaasa, Finland.
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15
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Abstract
PURPOSE To compare preoperative visual acuities in patients who underwent cataract surgery between 1982 and 2000. METHODS Information on visual acuity (VA), ocular disease and general disease was obtained from records relating to samples of consecutive cataract operations in 1982, 1985, 1990, 1995 and 2000 in two hospitals in the Vaasa region of Finland. RESULTS Between 1982 and 2000, the average preoperative VA in the operated eye increased by 0.85 logMAR units (from logMAR 1.56 to logMAR 0.71) or 8.5 log lines. Corresponding decimal values are 0.03 and 0.2, respectively. In the better eye, VA increased from logMAR 0.64 to logMAR 0.37. Corresponding decimal values are 0.23 and 0.43, respectively. The incidence of cataract surgery increased from 1.0 to 7.2 operations per 1000 of the population per year over the period. For an annual increase of one operation per 1000 inhabitants, the increase in average VA before surgery is 1.3 log lines in the operated eye and 0.4 log lines in the better eye. The number of patients with visual impairment (WHO definition: VA < 0.3) before surgery fell from 47% to 15%, and the number of patients with profound visual handicaps (VA < 0.1) before surgery fell from 15% to 4%. CONCLUSION The preoperative vision of patients undergoing cataract surgery during the last two decades has improved significantly. Preoperative VA has increased linearly in line with the incidence of surgery. Only a small proportion of the increase in incidence of cataract surgery can be explained by the increasing average age of the population.
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Affiliation(s)
- Jaakko Leinonen
- Department of Ophthalmology, Vaasa Central Hospital, Finland.
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16
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Hakama M, Stenman UH, Aromaa A, Leinonen J, Hakulinen T, Knekt P. Validity of the prostate specific antigen test for prostate cancer screening: followup study with a bank of 21,000 sera in Finland. J Urol 2001; 166:2189-91; discussion 2191-2. [PMID: 11696733 DOI: 10.1016/s0022-5347(05)65532-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE We investigate the validity of prostate specific antigen (PSA) as a screening test for prostate cancer. MATERIALS AND METHODS A registry of serum samples drawn from 1968 to 1976 from 21,387 men was linked to the Finnish Cancer Registry. During followup from 1968 to 1991, 104 prostate cancers were identified. A matched case control design with incidence density sampling and nested in the serum sample bank was applied, and PSA was assessed. RESULTS The estimated sensitivity of the test was 44% and specificity 94% at a cutoff of 4.0 microg./l. in the total material. The sensitivity had improved to 86% in patients diagnosed in 5 years after the sample drawing. The test had a better sensitivity (93%) and specificity (96%) in men younger than 65 years at the time of the sample drawing compared to those older. The sensitivity further improved to 100% with a cutoff of 2.5 microg./l. CONCLUSIONS PSA is a valid screening test for prostate cancer, which compares favorably with mammography for breast cancer. However, until an effect on mortality has been shown, routine screening cannot be recommended.
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Affiliation(s)
- M Hakama
- Department of Public Health, Helsinki University, Tampere University School of Public Health, Finnish Cancer Registry, University Hospital of Helsinki, The National Public Health Institute, Helsinki, Finland
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Karhumaa P, Leinonen J, Parkkila S, Kaunisto K, Tapanainen J, Rajaniemi H. The identification of secreted carbonic anhydrase VI as a constitutive glycoprotein of human and rat milk. Proc Natl Acad Sci U S A 2001; 98:11604-8. [PMID: 11553764 PMCID: PMC58776 DOI: 10.1073/pnas.121172598] [Citation(s) in RCA: 83] [Impact Index Per Article: 3.6] [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: 12/20/2000] [Accepted: 04/09/2001] [Indexed: 01/11/2023] Open
Abstract
In addition to essential nutrients, human milk contains several classes of bioactive factors such as enzymes, hormones, and growth factors, many of which are implicated in infantile growth and development. Secretory carbonic anhydrase isoenzyme VI (CA VI) has been identified earlier as an essential component of mammalian saliva, and we demonstrate here by using biochemical and immunohistochemical techniques that it is also an elementary component of milk. The 42-kDa glycopolypeptide purified from human milk in CA inhibitor affinity chromatography shared 100% homology with salivary CA VI in the protein sequence analysis (40% coverage), and its digestion with PNGase F resulted in a polypeptide backbone similar in size to salivary CA VI. Quantification of CA VI in milk by using a time-resolved immunofluorometric assay revealed an approximately eight-times-higher concentration in human colostrum than in mature milk, the latter corresponding to the levels previously detected in human saliva. The high concentration in the colostrum, in particular its functional and structural stability in an acidic milieu, and its growth-supporting role in the taste buds suggest that milk CA VI is an essential factor in normal growth and development of the infant alimentary tract.
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Affiliation(s)
- P Karhumaa
- Department of Anatomy and Cell Biology, University of Oulu, FIN-90014 Oulu, Finland.
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18
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Hedström J, Haglund C, Leinonen J, Nordling S, Stenman UH. Trypsinogen-1, -2 and tumour-associated trypsin-inhibitor in bile and biliary tract tissues from patients with biliary tract diseases and pancreatic carcinomas. Scand J Clin Lab Invest 2001; 61:111-8. [PMID: 11347977 DOI: 10.1080/00365510151097584] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The bile concentrations of trypsinogen-1, -2 and tumour-associated trypsin-inhibitor (TATI) were determined in 23 patients with benign biliary tract disease, two with biliary tract cancer, and in 15 with pancreatic cancer. We also examined the trypsinogen and TATI expression by immunohistochemistry in tissue specimens from biliary tract cancer and non-neoplastic extrahepatic biliary tract. High levels of trypsinogen-1, trypsinogen-2, and TATI occur in bile of most patients. In contrast to the trypsinogens, the levels of TATI were significantly higher in patients with malignant disease than in those with benign diseases (p=0.04). There was no significant correlation between trypsinogen-2 and amylase (r=0.13, p=0.40), indicating that the occurrence of trypsinogen in bile is not a result of reflux of pancreatic fluid into the bile duct. Immunohistochemically, trypsinogen-2 was detected in five and TATI in 12 out of 15 non-neoplastic biliary tract specimens, and in four and seven out of 11 cholangiocarcinomas, respectively. High concentrations of trypsinogen-1, trypsinogen-2 and TATI occur in the bile of patients with non-neoplastic and malignant biliary tract disease and in patients with pancreatic cancer. At least part of the trypsinogen-2 and TATI found in bile appears to be derived from the biliary epithelium itself.
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Affiliation(s)
- J Hedström
- Department of Clinical Chemistry, University of Helsinki, Finland.
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19
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Zhang WM, Finne P, Leinonen J, Stenman UH. Characterization and determination of the complex between prostate-specific antigen and alpha 1-protease inhibitor in benign and malignant prostatic diseases. Scand J Clin Lab Invest Suppl 2001; 233:51-8. [PMID: 11317942] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Prostate-specific antigen (PSA) is a tissue-specific serine protease which forms complexes with protease inhibitors such as alpha 1-antichymotrypsin and alpha 2-macroglobulin. We have studied the interaction between PSA and alpha 1-protease inhibitor (API) in vitro and found that 15% of the added PSA binds to API while the majority of API is cleaved between Met358 and Ser359 when PSA is incubated with a 5-fold excess of API at 37 degrees C for 7 days. The complex between PSA and API (PSA-API) formed in vitro displays the same chromatographic behavior, molecular size and immunoreactivity as endogenous PSA-API occurring in serum, indicating that they are identical. PSA-API can be detected in serum by a time-resolved immunofluorometric assay (IFMA), in which a monoclonal antibody to PSA is used as a catcher and a polyclonal antibody to API labeled with a Eu-chelate is used as a tracer. Purified PSA-API formed in vitro is used as a calibrator. PSA-API in serum represents 1.0-7.9% (median 2.4%) of total PSA (tPSA) in prostate cancer (PCa, n = 82) and 1.3-12.2% (median 3.6%, p < 0.01) in patients with benign prostatic hyperplasia (BPH, n = 66). The IFMA for PSA-API in serum is hampered by a variable background, which is caused by non-specific adsorption of the huge excess of API in serum to the solid phase. The background can be determined by an assay using the same tracer as in the IFMA for PSA-API but PSA-unrelated antibody on the solid phase. The background signal is subtracted from the PSA-API signal. The clinical utility of PSA-API in serum has been evaluated in PSA-positive subjects from the Finnish PCa screening trial. After subtraction of the background, the proportion of PSA-API in relation to tPSA is lower in PCa than in controls, 0.9% vs. 1.6%, respectively (p < 0.001). Logistic regression analysis showed that the concentration of PSA-API was independent of the proportion of free PSA as a diagnostic variable among subjects with a tPSA of 4-10 micrograms/l (p = 0.009). The probability of PCa calculated by logistic regression using the concentration of PSA-API and the proportion of free PSA in serum significantly improved cancer specificity at high sensitivity levels (85-95%) as compared to the proportion of free PSA alone.
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Affiliation(s)
- W M Zhang
- Department of Clinical Chemistry, Helsinki University Central Hospital, Helsinki, Finland
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Leinonen J, Wu P, Koivunen E, Närvänen A, Stenman UH. Development of novel peptide ligands modulating the enzyme activity of prostate-specific antigen. Scand J Clin Lab Invest Suppl 2001; 233:59-64. [PMID: 11317943] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Prostate-specific antigen (PSA) is a serine proteinase produced mainly by epithelial cells of the prostate. Measurement of PSA in serum is widely used for diagnosis and monitoring of prostate cancer. The major problem of the PSA determination in early diagnosis is the high false positive rate due to benign prostatic hyperplasia, but the clinical accuracy can be improved by determining the proportions of various molecular forms of PSA. The main biological function of PSA is liquefaction of the seminal gel formed after ejaculation, but PSA has also been suggested to regulate invasiveness and metastatic potential of prostatic tumors. Thus, agents binding to and affecting the function of PSA have the potential to be used for diagnosis and therapy of prostate cancer. We have developed peptides specific for PSA by using cyclic phage display peptide libraries. After deducing the amino acid sequence of the peptides by sequencing the relevant part of phage genome, the peptides were expressed as glutathione-S-transferase (GST) fusion proteins or produced by chemical synthesis. The peptides were shown to bind to PSA specifically as indicated by lack of binding to other related serine proteinases. The binding of the peptides with PSA was strongly inhibited by monoclonal antibodies specific for free PSA and they did not bind to PSA-inhibitor complexes indicating that they bind close to the active site of the enzyme. Most of the peptides enhanced the enzyme activity of PSA against a chromogenic substrate. The affinity of the peptides could be increased by including Zn2+ in the reaction mixture. These results show that peptides that bind to PSA and modulate its enzyme activity can be developed by phage display techniques. These peptides have the potential to be used for targeting of prostatic tumors and diagnostics of prostate cancer.
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Affiliation(s)
- J Leinonen
- Department of Clinical Chemistry, Helsinki University Central Hospital, Helsinki, Finland.
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Leinonen J, Parkkila S, Kaunisto K, Koivunen P, Rajaniemi H. Secretion of carbonic anhydrase isoenzyme VI (CA VI) from human and rat lingual serous von Ebner's glands. J Histochem Cytochem 2001; 49:657-62. [PMID: 11304804 DOI: 10.1177/002215540104900513] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Salivary carbonic anhydrase VI (CA VI) appears to contribute to taste function by protecting taste receptor cells (TRCs) from apoptosis. The serous von Ebner's glands locating in the posterior tongue deliver their saliva into the bottom of the trenches surrounding the TRC-rich circumvallate and foliate papillae. Because these glands deliver their saliva directly into the immediate vicinity of TRCs, we investigated whether CA VI is secreted by the von Ebner's glands, using immunochemical techniques. The immunohistochemical results showed that CA VI is present in the serous acinar cells, ductal cells, and ductal content of von Ebner's glands and in the demilune and ductal cells plus ductal content of rat lingual mucous glands. More importantly, CA VI was also detected in taste buds and in the taste pores. Western blotting of saliva collected from the orifices of human von Ebner's glands and CAs purified from rat von Ebner's glands confirmed that CA VI is expressed in these glands and secreted to the bottom of the trenches surrounding the circumvallate and foliate papillae. These findings are consistent with the hypothesis that locally secreted CA VI is implicated in the paracrine modulation of taste function and TRC apoptosis. (J Histochem Cytochem 49:657-662, 2001)
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Affiliation(s)
- J Leinonen
- Department of Anatomy and Cell Biology, PO Box 5000, 90014 University of Oulu, Oulu, Finland
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Affiliation(s)
- U Stenman
- Department of Clinical Chemistry, Helsinki University Central Hospital, Helsinki, Finland
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Finne P, Zhang WM, Auvinen A, Leinonen J, Määttänen L, Rannikko S, Tammela TL, Stenman UH. Use of the complex between prostate specific antigen and alpha 1-protease inhibitor for screening prostate cancer. J Urol 2000; 164:1956-60. [PMID: 11061890] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
PURPOSE We assess whether the complex between prostate specific antigen (PSA) and alpha1-protease inhibitor in serum can be used to reduce further the number of false-positive PSA screen results independent of total and free PSA. MATERIALS AND METHODS Sera from 304 consecutive screen positive subjects, including 78 with and 226 without prostate cancer, and serum PSA of 4 to 10 microg./l. or higher in the Finnish, randomized, population based prostate cancer screening trial were analyzed for PSA-alpha-protease inhibitor, and total and free PSA. Main outcome measures were specificity, sensitivity and area under receiver operating characteristics curve for proportions of free PSA and PSA-alpha 1-protease inhibitor, and for a combination of these among screen positive cases. RESULTS The proportion of serum PSA-alpha 1-protease inhibitor of total PSA was lower in cancer cases than in controls (0.9% versus 1.6%, p <0.001). Logistic regression analysis of total PSA, free PSA and PSA-alpha 1-protease inhibitor showed that PSA-alpha 1-protease inhibitor in serum was an independent variable for discrimination between subjects with and without prostate cancer (p = 0.006) in the PSA range of 4 to 10 microg./l. The proportion of PSA-alpha 1-protease inhibitor alone improved specificity less than the proportion of free PSA but when these were combined by logistic regression they performed better than the proportion of free PSA alone at sensitivities of 85% to 95% (p <0.001). CONCLUSIONS Serum PSA-alpha 1-protease inhibitor improves the specificity of total and free PSA in a screening population with total PSA 4 to 10 microg./l.
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Affiliation(s)
- P Finne
- Department of Clinical Chemistry, Helsinki University Central Hospital, Finland
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Stenman UH, Paus E, Allard WJ, Andersson I, Andrès C, Barnett TR, Becker C, Belenky A, Bellanger L, Pellegrino CM, Børmer OP, Davis G, Dowell B, Grauer LS, Jette DC, Karlsson B, Kreutz FT, van der Kwast TM, Lauren L, Leinimaa M, Leinonen J, Lilja H, Linton HJ, Nap M, Hilgers J. Summary report of the TD-3 workshop: characterization of 83 antibodies against prostate-specific antigen. Tumour Biol 2000; 20 Suppl 1:1-12. [PMID: 10628402 DOI: 10.1159/000056523] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Twelve research groups participated in the ISOBM TD-3 Workshop in which the reactivity and specificity of 83 antibodies against prostate-specific antigen (PSA) were investigated. Using a variety of techniques including cross-inhibition assays, Western blotting, BIAcore, immunoradiometric assays and immunohistochemistry, the antibodies were categorized into six major groups which formed the basis for mapping onto two- and three-dimensional (2-D and 3-D) models of PSA. The overall findings of the TD-3 Workshop are summarized in this report. In agreement with all participating groups, three main antigenic domains were identified: free PSA-specific epitopes located in or close to amino acids 86-91; discontinuous epitopes specific for PSA without human kallikrein (hK2) cross-reactivity located at or close to amino acids 158-163; and continuous or linear epitopes shared between PSA and hK2 located close to amino acids 3-11. In addition, several minor and partly overlapping domains were also identified. Clearly, the characterization of antibodies from this workshop and the location of their epitopes on the 3-D model of PSA illustrate the importance of selecting appropriate antibody pairs for use in immunoassays. It is hoped that these findings and the epitope nomenclature described in this TD-3 Workshop are used as a standard for future evaluation of anti-PSA antibodies.
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Affiliation(s)
- U H Stenman
- Department of Clinical Chemistry, Helsinki University Central Hospital, Finland
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Leinonen J, Leinimaa M, Zhang WM, Piironen T, Pettersson K, Lilja H, Dowell B, Stenman UH. Reactivity of anti-PSA monoclonal antibodies with recombinant human kallikrein-2. Tumour Biol 2000; 20 Suppl 1:35-7. [PMID: 10628407 DOI: 10.1159/000056528] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Seventy-nine monoclonal antibodies submitted to the ISOBM TD-3 PSA Workshop were tested for their reactivity with recombinant human kallikrein-2 (rhK2). A sandwich immunofluorometric assay using polyclonal anti-prostate-specific antigen (PSA) antiserum-coated plates was used to capture rhK2 and subsequently the test antibody. The response of each test antibody was compared with 3 reference antibodies (H50, H117 and 5E4) known to react with hK2. Nine antibodies from the workshop panel failed to react with purified PSA and rhK2 in this assay and were subsequently excluded. From the remaining panel of antibodies, 11/70 showed strong reactivity with rhK2, 9/70 showed weak reactivity with rhK2, while 50/70 antibodies did not react with rhK2 in this assay format. All antibodies binding to rhK2 recognized both free and complexed PSA.
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Affiliation(s)
- J Leinonen
- Department of Clinical Chemistry, Helsinki University Central Hospital, Finland.
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Leinonen J, Zhang WM, Paus E, Stenman UH. Reactivity of 77 antibodies to prostate-specific antigen with isoenzymes and complexes of prostate-specific antigen. Tumour Biol 2000; 20 Suppl 1:28-34. [PMID: 10628406 DOI: 10.1159/000056527] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Seventy-seven antibodies submitted to the ISOBM TD-3 PSA Workshop (TD-3.1 and TD-3.2) were characterized by measuring their reactivity with isoenzymes of free prostate-specific antigen (PSA), PSA complexed to alpha1-antichymotrypsin (PSA-ACT) and alpha1-proteinase inhibitor (PSA-API). Antibodies were classified into 15 distinct groups according to their reaction profiles with the various isoenzymes. Some antibodies recognizing both free and complexed PSA were inaccurate in measuring total PSA. Eight of the 9 free PSA-specific antibodies cross-reacted more with PSA-API than with PSA-ACT, while 1 antibody reacted less with PSA-API than PSA-ACT. From the panel of antibodies 39 reacted with both free and complexed PSA and were classified as total PSA antibodies.
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Affiliation(s)
- J Leinonen
- Department of Clinical Chemistry, Helsinki University Central Hospital, Finland.
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Wu P, Leinonen J, Koivunen E, Lankinen H, Stenman UH. Identification of novel prostate-specific antigen-binding peptides modulating its enzyme activity. Eur J Biochem 2000; 267:6212-20. [PMID: 11012675 DOI: 10.1046/j.1432-1327.2000.01696.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Prostate-specific antigen (PSA) is a serine protease with highly prostate-specific expression. Measurement of PSA in serum is widely used for diagnosis and monitoring of prostate cancer. PSA dissolves the seminal gel forming after ejaculation. It has been suggested to mediate invasion and metastasis of prostate cancer but also to exert antiangiogenic activity. We have identified peptides specific for PSA by screening cyclic phage display peptide libraries. PSA-binding peptides were isolated from four different libraries and produced as a fusion protein with glutathione S-transferase (GST). The phage and fusion proteins were shown to bind to PSA specifically as indicated by lack of binding to other serine proteinases. A peptide with four cysteines showed the highest affinity for PSA. Zn2+, an inhibitor of PSA activity, increased the affinity of the peptides to PSA. The binding specificity was characterized by cross-inhibition using monoclonal anti-PSA antibodies of known epitope specificities. The peptides bound to the same region as mAbs specific for free PSA indicating that they bind close to the active site of the enzyme. The peptides enhanced the enzyme activity of PSA against a chromogenic substrate. These results show that peptides binding to PSA and modulating its enzyme activity can be developed by phage display technique. The peptides have the potential to be used for identification of PSA variants and for imaging and targeting of prostatic tumors.
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Affiliation(s)
- P Wu
- Department of Clinical Chemistry, Helsinki University Central Hospital, Finland
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Zhang WM, Finne P, Leinonen J, Salo J, Stenman UH. Determination of prostate-specific antigen complexed to alpha(2)-macroglobulin in serum increases the specificity of free to total PSA for prostate cancer. Urology 2000; 56:267-72. [PMID: 10925092 DOI: 10.1016/s0090-4295(00)00609-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To determine whether prostate-specific antigen (PSA) complexed to alpha(2)-macroglobulin (A2M) increases the specificity of free PSA (fPSA) and total PSA (tPSA) for the diagnosis of prostate cancer (PCa). METHODS In a series of 73 patients with PCa and 58 with benign prostatic hyperplasia (BPH), fPSA, tPSA, and PSA complexed with A2M (PSA-A2M) in serum were determined by specific immunoassays. The assay for PSA-A2M was based on the immunoadsorption of immunoreactive PSA in serum and the measurement of the PSA immunoreactivity released by denaturation of PSA-A2M at pH 11.4. RESULTS The median proportion of PSA-A2M [ %PSA-A2M=PSA-A2M/(tPSA+PSA-A2M)] and that of fPSA ( %fPSA=fPSA/tPSA) were significantly lower in patients with PCa (8.2% and 12.4%, respectively) than in patients with BPH (11.6% and 22.5%, P = 0.0014 and P <0.0001, respectively). The median sum of %PSA-A2M and %fPSA was 22.4% in PCa and 38.2% in BPH (P <0.0001). When the sum of %PSA-A2M and %fPSA was used as a diagnostic test for PCa, 57% of patients with "falsely" elevated PSA concentrations (4 to 10 ng/mL) caused by BPH could be correctly identified without missing patients with PCa compared with 18% of the patients with BPH but not PCa using %fPSA alone. CONCLUSIONS Measurement of the sum of %PSA-A2M and %fPSA in serum significantly improves the cancer specificity of the PSA test compared with the use of tPSA and %fPSA.
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Affiliation(s)
- W M Zhang
- Department of Clinical Chemistry, Helsinki University Central Hospital, Helsinki, Finland
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Zhang W, Finne P, Leinonen J, Stenman U. Characterization and determination of the complex between prostate-specific antigen and α1-protease inhibitor in benign and malignant prostatic diseases. Scand J of Clinical & Lab Investigation 2000. [DOI: 10.1080/713783586] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Leinonen J, Wu P, Stenman U, Koivunen E, Närvänen A. Development of novel peptide ligands modulating the enzyme activity of prostate-specific antigen. Scand J of Clinical & Lab Investigation 2000. [DOI: 10.1080/00365510050217726] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Abstract
The measurement of serum prostate-specific antigen (PSA) is widely used for the detection and management of patients with prostate cancer. Many studies on the validity of PSA as a marker for prostate cancer are performed on clinical samples that have been stored frozen for years. We have studied the stability of free (F), total (T) and complexed (C) PSA immunoreactivity and the proportion of free to total PSA (F/T) in serum after melting sera stored at -20 degrees C for 2 years and 2 weeks, respectively. In contrast to the decrease in PSA-F and F/T observed in fresh samples, PSA-C decreased and PSA-F increased in a time-dependent fashion after thawing samples that had been kept frozen for 2 years. This caused a net decrease in PSA-T and an increase in F/T. These results suggest that even though serum PSA is fairly stable during short-term storage, long-term storage at -20 degrees C reduces the stability of PSA immunoreactivity. Thus, results obtained on samples stored for prolonged times at -20 degrees C should be interpreted with caution. Because of the changes in PSA-F and F/T in both fresh and archival samples stored unfrozen, it is recommended that sera are melted only for the period required for pipetting the samples.
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Affiliation(s)
- J Leinonen
- Department of Clinical Chemistry, Helsinki University Central Hospital, Helsinki, Finland.
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Abstract
PURPOSE To investigate the rapidity of vision loss in eyes waiting for cataract surgery and to estimate what proportion of life expectancy the extended wait for surgery comprised. METHODS The visual acuities at the time of referral and on the day before surgery were compared in 124 patients operated on for cataract in the Vaasa Central Hospital, Finland. The expected survival of the patients after surgery was calculated individually using the Finnish life statistics. RESULTS During the waiting time of 13 months on the average, the visual acuity in the study eye decreased from 0.68 logMAR (0.2 in decimal values) to 0.96 logMAR (0.1). The average decrease in vision was 0.27 logMAR per year varying from none to 2.07 logMAR units. 30% of the eyes experienced worsening of vision by 60% or more while 48% had no or minimal worsening (<0.2 logMAR). The rapidity of change in visual acuity was somewhat less in older patients (75 years or older), but the difference was not statistically significant. The percentage of persons with visual acuity of 0.5 or better in the better eye decreased from 66% to 41% and those with low vision (<0.3 in the better eye) increased from 8% to 21%. The mean waiting time in relation to the expected survival for all patients was 13% varying from less than 5% in 10 patients to more than 25% in 8 patients. CONCLUSION Progression of vision loss in eyes waiting for cataract surgery varies significantly. For many patients the extended delay caused remarkable disability for a considerable part of their remaining lifetime.
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Affiliation(s)
- J Leinonen
- Department of Ophthalmology, Vassa Central Hospital, Finland
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Abstract
The carbonic anhydrases (CAs) participate in the maintenance of pH homeostasis in various tissues and biological fluids of the human body by catalysing the reversible reaction CO2 + H2O HCO3- + H+ (Davenport & Fisher, 1938; Davenport, 1939; Maren, 1967). Carbonic anhydrase isoenzyme VI (CA VI) is the only secretory isoenzyme of the mammalian CA gene family. It is exclusively expressed in the serous acinar cells of the parotid and submandibular glands, from where it is secreted into the saliva. In this review, we will discuss recent advances in research focused on the physiological role of salivary CA VI in the oral cavity and upper alimentary canal.
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Affiliation(s)
- J Kivela
- Department of Anatomy and Cell Biology, University of Oulu, Oulu, Parolannummi Garrison Hospital, Finnish Defence Forces, Hattula.
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Hedström J, Haglund C, Kemppainen E, Leinimaa M, Leinonen J, Stenman UH. Time-resolved immunofluorometric assay of trypsin-1 complexed with alpha(1)-antitrypsin in serum: increased immunoreactivity in patients with biliary tract cancer. Clin Chem 1999; 45:1768-73. [PMID: 10508123] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
BACKGROUND Increased serum concentrations of trypsin immunoreactivity occur in patients with biliary tract cancer. To characterize this trypsin, we developed a sensitive time-resolved immunofluorometric assay for trypsin-1 complexed with alpha(1)-antitrypsin (AAT) and studied the concentrations of this complex in sera from healthy individuals (n = 130) and patients with benign biliary disease (n = 32), biliary tract cancer (n = 17), pancreatic cancer (n = 27), and hepatocellular cancer (n = 12). METHODS We used a trypsin-1-specific monoclonal antibody on the solid phase and a europium-labeled polyclonal antibody to AAT as tracer. The detection limit was 0.42 microgram/L. The validity of the trypsin-1-AAT test for detection of biliary tract cancer was compared with trypsin-2-AAT and CA19-9. RESULTS Increased concentrations of trypsin-1-AAT (>33 microgram/L) were found in 76% of patients with biliary tract cancer, and the concentrations were significantly higher than in those with benign biliary disease (P <0. 0001). The median concentration of trypsin-1-AAT in serum from patients with biliary tract cancer was 3.7-fold higher than in healthy controls, 2.6-fold higher than in patients with benign biliary tract disease, 1.7-fold higher than in patients with pancreatic cancer, and 2.0-fold higher than in patients with hepatocellular cancer. CONCLUSIONS Of the markers studied, trypsin-1-AAT had the largest area (0.83) under the receiver operating curve in differentiating biliary tract cancer from benign biliary tract disease. Our results suggest that trypsin-1-AAT is a new potential marker for biliary tract cancer.
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Affiliation(s)
- J Hedström
- Department of Clinical Chemistry, University of Helsinki, FIN-00029 Helsinki, Finland.
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Haverinen U, Husman T, Toivola M, Suonketo J, Pentti M, Lindberg R, Leinonen J, Hyvärinen A, Meklin T, Nevalainen A. An approach to management of critical indoor air problems in school buildings. Environ Health Perspect 1999; 107 Suppl 3:509-14. [PMID: 10423392 PMCID: PMC1566231 DOI: 10.1289/ehp.99107s3509] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
This study was conducted in a school center that had been the focus of intense public concern over 2 years because of suspected mold and health problems. Because several attempts to find solutions to the problem within the community were not satisfactory, outside specialists were needed for support in solving the problem. The study group consisted of experts in civil engineering, indoor mycology, and epidemiology. The studies were conducted in close cooperation with the city administration. Structures at risk were opened, moisture and temperature were measured, and the causes of damage were analyzed. Microbial samples were taken from the air, surfaces, and materials. Health questionnaires were sent to the schoolchildren and personnel. Information on the measurements and their results was released regularly to school employees, students and their parents, and to the media. Repairs were designed on the basis of this information. Moisture damage was caused mainly by difficult moisture conditions at the building site, poor ventilation, and water leaks. Fungal genera (concentrations <200 colony-forming units (cfu)/m(3), <3000 cfu/cm(2)) typical to buildings with mold problems (e.g., Aspergillus versicolor, Eurotium) were collected from the indoor air and surfaces of the school buildings. Where moisture-prone structures were identified and visible signs of damage or elevated moisture content were recorded, the numbers of microbes also were high; thus microbial results from material samples supported the conclusions made in the structural studies. Several irritative and recurrent symptoms were common among the upper secondary and high school students. The prevalence of asthma was high (13%) among the upper secondary school students. During the last 4 years, the incidence of asthma was 3-fold that of the previous 4-year period.
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Affiliation(s)
- U Haverinen
- National Public Health Institute, Laboratory of Environmental Microbiology and Unit of Epidemiology, Kuopio, Finland.
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Zhang WM, Finne P, Leinonen J, Vesalainen S, Nordling S, Stenman UH. Measurement of the complex between prostate-specific antigen and alpha1-protease inhibitor in serum. Clin Chem 1999; 45:814-21. [PMID: 10351990] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
BACKGROUND Prostate-specific antigen (PSA) occurs in serum both free and in complex with protease inhibitors. The complex with alpha1-antichymotrypsin (ACT) is the major form in serum, and the proportion of PSA-ACT is higher in prostate cancer (PCa) than in benign prostatic hyperplasia (BPH). PSA also forms a complex with alpha1-protease inhibitor (API) in vitro, and the PSA-ACT complex has been detected in serum from patients with prostate cancer. The aim of the present study was to develop a quantitative method for the determination of PSA-API and to determine the serum concentrations in patients with PCa and BPH. METHODS The assay for PSA-API utilizes a monoclonal antibody to PSA as capture and a polyclonal antibody to API labeled with a Eu-chelate as a tracer. For calibrators, PSA-API formed in vitro was used. Serum samples were obtained before treatment from 82 patients with PCa, from 66 patients with BPH, and from 22 healthy females. RESULTS The concentrations of PSA-API are proportional to the concentrations of total PSA. PSA-API comprises 1.0-7.9% (median, 2.4%) of total immunoreactive PSA in PCa and 1.3-12.2% (median, 3.6%) in BPH patients with serum PSA concentrations >4 microgram/L. In patients with 4-20 microgram/L total PSA, the proportion of PSA-API serum is significantly higher in BPH (median, 4.1%) than in PCa (median, 3. 2%; P = 0.02). CONCLUSIONS The proportion of PSA-API in serum is lower in patients with PCa than in those with BPH. These results suggest that PSA-API is a potential adjunct to total and free PSA in the diagnosis of prostate cancer.
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Affiliation(s)
- W M Zhang
- Departments of Clinical Chemistry, Urology, and Pathology, Helsinki University Central Hospital, FIN-00290 Helsinki, Finland
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Leinonen J, Kivelä J, Parkkila S, Parkkila AK, Rajaniemi H. Salivary carbonic anhydrase isoenzyme VI is located in the human enamel pellicle. Caries Res 1999; 33:185-90. [PMID: 10207193 DOI: 10.1159/000016515] [Citation(s) in RCA: 66] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Salivary carbonic anhydrase (CA VI) appears to protect teeth from caries via mechanisms other than direct regulation of salivary pH and buffering capacity. To elucidate whether CA VI acts in the local microenvironment of the tooth surface, we studied the location and activity of the enzyme in the human enamel pellicle. The study was performed using a specific rabbit antiserum to human CA VI in conjunction with immunostaining and immunoblot techniques. CA activity was demonstrated using a histochemical staining method. CA VI immunostaining of extracted teeth having in vivo formed pellicle showed that the enzyme is present in the enamel pellicle. Immunostaining for salivary alpha-amylase, which is known to be present in the pellicle, showed a similar staining pattern. The presence of CA VI in the enamel pellicle was confirmed by immunoblotting of in vivo formed pellicle proteins. In vitro studies showed that CA VI binds to polished enamel surfaces from both saliva and solutions of purified enzyme. The intensity of the CA VI immunostaining on the enamel surface was dependent on the concentration of the applied enzyme. The histochemical staining of in vitro formed enamel pellicle confirmed that the bound enzyme retains its enzymatic activity. The presence of active CA VI in the human enamel pellicle suggests that it may accelerate the removal of acid by functioning locally in the pellicle layer on dental surfaces.
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Affiliation(s)
- J Leinonen
- Department of Anatomy, University of Oulu, Finland
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Abstract
Prostate specific antigen (PSA) is serine protease produced at high concentrations by normal and malignant prostatic epithelium. It is mainly secreted into seminal fluid, where it digests the gel forming after ejaculation. Only minor amounts of PSA leak out into circulation from the normal prostate, but the release of PSA is increased in prostatic disease. Thus PSA is a sensitive serum marker for prostate cancer but its specificity is limited by a high frequency of falsely elevated values in men with benign prostatic hyperplasia (BPH). Approximately two-thirds of all elevated values (>4 microg/l) in men over 50 years of age are due to BPH. In serum, most of the PSA immunoreactivity consists of a complex between PSA and alpha1-antichymotrypsin (PSA-ACT) whereas approximately 5-40% are free. The proportion of PSA-ACT is larger and the free fraction is smaller in prostate cancer than in benign prostatic hyperplasia (BPH). Determination of the proportion of free PSA has become widely used to improve the cancer specificity of PSA especially in men with PSA values in the 'grey zone' (4-10 microg/l). PSA also occurs in complexes with other protease inhibitors and determination of these and other markers may further improve the diagnostic accuracy for prostate cancer. Interpretation of the results for many different markers is complicated, but this can be simplified by using statistical methods. The diagnostic accuracy can be further improved by using logistic regression or neural networks to estimate the combined impact of marker results and other findings like digital rectal examination (DRE), transrectal ultrasound (TRUS) and heredity.
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Affiliation(s)
- U H Stenman
- Department of Clinical Chemistry, Helsinki University Central Hospital, Helsinki, FIN-00290, Finland
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Black MH, Grass CL, Leinonen J, Stenman UH, Diamandis EP. Characterization of monoclonal antibodies for prostate-specific antigen and development of highly sensitive free prostate-specific antigen assays. Clin Chem 1999; 45:347-54. [PMID: 10053035] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
BACKGROUND The recent elucidation of the importance of serological free prostate-specific antigen (PSA) in the diagnosis of prostate cancer has created a demand for immunoassays specific for free PSA. METHODS We developed and characterized 11 monoclonal antibodies with high affinities for PSA (Ka values from 1.1 x 10(8) to 1.8 x 10(10)L/mol), only 3 of which cross-react with human glandular kallikrein (hK2). Using these antibodies and PSA antibodies developed by others, in conjunction with time-resolved fluorometry, we developed ultrasensitive sandwich immunoassays specific for the free form of PSA. RESULTS The analytical detection limit of these immunoassays is 0.001 microg/L. To our knowledge, this is the most sensitive free PSA assay reported to date. The free PSA immunoassays exhibit <1% cross-reactivity with PSA-alpha1-antichymotrypsin, show no cross-reactivity with hK2, and correlate well with established free PSA kits. The 11 antibodies developed by our group, in conjunction with 4 commercially available antibodies, were used to generate a putative epitope map of the PSA molecule. CONCLUSION The highly sensitive free PSA immunoassays may be used for measuring PSA subfractions in female serum, an application currently impossible with other reported free PSA immunoassays.
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Affiliation(s)
- M H Black
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, 600 University Avenue, Toronto, Ontario, Canada M5G 1X5
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Affiliation(s)
- H Alho
- Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland
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Zhang WM, Finne P, Leinonen J, Vesalainen S, Nordling S, Rannikko S, Stenman UH. Characterization and immunological determination of the complex between prostate-specific antigen and alpha2-macroglobulin. Clin Chem 1998; 44:2471-9. [PMID: 9836714] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Prostate-specific antigen (PSA) rapidly forms a complex with alpha2-macroglobulin (A2M) in vitro; however, PSA complexed with A2M (PSA-A2M) is not detected by conventional immunoassays for PSA because it is encapsulated by the A2M. In this study, we show that denaturation of PSA-A2M at high pH renders PSA immunoreactive. Part of the complexed PSA is released in free form and part remains bound to denatured A2M. These forms can be measured by a conventional immunoassay for PSA. This finding enabled us to design a dissociation assay for the detection of PSA-A2M, which was based on the removal of immunoreactive PSA in serum by immunoadsorption, denaturation of PSA-A2M at high pH, and measurement of the released PSA immunoreactivity by a conventional PSA immunoassay. This PSA-A2M assay was calibrated with PSA-A2M formed in vitro. The detection limit of the assay was 0.14 microg/L. Inter- and intraassay coefficients variation were 4-9% and 8-14%, respectively. When purified PSA was incubated with A2M, the loss of PSA immunoreactivity was highly correlated with the PSA-A2M formed, as measured by the dissociation assay for PSA-A2M (r = 0.99; P <0.0001). The concentration of PSA-A2M in serum correlated with that of total PSA both in prostate cancer (PCa) and benign prostatic hyperplasia (BPH); however, the ratio of PSA-A2M in relation to total PSA was significantly higher in BPH than in PCa (P <0.0003). ROC curve analysis suggested that measurement of the ratio of PSA-A2M to total PSA in serum improves the diagnostic accuracy for PCa compared with assays for total PSA only.
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Affiliation(s)
- W M Zhang
- Department of Clinical Chemistry, Helsinki University Central Hospital, Helsinki, Finland.
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Leinonen J, Rantalaiho V, Lehtimäki T, Koivula T, Wirta O, Pasternack A, Alho H. The association between the total antioxidant potential of plasma and the presence of coronary heart disease and renal dysfunction in patients with NIDDM. Free Radic Res 1998; 29:273-81. [PMID: 9860042 DOI: 10.1080/10715769800300311] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Oxidative stress may be an important pathogenetic factor in the development of diabetic vascular complications. The total antioxidative potential of plasma reflects the ability of an individual to resist oxidative stress. We measured the plasma total peroxyl radical-trapping potential (TRAP) and the concentrations of four plasma chain-breaking antioxidants in 81 patients with non-insulin-dependent diabetes mellitus (NIDDM) nine years after diagnosis and in 102 well-matched non-diabetic control subjects. The association between the total antioxidative potential and the presence of coronary heart disease (CHD) and diabetic kidney disease were also studied. There were no significant differences in plasma TRAP between NIDDM patients and control subjects (1250+/-199 vs. 1224+/-198 microM). Nor were there any significant differences in the concentrations of plasma uric acid, ascorbic acid, alpha-tocopherol, and protein thiols between NIDDM patients and control subjects. Patients with a low glomerular filtration rate and/or high urinary albumin excretion had elevated plasma uric acid. Plasma TRAP was not, however, associated with renal dysfunction. The plasma of NIDDM patients with CHD had a significantly higher value of unidentified antioxidative potential than that of patients without CHD. This relation was strongly dependent upon smoking. In conclusion, these data demonstrate that there are no major defects in the antioxidative potential of plasma caused by NIDDM per se. CHD and diabetic renal dysfunction were not associated with changes in plasma TRAP.
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Affiliation(s)
- J Leinonen
- University of Tampere, Department of Clinical Chemistry, Tampere University Hospital, Finland.
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Abstract
The proportion of free prostate-specific antigen (PSA) in serum relative to total PSA (F/T) is lower in patients with prostate cancer than in those with elevated levels of PSA due to benign prostatic disease. When applied to early diagnosis and screening for prostate cancer, the proportion of free PSA can be used to reduce the number of false-positive results by 20-40%. The utility of F/T is better in men with a small prostate volume, i.e. in relatively young men, who are most likely to benefit from early diagnosis and treatment of prostate cancer. The concentrations of PSA and especially free PSA are affected by considerable intra-individual variation and sample stability. Assay standardization is variable and it is therefore important to establish reference values for the methods used. Better control of these factors is likely to improve the diagnostic accuracy. The utility of determining free PSA can be improved by evaluating the combined impact of free and total PSA by logistic regression analysis or neural networks.
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Affiliation(s)
- U H Stenman
- Department of Clinical Chemistry, Helsinki University Central Hospital, Helsinki, Finland
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Leinonen J, Alho H, Knip M. Antioxidant activity of plasma in subjects at increased risk for type I diabetes (IDDM). Pathophysiology 1998. [DOI: 10.1016/s0928-4680(98)80976-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Leinonen J, Lehtimäki T, Toyokuni S, Okada K, Tanaka T, Hiai H, Ochi H, Laippala P, Rantalaiho V, Wirta O, Pasternack A, Alho H. New biomarker evidence of oxidative DNA damage in patients with non-insulin-dependent diabetes mellitus. FEBS Lett 1997; 417:150-2. [PMID: 9395094 DOI: 10.1016/s0014-5793(97)01273-8] [Citation(s) in RCA: 206] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG) has been reported to serve as a sensitive biomarker of oxidative DNA damage and also of oxidative stress. We have investigated oxidative DNA damage in patients with non-insulin-dependent diabetes mellitus (NIDDM) by urinary 8-OHdG assessments. We determined the total urinary excretion of 8-OHdG from 24 h urine samples of 81 NIDDM patients 9 years after the initial diagnosis and of 100 non-diabetic control subjects matched for age and gender. The total 24 h urinary excretion of 8-OHdG was markedly higher in NIDDM patients than in control subjects (68.2 +/- 39.4 microg vs. 49.6 +/- 37.7 microg, P = 0.001). High glycosylated hemoglobin was associated with a high level of urinary 8-OHdG. The increased excretion of urinary 8-OHdG is seen as indicating an increased systemic level of oxidative DNA damage in NIDDM patients.
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Affiliation(s)
- J Leinonen
- Laboratory of Neurobiology, Medical School, University of Tampere, Finland
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Abstract
BACKGROUND Complexes between prostate-specific antigen (PSA) and alpha 1-protease inhibitor (API) occur in serum and they are of potential interest in the diagnosis of prostate cancer. Pure PSA-API complexes are needed for development of specific assays, but complex formation has not earlier been achieved in vitro. METHODS PSA was incubated with an excess of API at 37 degrees C. Complexes formed were quantitated by an immunofluorometric assay using antibodies to PSA and API. The products were further characterized by SDS-PAGE, immunoblotting and amino-acid sequencing. PSA-API was purified by gel filtration and immunoaffinity chromatography. RESULTS PSA formed an SDS-stable 80-kDa one-to-one complex with API. The rate of formation of PSA-API was slow compared to that of PSA-alpha 2-macroglobulin (A2M) or PSA-alpha 1-antichymotrypsin (ACT), and only about 15% of PSA complexed with a 5-fold molar excess of API at 37 degrees C in 7 days. A major part of API was cleaved between 358-Met and 359-Ser, causing loss of inhibitory activity. PSA-API formed in vitro was purified by gel filtration and immunoaffinity chromatography with anti-PSA antibody. After incubation for 7 days at 37 degrees C, 30-40% of the complex had dissociated causing release of active PSA and proteolytically cleaved inactive API. The dissociation was accelerated in the presence of serum, and released PSA complexed with A2M and ACT. CONCLUSIONS PSA forms a complex with API in vitro, but the reaction is slow and part of the API is cleaved. Complex formation is reversible and released PSA is enzymatically active, whereas API is inactivated. Purified PSA-API will facilitate development of quantitative immunoassays for this complex.
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Affiliation(s)
- W M Zhang
- Department of Clinical Chemistry, Helsinki University Central Hospital, Finland
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Leinonen J, Rantalaiho V, Wirta O, Pasternack A, Solakivi T, Jaakkola O, Koivula T, Alho H, Lehtimäki T. 4.P.75 Autoantibodies against oxidized LDL in NIDDM patients. Atherosclerosis 1997. [DOI: 10.1016/s0021-9150(97)89601-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Sorsa T, Salo T, Koivunen E, Tyynelä J, Konttinen YT, Bergmann U, Tuuttila A, Niemi E, Teronen O, Heikkilä P, Tschesche H, Leinonen J, Osman S, Stenman UH. Activation of type IV procollagenases by human tumor-associated trypsin-2. J Biol Chem 1997; 272:21067-74. [PMID: 9261109 DOI: 10.1074/jbc.272.34.21067] [Citation(s) in RCA: 153] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Increased production of proteinases, such as matrix metalloproteinases (MMPs), is a characteristic feature of malignant tumors. Some human cancers and cell lines derived from them also express trypsinogen, but the function of the extrapancreatic trypsin has remained unclear. In this study we cloned and sequenced trypsinogen-2 cDNA from human COLO 205 colon carcinoma cells and characterized the ability of the enzyme to activate latent human type IV procollagenases (proMMP-2 and proMMP-9). As shown by cloning and N-terminal amino acid sequencing, the amino acid sequence of tumor-associated trypsin-2 is identical to that of pancreatic trypsin-2. We found that both pancreatic trypsin-2 and tumor cell-derived trypsin-2 are efficient activators of proMMP-9 and are capable of activating proMMP-9 at a molar ratio of 1:1000, the lowest reported so far. Human trypsin-2 was a more efficient activator than widely used bovine trypsin and converted the 92-kDa proMMP-9 to a single 77-kDa product that was not fragmented further. The single peptide bond cleaved by trypsin-2 in proMMP-9 was Arg87-Phe88. The generation of the 77-kDa species coincided with the increase in specific activity of MMP-9. In contrast, trypsin-2 only partially activated proMMP-2. Trypsin-2 cleaved the Arg99-Lys100 peptide bond of proMMP-2 generating 62-65-kDa MMP-2 species. Trypsin-2-induced proMMP-2 and -9 conversions were inhibited by tumor-associated trypsin inhibitor added either prior to or during activation indicating that proMMPs were not activated autocatalytically. Trypsin-2 also activated proMMPs associated with tissue inhibitor of matrix metalloproteinases, the complexes of which are thought to be the major MMP forms in vivo. The ability of human tumor cell-derived trypsin-2 to activate latent MMPs suggests a role for trypsin-2 in initiating the proteinase cascade that mediates tumor invasion and metastasis formation.
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Affiliation(s)
- T Sorsa
- Departments of Medical Chemistry and Periodontology, University of Helsinki, FIN-00014 Helsinki, Finland.
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Stenman UH, Leinonen J, Zhang WM. Problems in the determination of prostate specific antigen. Eur J Clin Chem Clin Biochem 1996; 34:735-40. [PMID: 8891526] [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] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Accurate determination of prostate specific antigen is important because of the increasing use of prostate specific antigen for diagnosis, follow-up and screening of prostate cancer. Standardization of this assay is complicated by the occurrence in serum of two major molecular forms of prostate specific antigen, free prostate specific antigen and a complex between prostate specific antigen and alpha 1-antichymotrypsin. These two forms of prostate specific antigen are recognized differently by many but not all antibodies. Thus, it is possible and desirable to develop methods that measure each form equally. To achieve better comparability, it is also necessary to prepare international standards for prostate specific antigen and its complex with alpha 1-antichymotrypsin. Furthermore, reference methods should be established which use these standards and carefully selected reference antibodies.
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Affiliation(s)
- U H Stenman
- Department of Clinical Chemistry, Helsinki University Central Hospital, Finland
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Hedström J, Sainio V, Kemppainen E, Haapiainen R, Kivilaakso E, Schröder T, Leinonen J, Stenman UH. Serum complex of trypsin 2 and alpha 1 antitrypsin as diagnostic and prognostic marker of acute pancreatitis: clinical study in consecutive patients. BMJ 1996; 313:333-7. [PMID: 8760740 PMCID: PMC2351744 DOI: 10.1136/bmj.313.7053.333] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To estimate the usefulness of serum concentrations of the complex of trypsin 2 and alpha 1 antitrypsin in diagnosing and assessing the severity of acute pancreatitis in comparison with serum C reactive protein, amylase, and trypsinogen 2 concentrations (reference markers). DESIGN Markers were measured in consecutive patients admitted with acute abdominal pain that was either due to pancreatitis or to other disease unrelated to the pancreas (controls). SETTING Department of surgery of a teaching hospital in Helsinki. SUBJECTS 110 patients with acute pancreatitis and 66 with acute abdominal diseases of extrapancreatic origin. On the basis of the clinical course, acute pancreatitis was classified as mild (82 patients) or severe (28 patients). MAIN OUTCOME MEASURES Clinical diagnosis of acute pancreatitis and severity of the disease. RESULTS At admission all patients with acute pancreatitis had clearly raised concentrations of trypsin 2-alpha 1 antitrypsin complex (32 micrograms/l), whereas only three of the controls had such values. Of the markers studied, trypsin 2-alpha 1 antitrypsin complex had the largest area under the receiver operating curve, both in differentiating acute pancreatitis from extrapancreatic disease and in differentiating mild from severe disease. CONCLUSIONS Of the markers studied, trypsin 2-alpha 1 antitrypsin complex was the most accurate in differentiating between acute pancreatitis and extrapancreatic disease and in predicting a severe course for acute pancreatitis.
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Affiliation(s)
- J Hedström
- Department of Clinical Chemistry, Helsinki University Central Hospital, Finland
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