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Hurych J, Oscarsson E, Håkanson Å, Jirků-Pomajbíková K, Jirků M, Aronson CA, Cinek O, Agardh D. Effects of Lactiplantibacillus plantarum and Lacticaseibacillus paracasei supplementation on the single-cell fecal parasitome in children with celiac disease autoimmunity: a randomized, double-blind placebo-controlled clinical trial. Parasit Vectors 2023; 16:411. [PMID: 37946274 PMCID: PMC10636941 DOI: 10.1186/s13071-023-06027-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 10/19/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Lactiplantibacillus plantarum HEAL9 and Lacticaseibacillus paracasei 8700:2 positively affect the fecal bacteriome in children with celiac disease autoimmunity after 6 months of supplementation. The aim of the present investigation was to study the effects of Lactiplantibacillus plantarum HEAL9 and Lacticaseibacillus paracasei 8700:2 on the single-cell parasitome, with a primary focus on Blastocystis. METHODS Stool samples were collected from 78 Swedish children with celiac disease autoimmunity participating in a randomized, double-blind, placebo-controlled clinical trial to either receive a mixture of supplementation with L. plantarum HEAL9 and L. paracasei 8700:2 (n = 38) or placebo (n = 40). A total of 227 stool samples collected at baseline and after 3 and 6 months of intervention, respectively, were retrospectively analyzed for Blastocystis by quantitative real-time PCR and subtyped by massively parallel amplicon sequencing. Other single-cell parasites were detected by untargeted 18S rDNA amplicon sequencing and verified by real-time PCR. The relation between the parasites and the bacteriome community was characterized by using 16S rDNA profiling of the V3-V4 region. RESULTS Three different single-cell protists were identified, of which the highest prevalence was found for Dientamoeba fragilis (23.1%, 18/78 children), followed by Blastocystis (15.4%, 12/78) and Entamoeba spp. (2.6%, 2/78). The quantity of the protists was stable over time and not affected by probiotic intervention (P = 0.14 for Blastocystis, P = 0.10 for D. fragilis). The positivity of the protists was associated with increased bacteriome diversity (measured by multiple indices, P < 0.03). Bacterial composition was influenced by the presence of the protists: positivity of Blastocystis was inversely associated with Akkermansia (at the levels of the genus as well as its family, order, class and phylum); P < 0.002), Faecalibacterium (P = 0.003) and Romboutsia (P = 0.029); positivity of D. fragilis was inversely associated with families Enterobacteriaceae (P = 0.016) and Coriobacteriaceae (P = 0.022) and genera Flavonifractor (P < 0.001), Faecalibacterium (P = 0.009), Lachnoclostridium (P = 0.029), Ruminococcus (P < 0.001) and Granulicatella (P = 0.018). CONCLUSIONS The prevalence of single-cell protists is low in children with celiac disease autoimmunity. The colonization was stable regardless of the probiotic intervention and associated with increased diversity of the fecal bacteriome but inversely associated with some beneficial bacteria.
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Affiliation(s)
- Jakub Hurych
- Department of Medical Microbiology, 2nd Faculty of Medicine, Charles University, Prague, Czechia
- Department of Paediatrics, 2nd Faculty of Medicine, Charles University, Prague, Czechia
| | - Elin Oscarsson
- Department of Food Technology, Engineering and Nutrition, Lund University, Lund, Sweden
| | - Åsa Håkanson
- Department of Food Technology, Engineering and Nutrition, Lund University, Lund, Sweden
| | | | - Milan Jirků
- Institute of Parasitology, Biology Centre, Czech Academy of Sciences, České Budějovice, Czechia
| | - Carin Andrén Aronson
- Celiac Disease and Diabetes Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Ondřej Cinek
- Department of Medical Microbiology, 2nd Faculty of Medicine, Charles University, Prague, Czechia
- Department of Paediatrics, 2nd Faculty of Medicine, Charles University, Prague, Czechia
| | - Daniel Agardh
- Celiac Disease and Diabetes Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.
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Cinek O. Green demands must not trump response to military aggression. Nature 2023; 613:27. [PMID: 36596950 DOI: 10.1038/d41586-022-04566-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Svensson J, Ibfelt EH, Carstensen B, Neu A, Cinek O, Skrivarhaug T, Rami-Merhar B, Feltbower RG, Castell C, Konrad D, Gillespie K, Jarosz-Chobot P, Marčiulionytė D, Rosenbauer J, Bratina N, Ionescu-Tirgoviste C, Gorus F, Kocova M, de Beaufort C, Patterson CC. Age-period-cohort modelling of type 1 diabetes incidence rates among children included in the EURODIAB 25-year follow-up study. Acta Diabetol 2023; 60:73-82. [PMID: 36205797 DOI: 10.1007/s00592-022-01977-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 09/15/2022] [Indexed: 01/07/2023]
Abstract
AIMS Specific patterns in incidence may reveal environmental explanations for type 1 diabetes incidence. We aimed to study type 1 diabetes incidence in European childhood populations to assess whether an increase could be attributed to either period or cohort effects. METHODS Nineteen EURODIAB centres provided single year incidence data for ages 0-14 in the 25-year period 1989-2013. Case counts and person years were classified by age, period and cohort (APC) in 1-year classes. APC Poisson regression models of rates were fitted using restricted cubic splines for age, period and cohort per centre and sex. Joint models were fitted for all centres and sexes, to find a parsimonious model. RESULTS A total of 57,487 cases were included. In ten and seven of the 19 centres the APC models showed evidence of nonlinear cohort effects or period effects, respectively, in one or both sexes and indications of sex-specific age effects. Models showed a positive linear increase ranging from approximately 0.6 to 6.6%/year. Centres with low incidence rates showed the highest overall increase. A final joint model showed incidence peak at age 11.6 and 12.6 for girls and boys, respectively, and the rate-ratio was according to sex below 1 in ages 5-12. CONCLUSION There was reasonable evidence for similar age-specific type 1 diabetes incidence rates across the EURODIAB population and peaks at a younger age for girls than boys. Cohort effects showed nonlinearity but varied between centres and the model did not contribute convincingly to identification of environmental causes of the increase.
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Affiliation(s)
- J Svensson
- Diabetes Technology Research, Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, 2730, Herlev, Denmark.
- Department of Clinical Medicine, Copenhagen University, Copenhagen, Denmark.
| | - E H Ibfelt
- Clinical Epidemiology Research, Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - B Carstensen
- Clinical Epidemiology Research, Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - A Neu
- University Children´S Hospital, Tübingen, Germany
| | - O Cinek
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czechia
| | - T Skrivarhaug
- Division of Adolescent and Paediatric Medicine, Institute of Clinical Medicine, Oslo University Hospital, University of Oslo, Oslo, Norway
| | - B Rami-Merhar
- Department of Pediatric and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - R G Feltbower
- Leeds Institute for Data Analytics, School of Medicine, University of Leeds, Leeds, UK
| | - C Castell
- Department of Health, Government of Catalonia, Barcelona, Spain
| | - D Konrad
- Division of Paediatric Endocrinology and Diabetology and Children's Research Center, University Children's Hospital, University of Zurich, Zurich, Switzerland
| | - K Gillespie
- Diabetes and Metabolism, Bristol Medical School, University of Bristol, Bristol, UK
| | - P Jarosz-Chobot
- Department of Children's Diabetology, Medical University of Silesia, Katowice, Poland
| | - D Marčiulionytė
- Institute of Endocrinology, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Institute of Microbiology and Virology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - J Rosenbauer
- German Diabetes Center, Institute of Biometrics and Epidemiology, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - N Bratina
- Diabetes & Metabolic Diseases, Department of Endocrinology, University Children's Hospital, Ljubljana, Slovenia
| | - C Ionescu-Tirgoviste
- National Institute of Diabetes Nutrition and Metabolic Diseases, NC Paulescu, Bucharest, Romania
| | - F Gorus
- Diabetes Research Center, Brussels Free University - Vrije Universiteit Brussel, Brussels, Belgium
| | - M Kocova
- Department of Endocrinology and Genetics, University Children's Hospital, Skopje, North Macedonia
| | - C de Beaufort
- Department of Paediatric Diabetes and Endocrinology, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - C C Patterson
- Centre for Public Health, Queen's University Belfast, Belfast, UK
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Cinek O, Slavenko M, Pomahačová R, Venháčová P, Petruželková L, Škvor J, Neumann D, Vosáhlo J, Konečná P, Kocourková K, Strnadel J, Průhová Š, Šumník Z. Type 1 diabetes incidence increased during the COVID-19 pandemic years 2020-2021 in Czechia: Results from a large population-based pediatric register. Pediatr Diabetes 2022; 23:956-960. [PMID: 35982508 PMCID: PMC9538386 DOI: 10.1111/pedi.13405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 06/16/2022] [Accepted: 08/14/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND To explore type 1 diabetes incidence patterns during the pandemic years 2020 and 2021 in Czechia, to compare them to the trends from the previous decade, and to test its association with indicators of containment measures and of pandemic severity (school closing and the all-cause excess mortality). METHODS The Czech Childhood Diabetes Register is a population-based incidence register recording patients age 0-14.99 years at diabetes onset. Type 1 diabetes incidence in the pandemic period (April 2020-end of observation Dec 2021) was compared by Poisson regression models to the incidence patterns over the past decade 2010-2019. RESULTS During the pandemic years 2020-2021, 956 children 0-14.99 years old manifested with type 1 diabetes in Czechia. The observed incidence (27.2/100,000/year) was significantly higher than what was expected from the trends over 2010-2019 (incidence rate ratio, IRR = 1.16, 95%CI 1.06-1.28, p = 0.0022). The incidence had a trough during the first lockdown (March-May 2020), then it rose above expected values with no usual summer decrease. The assessed pandemic indicators (school closing and all-cause excess mortality) were not associated with the incidence levels. CONCLUSIONS The COVID-19 pandemic was associated with a notable upward inflection of the type 1 diabetes incidence curve; the early months of the first lockdown were however hallmarked by a significant dip in new diabetes diagnoses. Long-term observation will show whether the increased incidence originated only from accelerating an advanced preclinical Stage 2 to overt diabetes, or whether the pandemic triggered new cases of islet autoimmunity.
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Affiliation(s)
- Ondřej Cinek
- Department of PediatricsMotol University HospitalPragueCzech Republic
| | - Matvei Slavenko
- Department of PediatricsMotol University HospitalPragueCzech Republic,Department of Probability and Mathematical Statistics, Faculty of Mathematics and PhysicsCharles UniversityPragueCzech Republic
| | - Renata Pomahačová
- Department of PediatricsUniversity Hospital PilsenPilsenCzech Republic
| | - Petra Venháčová
- Department of PediatricsUniversity Hospital OlomoucOlomoucCzech Republic
| | | | - Jaroslav Škvor
- Department of PediatricsMasaryk HospitalÚstí nad LabemCzech Republic
| | - David Neumann
- Department of PediatricsUniversity HospitalHradec KrálovéCzech Republic
| | - Jan Vosáhlo
- Department of Pediatrics3rd Faculty of MedicinePragueCzech Republic
| | - Petra Konečná
- Department of PediatricsUniversity Hospital BrnoBrnoCzech Republic
| | - Kamila Kocourková
- Department of PediatricsHospital České BudějoviceČeské BudějoviceCzech Republic
| | - Jiří Strnadel
- Department of PediatricsUniversity Hospital OstravaOstravaCzech Republic
| | - Štěpánka Průhová
- Department of PediatricsMotol University HospitalPragueCzech Republic
| | - Zdeněk Šumník
- Department of PediatricsMotol University HospitalPragueCzech Republic
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Roslund MI, Parajuli A, Hui N, Puhakka R, Grönroos M, Soininen L, Nurminen N, Oikarinen S, Cinek O, Kramná L, Schroderus AM, Laitinen OH, Kinnunen T, Hyöty H, Sinkkonen A. A Placebo-controlled double-blinded test of the biodiversity hypothesis of immune-mediated diseases: Environmental microbial diversity elicits changes in cytokines and increase in T regulatory cells in young children. Ecotoxicol Environ Saf 2022; 242:113900. [PMID: 35930838 DOI: 10.1016/j.ecoenv.2022.113900] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 07/15/2022] [Accepted: 07/17/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND According to the biodiversity hypothesis of immune-mediated diseases, lack of microbiological diversity in the everyday living environment is a core reason for dysregulation of immune tolerance and - eventually - the epidemic of immune-mediated diseases in western urban populations. Despite years of intense research, the hypothesis was never tested in a double-blinded and placebo-controlled intervention trial. OBJECTIVE We aimed to perform the first placebo-controlled double-blinded test that investigates the effect of biodiversity on immune tolerance. METHODS In the intervention group, children aged 3-5 years were exposed to playground sand enriched with microbially diverse soil, or in the placebo group, visually similar, but microbially poor sand colored with peat (13 participants per treatment group). Children played twice a day for 20 min in the sandbox for 14 days. Sand, skin and gut bacterial, and blood samples were taken at baseline and after 14 days. Bacterial changes were followed for 28 days. Sand, skin and gut metagenome was determined by high throughput sequencing of bacterial 16 S rRNA gene. Cytokines were measured from plasma and the frequency of blood regulatory T cells was defined as a percentage of total CD3 +CD4 + T cells. RESULTS Bacterial richness (P < 0.001) and diversity (P < 0.05) were higher in the intervention than placebo sand. Skin bacterial community, including Gammaproteobacteria, shifted only in the intervention treatment to resemble the bacterial community in the enriched sand (P < 0.01). Mean change in plasma interleukin-10 (IL-10) concentration and IL-10 to IL-17A ratio supported immunoregulation in the intervention treatment compared to the placebo treatment (P = 0.02). IL-10 levels (P = 0.001) and IL-10 to IL-17A ratio (P = 0.02) were associated with Gammaproteobacterial community on the skin. The change in Treg frequencies was associated with the relative abundance of skin Thermoactinomycetaceae 1 (P = 0.002) and unclassified Alphaproteobacteria (P < 0.001). After 28 days, skin bacterial community still differed in the intervention treatment compared to baseline (P < 0.02). CONCLUSIONS This is the first double-blinded placebo-controlled study to show that daily exposure to microbial biodiversity is associated with immune modulation in humans. The findings support the biodiversity hypothesis of immune-mediated diseases. We conclude that environmental microbiota may contribute to child health, and that adding microbiological diversity to everyday living environment may support immunoregulation.
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Affiliation(s)
- Marja I Roslund
- Natural Resources Institute Finland (Luke), Helsinki and Turku, Finland; Ecosystems and Environment Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Niemenkatu 73, FI-15140 Lahti, Finland
| | - Anirudra Parajuli
- Ecosystems and Environment Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Niemenkatu 73, FI-15140 Lahti, Finland
| | - Nan Hui
- Ecosystems and Environment Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Niemenkatu 73, FI-15140 Lahti, Finland
| | - Riikka Puhakka
- Ecosystems and Environment Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Niemenkatu 73, FI-15140 Lahti, Finland
| | - Mira Grönroos
- Ecosystems and Environment Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Niemenkatu 73, FI-15140 Lahti, Finland
| | - Laura Soininen
- Ecosystems and Environment Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Niemenkatu 73, FI-15140 Lahti, Finland
| | - Noora Nurminen
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, FI-33520 Tampere, Finland
| | - Sami Oikarinen
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, FI-33520 Tampere, Finland
| | - Ondřej Cinek
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University, V Úvalu 84, Praha 5, 150 06 Prague, Czech Republic
| | - Lenka Kramná
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University, V Úvalu 84, Praha 5, 150 06 Prague, Czech Republic
| | - Anna-Mari Schroderus
- Department of Clinical Microbiology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Olli H Laitinen
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, FI-33520 Tampere, Finland
| | - Tuure Kinnunen
- Department of Clinical Microbiology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland; Eastern Finland Laboratory Centre (ISLAB), Kuopio, Finland
| | - Heikki Hyöty
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, FI-33520 Tampere, Finland; Fimlab Laboratories, Pirkanmaa Hospital District, Tampere, Finland
| | - Aki Sinkkonen
- Natural Resources Institute Finland (Luke), Helsinki and Turku, Finland.
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Šloufová M, Lhotská Z, Jirků M, Petrželková KJ, Stensvold CR, Cinek O, Pomajbíková KJ. Comparison of molecular diagnostic approaches for the detection and differentiation of the intestinal protist Blastocystis sp. in humans. Parasite 2022; 29:30. [PMID: 35638752 PMCID: PMC9153396 DOI: 10.1051/parasite/2022029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 05/12/2022] [Indexed: 11/29/2022] Open
Abstract
Blastocystis is the most commonly found intestinal protist in the world. Accurate detection and differentiation of Blastocystis including its subtypes (arguably species) are essential to understand its epidemiology and role in human health. We compared (i) the sensitivity of conventional PCR (cPCR) and qPCR in a set of 288 DNA samples obtained from stool samples of gut-healthy individuals, and (ii) subtype diversity as detected by next-generation sequencing (NGS) versus Sanger sequencing. Real-time PCR resulted in more positive samples than cPCR, revealing high fecal load of Blastocystis based on the quantification curve in most samples. In subtype detection, NGS was largely in agreement with Sanger sequencing but showed higher sensitivity for mixed subtype colonization within one host. This fact together with use of the combination of qPCR and NGS and obtaining information on the fecal protist load will be beneficial for epidemiological and surveillance studies.
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Affiliation(s)
- Martina Šloufová
- Institute of Parasitology, Biology Centre, the Czech Academy of Sciences, České Budějovice 370 05, Czech Republic - Department of Medical Biology, Faculty of Science, University of South Bohemia, České Budějovice 370 05, Czech Republic
| | - Zuzana Lhotská
- Institute of Parasitology, Biology Centre, the Czech Academy of Sciences, České Budějovice 370 05, Czech Republic - Department of Medical Biology, Faculty of Science, University of South Bohemia, České Budějovice 370 05, Czech Republic
| | - Milan Jirků
- Institute of Parasitology, Biology Centre, the Czech Academy of Sciences, České Budějovice 370 05, Czech Republic
| | - Klára J Petrželková
- Institute of Parasitology, Biology Centre, the Czech Academy of Sciences, České Budějovice 370 05, Czech Republic - Institute of Vertebrate Biology, Czech Academy of Sciences, Květná 8, Brno 603 65, Czech Republic
| | - C Rune Stensvold
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen DK-2300, Denmark
| | - Ondřej Cinek
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Prague 150 06, Czech Republic
| | - Kateřina Jirků Pomajbíková
- Institute of Parasitology, Biology Centre, the Czech Academy of Sciences, České Budějovice 370 05, Czech Republic - Department of Medical Biology, Faculty of Science, University of South Bohemia, České Budějovice 370 05, Czech Republic
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Roslund MI, Puhakka R, Nurminen N, Oikarinen S, Siter N, Grönroos M, Cinek O, Kramná L, Jumpponen A, Laitinen OH, Rajaniemi J, Hyöty H, Sinkkonen A. Long-term biodiversity intervention shapes health-associated commensal microbiota among urban day-care children. Environ Int 2021; 157:106811. [PMID: 34403882 DOI: 10.1016/j.envint.2021.106811] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/17/2021] [Accepted: 07/30/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND In modern urban environments children have a high incidence of inflammatory disorders, including allergies, asthma, and type1 diabetes. The underlying cause of these disorders, according to the biodiversity hypothesis, is an imbalance in immune regulation caused by a weak interaction with environmental microbes. In this 2-year study, we analyzed bacterial community shifts in the soil surface in day-care centers and commensal bacteria inhabiting the mouth, skin, and gut of children. We compared two different day-care environments: standard urban day-care centers and intervention day-care centers. Yards in the latter were amended with biodiverse forest floor vegetation and sod at the beginning of the study. RESULTS Intervention caused a long-standing increase in the relative abundance of nonpathogenic environmental mycobacteria in the surface soils. Treatment-specific shifts became evident in the community composition of Gammaproteobacteria, Negativicutes, and Bacilli, which jointly accounted for almost 40 and 50% of the taxa on the intervention day-care children's skin and in saliva, respectively. In the year-one skin swabs, richness of Alpha-, Beta-, and Gammaproteobacteria was higher, and the relative abundance of potentially pathogenic bacteria, including Haemophilus parainfluenzae, Streptococcus sp., and Veillonella sp., was lower among children in intervention day-care centers compared with children in standard day-care centers. In the gut, the relative abundance of Clostridium sensu stricto decreased, particularly among the intervention children. CONCLUSIONS This study shows that a 2-year biodiversity intervention shapes human commensal microbiota, including taxa that have been associated with immune regulation. Results indicate that intervention enriched commensal microbiota and suppressed the potentially pathogenic bacteria on the skin. We recommend future studies that expand intervention strategies to immune response and eventually the incidence of immune-mediated diseases.
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Affiliation(s)
- Marja I Roslund
- Ecosystems and Environment Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Niemenkatu 73, FI-15140 Lahti, Finland
| | - Riikka Puhakka
- Ecosystems and Environment Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Niemenkatu 73, FI-15140 Lahti, Finland
| | - Noora Nurminen
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, FI-33520 Tampere, Finland
| | - Sami Oikarinen
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, FI-33520 Tampere, Finland
| | - Nathan Siter
- Faculty of Built Environment, Tampere University, Korkeakoulunkatu 5, FI-33720 Tampere, Finland
| | - Mira Grönroos
- Ecosystems and Environment Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Niemenkatu 73, FI-15140 Lahti, Finland
| | - Ondřej Cinek
- Department of Pediatrics, Second Faculty of Medicine, Charles University, V Úvalu 84, Praha 5, 150 06 Prague, Czech Republic
| | - Lenka Kramná
- Department of Pediatrics, Second Faculty of Medicine, Charles University, V Úvalu 84, Praha 5, 150 06 Prague, Czech Republic
| | - Ari Jumpponen
- Division of Biology, Kansas State University, Manhattan KS66506, KS, United States of America
| | - Olli H Laitinen
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, FI-33520 Tampere, Finland
| | - Juho Rajaniemi
- Faculty of Built Environment, Tampere University, Korkeakoulunkatu 5, FI-33720 Tampere, Finland
| | - Heikki Hyöty
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, FI-33520 Tampere, Finland
| | - Aki Sinkkonen
- Natural Resources Institute Finland, Turku, Finland.
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Šumník Z, Pavlíková M, Pomahačová R, Venháčová P, Petruželková L, Škvor J, Neumann D, Vosáhlo J, Konečná P, Čížek J, Strnadel J, Průhová Š, Cinek O. Use of continuous glucose monitoring and its association with type 1 diabetes control in children over the first 3 years of reimbursement approval: Population data from the ČENDA registry. Pediatr Diabetes 2021; 22:439-447. [PMID: 33533545 DOI: 10.1111/pedi.13184] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 01/12/2021] [Accepted: 01/18/2021] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE Increased access to modern technologies is not always accompanied by a decrease in HbA1c. The aim of this study was to identify changes in the proportion of continuous glucose monitoring (CGM) users since 2017, when general reimbursement for CGM became effective in Czechia, and to test whether HbA1c is associated with the percentage of time spent on CGM. RESEARCH DESIGN AND METHODS All T1D children in the Czech national ČENDA registry (3197 children) were categorized according to their time spent on CGM and associations with age, sex, center size, and HbA1c were tested with calendar year as a stratification factor. RESULTS The proportion of children with any CGM use increased from 37.9% in 2017 to 50.3% in 2018 and 74.8% in 2019. Of the CGM users, 16%, 28%, and 41% of the children spent >70% of their time on CGM over the 3 years of the study period, with an overrepresentation of children in the <10 years age group versus the older age groups (p < 0.001). The proportion of CGM users differed among centers and was positively associated with a large center size (>100 patients) (p < 0.001). HbA1c was negatively associated with the time spent on CGM (p < 0.001). CONCLUSIONS A rapid increase in CGM use was reported over the 3 years after general reimbursement. HbA1c was associated with time spent on CGM, a continuing decrease was observed in the >70% category. Reimbursement for CGM likely contributes to the improvement of T1D control at the population level.
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Affiliation(s)
- Zdeněk Šumník
- Department of Pediatrics, Motol University Hospital and Charles University, 2nd Faculty of Medicine, Prague, Czech Republic
| | - Markéta Pavlíková
- Department of Probability and Mathematical Statistics, Faculty of Mathematics and Physics, Charles University, Prague, Czech Republic
| | - Renata Pomahačová
- Department of Pediatrics, University Hospital Pilsen, Pilsen, Czech Republic
| | - Petra Venháčová
- Department of Pediatrics, University Hospital Olomouc, Olomouc, Czech Republic
| | - Lenka Petruželková
- Department of Pediatrics, Motol University Hospital and Charles University, 2nd Faculty of Medicine, Prague, Czech Republic
| | - Jaroslav Škvor
- Department of Pediatrics, Masaryk Hospital, Ústí nad Labem, Czech Republic
| | - David Neumann
- Department of Pediatrics, University Hospital, Hradec Králové, Czech Republic
| | - Jan Vosáhlo
- Department of Pediatrics, 3rd Faculty of Medicine, Prague, Czech Republic
| | - Petra Konečná
- Department of Pediatrics, University Hospital Brno, Brno, Czech Republic
| | - Jindřich Čížek
- Department of Pediatrics, Hospital České Budějovice, České Budějovice, Czech Republic
| | - Jiří Strnadel
- Department of Pediatrics, University Hospital Ostrava, Ostrava, Czech Republic
| | - Štěpánka Průhová
- Department of Pediatrics, Motol University Hospital and Charles University, 2nd Faculty of Medicine, Prague, Czech Republic
| | - Ondřej Cinek
- Department of Pediatrics, Motol University Hospital and Charles University, 2nd Faculty of Medicine, Prague, Czech Republic
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9
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Jaimes JD, Slavíčková A, Hurych J, Cinek O, Nichols B, Vodolánová L, Černý K, Havlík J. Stool metabolome-microbiota evaluation among children and adolescents with obesity, overweight, and normal-weight using 1H NMR and 16S rRNA gene profiling. PLoS One 2021; 16:e0247378. [PMID: 33765008 PMCID: PMC7993802 DOI: 10.1371/journal.pone.0247378] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 02/05/2021] [Indexed: 02/07/2023] Open
Abstract
Characterization of metabolites and microbiota composition from human stool provides powerful insight into the molecular phenotypic difference between subjects with normal weight and those with overweight/obesity. The aim of this study was to identify potential metabolic and bacterial signatures from stool that distinguish the overweight/obesity state in children/adolescents. Using 1H NMR spectral analysis and 16S rRNA gene profiling, the fecal metabolic profile and bacterial composition from 52 children aged 7 to 16 was evaluated. The children were classified into three groups (16 with normal-weight, 17 with overweight, 19 with obesity). The metabolomic analysis identified four metabolites that were significantly different (p < 0.05) among the study groups based on one-way ANOVA testing: arabinose, butyrate, galactose, and trimethylamine. Significantly different (p < 0.01) genus-level taxa based on edgeR differential abundance tests were genus Escherichia and Tyzzerella subgroup 3. No significant difference in alpha-diversity was detected among the three study groups, and no significant correlations were found between the significant taxa and metabolites. The findings support the hypothesis of increased energy harvest in obesity by human gut bacteria through the growing observation of increased fecal butyrate in children with overweight/obesity, as well as an increase of certain monosaccharides in the stool. Also supported is the increase of trimethylamine as an indicator of an unhealthy state.
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Affiliation(s)
- José Diógenes Jaimes
- Department of Food Science, Czech University of Life Sciences Prague, Prague, Czech Republic
| | - Andrea Slavíčková
- Department of Food Science, Czech University of Life Sciences Prague, Prague, Czech Republic
| | - Jakub Hurych
- Department of Medical Microbiology, 2nd Faculty of Medicine, Charles University, Motol University Hospital, Prague, Czech Republic
| | - Ondřej Cinek
- Department of Medical Microbiology, 2nd Faculty of Medicine, Charles University, Motol University Hospital, Prague, Czech Republic.,Department of Paediatrics, 2nd Faculty of Medicine, Charles University, Motol University Hospital, Prague, Czech Republic
| | - Ben Nichols
- Human Nutrition, School of Medicine, Dentistry & Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow Royal Infirmary, Glasgow, United Kingdom
| | - Lucie Vodolánová
- Department of Medical Microbiology, 2nd Faculty of Medicine, Charles University, Motol University Hospital, Prague, Czech Republic
| | - Karel Černý
- Olivova Children's Medical Institution, Říčany, Czech Republic
| | - Jaroslav Havlík
- Department of Food Science, Czech University of Life Sciences Prague, Prague, Czech Republic
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10
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Furstova E, Dousova T, Beranek J, Libik M, Fila L, Modrak M, Cinek O, Macek M, Drevinek P. P029 First report: Kaftrio® vs. Symkevi® in intestinal organoids. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01056-0] [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: 10/21/2022]
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11
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Roslund MI, Puhakka R, Grönroos M, Nurminen N, Oikarinen S, Gazali AM, Cinek O, Kramná L, Siter N, Vari HK, Soininen L, Parajuli A, Rajaniemi J, Kinnunen T, Laitinen OH, Hyöty H, Sinkkonen A. Biodiversity intervention enhances immune regulation and health-associated commensal microbiota among daycare children. Sci Adv 2020; 6:eaba2578. [PMID: 33055153 PMCID: PMC7556828 DOI: 10.1126/sciadv.aba2578] [Citation(s) in RCA: 110] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 08/14/2020] [Indexed: 05/02/2023]
Abstract
As the incidence of immune-mediated diseases has increased rapidly in developed societies, there is an unmet need for novel prophylactic practices to fight against these maladies. This study is the first human intervention trial in which urban environmental biodiversity was manipulated to examine its effects on the commensal microbiome and immunoregulation in children. We analyzed changes in the skin and gut microbiota and blood immune markers of children during a 28-day biodiversity intervention. Children in standard urban and nature-oriented daycare centers were analyzed for comparison. The intervention diversified both the environmental and skin Gammaproteobacterial communities, which, in turn, were associated with increases in plasma TGF-β1 levels and the proportion of regulatory T cells. The plasma IL-10:IL-17A ratio increased among intervention children during the trial. Our findings suggest that biodiversity intervention enhances immunoregulatory pathways and provide an incentive for future prophylactic approaches to reduce the risk of immune-mediated diseases in urban societies.
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Affiliation(s)
- Marja I Roslund
- Ecosystems and Environment Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Niemenkatu 73, FI-15140 Lahti, Finland
| | - Riikka Puhakka
- Ecosystems and Environment Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Niemenkatu 73, FI-15140 Lahti, Finland
| | - Mira Grönroos
- Ecosystems and Environment Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Niemenkatu 73, FI-15140 Lahti, Finland
| | - Noora Nurminen
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, FI-33520 Tampere, Finland
| | - Sami Oikarinen
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, FI-33520 Tampere, Finland
| | - Ahmad M Gazali
- Department of Clinical Microbiology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Ondřej Cinek
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University and University Hospital Motol, V Úvalu 84, Praha 5, 150 06 Prague, Czech Republic
| | - Lenka Kramná
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University and University Hospital Motol, V Úvalu 84, Praha 5, 150 06 Prague, Czech Republic
| | - Nathan Siter
- Faculty of Built Environment, Tampere University, Korkeakoulunkatu 5, FI-33720 Tampere, Finland
| | - Heli K Vari
- Ecosystems and Environment Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Niemenkatu 73, FI-15140 Lahti, Finland
| | - Laura Soininen
- Ecosystems and Environment Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Niemenkatu 73, FI-15140 Lahti, Finland
| | - Anirudra Parajuli
- Ecosystems and Environment Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Niemenkatu 73, FI-15140 Lahti, Finland
| | - Juho Rajaniemi
- Faculty of Built Environment, Tampere University, Korkeakoulunkatu 5, FI-33720 Tampere, Finland
| | - Tuure Kinnunen
- Department of Clinical Microbiology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- Eastern Finland Laboratory Centre (ISLAB), Kuopio, Finland
| | - Olli H Laitinen
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, FI-33520 Tampere, Finland
| | - Heikki Hyöty
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, FI-33520 Tampere, Finland
| | - Aki Sinkkonen
- Ecosystems and Environment Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Niemenkatu 73, FI-15140 Lahti, Finland.
- Natural Resources Institute Finland Luke, Itäinen Pitkäkatu 4A, 20520 Turku, Finland
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12
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Parajuli A, Hui N, Puhakka R, Oikarinen S, Grönroos M, Selonen VAO, Siter N, Kramna L, Roslund MI, Vari HK, Nurminen N, Honkanen H, Hintikka J, Sarkkinen H, Romantschuk M, Kauppi M, Valve R, Cinek O, Laitinen OH, Rajaniemi J, Hyöty H, Sinkkonen A. Yard vegetation is associated with gut microbiota composition. Sci Total Environ 2020; 713:136707. [PMID: 32019041 DOI: 10.1016/j.scitotenv.2020.136707] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 01/08/2020] [Accepted: 01/13/2020] [Indexed: 06/10/2023]
Abstract
Gut microbes play an essential role in the development and functioning of the human immune system. A disturbed gut microbiota composition is often associated with a number of health disorders including immune-mediated diseases. Differences in host characteristics such as ethnicity, living habit and diet have been used to explain differences in the gut microbiota composition in inter-continental comparison studies. As our previous studies imply that daily skin contact with organic gardening materials modify gut microflora, here we investigated the association between living environment and gut microbiota in a homogenous western population along an urban-rural gradient. We obtained stool samples from 48 native elderly Finns in province Häme in August and November 2015 and identified the bacterial phylotypes using 16S rRNA Illumina MiSeq sequencing. We assumed that yard vegetation and land cover classes surrounding homes explain the stool bacterial community in generalized linear mixed models. Diverse yard vegetation was associated with a reduced abundance of Clostridium sensu stricto and an increased abundance of Faecalibacterium and Prevotellaceae. The abundance of Bacteroides was positively and strongly associated with the built environment. Exclusion of animal owners did not alter the main associations. These results suggest that diverse vegetation around homes is associated with health-related changes in gut microbiota composition. Manipulation of the garden diversity, possibly jointly with urban planning, is a promising candidate for future intervention studies that aim to maintain gut homeostasis.
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Affiliation(s)
- Anirudra Parajuli
- Ecosystems and Environment Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Lahti, Finland
| | - Nan Hui
- Ecosystems and Environment Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Lahti, Finland; School of Agriculture and Biology, Shanghai Jiao Tong University, Shanghai, China
| | - Riikka Puhakka
- Ecosystems and Environment Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Lahti, Finland
| | - Sami Oikarinen
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Mira Grönroos
- Ecosystems and Environment Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Lahti, Finland
| | - Ville A O Selonen
- Ecosystems and Environment Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Lahti, Finland
| | - Nathan Siter
- School of Architecture, Tampere University of Technology, Tampere, Finland
| | - Lenka Kramna
- Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Marja I Roslund
- Ecosystems and Environment Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Lahti, Finland
| | - Heli K Vari
- Ecosystems and Environment Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Lahti, Finland
| | - Noora Nurminen
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Hanna Honkanen
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | | | | | - Martin Romantschuk
- Ecosystems and Environment Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Lahti, Finland
| | | | - Raisa Valve
- Division of Food and Nutrition Sciences, Faculty of Agriculture and Forestry, University of Helsinki, Helsinki, Finland
| | - Ondřej Cinek
- Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Olli H Laitinen
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Juho Rajaniemi
- School of Architecture, Tampere University of Technology, Tampere, Finland
| | - Heikki Hyöty
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Aki Sinkkonen
- Ecosystems and Environment Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Lahti, Finland; Natural Resources Institute Finland, Turku, Finland.
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13
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Šumník Z, Venháčová J, Škvor J, Pomahačová R, Konečná P, Neumann D, Vosáhlo J, Strnadel J, Čížek J, Obermannová B, Petruželková L, Průhová Š, Pavlíková M, Cinek O. Five years of improving diabetes control in Czech children after the establishment of the population-based childhood diabetes register ČENDA. Pediatr Diabetes 2020; 21:77-87. [PMID: 31605416 DOI: 10.1111/pedi.12929] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 11/03/2018] [Revised: 09/02/2019] [Accepted: 09/18/2019] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES The Czech National Childhood Diabetes Register (ČENDA) is a web-based nationwide database that collects treatment and outcome data in children and adolescents with diabetes. Here, we present data from the first 5 years of ČENDA (2013-2017). METHODS Data include characteristics of disease onset and annual summaries of key clinical care parameters from every patient treated by participating pediatric diabetes outpatient clinics. RESULTS The database contains data of 4361 children (aged 0-19 years) from 52 centers (85% of all Czech pediatric patients). Of these, 94% had type 1 diabetes (T1D), 4.5% had genetically proven monogenic or secondary, and 1.5% had type 2 diabetes. In children with T1D, median glycated hemoglobin (HbA1c) decreased throughout the observed period from 66.3 to 61.0 mmol/mol (P < .0001, 95% confidence interval [CI] for change -5.6 to -4 mmol/mol). Consequently, the proportion of children reaching the target therapeutic goal of 58.5 mmol/mol increased from 28% in 2013 to 40% in 2017. The proportion of children treated with insulin pumps (CSII) remained stable over the observed period (25%). In a subanalysis of 1602 patients (long-standing T1D diagnosed before 2011), the main predictors associated with lower HbA1c were treatment with CSII, male sex and care provided at a large diabetes center (>100 patients). CONCLUSIONS A significant continuous decrease in HbA1c was observed in Czech children over the past 5 years. As this improvement was not accompanied by appreciable changes in the mode of therapy, we assume that the establishment of our nationwide register has itself constituted a stimulus towards improvement in the care process.
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Affiliation(s)
- Zdeněk Šumník
- Department of Pediatrics, Motol University Hospital and Charles University, 2nd Faculty of Medicine, Prague, Czech Republic
| | - Jitřenka Venháčová
- Department of Pediatrics, University Hospital Olomouc, Olomouc, Czech Republic
| | - Jaroslav Škvor
- Department of Pediatrics, Masaryk Hospital, Ústí nad Labem, Ústí nad Labem, Czech Republic
| | - Renata Pomahačová
- Department of Pediatrics, University Hospital Pilsen, Pilsen, Czech Republic
| | - Petra Konečná
- Department of Pediatrics, University Hospital Brno, Brno, Czech Republic
| | - David Neumann
- Department of Pediatrics, University Hospital, Hradec Králové, Czech Republic
| | - Jan Vosáhlo
- Department of Pediatrics, 3rd Faculty of Medicine, Prague, Czech Republic
| | - Jiří Strnadel
- Department of Pediatrics, University Hospital Ostrava, Ostrava, Czech Republic
| | - Jindřich Čížek
- Department of Pediatrics, Hospital České Budějovice, České Budějovice, Czech Republic
| | - Barbora Obermannová
- Department of Pediatrics, Motol University Hospital and Charles University, 2nd Faculty of Medicine, Prague, Czech Republic
| | - Lenka Petruželková
- Department of Pediatrics, Motol University Hospital and Charles University, 2nd Faculty of Medicine, Prague, Czech Republic
| | - Štěpánka Průhová
- Department of Pediatrics, Motol University Hospital and Charles University, 2nd Faculty of Medicine, Prague, Czech Republic
| | - Markéta Pavlíková
- Department of Probability and Mathematical Statistics, Faculty of Mathematics and Physics, Charles University, Prague, Czech Republic
| | - Ondřej Cinek
- Department of Pediatrics, Motol University Hospital and Charles University, 2nd Faculty of Medicine, Prague, Czech Republic
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14
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Bezdíčka M, Dluholucký M, Cinek O, Zieg J. Successful maintenance of partial remission in a child with COQ2 nephropathy by coenzyme Q10 treatment. Nephrology (Carlton) 2019; 25:187-188. [PMID: 31137081 DOI: 10.1111/nep.13600] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Martin Bezdíčka
- Department of Paediatrics, 2nd Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Martin Dluholucký
- Banská Bystrica Children's University Hospital, Banská Bystrica, Slovakia
| | - Ondřej Cinek
- Department of Paediatrics, 2nd Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Jakub Zieg
- Department of Paediatrics, 2nd Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
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15
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Bezdíčka M, Štolbová Š, Seeman T, Cinek O, Malina M, Šimánková N, Průhová Š, Zieg J. Genetic diagnosis of steroid-resistant nephrotic syndrome in a longitudinal collection of Czech and Slovak patients: a high proportion of causative variants in NUP93. Pediatr Nephrol 2018; 33:1347-1363. [PMID: 29869118 DOI: 10.1007/s00467-018-3950-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [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: 11/24/2017] [Revised: 03/12/2018] [Accepted: 03/22/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Steroid-resistant nephrotic syndrome (SRNS) has a heterogeneous spectrum of monogenic causes that substantially differ among populations. The aim of this study was to analyse the genetic aetiology of SRNS in Czech and Slovak paediatric patients. METHODS We analysed clinical data from 74 patients (38 boys) with congenital (15%), infant (14%), and childhood-onset (71%) SRNS collected from the Czech Republic and Slovakia from 2000 to 2017 (inclusive). The DNA samples were first analysed by Sanger sequencing (genes NPHS2, NPHS1, and WT1) and then by next generation sequencing (NGS) using a targeted panel of 48 genes previously associated with SRNS. Family segregation of the causative variants was confirmed by Sanger sequencing when possible. RESULTS Genetic diagnosis was established in 28/74 patients (38%) based on findings of pathogenic or likely pathogenic causative variants in genotypes conforming to the expected mode of inheritance. Sanger sequencing diagnosed 26% of patients, whereas second-tier testing by a targeted NGS panel diagnosed a further 12%. Frequent causative genes were NPHS2 (15%), WT1 (9.5%), and surprisingly NUP93 with four (5.4%) unrelated cases. Additional causative genes included COQ2 (two patients), NPHS1, INF2, DGKE, and LMX1B (one patient each). CONCLUSIONS Compared with outright use of NGS, our tiered genetic testing strategy was considerably more rapid and marginally less expensive. Apart from a high aetiological fraction of NPHS2 and WT1 genes, our study has identified an unexpectedly high frequency of a limited set of presumably ancestral causative mutations in NUP93. The results may aid in tailoring testing strategies in Central European populations.
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Affiliation(s)
- Martin Bezdíčka
- Department of Paediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, V Uvalu 84, Prague, Czech Republic
| | - Šárka Štolbová
- Department of Paediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, V Uvalu 84, Prague, Czech Republic
| | - Tomáš Seeman
- Department of Paediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, V Uvalu 84, Prague, Czech Republic
| | - Ondřej Cinek
- Department of Paediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, V Uvalu 84, Prague, Czech Republic.
| | - Michal Malina
- Department of Paediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, V Uvalu 84, Prague, Czech Republic
| | - Naděžda Šimánková
- Department of Paediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, V Uvalu 84, Prague, Czech Republic
| | - Štěpánka Průhová
- Department of Paediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, V Uvalu 84, Prague, Czech Republic
| | - Jakub Zieg
- Department of Paediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, V Uvalu 84, Prague, Czech Republic
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16
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Abstract
Next-generation sequencing has opened avenues to studying complex populations such as the bacteriome (all bacteria), mycobiome (all fungi), and virome (all viruses in a given sample). Viromes are less often investigated as compared to bacteriomes. The reasons are mostly methodological: because no common pan-viral sequence signature exists, metagenomic sequencing remains the only option. This brings about the need of laborious virus enrichment, multiple signal amplification steps with virtually no possibility of interim quality control, and complicated bioinformatic analysis of the ensuing sequence data. Nevertheless, over the past decade virome sequencing has been enormously successful in identifying new agents in human and animal diseases, and in characterizing viruses in various ecological niches. Recently, virome sequencing has been also employed in studies of non-infectious diseases, which has brought about new challenges of sensitivity, costs, and reproducibility in testing of large sets of samples. Here, we present a detailed protocol that has been utilized in virome studies where hundreds of samples had to be reliably tested in order to assess the association of the stool virome with susceptibility to type 1 diabetes, a non-infectious autoimmune disease.
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Affiliation(s)
- Lenka Kramná
- Department of Pediatrics, Second Faculty of Medicine, Charles University, Prague, Czech Republic
- Department of Medical Microbiology, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Ondřej Cinek
- Department of Pediatrics, Second Faculty of Medicine, Charles University, Prague, Czech Republic.
- Department of Medical Microbiology, Second Faculty of Medicine, Charles University, Prague, Czech Republic.
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17
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Dáňová K, Grohová A, Strnadová P, Funda DP, Šumník Z, Lebl J, Cinek O, Průhová Š, Koloušková S, Obermannová B, Petruželková L, Šedivá A, Fundová P, Buschard K, Špíšek R, Palová-Jelínková L. Tolerogenic Dendritic Cells from Poorly Compensated Type 1 Diabetes Patients Have Decreased Ability To Induce Stable Antigen-Specific T Cell Hyporesponsiveness and Generation of Suppressive Regulatory T Cells. J Immunol 2016; 198:729-740. [PMID: 27927966 DOI: 10.4049/jimmunol.1600676] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 09/29/2016] [Indexed: 12/15/2022]
Abstract
Tolerogenic dendritic cells (tolDCs) may offer an interesting intervention strategy to re-establish Ag-specific tolerance in autoimmune diseases, including type 1 diabetes (T1D). T1D results from selective destruction of insulin-producing β cells leading to hyperglycemia that, in turn, specifically affects a patient's immune system. In this study, we prepared monocyte-derived tolDCs modulated by dexamethasone and vitamin D2 from 31 T1D patients with optimal glycemic control and 60 T1D patients with suboptimal glycemic control and assessed their tolerogenic properties in correlation with metabolic state of patients. tolDCs differentiated from both groups of patients acquired a regulatory phenotype and an anti-inflammatory profile. Interestingly, tolDCs from well-controlled patients expressed higher levels of inhibitory molecules IL-T3 and PD-L1. Additionally, glutamic acid decarboxylase (GAD)65-loaded tolDCs from well-controlled patients decreased significantly primary Th1/Th17 responses, induced stable GAD65-specific T cell hyporesponsiveness, and suppressed markedly control DC-induced GAD65-specific T cell activation compared with poorly controlled patients. The ability of tolDCs from poorly controlled patients to induce durable GAD65-specific T cell hyporesponsiveness was reversed once the control of glycemia improved. In both groups of patients, tolDCs were able to induce regulatory T cells from autologous naive CD4+ T cells. However, regulatory T cells from well-controlled patients had better suppressive abilities. The functionality of tolDCs was confirmed in the adoptive transfer model of NOD-SCID mice where tolDCs delayed diabetes onset. These results suggest that metabolic control of T1D affects the functional characteristics of tolDCs and subsequent effector T cell responses. Metabolic control may be relevant for refining inclusion criteria of clinical trials in the settings of T1D.
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Affiliation(s)
- Klára Dáňová
- Sotio a.s., 170 00 Prague, Czech Republic.,Department of Immunology, Charles University in Prague, Second Faculty of Medicine and University Hospital Motol, 150 06 Prague, Czech Republic
| | - Anna Grohová
- Sotio a.s., 170 00 Prague, Czech Republic.,Department of Immunology, Charles University in Prague, Second Faculty of Medicine and University Hospital Motol, 150 06 Prague, Czech Republic
| | | | - David P Funda
- Department of Immunology and Gnotobiology, Institute of Microbiology of the Czech Academy of Sciences, v.v.i., 142 20 Prague, Czech Republic
| | - Zdeněk Šumník
- Department of Pediatrics, Charles University in Prague, Second Faculty of Medicine and University Hospital Motol, 150 06 Prague, Czech Republic; and
| | - Jan Lebl
- Department of Pediatrics, Charles University in Prague, Second Faculty of Medicine and University Hospital Motol, 150 06 Prague, Czech Republic; and
| | - Ondřej Cinek
- Department of Pediatrics, Charles University in Prague, Second Faculty of Medicine and University Hospital Motol, 150 06 Prague, Czech Republic; and
| | - Štěpánka Průhová
- Department of Pediatrics, Charles University in Prague, Second Faculty of Medicine and University Hospital Motol, 150 06 Prague, Czech Republic; and
| | - Stanislava Koloušková
- Department of Pediatrics, Charles University in Prague, Second Faculty of Medicine and University Hospital Motol, 150 06 Prague, Czech Republic; and
| | - Barbora Obermannová
- Department of Pediatrics, Charles University in Prague, Second Faculty of Medicine and University Hospital Motol, 150 06 Prague, Czech Republic; and
| | - Lenka Petruželková
- Department of Pediatrics, Charles University in Prague, Second Faculty of Medicine and University Hospital Motol, 150 06 Prague, Czech Republic; and
| | - Anna Šedivá
- Department of Immunology, Charles University in Prague, Second Faculty of Medicine and University Hospital Motol, 150 06 Prague, Czech Republic
| | - Petra Fundová
- Department of Immunology and Gnotobiology, Institute of Microbiology of the Czech Academy of Sciences, v.v.i., 142 20 Prague, Czech Republic
| | - Karsten Buschard
- The Bartholin Institute, Rigshospitalet, 2100 Copenhagen, Denmark
| | - Radek Špíšek
- Sotio a.s., 170 00 Prague, Czech Republic.,Department of Immunology, Charles University in Prague, Second Faculty of Medicine and University Hospital Motol, 150 06 Prague, Czech Republic
| | - Lenka Palová-Jelínková
- Sotio a.s., 170 00 Prague, Czech Republic; .,Department of Immunology, Charles University in Prague, Second Faculty of Medicine and University Hospital Motol, 150 06 Prague, Czech Republic
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Petruzelkova L, Dusatkova P, Cinek O, Sumnik Z, Pruhova S, Hradsky O, Vcelakova J, Lebl J, Kolouskova S. Substantial proportion of MODY among multiplex families participating in a Type 1 diabetes prediction programme. Diabet Med 2016; 33:1712-1716. [PMID: 26641800 DOI: 10.1111/dme.13043] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/26/2015] [Indexed: 11/30/2022]
Abstract
AIMS Patients with maturity-onset diabetes of the young (MODY) might be over-represented in families with histories of Type 1 diabetes. Our aim was to re-evaluate families participating in the Czech T1D Prediction Programme (PREDIA.CZ) with at least two members affected with diabetes to assess the proportion of MODY among these families and determine its most significant clinical predictors. METHODS Of the 557 families followed up by the PREDIA.CZ, 53 (9.5%) had two or more family members with diabetes. One proband with diabetes from these families was chosen for direct sequencing of the GCK, HNF1A, HNF4A and INS genes. Non-parametric tests and a linear logistic regression model were used to evaluate differences between MODY and non-MODY families. RESULTS MODY was genetically diagnosed in 24 of the 53 families with multiple occurrences of diabetes (45%). Mutations were detected most frequently in GCK (58%), followed by HNF1A (38%) and INS (4%). MODY families were more likely to have a parent with diabetes and had a higher proportion of females with diabetes than non-MODY families. Higher age (P < 0.001), a lower level of HbA1c (P < 0.001) at clinical onset and at least two generations affected by diabetes were the variables most predictive for probands of MODY families already presenting with diabetes. CONCLUSIONS A prediction programme for Type 1 diabetes would provide a useful new source of patients with MODY most likely to benefit from an accurate diagnosis. This identification has implications for patient treatment and disease prognosis.
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Affiliation(s)
- L Petruzelkova
- Department of Paediatrics, University Hospital Motol and 2nd Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - P Dusatkova
- Department of Paediatrics, University Hospital Motol and 2nd Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - O Cinek
- Department of Paediatrics, University Hospital Motol and 2nd Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Z Sumnik
- Department of Paediatrics, University Hospital Motol and 2nd Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - S Pruhova
- Department of Paediatrics, University Hospital Motol and 2nd Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - O Hradsky
- Department of Paediatrics, University Hospital Motol and 2nd Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - J Vcelakova
- Department of Paediatrics, University Hospital Motol and 2nd Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - J Lebl
- Department of Paediatrics, University Hospital Motol and 2nd Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - S Kolouskova
- Department of Paediatrics, University Hospital Motol and 2nd Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
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Gerasimidi Vazeou A, Kordonouri O, Witsch M, Hermann JM, Forsander G, de Beaufort C, Veeze HJ, Maffeis C, Cherubini V, Cinek O, Piccini B, Holl RW, Danne T. Seasonality at the clinical onset of type 1 diabetes-Lessons from the SWEET database. Pediatr Diabetes 2016; 17 Suppl 23:32-37. [PMID: 28334496 DOI: 10.1111/pedi.12433] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 07/19/2016] [Accepted: 08/02/2016] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Seasonality at the clinical onset of type 1 diabetes (T1D) has been suggested by different studies, however, the results are conflicting. This study aimed to evaluate the presence of seasonality at clinical onset of T1D based on the SWEET database comprising data from 32 different countries. METHODS The study cohort included 23 603 patients (52% males) recorded in the international multicenter SWEET database (48 centers), with T1D onset ≤20 years, year of onset between 1980 and 2015, gender, year and month of birth and T1D-diagnosis documented. Data were stratified according to four age groups (<5, 5-<10, 10-<15, 15-20 years) at T1D onset, the latitude of European center (Northern ≥50°N and Southern Europe <50°N) and the year of onset ≤ or >2009. RESULTS Analysis by month revealed significant seasonality with January being the month with the highest and June with the lowest percentage of incident cases (P < .001). Winter, early spring and late autumn months had higher percentage of incident cases compared with late spring and summer months. Stratification by age showed similar seasonality patterns in all four age groups (P ≤ .003 each), but not in children <24 months of age. There was no gender or latitude effect on seasonality pattern, however, the pattern differed by the year of onset (P < .001). Seasonality of diagnosis conformed to a sinusoidal model for all cases, females and males, age groups, northern and southern European countries. CONCLUSIONS Seasonality at T1D clinical onset is documented by the large SWEET database with no gender or latitude (Europe only) effect except from the year of manifestation.
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Affiliation(s)
| | - O Kordonouri
- Kinderkrankenhaus auf der Bult, Hannover, Germany
| | - M Witsch
- DCCP-Clinique pédiatrique de Luxembourg, Luxembourg, Luxembourg
| | - J M Hermann
- Institute for Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany.,German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - G Forsander
- The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - C de Beaufort
- DCCP-Clinique pédiatrique de Luxembourg, Luxembourg, Luxembourg
| | - H J Veeze
- Stichting Diabeter, Center for Pediatric and Adolescent Diabetes Care and Research, Rotterdam, The Netherlands
| | - C Maffeis
- Pediatric Diabetes and Metabolic Disorders Unit, University of Verona, University City Hospital, Verona, Italy
| | - V Cherubini
- Department of women's & children's health G. Salesi Children's Hospital, Ancona, Italy
| | - O Cinek
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague, University Hospital Motol, Prague, Czech Republic
| | - B Piccini
- Tuscany Regional Centre of Pediatric Diabetes, Meyer University Children's Hospital, Florence, Italy
| | - R W Holl
- Institute for Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany.,German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - T Danne
- Kinderkrankenhaus auf der Bult, Hannover, Germany
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Djakow J, Kramná L, Dušátková L, Uhlík J, Pursiheimo JP, Svobodová T, Pohunek P, Cinek O. An effective combination of sanger and next generation sequencing in diagnostics of primary ciliary dyskinesia. Pediatr Pulmonol 2016; 51:498-509. [PMID: 26228299 DOI: 10.1002/ppul.23261] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2014] [Revised: 06/15/2015] [Accepted: 06/16/2015] [Indexed: 01/07/2023]
Abstract
BACKGROUND Primary ciliary dyskinesia (PCD) is a multigenic autosomal recessive condition affecting respiratory tract and other organs where ciliary motility is required. The extent of its genetic heterogeneity is remarkable. The aim of the study was to develop a cost-effective pipeline for genetic diagnostics using a combination of Sanger and next generation sequencing (NGS). MATERIALS AND METHODS Data and samples of 33 families with 38 affected subjects with PCD diagnosed in childhood were collected over the territory of the Czech Republic. A panel of 18 PCD causative or candidate genes was implemented into an Illumina TruSeq Custom Amplicon NGS assay, and three ancestral mutations in SPAG1 were screened by conventional Sanger sequencing, which was also used for the confirmation of the NGS results and for the analysis of familial segregation. RESULTS The causative gene was DNAH5 in 11/33 (33%) probands, SPAG1 in 8/33 (24%), and DNAI1, CCDC40, LRRC6 in one family each. If the high proportion of subjects with bi-allelic ancestral mutations in SPAG1 is corroborated in other Caucasian populations, a simple Sanger sequencing test for these three mutations may serve as an effective pre-screening step, being followed by an NGS panel for other, much larger, PCD genes. CONCLUSIONS We present a combination of Sanger sequencing with an NGS panel for known and candidate PCD genes, implemented in a moderate-size national collection of patients. This strategy has proven to be cost-effective, rapid and reliable, and was able to detect the causative gene in two thirds of our PCD patients.
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Affiliation(s)
- Jana Djakow
- Department of Paediatrics, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Czech Republic
| | - Lenka Kramná
- Department of Paediatrics, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Czech Republic
| | - Lenka Dušátková
- Department of Paediatrics, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Czech Republic
| | - Jiří Uhlík
- Department of Histology and Embryology, 2nd Faculty of Medicine, Charles University in Prague, Czech Republic
| | - Juha-Pekka Pursiheimo
- Department of Medical Biochemistry and Genetics, University of Turku, Turku, Finland
| | - Tamara Svobodová
- Department of Paediatrics, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Czech Republic
| | - Petr Pohunek
- Department of Paediatrics, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Czech Republic
| | - Ondřej Cinek
- Department of Paediatrics, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Czech Republic
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Šumník Z, Průhová Š, Cinek O. [Heterogeneity of childhood diabetes and its therapeutic implications]. Vnitr Lek 2016; 62:S129-S135. [PMID: 27921438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The prevalence of diabetes in Czech children is 1 : 500-1 000. Its incidence rose about threefold over the past 25 years. Type 1 diabetes is the prevailing form of diabetes in childhood, but also monogenic forms are frequently diagnosed. The occurrence of type 2 diabetes is still marginal in Czech children, with a relative proportion of less than 1 % of all diabetic children. Etiological diagnosis is the basic prerequisite of an effective diabetes treatment. In this review we present novel aspects on etiology and therapy of diabetes diagnosed in childhood and adolescence.
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Patterson CC, Gyürüs E, Rosenbauer J, Cinek O, Neu A, Schober E, Parslow RC, Joner G, Svensson J, Castell C, Bingley PJ, Schoenle E, Jarosz-Chobot P, Urbonaité B, Rothe U, Kržišnik C, Ionescu-Tirgoviste C, Weets I, Kocova M, Stipancic G, Samardzic M, de Beaufort CE, Green A, Soltész G, Dahlquist GG. Seasonal variation in month of diagnosis in children with type 1 diabetes registered in 23 European centers during 1989-2008: little short-term influence of sunshine hours or average temperature. Pediatr Diabetes 2015; 16:573-80. [PMID: 25316271 DOI: 10.1111/pedi.12227] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [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: 07/16/2014] [Revised: 09/11/2014] [Accepted: 09/11/2014] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The month of diagnosis in childhood type 1 diabetes shows seasonal variation. OBJECTIVE We describe the pattern and investigate if year-to-year irregularities are associated with meteorological factors using data from 50 000 children diagnosed under the age of 15 yr in 23 population-based European registries during 1989-2008. METHODS Tests for seasonal variation in monthly counts aggregated over the 20 yr period were performed. Time series regression was used to investigate if sunshine hour and average temperature data were predictive of the 240 monthly diagnosis counts after taking account of seasonality and long term trends. RESULTS Significant sinusoidal pattern was evident in all but two small centers with peaks in November to February and relative amplitudes ranging from ± 11 to ± 38% (median ± 17%). However, most centers showed significant departures from a sinusoidal pattern. Pooling results over centers, there was significant seasonal variation in each age-group at diagnosis, with least seasonal variation in those under 5 yr. Boys showed greater seasonal variation than girls, particularly those aged 10-14 yr. There were no differences in seasonal pattern between four 5-yr sub-periods. Departures from the sinusoidal trend in monthly diagnoses in the period were significantly associated with deviations from the norm in average temperature (0.8% reduction in diagnoses per 1 °C excess) but not with sunshine hours. CONCLUSIONS Seasonality was consistently apparent throughout the period in all age-groups and both sexes, but girls and the under 5 s showed less marked variation. Neither sunshine hour nor average temperature data contributed in any substantial way to explaining departures from the sinusoidal pattern.
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Affiliation(s)
- C C Patterson
- Centre of Excellence for Public Health Northern Ireland, Queen's University Belfast, Belfast, UK
| | - E Gyürüs
- Department of Paediatrics, Pécs University, Pecs, Hungary
| | - J Rosenbauer
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Institute for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany
| | - O Cinek
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, Czech Republic
| | - A Neu
- Pediatric Endocrinology & Diabetes, University Children's Hospital, Tübingen, Germany
| | - E Schober
- Department of Pediatric and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - R C Parslow
- Leeds Institute of Genetics, Health and Therapeutics, University of Leeds, Leeds, UK
| | - G Joner
- Department of Pediatrics, Ullevål University Hospital, Oslo, Norway
| | - J Svensson
- Department of Paediatrics, Herlev University Hospital, Copenhagen, Denmark
| | - C Castell
- Public Health Agency, Department of Health, Government of Catalonia, Barcelona, Spain
| | - P J Bingley
- School of Clinical Sciences, University of Bristol, Bristol, UK
| | - E Schoenle
- Department of Endocrinology and Diabetology, University Children's Hospital, Zurich, Switzerland
| | - P Jarosz-Chobot
- Department of Pediatrics, Endocrinology and Diabetes, Medical University of Silesia, Katowice, Poland
| | - B Urbonaité
- Institute of Endocrinology, Lithuanian University of Health Science, Kaunas, Lithuania
| | - U Rothe
- Department for Epidemiology and Health Care Research, Technical University of Dresden, Dresden, Germany
| | - C Kržišnik
- Department of Pediatrics, University Children's Hospital, Ljubljana, Slovenia
| | - C Ionescu-Tirgoviste
- Nutrition and Metabolic Diseases Clinic, N Paulescu Institute of Diabetes and Metabolic Diseases, Bucharest, Romania
| | - I Weets
- Diabetes Research Center, Brussels Free University, Vrije Universiteit Brussel, Brussels, Belgium
| | - M Kocova
- Department of Endocrinology and Genetics, University Children's Hospital, Skopje, Macedonia
| | - G Stipancic
- Department of Paediatrics, University Hospital Sestre Milosrdnice, Zagreb, Croatia
| | - M Samardzic
- Department of Endocrinology and Diabetes, University Children's Hospital, Podgorica, Montenegro
| | - C E de Beaufort
- Department of Paediatric Diabetes and Endocrinology, Centre Hospitalier de Luxembourg, Luxembourg
| | - A Green
- Odense Patient data Exploratory Network, University of Southern Denmark, Odense, Denmark
| | - G Soltész
- Department of Paediatrics, Pécs University, Pecs, Hungary
| | - G G Dahlquist
- Department of Clinical Science, University of Umeå, Umeå, Sweden
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Lebl J, Koloušková S, Dušátková P, Cinek O, Dušátková L, Dědič T, Kotalová R, Sumník Z, Seeman T, Průhová S. [Liver, kidneys and diabetes: three faces of HNF1B gene deficit]. Vnitr Lek 2014; 60:725-729. [PMID: 25294760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The renal cysts and diabetes syndrome (RCAD), also known as HNF1B-MODYor MODY5, is caused by the deletion or point mutation of HNF1B gene which leads to the depletion of HNF1B transcription factor. The main clinical components of RCAD include cystic kidney disease or other developmental anomalies of the kidneys and diabetes mellitus which typically manifests in the second decade of life or later. Renal disorders may lead to the development of chronic renal insufficiency already in childhood or young adulthood. The other symptoms include hepatic impairment - cholestatic jaundice in middle-aged patients, sometimes even neonatal cholestasis, atrophy of the pancreas with the impairment of exocrine pancreatic secretion and some congenital anomalies of the genital tract. As opposed to the other forms of MODY diabetes, the family history may not be positive because most of the deviations of HNF1B appear de novo. We associate RCAD in particular with adults suffering from diabetes and cystic kidney disease and/or cholestatic jaundice and children with cystic kidney disease of unclear etiology, even without the presence of diabetes. A supportive finding may be hypomagnesemia which occurs in up to 70 % of patients diagnosed with HNF1B related disease and hyperuricemia.Key words: HNF1B - MODY - RCAD - diabetes mellitus - cholestatic jaundice.
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Mekahli D, Van Straelen K, Jager K, Schaefer F, Groothoff J, Assadi MH, Landau D, Chen Y, Rabkin R, Medrano J, Segev Y, Donadio ME, Loiacono E, Peruzzi L, Amore A, Camilla R, Chiale F, Vergano L, Boido A, Conrieri M, Bianciotto M, Bosetti FM, Lastauka I, Coppo R, Laszki-SzczaChor K, Dorota PJ, Zwolinska D, Filipowski H, Rusiecki L, Sobieszczanska M, Dagan R, Davidovits M, Cleper R, Krause I, Chesnaye NC, Jager KJ, Schaefer F, Groothoff JW, Heaf JG, Topaloglu R, Merenmies J, Lewis M, Shtiza D, Maurer E, Zaicova N, Kushnirenko S, Zampetoglou A, Van Stralen KJ, Milo evski-Lomi G, Lezaic V, Radivojevic D, Kostic M, Paripovic D, Peco-Antic A, Benedyk A, Sobiak J, Resztak M, Ostalska-Nowicka D, Zachwieja J, Jarosz K, Chrzanowska M, Soltysiak J, Skowronska B, Stankiewicz W, Fichna P, Lewandowska-Stachowiak M, Silska-Dittmar M, Ostalska-Nowicka D, Zachwieja J, Lemoine S, De Souza V, Ranchin B, Cartier R, Pottel H, Dolomanova O, Hadj-Aissa A, Cochat P, Dubourg L, Hoelttae T, Van Stralen KJ, Groothoff JW, Schaefer F, Bjerre A, Jager KJ, Jobs K, Jung A, Lichosik M, Placzynska M, Tjaden LA, Noordzij M, Van Stralen KJ, Schaefer F, Groothoff JW, Jager KJ, Lazzeri E, Ronconi E, Angelotti ML, Peired AJ, Mazzinghi B, Becherucci F, Sansavini G, Sisti A, Provenzano A, Giglio S, Lasagni L, Romagnani P, Pozziani G, Sinatora F, Benetti E, Ghirardo G, Longo G, Cattelan C, Murer L, Malina M, Dusatkova P, Dusek J, Slamova Z, Cinek O, Pruhova S, Bergmann C, Seeman T, Schaefer F, Arbeiter K, Hoppe B, Jungraithmayr T, Klaus G, Pape L, Dinavahi R, Farouk M, Manamley N, Vondrak K, Vidal E, Ranieri M, Ghirardo G, Scavia G, Benetti E, Longo G, Parolin M, Murer L, Aksu N, Yavascan O, Alparslan C, Elmas CH, Saritas S, Anil AB, Kamit Can F, Anil M, Bal A, Kasap Demir B, Mutlubas Ozsan F, Van Huis M, Bonthuis M, Van Stralen KJ, Schaefer F, Jager KJ, Groothoff JW, Makieieva NI, Gramatiuk SM, Tsymbal VM, Buzhynskaya NR, Oborn H, Forinder U, Herthelius M, Westland R, Schreuder MF, Van Der Lof DF, Vermeulen A, Dekker IMJ, Bokenkamp A, Van Wijk JAE, Gramatiuk S, Makieieva NI, Tsymbal VM, Ghirardo G, Seveso M, Della Vella M, Cozzi E, Murer L, Garzotto F, Vidal E, Zanella M, Murer L, Ronco C, Prikhodina L, Chumak O, Dobrynina M, Nusken E, Von Gersdorff G, Schaller M, Rascher K, Barth C, Bach D, Weber L, Dotsch J, Roszkowska-Blaim M, Skrzypczyk P, Jander A, Tkaczyk M, Balasz-Chmielewska I, Zurowska A, Drozdz D, Pietrzyk JA, Aksenova M, Zhetlina V, Mitrofanova A, Choi Y, Cho BS, Suh JS, Abd El-Fattah MA, El-Ghoneimy DH, Elhakim IZ, El-Owaidy RH, Afifi HM, Abo-Elnaga GM, Zvenigorodska A, Tasic V, Gucev Z, Polenakovic M, Silska-Dittmar M, Zaorska K, So tysiak J, Ostalska-Nowicka D, Zachwieja J, Nowicki M, Jobs K, Jung A, Emirova K, Tolstova E, Zaytseva O, Muzurov A, Makulova A, Zverev D, Kamit Can F, Mutlbas Ozsan F, Alparslan C, Elmas CH, Saritas S, Manyas H, Kasap Demir B, Yavascan O, Aksu N, Hoste L, Braat E, De Waele L, Goemans N, Vermeersch P, Gheysens O, Levtchenko E, Pottel H, Golovachova VA, Odinets YV, Zharkova TS, Trynduk YS, Odinets YV, Kharchenko TV, Musial K, Zwolinska D, Roomizadeh P, Gheissari A, Abedini A, Mehdikhani B, Gheissari A, Rezaii Z, Merrikhi A, Madihi Y, Kelishadi R, Dryl IS, Senatorova GS, Kolybaeva TF, Muratov GR, Yavascan O, Aksu N, Alparslan C, Eliacik K, Kanik A, Saritas S, Elmas CH, Mutlubas Ozsan F, Kasap Demir B, Anil M, Bal A, Postorino V, Guzzo G, Ghiotto S, Mazzone L, Loi V, Maxia S, Roggero S, Attini R, Piga A, Postorino M, Pani A, Cabiddu G, Piccoli GB, Peco-Antic A, Kostic M, Spasojevic-Dimitrijeva B, Milosevski-Lomic G, Cvetkovic M, Kruscic D, Paripovic D. PAEDIATRIC NEPHROLOGY. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Borowiec M, Fendler W, Dusatkova P, Antosik K, Pruhova S, Cinek O, Mysliwiec M, Jarosz-Chobot P, Malecki MT, Mlynarski W. HbA1c-based diabetes diagnosis among patients with glucokinase mutation (GCK-MODY) is affected by a genetic variant of glucose-6-phosphatase (G6PC2). Diabet Med 2012; 29:1465-9. [PMID: 22486180 DOI: 10.1111/j.1464-5491.2012.03671.x] [Citation(s) in RCA: 3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIMS Genetic variation at the rs560887 locus of the glucose-6-phosphatase, catalytic 2 gene (G6PC2) is known to affect regulation of fasting glycaemia. We determined the rs560887 genotype of patients with monogenic diabetes and glucokinase gene mutations (GCK-MODY) and correlated the genotypes with HbA(1c) levels. METHODS Patients from families with GCK-MODY were recruited from two large cohorts from Poland (n = 128) and the Czech Republic (n = 154). Genotypes at the rs560887 polymorphic site in G6PC2 were examined using real-time quantitative polymerase chain reaction. The effect of rs560887 genotype on age at diagnosis of GCK-MODY and initial HbA(1c) levels were evaluated separately within both cohorts. Following that, a meta-analysis of rs560887 genotype-HbA(1c) associations of both Polish and Czech cohorts was performed to confirm homogeneity of findings and validate cohort-specific results. RESULTS GG homozygosity at rs560887 was associated with marginally elevated HbA(1c) levels (P = 0.07 in both cohorts). The effects observed in both groups were very homogeneous (Q = 0.18; P = 0.68). Meta-analysis showed that GG homozygosity at rs560887 was associated with mean HbA(1c) levels higher by 2.4 mmol/mol (0.24%), 95% CI 0.5-4.4 mmol/mol (0.05-0.44%) than in individuals with other genotypes. Additionally, meta-analysis of both cohorts showed that GG homozygous individuals had higher odds of reaching the 48 mmol/mol (6.5%) diagnostic threshold of diabetes; (odds ratio 1.90; 95% CI 1.07-3.36; P = 0.03). No such effects were observed for age at diagnosis of diabetes. CONCLUSIONS Variation at the rs560887 locus of G6PC2 is associated with worse glycated haemoglobin levels in individuals with GCK mutations; GG homozygotes are more likely to meet diagnostic criteria for diabetes based on HbA(1c) level.
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Affiliation(s)
- M Borowiec
- Department of Paediatrics, Oncology, Haematology and Diabetology, Medical University of Lodz, Poland
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Djakow J, Svobodová T, Hrach K, Uhlík J, Cinek O, Pohunek P. Effectiveness of sequencing selected exons of DNAH5 and DNAI1 in diagnosis of primary ciliary dyskinesia. Pediatr Pulmonol 2012; 47:864-75. [PMID: 22416021 DOI: 10.1002/ppul.22520] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2011] [Accepted: 11/28/2011] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Primary ciliary dyskinesia (PCD) is a rare genetically heterogenous condition. Mutations in DNAH5 or DNAI1 genes can be found in about a third of the patients with PCD. Increased occurrence of mutations was described in several exons of these long genes. The objective of the study was to test the sensitivity of sequencing of selected 13 exons (as compared to costly sequencing of all 100 exons of the two genes), and to determine the prevalence of the DNAH5 or DNAI1 mutations in the Czech PCD database. METHODS The Czech national PCD database has identified 31 pediatric patients, diagnosed based on clinical findings and tests on the ciliated epithelium. Twenty-seven patients from 24 families agreed on genetic testing. In the first step, direct sequencing of selected 13 exons (9 of DNAH5 and 4 of DNAI1) was performed, and then we compared its effectiveness in detecting at least one mutation with results of sequencing all 100 exons of the two genes. RESULTS The sequencing of all exons identified compound heterozygosity for PCD mutations in nine patients from eight families (DNAH5 in eight and DNAI1 in one patient), and heterozygozity for a DNAH5 mutation of uncertain functional significance in one additional patient. The first step of selected exon sequencing detected a mutation in five out of these eight families, its actual sensitivity being 62.5%, with a high predictive value. The phenotypic and clinical characteristics of all the paediatric patients with PCD are shown. CONCLUSIONS Selected exon sequencing detects at least one mutated allele in over a half of our patients who have PCD due to DNAH5 or DNAI1 mutations. To lower the costs of the genetic testing, targeted step-wise genetic testing may be a reasonable approach to detect mutations in PCD patients, especially if their phenotype is taken into account.
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Affiliation(s)
- Jana Djakow
- 2nd Faculty of Medicine, Department of Pediatrics, Charles University in Prague and University Hospital Motol, Prague, Czech Republic.
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Patterson CC, Gyürüs E, Rosenbauer J, Cinek O, Neu A, Schober E, Parslow RC, Joner G, Svensson J, Castell C, Bingley PJ, Schoenle E, Jarosz-Chobot P, Urbonaité B, Rothe U, Krzisnik C, Ionescu-Tirgoviste C, Weets I, Kocova M, Stipancic G, Samardzic M, de Beaufort CE, Green A, Dahlquist GG, Soltész G. Trends in childhood type 1 diabetes incidence in Europe during 1989-2008: evidence of non-uniformity over time in rates of increase. Diabetologia 2012; 55:2142-7. [PMID: 22638547 DOI: 10.1007/s00125-012-2571-8] [Citation(s) in RCA: 310] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2011] [Accepted: 04/02/2012] [Indexed: 12/13/2022]
Abstract
AIMS/HYPOTHESIS The aim of the study was to describe 20-year incidence trends for childhood type 1 diabetes in 23 EURODIAB centres and compare rates of increase in the first (1989-1998) and second (1999-2008) halves of the period. METHODS All registers operate in geographically defined regions and are based on a clinical diagnosis. Completeness of registration is assessed by capture-recapture methodology. Twenty-three centres in 19 countries registered 49,969 new cases of type 1 diabetes in individuals diagnosed before their 15th birthday during the period studied. RESULTS Ascertainment exceeded 90% in most registers. During the 20-year period, all but one register showed statistically significant changes in incidence, with rates universally increasing. When estimated separately for the first and second halves of the period, the median rates of increase were similar: 3.4% per annum and 3.3% per annum, respectively. However, rates of increase differed significantly between the first half and the second half for nine of the 21 registers with adequate coverage of both periods; five registers showed significantly higher rates of increase in the first half, and four significantly higher rates in the second half. CONCLUSIONS/INTERPRETATION The incidence rate of childhood type 1 diabetes continues to rise across Europe by an average of approximately 3-4% per annum, but the increase is not necessarily uniform, showing periods of less rapid and more rapid increase in incidence in some registers. This pattern of change suggests that important risk exposures differ over time in different European countries. Further time trend analysis and comparison of the patterns in defined regions is warranted.
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Affiliation(s)
- C C Patterson
- Centre for Public Health, Queen's University Belfast, Institute of Clinical Science Block B, Grosvenor Road, Belfast, BT12 6BJ, UK.
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Ellinghaus E, Stanulla M, Richter G, Ellinghaus D, te Kronnie G, Cario G, Cazzaniga G, Horstmann M, Panzer Grümayer R, Cavé H, Trka J, Cinek O, Teigler-Schlegel A, ElSharawy A, Häsler R, Nebel A, Meissner B, Bartram T, Lescai F, Franceschi C, Giordan M, Nürnberg P, Heinzow B, Zimmermann M, Schreiber S, Schrappe M, Franke A. Identification of germline susceptibility loci in ETV6-RUNX1-rearranged childhood acute lymphoblastic leukemia. Leukemia 2012; 26:902-9. [PMID: 22076464 PMCID: PMC3356560 DOI: 10.1038/leu.2011.302] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2011] [Revised: 09/03/2011] [Accepted: 09/21/2011] [Indexed: 02/08/2023]
Abstract
Acute lymphoblastic leukemia (ALL) is a malignant disease of the white blood cells. The etiology of ALL is believed to be multifactorial and likely to involve an interplay of environmental and genetic variables. We performed a genome-wide association study of 355 750 single-nucleotide polymorphisms (SNPs) in 474 controls and 419 childhood ALL cases characterized by a t(12;21)(p13;q22) - the most common chromosomal translocation observed in childhood ALL - which leads to an ETV6-RUNX1 gene fusion. The eight most strongly associated SNPs were followed-up in 951 ETV6-RUNX1-positive cases and 3061 controls from Germany/Austria and Italy, respectively. We identified a novel, genome-wide significant risk locus at 3q28 (TP63, rs17505102, P(CMH)=8.94 × 10(-9), OR=0.65). The separate analysis of the combined German/Austrian sample only, revealed additional genome-wide significant associations at 11q11 (OR8U8, rs1945213, P=9.14 × 10(-11), OR=0.69) and 8p21.3 (near INTS10, rs920590, P=6.12 × 10(-9), OR=1.36). These associations and another association at 11p11.2 (PTPRJ, rs3942852, P=4.95 × 10(-7), OR=0.72) remained significant in the German/Austrian replication panel after correction for multiple testing. Our findings demonstrate that germline genetic variation can specifically contribute to the risk of ETV6-RUNX1-positive childhood ALL. The identification of TP63 and PTPRJ as susceptibility genes emphasize the role of the TP53 gene family and the importance of proteins regulating cellular processes in connection with tumorigenesis.
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Affiliation(s)
- E Ellinghaus
- Institute of Clinical Molecular Biology, Christian-Albrechts-University Kiel, Kiel, Germany
| | - M Stanulla
- Department of Pediatrics, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany, on behalf of the German Berlin-Frankfurt-Münster Study Group for Treatment of Childhood Acute Lymphoblastic Leukemia
| | - G Richter
- Institute of Clinical Molecular Biology, Christian-Albrechts-University Kiel, Kiel, Germany
| | - D Ellinghaus
- Institute of Clinical Molecular Biology, Christian-Albrechts-University Kiel, Kiel, Germany
| | - G te Kronnie
- Department of Pediatrics, Laboratory of Pediatric Hematology/Oncology, University of Padua, Padua, Italy
| | - G Cario
- Department of Pediatrics, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany, on behalf of the German Berlin-Frankfurt-Münster Study Group for Treatment of Childhood Acute Lymphoblastic Leukemia
| | - G Cazzaniga
- M. Tettamanti Research Center, Children's Hospital, University of Milan-Bicocca, Monza, Italy
| | - M Horstmann
- Clinic of Pediatric Hematology and Oncology, University Medical Center, and Research Center Children's Cancer Center, Hamburg, Germany
| | - R Panzer Grümayer
- St Anna Children's Hospital and Children's Cancer Research Institute, Vienna, Austria
| | - H Cavé
- Department of Genetics, Hôpital Robert Debré, Paris, France
| | - J Trka
- Department of Pediatric Hematology/Oncology, Second Faculty of Medicine, Charles University Prague, Prague, Czech Republic
| | - O Cinek
- Department of Pediatrics, Second Faculty of Medicine, Charles University Prague, Prague, Czech Republic
| | - A Teigler-Schlegel
- Oncogenetic Laboratory, Department of Pediatric Hematology and Oncology, Justus-Liebig-University, Giessen, Germany
| | - A ElSharawy
- Institute of Clinical Molecular Biology, Christian-Albrechts-University Kiel, Kiel, Germany
| | - R Häsler
- Institute of Clinical Molecular Biology, Christian-Albrechts-University Kiel, Kiel, Germany
| | - A Nebel
- Institute of Clinical Molecular Biology, Christian-Albrechts-University Kiel, Kiel, Germany
| | - B Meissner
- Department of Pediatrics, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany, on behalf of the German Berlin-Frankfurt-Münster Study Group for Treatment of Childhood Acute Lymphoblastic Leukemia
| | - T Bartram
- Department of Pediatrics, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany, on behalf of the German Berlin-Frankfurt-Münster Study Group for Treatment of Childhood Acute Lymphoblastic Leukemia
| | - F Lescai
- Division of Research Strategy, University College London, London, UK
| | - C Franceschi
- Department of Experimental Pathology, University of Bologna, Bologna, Italy
| | - M Giordan
- Department of Pediatrics, Laboratory of Pediatric Hematology/Oncology, University of Padua, Padua, Italy
| | - P Nürnberg
- Cologne Center for Genomics, University of Cologne, Cologne, Germany
| | - B Heinzow
- State Social Services Agency Schleswig-Holstein, Kiel, Germany
- University of Notre Dame, Sydney Medical School, Sydney, Australia
| | - M Zimmermann
- Pediatric Hematology and Oncology, Hannover Medical School, Hannover, Germany
| | - S Schreiber
- Institute of Clinical Molecular Biology, Christian-Albrechts-University Kiel, Kiel, Germany
- Department of General Internal Medicine, University Hospital Schleswig-Holstein, Christian-Albrechts-University Kiel, Kiel, Germany
- Popgen Biobank, University Hospital Schleswig-Holstein, Christian-Albrechts-University Kiel, Kiel, Germany
| | - M Schrappe
- Department of Pediatrics, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany, on behalf of the German Berlin-Frankfurt-Münster Study Group for Treatment of Childhood Acute Lymphoblastic Leukemia
| | - A Franke
- Institute of Clinical Molecular Biology, Christian-Albrechts-University Kiel, Kiel, Germany
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Soucek O, Komrska V, Hlavka Z, Cinek O, Rocek M, Zemkova D, Lebl J, Sumnik Z. Boys with haemophilia have low trabecular bone mineral density and sarcopenia, but normal bone strength at the radius. Haemophilia 2011; 18:222-8. [PMID: 21752160 DOI: 10.1111/j.1365-2516.2011.02616.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Although a decreased areal bone mineral density (BMD) has been reported in patients with haemophilia, data are lacking that would reflect the three-dimensional structure of the bone and the muscle-bone relationship. We aimed to assess volumetric BMD, bone geometry and muscle-bone phenotype in boys with haemophilia, and to describe the association between clinical characteristics of haemophilia and bone quality and structure. A cross-sectional study was conducted in 41 boys with haemophilia (mean age 12.4, range 6.6-19.8 years) using peripheral quantitative CT (pQCT) at the nondominant forearm. Results were transformed into Z-scores using previously published reference data. Significant differences were tested by one-sample t-test or sign test. Two-sample t-test and anova were used to compare results between subgroups of patients divided according to the severity of the disease, the fracture history and the number of joint and muscle bleedings. Boys with haemophilia had a decreased trabecular volumetric BMD (mean Z-score -0.5, P < 0.01), while their cortical volumetric BMD was increased (mean Z-score 0.4, P < 0.05). The volumetric bone mineral content and the bone geometry at the radial diaphysis were normal when adjusted for patients' shorter body height. Muscle area was decreased (mean Z-score -1.0, P < 0.001), irrespective of age. No association was observed of bone quality parameters and bone geometry with the disease severity, fracture history or number of bleedings. Bone strength measured at the diaphysis of the radius is not impaired in boys with haemophilia. The finding of the decreased trabecular bone density can be most likely attributed to their sarcopenia.
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Affiliation(s)
- O Soucek
- Department of Paediatrics, University Hospital Motol, 2nd Faculty of Medicine, Charles University In Prague, Prague, Czech Republic.
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Dušátková P, Průhová Š, Šumník Z, Koloušková S, Obermannová B, Cinek O, Lebl J. HNF1A mutation presenting with fetal macrosomia and hypoglycemia in childhood prior to onset of overt diabetes. ACTA ACUST UNITED AC 2011. [DOI: 10.1515/jpem.2011.049] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Cardwell CR, Stene LC, Joner G, Bulsara MK, Cinek O, Rosenbauer J, Ludvigsson J, Svensson J, Goldacre MJ, Waldhoer T, Jarosz-Chobot P, Gimeno SG, Chuang LM, Roberts CL, Parslow RC, Wadsworth EJ, Chetwynd A, Brigis G, Urbonaite B, Sipetic S, Schober E, Devoti G, Ionescu-Tirgoviste C, de Beaufort CE, Stoyanov D, Buschard K, Radon K, Glatthaar C, Patterson CC. Birth order and childhood type 1 diabetes risk: a pooled analysis of 31 observational studies. Int J Epidemiol 2010; 40:363-74. [DOI: 10.1093/ije/dyq207] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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Dedeckova K, Cinek O, Melter O, Drevinek P. The role of PCR in early diagnosis and monitoring of infection with Burkholderia cepacia complex. J Cyst Fibros 2010. [DOI: 10.1016/s1569-1993(10)60104-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Cardwell CR, Stene LC, Joner G, Davis EA, Cinek O, Rosenbauer J, Ludvigsson J, Castell C, Svensson J, Goldacre MJ, Waldhoer T, Polanska J, Gimeno SGA, Chuang LM, Parslow RC, Wadsworth EJK, Chetwynd A, Pozzilli P, Brigis G, Urbonaite B, Sipetić S, Schober E, Ionescu-Tirgoviste C, de Beaufort CE, Stoyanov D, Buschard K, Patterson CC. Birthweight and the risk of childhood-onset type 1 diabetes: a meta-analysis of observational studies using individual patient data. Diabetologia 2010; 53:641-51. [PMID: 20063147 DOI: 10.1007/s00125-009-1648-5] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2009] [Accepted: 12/10/2009] [Indexed: 10/20/2022]
Abstract
AIMS/HYPOTHESIS We investigated whether children who are heavier at birth have an increased risk of type 1 diabetes. METHODS Relevant studies published before February 2009 were identified from literature searches using MEDLINE, Web of Science and EMBASE. Authors of all studies containing relevant data were contacted and asked to provide individual patient data or conduct pre-specified analyses. Risk estimates of type 1 diabetes by category of birthweight were calculated for each study, before and after adjustment for potential confounders.Meta-analysis techniques were then used to derive combined ORs and investigate heterogeneity between studies. RESULTS Data were available for 29 predominantly European studies (five cohort, 24 case-control studies), including 12,807 cases of type 1 diabetes. Overall, studies consistently demonstrated that children with birthweight from 3.5 to 4 kg had an increased risk of diabetes of 6% (OR 1.06 [95% CI 1.01-1.11]; p=0.02) and children with birthweight over 4 kg had an increased risk of 10% (OR 1.10 [95% CI 1.04-1.19]; p=0.003), compared with children weighing 3.0 to 3.5 kg at birth. This corresponded to a linear increase in diabetes risk of 3% per 500 g increase in birthweight (OR 1.03 [95% CI 1.00-1.06]; p=0.03). Adjustments for potential confounders such as gestational age, maternal age, birth order, Caesarean section, breastfeeding and maternal diabetes had little effect on these findings. CONCLUSIONS/INTERPRETATION Children who are heavier at birth have a significant and consistent, but relatively small increase in risk of type 1 diabetes.
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Affiliation(s)
- C R Cardwell
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Grosvenor Road, Belfast BT12 6BJ, UK,
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Hradsky O, Lenicek M, Dusatkova P, Bronsky J, Nevoral J, Valtrova V, Kotalova R, Szitanyi P, Petro R, Starzykova V, Bortlik M, Vitek L, Lukas M, Cinek O. Variants of CARD15, TNFA and PTPN22 and susceptibility to Crohn's disease in the Czech population: high frequency of the CARD15 1007fs. ACTA ACUST UNITED AC 2008; 71:538-47. [PMID: 18489434 DOI: 10.1111/j.1399-0039.2008.01047.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Crohn's disease (CD) has been shown to be associated with the variants in the CARD15 gene as well as in other genes involved in the immune response. The frequencies of the variants profoundly differ among populations and so does the associated risk. We examined the associations of variants in the CARD15, TNFA and PTPN22 genes with pediatric-onset and adult-onset CD in the Czech population. Genotype, phenotype and allelic frequencies were compared between 345 patients with CD (136 pediatric-onset and 209 adult-onset patients) and 501 unrelated healthy controls. At least one minor allele of the CARD15 gene was carried by 46% patients and only 21% control subjects (OR = 3.2, 95% CI 2.4-4.4). In a multiple logistic regression model, the strongest association with CD was found for the 1007fs variant (OR = 4.6, 95% CI 3.0-7.0), followed by p.G908R (OR = 2.9, 95% CI 1.5-5.7) and p.R702W (OR = 1.7, 95% CI 1.0-2.9), while no independent association was found for the remaining variants in the CARD15 gene (p.268S, p.955I and p.289S), for the p.R620W variant in the PTPN22 gene or for the g.-308G>A variant in the TNFA gene. The age at CD onset was strongly modified by positivity for the 1007fs allele: it was present in 42% pediatric-onset and only 25% adult-onset patients. In conclusion, we report a high frequency of the minor allele of the CARD15 1007fs polymorphism in the Czech population and a strong effect of this allele on the age at disease onset.
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Affiliation(s)
- O Hradsky
- Department of Pediatrics, University Hospital Motol, Prague, Czech Republic
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Cardwell CR, Stene LC, Joner G, Cinek O, Svensson J, Goldacre MJ, Parslow RC, Pozzilli P, Brigis G, Stoyanov D, Urbonaite B, Sipetić S, Schober E, Ionescu-Tirgoviste C, Devoti G, de Beaufort CE, Buschard K, Patterson CC. Caesarean section is associated with an increased risk of childhood-onset type 1 diabetes mellitus: a meta-analysis of observational studies. Diabetologia 2008; 51:726-35. [PMID: 18292986 DOI: 10.1007/s00125-008-0941-z] [Citation(s) in RCA: 377] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2007] [Accepted: 01/14/2008] [Indexed: 01/15/2023]
Abstract
AIMS/HYPOTHESIS The aim of this study was to investigate the evidence of an increased risk of childhood-onset type 1 diabetes in children born by Caesarean section by systematically reviewing the published literature and performing a meta-analysis with adjustment for recognised confounders. METHODS After MEDLINE, Web of Science and EMBASE searches, crude ORs and 95% CIs for type 1 diabetes in children born by Caesarean section were calculated from the data reported in each study. Authors were contacted to facilitate adjustments for potential confounders, either by supplying raw data or calculating adjusted estimates. Meta-analysis techniques were then used to derive combined ORs and to investigate heterogeneity between studies. RESULTS Twenty studies were identified. Overall, there was a significant increase in the risk of type 1 diabetes in children born by Caesarean section (OR 1.23, 95% CI 1.15-1.32, p < 0.001). There was little evidence of heterogeneity between studies (p = 0.54). Seventeen authors provided raw data or adjusted estimates to facilitate adjustments for potential confounders. In these studies, there was evidence of an increase in diabetes risk with greater birthweight, shorter gestation and greater maternal age. The increased risk of type 1 diabetes after Caesarean section was little altered after adjustment for gestational age, birth weight, maternal age, birth order, breast-feeding and maternal diabetes (adjusted OR 1.19, 95% CI 1.04-1.36, p = 0.01). CONCLUSIONS/INTERPRETATION This analysis demonstrates a 20% increase in the risk of childhood-onset type 1 diabetes after Caesarean section delivery that cannot be explained by known confounders.
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Affiliation(s)
- C R Cardwell
- Department of Epidemiology and Public Health, School of Medicine and Dentistry, Queen's University Belfast, Grosvenor Road, Belfast, BT12 6BJ, UK.
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Hubacek P, Maalouf J, Zajickova M, Kouba M, Cinek O, Hyncicova K, Fales I, Cetkovsky P. Failure of multiple antivirals to affect high HHV-6 DNAaemia resulting from viral chromosomal integration in case of severe aplastic anaemia. Haematologica 2007; 92:e98-e100. [PMID: 18024365 DOI: 10.3324/haematol.11592] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
We report a fifty-year-old woman presenting with severe aplastic anaemia (SAA) and prolonged high Human Herpesvirus 6 (HHV6) variant A DNAeamia detected by quantitative PCR. Multiple antiviral treatments failed to affect the HHV6 DNAemia and subsequent immunosuppressive treatment reached only partial improvement as judged by bone marrow examinations. The patient remained dependent on thrombocyte transfusions and G-CSF treatment. After one year of steady high HHV6 DNA load in blood, viral chromosomal integration was proved by demonstrating the viral DNA in hair follicles. This condition appeared to be unconnected with, and to have no effect, on the original SAA.
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Affiliation(s)
- P Hubacek
- Department of Paediatric Haematology and Oncology, Motol University Hospital, Prague, The Czech Republic.
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Sumnik Z, Kolouskova S, Wales JKH, Komarek V, Cinek O. Sulphonylurea treatment does not improve psychomotor development in children with KCNJ11 mutations causing permanent neonatal diabetes mellitus accompanied by developmental delay and epilepsy (DEND syndrome). Diabet Med 2007; 24:1176-8. [PMID: 17888143 DOI: 10.1111/j.1464-5491.2007.02228.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Hubacek P, Hyncicova K, Muzikova K, Cinek O, Zajac M, Sedlacek P. Disappearance of pre-existing high HHV-6 DNA load in blood after allogeneic SCT. Bone Marrow Transplant 2007; 40:805-6. [PMID: 17704794 DOI: 10.1038/sj.bmt.1705813] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Sumnik Z, Cinek O, Bratanic N, Lebl J, Rozsai B, Limbert C, Paskova M, Schober E. Thyroid autoimmunity in children with coexisting type 1 diabetes mellitus and celiac disease: a multicenter study. J Pediatr Endocrinol Metab 2006; 19:517-22. [PMID: 16759037] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
BACKGROUND Children with type 1 diabetes mellitus (DM1) are more prone to developing thyroid autoimmunity (TAI); TAI also occurs more frequently in patients with celiac disease (CD). AIM To determine whether TAI occurs more frequently in children with coexisting DM1 and CD compared to children with DM1 only, and whether the clinical course of DM1 is influenced by concomitant TAI. PATIENTS AND METHODS We performed a multicenter retrospective case-control study comparing data from 84 diabetic children with CD (group 1) to 167 diabetic children without CD (group 2), matched by age at DM1 onset, duration of DM1 and center. Markers of TAI, thyroid function and HbA1c were recorded. The TAI follow-up lasted 4.9 +/- 2.8 years. RESULTS TAI was diagnosed in 13% of children in group 1 and 19% of children in group 2 (ns). Diabetes control was not influenced by TAI in either group. CONCLUSIONS Occurrence of TAI in diabetic children is not related to coexisting CD. TAI does not lead to worsening of metabolic control in children with DM1.
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Affiliation(s)
- Z Sumnik
- Department of Pediatrics, 2nd Faculty of Medicine, Prague, Czech Republic.
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Sumnik Z, Cinek O, Bratanic N, Lebl J, Rozsai B, Limbert C, Paskova M, Schober E. Thyroid Autoimmunity in Children with Coexisting Type 1 Diabetes Mellitus and Celiac Disease: A Multicenter Study. J Pediatr Endocrinol Metab 2006; 19:517-522. [PMID: 37909820 DOI: 10.1515/jpem-2006-190409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
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Cinek O, Witsø E, Jeansson S, Rasmussen T, Drevinek P, Wetlesen T, Vavrinec J, Grinde B, Rønningen KS. Longitudinal observation of enterovirus and adenovirus in stool samples from Norwegian infants with the highest genetic risk of type 1 diabetes. J Clin Virol 2006; 35:33-40. [PMID: 15916916 DOI: 10.1016/j.jcv.2005.03.007] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2004] [Revised: 02/28/2005] [Accepted: 03/08/2005] [Indexed: 11/29/2022]
Abstract
BACKGROUND Enterovirus and adenovirus are common in infancy, causing mostly asymptomatic infections. However, even an asymptomatic infection may be associated with increased risk of development of certain chronic non-infectious diseases, as has been suggested for enterovirus and type 1 diabetes. Data on occurrence and course of the infections in infancy are therefore important for designing effective approaches towards study of the association. OBJECTIVES To estimate the frequency of enterovirus and adenovirus infections in Norwegian infants, to evaluate the duration of the infections, to investigate their association with symptoms, and to establish a robust procedure that will be used to study the association between these viruses and the development of auto-immunity leading to type 1 diabetes. STUDY DESIGN Parents of infants, recruited for a study on environmental triggers of type 1 diabetes, submitted monthly samples of infant faeces, as well as information on symptoms of infection. The samples were analysed for enterovirus and adenovirus using quantitative real-time PCR, and enterovirus-positive samples were sequenced. RESULTS Enteroviruses were found in 142/1,255 (11.3%), and adenoviruses in 138/1,255 (11.0%) of stool samples. Approximately half of the infants were exposed to these viruses at least once during the first year of observation (period 3-14 months of age). The presence of adenovirus was associated with fever and with symptoms of cold but not with diarrhoea and vomiting. The enterovirus positivity was not associated with any symptoms. CONCLUSIONS The prevalence of enterovirus and adenovirus in longitudinally obtained faecal samples from infants is sufficiently high to enable studies of their association with chronic diseases. The present protocol for evaluating exposure to these viruses is well suited for large-scale efforts aimed at assessing possible long-term consequences, particularly in relation to type 1 diabetes.
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MESH Headings
- Adenovirus Infections, Human/complications
- Adenovirus Infections, Human/epidemiology
- Adenovirus Infections, Human/virology
- Adenoviruses, Human/genetics
- Adenoviruses, Human/isolation & purification
- Child, Preschool
- DNA, Viral/analysis
- Diabetes Mellitus, Type 1/etiology
- Diabetes Mellitus, Type 1/virology
- Enterovirus/genetics
- Enterovirus/isolation & purification
- Enterovirus Infections/complications
- Enterovirus Infections/epidemiology
- Enterovirus Infections/virology
- Feces/virology
- Female
- Humans
- Infant
- Longitudinal Studies
- Male
- Norway/epidemiology
- Polymerase Chain Reaction
- Prevalence
- RNA, Viral/analysis
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Affiliation(s)
- O Cinek
- Motol University Hospital, Charles University Prague, V Uvalu 85, CZ-150 06 Praha 5, The Czech Republic.
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43
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Holub M, Beran O, Lacinová Z, Cinek O, Chalupa P. Interferon-gamma and cortisol levels in cerebrospinal fluid and its relationship to the etiology of aseptic meningoencephalitis. Prague Med Rep 2006; 107:343-53. [PMID: 17385407] [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: 05/14/2023] Open
Abstract
The aim of the study was to analyze the concentrations of Th1/Th2 cytokines and cortisol in the cerebrospinal fluid (CSF) from patients with aseptic meningoencephalitis (AM). The study enrolled 37 patients with AM and 11 control subjects. CSF concentrations of IL-2, IL-4, IL-5, IL-10, IFN-gamma, and TNF-alpha were analyzed using cytokine bead array and flow cytometry; CSF cortisol concentrations were measured by a RIA method. Cortisol was detected in 37 CSF samples (100%) from patients with AM, and it was significantly elevated in comparison to control subjects. IFN-gamma was detected in 32 CSF samples (86.5%) and IL-10 was detectable in 9 CSF samples (24.3%). The CSF cortisol levels correlated negatively with the duration of AM. The intrathecal concentration of IFN-gamma correlated positively with CSF numbers of leukocytes and lymphocytes, and negatively with the duration of AM. The etiology of AM influenced the CSF cortisol concentration, which was significantly higher in patients with tick-borne encephalitis when compared to persons with AM of unknown origin and control subjects. The results indicate that the prevailing intrathecal immune reaction during AM is shifted to a Th1-like response, whereas anti-inflammatory response in the brain is executed by the effect of cortisol.
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Affiliation(s)
- M Holub
- Third Department of Infectious and Tropical Diseases, First Faculty of Medicine, Charles University, Teaching Hospital Na Bulovce, Prague, Czech Republic.
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44
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Hubácek P, Cinek O, Kulich M, Zajac M, Keslová P, Formánková R, Starý J, Sedlácek P. [EBV quantification in children after allogeneic hematopoietic stem cell transplantation]. Cas Lek Cesk 2006; 145:301-6. [PMID: 16639931] [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: 05/08/2023]
Abstract
BACKGROUND Patients undergoing allogeneic hematopoietic stem cell transplantation (AHSCT) are endangered by developing Epstein-Barr virus-related post-transplant lymfoprolipherative disease (EBV-LPD). The aims of the study were to retrospectively characterise the viral loads in four patients who died of this complication, and to test possible risk factors for EBV reactivation in a prospectively observed cohort of children after AHSCT. METHODS AND RESULTS Serial DNA samples extracted from whole blood from four patients who died of post-transplant EBV-LPD in year 2000 were retrospectively analysed for EBV load using quantitative real-time PCR. First detection of EBV activation preceded death by 24-91 days. All four patients exceeded a viral load of one million EBV copies per 100,000 human genome equivalents. A cohort of 72 children undergoing AHSCT between 2001-2004 was prospectively followed-on using the same quantification method from regularly obtained samples of whole blood, and clinical and laboratory data were recorded on a weekly basis, totalling at 3,896 person-weeks of observation. Approximately one half of the cohort experienced at least one episode of EBV reactivation during the first 100 days after AHSCT, four of the episodes being accompanied with viral loads higher than our provisional threshold of 10,000 copies per 100,000 human genome equivalents. Three of the four patients developed EBV-LPD and were successfully treated by intravenous administration of anti-CD20 antibody. Testing of possible clinical and laboratory predictors of EBV reactivation did not reveal any clinically useful association. CONCLUSIONS The cornerstone of predicting EBV-LPD in AHSCT is a regular monitoring of EBV viral load using quantitative methods. Using this strategy with a threshold of 10,000 EBV copies per 100,000 human genome equivalents was proved to be effective, as shown by no death of EBV for the study period, compared to four cases in the year before the quantitative monitoring.
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Affiliation(s)
- P Hubácek
- Klinika dĕtské hematologie a onkologie 2, LF UK a FNM, Praha.
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45
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Cinek O, Sumník Z, Vavrinec J. [Childhood diabetes in the Czech Republic: a steady increase in incidence]. Cas Lek Cesk 2005; 144:266-71; discussion 271-2. [PMID: 15945487] [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: 05/02/2023]
Abstract
BACKGROUND The aim of the study was to assess the incidence and prevalence of type 1 diabetes in Czech children aged 0-15 years over the period 1989-2003. METHODS AND RESULTS The cases were ascertained using two independent sources, the population-wide Czech Childhood Diabetes Register and the Association of Parents and Friends of Diabetic Children, and the completeness was calculated using the capture-recapture method. The background population size was obtained from annual reports of the Czech Statistic Bureau. Trends in incidence were estimated using Poisson regression. A total of 3 454 cases was ascertained, with an estimated deficit of 28 (95% CI 16-41) individuals. The average age-standardized incidence was 12.0 (95% CI 11.6-12.4) / 100,000/year, and its average relative increase was 6.8% / year. The incidence has risen from 6.8 (95% CI 5.7-7.9) in 1989 to 18.3 (95% CI 16.2-20.4) in 2003. The prevalence in 2003 was 1.01 (95% CI 0.96-0.06) cases per 1000, and its projection into the coming decade expects a rise to approximately 1.7/1000 in 2013. CONCLUSIONS The present work shows that the Czech population has an intermediate childhood type 1 diabetes incidence compared to other European countries, and although its continuous rise may be expected, the prevalence is very unlikely to reach dramatically high figures.
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Affiliation(s)
- O Cinek
- Ceský registr detského diabetu, Praha.
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Sumnik Z, Drevinek P, Lanska V, Malcova H, Vavrinec J, Cinek O. Higher Maternal Age at Delivery, and Lower Birth Orders Are Associated with Increased Risk of Childhood Type 1 Diabetes Mellitus. Exp Clin Endocrinol Diabetes 2004; 112:294-7. [PMID: 15216445 DOI: 10.1055/s-2004-820907] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
In several populations, maternal age at delivery and birth order have been demonstrated to variously affect the risk of Type 1 diabetes mellitus in the offspring. The aim of the present study was to investigate this relation in the Czech population. Questionnaire data on 640 children with childhood-onset Type 1 DM and data on 50 random controls to each case, obtained from the national Birth Registry and matched for the calendar year of birth, were analysed using multivariate logistic regression. The risk of Type 1 DM increases with higher maternal age at birth of the child (OR = 1.07, CI 95 % 1.05 - 1.09 per one year increment), and decreases with higher birth order (OR = 0.70, CI 95 % 0.62 - 0.79 per increment in birth order). There was no significant difference in these effects across the five-years bands of age at diabetes onset. We detected no independent effect of maternal education, either. Our study provides further evidence that the risk of Type 1 diabetes in the offspring increases with higher maternal age at delivery and lower birth order.
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Affiliation(s)
- Z Sumnik
- Department of Paediatrics, 2nd Medical School, Charles University, V Uvalu 84, Prague 5, The Czech Republic
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Stechova K, Bartaskova D, Mrstinova M, Cerny M, Snajderova M, Cinek O, Sumnik Z, Vavrinec J. Pregnancy in a Woman Suffering from Type 1 Diabetes Associated with Addison's Disease and Hashimoto's Thyroiditis (Fully Developed Autoimmune Polyglandular Syndrome Type 2). Exp Clin Endocrinol Diabetes 2004; 112:333-7. [PMID: 15216452 DOI: 10.1055/s-2004-820912] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
In this article the pregnancy of a woman suffering from the complete triad typical of Autoimmune Polyglandular Syndrome Type 2 (Addison's disease + type 1 diabetes + Hashimoto's thyroiditis) is reported. By using insulin pump therapy with insulin lispro, it was possible to balance diabetes control with changes of steroid replacement therapy. Pregnancy was uneventful until week 27, when signs of preeclampsia occurred. The boy was born without difficulty at gestational age 37 weeks by planned cesarean section but signs of diabetic fetopathy (macrosomia, hypoglycaemia and hypocalcaemia) were expressed. He required a short course of hydrocortisone therapy. He made a good and rapid recovery. The mother made a good post-operative recovery too, but 4 months after the delivery microalbuminuria as well as mild hyperuricemia are still present. Interdisciplinary approach and very careful observation of the mother as well as of the child enabled successful outcome of this highly risky pregnancy.
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Affiliation(s)
- K Stechova
- 2nd Department of Paediatrics, University Hospital Motol in Prague, V Uvalu 84, Prague 5, Czech Republic.
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Matejková-Behanová M, Vanková M, Hill M, Kucera P, Cinek O, Andel M, Bendlová B. Polymorphism of INS VNTR is associated with glutamic acid decarboxylase antibodies and postprandial C-peptide in patients with onset of diabetes after 35 years of age. Physiol Res 2004; 53:187-90. [PMID: 15046555] [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: 04/29/2023] Open
Abstract
Variability in the number of tandem repeats of the insulin gene (INS VNTR) is probably involved in the genetic regulation of insulin secretion. The aim of this study was to investigate the association of INS VNTR polymorphism with the presence of glutamic acid decarboxylase antibodies (GADA) and C-peptide levels in patients with the onset of diabetes after 35 years of age. We investigated 117 patients, median of age 63 (range 40-83) years, median of diabetes duration 8 (range 1-30) years; 31 GADA-positive and 86 GADA-negative subjects. INS VNTR polymorphism was typed indirectly using - 23HphI (T/A) polymorphism, which is in complete linkage disequilibrium with INS VNTR. The I/I, I/III and III/III genotypes were found in 22 (71 %), 8 (26 %), 1 (3 %) GADA-positive individuals and in 39 (45 %), 35 (41 %), 12 (14 %) GADA-negative individuals, respectively. The Class I allele and the genotype I/I were significantly associated with the presence of GADA (OR=2.72, CI 95 %=1.29-5.73 and OR=2.95, CI 95 %=1.22-7.13). The presence of Class III allele was significantly associated with a higher level of postprandial C-peptide in GADA-positive subjects, even when regarding the duration of diabetes. Our results of INS VNTR polymorphism in patients with the onset of diabetes after 35 years of age confirm the association of Class I INS VNTR with autoimmune diabetes and the protective effect of Class III INS VNTR on the insulin secretion in GADA-positive subjects.
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Affiliation(s)
- M Matejková-Behanová
- Institute of Endocrinology, Third Faculty of Medicine, Charles University, Prague, Czech Republic
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Cinek O, Drevínek P, Sumník Z, Bendlová B, Vavrinec J. [Association of insulin gene variants with type 1 diabetes mellitus in Czech population]. Cas Lek Cesk 2004; 143:318-22. [PMID: 15305767] [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: 04/30/2023]
Abstract
BACKGROUND The objective of the study was to quantify the association of insulin gene variants with type 1 diabetes mellitus (TIDM) in the Czech population. METHODS AND RESULTS In an association study, we compared genotypes of 332 T1DM patients (age at T1DM onset was 8.1 +/- 4.4 yrs) with 292 healthy nondiabetic controls of similar age. All subjects were previously genotyped for HLA-DQB1, -DQA1 polymorphisms and DRB1*04 subtypes. The insulin gene was typed using the -23 HphI single nucleotide polymorphism after we had demonstrated a nearly complete linkage disequilibrium between this polymorphism, and the etiological VNTR in the Czech population. The protective variant of the insulin gene was present in 24% T1DM patients, and in 48% controls (OR=0.34, CI 95% 0.24-0.48), a risk comparable to weaker-associated HLA-DQ alleles. The association was independent of the HLA-conferred T1DM risk. The insulin gene polymorphism had no influence on the age at T1DM onset. CONCLUSIONS We conclude that the insulin gene genotyping confers important information on T1DM risk in our population, and should be used in determining the disease risk along with the HLA-DQ typing.
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Affiliation(s)
- O Cinek
- Pediatrická klinika 2. LF UK a FNM, Praha.
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50
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Matějková-Běhanová M, Vaňková M, Hill M, Kučera P, Cinek O, Anděl M, Bendlová B. Polymorphism of INS VNTR is associated with glutamic acid decarboxylase antibodies and postprandial C-peptide in patients with diabetes onset after 35 years of age. Physiol Res 2004. [DOI: 10.33549/physiolres.930431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Variability in the number of tandem repeats of the insulin gene (INS VNTR) is probably involved in the genetic regulation of insulin secretion. The aim of this study was to investigate the association of INS VNTR polymorphism with the presence of glutamic acid decarboxylase antibodies (GADA) and C-peptide levels in patients with the onset of diabetes after 35 years of age. We investigated 117 patients, median of age 63 (range 40-83) years, median of diabetes duration 8 (range 1-30) years; 31 GADA-positive and 86 GADA-negative subjects. INS VNTR polymorphism was typed indirectly using - 23HphI (T/A) polymorphism, which is in complete linkage disequilibrium with INS VNTR. The I/I, I/III and III/III genotypes were found in 22 (71 %), 8 (26 %), 1 (3 %) GADA-positive individuals and in 39 (45 %), 35 (41 %), 12 (14 %) GADA-negative individuals, respectively. The Class I allele and the genotype I/I were significantly associated with the presence of GADA (OR=2.72, CI 95 %=1.29-5.73 and OR=2.95, CI 95 %=1.22-7.13). The presence of Class III allele was significantly associated with a higher level of postprandial C-peptide in GADA-positive subjects, even when regarding the duration of diabetes. Our results of INS VNTR polymorphism in patients with the onset of diabetes after 35 years of age confirm the association of Class I INS VNTR with autoimmune diabetes and the protective effect of Class III INS VNTR on the insulin secretion in GADA-positive subjects.
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