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Gu P, Dube S, Gellada N, Choi SY, Win S, Lee YJ, Yang S, Haritunians T, Melmed GY, Vasiliauskas EA, Bonthala N, Syal G, Yarur AJ, Ziring D, Rabizadeh S, Fleshner P, Kallman C, Devkota S, Targan SR, Li D, McGovern DPB. Pre-operative visceral adipose tissue radiodensity is a potentially novel prognostic biomarker for early endoscopic post-operative recurrence in Crohn's disease. World J Gastrointest Surg 2024; 16:740-750. [PMID: 38577075 PMCID: PMC10989343 DOI: 10.4240/wjgs.v16.i3.740] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/04/2024] [Accepted: 01/30/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Evidence suggests inflammatory mesenteric fat is involved in post-operative recurrence (POR) of Crohn's disease (CD). However, its prognostic value is uncertain, in part, due to difficulties studying it non-invasively. AIM To evaluate the prognostic value of pre-operative radiographic mesenteric parameters for early endoscopic POR (ePOR). METHODS We conducted a retrospective cohort study of CD subjects ≥ 12 years who underwent ileocecal or small bowel resection between 1/1/2007 to 12/31/2021 with computerized tomography abdomen/pelvis ≤ 6 months pre-operatively and underwent ileocolonoscopy ≤ 15 months post-operatively. Visceral adipose tissue (VAT) volume (cm3), ratio of VAT:subcutaneous adipose tissue (SAT) volume, VAT radiodensity, and ratio of VAT:SAT radiodensity were generated semiautomatically. Mesenteric lymphadenopathy (LAD, largest lymph node > 10 mm) and severe vasa recta (VR) engorgement (diameter of the VR supplying diseased bowel ≥ 2 × VR supplying healthy bowel) were derived manually. The primary outcome was early ePOR (Rutgeert's score ≥ i2 on first endoscopy ≤ 15 months post-operatively) and the secondary outcome was ePOR severity (Rutgeert's score i0-4). Regression analyses were performed adjusting for demographic and disease-related characteristics to calculate adjusted odds ratio (aOR) and 95% confidence interval (CI). RESULTS Of the 139 subjects included, 45% of subjects developed early ePOR (n = 63). VAT radiodensity (aOR 0.59, 95%CI: 0.38-0.90) and VAT:SAT radiodensity (aOR 8.54, 95%CI: 1.48-49.28) were associated with early ePOR, whereas, VAT volume (aOR 1.23, 95%CI: 0.78-1.95), VAT:SAT volume (aOR 0.80, 95%CI: 0.53-1.20), severe VR engorgement (aOR 1.53, 95%CI: 0.64-3.66), and mesenteric LAD (aOR 1.59, 95%CI: 0.67-3.79) were not. Similar results were observed for severity of ePOR. CONCLUSION VAT radiodensity is potentially a novel non-invasive prognostic imaging marker to help risk stratify CD patients for POR.
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Affiliation(s)
- Phillip Gu
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States
| | - Shishir Dube
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States
| | - Norman Gellada
- Department of Imaging, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States
| | - So Yung Choi
- Department of Biostatistics Shared Resource, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States
| | - Susan Win
- Department of Imaging, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States
| | - Yoo Jin Lee
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu 42601, South Korea
| | - Shaohong Yang
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States
| | - Talin Haritunians
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States
| | - Gil Y Melmed
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States
| | - Eric A Vasiliauskas
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States
| | - Niru Bonthala
- Department of Medicine, University of California at Los Angeles, Los Angeles, CA 90095, United States
| | - Gaurav Syal
- Department of Medicine, University of California at San Diego, San Diego, CA 92093, United States
| | - Andres J Yarur
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States
| | - David Ziring
- Department of Pediatrics, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States
| | - Shervin Rabizadeh
- Department of Pediatrics, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States
| | - Phillip Fleshner
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States
| | - Cindy Kallman
- Department of Imaging, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States
| | - Suzanne Devkota
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States
| | - Stephan R Targan
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States
| | - Dalin Li
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States
| | - Dermot PB McGovern
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States
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Gu P, Mendonca O, Carter D, Dube S, Wang P, Huang X, Li D, Moore JH, McGovern DPB. AI-luminating Artificial Intelligence in Inflammatory Bowel Diseases: A Narrative Review on the Role of AI in Endoscopy, Histology, and Imaging for IBD. Inflamm Bowel Dis 2024:izae030. [PMID: 38452040 DOI: 10.1093/ibd/izae030] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Indexed: 03/09/2024]
Abstract
Endoscopy, histology, and cross-sectional imaging serve as fundamental pillars in the detection, monitoring, and prognostication of inflammatory bowel disease (IBD). However, interpretation of these studies often relies on subjective human judgment, which can lead to delays, intra- and interobserver variability, and potential diagnostic discrepancies. With the rising incidence of IBD globally coupled with the exponential digitization of these data, there is a growing demand for innovative approaches to streamline diagnosis and elevate clinical decision-making. In this context, artificial intelligence (AI) technologies emerge as a timely solution to address the evolving challenges in IBD. Early studies using deep learning and radiomics approaches for endoscopy, histology, and imaging in IBD have demonstrated promising results for using AI to detect, diagnose, characterize, phenotype, and prognosticate IBD. Nonetheless, the available literature has inherent limitations and knowledge gaps that need to be addressed before AI can transition into a mainstream clinical tool for IBD. To better understand the potential value of integrating AI in IBD, we review the available literature to summarize our current understanding and identify gaps in knowledge to inform future investigations.
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Affiliation(s)
- Phillip Gu
- F. Widjaja Inflammatory Bowel Disease Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | | | - Dan Carter
- Department of Gastroenterology, Sheba Medical Center, Tel Aviv, Israel
| | - Shishir Dube
- F. Widjaja Inflammatory Bowel Disease Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Paul Wang
- Department of Computational Biomedicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Xiuzhen Huang
- Department of Computational Biomedicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Debiao Li
- Biomedical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Jason H Moore
- Department of Computational Biomedicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Dermot P B McGovern
- F. Widjaja Inflammatory Bowel Disease Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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Gu P, Dube S, Lee Y, Yang S, Li D, Haritunians T, Vasiliauskas E, Bonthala N, Syal G, Yarur A, Ziring D, Targan S, Rabizadeh S, Melmed GY, Fleshner P, McGovern DPB. Comparative Persistence of Non-tumor Necrosis Factor (TNF) vs. TNF Antagonists for Post-operative Prophylaxis in Crohn's Disease (CD). Dig Dis Sci 2024; 69:235-245. [PMID: 38015321 PMCID: PMC10787872 DOI: 10.1007/s10620-023-08192-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 11/09/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND The comparative safety and effectiveness of available biologics for post-operative prophylaxis in Crohn's disease (CD) is uncertain. Drug persistence may serve as a real-world proxy for tolerability and effectiveness. We evaluated the comparative persistence of non-TNF and TNF antagonists for post-operative prophylaxis and their comparative effectiveness for preventing early endoscopic post-operative recurrence (POR). METHODS We conducted a single-center, retrospective study of surgically naïve CD subjects undergoing ileocecal or small bowel resection between 1/1/2000 and 12/31/2021 and prescribed a biologic for post-operative prophylaxis. We compared the risk of prophylaxis failure (requiring recurrent surgery or discontinuation of therapy due to persistent POR despite optimized drug level or dose escalation, immunogenicity, and/or adverse event) and early endoscopic POR (Rutgeert's score ≥ i2 within 15 months postoperatively) between non-TNF and TNF antagonist prophylaxis using Cox proportional hazard and logistic regression, respectively, adjusting for demographic and disease characteristics. RESULTS The study included 291 subjects (81% TNF antagonists). After multivariable adjustment, non-TNF antagonist prophylaxis was associated with a significantly lower risk of prophylaxis failure than TNF antagonists (hazard ratio 0.26; 95% confidence interval (CI) [0.13-0.53]). Prophylaxis with non-TNF and TNF antagonists had similar risk of early endoscopic POR (odds ratio 0.66; 95% CI [0.32-1.36]). Stratifying the non-TNF antagonists by anti-integrin and anti-IL12/23 yielded similar results. CONCLUSION In a cohort of surgically naïve CD subjects prescribed a biologic for post-operative prophylaxis, non-TNF antagonists had greater persistence than TNF antagonists with similar risk for early endoscopic POR. If confirmed by large, prospective studies, these findings can inform post-operative management strategies in CD.
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Affiliation(s)
- Phillip Gu
- F. Widjaja Inflammatory Bowel Disease Institute, 8730 Alden Drive, Thalians Bldg, #E222, Los Angeles, CA, 90048, USA.
| | - Shishir Dube
- F. Widjaja Inflammatory Bowel Disease Institute, 8730 Alden Drive, Thalians Bldg, #E222, Los Angeles, CA, 90048, USA
| | - YooJin Lee
- F. Widjaja Inflammatory Bowel Disease Institute, 8730 Alden Drive, Thalians Bldg, #E222, Los Angeles, CA, 90048, USA
| | - Shaohong Yang
- F. Widjaja Inflammatory Bowel Disease Institute, 8730 Alden Drive, Thalians Bldg, #E222, Los Angeles, CA, 90048, USA
| | - Dalin Li
- F. Widjaja Inflammatory Bowel Disease Institute, 8730 Alden Drive, Thalians Bldg, #E222, Los Angeles, CA, 90048, USA
| | - Talin Haritunians
- F. Widjaja Inflammatory Bowel Disease Institute, 8730 Alden Drive, Thalians Bldg, #E222, Los Angeles, CA, 90048, USA
| | - Eric Vasiliauskas
- F. Widjaja Inflammatory Bowel Disease Institute, 8730 Alden Drive, Thalians Bldg, #E222, Los Angeles, CA, 90048, USA
| | - Niru Bonthala
- F. Widjaja Inflammatory Bowel Disease Institute, 8730 Alden Drive, Thalians Bldg, #E222, Los Angeles, CA, 90048, USA
| | - Gaurav Syal
- Division of Gastroenterology, Department of Medicine, UC San Diego, La Jolla, CA, USA
| | - Andres Yarur
- F. Widjaja Inflammatory Bowel Disease Institute, 8730 Alden Drive, Thalians Bldg, #E222, Los Angeles, CA, 90048, USA
| | - David Ziring
- F. Widjaja Inflammatory Bowel Disease Institute, 8730 Alden Drive, Thalians Bldg, #E222, Los Angeles, CA, 90048, USA
| | - Stephan Targan
- F. Widjaja Inflammatory Bowel Disease Institute, 8730 Alden Drive, Thalians Bldg, #E222, Los Angeles, CA, 90048, USA
| | - Shervin Rabizadeh
- F. Widjaja Inflammatory Bowel Disease Institute, 8730 Alden Drive, Thalians Bldg, #E222, Los Angeles, CA, 90048, USA
| | - Gil Y Melmed
- F. Widjaja Inflammatory Bowel Disease Institute, 8730 Alden Drive, Thalians Bldg, #E222, Los Angeles, CA, 90048, USA
| | - Phillip Fleshner
- F. Widjaja Inflammatory Bowel Disease Institute, 8730 Alden Drive, Thalians Bldg, #E222, Los Angeles, CA, 90048, USA
| | - Dermot P B McGovern
- F. Widjaja Inflammatory Bowel Disease Institute, 8730 Alden Drive, Thalians Bldg, #E222, Los Angeles, CA, 90048, USA
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Yarur AJ, Abreu MT, Deepak P, Beniwal-Patel P, Papamichael K, Vaughn B, Bruss A, Sekhri S, Moosreiner A, Gu P, Kennedy W, Dubinsky M, Cheifetz A, Melmed GY. Patients With Inflammatory Bowel Diseases and Higher Visceral Adipose Tissue Burden May Benefit From Higher Infliximab Concentrations to Achieve Remission. Am J Gastroenterol 2023; 118:2005-2013. [PMID: 37207314 PMCID: PMC10720850 DOI: 10.14309/ajg.0000000000002330] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 04/27/2023] [Indexed: 05/21/2023]
Abstract
INTRODUCTION In patients with inflammatory bowel diseases (IBDs), high visceral adipose tissue (VAT) burden is associated with a lower response to infliximab, potentially through alterations in volume distribution and/or clearance. Differences in VAT may also explain the heterogeneity in target trough levels of infliximab associated with favorable outcomes. The aim of this study was to assess whether VAT burden may be associated with infliximab cutoffs associated with efficacy in patients with IBD. METHODS We conducted a prospective cross-sectional study of patients with IBD receiving maintenance infliximab therapy. We measured baseline body composition parameters (Lunar iDXA), disease activity, trough levels of infliximab, and biomarkers. The primary outcome was steroid-free deep remission. The secondary outcome was endoscopic remission within 8 weeks of infliximab level measurement. RESULTS Overall, 142 patients were enrolled. The optimal trough levels of infliximab cutoffs associated with steroid-free deep remission and endoscopic remission were 3.9 mcg/mL (Youden Index [J]: 0.52) for patients in the lowest 2 VAT % quartiles (<1.2%) while optimal infliximab level cutoffs associated with steroid-free deep remission for those patients in the highest 2 VAT % quartiles was 15.3 mcg/mL (J: 0.63). In a multivariable analysis, only VAT % and infliximab level remained independently associated with steroid-free deep remission (odds ratio per % of VAT: 0.3 [95% confidence interval: 0.17-0.64], P < 0.001 and odds ratio per μg/mL: 1.11 [95% confidence interval: 1.05-1.19], P < 0.001). DISCUSSION The results may suggest that patients with higher visceral adipose tissue burden may benefit from achieving higher infliximab levels to achieve remission.
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Affiliation(s)
- Andres J. Yarur
- Division of Gastroenterology and Hepatology, Center for Inflammatory Bowel Diseases, Cedars Sinai Medical Center, Los Angeles, California, USA
- Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Maria T. Abreu
- Center for Inflammatory Bowel Diseases, Division of Gastroenterology and Hepatology, University of Miami, Miller School of Medicine, Miami, Florida, USA
| | - Parakkal Deepak
- Division of Gastroenterology and Hepatology, Washington University, St Louis, Missouri, USA
| | - Poonam Beniwal-Patel
- Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Konstantinos Papamichael
- Center for Inflammatory Bowel Diseases, Division of Gastroenterology, Beth-IsraelDeaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Byron Vaughn
- Division of Gastroenterology, Hepatology, and Nutrition, University of Minnesota, Minneapolis, Minnesota, USA
| | - Alexandra Bruss
- Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Shaina Sekhri
- Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Andrea Moosreiner
- Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Phillip Gu
- Division of Gastroenterology and Hepatology, Center for Inflammatory Bowel Diseases, Cedars Sinai Medical Center, Los Angeles, California, USA
| | - William Kennedy
- Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Marla Dubinsky
- Division of Pediatric Gastroenterology and Nutrition, Mount Sinai Kravis Children's Hospital, Icahn School of Medicine Mount Sinai, New York, USA.
| | - Adam Cheifetz
- Center for Inflammatory Bowel Diseases, Division of Gastroenterology, Beth-IsraelDeaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Gil Y. Melmed
- Division of Gastroenterology and Hepatology, Center for Inflammatory Bowel Diseases, Cedars Sinai Medical Center, Los Angeles, California, USA
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Li S, Yu LL, Li L, Tang XM, He P, Gu P. Ultrasound-guided core-needle biopsy for peripheral pulmonary lesions: a systematic review and meta-analysis. Clin Radiol 2023; 78:755-762. [PMID: 37558538 DOI: 10.1016/j.crad.2023.07.005] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 06/30/2023] [Accepted: 07/08/2023] [Indexed: 08/11/2023]
Abstract
AIM To evaluate the diagnostic value and safety of ultrasound-guided core-needle biopsy for peripheral pulmonary lesions (PPLs). MATERIALS AND METHODS PubMed, EMBASE, and the Cochrane Library for relevant were searched for studies published up to June 2022. The diagnostic accuracy of US-guided percutaneous transthoracic needle biopsy (PTNB) for the diagnosis of PPLs was evaluated using pooled sensitivity, specificity, diagnostic odds ratio (DOR), positive and negative likelihood ratios (PLR and NLR), and the area under the summary receiver operating characteristic curves value (SROC). RESULTS The search included 12 original studies (3,830 procedures). For US-guided PTNB, the pooled sensitivity and specificity for the diagnosis of PPLs were 0.93 (95% confidence interval [CI]: 0.91-0.94) and 0.99 (95% CI: 0.96-1.00), respectively. The pooled estimates of the PLR, NLR, and DOR were 134.88 (95% CI: 24.88-731.74), 0.07 (95% CI: 0.06-0.09), and 1,814.95 (95% CI: 333.62-9,873.76), respectively. The area under the SROC curve was 0.95 (95% CI: 0.93-0.97). The overall complication rate was 3.6% (136 of 3,830), including self-limited haemoptysis and asymptomatic pneumothorax, and only six cases of pneumothorax requiring chest tube drainage and one case of severe bleeding were reported. CONCLUSIONS US-guided core-needle biopsy is an excellent diagnostic tool for PPLs, with high accuracy and excellent technical performance and safety.
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Affiliation(s)
- S Li
- Department of Ultrasound, Affiliated Hospital of North Sichuan Medical College, 637000, Nanchong, China
| | - L-L Yu
- Department of Ultrasound, Affiliated Hospital of North Sichuan Medical College, 637000, Nanchong, China
| | - L Li
- Department of Ultrasound, Affiliated Hospital of North Sichuan Medical College, 637000, Nanchong, China
| | - X-M Tang
- Department of Ultrasound, Affiliated Hospital of North Sichuan Medical College, 637000, Nanchong, China
| | - P He
- Department of Ultrasound, Affiliated Hospital of North Sichuan Medical College, 637000, Nanchong, China
| | - P Gu
- Department of Ultrasound, Affiliated Hospital of North Sichuan Medical College, 637000, Nanchong, China.
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Gu P, Dube S, McGovern DPB. Medical and Surgical Implications of Mesenteric Adipose Tissue in Crohn's Disease: A Review of the Literature. Inflamm Bowel Dis 2023; 29:458-469. [PMID: 35731568 DOI: 10.1093/ibd/izac120] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Indexed: 12/09/2022]
Abstract
Mesenteric adipose tissue (MAT) has gained substantial attention as an active player in Crohn's disease (CD), but its clinical significance is poorly understood and likely reflects, in part, difficulties assessing MAT noninvasively. Recent radiologic studies have identified candidate surrogate markers that may reflect inflammatory alterations of MAT in CD and have found that certain features including visceral adipose tissue may inform risk of complicated disease behavior, risk for surgery, and postoperative outcomes. Additionally, emerging surgical data have suggested MAT may even be a therapeutic target to mitigate postoperative recurrence of CD. However, the current studies have variable results, reduced sample sizes, and methodological limitations that preclude incorporating the radiologic and surgical findings into clinical practice. Nonetheless, the results are promising and potentially have important implications for the medical and surgical management of CD, which merits that additional studies are warranted. Thus, we have reviewed the available literature on the medical and surgical implications of MAT in CD to summarize our current understanding and identify gaps in knowledge to inform future investigations.
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Affiliation(s)
- Phillip Gu
- Karsh Division of Gastroenterology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Shishir Dube
- Karsh Division of Gastroenterology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Dermot P B McGovern
- Karsh Division of Gastroenterology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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Gu P, Luo J, Kim J, Paul P, Limketkai B, Sauk JS, Park S, Parekh N, Zheng K, Rudrapatna V, Syal G, Ha C, McGovern DP, Melmed GY, Fleshner P, Eisenstein S, Ramamoorthy S, Dulai PS, Boland BS, Grunvald E, Mahadevan U, Ohno-Machado L, Sandborn WJ, Singh S. Effect of Obesity on Risk of Hospitalization, Surgery, and Serious Infection in Biologic-Treated Patients With Inflammatory Bowel Diseases: A CA-IBD Cohort Study. Am J Gastroenterol 2022; 117:1639-1647. [PMID: 35973139 DOI: 10.14309/ajg.0000000000001855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 04/22/2022] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Obesity is variably associated with treatment response in biologic-treated patients with inflammatory bowel diseases (IBD). We evaluated the association between obesity and risk of hospitalization, surgery, or serious infections in patients with IBD in new users of biologic agents in a large, multicenter, electronic health record (EHR)-based cohort (CA-IBD). METHODS We created an EHR-based cohort of adult patients with IBD who were new users of biologic agents (tumor necrosis factor [TNF-α] antagonists, ustekinumab, and vedolizumab) between January 1, 2010, and June 30, 2017, from 5 health systems in California. Patients were classified as those with normal body mass index (BMI), overweight, or obese based on the World Health Organization classification. We compared the risk of all-cause hospitalization, IBD-related surgery, or serious infections among patients with obesity vs those overweight vs those with normal BMI, using Cox proportional hazard analyses, adjusting for baseline demographic, disease, and treatment characteristics. RESULTS Of 3,038 biologic-treated patients with IBD (69% with Crohn's disease and 76% on TNF-α antagonists), 28.2% (n = 858) were overweight, and 13.7% (n = 416) were obese. On a follow-up after biologic initiation, obesity was not associated with an increased risk of hospitalization (adjusted hazard ratio [aHR] vs normal BMI, 0.90; [95% confidence interval, 0.72-1.13]); IBD-related surgery (aHR, 0.62 [0.31-1.22]); or serious infection (aHR, 1.11 [0.73-1.71]). Similar results were observed on stratified analysis by disease phenotype (Crohn's disease vs ulcerative colitis) and index biologic therapy (TNF-α antagonists vs non-TNF-α antagonists). DISCUSSION In a multicenter, EHR-based cohort of biologic-treated patients with IBD, obesity was not associated with hospitalization, surgery, or serious infections. Further studies examining the effect of visceral obesity on patient-reported and endoscopic outcomes are needed.
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Affiliation(s)
- Phillip Gu
- Karsh Division of Gastroenterology and Hepatology, Department of Medicine, Cedars-Sinai Medical System, Los Angeles, California, USA
| | - Jiyu Luo
- Division of Biostatistics and Bioinformatics, Department of Family Medicine and Public Health, UC San Diego, La Jolla, California, USA
| | - Jihoon Kim
- Division of Biomedical Informatics, Department of Medicine, UC San Diego, La Jolla, California, USA
| | - Paulina Paul
- Division of Biomedical Informatics, Department of Medicine, UC San Diego, La Jolla, California, USA
| | - Berkeley Limketkai
- Vatche and Tamar Manoukian Division of Digestive Diseases, Department of Medicine, UC Los Angeles, Los Angeles, California, USA
| | - Jenny S Sauk
- Vatche and Tamar Manoukian Division of Digestive Diseases, Department of Medicine, UC Los Angeles, Los Angeles, California, USA
| | - Sunhee Park
- Division of Gastroenterology, Department of Medicine, UC Irvine, Orange, California, USA
| | - Nimisha Parekh
- Division of Gastroenterology, Department of Medicine, UC Irvine, Orange, California, USA
| | - Kai Zheng
- Department of Informatics, Donald Bren School of Information and Computer Sciences, UC Irvine, Orange, California, USA
| | - Vivek Rudrapatna
- Division of Gastroenterology, Department of Medicine, UC San Francisco, California, USA
| | - Gaurav Syal
- Karsh Division of Gastroenterology and Hepatology, Department of Medicine, Cedars-Sinai Medical System, Los Angeles, California, USA
| | - Christina Ha
- Karsh Division of Gastroenterology and Hepatology, Department of Medicine, Cedars-Sinai Medical System, Los Angeles, California, USA
| | - Dermot P McGovern
- Karsh Division of Gastroenterology and Hepatology, Department of Medicine, Cedars-Sinai Medical System, Los Angeles, California, USA
| | - Gil Y Melmed
- Karsh Division of Gastroenterology and Hepatology, Department of Medicine, Cedars-Sinai Medical System, Los Angeles, California, USA
| | - Phillip Fleshner
- Division of Colorectal Surgery, Department of Surgery, Cedars-Sinai Medical System, Los Angeles, California, USA
| | - Samuel Eisenstein
- Division of Colon and Rectal Surgery, Department of Surgery, UC San Diego, La Jolla, California, USA
| | - Sonia Ramamoorthy
- Division of Colon and Rectal Surgery, Department of Surgery, UC San Diego, La Jolla, California, USA
| | - Parambir S Dulai
- Division of Gastroenterology, Department of Medicine, UC San Diego, La Jolla, California, USA
| | - Brigid S Boland
- Division of Gastroenterology, Department of Medicine, UC San Diego, La Jolla, California, USA
| | - Eduardo Grunvald
- Division of General Internal Medicine, Department of Medicine, UC San Diego, La Jolla, California, USA
| | - Uma Mahadevan
- Division of Gastroenterology, Department of Medicine, UC San Francisco, California, USA
| | - Lucila Ohno-Machado
- Division of Biomedical Informatics, Department of Medicine, UC San Diego, La Jolla, California, USA
| | - William J Sandborn
- Division of Gastroenterology, Department of Medicine, UC San Diego, La Jolla, California, USA
| | - Siddharth Singh
- Division of Biomedical Informatics, Department of Medicine, UC San Diego, La Jolla, California, USA
- Division of Gastroenterology, Department of Medicine, UC San Diego, La Jolla, California, USA
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Lin G, Wang A, Li F, Gu P, Zhou H, Yao J, Wang M, Liu W, Zheng X, Zheng X. EP16.02-016 Exploration of Factors Affecting the Performance of MRD Tumor-Informed Assay in Chinese Lung Cancer Patients. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.1047] [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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9
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Lin G, Wang Y, Gu P. EP16.03-018 Molecular Features of Subtypes Classified Based on Predominance and Components in Chinese Patients with Lung Adenocarcinoma. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.1079] [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: 10/14/2022]
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10
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Gu P, Clifford E, Gilman A, Chang C, Moss E, Fudman DI, Kilgore P, Cvek U, Trutschl M, Alexander JS, Burstein E, Boktor M. Improved Healthcare Access Reduces Requirements for Surgery in Indigent IBD Patients Using Biologic Therapy: A 'Safety-Net' Hospital Experience. Pathophysiology 2022; 29:383-393. [PMID: 35893600 PMCID: PMC9326631 DOI: 10.3390/pathophysiology29030030] [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] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 07/10/2022] [Accepted: 07/11/2022] [Indexed: 11/18/2022] Open
Abstract
Low socioeconomic status (SES) is associated with greater morbidity and increased healthcare resource utilization (HRU) in IBD. We examined whether a financial assistance program (FAP) to improve healthcare access affected outcomes and HRU in a cohort of indigent IBD patients requiring biologics. IBD patients (>18 years) receiving care at a ‘safety-net’ hospital who initiated biologics as outpatients between 1 January 2010 and 1 January 2019 were included. Patients were divided by FAP status. Patients without FAP had Medicare, Medicaid, or commercial insurance. Primary outcomes were steroid-free clinical remission at 6 and 12 months. Secondary outcomes were surgery, hospitalization, and ED utilization. Multivariate logistic regression was used to calculate odds ratio (OR) and 95% confidence interval (CI). Decision tree analysis (DTA) was also performed. We included 204 patients with 258 new biologic prescriptions. FAP patients had less complex Crohn’s disease (50.7% vs. 70%, p = 0.033) than non-FAP patients. FAP records indicated fewer prior surgeries (19.6% vs. 38.4% p = 0.003). There were no statistically significant differences in remission rates, disease duration, or days between prescription and receipt of biologics. In multivariable logistic regression, adjusting for baseline demographics and disease severity variables, FAP patients were less likely to undergo surgery (OR: 0.28, 95% CI [0.08−0.91], p = 0.034). DTA suggests that imaging utilization may shed light on surgical differences. We found FAP enrollment was associated with fewer surgeries in a cohort of indigent IBD patients requiring biologics. Further studies are needed to identify interventions to address healthcare disparities in IBD.
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Affiliation(s)
- Phillip Gu
- Division of Digestive and Liver Diseases, UT Southwestern, Dallas, TX 75390, USA; (P.G.); (A.G.); (D.I.F.); (E.B.); (M.B.)
| | - Eric Clifford
- Department of Computer Science, Louisiana State University, Shreveport, LA 71103, USA; (E.C.); (P.K.); (M.T.)
| | - Andrew Gilman
- Division of Digestive and Liver Diseases, UT Southwestern, Dallas, TX 75390, USA; (P.G.); (A.G.); (D.I.F.); (E.B.); (M.B.)
| | | | - Elizabeth Moss
- Ambulatory Care Pharmacy, Parkland Memorial Hospital, Dallas, TX 75390, USA; (E.M.); (U.C.)
| | - David I. Fudman
- Division of Digestive and Liver Diseases, UT Southwestern, Dallas, TX 75390, USA; (P.G.); (A.G.); (D.I.F.); (E.B.); (M.B.)
| | - Phillip Kilgore
- Department of Computer Science, Louisiana State University, Shreveport, LA 71103, USA; (E.C.); (P.K.); (M.T.)
| | - Urska Cvek
- Ambulatory Care Pharmacy, Parkland Memorial Hospital, Dallas, TX 75390, USA; (E.M.); (U.C.)
| | - Marjan Trutschl
- Department of Computer Science, Louisiana State University, Shreveport, LA 71103, USA; (E.C.); (P.K.); (M.T.)
| | - J. Steven Alexander
- Department of Molecular and Cellular Physiology, LSUHSC-S, Louisiana State University, Shreveport, LA 71103, USA
- Correspondence:
| | - Ezra Burstein
- Division of Digestive and Liver Diseases, UT Southwestern, Dallas, TX 75390, USA; (P.G.); (A.G.); (D.I.F.); (E.B.); (M.B.)
| | - Moheb Boktor
- Division of Digestive and Liver Diseases, UT Southwestern, Dallas, TX 75390, USA; (P.G.); (A.G.); (D.I.F.); (E.B.); (M.B.)
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Abstract
Crohn's disease (CD) is chronic immune-related disease of the gastrointestinal tract hypothesized to be caused by an interplay of genetic predisposition and environmental exposures. With the global incidence increasing, more patients are exploring dietary exposures to explain and treat CD. However, most patients report minimal nutritional education from their provider, and providers report few nutritional resources to help them educate patients. This highlights the previous deficit of literature describing the role and influence of diet in CD. To address this need, this article reviews available literature on the possible roles of diet in the pathogenesis, exacerbation, and treatment of CD.
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Affiliation(s)
- Phillip Gu
- Division of Digestive and Liver Diseases, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390, USA
| | - Linda A Feagins
- Department of Medicine, Center for Inflammatory Bowel Diseases, University of Texas at Austin, Dell Medical School, Health Discovery Building, Z0900 1601 Trinity Street, Building B, Austin, TX 78712, USA.
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12
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Gu P, Chhabra A, Chittajallu P, Chang C, Mendez D, Gilman A, Fudman DI, Xi Y, Feagins LA. Visceral Adipose Tissue Volumetrics Inform Odds of Treatment Response and Risk of Subsequent Surgery in IBD Patients Starting Antitumor Necrosis Factor Therapy. Inflamm Bowel Dis 2022; 28:657-666. [PMID: 34291800 DOI: 10.1093/ibd/izab167] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Data describing the effect of obesity on antitumor necrosis factor (anti-TNF) treatment response are inconsistent. Visceral adipose tissue (VAT) is a superior marker of adiposity to body mass index. However, its effect on treatment response is unclear. We aimed to evaluate the effect of VAT on anti-TNF treatment response. METHODS Inflammatory bowel disease (IBD) patients starting anti-TNF agents between January 1, 2009, and July 31, 2019, were included. 3-dimensional measurements of VAT volume and visceral fat index (visceral:subcutaneous adipose tissue ratio; VFI) were obtained from computed tomography (CT) scans. Subjects were categorized by predefined volume cutoffs (<1500cm3, 1500-2999cm3, ≥3000cm3) and VFI (<0.33, 0.33-0.66, ≥0.67). Primary outcomes included a composite treatment response end point at 6 and 12 months. Secondary outcomes were surgery at 6 and 12 months. Multivariable logistic regression was used to calculate adjusted odds ratio (aOR) and 95% confidence interval (CI). RESULTS The final cohort included 176 patients. No significant differences in treatment response at 6 months was observed. At 12 months, compared with volume <1500cm3, patients with volume 1500-2999cm3 had higher odds of response (aOR, 3.52; 95% CI, 1.16-10.71; P = .023), whereas volume ≥3000cm3 did not. Compared with VFI<0.33, VFI ≥0.67 had higher odds of surgery at 6 (aOR, 48.22; 95% CI, 4.73-491.57; P = .023) and 12 months (aOR, 20.94; 95% CI, 3.14-139.67; P = .004). Post hoc analysis suggested VAT may affect drug pharmacokinetics. CONCLUSIONS We found VAT volume is associated with anti-TNF treatment response in a nondose dependent manner, and VFI may inform risk of surgery after anti-TNF initiation. If confirmed by prospective studies, VAT volumetrics are potentially useful biomarkers to inform IBD treatment decisions.
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Affiliation(s)
- Phillip Gu
- Division of Digestive and Liver Diseases, UT Southwestern, Dallas,TX, USA.,Department of Internal Medicine, UT Southwestern, Dallas,TX, USA
| | - Avneesh Chhabra
- Division of Musculoskeletal Radiology, Department of Radiology, UT Southwestern, Dallas,TX, USA
| | | | | | - Denisse Mendez
- Department of Internal Medicine, UT Southwestern, Dallas,TX, USA
| | - Andrew Gilman
- Division of Digestive and Liver Diseases, UT Southwestern, Dallas,TX, USA.,Department of Internal Medicine, UT Southwestern, Dallas,TX, USA
| | - David I Fudman
- Division of Digestive and Liver Diseases, UT Southwestern, Dallas,TX, USA.,Department of Internal Medicine, UT Southwestern, Dallas,TX, USA
| | - Yin Xi
- Division of Musculoskeletal Radiology, Department of Radiology, UT Southwestern, Dallas,TX, USA.,Department of Population and Data Sciences, UT Southwestern, Dallas,TX, USA
| | - Linda A Feagins
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Texas at Austin Dell Medical School, Austin,TX, USA
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13
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Chen K, Gu P, Chen M, Wang W, Meng Y, Yang H. P29.06 Both Endostar and Amifostine Reduced All the Incidence of Pneumonitis Above Grade 2 in Chemoradiotherapy With Locally Advanced NSCLC. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.401] [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: 11/30/2022]
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14
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Zhang J, Xu Z, Wang H, Zhang J, You D, Gu P. 804P Molecular typing and TMB correlation analysis of endometrial cancer based on targeted NGS. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1246] [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: 10/20/2022] Open
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15
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Chen J, Wang W, Guo Z, Huang S, Lei H, Zang P, Lu B, Shao J, Gu P. Associations between gut microbiota and thyroidal function status in Chinese patients with Graves' disease. J Endocrinol Invest 2021; 44:1913-1926. [PMID: 33481211 DOI: 10.1007/s40618-021-01507-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [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: 10/31/2020] [Accepted: 01/09/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The imbalance of gut microbiota has been linked to manifold endocrine diseases, but the association with Graves' disease (GD) is still unclear. The purpose of this study was to investigate the correlation between human gut microbiota and clinical characteristics and thyroidal functional status of GD. METHODS 14 healthy volunteers (CG) and 15 patients with primary GD (HG) were recruited as subjects. 16SrDNA high-throughput sequencing was performed on IlluminaMiSeq platform to analyze the characteristics of gut microbiota in patients with GD. Among them, the thyroid function of 13 patients basically recovered after treatment with anti-thyroid drugs (oral administration of Methimazole for 3-5 months). The fecal samples of patients after treatment (TG) were sequenced again, to further explore and investigate the potential relationship between dysbacteriosis and GD. RESULTS In terms of alpha diversity index, the observed OTUs, Simpson and Shannon indices of gut microbiota in patients with GD were significantly lower than those in healthy volunteers (P < 0.05).The difference of bacteria species was mainly reflected in the genus level, in which the relative abundance of Lactobacillus, Veillonella and Streptococcus increased significantly in GD. After the improvement of thyroid function, a significant reduction at the genus level were Blautia, Corynebacter, Ruminococcus and Streptococcus, while Phascolarctobacterium increased significantly (P < 0.05). According to Spearman correlation analysis, the correlation between the level of thyrotropin receptor antibody (TRAb) and the relative abundance of Lactobacillus and Ruminococcus was positive, while Synergistetes and Phascolarctobacterium showed a negative correlation with TRAb. Besides, there were highly significant negative correlation between Synergistetes and clinical variables of TRAb, TPOAb and TGAb (P < 0.05, R < - 0.6). CONCLUSIONS This study revealed that functional status and TRAb level in GD were associated with composition and biological function in the gut microbiota, with Synergistetes and Phascolarctobacterium protecting the thyroid probably, while Ruminococcus and Lactobacillus may be novel biomarkers of GD.
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Affiliation(s)
- J Chen
- Department of Endocrinology, Jinling Hospital, Southeast Univ, Sch Med, Nanjing, China
| | - W Wang
- Department of Endocrinology, Jinling Hospital, Nanjing Univ, Sch Med, Nanjing, China
| | - Z Guo
- Department of Endocrinology, Jinling Hospital, Nanjing Med Univ, Nanjing, China
| | - S Huang
- Department of Endocrinology, Jinling Hospital, Nanjing Univ, Sch Med, Nanjing, China
| | - H Lei
- Department of Endocrinology, Jinling Hospital, Southern Medical University, Nanjing, China
| | - P Zang
- Department of Endocrinology, Jinling Hospital, Nanjing Univ, Sch Med, Nanjing, China
| | - B Lu
- Department of Endocrinology, Jinling Hospital, Nanjing Univ, Sch Med, Nanjing, China
| | - J Shao
- Department of Endocrinology, Jinling Hospital, Nanjing Univ, Sch Med, Nanjing, China.
| | - P Gu
- Department of Endocrinology, Jinling Hospital, Nanjing Univ, Sch Med, Nanjing, China.
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16
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Gautam SG, Ouyang Y, Gu P, Grafton-Cardwell EE. Field Ecology and Food Suitability of Tarsonemus spp. (Acari: Tarsonemidae). Environ Entomol 2021; 50:744-751. [PMID: 33675654 DOI: 10.1093/ee/nvab013] [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] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Indexed: 06/12/2023]
Abstract
Tarsonemus bakeri Ewing (Acari: Tarsonemidae) is a species of mite commonly associated with citrus in many countries including the United States. A short report in 1942 suggested this species is phytophagous, but it has not been reported as a pest in citrus or any other crop since then. A single survey of 78 orchards in three growing regions in California demonstrated that Tarsonemus spp. mites were only associated with leaf samples that had visible sooty mold. A seasonal population study in one citrus orchard showed that all life stages of Tarsonemus spp. were present year-round on leaves and fruit, with the population on fruit reaching a peak in December (59.7 ± 15.2 mites per fruit). Results from a food suitability study showed that the population declined sharply on both plastic and leaf substrate when the mites were not provided a supplementary food source. When supplementary food was provided in the form of Alternaria, honeydew, molasses, or combinations of these, mites survived and multiplied throughout the 29-d study, irrespective of the substrate. Tarsonemus bakeri were found on excised, decaying leaves collected from an orchard. These studies verify that Tarsonemus spp. are associated only with sooty mold in citrus orchards. T. bakeri populations cannot sustain themselves on leaf tissue alone, indicating that they are nondamaging to citrus and therefore need not be considered a phytosanitary concern by importing countries.
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Affiliation(s)
- S G Gautam
- Department of Entomology, University of California, Riverside, CA, USA
- Kearney Agricultural Research and Extension Center, Riverbend Avenue, Parlier, CA, USA
| | - Y Ouyang
- Department of Entomology, University of California, Riverside, CA, USA
| | - P Gu
- Department of Entomology, University of California, Riverside, CA, USA
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17
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Tai WL, Sun L, Li H, Gu P, Joosten EA, Cheung CW. Additive Effects of Environmental Enrichment and Ketamine on Neuropathic Pain Relief by Reducing Glutamatergic Activation in Spinal Cord Injury in Rats. Front Neurosci 2021; 15:635187. [PMID: 33828447 PMCID: PMC8019908 DOI: 10.3389/fnins.2021.635187] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 02/05/2021] [Indexed: 11/20/2022] Open
Abstract
Spinal cord injury (SCI) impairs mobility and often results in complications like intractable neuropathic pain. A multi-approach management of this chronic pain condition has been encouraged, but little has been explored of the field. Here, we focus on the effect and underlying mechanism of environmental enrichment (EE), which promotes voluntary social and physical activities, combined with a clinical analgesic, ketamine, on SCI-induced neuropathic pain as well as motor dysfunction. We performed T13 spinal hemisection in rats, which induced unilateral motor impairment and neuropathic pain-like behaviors in the hindlimb. Treatment regimen started a week after SCI, which consists of ketamine administration (30 mg kg–1 day–1; intramuscular) for 10 days, or EE housing for 20 days, or their combination. Paw withdrawal response to mechanical and thermal stimuli, motor function, burrowing behaviors, and body weight was monitored. Spinal segments at T13 lesion and L4–L6 were collected for histopathological and protein analyses. The joint treatment of EE and ketamine provided greater relief of pain-like behaviors and locomotor recovery than did either paradigm alone. These improvements were associated with reduced cavitation area, astrogliosis, and perilesional phosphorylation of glutamate N-methyl-D-aspartate receptor (NMDAR). Concurrently, lumbar spinal analysis of NMDAR-linked excitatory markers in hypersensitization showed reduced activation of NMDAR, mitogen-activated protein kinase (MAPK) family, nuclear factor (NF)-κB, interleukin (IL)-1β signaling, and restored excitatory amino acid transporter 2 level. Our data support a better therapeutic efficacy of the combination, EE, and ketamine, in the attenuation of neuropathic pain and motor recovery by reducing spinal glutamatergic activation, signifying a potential multifaceted neurorehabilitation strategy to improve SCI patient outcome.
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Affiliation(s)
- W L Tai
- Laboratory and Clinical Research Institute for Pain, Department of Anesthesiology, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
| | - L Sun
- Laboratory and Clinical Research Institute for Pain, Department of Anesthesiology, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China.,The First Rehabilitation Hospital of Shanghai, Brain and Spinal Cord Innovation Research Center, Advanced Institute of Translational Medicine, Tongji University School of Medicine, Shanghai, China
| | - H Li
- Laboratory and Clinical Research Institute for Pain, Department of Anesthesiology, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
| | - P Gu
- Laboratory and Clinical Research Institute for Pain, Department of Anesthesiology, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
| | - E A Joosten
- Laboratory and Clinical Research Institute for Pain, Department of Anesthesiology, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China.,Department of Anesthesiology and Pain Management, University Pain Centre Maastricht (UPCM), Maastricht University Medical Centre, Maastricht, Netherlands.,Department of Translational Neuroscience, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - C W Cheung
- Laboratory and Clinical Research Institute for Pain, Department of Anesthesiology, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
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18
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Yuan HC, Yu QT, Bai H, Xu HZ, Gu P, Chen LY. Alcohol intake and the risk of chronic kidney disease: results from a systematic review and dose-response meta-analysis. Eur J Clin Nutr 2021; 75:1555-1567. [PMID: 33674776 DOI: 10.1038/s41430-021-00873-x] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 01/15/2021] [Accepted: 01/28/2021] [Indexed: 01/11/2023]
Abstract
Many prospective cohort studies have investigated the association between the consumption of alcohol and CKD risk and have revealed inconsistent results. In the present study, we aimed to perform a meta-analysis of these studies to assess this association.We searched the PubMed and Embase databases up to 2020 and reviewed the reference lists of relevant articles to identify appropriate studies. We calculated the pooled relative risks with 95% CIs using random effects models, and then performed subgroup and meta-regression analyses. Dose-response meta-analyses were performed by sex separately. We identified 25 eligible prospective cohort studies, including 514,148 participants and 35,585 incident CKD cases. Compared with the category of minimal alcohol intake, light (RR = 0.90, I2 = 49%), moderate (RR = 0.86, I2 = 40%), and heavy (RR = 0.85, I2 = 51%) alcohol intake were associated with a lower risk of CKD. Subgroup meta-analysis by sex indicated that light (RR = 0.92, I2 = 0%), moderate (RR = 0.83, I2 = 39%) and heavy (RR = 0.76, I2 = 40%), alcohol consumption were inversely associated with CKD risk in male. Dose-response meta-analyses detected a nonlinear inverse association between alcohol consumption and the risk of CKD in all participants and linear inverse association in female participants. This meta-analysis shows that light (<12 g/day), moderate (12-24 g/day), and heavy (>24 g/day) alcohol consumption are protective against chronic kidney disease in adult participants especially in males.
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Affiliation(s)
- H C Yuan
- Department of Nutrition, Qingdao Municipal Hospital, Qingdao, China
| | - Q T Yu
- The People's Hospital of Huaiyin, Jinan, China
| | - H Bai
- The People's Hospital of Huaiyin, Jinan, China
| | - H Z Xu
- Department of Nutrition and Food Hygiene, School of Public Health, Shandong University, Jinan, China
| | - P Gu
- Department of Nutrition, Qingdao Municipal Hospital, Qingdao, China.
| | - L Y Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Shandong University, Jinan, China. .,Department of Clinical Nutrition, Shandong Provincial Hospital, Jinan, China.
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Zhang T, Yu GD, Gu P, Tang Q, Jin Y, He XC. [Evaluation and analysis of anxiety, depression and quality of life in vasomotor rhinitis]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2020; 55:769-773. [PMID: 32791776 DOI: 10.3760/cma.j.cn115330-20191230-00787] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To evaluate the mental state and quality of life in patients with vasomotor rhinitis (VMR) before and after treatment, and to provide guidance for improving the overall health of VMR patients. Methods: Two hundred and twenty VMR patients (VMR group, 118 males, 102 females; aged from 18 to 72 years old), three hundred and twenty allergic rhinitis (AR) patients (AR group, 178 males, 142 females; aged from 18 to 79 years old) from January 2016 to September 2019 were selected in the otolaryngology clinic of Affiliated Hospital of Guizhou Medical University, four hundred and twenty-three healthy people (control group, 243 males, 180 females; aged from 19 to 70 years old) were selected in physical examination center at the same time by continuous enrollment method, symptom check list (SCL-90), self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to evaluate the mental state of VMR patients before and after treatment, and 12-item short form health survey version 2.0 (SF-12v2) was used to evaluate their quality of life, statistical data were collected and analyzed by ANOVA and t-test. Results: The scores of eight factors (physical function, role physical function, general health, vitality, role-emotional, mental health) of SF-12v2 in VMR patients before treatment were lower than that of posttreatment, that of AR patients and the control group, the differences were significant (all P<0.05), the scores of somatization, obsession, depression, anxiety and psychosis in SCL-90 in VMR patients before treatment were significantly higher than that of posttreatment, that of AR patients and the control group (all P<0.05), the SAS and SDS in VMR patients before treatment (51.28±16.32; 53.28±18.55) were significantly higher than that of posttreatment (38.53±13.21; 39.35±13.34), that of AR patients (42.23±14.32; 43.32±13.78) and the control group (29.78±10.07;33.46±10.55; t(SAS) were 9.007, 6.813 and 20.59; t(SDS) were 9.043, 7.154 and 17.260, all P<0.05). Conclusion: VMR patients generally suffer from psychological damage, which seriously affects the quality of life of the patients. On the basis of routine treatment, we should attach more importance to the negative psychology of VMR patients and intervene when necessary.
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Affiliation(s)
- T Zhang
- Department of Otolaryngology Head and Neck Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang 550002, China
| | - G D Yu
- Department of Otolaryngology Head and Neck Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang 550002, China
| | - P Gu
- Department of Otolaryngology Head and Neck Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang 550002, China
| | - Q Tang
- Department of Otolaryngology Head and Neck Surgery, Affiliated Tumor Hospital of Guizhou Medical University, Guiyang 550002, China
| | - Y Jin
- Department of Otolaryngology Head and Neck Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang 550002, China
| | - X C He
- Department of Otolaryngology Head and Neck Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang 550002, China
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20
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Lou Y, Xu J, Zhang Y, Zhang W, Zhang X, Gu P, Wang H, Zhong H, Lu J, Han B. 1997P The Akt kinase LANCL2 functions as a key driver in EGFR-mutant lung adenocarcinoma tumorigenesis. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1303] [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: 10/23/2022] Open
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21
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Gu P, Patel D, Lakhoo K, Ko J, Liu X, Chang B, Pan D, Lentz G, Sonesen M, Estiandan R, Lin E, Pimentel M, Rezaie A. Breath Test Gas Patterns in Inflammatory Bowel Disease with Concomitant Irritable Bowel Syndrome-Like Symptoms: A Controlled Large-Scale Database Linkage Analysis. Dig Dis Sci 2020; 65:2388-2396. [PMID: 31754993 DOI: 10.1007/s10620-019-05967-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 06/15/2019] [Accepted: 11/16/2019] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Breath testing (BT) has gained interest for diagnosing small intestinal bacterial overgrowth (SIBO) in IBD patients with irritable bowel syndrome (IBS) overlap. We aim to characterize the rate of SIBO and BT gas patterns in IBD patients with IBS-like symptoms compared to non-IBD patients. METHODS A database of 14,847 consecutive lactulose BTs was developed from patients with IBS-like symptoms between November 2005 and October 2013. BTs were classified as normal, H2 predominant, CH4 predominant, and flatline based on criteria established from the literature. BT data linkage with electronic health records and chart review identified IBD patients along with disease phenotype, location, severity, and antibiotic response. Poisson loglinear model evaluated differences in gas patterns between the two groups. RESULTS After excluding patients with repeat breath tests, we identified 486 IBD and 10,505 non-IBD patients with at least one BT. Positive BT was present in 57% (n = 264) of IBD patients. Crohn's disease (odds ratio (OR) 0.21, [95% confidence interval (CI) 0.11-0.38]) and ulcerative colitis (OR 0.39, [95% CI 0.22-0.70]) patients were less likely to produce excess CH4. IBD patients were more likely to have flatline BT (OR 1.82, [95% CI 1.20-2.77]). In IBD patients with SIBO, 57% improved symptomatically with antibiotics. CONCLUSION In a cohort of IBD patients with IBS-like symptoms, a high rate of patients had positive BT and symptomatic improvement with antibiotics. In IBD, methanogenesis is suppressed and flatline BT is more frequent, suggesting excess hydrogenotrophic bacteria. These findings suggest methanogenic and hydrogenotrophic microorganisms as potential targets for microbiome-driven biomarkers and therapies.
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Affiliation(s)
- Phillip Gu
- Division of Digestive and Liver Diseases, University of Texas Southwestern, Dallas, TX, USA.
| | - Devin Patel
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Krutika Lakhoo
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Jeffrey Ko
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Xiaochen Liu
- Division of Digestive and Liver Diseases, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Bianca Chang
- Section of Gastroenterology, Hepatology and Nutrition, University of Chicago, Chicago, IL, USA
| | - Dana Pan
- Division of Gastroenterology and Hepatology, University of California in Davis, Sacramento, CA, USA
| | - Greg Lentz
- Enterprise Information Services- Initiate Team, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Matthew Sonesen
- Enterprise Information Services- Initiate Team, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Renier Estiandan
- Enterprise Information Services- Initiate Team, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Eugenia Lin
- Division of Digestive and Liver Diseases, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Mark Pimentel
- Division of Digestive and Liver Diseases, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Ali Rezaie
- Division of Digestive and Liver Diseases, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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22
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She Z, Jia LP, Yue Q, Ma H, Kang KJ, Li YJ, Agartioglu M, An HP, Chang JP, Chen JH, Chen YH, Cheng JP, Dai WH, Deng Z, Geng XP, Gong H, Gu P, Guo QJ, Guo XY, He L, He SM, He HT, Hu JW, Huang TC, Huang HX, Li HB, Li H, Li JM, Li J, Li MX, Li X, Li XQ, Li YL, Liao B, Lin FK, Lin ST, Liu SK, Liu YD, Liu YY, Liu ZZ, Mao YC, Nie QY, Ning JH, Pan H, Qi NC, Qiao CK, Ren J, Ruan XC, Sevda B, Shang CS, Sharma V, Singh L, Singh MK, Sun TX, Tang CJ, Tang WY, Tian Y, Wang GF, Wang L, Wang Q, Wang Y, Wang YX, Wang Z, Wong HT, Wu SY, Xing HY, Xu Y, Xue T, Yan YL, Yang LT, Yi N, Yu CX, Yu HJ, Yue JF, Zeng M, Zeng Z, Zhang BT, Zhang L, Zhang FS, Zhang ZY, Zhao MG, Zhou JF, Zhou ZY, Zhu JJ. Direct Detection Constraints on Dark Photons with the CDEX-10 Experiment at the China Jinping Underground Laboratory. Phys Rev Lett 2020; 124:111301. [PMID: 32242731 DOI: 10.1103/physrevlett.124.111301] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 02/26/2020] [Indexed: 06/11/2023]
Abstract
We report constraints on the dark photon effective kinetic mixing parameter (κ) with data taken from two p-type point-contact germanium detectors of the CDEX-10 experiment at the China Jinping Underground Laboratory. The 90% confidence level upper limits on κ of solar dark photon from 205.4 kg-day exposure are derived, probing new parameter space with masses (m_{V}) from 10 to 300 eV/c^{2} in direct detection experiments. Considering dark photon as the cosmological dark matter, limits at 90% confidence level with m_{V} from 0.1 to 4.0 keV/c^{2} are set from 449.6 kg-day data, with a minimum of κ=1.3×10^{-15} at m_{V}=200 eV/c^{2}.
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Affiliation(s)
- Z She
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - L P Jia
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - Q Yue
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - H Ma
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - K J Kang
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - Y J Li
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - M Agartioglu
- Institute of Physics, Academia Sinica, Taipei 11529
- Department of Physics, Dokuz Eylül University, İzmir 35160
| | - H P An
- Department of Physics, Tsinghua University, Beijing 100084
| | | | - J H Chen
- Institute of Physics, Academia Sinica, Taipei 11529
| | - Y H Chen
- YaLong River Hydropower Development Company, Chengdu 610051
| | - J P Cheng
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
- College of Nuclear Science and Technology, Beijing Normal University, Beijing 100875
| | - W H Dai
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - Z Deng
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - X P Geng
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - H Gong
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - P Gu
- College of Physics, Sichuan University, Chengdu 610064
| | - Q J Guo
- School of Physics, Peking University, Beijing 100871
| | - X Y Guo
- YaLong River Hydropower Development Company, Chengdu 610051
| | - L He
- NUCTECH Company, Beijing 100084
| | - S M He
- YaLong River Hydropower Development Company, Chengdu 610051
| | - H T He
- College of Physics, Sichuan University, Chengdu 610064
| | - J W Hu
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - T C Huang
- Sino-French Institute of Nuclear and Technology, Sun Yat-sen University, Zhuhai, 519082
| | - H X Huang
- Department of Nuclear Physics, China Institute of Atomic Energy, Beijing 102413
| | - H B Li
- Institute of Physics, Academia Sinica, Taipei 11529
| | - H Li
- NUCTECH Company, Beijing 100084
| | - J M Li
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - J Li
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - M X Li
- College of Physics, Sichuan University, Chengdu 610064
| | - X Li
- Department of Nuclear Physics, China Institute of Atomic Energy, Beijing 102413
| | - X Q Li
- School of Physics, Nankai University, Tianjin 300071
| | - Y L Li
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - B Liao
- College of Nuclear Science and Technology, Beijing Normal University, Beijing 100875
| | - F K Lin
- Institute of Physics, Academia Sinica, Taipei 11529
| | - S T Lin
- College of Physics, Sichuan University, Chengdu 610064
| | - S K Liu
- College of Physics, Sichuan University, Chengdu 610064
| | - Y D Liu
- College of Nuclear Science and Technology, Beijing Normal University, Beijing 100875
| | - Y Y Liu
- College of Nuclear Science and Technology, Beijing Normal University, Beijing 100875
| | - Z Z Liu
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - Y C Mao
- School of Physics, Peking University, Beijing 100871
| | - Q Y Nie
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - J H Ning
- YaLong River Hydropower Development Company, Chengdu 610051
| | - H Pan
- NUCTECH Company, Beijing 100084
| | - N C Qi
- YaLong River Hydropower Development Company, Chengdu 610051
| | - C K Qiao
- College of Physics, Sichuan University, Chengdu 610064
| | - J Ren
- Department of Nuclear Physics, China Institute of Atomic Energy, Beijing 102413
| | - X C Ruan
- Department of Nuclear Physics, China Institute of Atomic Energy, Beijing 102413
| | - B Sevda
- Institute of Physics, Academia Sinica, Taipei 11529
- Department of Physics, Dokuz Eylül University, İzmir 35160
| | - C S Shang
- YaLong River Hydropower Development Company, Chengdu 610051
| | - V Sharma
- Institute of Physics, Academia Sinica, Taipei 11529
- Department of Physics, Banaras Hindu University, Varanasi 221005
| | - L Singh
- Institute of Physics, Academia Sinica, Taipei 11529
- Department of Physics, Banaras Hindu University, Varanasi 221005
| | - M K Singh
- Institute of Physics, Academia Sinica, Taipei 11529
- Department of Physics, Banaras Hindu University, Varanasi 221005
| | - T X Sun
- College of Nuclear Science and Technology, Beijing Normal University, Beijing 100875
| | - C J Tang
- College of Physics, Sichuan University, Chengdu 610064
| | - W Y Tang
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - Y Tian
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - G F Wang
- College of Nuclear Science and Technology, Beijing Normal University, Beijing 100875
| | - L Wang
- Department of Physics, Beijing Normal University, Beijing 100875
| | - Q Wang
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
- Department of Physics, Tsinghua University, Beijing 100084
| | - Y Wang
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
- Department of Physics, Tsinghua University, Beijing 100084
| | - Y X Wang
- School of Physics, Peking University, Beijing 100871
| | - Z Wang
- College of Physics, Sichuan University, Chengdu 610064
| | - H T Wong
- Institute of Physics, Academia Sinica, Taipei 11529
| | - S Y Wu
- YaLong River Hydropower Development Company, Chengdu 610051
| | - H Y Xing
- College of Physics, Sichuan University, Chengdu 610064
| | - Y Xu
- School of Physics, Nankai University, Tianjin 300071
| | - T Xue
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - Y L Yan
- College of Physics, Sichuan University, Chengdu 610064
| | - L T Yang
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - N Yi
- NUCTECH Company, Beijing 100084
| | - C X Yu
- School of Physics, Nankai University, Tianjin 300071
| | - H J Yu
- NUCTECH Company, Beijing 100084
| | - J F Yue
- YaLong River Hydropower Development Company, Chengdu 610051
| | - M Zeng
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - Z Zeng
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - B T Zhang
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - L Zhang
- College of Physics, Sichuan University, Chengdu 610064
| | - F S Zhang
- College of Nuclear Science and Technology, Beijing Normal University, Beijing 100875
| | - Z Y Zhang
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - M G Zhao
- School of Physics, Nankai University, Tianjin 300071
| | - J F Zhou
- YaLong River Hydropower Development Company, Chengdu 610051
| | - Z Y Zhou
- Department of Nuclear Physics, China Institute of Atomic Energy, Beijing 102413
| | - J J Zhu
- College of Physics, Sichuan University, Chengdu 610064
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23
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Gu P, Feagins LA. Dining With Inflammatory Bowel Disease: A Review of the Literature on Diet in the Pathogenesis and Management of IBD. Inflamm Bowel Dis 2020; 26:181-191. [PMID: 31670372 DOI: 10.1093/ibd/izz268] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [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: 08/16/2019] [Indexed: 12/13/2022]
Abstract
Inflammatory bowel diseases (IBDs) are chronic immune-related diseases hypothesized to be a sequela of an interplay of genetic predisposition and environmental exposures. The global incidence of IBD is increasing, and more patients are exploring diet as a means to explain and treat their IBD. In fact, many patients strongly believe diet plays a fundamental role in the onset and management of their IBD. However, a significant proportion of patients report limited nutritional education from their provider, and providers report limited nutritional resources to aid in discussions with patients. This imbalance between supply and demand likely reflects the previous paucity of available literature characterizing the influence of diet in IBD. To address this gap in knowledge, we review the available literature to characterize the role of diet in the pathogenesis, exacerbation, and treatment of IBD. We aim to provide patients and providers with resources to better understand and discuss the role of diet in IBD, with the overall goal of improving patient care and satisfaction.
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Affiliation(s)
- Phillip Gu
- Division of Digestive and Liver Diseases, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Linda A Feagins
- Department of Medicine, University of Texas at Austin, Dell Medical School, Austin, Texas, USA
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24
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Guo QY, Song WJ, Xu SY, Zang P, Lu B, Gu P, Shao JQ. [Correlation between serum bilirubin and cardiovascular autonomic neuropathy in patients with type 2 diabetes]. Zhonghua Yi Xue Za Zhi 2019; 99:3132-3138. [PMID: 31694103 DOI: 10.3760/cma.j.issn.0376-2491.2019.40.003] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Objective: To investigate the correlation between serum bilirubin and cardiovascular autonomic neuropathy (CAN) in type 2 diabetes mellitus patients. Methods: A total of 369 patients with type 2 diabetes mellitus who were hospitalized at the Department of Endocrinology, Nanjing Jinling Hospital from April 2017 to October 2018 were enrolled, including 226 males and 143 females, with an average age of (54.6±12.1) years. According to cardiovascular reflex tests (CARTs), all the patients were divided into Non CAN group(149 patients without CAN) and CAN group (220 patients complicated with CAN). The difference of serum bilirubin levels between the two groups was compared. The differences of CARTs and the incidence of CAN were compared by tertiles of serum bilirubin levels. The binary logistic regression was used to analyze the risk factors for diabetic cardiovascular autonomic neuropathy. Results: The serum total bilirubin [(9.28±2.74) μmol/L vs (11.08±2.98) μmol/L, P<0.001], direct bilirubin [(3.17±1.20) μmol/L vs (3.71±1.24) μmol/L, P<0.001] and indirect bilirubin levels [(6.11±1.89) μmol/L vs (7.37±2.10) μmol/L, P<0.001] in CAN group were significantly lower than that in Non CAN group. With the increase of serum bilirubin, the incidence of CAN decreased (P<0.01). Multivariate Logistic regression analysis showed that serum total bilirubin (OR=0.819, 95%CI: 0.744-0.901, P<0.001), direct bilirubin (OR=0.739, 95%CI: 0.601-0.908, P=0.004) and indirect bilirubin (OR=0.749, 95%CI: 0.653-0.860, P<0.001) were inversely correlated with the incidence of CAN. Conclusions: Within the physiological range, lower level of serum bilirubin is inversely correlated with the incidence of CAN. It is noteworthy to screen diabetic cardiovascular autonomic neuropathy in patients with type 2 diabetes mellitus who had a lower serum bilirubin level.
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Affiliation(s)
- Q Y Guo
- Department of Endocrinology, Jinling Hospital Affiliated to Nanjing University, General Hospital of Eastern Theater Command, Nanjing 210002, China
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25
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Shen Y, Meng Y, Tang X, Gu P, Yu C, Wang W, Kong F, Yang H. JCSE01.17 Modelling the Immunosuppressive Difference of SBRT and CRT by Simulating the Dose to Circulating Lymphocytes in Non-Small Cell Lung Cancer. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.273] [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: 11/24/2022]
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26
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Meng Y, Hou L, Gu P, Wang W, Shen Y, Zhou S, Kong F, Yang H. P1.18-15 Dosimetric and Toxicity Benefits of Adaptive IMRT in Patients with Stage III Non-Small Cell Lung Cancer. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1331] [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: 11/24/2022]
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27
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Shen Y, Meng Y, Tang X, Gu P, Yu C, Wang W, Kong F, Yang H. P1.04-69 Modelling the Immunosuppressive Difference of SBRT and CRT by Simulating the Dose to Circulating Lymphocytes in Non-Small Cell Lung Cancer. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.972] [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: 11/24/2022]
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28
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Li C, Guo J, Zhao L, Hu F, Nie W, Wang H, Zheng X, Shen Y, Gu P, Zhang Y, Zhang X. Upfront whole brain radiotherapy for multiple brain metastases in patients with EGFR-mutant lung adenocarcinoma. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz063.029] [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: 11/14/2022] Open
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29
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Gautam SG, Ouyang Y, Gu P, Grafton-Cardwell EE. Food Suitability and Population Dynamics of Lorryia formosa (Acari: Tydeidae). Environ Entomol 2018; 47:511-518. [PMID: 29659766 DOI: 10.1093/ee/nvy043] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Lorryia formosa Cooreman (Acari: Tydeidae) is a species of mite commonly associated with citrus in many countries including the United States. A survey report in 1957 suggested phytophagous nature, while other studies claimed that L. formosa populations are associated with honeydew producing insects and sooty mold and it acts as a sanitizing agent. We investigated the effect of various diets on the survival and progeny production of L. formosa on excised leaves and the survival and potential to cause feeding damage to leaves of potted plants in a greenhouse study. A 2-yr field survey of a mandarin orchard was also conducted to elucidate the seasonal infestation, damage potential and population structure of L. formosa in a natural habitat. Results showed that all L. formosa adults and immatures died in less than 14 d on excised leaves, did not survive beyond 7 d on potted citrus plants alone, and caused no observable feeding damage to leaves or fruit. When sugar water, honeydew, or cottony cushion scale, Icerya purchasi Maskell (Hemiptera: Margarodidae), was present, adults and immatures survived the duration of the experiments and produced additional generations. The field survey showed that all stages of L. formosa were present in a mandarin orchard throughout the year and insecticide applications affected but did not eliminate mite populations. Fruit generally had a greater percentage infestation of mites (44.8 ± 4.0) than leaves (16.0 ± 4.7). These studies confirmed that L. formosa cannot sustain a population on leaf tissue alone and is nondamaging to citrus in California.
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Affiliation(s)
- S G Gautam
- Department of Entomology, University of California, Riverside, CA
| | - Y Ouyang
- Department of Entomology, University of California, Riverside, CA
| | - P Gu
- Department of Entomology, University of California, Riverside, CA
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30
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Gu P, Kuenzig ME, Kaplan GG, Pimentel M, Rezaie A. Fecal Incontinence in Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis. Inflamm Bowel Dis 2018; 24:1280-1290. [PMID: 29617820 DOI: 10.1093/ibd/izx109] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [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: 09/17/2017] [Accepted: 11/03/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND Understanding of the prevalence, pathophysiology, and management of fecal incontinence (FI) in inflammatory bowel disease (IBD) patients without an ileal pouch anal anastomosis (IPAA) is suboptimal. We conducted a systematic review and meta-analysis on the prevalence, pathophysiology, and management of primary FI in IBD patients without IPAA. METHODS We searched MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews (1966 through March 2017) for studies on the prevalence, physiology, or management of FI in IBD patients without IPAA. A random effects model was used to calculate pooled prevalence rates and odds ratio (OR) with 95% confidence interval (CI). Heterogeneity was assessed with I2 statistics, Cochran Q statistic, and sensitivity analyses. RESULTS Seventeen studies were included. Six studies evaluated the prevalence of FI in 4671 IBD patients. There was significant heterogeneity among the studies, but the pooled prevalence of FI among case-control studies was homogeneous at 24% (95% CI 18%-30%, I2 = 50.6%, P = 0.16). FI was more common among IBD patients than non-IBD controls (OR = 7.73; 95% CI 6.26 to 9.84). Therapeutic options were poorly evaluated in uncontrolled studies. Surgery was effective in 70% of patients (7/10), sacral nerve stimulation was effective in 100% of patients (5/5), and 41.6% of patients (5/12) reported subjective improvement in FI with percutaneous tibial nerve stimulation. CONCLUSIONS FI is prevalent in IBD patients without IPAA, and more common than non-IBD controls. Additional controlled studies are warranted to further identify effective therapeutic interventions for FI in IBD. 10.1093/ibd/izx109_video1izx109_Video_15760611117001.
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Affiliation(s)
- Phillip Gu
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA
| | - M Ellen Kuenzig
- Children's Hospital of Eastern Ontario (CHEO) Inflammatory Bowel Disease Centre, Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Eastern Ontario, Ottawa, Canada.,CHEO Research Institute, Ottawa, Canada.,Institute for Clinical Evaluative Sciences, Ottawa, Canada
| | - Gilaad G Kaplan
- Division of Gastroenterology, Department of Medicine, University of Calgary, AB, Canada
| | - Mark Pimentel
- Division of Gastroenterology, Department of Medicine, University of Calgary, AB, Canada.,Division of Gastroenterology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Ali Rezaie
- Division of Gastroenterology, Department of Medicine, University of Calgary, AB, Canada.,Division of Gastroenterology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA
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31
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Abstract
BACKGROUND Inflammatory bowel disease (IBD) patients often continue to experience nonspecific gastrointestinal symptoms despite quiescent disease. Unlike non-IBD patients, IBD patients with dyssynergic defecation (DD) may present with various symptoms such as diarrhea, fecal incontinence, constipation, and rectal discomfort. Despite its importance and treatability, DD in IBD patients is not well recognized in practice. We conducted a systematic review and meta-analysis on the prevalence, diagnosis, and management of DD in IBD patients with ongoing defecatory symptoms. METHODS We searched MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews (from 1966 through February 2017) to identify relevant studies on the prevalence, diagnostic methods, or management of DD in IBD patients with and without ileal pouch-anal anastomoses (IPAAs). A random effects model was used to calculate the pooled estimates with 95% confidence intervals (CIs). Heterogeneity was assessed with I2 statistics, Cochran Q statistic, and sensitivity analyses. RESULTS Seven studies (n = 442) were included. In patients with ongoing defecatory symptoms, the prevalence of DD without IPAA ranged from 45% to 97%, and in patients with IPAA, it ranged from 25% to 75%. The prevalence of DD in IPAA patients with and without pouchitis ranged from 17% to 67% and 29% to 50%, respectively. The pooled response rate to biofeedback therapy in patients without IPAA was 70% (95% CI, 55%-84%; I2 = 95%; P < 0.01), and it was 86% (95% CI, 67%-98%; I2 = 61%; P = 0.05) in those with IPAA. CONCLUSIONS Despite limited data, the current literature suggests that DD is highly prevalent in active or quiescent IBD patients with ongoing defecatory symptoms and is responsive to biofeedback therapy. Although more studies are needed, DD should be considered in IBD patients with persistent defecatory symptoms.
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Affiliation(s)
- Ali Rezaie
- Division of Gastroenterology, Los Angeles, California
| | - Phillip Gu
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California
| | - Gilaad G Kaplan
- Division of Gastroenterology, Department of Medicine, University of Calgary, AB, Canada
| | - Mark Pimentel
- Division of Gastroenterology, Los Angeles, California
| | - Ahmed K Al-Darmaki
- Division of Gastroenterology, Department of Medicine, University of Calgary, AB, Canada
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32
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Ahmed S, Almario CV, Chey WD, Robbins LA, Chang B, Ahn J, Ko J, Gu P, Siu A, Spiegel BMR. Electronic patient agenda forms: comparing agreement between the reason for specialty consultation reported by referring providers and patients. Inform Health Soc Care 2018; 44:105-113. [PMID: 29509054 DOI: 10.1080/17538157.2018.1437041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE Little is known about the agreement between referring providers' reason for specialty evaluation and patients' understanding of why they are referred for consultation. Here, we compared the reason for consult (RFC) documented by referring providers during usual care vs. the perceived RFC independently reported by patients through an e-portal just prior to the specialist visit. METHODS We performed an observational study among patients referred for gastrointestinal (GI) evaluation. Patients referred to the specialty clinic submitted their self-reported RFC using an online patient agenda form prior to their visit. Therefore, each participant had a referring provider- and patient-documented RFC. Blinded physicians reviewed the RFCs in random order using a priori coding criteria. We then compared whether the provider and patient RFC pairs were concordant (i.e., ≥1 clinical topic[s] in the RFCs matched). RESULTS Sixty patients completed the e-portal prior to their visit, leading to 60 provider-patient RFC pairs. The RFC pairs were concordant in only 52% of cases. CONCLUSIONS There is poor agreement between referring providers' reason for GI referral and patients' understanding of why they are visiting the clinic. Future research examining whether electronic patient agenda forms impact diagnostic and management precision, patient satisfaction, and healthcare utilization is warranted.
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Affiliation(s)
- Shahzad Ahmed
- a Department of Medicine , Cedars-Sinai Medical Center , Los Angeles , CA , USA
| | - Christopher V Almario
- a Department of Medicine , Cedars-Sinai Medical Center , Los Angeles , CA , USA.,b Division of Digestive and Liver Diseases , Cedars-Sinai Medical Center , Los Angeles , CA , USA.,c Division of Health Services Research , Cedars-Sinai Medical Center , Los Angeles , CA , USA.,d Division of Informatics , Cedars-Sinai Medical Center , Los Angeles , CA , USA.,e Cedars-Sinai Center for Outcomes Research and Education (CS-CORE) , Los Angeles , CA , USA
| | - William D Chey
- f Division of Gastroenterology , University of Michigan , Ann Arbor , MI , USA
| | - Lori A Robbins
- a Department of Medicine , Cedars-Sinai Medical Center , Los Angeles , CA , USA.,b Division of Digestive and Liver Diseases , Cedars-Sinai Medical Center , Los Angeles , CA , USA
| | - Bianca Chang
- a Department of Medicine , Cedars-Sinai Medical Center , Los Angeles , CA , USA
| | - Joseph Ahn
- a Department of Medicine , Cedars-Sinai Medical Center , Los Angeles , CA , USA
| | - Jeffrey Ko
- a Department of Medicine , Cedars-Sinai Medical Center , Los Angeles , CA , USA
| | - Phillip Gu
- a Department of Medicine , Cedars-Sinai Medical Center , Los Angeles , CA , USA
| | - Alvin Siu
- a Department of Medicine , Cedars-Sinai Medical Center , Los Angeles , CA , USA
| | - Brennan M R Spiegel
- a Department of Medicine , Cedars-Sinai Medical Center , Los Angeles , CA , USA.,b Division of Digestive and Liver Diseases , Cedars-Sinai Medical Center , Los Angeles , CA , USA.,c Division of Health Services Research , Cedars-Sinai Medical Center , Los Angeles , CA , USA.,d Division of Informatics , Cedars-Sinai Medical Center , Los Angeles , CA , USA.,e Cedars-Sinai Center for Outcomes Research and Education (CS-CORE) , Los Angeles , CA , USA
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Sun L, Li H, Tai LW, Gu P, Cheung CW. Adiponectin regulates thermal nociception in a mouse model of neuropathic pain. Br J Anaesth 2018; 120:1356-1367. [PMID: 29793601 DOI: 10.1016/j.bja.2018.01.016] [Citation(s) in RCA: 15] [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] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Revised: 12/11/2017] [Accepted: 01/20/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Adiponectin, a cytokine secreted by adipocytes, plays an important role in regulating glucose and lipid metabolism. However, the role of adiponectin in pain conditions is largely unknown. This study aimed to identify the role and mechanism of adiponectin in nociceptive sensitivity under physiological and pathological states utilising adiponectin knockout (KO) mice. METHODS Wild type (WT) and adiponectin KO mice were subjected to partial sciatic nerve ligation (pSNL) or sham operation. Pain-like behavioural tests, including thermal allodynia, hyperalgesia, and mechanical allodynia, were performed before and after pSNL from Day 3-21. Dorsal root ganglions (DRGs), lumbar spinal segments at L3-5, and somatosensory cortex were collected for protein measurement via western blotting and immunofluorescence staining. RESULTS Compared with WT mice, KO mice had significantly lower (40-50%) paw withdrawal latency to innocuous and noxious stimuli before and after pSNL. In DRG neurones from KO mice, where adiponectin receptor (AdipoR) 2 is located, phosphorylated p38 mitogen-activated protein kinase (p-p38 MAPK) and heat-sensitive transient receptor potential cation channel subfamily V member 1 (TRPV1) were significantly higher (by two- to three-fold) than from WT mice. In spinal microglia and somatosensory cortical neurones, where AdipoR1 is mainly located, p-p38 MAPK and TRPV1 were also higher (by two- to three-fold) in KO compared with WT mice, and altered signalling of these molecules was exacerbated (1.2- to 1.3-fold) by pSNL. CONCLUSIONS Our results show that adiponectin regulates thermal nociceptive sensitivity by inhibiting activation of DRG neurones, spinal microglia, and somatosensory cortical neurones in physiological and neuropathic pain states. This study has relevance for patients with adiponectin disorders, such as obesity and diabetes.
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Affiliation(s)
- L Sun
- Laboratory and Clinical Research Institute for Pain, The University of Hong Kong, China; Department of Anaesthesiology, The University of Hong Kong, China
| | - H Li
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Harvard University, Boston, MA, USA
| | - L W Tai
- Laboratory and Clinical Research Institute for Pain, The University of Hong Kong, China; Department of Anaesthesiology, The University of Hong Kong, China
| | - P Gu
- Laboratory and Clinical Research Institute for Pain, The University of Hong Kong, China; Department of Anaesthesiology, The University of Hong Kong, China
| | - C W Cheung
- Laboratory and Clinical Research Institute for Pain, The University of Hong Kong, China; Department of Anaesthesiology, The University of Hong Kong, China.
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Gu P, Kapur A, Li D, Haritunians T, Vasiliauskas E, Shih DQ, Targan SR, Spiegel BM, McGovern DP, Black JT, Melmed GY. Serological, genetic and clinical associations with increased health-care resource utilization in inflammatory bowel disease. J Dig Dis 2018; 19:15-23. [PMID: 29251413 PMCID: PMC6023617 DOI: 10.1111/1751-2980.12566] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 12/05/2017] [Accepted: 12/12/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Inflammatory bowel diseases (IBD) are associated with significant morbidity and economic burden. The variable course of IBD creates a need for predictors of clinical outcomes and health resource utilization (HRU) to guide treatment decisions. We aimed to identify clinical, serological or genetic markers associated with inpatient resource utilization in patients with ulcerative colitis (UC) and Crohn's disease (CD). METHODS Patients with IBD with available genetic and serological data who had at least one emergency department visit or hospitalization in a 3-year period were included. The primary outcome measure was HRU, as measured by the All Patient Refined Diagnosis Related Group classification system. Univariate and multivariate linear and logistic regression models were used to identify the associations with HRU. RESULTS Altogether 858 (562 CD and 296 UC) patients were included. Anti-CBir1 seropositivity (P = 0.002, effect size [ES]: 0.762, 95% confidence interval [CI] 0.512-1.012) and low socioeconomic status (P = 0.005, ES: 1.620 [95% CI 1.091-2.149]) were independently associated with a high HRU. CD diagnosis (P = 0.006, ES: -0.701 [95% CI -0.959 to -0.443]) was independently associated with a low inpatient HRU. CONCLUSION In patients with IBD who required at least one emergency department visit or hospitalization, anti-CBir1 antibody status may be a useful biomarker of HRU when formulating management strategies to reduce disease complications and resource utilization.
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Affiliation(s)
- Phillip Gu
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Anshika Kapur
- F Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Dalin Li
- F Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Talin Haritunians
- F Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Eric Vasiliauskas
- F Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | - David Q. Shih
- F Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Stephan R. Targan
- F Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Brennan M.R. Spiegel
- Center for Outcomes Research and Education, Cedars-Sinai Health System, Los Angeles, CA
| | - Dermot P.B. McGovern
- F Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Jeanne T. Black
- Resource & Outcomes Management Department, Cedars-Sinai Health System, Los Angeles, CA
| | - Gil Y. Melmed
- F Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA
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Suh J, Severson E, Hechtman J, Frampton G, Fabrizio D, Sun J, Ali S, Gu P, Klempner S, Miller V, Stephens P, Ross J. Hybrid-capture based comprehensive genomic profiling of hepatocellular carcinoma identifies patients who may benefit from targeted therapies and immune checkpoint blockade. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx660.001] [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: 11/14/2022] Open
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Affiliation(s)
- Phillip Gu
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California
| | - Brian Huang
- Division of Gastroenterology, University of California in Los Angeles, Los Angeles, California
| | - Ali Rezaie
- Division of Gastroenterology, Cedars-Sinai Medical Center, Los Angeles, California
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Lou Y, Zhang Y, Xu J, Gu P, Zhang W, Zhang X, Zhong H, Jiang L, Han B. Knockdown of MFN2 gene expression inhibits lung adenocarcinoma cell proliferation. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx090.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Gu P, Wang Y, Bisht KK, Wu L, Kukova L, Smith EM, Xiao Y, Bailey SM, Lei M, Nandakumar J, Chang S. Pot1 OB-fold mutations unleash telomere instability to initiate tumorigenesis. Oncogene 2016; 36:1939-1951. [PMID: 27869160 PMCID: PMC5383532 DOI: 10.1038/onc.2016.405] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 08/02/2016] [Accepted: 09/19/2016] [Indexed: 02/06/2023]
Abstract
Chromosomal aberrations are a hallmark of human cancers, with complex cytogenetic rearrangements leading to genetic changes permissive for cancer initiation and progression. Protection of Telomere 1 (POT1) is an essential component of the shelterin complex and functions to maintain chromosome stability by repressing the activation of aberrant DNA damage and repair responses at telomeres. Sporadic and familial mutations in the oligosaccharide-oligonucleotide (OB) folds of POT1 have been identified in many human cancers, but the mechanism underlying how hPOT1 mutations initiate tumorigenesis has remained unclear. Here we show that the human POT1’s OB-folds are essential for the protection of newly replicated telomeres. Oncogenic mutations in hPOT1 OB-fold fail to bind to ss telomeric DNA, eliciting a DNA damage response at telomeres that promote inappropriate chromosome fusions via the mutagenic alternative non-homologous end joining (A-NHEJ) pathway. hPOT1 mutations also result in telomere elongation and the formation of transplantable hematopoietic malignancies. Strikingly, conditional deletion of both mPot1a and p53 in mouse mammary epithelium resulted in development of highly invasive breast carcinomas and the formation of whole chromosomes containing massive arrays of telomeric fusions reminiscent of chromothripsis. Our results reveal that hPOT1 OB-folds are required to protect and prevent newly replicated telomeres from engaging in A-NHEJ mediated fusions that would otherwise promote genome instability to fuel tumorigenesis.
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Affiliation(s)
- P Gu
- Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Y Wang
- Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - K K Bisht
- Department of Molecular, Cellular, and Developmental Biology, University of Michigan, Ann Arbor, MI, USA.,Program in Chemical Biology, University of Michigan, Ann Arbor, MI, USA
| | - L Wu
- Department of GI Medical Oncology, UT MD Anderson Cancer Center, Houston, TX, USA
| | - L Kukova
- Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - E M Smith
- Department of Molecular, Cellular, and Developmental Biology, University of Michigan, Ann Arbor, MI, USA.,Program in Chemical Biology, University of Michigan, Ann Arbor, MI, USA
| | - Y Xiao
- Section of Hematology-Oncology, Department of Medicine and Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX, USA
| | - S M Bailey
- Department of Environmental & Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - M Lei
- National Center for Protein Science Shanghai, State Key Laboratory of Molecular Biology, Institute of Biochemistry and Cell Biology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, China
| | - J Nandakumar
- Department of Molecular, Cellular, and Developmental Biology, University of Michigan, Ann Arbor, MI, USA.,Program in Chemical Biology, University of Michigan, Ann Arbor, MI, USA
| | - S Chang
- Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT, USA.,Department of Pathology, Yale University School of Medicine, New Haven, CT, USA.,Department of Molecular Biophysics and Biochemistry, Yale University School of Medicine, New Haven, CT, USA
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Kwa M, Novik Y, Oratz R, Jhaveri K, Wu J, Gu P, Meyers M, Muggia F, Bonakdar M, Abidoglu C, Kozhaya L, Li X, Joseph B, Iwano A, Friedman K, Goldberg JD, Unutmaz D, Adams S. Abstract P2-11-11: Phase II trial of exemestane with immunomodulatory oral cyclophosphamide in metastatic hormone receptor (HR)-positive breast cancer: Prolonged progression-free survival (PFS) in patients with distinct T regulatory cell (Treg) profile. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p2-11-11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Resistance to endocrine therapies in HR-positive breast cancer is a significant challenge. The steroidal aromatase inhibitor (AI) exemestane (EXE) has demonstrated short-term efficacy in metastatic HR-positive HER2-negative breast cancer (mHR+BC) that has progressed during treatment with a non-steroidal AI. Combination strategies have not shown a survival benefit. Immunotherapy represents a promising approach as it may increase durability of responses. Low dose cyclophosphamide (CTX) has demonstrated efficacy in combination with neoadjuvant letrozole in HR+BC, conceivably by enhancing anti-tumor immune responses. Here we investigated whether EXE combined with immunomodulatory CTX could provide durable responses in heavily pretreated patients and assessed immunological profiles (NCT01963481).
Methods: Phase II trial of EXE (25mg PO daily) with CTX (50 mg PO daily) enrolled postmenopausal women (n=23) with mHR+BC who had progressed on prior endocrine therapy (including nonsteroidal AI, tamoxifen, and/or fulvestrant); prior chemotherapy was allowed. The primary endpoint was PFS (per RECIST 1.1) at 3 months; secondary endpoints were response rate, tolerability, and immune correlates. Detailed functional immune profiling of peripheral T cell subsets were performed by flow cytometry at baseline, 1, 3, 6, 9 & 12 months, with healthy donors available as controls.
Results: All 23 patients have been enrolled, and 21 are evaluable for response. Median age was 54 (range 31-77), median prior lines of endocrine therapy was 2 (1-3) and chemotherapy was 1 (0-5). The majority (15/23) had visceral organ involvement. Combination treatment was well tolerated with one grade 3 urinary tract infection but no grade 4 or 5 toxicity. An objective response was observed in 19% of patients (4/21, 1 CR and 3 PR) and an additional 33% (7/21) had SD, resulting in a 3-month-PFS of 48.5% (95% CI, 30.5-77.1). Responses were durable in all patients, lasting =/> 9 months and included patients with liver metastases.
Comparison of peripheral immune cell subsets of patients (n=16) at baseline to age/sex-matched healthy controls demonstrated an increased proportion of CD4+ memory T cells with central memory phenotype (CD45RO+CD27+, p<0.0001). When patients were stratified based on PFS at 3 months, the proportion of naïve Tregs (CD4+CD45RO-FOXP3+Helios+) at baseline was significantly lower (p=0.003) in the non-progressor group compared to patients with progression. Remarkably, when these patient groups were compared for changes in T cell subsets during treatment, the proportion of both naïve and memory Treg subsets increased from baseline to 3 months (p<0.01), but only in the non-progressor patient group. While preliminary, these findings are possibly indicative of novel predictive biomarkers.
Conclusion: EXE and CTX had a favorable safety profile with evidence of clinical activity in patients with heavily pretreated mHR+BC, including durable responses in liver and bone. Correlative studies are ongoing to identify potential biomarkers of response or resistance to therapy.
Citation Format: Kwa M, Novik Y, Oratz R, Jhaveri K, Wu J, Gu P, Meyers M, Muggia F, Bonakdar M, Abidoglu C, Kozhaya L, Li X, Joseph B, Iwano A, Friedman K, Goldberg JD, Unutmaz D, Adams S. Phase II trial of exemestane with immunomodulatory oral cyclophosphamide in metastatic hormone receptor (HR)-positive breast cancer: Prolonged progression-free survival (PFS) in patients with distinct T regulatory cell (Treg) profile. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P2-11-11.
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Affiliation(s)
- M Kwa
- New York University, NY, NY; Jackson Laboratory for Genomic Medicine, Farmington, CT
| | - Y Novik
- New York University, NY, NY; Jackson Laboratory for Genomic Medicine, Farmington, CT
| | - R Oratz
- New York University, NY, NY; Jackson Laboratory for Genomic Medicine, Farmington, CT
| | - K Jhaveri
- New York University, NY, NY; Jackson Laboratory for Genomic Medicine, Farmington, CT
| | - J Wu
- New York University, NY, NY; Jackson Laboratory for Genomic Medicine, Farmington, CT
| | - P Gu
- New York University, NY, NY; Jackson Laboratory for Genomic Medicine, Farmington, CT
| | - M Meyers
- New York University, NY, NY; Jackson Laboratory for Genomic Medicine, Farmington, CT
| | - F Muggia
- New York University, NY, NY; Jackson Laboratory for Genomic Medicine, Farmington, CT
| | - M Bonakdar
- New York University, NY, NY; Jackson Laboratory for Genomic Medicine, Farmington, CT
| | - C Abidoglu
- New York University, NY, NY; Jackson Laboratory for Genomic Medicine, Farmington, CT
| | - L Kozhaya
- New York University, NY, NY; Jackson Laboratory for Genomic Medicine, Farmington, CT
| | - X Li
- New York University, NY, NY; Jackson Laboratory for Genomic Medicine, Farmington, CT
| | - B Joseph
- New York University, NY, NY; Jackson Laboratory for Genomic Medicine, Farmington, CT
| | - A Iwano
- New York University, NY, NY; Jackson Laboratory for Genomic Medicine, Farmington, CT
| | - K Friedman
- New York University, NY, NY; Jackson Laboratory for Genomic Medicine, Farmington, CT
| | - JD Goldberg
- New York University, NY, NY; Jackson Laboratory for Genomic Medicine, Farmington, CT
| | - D Unutmaz
- New York University, NY, NY; Jackson Laboratory for Genomic Medicine, Farmington, CT
| | - S Adams
- New York University, NY, NY; Jackson Laboratory for Genomic Medicine, Farmington, CT
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Bitterman D, Resende-Salgado L, Moore H, Sanfilippo N, Gu P, Hatzaras I, Du K. Predictors of Complete Response and Recurrence Following Neoadjuvant Chemoradiation Therapy in Rectal Cancer. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.919] [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: 10/22/2022]
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Zhang Q, Zhu L, Gu P, Zhang Y, Han B, Zhang J. EGFR Mutation is not a Rare Issue for Peripheral Squamous Carcinoma of Lung. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv043.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Zhang Z, Jiang L, Wang J, Gu P, Chen M. MTide: an integrated tool for the identification of miRNA-target interaction in plants. Bioinformatics 2014; 31:290-1. [DOI: 10.1093/bioinformatics/btu633] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [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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Deng Y, Bi X, Zhou H, You Z, Wang Y, Gu P, Fan X, Fan X. Repair of critical-sized bone defects with anti-miR-31-expressing bone marrow stromal stem cells and poly(glycerol sebacate) scaffolds. Eur Cell Mater 2014; 27:13-24; discussion 24-5. [PMID: 24425157 DOI: 10.22203/ecm.v027a02] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [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] [Indexed: 01/31/2023] Open
Abstract
The repair of critical-sized defects (CSDs) is a significant challenge in bone tissue engineering. Combining the use of progenitor cells with gene therapy represents a promising approach for bone regeneration. MicroRNAs play important roles in most gene regulatory networks, regulate the endogenous expression of multiple growth factors and simultaneously modulate stem cell differentiation. Our previous study showed that knocking down miR-31 promotes the osteogenesis of bone marrow stromal stem cells (BMSCs). To investigate the therapeutic potential of cells engineered to express anti-miR-31 for CSD repair, lentiviral vectors encoding negative control, miR-31 precursor and anti-sense sequences were constructed and transduced into osteo-inductive BMSCs. The expression of osteogenic-specific genes, alkaline phosphatase activity and Alizarin Red S staining were investigated to evaluate the effects of miR-31 on the cell fate of BMSCs over a 3-week period. In addition, miR-31-modified BMSCs seeded on poly(glycerol sebacate) (PGS) scaffolds were used to repair 8 mm critical-sized calvarial defects in rats. The results showed that miR-31 suppression significantly increased the expression of osteogenic-specific genes in vitro at the mRNA and protein levels, and that robust new bone formation with high local bone mineral density was observed in the anti-miR groups in vivo. Moreover, the PGS scaffolds carrying anti-miR-31-expressing BMSCs exhibited good biocompatibility and a high regeneration rate (~60%) within in vivo bone defects. Our results suggest that miR-31 gene delivery affects the potential of BMSCs for osteogenic differentiation and bone regeneration and that PGS is a potential substrate for genetically modified, tissue-engineered bone in the repair of large bone defects.
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Affiliation(s)
- Y Deng
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Rd., Shanghai, 200011, PR
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Garcia Martin A, Fernandez Golfin C, Salido Tahoces L, Fernandez Santos S, Jimenez Nacher J, Moya Mur J, Velasco Valdazo E, Hernandez Antolin R, Zamorano Gomez J, Veronesi F, Corsi C, Caiani E, Lamberti C, Tsang W, Holmgren C, Guo X, Bateman M, Iaizzo P, Vannier M, Lang R, Patel A, Adamayn K, Tumasyan LR, Chilingaryan A, Nasr G, Eleraki A, Farouk N, Axelsson A, Langhoff L, Jensen M, Vejlstrup N, Iversen K, Bundgaard H, Watanabe T, Iwai-Takano M, Attenhofer Jost CH, Pfyffer M, Seifert B, Scharf C, Candinas R, Medeiros-Domingo A, Chin JY, Yoon H, Vollbon W, Singbal Y, Rhodes K, Wahi S, Katova TM, Simova II, Hristova K, Kostova V, Pauncheva B, Bircan A, Sade L, Eroglu S, Pirat B, Okyay K, Bal U, Muderrisoglu H, Heggemann F, Buggisch H, Welzel G, Doesch C, Hansmann J, Schoenberg S, Borggrefe M, Wenz F, Papavassiliu T, Lohr F, Roussin I, Drakopoulou M, Rosen S, Sharma R, Prasad S, Lyon A, Carpenter J, Senior R, Breithardt OA, Razavi H, Arya A, Nabutovsky Y, Ryu K, Gaspar T, Kosiuk J, Eitel C, Hindricks G, Piorkowski C, Pires S, Nunes A, Cortez-Dias N, Belo A, Zimbarra Cabrita I, Sousa C, Pinto F, Baron T, Johansson K, Flachskampf F, Christersson C, Pires S, Cortez-Dias N, Nunes A, Belo A, Zimbarra Cabrita I, Sousa C, Pinto F, Santoro A, Federico Alvino F, Giovanni Antonelli G, Raffaella De Vito R, Roberta Molle R, Sergio Mondillo S, Gustafsson M, Alehagen U, Johansson P, Tsukishiro Y, Onishi T, Chimura M, Yamada S, Taniguchi Y, Yasaka Y, Kawai H, Souza JRM, Zacharias LGT, Pithon KR, Ozahata TM, Cliquet AJ, Blotta MH, Nadruz WJ, Fabiani I, Conte L, Cuono C, Liga R, Giannini C, Barletta V, Nardi C, Delle Donne M, Palagi C, Di Bello V, Glaveckaite S, Valeviciene N, Palionis D, Laucevicius A, Hristova K, Bogdanova V, Ferferieva V, Shiue I, Castellon X, Boles U, Rakhit R, Shiu MF, Gilbert T, Papachristidis A, Henein MY, Westholm C, Johnson J, Jernberg T, Winter R, Ghosh Dastidar A, Augustine D, Cengarle M, Mcalindon E, Bucciarelli-Ducci C, Nightingale A, Onishi T, Watanabe T, Fujita M, Mizukami Y, Sakata Y, Nakatani S, Nanto S, Uematsu M, Saraste A, Luotolahti M, Varis A, Vasankari T, Tunturi S, Taittonen M, Rautakorpi P, Airaksinen J, Ukkonen H, Knuuti J, Boshchenko A, Vrublevsky A, Karpov R, Yoshikawa H, Suzuki M, Hashimoto G, Kusunose Y, Otsuka T, Nakamura M, Sugi K, Rosner S, Orban M, Lesevic H, Karl M, Hadamitzky M, Sonne C, Panaro A, Martinez F, Huguet M, Moral S, Palet J, Oller G, Cuso I, Jornet A, Rodriguez Palomares J, Evangelista A, Stoebe S, Tarr A, Pfeiffer D, Hagendorff A, Gilmanov D, Baroni M, Cerone E, Galli E, Berti S, Glauber M, Soesanto A, Yuniadi Y, Mansyur M, Kusmana D, Venkateshvaran A, Dash PK, Sola S, Govind SC, Shahgaldi K, Winter R, Brodin LA, Manouras A, Dokainish H, Sadreddini M, Nieuwlaat R, Lonn E, Healey J, Nguyen V, Cimadevilla C, Dreyfus J, Codogno I, Vahanian A, Messika-Zeitoun D, Lim YJ, Kawamura A, Kawano S, Polte C, Gao S, Lagerstrand K, Cederbom U, Bech-Hanssen O, Baum J, Beeres F, Van Hall S, Boering Y, Zeus T, Kehmeier E, Kelm M, Balzer J, Della Mattia A, Pinamonti B, Abate E, Nicolosi G, Proclemer A, Bassetti M, Luzzati R, Sinagra G, Hlubocka Z, Jiratova K, Dostalova G, Hlubocky J, Dohnalova A, Linhart A, Palecek T, Sonne C, Lesevic H, Karl M, Rosner S, Hadamitzky M, Ott I, Malev E, Reeva S, Zemtsovsky E, Igual Munoz B, Alonso Fernandez Pau P, Miro Palau Vicente V, Maceira Gonzalez Alicia A, Estornell Erill J, Andres La Huerta A, Donate Bertolin L, Valera Martinez F, Salvador Sanz Antonio A, Montero Argudo Anastasio A, Nemes A, Kalapos A, Domsik P, Chadaide S, Sepp R, Forster T, Onaindia J, Arana X, Cacicedo A, Velasco S, Rodriguez I, Capelastegui A, Sadaba M, Gonzalez J, Salcedo A, Laraudogoitia E, Archontakis S, Gatzoulis K, Vlasseros I, Arsenos P, Tsiachris D, Vouliotis A, Sideris S, Karistinos G, Kalikazaros I, Stefanadis C, Ancona R, Comenale Pinto S, Caso P, Coppola M, Arenga F, Cavallaro C, Vecchione F, D'onofrio A, Calabro R, Correia CE, Moreira D, Cabral C, Santos J, Cardoso J, Igual Munoz B, Maceira Gonzalez A, Estornell Erill Jordi J, Jimenez Carreno R, Arnau Vives M, Monmeneu Menadas J, Domingo-Valero D, Sanchez Fernandez E, Montero Argudo Anastasio A, Zorio Grima E, Cincin A, Tigen K, Karaahmet T, Dundar C, Sunbul M, Guler A, Bulut M, Basaran Y, Mordi I, Carrick D, Berry C, Tzemos N, Cruz I, Ferreira A, Rocha Lopes L, Joao I, Almeida A, Fazendas P, Cotrim C, Pereira H, Ochoa JP, Fernandez A, Filipuzzi J, Casabe J, Salmo J, Vaisbuj F, Ganum G, Di Nunzio H, Veron L, Guevara E, Salemi V, Nerbass F, Portilho N, Ferreira Filho J, Pedrosa R, Arteaga-Fernandez E, Mady C, Drager L, Lorenzi-Filho G, Marques J, Almeida AMG, Menezes M, Silva G, Placido R, Amaro C, Brito D, Diogo A, Lourenco MR, Azevedo O, Moutinho J, Nogueira I, Machado I, Portugues J, Quelhas I, Lourenco A, Calore C, Muraru D, Melacini P, Badano L, Mihaila S, Puma L, Peluso D, Casablanca S, Ortile A, Iliceto S, Kang MK, Yu S, Park J, Kim S, Park T, Mun HS, C S, Cho SR, Han S, Lee N, Khalifa EA, Hamodraka E, Kallistratos M, Zacharopoulou I, Kouremenos N, Mavropoulos D, Tsoukas A, Kontogiannis N, Papanikolaou N, Tsoukanas K, Manolis A, Villagraz Tecedor L, Jimenez Lopez Guarch C, Alonso Chaterina S, Blazquez Arrollo L, Lopez Melgar B, Veitia Sarmiento A, Mayordomo Gomez S, Escribano Subias M, Lichodziejewska B, Kurnicka K, Goliszek S, Dzikowska Diduch O, Kostrubiec M, Krupa M, Grudzka K, Ciurzynski M, Palczewski P, Pruszczyk P, Sakata K, Ishiguro M, Kimura G, Uesugo Y, Takemoto K, Minamishima T, Futuya M, Matsue S, Satoh T, Yoshino H, Signorello M, Gianturco L, Colombo C, Stella D, Atzeni F, Boccassini L, Sarzi-Puttini P, Turiel M, Kinova E, Deliiska B, Krivoshiev S, Goudev A, De Stefano F, Santoro C, Buonauro A, Schiano-Lomoriello V, Muscariello R, De Palma D, Galderisi M, Ranganadha Babu B, Chidambaram S, Sangareddi V, Dhandapani V, Ravi M, Meenakshi K, Muthukumar D, Swaminathan N, Ravishankar G, Bruno RM, Giardini G, Catizzo B, Brustia R, Malacrida S, Armenia S, Cauchy E, Pratali L, Cesana F, Alloni M, Vallerio P, De Chiara B, Musca F, Belli O, Ricotta R, Siena S, Moreo A, Giannattasio C, Magnino C, Omede' P, Avenatti E, Presutti D, Sabia L, Moretti C, Bucca C, Gaita F, Veglio F, Milan A, Eichhorn J, Springer W, Helling A, Alarajab A, Loukanov T, Ikeda M, Kijima Y, Akagi T, Toh N, Oe H, Nakagawa K, Tanabe Y, Watanabe N, Ito H, Hascoet S, Hadeed K, Marchal P, Bennadji A, Peyre M, Dulac Y, Heitz F, Alacoque X, Chausseray G, Acar P, Kong W, Ling L, Yip J, Poh K, Vassiliou V, Rekhraj S, Hoole S, Watkinson O, Kydd A, Boyd J, Mcnab D, Densem C, Shapiro L, Rana B, Potpara T, Djikic D, Polovina M, Marcetic Z, Peric V, Lip G, Gaudron P, Niemann M, Herrmann S, Hu K, Strotmann J, Beer M, Bijnens B, Liu D, Ertl G, Weidemann F, Peric V, Jovanovic A, Djikic D, Otasevic P, Kochanowski J, Piatkowski R, Scislo P, Grabowski M, Marchel M, Opolski G, Bandera F, Guazzi M, Arena R, Corra U, Ghio S, Forfia P, Rossi A, Dini F, Cahalin L, Temporelli L, Rallidis L, Tsangaris I, Makavos G, Anthi A, Pappas A, Orfanos S, Lekakis J, Anastasiou-Nana M, Kuznetsov VA, Krinochkin DV, Yaroslavskaya EI, Zaharova EH, Pushkarev GS, Mizia-Stec K, Wita K, Mizia M, Loboz-Grudzien K, Szwed H, Kowalik I, Kukulski T, Gosciniak P, Kasprzak J, Plonska-Gosciniak E, Cimino S, Pedrizzetti G, Tonti G, Cicogna F, Petronilli V, De Luca L, Iacoboni C, Agati L, Hoffmann R, Barletta G, Von Bardeleben S, Kasprzak J, Greis C, Vanoverschelde J, Becher H, Galrinho A, Moura Branco L, Fiarresga A, Cacela D, Ramos R, Cruz Ferreira R, Van Den Oord S, Akkus Z, Bosch J, Renaud G, Sijbrands E, Verhagen H, Van Der Lugt A, Van Der Steen A, Schinkel A, Mordi I, Tzemos N, Stanton T, Delgado D, Yu E, Drakopoulou M, Gonzalez-Gonzalez A, Karonis T, Roussin I, Babu-Narayan S, Swan L, Senior R, Li W, Parisi V, Pagano G, Pellegrino T, Femminella G, De Lucia C, Formisano R, Cuocolo A, Perrone Filardi P, Leosco D, Rengo G, Unlu S, Farsalinos K, Amelot K, Daraban A, Ciarka A, Delcroix M, Voigt J, Miskovic A, Poerner T, Goebel B, Stiller C, Moritz A, Sakata K, Uesugo Y, Kimura G, Ishiguro M, Takemoto K, Minamishima T, Futuya M, Satoh T, Yoshino H, Miyoshi T, Tanaka H, Kaneko A, Matsumoto K, Imanishi J, Motoji Y, Mochizuki Y, Minami H, Kawai H, Hirata K, Wutthimanop A, See O, Vathesathokit P, Yamwong S, Sritara P, Rosner A, Kildal A, Stenberg T, Myrmel T, How O, Capriolo M, Frea S, Giustetto C, Scrocco C, Benedetto S, Grosso Marra W, Morello M, Gaita F, Garcia-Gonzalez P, Cozar-Santiago P, Chacon-Hernandez N, Ferrando-Beltran M, Fabregat-Andres O, De La Espriella-Juan R, Fontane-Martinez C, Jurado-Sanchez R, Morell-Cabedo S, Ridocci-Soriano F, Mihaila S, Piasentini E, Muraru D, Peluso D, Casablanca S, Puma L, Naso P, Iliceto S, Vinereanu D, Badano L, Tarzia P, Villano A, Figliozzi S, Russo G, Parrinello R, Lamendola P, Sestito A, Lanza G, Crea F, Sulemane S, Panoulas V, Bratsas A, Frankel A, Nihoyannopoulos P, Dores H, Andrade M, Almeida M, Goncalves P, Branco P, Gaspar A, Gomes A, Horta E, Carvalho M, Mendes M, Yue W, Li X, Chen Y, Luo Y, Gu P, Yiu K, Siu C, Tse H, Cho E, Lee S, Hwang B, Kim D, Jang S, Jeon H, Youn H, Kim J. Poster session Thursday 12 December - PM: 12/12/2013, 14:00-18:00 * Location: Poster area. Eur Heart J Cardiovasc Imaging 2013. [DOI: 10.1093/ehjci/jet204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Meng F, Wang X, Gu P, Wang Z, Guo W. Induction of retinal ganglion-like cells from fibroblasts by adenoviral gene delivery. Neuroscience 2013; 250:381-93. [PMID: 23856066 DOI: 10.1016/j.neuroscience.2013.07.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Revised: 06/30/2013] [Accepted: 07/01/2013] [Indexed: 12/29/2022]
Abstract
Central nervous system neurons fail to regenerate after birth, which greatly hampers the effective treatment of many neurodegenerative diseases. Neurons differentiated from induced pluripotent stem cells have been considered a possible option for cell-based therapies. Recent discoveries have revealed that fibroblasts can be directly converted into neurons without a transition through a pluripotent state. This approach might serve as a more efficient and convenient method for the cellular therapy of neurodegenerative diseases. Currently, several types of neurons have been directly generated from fibroblasts, including dopamine neurons, motor neurons and neural progenitor cells. In our study, by screening a series of candidate genes, we found that the adenovirus-mediated transduction of Ascl1, Brn3b and Ngn2 can directly convert mouse fibroblasts to retinal ganglion-like cells. The induced retinal ganglion-like cells co-express multiple retinal ganglion cell markers, and exhibit membrane properties of functional neurons. The reprogramming mediated by adenoviruses occurs much sooner than that mediated by lentiviruses. Furthermore, the induced retinal ganglion-like cells that are produced via adenoviral gene delivery are free of exogenous gene integration. Retinal ganglion-like cells that are induced by adenoviruses demonstrate great potential applicability in clinical therapy and provide a novel platform for the research of retinal degenerative diseases.
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Affiliation(s)
- F Meng
- Department of Ophthalmology, Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Shanghai 200031, China; Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai 200032, China
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Gu P, Jiang W, Chen M, Lu B, Shao J, Du H, Jiang S. Association of leptin receptor gene polymorphisms and essential hypertension in a Chinese population. J Endocrinol Invest 2012; 35:859-65. [PMID: 22293279 DOI: 10.3275/8238] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [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: 12/21/2022]
Abstract
BACKGROUND The leptin receptor (LEPR) is an important regulator of leptin activity and resistance. Several single nucleotide polymorphisms (SNP) of LEPR have been linked to diseases accompanying obesity and/or obesity-related diseases in different populations. However, the results from published studies remain inconsistent rather than conclusive. AIM To investigate whether LEPR SNP are associated with essential hypertension and related metabolic traits in Chinese subjects. MATERIALS AND METHODS A total of 544 Chinese patients with hypertension and 357 non-hypertensive subjects were screened. The genotypes of LEPR polymorphisms were determined by PCR-restriction fragment length polymorphism methods. Demographic and biochemical characteristics including waist circumference, waist-to-hip ratio, body mass index (BMI), lipids profiles, glucose metabolism, and leptin levels were obtained for analysis. RESULTS This case-control study showed associations between the frequencies of AA genotype and A allele of Gln223Arg and hypertension (p=0.029, p=0.002, respectively). Furthermore, the Gln223Arg polymorphism was significantly associated with plasma leptin levels (p<0.001), while no correlations between Lys109Arg SNP and hypertension were found. Multivariate logistic regression analysis evidenced that A allele carriers of Gln223Arg (AA+AG) showed higher risks of hypertension than GG carriers after adjustment of age and sex (adjusted odds ratio: 1.549, 95% confidence interval: 1.031- 2.036, p=0.035). BMI, fasting serum insulin, oral glucose tolernace test (OGTT)-2h glucose, serum leptin, as well as LDL-cholesterol (LDL-C) levels were also independent risk factors of hypertension in this population. In addition, significant associations were observed between the Gln223Arg and Lys109Arg SNP and serum total cholesterol, LDL-C, and fasting plasma glucose levels in hypertensive patients. Besides, A allele of Gln223Arg had raised diastolic blood pressure, compared with GG carriers (p=0.001). While variance of Lys109Arg was associated with waist-to-hip ratio, OGTT-2h glucose, and homeostasis model assessment of insulin resistance (p<0.05). CONCLUSIONS LEPR polymorphisms may be a marker for susceptibility to essential hypertension in Chinese subjects, and be involved in the development of several features including dyslipidemia and impaired glucose regulation in hypertension subjects.
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Affiliation(s)
- P Gu
- Department of Endocrinology, Nanjing General Hospital of Nanjing Command, Jiangsu Province, PR China
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Abstract
AIMS In the present study, we investigated whether rhein exerted hypoglycemic action and rhein's effect on the pancreatic β cell in db/db mice. MATERIALS AND METHODS Thirty 4-week-old db/db mice were randomized to treatment with rhein (120 mg/kg) (no.=15) and placebo (1% natrium cellulose solution) (no.=15) for 8 weeks, respectively. Fifteen age-matched non-diabetic littermates db/m mice treated with placebo were studied as non-diabetic control. After an 8-week treatment, ip glucose tolerance test (IPGTT) and arginine tolerance test were performed. Area under curve (AUC) of insulin levels in IPGTT was calculated to evaluate insulin secretory function. Immunohistochemical staining of insulin was performed to estimate β cell mass. TUNEL assay was performed to determine β cell apoptosis. Islet isolation and perifusion were performed to evaluate kinetics of insulin release in vitro, especially first-phase insulin. RESULTS Compared with control group, AUC of glucose concentrations significantly decreased in the rhein-treated group (p<0.05). Simultaneously, AUC of insulin levels increased in the rhein-treated group (p<0.05), especially in the first 30 min after glucose load. Perifusion showed that the rhein-treated group manifested a significantly increase of first-phase insulin secretion. Immunohistochemical study and TUNEL assay showed that rhein treatment greatly preserved β cell mass and inhibited β cell apoptosis. CONCLUSIONS Rhein treatment significantly improved glucose- dependent and independent insulin secretion by preservation of β cell mass and inhibition of β cell apoptosis in db/db mice. The characteristics of rhein may make it a novel therapeutic means for preventing from or curing diabetes in the near future.
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Affiliation(s)
- H Du
- Department of Endocrinology, Nanjing Jinling Hospital, Nanjing, China
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Gu P, DeFina LF, Leonard D, John S, Weiner MF, Brown ES. Relationship between serum homocysteine levels and depressive symptoms: the Cooper Center Longitudinal Study. J Clin Psychiatry 2012; 73:691-5. [PMID: 22480447 DOI: 10.4088/jcp.11m07223] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [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: 06/20/2011] [Accepted: 08/19/2011] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Elevated serum levels of the amino acid homocysteine (HCY) are associated with a variety of diseases. To resolve conflicting findings in studies that suggest a relationship between elevated serum HCY levels and depression, we examined the relationship between HCY levels and depressive symptoms in the largest sample studied to date. METHOD We conducted a cross-sectional study of 11,757 participants (68.9% men) aged 20 to 90 years who completed preventive health examinations at the Cooper Clinic, Dallas, Texas, from 2007 to 2010. Currently experiencing depression was defined as a 10-item Center for Epidemiologic Studies Depression Scale (CES-D) score of ≥ 10. Serum HCY levels were obtained. Data were analyzed in a multiple logistic regression model of CES-D score of ≥ 10. RESULTS When controlling for age, sex, body mass index, exercise, education, smoking, antidepressant use, creatinine level, alcohol use, and chronic medical conditions, elevated HCY was associated with 26% greater odds of currently experiencing depressive symptoms (P = .007) as defined by CES-D score. CONCLUSIONS In the largest sample examined to date, we found a significant positive relationship between elevated serum HCY levels and currently experiencing depressive symptoms. Given the cross-sectional nature of the study, it is not possible to determine the direction of the relationship or whether lowering HCY levels will ameliorate depressive symptoms. Thus, longitudinal studies are needed.
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Affiliation(s)
- Phillip Gu
- Department of Psychiatry, the University of Texas Southwestern Medical Center, Dallas, TX 75390-8849, USA
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