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Pieruccini-Faria F, Cornish B, Binns M, Fraser J, Haddad SMH, Sunderland K, Ramirez J, Beaton D, Kwan D, Dilliott AA, Scott C, Sarquis-Adamson Y, Black A, Van Ooteghem K, Casaubon L, Dowlatshahi D, Hassan A, Mandzia J, Sahlas D, Saposnik G, Tan B, Hegele R, Bulman D, Ghani M, Robinson J, Rogaeva E, Farhan S, Symons S, Nanayakkara N, Arnott SR, Berezuk C, Holmes M, Adamo S, Ozzoude M, Zamyadi M, Lou W, Sujanthan S, Bartha R, Black SE, Swartz RH, McIlroy W, Montero-Odasso M. Association of Dual-Task Gait Cost and White Matter Hyperintensity Burden Poststroke: Results From the ONDRI. Neurorehabil Neural Repair 2023:15459683231177606. [PMID: 37269105 DOI: 10.1177/15459683231177606] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Acute change in gait speed while performing a mental task [dual-task gait cost (DTC)], and hyperintensity magnetic resonance imaging signals in white matter are both important disability predictors in older individuals with history of stroke (poststroke). It is still unclear, however, whether DTC is associated with overall hyperintensity volume from specific major brain regions in poststroke. METHODS This is a cohort study with a total of 123 older (69 ± 7 years of age) participants with history of stroke were included from the Ontario Neurodegenerative Disease Research Initiative. Participants were clinically assessed and had gait performance assessed under single- and dual-task conditions. Structural neuroimaging data were analyzed to measure both, white matter hyperintensity (WMH) and normal appearing volumes. Percentage of WMH volume in frontal, parietal, occipital, and temporal lobes as well as subcortical hyperintensities in basal ganglia + thalamus were the main outcomes. Multivariate models investigated associations between DTC and hyperintensity volumes, adjusted for age, sex, years of education, global cognition, vascular risk factors, APOE4 genotype, residual sensorimotor symptoms from previous stroke and brain volume. RESULTS There was a significant positive global linear association between DTC and hyperintensity burden (adjusted Wilks' λ = .87, P = .01). Amongst all WMH volumes, hyperintensity burden from basal ganglia + thalamus provided the most significant contribution to the global association (adjusted β = .008, η2 = .03; P = .04), independently of brain atrophy. CONCLUSIONS In poststroke, increased DTC may be an indicator of larger white matter damages, specifically in subcortical regions, which can potentially affect the overall cognitive processing and decrease gait automaticity by increasing the cortical control over patients' locomotion.
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Affiliation(s)
- Frederico Pieruccini-Faria
- Gait and Brain Lab, St. Joseph's Hospital, Parkwood Institute, Lawson Health Research Institute, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Benjamin Cornish
- Neuroscience, Mobility and Balance Lab (NiMBaL), Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Malcolm Binns
- Rotman Research Institute, Baycrest Centre, Toronto, ON, Cananda; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Julia Fraser
- Neuroscience, Mobility and Balance Lab (NiMBaL), Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Seyyed M H Haddad
- Department of Medicine, Robarts Research Institute, Schulich of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Kelly Sunderland
- Rotman Research Institute, Baycrest Centre, Toronto, ON, Cananda; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Joel Ramirez
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Derek Beaton
- Data Science & Advanced Analytics, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Donna Kwan
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Allison A Dilliott
- Department of Biochemistry, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada; Robarts Research Institute, Western University, London, ON, Canada
| | - Christopher Scott
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Yanina Sarquis-Adamson
- Gait and Brain Lab, St. Joseph's Hospital, Parkwood Institute, Lawson Health Research Institute, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Alanna Black
- Gait and Brain Lab, St. Joseph's Hospital, Parkwood Institute, Lawson Health Research Institute, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Karen Van Ooteghem
- Neuroscience, Mobility and Balance Lab (NiMBaL), Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Leanne Casaubon
- Department of Medicine, Sunnybrook HSC, University of Toronto; Dr. Sandra Black Centre for Brain Resilience and Recovery; Hurvitz Brain Sciences Research Program Director, Sunnybrook Research Institute; Heart and Stroke Foundation Canadian Partnership for Stroke Recovery Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Dar Dowlatshahi
- Department of Medicine, University of Ottawa Brain and Mind Research Institute and Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Ayman Hassan
- Thunder Bay Regional Research Institute, Northern Ontario School of Medicine, Thunder Bay, ON, Canada
| | - Jennifer Mandzia
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, and London Health Sciences Center, London, ON, Canada
| | - Demetrios Sahlas
- Division of Neurology, Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Gustavo Saposnik
- St. Michaels Hospital, University of Toronto, Toronto, ON, Canada
| | - Brian Tan
- Rotman Research Institute, Baycrest Centre, Toronto, ON, Cananda; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Robert Hegele
- Department of Medicine, Robarts Research Institute, Schulich of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Dennis Bulman
- Department of Medicine, University of Ottawa Brain and Mind Research Institute and Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Mahdi Ghani
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada
| | - John Robinson
- Department of Medicine, Robarts Research Institute, Schulich of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Ekaterina Rogaeva
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada
| | - Sali Farhan
- Department of Neurology and Neurosurgery, Department of Human Genetics, The Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Sean Symons
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Nuwan Nanayakkara
- Department of Medicine, Robarts Research Institute, Schulich of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Stephen R Arnott
- Rotman Research Institute, Baycrest Centre, Toronto, ON, Cananda; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Courtney Berezuk
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Melissa Holmes
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Sabrina Adamo
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Miracle Ozzoude
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Mojdeh Zamyadi
- Rotman Research Institute, Baycrest Centre, Toronto, ON, Cananda; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Wendy Lou
- Dalla Lana School of Public Health; University of Toronto, Toronto, ON, Canada
| | - Sujeevini Sujanthan
- Department of Ophthalmology and Visual Sciences, Research Institute of the McGill University Health Center, Montreal, QC, Canada
| | - Robert Bartha
- Department of Medicine, Robarts Research Institute, Schulich of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Sandra E Black
- Department of Medicine, Sunnybrook HSC, University of Toronto; Dr. Sandra Black Centre for Brain Resilience and Recovery; Hurvitz Brain Sciences Research Program Director, Sunnybrook Research Institute; Heart and Stroke Foundation Canadian Partnership for Stroke Recovery Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Richard H Swartz
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - William McIlroy
- Neuroscience, Mobility and Balance Lab (NiMBaL), Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Manuel Montero-Odasso
- Department of Medicine (Geriatrics) and Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
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Abedi AH, Yıldırım Şimşir I, Bayram F, Onay H, Özgür S, Mcintyre A, Toth P, Hegele R. Genetic Variants Associated with Severe Hypertriglyceridemia: LPL, APOC2, APOA5, GPIHBP1, LMF1, and APOE. Turk Kardiyol Dern Ars 2023; 51:10-21. [PMID: 36689289 DOI: 10.5543/tkda.2022.98544] [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] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE High triglyceride (TG) levels are associated with an increased risk for atherosclerotic cardiovascular disease (ASCVD) and pancreatitis. The objectives for this study were to evaluate for the coexistence of severe HTG and pancreatitis in two different geographic regions of Turkey and to identify rare variants that cause monogenic HTG in our country. METHODS In our study from 2014 to 2019, patients with severe HTG who presented to the endocrinology outpatient clinics with TG levels >500 mg/dL (5.7 mmol/L) were evaluated. The LPL, APOC2, APOA5, GPIHBP1, LMF1, and APOE genes were sequenced using next generation sequencing to screen for potentially pathogenic variants. RESULTS Potentially pathogenic variants were identified in 64 (47.1%) of 136 patients. Variants in LPL were seen in 42 (30.9%) cases, APOA5 variants in 10 (7.4%) cases, APOC2 variants in 5 (3.7%) cases, LMF1 variants in 5 (3.7%) cases, and APOE mutations in 2 (1.5%) cases. In the subgroup that experienced pancreatitis (n = 76, 56.3%), LPL variants were seen at higher frequency (P <0.001) than in the subgroup with no history of pancreatitis (n = 60, 43.7%). Patients who developed pancreatitis (56.3%) demonstrated a median TG of 2083 mg/dL (23.5 mmol/L), and patients without pancreatitis (43.7%) demonstrated a median TG of 1244.5 mg/dL (14.1 mmol/L) (P <0.001). CONCLUSION Accurate approach to HTG diagnosis is important for the prevention of pancreatitis and ASCVD. Evaluation of variants in primary HTG after excluding secondary causes may help provide a patient-centric precision treatment plan.
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Affiliation(s)
- Amir Hossein Abedi
- Erciyes University Faculty of Medicine, Department of Internal Medicine, Kayseri, Türkiye
| | - Ilgın Yıldırım Şimşir
- Ege University Faculty of Medicine, Division of Endocrinology and Metabolism Disorders, Izmir, Türkiye
| | - Fahri Bayram
- Erciyes University Faculty of Medicine, Division of Endocrinology and Metabolism Disorders, Kayseri, Türkiye
| | - Huseyin Onay
- Ege University Faculty of Medicine, Department of Medical Genetics, Izmir, Türkiye
| | - Su Özgür
- Ege University Faculty of Medicine, Department of Biostatistics and Medical Informatics, Izmir, Türkiye
| | - Adam Mcintyre
- Robarts Research Institute, Schulich School of Medicine, Western University, London ON, Canada
| | - Peter Toth
- Cicarrone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Robert Hegele
- Robarts Research Institute, Schulich School of Medicine, Western University, London ON, Canada
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Xiong LY, Yu D, Liang N, Shen Q, Hegele R, Ramirez J, Goubran M, Rabin JS, Lanctôt KL, Black SE, Tartaglia C, Lang AE, Tan B, Symons S, Taha AY, Swardfager W. Peripheral blood leukotriene B4 and E4 as biomarkers in Alzheimer’s disease. Alzheimers Dement 2022. [DOI: 10.1002/alz.068991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Lisa Y. Xiong
- Sunnybrook Research Institute Toronto ON Canada
- University of Toronto Toronto ON Canada
| | - Di Yu
- Sunnybrook Research Institute Toronto ON Canada
- University of Toronto Toronto ON Canada
| | | | - Qing Shen
- University of California, Davis Davis CA USA
| | | | | | | | - Jennifer S. Rabin
- Sunnybrook Research Institute Toronto ON Canada
- University of Toronto Toronto ON Canada
| | - Krista L. Lanctôt
- Sunnybrook Research Institute Toronto ON Canada
- University of Toronto Toronto ON Canada
| | - Sandra E. Black
- Sunnybrook Research Institute Toronto ON Canada
- University of Toronto Toronto ON Canada
| | | | - Anthony E Lang
- The Edmond J. Safra Program in Parkinson’s Disease and Morton and Gloria Shulman Movement Disorders Clinic Toronto ON Canada
| | - Brian Tan
- Rotman Research Institute Toronto ON Canada
| | - Sean Symons
- Sunnybrook Health Sciences Centre Toronto ON Canada
| | | | - Walter Swardfager
- Sunnybrook Research Institute Toronto ON Canada
- University of Toronto Toronto ON Canada
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Gupta M, Padarath M, Prest L, Naik N, Hegele R. Awareness of lipid guideline recommendations for high-risk patients amongst primary care physicians in Canada. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Lipid guidelines for cardiovascular (CV) risk reduction have evolved in recent years, particularly since the introduction of PCSK9 inhibitors. In many jurisdictions, CV risk management is provided by primary care physicians (PCPs). We surveyed Canadian PCPs regarding their awareness and implementation of the 2021 Canadian Cardiovascular Society (CCS) lipid guideline recommendations for patients following an acute coronary syndrome (ACS) or for those with diabetes but without CV disease.
Methods and results
From a national database of PCPs with interest and/or experience in CV medicine, we invited PCPs to complete a survey regarding lipid management in high-risk patients. A committee of PCPs and specialists with lipid expertise including several co-authors of the 2021 CCS lipid guidelines had designed the survey to probe awareness and practice patterns. A total of 203 PCPs from across Canada completed the survey between January and March 2022. 23.6% of respondents had previously prescribed a PCSK9 inhibitor. Almost all (96.5%) PCPs concurred that a post-ACS patient should be seen by their PCP within 4 weeks of hospital discharge (79.3% within 2 weeks). Almost half (45.3%) responded that discharge summaries provided inadequate information relevant for PCPs, and 43% felt that lipid management post-ACS was the primary responsibility of specialists. More than half (56%) articulated challenges when seeing a post-ACS patient, related to inadequate discharge information, complexities of polypharmacy and duration of therapies, and managing perceived or real statin intolerance. 62% correctly identified the LDL-C intensification threshold of 1.8 mmol/L in post-ACS patients, while 79% considered that PCSK9 inhibitors were indicated only for those patients who were already receiving statins plus ezetimibe or had substantially elevated LDL-C levels. 55.2% were able to correctly identify clinical features associated with greatest absolute benefit of PCSK9 inhibitors in post-ACS patients. For patients with diabetes but without ASCVD, 80% of PCPs incorrectly believed that PCSK9 inhibitors were indicated for LDL-C levels above threshold despite statin therapy, and only 42% correctly identified the LDL-C threshold for treatment intensification of 2.0 mmol/L.
Conclusion
While PCPs are aware of the urgency regarding lipid management in post-ACS patients, many encounter challenges after hospital discharge, frequently deferring lipid management to specialists. Thus, almost one year following publication of the 2021 CCS lipid guidelines, substantial knowledge gaps remain regarding intensification thresholds and treatment options for patients post-ACS or for those with diabetes. Innovative and effective knowledge translation programs are urgently required.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Amgen Canada
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Affiliation(s)
- M Gupta
- University of Toronto , Toronto , Canada
| | - M Padarath
- Canadian Collaborative Research Network , Brampton , Canada
| | - L Prest
- Canadian Collaborative Research Network , Brampton , Canada
| | - N Naik
- McMaster University , Hamilton , Canada
| | - R Hegele
- Western University , London , Canada
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5
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Krakovsky J, Mcintyre A, Hegele R. The Lipid Profile of Individuals With the APOE c.T137C:p.L46P Mutation. Can J Diabetes 2021. [DOI: 10.1016/j.jcjd.2021.09.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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6
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Brown L, Ruel I, Bélanger A, Couture P, Bergeron J, Sherman M, Francis G, Cermakova L, Mancini G, Brunham L, Hegele R, Genest J. HOMOZYGOUS FAMILIAL HYPERCHOLESTEROLEMIA IN CANADA. Can J Cardiol 2021. [DOI: 10.1016/j.cjca.2021.07.056] [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: 11/25/2022] Open
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Sakurai R, Faria‐Pieruccini F, Dilliott AA, Hegele R, Tartaglia C, McLaughlin P, Binns M, Blue K, Cornish B, Sunderland KM, Beaton D, Haddad SM, Tan B, Swartz RH, Kwan D, Masellis M, Ramirez J, Roberts AC, Black SE, Symons S, Strother SC, Borrie M, Pasternak SH, Freedman M, Bartha R, Lang A, Munoz D, McIlroy B, Montero‐Odasso M. Abnormal brain structure mediates the association between ApoE4 and slow gait among patients with pathological cognitive impairment: Results from the Ontario Neurodegenerative Research Initiative. Alzheimers Dement 2020. [DOI: 10.1002/alz.044540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Ryota Sakurai
- Tokyo Metropolitan Institute of Gerontology Tokyo Japan
| | | | | | | | | | - Paula McLaughlin
- Ontario Neurodegenerative Disease Research Initiative Toronto ON Canada
| | | | - Korbin Blue
- Gait and Brain Laboratory, Parkwood Institute London ON Canada
| | | | | | | | | | - Brian Tan
- Sunnybrook Health Sciences Centre Toronto ON Canada
| | | | - Donna Kwan
- Ontario Neurodegenerative Disease Research Initiative Toronto ON Canada
| | | | - Joel Ramirez
- LC Campbell Cognitive Neurology Research Unit Toronto ON Canada
| | | | - Sandra E. Black
- L.C. Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Research Program Sunnybrook Health Sciences Centre Toronto ON Canada
| | - Sean Symons
- Sunnybrook Health Sciences Centre Toronto ON Canada
| | | | | | | | | | | | - Anthony Lang
- Movement Disorder Clinic, Toronto Western Hospital University Health Network Toronto ON Canada
| | | | | | - Manuel Montero‐Odasso
- Schulich School of Medicine & Dentistry, Division of Geriatric Medicine Western University London ON Canada
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Watts G, Schwabe C, Scott R, Gladding P, Sullivan D, Baker J, Clifton P, Hamilton J, Given B, San Martin J, Melquist S, Knowles J, Goldberg I, Hegele R, Ballantyne C. RNAi inhibition of angiopoietin-like protein 3 (ANGPTL3) with ARO-ANG3 mimics the lipid and lipoprotein profile of familial combined hypolipidemia. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3331] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Elevated LDL-C and triglyceride rich lipoproteins (TRLs) are independent risk factors for cardiovascular disease (CVD). Genetic deficiency of angiopoietin-like protein 3 (ANGPTL3) is associated with reduced circulating levels of LDL-C, triglycerides (TGs), VLDL-C, HDL-C and reduced CVD risk, with no described adverse phenotype. ARO-ANG3 is a RNA interference drug designed to silence expression of ANGPTL3. Single doses of ARO-ANG3 have been shown to reduce ANGPTL3, TGs, VLDL-C and LDL-C in healthy volunteers (HVs, AHA 2019). We report the effects of multiple doses of ARO-ANG3 in HVs with a focus on the duration of action.
Methods
ARO-ANG3 was administered subcutaneously to HVs on days 1 and 29 at doses of 100, 200 or 300 mg (n=4 per group). Measured parameters included ANGPTL3, LDL-C, TGs, VLDL-C and HDL-C. Follow up is ongoing.
Results
All HVs have received both doses and follow-up is currently through week 16 (12 weeks after second dose). Mean nadir for ANGPTL3 levels occurred 2 weeks after the second dose (−83–93%) with minimal change for 200 and 300 mg but 16% recovery for 100 mg at week 16. Mean TGs and VLDL-C reached nadir earlier (3 wks, −61–65%) without apparent dose response and minimal change for any dose at wk 16. LDL-C nadir occurred 4–6 wks after the second dose (−45–54%), again with minimal evidence for dose response or change through wk 16. HDL-C was reduced 14–37% at wk 16. ARO-ANG3 was well tolerated without serious or severe adverse events or dropouts related to drug. The most common adverse events have been headache and upper respiratory infections.
Conclusions
Genetic deficiency of ANGPTL3 is a cause of familial combined hypolipemia and is associated with a decreased risk of CVD. Using RNAi to selectively suppress ANGPTL3 production reproduces these genetic effects with a duration of at least 12 weeks following a second dose and with good tolerability over 16 wks. ANGPTL3 inhibition results in lowering of LDL-C and TRLs which may confer protection against CVD in patients with atherogenic mixed dyslipidemia.
Funding Acknowledgement
Type of funding source: Private company. Main funding source(s): Arrowhead Pharmaceuticals
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Affiliation(s)
- G.F Watts
- University of Western Australia, Perth, Australia
| | - C Schwabe
- Auckland Clinical Studies, Auckland, New Zealand
| | - R Scott
- Christchurch Diabetes Centre, Division of Endocrinology, Diabetes, and Metabolism, Christchurch, New Zealand
| | - P Gladding
- Auckland City Hospital, Auckland, New Zealand
| | - D Sullivan
- Royal Prince Alfred Hospital, Sydney, Australia
| | - J Baker
- Middlemore Hospital, Auckland, New Zealand
| | - P Clifton
- Royal Adelaide Hospital, Adelaide, Australia
| | - J Hamilton
- Arrowhead Pharmaceuticals, Pasadena, United States of America
| | - B Given
- Arrowhead Pharmaceuticals, Pasadena, United States of America
| | - J San Martin
- Arrowhead Pharmaceuticals, Pasadena, United States of America
| | - S Melquist
- Arrowhead Pharmaceuticals, Pasadena, United States of America
| | - J.W Knowles
- School of Medicine, Stanford, United States of America
| | - I Goldberg
- NYU School of Medicine, NYU Langone Health, New York City, United States of America
| | - R Hegele
- University of Western Ontario, London, Canada
| | - C Ballantyne
- Baylor College of Medicine, Houston, United States of America
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Schwabe C, Scott R, Sullivan D, Baker J, Clifton P, Hamilton J, Given B, San Martin J, Melquist S, Watts G, Goldberg I, Knowles J, Hegele R, Ballantyne C. RNA interference targeting apolipoprotein C-III with ARO-APOC3 in healthy volunteers mimics lipid and lipoprotein findings seen in subjects with inherited apolipoprotein C-III deficiency. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3330] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Individuals with triglycerides (TGs) ≥1,000 mg/dL (11.1 mmol/L) are at increased risk of acute pancreatitis. Genetic studies indicate that individuals with apolipoprotein C-3 (APOC3) loss-of-function mutations have low TGs, reduced cardiovascular risk and no observed adverse phenotype. RNA interference (RNAi) with ARO-APOC3 has shown deep and durable knockdown (KD) of APOC3 after single doses in healthy volunteers (HVs, presented at AHA 2019) with good tolerability. We report here initial results using multiple doses of ARO-APOC3 to silence APOC3 expression in HVs.
Methods
ARO-APOC3 was administered subcutaneously to HVs on days 1 and 29 at doses of 10, 25 or 50 mg (n=4 per group). Measured parameters included plasma concentrations of APOC3, LDL-C, TGs, VLDL-C and HDL-C.
Results
All HVs have received both doses and follow-up for most parameters is available through week (wk) 14 (10 wks after second dose) for the 10 and 25 mg doses and through wk 10 for 50 mg. Mean nadir for APOC3 levels occurred at wk 3 for 10 mg (−73%) and remained similar at wk 10 (−66%), at wk 6 for 25 mg (−90%) with no change at wk 10 and at wk 2 for 50 mg (−94%) unchanged at wk 8. TGs fell faster in the 50 mg group (wk 1: 10 mg −41%; 25 mg −47%; 50 mg −72%). By wk 6 the 25 and 50 mg results were similar (−68% and −74%, respectively) and remained similar through wk 14. 10 mg was less active with a nadir of −56% and mean reductions between 42% and 56% post-nadir. VLDL-C values mirrored TGs. LDL-C reductions were more modest and did not manifest a dose response. Mean nadirs (−23–26%) occurred 4–6 wks after the first dose, again with minimal change through 10–14 wks of follow-up. Consistent with genetic studies, HDL-C increased to a maximum at approximately wk 8 (10 mg +42%, 25 mg +48%, 50 mg +84%). ARO-APOC3 was well tolerated without serious or severe adverse events or dropouts related to drug. The most common adverse events were mild injection site AEs and headache.
Conclusions
Genetic deficiency of APOC3 is associated with substantial reductions in TGs, VLDL-C and increases in HDL-C without an adverse phenotype. Using RNAi to selectively suppress APOC3 production mimics these lipid and lipoprotein effects, with a duration of at least 10 weeks following a second dose and with good tolerability over 16 wks using doses ranging from 10 to 50 mg. Investigation of optimal dosing regimen is ongoing, especially with respect to dosing interval. This therapeutic approach has potential for treating patients with chylomicronemia at risk of pancreatitis.
Funding Acknowledgement
Type of funding source: Private company. Main funding source(s): Arrowhead Pharmaceuticals
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Affiliation(s)
- C Schwabe
- Auckland Clinical Studies, Auckland, New Zealand
| | - R Scott
- Christchurch Diabetes Centre, Diabetes Research Institute, Christchurch, New Zealand
| | - D Sullivan
- Royal Prince Alfred Hospital, Camperdown, New Zealand
| | - J Baker
- Middlemore Hospital, Auckland, New Zealand
| | - P Clifton
- Royal Adelaide Hospital, Adelaide, Australia
| | - J Hamilton
- Arrowhead Pharmaceuticals, Pasadena, United States of America
| | - B Given
- Arrowhead Pharmaceuticals, Pasadena, United States of America
| | - J San Martin
- Arrowhead Pharmaceuticals, Pasadena, United States of America
| | - S Melquist
- Arrowhead Pharmaceuticals, Pasadena, United States of America
| | - G.F Watts
- University of Western Australia, Perth, Australia
| | - I Goldberg
- NYU School of Medicine, NYU Langone Health, Division of Endocrinology, Diabetes, and Metabolism, New York City, United States of America
| | - J.W Knowles
- School of Medicine, Stanford, United States of America
| | - R Hegele
- University of Western Ontario, London, Canada
| | - C Ballantyne
- Baylor College of Medicine, Houston, United States of America
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Trinder M, Paquette M, Cermakova L, Ban M, Hegele R, Mancini GJ, Francis G, Baass A, Brunham L. Modulation of Cardiovascular Risk by Monogenic and Polygenic Determinants of Low-Density Lipoprotein Cholesterol^. J Clin Lipidol 2020. [DOI: 10.1016/j.jacl.2020.05.023] [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]
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Baass A, Paquette M, Bernard S, Cariou B, Genest J, Hegele R, Trinder M, Brunham L, BÃliard S. The Montreal-FH-SCORE Predicts Major Adverse Cardiovascular Events in Multinational Cohorts of Familial Hypercholesterolemia. J Clin Lipidol 2020. [DOI: 10.1016/j.jacl.2020.05.065] [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]
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Lazarte J, Wang J, Robinson J, Dron J, McIntyre A, Cao H, Laksman Z, Hegele R, Roberts J. RARE LOSS-OF-FUNCTION VARIANT ANALYSIS IN LONE ATRIAL FIBRILLATION. Can J Cardiol 2019. [DOI: 10.1016/j.cjca.2019.07.304] [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] Open
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13
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Ueda M, Burke F, Maeda M, McIntyre A, Hegele R, Malloy M, Rader D. Importance of Nutritional Intervention for Infants with Abetalipoproteinemia. J Clin Lipidol 2019. [DOI: 10.1016/j.jacl.2019.04.074] [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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Ueda M, Burke F, Sviridov D, Escobar M, Walters L, Lalic D, Sikora T, Greene H, DerOhannessian S, McIntyre A, deGoma E, Remaley A, Hegele R, Rader D, Dunbar R. OR21-3 Familial Chylomicronemia Syndrome: Distinguishing the Rare Among the Common in Adults for Appropriate Management. J Endocr Soc 2019. [PMCID: PMC6554826 DOI: 10.1210/js.2019-or21-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background: Hypertriglyceridemia (HTG) is common, but familial chylomicronemia syndrome (FCS) is a very rare cause of severe HTG, associated with pancreatitis, which can be fatal. It is due to impaired lipoprotein lipase (LPL) function, typically caused by bi-allelic LPL loss-of-function mutations. Although FCS generally presents in childhood with acute pancreatitis and HTG, it should also be considered as a diagnosis in adults with severe HTG. Unlike polygenic HTG, dietary fat-restriction is the mainstay of treatment in FCS which is critical in preventing pancreatitis since traditional medications are ineffective. Several promising biologics currently under clinical development may provide novel therapeutic approaches in FCS. Clinical Case: 52-year-old fraternal twins and their 55-year-old brother born to consanguineous parents were recruited into an IRB-approved lipid genetic study. LPL activity and genetic analyses were performed to definitively diagnose FCS. Moreover, the twins participated in clinical trials which investigated novel therapies for HTG. The female twin seemed to have had undiagnosed pancreatitis since age 13, and was hospitalized at age 20 with HTG and severe pancreatitis for the first time. The male twin had multiple hospitalizations for pancreatitis and HTG. The older brother also had emergency room visits for pancreatitis. Misguidedly, all siblings had been on low-carbohydrate diet that lead to severe HTG. Their medical and family histories were consistent with FCS. The studies performed identified a previously unreported homozygous LPL variant, c.617T>C, p.V206A, corroborated by reduced LPL activities, and altered molecular dynamics, consistent with dysfunctional LPL and the diagnosis of FCS. A very low-fat diet was prescribed which facilitated in stabilizing their clinical picture with a reduction in TG and pancreatitis episodes. The female twin qualified to enroll in a clinical study for the treatment of HTG, receiving multiple doses of an experimental APOC3 inhibitor, which lowered her TG from 3,447 to 201 mg/dL (~94% reduction) within 90 days which persisted for several months. The result seemed to indicate that inhibiting APOC3 could effectively enhance the residual LPL lipolytic activity and lower TG. In addition, the twins qualified to participate in a double-blinded clinical trial with an experimental ANGPTL3 inhibitor whose results are forthcoming in the near future. Conclusion: Our case demonstrates the importance of elucidating FCS diagnosis even in adults with HTG for selecting the most appropriate therapy. This was the first reported case of this particular homozygous variant causing FCS. Particularly, the clinical trial result was encouraging that novel biologics may become an optional therapy in certain patients with FCS beyond dietary management in the future. Disclosure: permission to present the study result has been obtained.
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Affiliation(s)
- Masako Ueda
- University of Pennsylvania, Philadelphia, PA, United States
| | - Frances Burke
- University of Pennsylvania, Philadelphia, PA, United States
| | - Denis Sviridov
- National Institutes of Health, Bethesda, MD, United States
| | - Maria Escobar
- University of Pennsylvania, Philadelphia, PA, United States
| | - Laura Walters
- University of Pennsylvania, Philadelphia, PA, United States
| | - Dusanka Lalic
- University of Pennsylvania, Philadelphia, PA, United States
| | - Tracey Sikora
- University of Pennsylvania, Philadelphia, PA, United States
| | | | | | | | - Emil deGoma
- Akebia Therapeutics, Cambridge, MA, United States
| | - Alan Remaley
- National Institutes of Health, Bethesda, MD, United States
| | | | - Daniel Rader
- University of Pennsylvania, Philadelphia, PA, United States
| | - Richard Dunbar
- UPenn & Philadelphia VA Medical Center, Philadelphia, PA, United States
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15
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Iacocca M, Wang J, Dron J, Cao H, Robinson J, McIntyre A, Hegele R. DNA copy number variation screening in familial hypercholesterolemia-related genes. Atherosclerosis 2018. [DOI: 10.1016/j.atherosclerosis.2018.06.218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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16
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Ruel I, Aljenedil S, Brophy J, Gaudet D, McCrindle B, Frohlich J, Hegele R, Genest J. Update on the Familial Hypercholesterolemia Canada (FH Canada) Registry. ATHEROSCLEROSIS SUPP 2018. [DOI: 10.1016/j.atherosclerosissup.2018.04.155] [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: 11/26/2022]
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17
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Hegele R, Shah P, DiGioia K, Jurecka A, Blom D. Efficacy of Lomitapide Across the Spectrum of Homozygous Familial Hypercholesterolemia. J Clin Lipidol 2018. [DOI: 10.1016/j.jacl.2018.03.066] [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: 10/17/2022]
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18
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Tomlinson B, Hu M, Chan J, Mcintyre A, Hegele R. Severe hypertriglycerideamia related to a novel mutation in TRIB1 and a known variant in APOA5. Atherosclerosis 2017. [DOI: 10.1016/j.atherosclerosis.2017.06.748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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19
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Corral P, Geller A, Polisecki E, Bañares V, López G, Berg G, Cacciagiú L, Hegele R, Schaefer E, Schreier L. Genetic studies in definite/probable FH in Argentina. Atherosclerosis 2017. [DOI: 10.1016/j.atherosclerosis.2017.06.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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20
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Tomlinson B, Hu M, Chan J, Mcintyre A, Hegele R. Severe familial hypercholesterolaemia in two brothers with three heterozygous coding mutations in LDLR. Atherosclerosis 2017. [DOI: 10.1016/j.atherosclerosis.2017.06.749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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21
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Harvey L, Jordan H, Lemieux P, Lapointe JF, Pop R, Hegele R. A Phase 1, Single-Dose, Comparative Bioavailability Study of CaPre ® , a Novel Omega-3 Drug Candidate, and Lovaza ® Under Fasting and Fed Conditions. J Clin Lipidol 2017. [DOI: 10.1016/j.jacl.2017.04.092] [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: 11/16/2022]
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22
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Ueda M, Burke F, Walters L, Lalic D, Sikora T, Greene H, DerOhannessian S, McIntyre A, deGoma E, Hegele R, Rader D, Dunbar R. Familial Chylomicron Syndrome: Importance of Discerning the Rare Among the Common. J Clin Lipidol 2017. [DOI: 10.1016/j.jacl.2017.04.077] [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: 11/29/2022]
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23
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Frosk P, Arts HH, Philippe J, Gunn CS, Brown EL, Chodirker B, Simard L, Majewski J, Fahiminiya S, Russell C, Liu YP, Hegele R, Katsanis N, Goerz C, Del Bigio MR, Davis EE. A truncating mutation in CEP55 is the likely cause of MARCH, a novel syndrome affecting neuronal mitosis. J Med Genet 2017; 54:490-501. [PMID: 28264986 PMCID: PMC5502313 DOI: 10.1136/jmedgenet-2016-104296] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 11/08/2016] [Accepted: 12/14/2016] [Indexed: 11/17/2022]
Abstract
Background Hydranencephaly is a congenital anomaly leading to replacement of the cerebral hemispheres with a fluid-filled cyst. The goals of this work are to describe a novel autosomal-recessive syndrome that includes hydranencephaly (multinucleated neurons, anhydramnios, renal dysplasia, cerebellar hypoplasia and hydranencephaly (MARCH)); to identify its genetic cause(s) and to provide functional insight into pathomechanism. Methods We used homozygosity mapping and exome sequencing to identify recessive mutations in a single family with three affected fetuses. Immunohistochemistry, RT-PCR and imaging in cell lines, and zebrafish models, were used to explore the function of the gene and the effect of the mutation. Results We identified a homozygous nonsense mutation in CEP55 segregating with MARCH. Testing the effect of this allele on patient-derived cells indicated both a reduction of the overall CEP55 message and the production of a message that likely gives rise to a truncated protein. Suppression or ablation of cep55l in zebrafish embryos recapitulated key features of MARCH, most notably renal dysplasia, cerebellar hypoplasia and craniofacial abnormalities. These phenotypes could be rescued by full-length but not truncated human CEP55 message. Finally, we expressed the truncated form of CEP55 in human cells, where we observed a failure of truncated protein to localise to the midbody, leading to abscission failure and multinucleated daughter cells. Conclusions CEP55 loss of function mutations likely underlie MARCH, a novel multiple congenital anomaly syndrome. This association expands the involvement of centrosomal proteins in human genetic disorders by highlighting a role in midbody function.
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Affiliation(s)
- Patrick Frosk
- Departments of Pediatrics and Child Health, University of Manitoba, Manitoba, Canada.,Departments of Biochemistry and Medical Genetics, University of Manitoba, Manitoba, Canada
| | - Heleen H Arts
- Departments of Biochemistry, University of Western Ontario, London, Ontario, Canada.,Department of Human Genetics, Radboudumc, Nijmegen, The Netherlands
| | - Julien Philippe
- Center for Human Disease Modeling, Duke University Medical Center, Durham, North Carolina, USA
| | - Carter S Gunn
- Center for Human Disease Modeling, Duke University Medical Center, Durham, North Carolina, USA
| | - Emma L Brown
- Departments of Biochemistry, University of Western Ontario, London, Ontario, Canada
| | - Bernard Chodirker
- Departments of Pediatrics and Child Health, University of Manitoba, Manitoba, Canada.,Departments of Biochemistry and Medical Genetics, University of Manitoba, Manitoba, Canada
| | - Louise Simard
- Departments of Biochemistry and Medical Genetics, University of Manitoba, Manitoba, Canada
| | - Jacek Majewski
- McGill University and Genome Quebec Innovation Centre, Montreal, Quebec, Canada
| | - Somayyeh Fahiminiya
- McGill University and Genome Quebec Innovation Centre, Montreal, Quebec, Canada
| | - Chad Russell
- Center for Human Disease Modeling, Duke University Medical Center, Durham, North Carolina, USA
| | - Yangfan P Liu
- Center for Human Disease Modeling, Duke University Medical Center, Durham, North Carolina, USA
| | | | | | - Robert Hegele
- Departments of Biochemistry, University of Western Ontario, London, Ontario, Canada.,Departments of Medicine, University of Western Ontario, London, Ontario, Canada
| | - Nicholas Katsanis
- Center for Human Disease Modeling, Duke University Medical Center, Durham, North Carolina, USA
| | - Conrad Goerz
- Departments of Pathology, University of Manitoba, Manitoba, Canada
| | - Marc R Del Bigio
- Departments of Pathology, University of Manitoba, Manitoba, Canada.,Diagnostic Services Manitoba, Manitoba, Canada
| | - Erica E Davis
- Center for Human Disease Modeling, Duke University Medical Center, Durham, North Carolina, USA
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24
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Ziada A, Hegele R. Management of Very Severe Hypertriglyceridemia With and Without Plasma Exchange. Can J Diabetes 2015. [DOI: 10.1016/j.jcjd.2015.09.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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25
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Badalato L, Farhan SM, Dilliott A, Hegele R, Goobie S. MG-112 A KMT2D mutation segregating in a family presenting with autosomal dominant choanal atresia reinforces the kabuki/charge connexion. J Med Genet 2015. [DOI: 10.1136/jmedgenet-2015-103578.12] [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: 11/03/2022]
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26
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Rickels M, Goeser E, Fuller C, Lord C, Bowler A, Doliba N, Hegele R, Cuchel M. Mutations in abca1 are associated with enhanced beta-cell secretory capacity in humans. Atherosclerosis 2014. [DOI: 10.1016/j.atherosclerosis.2014.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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27
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Singh A, Milne V, Cuchel M, Fisher E, Underberg J, Hegele R. Severe Hypertriglyceridemia and Recurrent Pancreatitis In a Patient With SLE and an Underlying Mutation in the Lipase Maturation Factor-1 Gene*. J Clin Lipidol 2013. [DOI: 10.1016/j.jacl.2013.03.035] [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: 11/17/2022]
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28
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Saxena R, Elbers C, Guo Y, Peter I, Gaunt T, Mega J, Lanktree M, Tare A, Castillo B, Li Y, Johnson T, Bruinenberg M, Gilbert-Diamond D, Rajagopalan R, Voight B, Balasubramanyam A, Barnard J, Bauer F, Baumert J, Bhangale T, Böhm B, Braund P, Burton P, Chandrupatla H, Clarke R, Cooper-DeHoff R, Crook E, Davey-Smith G, Day I, de Boer A, de Groot M, Drenos F, Ferguson J, Fox C, Furlong C, Gibson Q, Gieger C, Gilhuijs-Pederson L, Glessner J, Goel A, Gong Y, Grant S, Grobbee D, Hastie C, Humphries S, Kim C, Kivimaki M, Kleber M, Meisinger C, Kumari M, Langaee T, Lawlor D, Li M, Lobmeyer M, Maitland-van der Zee AH, Meijs M, Molony C, Morrow D, Murugesan G, Musani S, Nelson C, Newhouse S, O'Connell J, Padmanabhan S, Palmen J, Patel S, Pepine C, Pettinger M, Price T, Rafelt S, Ranchalis J, Rasheed A, Rosenthal E, Ruczinski I, Shah S, Shen H, Silbernagel G, Smith E, Spijkerman A, Stanton A, Steffes M, Thorand B, Trip M, van der Harst P, van der A D, van Iperen E, van Setten J, van Vliet-Ostaptchouk J, Verweij N, Wolffenbuttel B, Young T, Zafarmand M, Zmuda J, Boehnke M, Altshuler D, McCarthy M, Kao W, Pankow J, Cappola T, Sever P, Poulter N, Caulfield M, Dominiczak A, Shields D, Bhatt DL, Zhang L, Curtis S, Danesh J, Casas J, van der Schouw Y, Onland-Moret N, Doevendans P, Dorn G, Farrall M, FitzGerald G, Hamsten A, Hegele R, Hingorani A, Hofker M, Huggins G, Illig T, Jarvik G, Johnson J, Klungel O, Knowler W, Koenig W, März W, Meigs J, Melander O, Munroe P, Mitchell B, Bielinski S, Rader D, Reilly M, Rich S, Rotter J, Saleheen D, Samani N, Schadt E, Shuldiner A, Silverstein R, Kottke-Marchant K, Talmud P, Watkins H, Asselbergs FW, de Bakker P, McCaffery J, Wijmenga C, Sabatine M, Wilson J, Reiner A, Bowden D, Hakonarson H, Siscovick D, Keating B. Large-scale gene-centric meta-analysis across 39 studies identifies type 2 diabetes loci. Am J Hum Genet 2012; 90:410-25. [PMID: 22325160 PMCID: PMC3309185 DOI: 10.1016/j.ajhg.2011.12.022] [Citation(s) in RCA: 195] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2011] [Revised: 12/06/2011] [Accepted: 12/31/2011] [Indexed: 01/12/2023] Open
Abstract
To identify genetic factors contributing to type 2 diabetes (T2D), we performed large-scale meta-analyses by using a custom ∼50,000 SNP genotyping array (the ITMAT-Broad-CARe array) with ∼2000 candidate genes in 39 multiethnic population-based studies, case-control studies, and clinical trials totaling 17,418 cases and 70,298 controls. First, meta-analysis of 25 studies comprising 14,073 cases and 57,489 controls of European descent confirmed eight established T2D loci at genome-wide significance. In silico follow-up analysis of putative association signals found in independent genome-wide association studies (including 8,130 cases and 38,987 controls) performed by the DIAGRAM consortium identified a T2D locus at genome-wide significance (GATAD2A/CILP2/PBX4; p = 5.7 × 10(-9)) and two loci exceeding study-wide significance (SREBF1, and TH/INS; p < 2.4 × 10(-6)). Second, meta-analyses of 1,986 cases and 7,695 controls from eight African-American studies identified study-wide-significant (p = 2.4 × 10(-7)) variants in HMGA2 and replicated variants in TCF7L2 (p = 5.1 × 10(-15)). Third, conditional analysis revealed multiple known and novel independent signals within five T2D-associated genes in samples of European ancestry and within HMGA2 in African-American samples. Fourth, a multiethnic meta-analysis of all 39 studies identified T2D-associated variants in BCL2 (p = 2.1 × 10(-8)). Finally, a composite genetic score of SNPs from new and established T2D signals was significantly associated with increased risk of diabetes in African-American, Hispanic, and Asian populations. In summary, large-scale meta-analysis involving a dense gene-centric approach has uncovered additional loci and variants that contribute to T2D risk and suggests substantial overlap of T2D association signals across multiple ethnic groups.
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Affiliation(s)
- Richa Saxena
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA 02114, USA
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02142, USA
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Clara C. Elbers
- Department of Genetics, University of Pennsylvania, School of Medicine, Philadelphia, PA 19104, USA
- Complex Genetics Section, Department of Medical Genetics, University Medical Center Utrecht, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands
| | - Yiran Guo
- Center for Applied Genomics, Abramson Research Center, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
- BGI Shenzhen, Beishan Industrial Zone, Yantian District, Shenzhen 518083, China
| | - Inga Peter
- Department of Genetics and Genomic Sciences, Mount Sinai School of Medicine, New York, NY 10029 USA
| | - Tom R. Gaunt
- Medical Research Council Centre for Causal Analyses in Translational Epidemiology, Department of Social Medicine, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK
| | - Jessica L. Mega
- Thrombolysis in Myocardial Infarction Study Group, Cardiovascular Division, Brigham and Women's Hospital, Boston, MA 021155 USA
| | - Matthew B. Lanktree
- Department of Biochemistry, University of Western Ontario, London, ON N6A 5C1, Canada
| | - Archana Tare
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA 02114, USA
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02142, USA
| | - Berta Almoguera Castillo
- Center for Applied Genomics, Abramson Research Center, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Servicio de Genética Instituto de Investigación Sanitaria-Fundación Jiménez Díaz, Avda. Reyes Católicos 228040, Madrid, Spain
| | - Yun R. Li
- Center for Applied Genomics, Abramson Research Center, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Toby Johnson
- Clinical Pharmacology, Barts and the London Genome Centre, Queen Mary University of London, London EC1M 6BQ, UK
- William Harvey Research Institute, Barts and the London School of Medicine, Queen Mary University of London, London EC1M 6BQ, UK
| | - Marcel Bruinenberg
- LifeLines Cohort Study and Biobank, University Medical Center Groningen, University of Groningen, the Netherlands
| | - Diane Gilbert-Diamond
- Children's Environmental Health and Disease Prevention Center at Dartmouth, Hanover, NH 03755, USA
- Section of Biostatistics and Epidemiology, Department of Community and Family Medicine, Dartmouth Medical School, Hanover, NH 03756, USA
| | | | - Benjamin F. Voight
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA 02114, USA
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02142, USA
| | - Ashok Balasubramanyam
- Translational Metabolism Unit, Division of Diabetes, Endocrinology and Metabolism, Baylor College of Medicine, Houston, TX 77030, USA
| | - John Barnard
- Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Florianne Bauer
- Complex Genetics Section, Department of Medical Genetics, University Medical Center Utrecht, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands
| | - Jens Baumert
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Tushar Bhangale
- Department of Genome Sciences, University of Washington, Seattle, WA 98195, USA
| | - Bernhard O. Böhm
- Cardiology Group Frankfurt-Sachsenhausen, Frankfurt 60598, Germany
| | - Peter S. Braund
- Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, Leicester, LE3 9QP, UK
| | - Paul R. Burton
- Department of Health Sciences, University of Leicester, University Rd, Leicester LE1 7RH, UK
| | - Hareesh R. Chandrupatla
- Cardiovascular Institute, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA
| | - Robert Clarke
- Clinical Trial Service Unit, Richard Doll Building, Old Road Campus, Roosevelt Drive, Oxford OX37LF, UK
| | - Rhonda M. Cooper-DeHoff
- Department of Pharmacotherapy and Translational Research, University of Florida College of Pharmacy, Gainesville, FL 32610, USA
- Division of Cardiovascular Medicine, University of Florida College of Medicine, Gainesville, FL 32610, USA
| | | | - George Davey-Smith
- Medical Research Council Centre for Causal Analyses in Translational Epidemiology, Department of Social Medicine, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK
| | - Ian N. Day
- Medical Research Council Centre for Causal Analyses in Translational Epidemiology, Department of Social Medicine, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK
| | - Anthonius de Boer
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, The Netherlands
| | - Mark C.H. de Groot
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, The Netherlands
| | - Fotios Drenos
- Centre for Cardiovascular Genetics, Department of Medicine, University College London, 5 University Street, London, WC1E 6JF, UK
| | - Jane Ferguson
- Cardiovascular Institute, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA
| | - Caroline S. Fox
- Framingham Heart Study, Boston University School of Medicine, Boston, MA 02118, USA
| | - Clement E. Furlong
- Department of Medicine (Medical Genetics), University of Washington, Seattle, WA 98195, USA
- Department of Genome Sciences, University of Washington, Seattle, WA 98195, USA
| | - Quince Gibson
- Division of Endocrinology, Diabetes and Nutrition, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Christian Gieger
- Institute of Genetic Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Lisa A. Gilhuijs-Pederson
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, The Netherlands
| | - Joseph T. Glessner
- Center for Applied Genomics, Abramson Research Center, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Anuj Goel
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, OX3 7BN, UK
| | - Yan Gong
- Division of Cardiovascular Medicine, University of Florida College of Medicine, Gainesville, FL 32610, USA
| | - Struan F.A. Grant
- Center for Applied Genomics, Abramson Research Center, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Diederick E. Grobbee
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands
| | - Claire Hastie
- British Heart Foundation Glasgow Cardiovascular Research Centre, Division of Cardiovascular and Medical Sciences, Western Infirmary, University of Glasgow, Glasgow G12 8TA, UK
| | - Steve E. Humphries
- Centre for Cardiovascular Genetics, Department of Medicine, University College London, 5 University Street, London, WC1E 6JF, UK
| | - Cecilia E. Kim
- Center for Applied Genomics, Abramson Research Center, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Mika Kivimaki
- Department of Epidemiology and Public Health, University College London, London, UK
- Genetic Epidemiology Group, Department of Epidemiology and Public Health, University College London, London WC1E 6BT, UK
| | - Marcus Kleber
- LURIC Study, Freiburg im Breisgau 79098, Germany
- Synlab Center of Laboratory Diagnostics Heidelberg, Heidelberg 69037, Germany
| | - Christa Meisinger
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Meena Kumari
- Genetic Epidemiology Group, Department of Epidemiology and Public Health, University College London, London WC1E 6BT, UK
| | - Taimour Y. Langaee
- Department of Pharmacotherapy and Translational Research, University of Florida College of Pharmacy, Gainesville, FL 32610, USA
| | - Debbie A. Lawlor
- Medical Research Council Centre for Causal Analyses in Translational Epidemiology, Department of Social Medicine, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK
| | - Mingyao Li
- Cardiovascular Institute, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA
| | - Maximilian T. Lobmeyer
- Division of Cardiovascular Medicine, University of Florida College of Medicine, Gainesville, FL 32610, USA
| | - Anke-Hilse Maitland-van der Zee
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, The Netherlands
| | - Matthijs F.L. Meijs
- Department of Cardiology, Division Heart and Lungs, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Cliona M. Molony
- Department of Genetics, Rosetta Inpharmatics, Seattle, WA 98109, USA
| | - David A. Morrow
- Thrombolysis in Myocardial Infarction Study Group, Cardiovascular Division, Brigham and Women's Hospital, Boston, MA 021155 USA
| | - Gurunathan Murugesan
- Department of Clinical Pathology, Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH 44106, USA
| | - Solomon K. Musani
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Christopher P. Nelson
- Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, Leicester, LE3 9QP, UK
| | - Stephen J. Newhouse
- Clinical Pharmacology, Barts and the London Genome Centre, Queen Mary University of London, London EC1M 6BQ, UK
- William Harvey Research Institute, Barts and the London School of Medicine, Queen Mary University of London, London EC1M 6BQ, UK
| | - Jeffery R. O'Connell
- Division of Endocrinology, Diabetes and Nutrition, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Sandosh Padmanabhan
- British Heart Foundation Glasgow Cardiovascular Research Centre, Division of Cardiovascular and Medical Sciences, Western Infirmary, University of Glasgow, Glasgow G12 8TA, UK
| | - Jutta Palmen
- Centre for Cardiovascular Genetics, Department of Medicine, University College London, 5 University Street, London, WC1E 6JF, UK
| | - Sanjey R. Patel
- Division of Sleep Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Carl J. Pepine
- Division of Cardiovascular Medicine, University of Florida College of Medicine, Gainesville, FL 32610, USA
| | - Mary Pettinger
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Thomas S. Price
- Medical Research Council Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London WC2R 2LS, UK
| | - Suzanne Rafelt
- Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, Leicester, LE3 9QP, UK
| | - Jane Ranchalis
- Department of Medicine (Medical Genetics), University of Washington, Seattle, WA 98195, USA
| | - Asif Rasheed
- Center for Non-Communicable Diseases, Karachi, Pakistan
| | - Elisabeth Rosenthal
- Department of Medicine (Medical Genetics), University of Washington, Seattle, WA 98195, USA
| | - Ingo Ruczinski
- Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Sonia Shah
- University College Genetics Institute, University College London, 5 University St London, WC1E 6BT, UK
| | - Haiqing Shen
- Division of Endocrinology, Diabetes and Nutrition, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Günther Silbernagel
- Division of Endocrinology, Diabetology, Nephrology, Vascular Disease, and Clinical Chemistry, Department of Internal Medicine, Eberhard-Karls-University Tübingen, Tübingen 72074, Germany
| | | | | | - Alice Stanton
- Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Michael W. Steffes
- Department of Laboratory Medicine and Pathology, Medical School, University of Minnesota, Minneapolis, MN 55455, USA
| | - Barbara Thorand
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Mieke Trip
- Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands
| | - Pim van der Harst
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Genetics, University Medical Center Groningen and Groningen University, 9700 RB Groningen, The Netherlands
| | - Daphne L. van der A
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | | | - Jessica van Setten
- Department of Medical Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jana V. van Vliet-Ostaptchouk
- Molecular Genetics, Department of Pathology and Medical Biology, University Medical Center Groningen and University of Groningen, The Netherlands
- Department of Endocrinology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Niek Verweij
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Bruce H.R. Wolffenbuttel
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Taylor Young
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02142, USA
| | - M. Hadi Zafarmand
- Department of Cardiology, Division Heart and Lungs, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Joseph M. Zmuda
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto St, Pittsburgh, PA 15261, USA
| | | | | | - Michael Boehnke
- Center for Statistical Genetics, Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA
| | - David Altshuler
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA 02114, USA
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02142, USA
- Department of Medicine, Harvard Medical School, Boston, MA, 02115, USA
- Department of Genetics, Harvard Medical School, Boston, MA 02115, USA
| | - Mark McCarthy
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, OX3 7BN, UK
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford OX3 7LJ, UK
| | - W.H. Linda Kao
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21287, USA
| | - James S. Pankow
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55454, USA
| | - Thomas P. Cappola
- Cardiovascular Institute, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA
| | - Peter Sever
- International Centre for Circulatory Health, Imperial College London, London W2 1PG, UK
| | - Neil Poulter
- International Centre for Circulatory Health, Imperial College London, London W2 1PG, UK
| | - Mark Caulfield
- Clinical Pharmacology, Barts and the London Genome Centre, Queen Mary University of London, London EC1M 6BQ, UK
- William Harvey Research Institute, Barts and the London School of Medicine, Queen Mary University of London, London EC1M 6BQ, UK
| | - Anna Dominiczak
- British Heart Foundation Glasgow Cardiovascular Research Centre, Division of Cardiovascular and Medical Sciences, Western Infirmary, University of Glasgow, Glasgow G12 8TA, UK
| | - Denis C. Shields
- Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin 4, Ireland
| | | | - Li Zhang
- Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Sean P. Curtis
- Merck Research Laboratories, P.O. Box 2000, Rahway, NJ 07065, USA
| | - John Danesh
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, CB1 8RN, UK
| | - Juan P. Casas
- Department of Epidemiology and Public Health, University College London, London, UK
- Department of Non-communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Yvonne T. van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands
| | - N. Charlotte Onland-Moret
- Complex Genetics Section, Department of Medical Genetics, University Medical Center Utrecht, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands
| | - Pieter A. Doevendans
- Department of Cardiology, Division Heart and Lungs, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Gerald W. Dorn
- Washington University Center for Pharmacogenetics, 660 S. Euclid Ave, Campus Box 8220, St. Louis, MO 63110, USA
| | - Martin Farrall
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, OX3 7BN, UK
- Department of Cardiovascular Medicine, University of Oxford, Level 6 West Wing, John Radcliffe Hospital, Headley Way, Headington, Oxford OX3 9DU, UK
| | - Garret A. FitzGerald
- The Institute for Translational Medicine and Therapeutics, School of Medicine, University of Pennsylvania, Philadelphia, PA 19146, USA
| | - Anders Hamsten
- Cardiovascular Genetics Group, Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, SE-17176 Stockholm, Sweden
| | - Robert Hegele
- Department of Biochemistry, University of Western Ontario, London, ON N6A 5C1, Canada
| | - Aroon D. Hingorani
- Centre for Clinical Pharmacology, Department of Medicine, University College London, London WC1E 6JF, UK
| | - Marten H. Hofker
- University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Gordon S. Huggins
- Molecular Cardiology Research Institute, Center for Translational Genomics, Tufts Medical Center and Tufts University, Boston, MA 02114, USA
| | - Thomas Illig
- Institute of Genetic Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- Hannover Unified Biobank, Hannover Medical School, 30625 Hannover, Germany
| | - Gail P. Jarvik
- Department of Medicine (Medical Genetics), University of Washington, Seattle, WA 98195, USA
| | - Julie A. Johnson
- Department of Pharmacotherapy and Translational Research, University of Florida College of Pharmacy, Gainesville, FL 32610, USA
- Division of Cardiovascular Medicine, University of Florida College of Medicine, Gainesville, FL 32610, USA
| | - Olaf H. Klungel
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, The Netherlands
| | - William C. Knowler
- National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ 85104, USA
| | - Wolfgang Koenig
- Department of Internal Medicine II-Cardiology, University of Ulm Medical Center, Ulm, Germany
| | - Winfried März
- Synlab Center of Laboratory Diagnostics Heidelberg, Heidelberg 69037, Germany
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, University of Heidelberg D-68167 Mannheim, Germany
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, 8010 Graz, Austria
| | - James B. Meigs
- Department of Medicine, Harvard Medical School, Boston, MA, 02115, USA
- General Medicine Division, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Olle Melander
- Clinical Research Center, Malmö University Hospital, Malmö SE-205 02, Sweden
| | - Patricia B. Munroe
- Clinical Pharmacology, Barts and the London Genome Centre, Queen Mary University of London, London EC1M 6BQ, UK
- William Harvey Research Institute, Barts and the London School of Medicine, Queen Mary University of London, London EC1M 6BQ, UK
| | - Braxton D. Mitchell
- Division of Endocrinology, Diabetes and Nutrition, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Susan J. Bielinski
- Division of Epidemiology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA
| | - Daniel J. Rader
- Cardiovascular Institute, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA
| | - Muredach P. Reilly
- Cardiovascular Institute, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA
| | - Stephen S. Rich
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA 22902, USA
| | - Jerome I. Rotter
- Medical Genetics Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Danish Saleheen
- Center for Non-Communicable Diseases, Karachi, Pakistan
- Merck Research Laboratories, P.O. Box 2000, Rahway, NJ 07065, USA
| | - Nilesh J. Samani
- Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, Leicester, LE3 9QP, UK
| | | | - Alan R. Shuldiner
- Division of Endocrinology, Diabetes and Nutrition, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Roy Silverstein
- Department of Cell Biology, Lerner Research Institute, Cleveland Clinic Foundation, Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, 9500 Euclid Avenue Cleveland, OH 44195, USA
| | | | - Philippa J. Talmud
- Centre for Cardiovascular Genetics, Department of Medicine, University College London, 5 University Street, London, WC1E 6JF, UK
| | - Hugh Watkins
- Washington University Center for Pharmacogenetics, 660 S. Euclid Ave, Campus Box 8220, St. Louis, MO 63110, USA
| | - Folkert W. Asselbergs
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands
- Department of Cardiology, Division Heart and Lungs, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Medical Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Paul I.W. de Bakker
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02142, USA
- Complex Genetics Section, Department of Medical Genetics, University Medical Center Utrecht, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands
- Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Jeanne McCaffery
- Weight Control and Diabetes Research Center, The Miriam Hospital and Warren Alpert School of Medicine at Brown University, Providence, RI 02906, USA
| | - Cisca Wijmenga
- Department of Genetics, University Medical Center Groningen and Groningen University, 9700 RB Groningen, The Netherlands
| | - Marc S. Sabatine
- Thrombolysis in Myocardial Infarction Study Group, Cardiovascular Division, Brigham and Women's Hospital, Boston, MA 021155 USA
| | - James G. Wilson
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Alex Reiner
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Donald W. Bowden
- Center for Human Genomics, Wake Forest University School of Medicine, Winston-Salem, NC 27106, USA
| | - Hakon Hakonarson
- Center for Applied Genomics, Abramson Research Center, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Division of Human Genetics, Abramson Research Center, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA
| | - David S. Siscovick
- Cardiovascular Health Research Unit, Departments of Medicine and Epidemiology, University of Washington, Seattle, WA 98101, USA
| | - Brendan J. Keating
- Center for Applied Genomics, Abramson Research Center, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Division of Human Genetics, Abramson Research Center, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA
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Al Riyami N, Al-Ali AM, Al-Sarraf AJ, Hill J, Sachs-Barrable K, Hegele R, Wasan KM, Frohlich J. Hepatic lipase deficiency in a Middle-Eastern-Arabic male. BMJ Case Rep 2010; 2010:2010/nov11_1/bcr1220092589. [PMID: 22798447 DOI: 10.1136/bcr.12.2009.2589] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Hepatic lipase (HL) deficiency is a rare genetic disorder that has been associated with premature atherosclerosis despite high plasma high-density lipoprotein (HDL) cholesterol concentrations in the affected individuals. The authors describe the clinical and biochemical features of HL deficiency in a young male of Middle-Eastern-Arabic origin. This is the first report of cholesterol ester transfer protein (CETP) activity and mass in HL deficiency in a patient from this ethnic group. While the CETP mass was high, its activity was low, a discrepancy likely due to the abnormal composition of patient's HDL particles.
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Affiliation(s)
- Nafila Al Riyami
- Department of Medical Biochemistry, Sultan Qaboos University Hospital, Muscat, Oman
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Soran H, Charlton-Menys V, Hegele R, Wang J, Benbow EW, Roberts I, Wood G, Durrington P. Proteinuria and severe mixed dyslipidemia associated with a novel APOAV gene mutation. J Clin Lipidol 2010; 4:310-3. [PMID: 21122665 DOI: 10.1016/j.jacl.2010.06.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2009] [Revised: 06/07/2010] [Accepted: 06/26/2010] [Indexed: 11/30/2022]
Affiliation(s)
- Handrean Soran
- Cardiovascular Research Group, School of Clinical & Laboratory Sciences, University of Manchester, Core Technology Facility (3(rd) Floor), 46 Grafton Street, Manchester M139NT, United Kingdom
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Al-Riyami NB, Al Ali AM, Al-Sarraf AJ, Hill J, Hegele R, Sachs-Barrable K, Wasan KM, Frohlich J. Hepatic Lipase Deficiency in a Middle-Eastern/Arabic Male∗. J Clin Lipidol 2010. [DOI: 10.1016/j.jacl.2010.03.065] [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: 10/19/2022]
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Mulvihill E, Allister E, Sutherland B, Hegele R, Huff M. Abstract: 136 NARINGENIN PREVENTS THE DYSLIPIDEMIA, APOB OVERPRODUCTION AND HYPERINSULINEMIA IN LDL-RECEPTOR NULL MICE WITH DIET-INDUCED INSULIN RESISTANCE. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)70061-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ronald J, Chen Y, Bernas L, Hegele R, Rogers K, Rutt B. IC‐P1‐049: Direct visualization of β‐amyloid plaques in hypercholesterolemic rabbits using clinical field‐strength magnetic resonance imaging. Alzheimers Dement 2008. [DOI: 10.1016/j.jalz.2008.05.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
| | | | | | | | - Kem Rogers
- University of Western OntarioLondonONCanada
| | - Brian Rutt
- Robarts Research InstituteLondonONCanada
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Chen Y, Ronald J, Hegele R, Rogers K, Rutt B. P1‐006: Accumulation of β‐amyloid plaques with microglial phagocytosis in rabbits fed with cholesterol‐enriched diets. Alzheimers Dement 2008. [DOI: 10.1016/j.jalz.2008.05.591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
| | | | | | - Kem Rogers
- University of Western OntarioLondonONCanada
| | - Brian Rutt
- Robarts Research InstituteLondonONCanada
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Ronald J, Chen Y, Bernas L, Hegele R, Rogers K, Rutt B. P1‐283: Direct visualization of β‐amyloid plaques in hypercholesterolemic rabbits using clinical field‐strength magnetic resonance imaging. Alzheimers Dement 2008. [DOI: 10.1016/j.jalz.2008.05.873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
| | | | | | | | - Kem Rogers
- University of Western OntarioLondonONCanada
| | - Brian Rutt
- Robarts Research InstituteLondonONCanada
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Alghofaili K, Hegele R, Sullivan D, Frohlich J. COMPLETE APO AI DEFICIENCY IN A FAMILY FROM IRAQ. ATHEROSCLEROSIS SUPP 2008. [DOI: 10.1016/s1567-5688(08)70451-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Lanktree M, Robinson J, Creider J, Cao H, Carter D, Horsch D, Hegele R. A genome-wide linkage scan for familial partial lipodystrophy susceptibility genes in a German kindreds. CLIN INVEST MED 2007. [DOI: 10.25011/cim.v30i4.2861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background: In Dunnigan-type familial partial lipodystrophy (FPLD) patients are born with normal fat distribution, but subcutaneous fat from extremities and gluteal regions are lost during puberty. The abnormal fat distribution leads to the development of metabolic syndrome (MetS), a cluster of phenotypes including hyperglycemia, dyslipidemia, hypertension, and visceral obesity. The study of FPLD as a monogenic model of MetS may uncover genetic risk factors of the common MetS which affects ~30% of adult North Americans. Two molecular forms of FPLD have been identified including FPLD2, resulting from heterozygous mutations in the LMNA gene, and FPLD3, resulting from both heterozygous dominant negative and haploinsufficiency mutations in the PPARG gene. However, many patients with clinically diagnosed FPLD have no mutation in either LMNA or PPARG, suggesting the involvement of additional genes in FPLD etiology.
Methods: Here, we report the results of an Affymetrix 10K GeneChip microarray genome-wide linkage analysis study of a German kindred displaying the FPLD phenotype and no known lipodystrophy-causing mutations.
Results: The investigation identified three chromosomal loci, namely 1q, 3p, and 9q, with non-parametric logarithm of odds (NPL) scores >2.7. While not meeting the criteria for genome-wide significance, it is interesting to note that the 1q and 3p peaks contain the LMNA and PPARG genes respectively.
Conclusions: Three possible conclusions can be drawn from these results: 1) the peaks identified are spurious findings, 2) additional genes physically close to LMNA, PPARG, or within 9q, are involved in FPLD etiology, or 3) alternative disease causing mechanisms not identified by standard exon sequencing approaches, such as promoter mutations, alternative splicing, or epigenetics, are also responsible for FPLD.
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Martinez LRC, Miname M, Rochitte CE, Coimbra SR, da Luz PL, Schaefer E, Hegele R, dos Santos Filho RD. L 032 EVALUATION OF SUBCLINICAL CORONARY ATHEROSCLEROSIS AND ENDOTHELIAL FUNCTION IN A FAMILY WITH HYPOALPHALIPOPROTEINEMIA DUE TO A RARE MUTATION IN THE APOLIPOPROTEIN A-I GENE (Q[-2]X). ATHEROSCLEROSIS SUPP 2007. [DOI: 10.1016/s1567-5688(07)71976-1] [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: 11/25/2022]
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Abstract
Atherosclerosis is a complex disease with various intermediate phenotypes that are themselves complex and influenced by many factors. Through the use of carotid ultrasound techniques, the intermediate stages of vascular disease can be imaged and studied for association with potential genetic determinants. In this article we review the most recent available data (reports published since 2004) on the genetic determinants of atherosclerosis, as measured by one-, two-, and three-dimensional ultrasonography of the carotid arteries. In general, associations are disparate and modest. For intima-media thickness, promising associations have been found for both TNFRSF1A R92Q and PPARG P12A, but associations also differed in the same individuals depending on the specific ultrasound trait studied (eg, linear intima-media thickness versus total plaque volume in carotid arteries). Some of the challenging issues for future studies include accounting for gene-environment interactions, sex-specific associations, and the distinctiveness of different carotid ultrasound measures.
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Affiliation(s)
- Rebecca L Pollex
- Blackburn Cardiovascular Genetics Laboratory, Robarts Research Institute, 100 Perth Drive, London, Ontario, Canada
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Whitfield A, Crawford G, Robertson K, Barrett P, Hegele R, Tran K, Yao Z, van Bockxmeer F, Burnett J. W13.340 A novel non-truncating APOB gene mutation, L343V, causes familial hypobetalipoproteinaemia. ATHEROSCLEROSIS SUPP 2004. [DOI: 10.1016/s1567-5688(04)90339-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Deschênes D, Acharfi S, Pouliot V, Hegele R, Krahn A, Daleau P, Chahine M. Biophysical characteristics of a new mutation on the KCNQ1 potassium channel (L251P) causing long QT syndrome. Can J Physiol Pharmacol 2003; 81:129-34. [PMID: 12710526 DOI: 10.1139/y02-162] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The congenital long QT syndrome (LQTS) is a hereditary cardiac disease characterized by prolonged ventricular repolarization, syncope, and sudden death. Mutations causing LQTS have been identified in various genes that encode for ionic channels or their regulatory subunits. Several of these mutations have been reported on the KCNQ1 gene encoding for a potassium channel or its regulatory subunit (KCNE1). In this study, we report the biophysical characteristics of a new mutation (L251P) in the transmembrane segment 5 (S5) of the KCNQ1 potassium channel. Potassium currents were recorded from CHO cells transfected with either wild type or mutant KCNQ1 in the presence or in the absence of its regulatory subunit (KCNE1), using the whole-cell configuration of the patch clamp technique. Wild-type KCNQ1 current amplitudes are increased particularly by KCNE1 co-expression but no current is observed with the KCNQ1 (L251P) mutant either in the presence or in the absence of KCNE1. Coexpressing KCNE1 with equal amount of cDNAs encoding wild type and mutant KCNQ1 results in an 11-fold reduction in the amplitude of potassium currents. The kinetics of activation and inactivation and the activation curve are minimally affected by this mutation. Our results suggest that the dominant negative effect of the P251L mutation on KCNQ1 channel explains the prolonged repolarization in patients carrying this mutation.
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Affiliation(s)
- Dominic Deschênes
- Laval University, Faculty of Medicine, Sainte-Foy, QC G1K 7P4, Canada
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Harris SB, Zinman B, Hanley A, Gittelsohn J, Hegele R, Connelly PW, Shah B, Hux JE. The impact of diabetes on cardiovascular risk factors and outcomes in a native Canadian population. Diabetes Res Clin Pract 2002; 55:165-73. [PMID: 11796183 DOI: 10.1016/s0168-8227(01)00316-3] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We measured cardiovascular disease (CVD) risk factors and their relationship to glucose intolerance in a Native Canadian population with very high rates of Type 2 diabetes mellitus. Five hundred and twenty five study-eligible Ojibwa-Cree individuals age 18 and over in the community of Sandy Lake, Canada who had participated in a population-based survey were studied. Diabetes status, plasma concentrations of total cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-C), calculated low density lipoprotein-cholesterol (LDL-C), waist/hip ratio (WHR), BMI, systolic and diastolic BP, and history of smoking were compared to a standard national population. Extremely high rates of obesity (BMI and WHR) were identified in the study population and were associated with increasing glucose intolerance for both males and females. Rates of smoking exceeded 70 and 80% in females and males, respectively. Interestingly, despite obesity individuals who had normal glucose tolerance had significantly lower rates of high risk TC, TG, LDL-C, and HDL-C levels compared to a national Canadian population survey. However, with worsening glucose intolerance, TC, TG, LDL-C and HDL-C dramatically deteriorated in comparison to nationally published levels. These changes in cardiovascular risk factors, as a consequence of diabetes, appear to result in increased clinical outcomes. Admission to hospital for Ischemic Heart Disease (IHD) for Sandy Lake residents increased from a rate of 34.8/10,000 to 109.1/10,000 in 15 years. Although this and similar populations have historically reported low rates of CVD, the impact of diabetes on lipid risk factor is having devastating consequences on cardiovascular outcomes. This trend is expected to continue unless the high rates of diabetes can be modified.
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Affiliation(s)
- Stewart B Harris
- Department of Family Medicine, Department of Biostatistics and Epidemiology, The University of Western Ontario, London, Ont., Canada
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Hunninghake GW, Zimmerman MB, Schwartz DA, King TE, Lynch J, Hegele R, Waldron J, Colby T, Müller N, Lynch D, Galvin J, Gross B, Hogg J, Toews G, Helmers R, Cooper JA, Baughman R, Strange C, Millard M. Utility of a lung biopsy for the diagnosis of idiopathic pulmonary fibrosis. Am J Respir Crit Care Med 2001; 164:193-6. [PMID: 11463586 DOI: 10.1164/ajrccm.164.2.2101090] [Citation(s) in RCA: 420] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
It is not known if a surgical lung biopsy is necessary in all patients for the diagnosis of idiopathic pulmonary fibrosis (IPF). We conducted a blinded, prospective study at eight referring centers. Initially, cases were evaluated by clinical history and examination, transbronchial biopsy, and high-resolution lung computed tomography scans. Pulmonologists at the referring centers then assessed their certainty of the diagnosis of IPF and provided an overall diagnosis, before surgical lung biopsy. The lung biopsies were reviewed by a pathology core and 54 of 91 patients received a pathologic diagnosis of IPF. The positive predictive value of a confident (certain) clinical diagnosis of IPF by the referring centers was 80%. The positive predictive value of a confident clinical diagnosis was higher, when the cases were reviewed by a core of pulmonologists (87%) or radiologists (96%). Lung biopsy was most important for diagnosis in those patients with an uncertain diagnosis and those thought unlikely to have IPF. These studies suggest that clinical and radiologic data that result in a confident diagnosis of IPF by an experienced pulmonologist or radiologist are sufficient to obviate the need for a lung biopsy. Lung biopsy is most helpful when clinical and radiologic data result in an uncertain diagnosis or when patients are thought not to have IPF.
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Affiliation(s)
- G W Hunninghake
- Department of Medicine, University of Iowa and Veterans Affairs Medical Center, Iowa City, IA 52242, USA.
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Ma P, Hegele R, Yale J, Schwartz B. CAVEAT: A comparison of cerivastatin 0.4 mg and 0.8 mg with atorvastatin 10 mg and 20 mg in patients with combined (type IIB) dyslipidaemia. ATHEROSCLEROSIS SUPP 2001. [DOI: 10.1016/s1567-5688(01)80058-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Spence J, Sarquella-Brugada G, Zhao G, Brugada R, Marian A, Hegele R, Freeman D, Malinow M. 1.P.312 Homocyst(e)ine level but not MTHFR genotype predicts carotid atherosclerosis. Atherosclerosis 1997. [DOI: 10.1016/s0021-9150(97)88491-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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49
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Spence J, Sarquella-Brugada G, Zhao G, Brugada R, Marian A, Hegele R, Freeman D, Malinow M. 4-07-49 Homocyst(e)ine level predicts carotid plaque better than MTHFR genotype. J Neurol Sci 1997. [DOI: 10.1016/s0022-510x(97)85957-6] [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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Bai TR, Zhou D, Weir T, Walker B, Hegele R, Hayashi S, McKay K, Bondy GP, Fong T. Substance P (NK1)- and neurokinin A (NK2)-receptor gene expression in inflammatory airway diseases. Am J Physiol 1995; 269:L309-17. [PMID: 7573463 DOI: 10.1152/ajplung.1995.269.3.l309] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The tachykinin neuropeptides substance P and neurokinin (NK) A have been postulated to participate in the inflammatory reaction in airways of smokers and asthmatics. We have examined the hypothesis that the expression of one or more of the three cloned tachykinin receptors (NK1, NK2, and NK3) is increased in inflammatory airway disorders, which could result in augmentation of the effect of released tachykinin neuropeptides. NK1 receptor and NK2 receptor but not NK3-receptor mRNA were detected by ribonuclease protection assay in RNA from both cartilaginous and membranous bronchi and subpleural lung. In lung samples containing membranous airways, NK2-receptor mRNA expression was increased fourfold in asthmatics compared with nonsmoking controls, whereas NK1-receptor mRNA levels were similar in the two groups. NK1- and NK2-receptor mRNA expression was increased twofold in smokers without airflow obstruction compared with nonsmokers, whereas NK1-receptor mRNA expression was significantly lower in patients with chronic obstructive pulmonary disease compared with smoking controls. In situ hybridization indicated NK1-receptor mRNA was expressed in submucosal glands and airway epithelial cells, whereas NK2-receptor and NK3-receptor mRNA were not detected. These observations have implications for the pathophysiology and treatment of both asthma and tobacco smoke-induced airway inflammation.
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Affiliation(s)
- T R Bai
- University of British Columbia Pulmonary Research Laboratory, St. Paul's Hospital, Vancouver
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