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Dabiri S, Ramírez Ruiz MI, Jean-Louis G, Ntekim OE, Obisesan TO, Campbell AL, Mwendwa DT. The Mediating Role of Inflammation in the Relationship Between α-Synuclein and Cognitive Functioning. J Gerontol A Biol Sci Med Sci 2023; 78:206-212. [PMID: 36269624 DOI: 10.1093/gerona/glac217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Indexed: 11/13/2022] Open
Abstract
Accumulating evidence suggests that α-synuclein plays a role in the pathophysiology of Alzheimer's disease (AD). This study examined whether α-synuclein level in cerebrospinal fluid (CSF) was associated with cognitive functioning among older adults. We also explored whether this relationship was mediated by proinflammatory cytokines TNF-α and IL-6, along with sIL-6R and vascular endothelial growth factor (VEGF). Using a cross-sectional Alzheimer's Disease Neuroimaging Initiative (ADNI; N = 148) sample, we examined the relationship between α-synuclein and participants' performance on Mini-Mental State Examination (MMSE) and Alzheimer's Disease Assessment Scale Cognitive Subscale (ADAS-Cog 13) at baseline. Mediation analyses were utilized, adjusting for age, education, APOEe4, and Geriatric Depression Scale scores. All biological markers were measured in CSF. Participants in the current sample were 58.3% males, 41.7% females, and Caucasian (95.5%); their average education and age were 15.5 (standard deviation [SD] = 2.97) and 74.4 (SD = 7.51) years, respectively. Higher accumulation of α-synuclein was associated with poorer MMSE scores (β = -0.41, standard error [SE] = 1.54, p < .001). This relationship appeared to be mediated by VEGF (β = 0.27, SE = 2.15, p = .025) and IL-6r (β = 0.22, SE = 1.66, p < .026). In addition, α-synuclein was associated with poorer performance on the ADAS-Cog 13 (β = 0.34, p = .005) and mediated by VEGF (β = -0.19, SE = 4.13, p = .025) after adjusting for age, education, APOEe4, and depressive symptoms. α-Synuclein may serve as an additional biomarker for determining poor cognitive functioning. VEGF and IL-6 soluble receptors were significant mediators of the relationship between α-synuclein and cognitive functioning. If confirmed in prospective analyses, these findings can further inform the pathologic cascade and early diagnosis of AD.
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Affiliation(s)
- Sanaz Dabiri
- Department of Psychology, Howard University, Washington, District of Columbia, Washington, DC, USA
| | - Mara I Ramírez Ruiz
- Department of Psychology, Howard University, Washington, District of Columbia, Washington, DC, USA
| | - Girardin Jean-Louis
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Oyonumo E Ntekim
- Department of Graduate Nutritional Sciences, Howard University, Washington, District of Columbia, Washington, DC, USA
| | - Thomas O Obisesan
- Division of Geriatrics, Department of Medicine, Howard University Hospital, Washington, District of Columbia, Washington, DC, USA
| | - Alfonso L Campbell
- Department of Psychology, Howard University, Washington, District of Columbia, Washington, DC, USA
| | - Denée T Mwendwa
- Department of Psychology, Howard University, Washington, District of Columbia, Washington, DC, USA
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Fungwe TV, Ngwa JS, Johnson SP, Turner JV, Ramirez Ruiz MI, Ogunlana OO, Bedada FB, Nadarajah S, Ntekim OE, Obisesan TO. Systolic Blood Pressure Is Associated with Increased Brain Amyloid Load in Mild Cognitively Impaired Participants: Alzheimer's Disease Neuroimaging Initiatives Study. Dement Geriatr Cogn Disord 2023; 52:39-46. [PMID: 36808103 PMCID: PMC10219843 DOI: 10.1159/000528117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 11/13/2022] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Cardiovascular disease (CVD), including elevated blood pressure (BP), is known to promote Alzheimer's disease (AD) risk. Although brain amyloid load is a recognized hallmark of pre-symptomatic AD, its relationship to increased BP is less known. The objective of this study was to examine the relationship of BP to brain estimates of amyloid-β (Aβ) and standard uptake ratio (SUVr). We hypothesized that increased BP is associated with increased SUVr. METHODS Using data from the Alzheimer's Disease Neuroimaging Initiative (ADNI), we stratified BP according to the Seventh Joint National Committee (JNC) on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure Classification (JNC VII). Florbetapir (AV-45) SUVr was derived from the averaged frontal, anterior cingulate, precuneus, and parietal cortex relative to the cerebellum. A linear mixed-effects model enabled the elucidation of amyloid SUVr relationships to BP. The model discounted the effects of demographics, biologics, and diagnosis at baseline within APOE genotype groups. The least squares means procedure was used to estimate the fixed-effect means. All analyses were performed using the Statistical Analysis System (SAS). RESULTS In non-ɛ4 carrier MCI subjects, escalating JNC categories of BP was associated with increasing mean SUVr using JNC-4 as a reference point (low-normal (JNC1) p = 0.018; normal (JNC-1) p = 0.039; JNC-2 p = 0.018 and JNC-3 p = 0.04). A significantly higher brain SUVr was associated with increasing BP despite adjustment for demographics and biological variables in non-ɛ4 carriers but not in ɛ4-carriers. This observation supports the view that CVD risk may promote increased brain amyloid load, and potentially, amyloid-mediated cognitive decline. CONCLUSION Increasing levels of JNC classification of BP is dynamically associated with significant changes in brain amyloid burden in non-ɛ4 carriers but not in ɛ4-carrier MCI subjects. Though not statistically significant, amyloid burden tended to decrease with increasing BP in ɛ4 homozygote, perhaps motivated by increased vascular resistance and the need for higher brain perfusion pressure.
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Affiliation(s)
- Thomas V. Fungwe
- Department of Nutritional Sciences, College of Nursing and Allied Health Sciences, Howard University
| | - Julius S. Ngwa
- Division of Cardiology, Department of Medicine, Howard University
| | - Steven P. Johnson
- Division of Geriatrics, Department of Internal Medicine, Howard University Hospital
| | - Jilian V. Turner
- Division of Geriatrics, Department of Internal Medicine, Howard University Hospital
| | - Mara I. Ramirez Ruiz
- Division of Geriatrics, Department of Internal Medicine, Howard University Hospital
| | | | - Fikru B Bedada
- Department of Clinical Laboratory Sciences, College of Nursing and Allied Health Sciences, Howard University
| | - Sheeba Nadarajah
- Department of Nursing, College of Nursing and Allied Health Sciences, Howard University
| | - Oyonumo E. Ntekim
- Department of Nutritional Sciences, College of Nursing and Allied Health Sciences, Howard University
| | - Thomas O. Obisesan
- Division of Geriatrics, Department of Internal Medicine, Howard University Hospital
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Largent EA, Walter S, Childs N, Dacks PA, Dodge S, Florian H, Jackson J, Guerra JJL, Iturriaga E, Miller DS, Moreno M, Nosheny RL, Obisesan TO, Portacolone E, Siddiqi B, Silverberg N, Warren RC, Welsh-Bohmer KA, Edelmayer RM. Putting participants and study partners FIRST when clinical trials end early. Alzheimers Dement 2022; 18:2736-2746. [PMID: 35917209 PMCID: PMC9926498 DOI: 10.1002/alz.12732] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 05/19/2022] [Accepted: 06/10/2022] [Indexed: 01/31/2023]
Abstract
Between 2018 and 2019, multiple clinical trials ended earlier than planned, resulting in calls to improve communication with and support for participants and their study partners ("dyads"). The multidisciplinary Participant Follow-Up Improvement in Research Studies and Trials (Participant FIRST) Work Group met throughout 2021. Its goals were to identify best practices for communicating with and supporting dyads affected by early trial stoppage. The Participant FIRST Work Group identified 17 key recommendations spanning the pre-trial, mid-trial, and post-trial periods. These focus on prospectively allocating sufficient resources for orderly closeout; developing dyad-centered communication plans; helping dyads build and maintain support networks; and, if a trial stops, informing dyads rapidly. Participants and study partners invest time, effort, and hope in their research participation. The research community should take intentional steps toward better communicating with and supporting participants when clinical trials end early. The Participant FIRST recommendations are a practical guide for embarking on that journey.
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Affiliation(s)
- Emily A. Largent
- Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine
| | - Sarah Walter
- Alzheimer’s Therapeutic Research Institute, University of Southern California
| | | | | | - Shana Dodge
- The Association for Frontotemporal Degeneration
| | | | - Jonathan Jackson
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School
| | | | - Erin Iturriaga
- National Institutes of Health, National Heart, Lung, and Blood Institute
| | | | | | - Rachel L. Nosheny
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, VA Advanced Imaging Research Center, San Francisco Veterans Administration Medical Center
| | - Thomas O. Obisesan
- Division of Geriatrics, Department of Medicine, Howard University and Hospital
| | - Elena Portacolone
- Institute for Health & Aging, Philip Lee Institute for Health Policy Studies, University of California San Francisco
| | | | | | - Rueben C. Warren
- National Center for Bioethics in Research and Health Care, Tuskegee University
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Graham L, Ngwa J, Ntekim O, Ogunlana O, Johnson S, Nadarajah S, Fungwe TV, Turner J, Ruiz MR, Khan J, Obisesan TO. The Role of Transportation in the Enrollment of Elderly African Americans into Exercise and Memory Study: GEMS Study. J Racial Ethn Health Disparities 2022:10.1007/s40615-022-01367-7. [PMID: 35931916 DOI: 10.1007/s40615-022-01367-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 06/30/2022] [Accepted: 07/04/2022] [Indexed: 10/16/2022]
Abstract
BACKGROUND Understanding the factors driving recruitment and enrollment of African Americans (AA)s in clinical translational research will assure that underrepresented populations benefit from scientific progress and new developments in the diagnosis and treatment of Alzheimer's disease and related disorders. While transportation is pivotal to volunteers' ability to participate in research, its contribution to enrollment in exercise studies on AD is yet to be elucidated. Thus, this research focuses on identifying factors that influence the recruitment and enrollment of African Americans in biomedical studies and determining whether the availability of transportation motivates participation in time-demanding exercise studies on AD. METHODS We analyzed recruitment data collected from 567 volunteers ages 55 and older screened through various recruitment sources and considered for enrollment in our exercise and memory study. To determine whether transportation influenced the enrollment of African Americans (AA)s in biomedical studies, multiple logistic regression analysis was performed to identify significant factors that drive enrollment. Furthermore, the association of race and demographic factors on the availability of transportation was assessed. RESULTS Demographic factors, age at screening, education, gender, and cognitive scores were not significantly different among those enrolled compared to control (not-enrolled). In the relationship of enrollment to transportation, enrolled participants were more likely to have access to transportation (79.12%) than not-enrolled participants who had less access to transportation (71.6%); however, the association was not statistically significant. However, race differentially influenced the likelihood of enrollment, with elderly AAs being significantly less likely to have transportation (p = 0.020) than the Whites but more likely than "others" to have transportation. CONCLUSION Our findings suggest that access to transportation may be a key factor motivating enrollment in an exercise and memory study in a predominantly AA sample. Notably, AAs in our sample were less likely to have transportation than Whites. Other demographic factors and cognitive scores did not significantly influence enrollment in our sample. A larger sample and more detailed assessment of transportation are needed to further discern the role of transportation in clinical trials.
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Affiliation(s)
- Lennox Graham
- Department of Health Management, College of Nursing and Allied Health Sciences, Howard University, Washington, DC, 20059, USA
| | - Julius Ngwa
- Division of Cardiovascular Medicine, College of Medicine, Howard University, Washington, DC, 20059, USA
| | - Oyonumo Ntekim
- Department of Nutritional Sciences, College of Nursing and Allied Health Sciences, Howard University, Washington, DC, 20059, USA
| | - Oludolapo Ogunlana
- Department of Medicine and Clinical Translational Science Program, Division of Geriatrics, Howard University Hospital, 2041 Georgia Ave NW, Washington, DC, 20060, USA
| | - Steven Johnson
- Department of Nutritional Sciences, College of Nursing and Allied Health Sciences, Howard University, Washington, DC, 20059, USA
| | - Sheeba Nadarajah
- Department of Nursing, College of Nursing and Allied Health Sciences, Howard University, Washington, DC, 20059, USA
| | - Thomas V Fungwe
- Department of Nutritional Sciences, College of Nursing and Allied Health Sciences, Howard University, Washington, DC, 20059, USA
| | - Jillian Turner
- Department of Medicine and Clinical Translational Science Program, Division of Geriatrics, Howard University Hospital, 2041 Georgia Ave NW, Washington, DC, 20060, USA
| | - Mara Ramirez Ruiz
- Department of Medicine and Clinical Translational Science Program, Division of Geriatrics, Howard University Hospital, 2041 Georgia Ave NW, Washington, DC, 20060, USA
| | - Javed Khan
- Department of Medicine and Clinical Translational Science Program, Division of Geriatrics, Howard University Hospital, 2041 Georgia Ave NW, Washington, DC, 20060, USA
| | - Thomas O Obisesan
- Department of Medicine and Clinical Translational Science Program, Division of Geriatrics, Howard University Hospital, 2041 Georgia Ave NW, Washington, DC, 20060, USA.
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Ngwa JS, Nwulia E, Ntekim O, Bedada FB, Kwabi-Addo B, Nadarajah S, Johnson S, Southerland WM, Kwagyan J, Obisesan TO. Aerobic Exercise Training-Induced Changes on DNA Methylation in Mild Cognitively Impaired Elderly African Americans: Gene, Exercise, and Memory Study - GEMS-I. Front Mol Neurosci 2022; 14:752403. [PMID: 35110995 PMCID: PMC8802631 DOI: 10.3389/fnmol.2021.752403] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 12/16/2021] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND DNA methylation at CpG sites is a vital epigenetic modification of the human genome affecting gene expression, and potentially, health outcomes. However, evidence is just budding on the effects of aerobic exercise-induced adaptation on DNA methylation in older mild cognitively impaired (MCI) elderly African American (AAs). Therefore, we examined the effects of a 6-month aerobic exercise-intervention on genome-wide DNA methylation in elderly AA MCI volunteers. DESIGN Elderly AA volunteers confirmed MCI assigned into a 6-month program of aerobic exercise (eleven participants) underwent a 40-min supervised-training 3-times/week and controls (eight participants) performed stretch training. Participants had maximal oxygen consumption (VO2max) test and Genome-wide methylation levels at CpG sites using the Infinium HumanMethylation450 BeadChip assay at baseline and after a 6-month exercise program. We computed false discovery rates (FDR) using Sidak to account for multiplicity of tests and performed quantitative real-time polymerase chain-reaction (qRT-PCR) to confirm the effects of DNA methylations on expression levels of the top 5 genes among the aerobic participants. CpG sites identified from aerobic-exercise participants were similarly analyzed by the stretch group to quantify the effects of exercise-induced methylation changes among the group of stretch participants. RESULTS Eleven MCI participants (aerobic: 73% females; mean age 72.3 ± 6.6 years) and eight MCI participants (stretch: 75% female; mean age 70.6 ± 6.7 years) completed the training. Aerobic exercise-training was associated with increases in VO2max and with global hypo- and hypermethylation changes. The most notable finding was CpG hypomethylation within the body of the VPS52 gene (P = 5.4 × 10-26), a Golgi-associated protein, involved in intracellular protein trafficking including amyloid precursor protein. qRT-PCR confirmed a nearly twofold increased expression of VPS52. Other top findings with FDR q-value < 10-5, include hypomethylations of SCARB1 (8.8 × 10-25), ARTN (6.1 × 10-25), NR1H2 (2.1 × 10-18) and PPP2R5D (9.8 × 10-18). CONCLUSION We conclude that genome-wide DNA methylation patterns is associated with exercise training-induced methylation changes. Identification of methylation changes around genes previously shown to interact with amyloid biology, intracellular protein trafficking, and lipoprotein regulations provide further support to the likely protective effect of exercise in MCI. Future studies in larger samples are needed to confirm our findings.
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Affiliation(s)
- Julius S. Ngwa
- Division of Cardiovascular Medicine, Department of Internal Medicine, Howard University, Washington, DC, United States
| | - Evaristus Nwulia
- Department of Psychiatry and Behavioral Sciences, Howard University, Washington, DC, United States
| | - Oyonumo Ntekim
- Department of Nutritional Sciences, Howard University, Washington, DC, United States
| | - Fikru B. Bedada
- Department of Clinical Laboratory Sciences, Howard University, Washington, DC, United States
| | - Bernard Kwabi-Addo
- Department of Biochemistry and Molecular Biology, Howard University, Washington, DC, United States
| | - Sheeba Nadarajah
- Division of Nursing, Howard University, Washington, DC, United States,School of Nursing and Allied Health Sciences, Howard University, Washington, DC, United States,Department of Medicine, Howard University, Washington, DC, United States
| | - Steven Johnson
- Division of Geriatrics, Department of Medicine and Clinical/Translational Science Program, Howard University Hospital, Washington, DC, United States
| | - William M. Southerland
- Department of Biochemistry and Molecular Biology, Howard University, Washington, DC, United States
| | - John Kwagyan
- Georgetown-Howard U Center for Clinical and Translation Science (GHUCCTS), Howard University Hospital, Washington, DC, United States
| | - Thomas O. Obisesan
- Division of Geriatrics, Department of Medicine and Clinical/Translational Science Program, Howard University Hospital, Washington, DC, United States,*Correspondence: Thomas O. Obisesan,
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6
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Dabiri S, Ruiz MR, Obisesan TO, Ntekim O, Mwendwa DT, Ngwa JS, Campbell AL. The mediating role of inflammation in the relationship between α‐synuclein and cognitive functioning. Alzheimers Dement 2021. [DOI: 10.1002/alz.052597] [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: 11/07/2022]
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Walter S, Craft S, Geldmacher DS, Menard W, Sano M, Obisesan TO, Combs M, Gessert D, Shaffer‐Bacareza E, Miller G, Donohue MC, Rafii MS, Aisen PS. Utilizing study and site performance metrics to improve efficiency of clinical trials: An initiative of the Alzheimer’s Clinical Trials Consortium (ACTC). Alzheimers Dement 2021. [DOI: 10.1002/alz.051137] [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: 11/07/2022]
Affiliation(s)
- Sarah Walter
- Alzheimer’s Therapeutic Research Institute/USC San Diego CA USA
| | | | | | | | - Mary Sano
- Icahn School of Medicine at Mount Sinai New York NY USA
| | | | | | | | | | - Garrett Miller
- Alzheimer's Therapeutic Research Institute University of Southern California San Diego CA USA
| | - Michael C Donohue
- Alzheimer's Therapeutic Research Institute University of Southern California San Diego CA USA
| | - Michael S Rafii
- Alzheimer's Therapeutic Research Institute University of Southern California San Diego CA USA
| | - Paul S Aisen
- Alzheimer's Therapeutic Research Institute University of Southern California San Diego CA USA
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Bedada FB, Ntekim OE, Nwulia EO, Fungwe TV, Nadarajah SR, Obisesan TO. Exercise Training-Increased FBXO32 and FOXO1 in a Gender-Dependent Manner in Mild Cognitively Impaired African Americans: GEMS-1 Study. Front Aging Neurosci 2021; 13:641758. [PMID: 33935685 PMCID: PMC8079639 DOI: 10.3389/fnagi.2021.641758] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 03/18/2021] [Indexed: 01/29/2023] Open
Abstract
The ubiquitin proteasome system (UPS) and FOXOs transcription factors play a pivotal role in cellular clearance and minimizing the accumulation of Aβ in neurodegeneration (ND). In African Americans (AAs) with mild cognitive impairment (MCI), the role of components of UPS and FOXOs; and whether they are amenable to exercise effects is unknown. We hypothesized that exercise can enhance cellular clearance systems during aging and ND by increasing expressions of FBXO32 and FOXO1. To test this hypothesis, we used TaqMan gene expression analysis in peripheral blood (PB) to investigate the component of UPS and FOXOs; and provide mechanistic insight at baseline, during exercise, and in both genders. At baseline, levels of FBXO32 were higher in women than in men. In our attempt to discern gender-specific exercise-related changes, we observed that levels of FBXO32 increased in men but not in women. Similarly, levels of FOXO1 increased in men only. These data suggest that a graded dose of FBXO32 and FOXO1 may be beneficial when PB cells carrying FBXO32 and FOXO1 summon into the brain in response to Alzheimer's disease (AD) perturbation (docking station PB cells). Our observation is consistent with emerging studies that exercise allows the trafficking of blood factors. Given the significance of FBXO32 and FOXO1 to ND and associated muscle integrity, our findings may explain, at least in part, the benefits of exercise on memory, associated gait, and balance perturbation acknowledged to herald the emergence of MCI.
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Affiliation(s)
- Fikru B. Bedada
- Department of Clinical Laboratory Sciences, College of Nursing and Allied Health Sciences, Howard University, Washington, DC, United States
| | - Oyonumo E. Ntekim
- Department of Nutritional Sciences, College of Nursing and Allied Health Sciences, Howard University, Washington, DC, United States
| | - Evaristus O. Nwulia
- Department of Psychiatry, Howard University Hospital, Washington, DC, United States
| | - Thomas V. Fungwe
- Department of Nutritional Sciences, College of Nursing and Allied Health Sciences, Howard University, Washington, DC, United States
| | - Sheeba Raaj Nadarajah
- Department of Nursing, College of Nursing and Allied Health Sciences, Howard University, Washington, DC, United States
| | - Thomas O. Obisesan
- Division of Geriatrics, Department of Medicine, Howard University Hospital, Washington, DC, United States
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Kunkle BW, Schmidt M, Klein HU, Naj AC, Hamilton-Nelson KL, Larson EB, Evans DA, De Jager PL, Crane PK, Buxbaum JD, Ertekin-Taner N, Barnes LL, Fallin MD, Manly JJ, Go RCP, Obisesan TO, Kamboh MI, Bennett DA, Hall KS, Goate AM, Foroud TM, Martin ER, Wang LS, Byrd GS, Farrer LA, Haines JL, Schellenberg GD, Mayeux R, Pericak-Vance MA, Reitz C. Novel Alzheimer Disease Risk Loci and Pathways in African American Individuals Using the African Genome Resources Panel: A Meta-analysis. JAMA Neurol 2021; 78:102-113. [PMID: 33074286 PMCID: PMC7573798 DOI: 10.1001/jamaneurol.2020.3536] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [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: 12/16/2019] [Accepted: 04/09/2020] [Indexed: 12/11/2022]
Abstract
Importance Compared with non-Hispanic White individuals, African American individuals from the same community are approximately twice as likely to develop Alzheimer disease. Despite this disparity, the largest Alzheimer disease genome-wide association studies to date have been conducted in non-Hispanic White individuals. In the largest association analyses of Alzheimer disease in African American individuals, ABCA7, TREM2, and an intergenic locus at 5q35 were previously implicated. Objective To identify additional risk loci in African American individuals by increasing the sample size and using the African Genome Resource panel. Design, Setting, and Participants This genome-wide association meta-analysis used case-control and family-based data sets from the Alzheimer Disease Genetics Consortium. There were multiple recruitment sites throughout the United States that included individuals with Alzheimer disease and controls of African American ancestry. Analysis began October 2018 and ended September 2019. Main Outcomes and Measures Diagnosis of Alzheimer disease. Results A total of 2784 individuals with Alzheimer disease (1944 female [69.8%]) and 5222 controls (3743 female [71.7%]) were analyzed (mean [SD] age at last evaluation, 74.2 [13.6] years). Associations with 4 novel common loci centered near the intracellular glycoprotein trafficking gene EDEM1 (3p26; P = 8.9 × 10-7), near the immune response gene ALCAM (3q13; P = 9.3 × 10-7), within GPC6 (13q31; P = 4.1 × 10-7), a gene critical for recruitment of glutamatergic receptors to the neuronal membrane, and within VRK3 (19q13.33; P = 3.5 × 10-7), a gene involved in glutamate neurotoxicity, were identified. In addition, several loci associated with rare variants, including a genome-wide significant intergenic locus near IGF1R at 15q26 (P = 1.7 × 10-9) and 6 additional loci with suggestive significance (P ≤ 5 × 10-7) such as API5 at 11p12 (P = 8.8 × 10-8) and RBFOX1 at 16p13 (P = 5.4 × 10-7) were identified. Gene expression data from brain tissue demonstrate association of ALCAM, ARAP1, GPC6, and RBFOX1 with brain β-amyloid load. Of 25 known loci associated with Alzheimer disease in non-Hispanic White individuals, only APOE, ABCA7, TREM2, BIN1, CD2AP, FERMT2, and WWOX were implicated at a nominal significance level or stronger in African American individuals. Pathway analyses strongly support the notion that immunity, lipid processing, and intracellular trafficking pathways underlying Alzheimer disease in African American individuals overlap with those observed in non-Hispanic White individuals. A new pathway emerging from these analyses is the kidney system, suggesting a novel mechanism for Alzheimer disease that needs further exploration. Conclusions and Relevance While the major pathways involved in Alzheimer disease etiology in African American individuals are similar to those in non-Hispanic White individuals, the disease-associated loci within these pathways differ.
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Affiliation(s)
- Brian W. Kunkle
- The John P. Hussman Institute for Human Genomics, University of Miami, Miami, Florida
- Dr. John T. MacDonald Foundation, Department of Human Genetics, University of Miami, Miami, Florida
| | - Michael Schmidt
- The John P. Hussman Institute for Human Genomics, University of Miami, Miami, Florida
- Dr. John T. MacDonald Foundation, Department of Human Genetics, University of Miami, Miami, Florida
| | - Hans-Ulrich Klein
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University, New York, New York
- Gertrude H. Sergievsky Center, Columbia University, New York, New York
- Department of Neurology, Columbia University, New York, New York
| | - Adam C. Naj
- Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | | | - Eric B. Larson
- Department of Medicine, University of Washington, Seattle
- Group Health Research Institute, Group Health, Seattle, Washington
| | - Denis A. Evans
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois
| | - Phil L. De Jager
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University, New York, New York
- Gertrude H. Sergievsky Center, Columbia University, New York, New York
- Department of Neurology, Columbia University, New York, New York
| | - Paul K. Crane
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Joe D. Buxbaum
- Department of Psychiatry, Mount Sinai School of Medicine, New York, New York
- Department of Genetics and Genomics Sciences, Mount Sinai School of Medicine, New York, New York
- Department of Neuroscience, Mount Sinai School of Medicine, New York, New York
- Friedman Brain Institute, Mount Sinai School of Medicine, New York, New York
| | - Nilufer Ertekin-Taner
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida
- Department of Neurology, Mayo Clinic, Jacksonville, Florida
| | - Lisa L. Barnes
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
- Department of Behavioral Sciences, Rush University Medical Center, Chicago, Illinois
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
| | - M. Daniele Fallin
- Department of Epidemiology, Johns Hopkins University School of Public Health, Baltimore, Maryland
| | - Jennifer J. Manly
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University, New York, New York
- Gertrude H. Sergievsky Center, Columbia University, New York, New York
- Department of Neurology, Columbia University, New York, New York
| | - Rodney C. P. Go
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham
| | | | - M. Ilyas Kamboh
- Department of Human Genetics, University of Pittsburgh, Pittsburgh, Pennsylvania
- Alzheimer’s Disease Research Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - David A. Bennett
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
| | - Kathleen S. Hall
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis
| | - Alison M. Goate
- Department of Genetics and Genomics Sciences, Mount Sinai School of Medicine, New York, New York
- Department of Neuroscience, Mount Sinai School of Medicine, New York, New York
- Friedman Brain Institute, Mount Sinai School of Medicine, New York, New York
- Ronald M. Loeb Center for Alzheimer’s Disease, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Tatiana M. Foroud
- Department of Medical and Molecular Genetics, Indiana University, Indianapolis
| | - Eden R. Martin
- The John P. Hussman Institute for Human Genomics, University of Miami, Miami, Florida
- Dr. John T. MacDonald Foundation, Department of Human Genetics, University of Miami, Miami, Florida
| | - Li-Sao Wang
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Goldie S. Byrd
- Maya Angelou Center for Health Equity, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Lindsay A. Farrer
- Department of Medicine (Biomedical Genetics), Boston University School of Medicine, Boston, Massachusetts
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
- Department of Ophthalmology, Boston University School of Medicine, Boston, Massachusetts
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - Jonathan L. Haines
- Department of Population and Quantitative Health Sciences, Institute for Computational Biology, Case Western Reserve University, Cleveland, Ohio
| | - Gerard D. Schellenberg
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Richard Mayeux
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University, New York, New York
- Gertrude H. Sergievsky Center, Columbia University, New York, New York
- Department of Neurology, Columbia University, New York, New York
- Department of Psychiatry, Columbia University, New York, New York
- Epidemiology, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Margaret A. Pericak-Vance
- The John P. Hussman Institute for Human Genomics, University of Miami, Miami, Florida
- Dr. John T. MacDonald Foundation, Department of Human Genetics, University of Miami, Miami, Florida
| | - Christiane Reitz
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University, New York, New York
- Gertrude H. Sergievsky Center, Columbia University, New York, New York
- Department of Neurology, Columbia University, New York, New York
- Epidemiology, College of Physicians and Surgeons, Columbia University, New York, New York
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10
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Rai N, Hipolito MM, VanMeter JW, Seth R, Adenuga A, Shelby M, Misiak-Christian M, Nwaokobia C, Manaye KF, Obisesan TO, Nwulia E. Comparative Effects of Repetitive Odor Identification and Odor Memory Tasks on Olfactory Engagement in Older Populations - A Pilot fMRI Study. Neuropsychiatr Dis Treat 2021; 17:1279-1288. [PMID: 33958869 PMCID: PMC8096456 DOI: 10.2147/ndt.s298303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 03/11/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE This study evaluated human Blood Oxygen Level-Dependent (BOLD) responses in primary and higher-order olfactory regions of older adults, using odor memory and odor identification tasks. The goal was to determine which olfactory and memory regions of interest are more strongly engaged in older populations comparing these two odor training tasks. METHODS Twelve adults 55-75 years old (75% females) without intranasal or major neurological disorders performed repetitive odor memory and identification tasks using a 3-tesla magnetic resonance scanner. Odors were presented intermittently at 10-second bursts separated by 20-second intervals of odorless air. Paired t-tests were used to compare differences in the degree of activation between odor identification and odor memory tasks within individuals. An FDR cluster-level correction of p<0.05 was used for multiplicity of tests (with a cluster-defining threshold set at p<0.01 and 10 voxels). RESULTS Odor identification compared to memory (ie, odor identification > odor memory) contrasts had several areas of significant activation, including many of the classical olfactory brain regions as well as the hippocampus. The opposite contrast (odor memory > odor identification) included the piriform cortex, though this was not significant. Both tasks equally activated the piriform cortex, and thus when the two tasks are compared to each other this area of activation appears to be either absent (OI > OM) or only weakly observed (OM > OI). CONCLUSION These findings from a predominantly African American sample suggest that odor identification tasks may be more potent than memory tasks in targeted olfactory engagement in older populations. Furthermore, repetitive odor identification significantly engaged the hippocampus - a region relevant to Alzheimer's disease - more significantly than did the odor memory task. If validated in larger studies, this result could have important implications in the design of olfactory training paradigms.
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Affiliation(s)
- Narayan Rai
- Department of Psychiatry and Behavioral Sciences, Howard University, Washington DC, USA
| | | | - John W VanMeter
- Department of Neurology, Center for Functional and Molecular Imaging, Georgetown University Medical Center, Washington DC, USA
| | | | | | | | | | | | | | | | - Evaristus Nwulia
- Department of Psychiatry and Behavioral Sciences, Howard University, Washington DC, USA.,Evon Medics LLC, Elkridge, MD, USA
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11
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Bedada FB, Ntekim O, Johnson SP, Turner J, Nadarajah SR, Ngwa JS, Bond V, Kwagyan J, Obisesan TO. Exercise intervention differentially induces the expression of cystathionine beta synthase (CBS) in African American with MCI: Implication for endogenous H
2
S generation and component of aging pathway. Alzheimers Dement 2020. [DOI: 10.1002/alz.043667] [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: 11/10/2022]
Affiliation(s)
| | | | | | | | | | | | - Vernon Bond
- Howard University Hospital Washington DC USA
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12
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Christensen KD, Karlawish J, Roberts JS, Uhlmann WR, Harkins K, Wood EM, Obisesan TO, Le LQ, Cupples LA, Zoltick ES, Johnson MS, Bradbury MK, Waterston LB, Chen CA, Feldman S, Perry DL, Green RC. Disclosing genetic risk for Alzheimer's dementia to individuals with mild cognitive impairment. Alzheimers Dement (N Y) 2020; 6:e12002. [PMID: 32211507 PMCID: PMC7087414 DOI: 10.1002/trc2.12002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 12/26/2019] [Indexed: 01/08/2023]
Abstract
INTRODUCTION The safety of predicting conversion from mild cognitive impairment (MCI) to Alzheimer's disease (AD) dementia using apolipoprotein E (APOE) genotyping is unknown. METHODS We randomized 114 individuals with MCI to receive estimates of 3-year risk of conversion to AD dementia informed by APOE genotyping (disclosure arm) or not (non-disclosure arm) in a non-inferiority clinical trial. Primary outcomes were anxiety and depression scores. Secondary outcomes included other psychological measures. RESULTS Upper confidence limits for randomization arm differences were 2.3 on the State Trait Anxiety Index and 0.5 on the Geriatric Depression Scale, below non-inferiority margins of 3.3 and 1.0. Moreover, mean scores were lower in the disclosure arm than non-disclosure arm for test-related positive impact (difference: -1.9, indicating more positive feelings) and AD concern (difference: -0.3). DISCUSSION Providing genetic information to individuals with MCI about imminent risk for AD does not increase risks of anxiety or depression and may provide psychological benefits.
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Affiliation(s)
- Kurt D. Christensen
- Department of Population MedicineHarvard Pilgrim Health Care Institute and Harvard Medical SchoolBostonMassachusettsUSA
- Broad Institute of Harvard and MITCambridgeMassachusettsUSA
| | - Jason Karlawish
- Department of MedicinePerelman School of Medicine at the University of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - J. Scott Roberts
- Department of Health Behavior and Health EducationUniversity of Michigan School of Public HealthAnn ArborMichiganUSA
| | - Wendy R. Uhlmann
- Departments of Internal Medicine and Human GeneticsUniversity of MichiganAnn ArborMichiganUSA
| | - Kristin Harkins
- Department of MedicinePerelman School of Medicine at the University of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Elisabeth M. Wood
- Department of MedicinePerelman School of Medicine at the University of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Thomas O. Obisesan
- Department of MedicineHoward University College of MedicineWashington, DCUSA
| | - Lan Q. Le
- Department of Health Behavior and Health EducationUniversity of Michigan School of Public HealthAnn ArborMichiganUSA
| | - L. Adrienne Cupples
- Departments of Biostatistics and EpidemiologyBoston University School of Public HealthBostonMassachusettsUSA
| | - Emilie S. Zoltick
- Division of Genetics, Department of MedicineBrigham and Women's HospitalBostonMassachusettsUSA
| | - Megan S. Johnson
- Department of MedicineHoward University College of MedicineWashington, DCUSA
| | | | - Leo B. Waterston
- Center for Outcomes Research & Evaluation (CORE)Maine Medical Center Research InstitutePortlandMaineUSA
| | - Clara A. Chen
- Biostatistics and Epidemiology Data Analytics CenterBoston University School of Public HealthBostonMassachusettsUSA
| | - Sara Feldman
- Department of Health Behavior and Health EducationUniversity of Michigan School of Public HealthAnn ArborMichiganUSA
| | - Denise L. Perry
- Division of Genetics, Department of MedicineBrigham and Women's HospitalBostonMassachusettsUSA
| | - Robert C. Green
- Broad Institute of Harvard and MITCambridgeMassachusettsUSA
- Division of Genetics, Department of MedicineBrigham and Women's HospitalBostonMassachusettsUSA
- Department of MedicineHarvard Medical SchoolBostonMassachusettsUSA
- Partners Personalized MedicineBostonMassachusettsUSA
| | - for the REVEAL Study Group
- Department of Population MedicineHarvard Pilgrim Health Care Institute and Harvard Medical SchoolBostonMassachusettsUSA
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13
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Fungwe TV, Ngwa JS, Ntekim OE, Allard JS, Nadarajah S, Wolday S, Ogunlana OO, Johnson SP, Hughes K, Larbi D, Gillum RF, Obisesan TO. Exercise Training Induced Changes In Nuclear Magnetic Resonance-Measured Lipid Particles In Mild Cognitively Impaired Elderly African American Volunteers: A Pilot Study. Clin Interv Aging 2019; 14:2115-2123. [PMID: 31824142 PMCID: PMC6900999 DOI: 10.2147/cia.s195878] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 03/02/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose Poor cardiorespiratory fitness (CRF) is linked to cognitive deterioration, but its effects on lipid heterogeneity and functional properties in older African American (AA) subjects with mild cognitive impairment (MCI) need elucidation. This study determined whether exercise training-induced changes in blood lipid particle sizes (LPS) were associated with CRF determined by VO2Max in elderly AAs with MCI. Given the pivotal role of brain-derived neurotrophic factor (BDNF) on glucose metabolism, and therefore, “diabetic dyslipidemia”, we also determined whether changes in LPS were associated with the levels of serum BDNF. Methods This analysis included 17 of the 29 randomized elderly AAs with MCI who had NMR data at baseline and after a 6-month training. We used Generalized Linear Regression (GLM) models to examine cardiorespiratory fitness (VO2Max) effects on training-induced change in LPS in the stretch and aerobic groups. Additionally, we determined whether the level of BDNF influenced change in LPS. Results Collectively, mean VO2Max (23.81±6.17) did not differ significantly between aerobic and stretch groups (difference=3.17±3.56, P=0.495). Training-related changes in very low-density lipoprotein, chylomicrons, and total low-density lipoprotein (LDL) particle sizes correlated significantly with VO2Max, but not after adjustment for age and gender. However, increased VO2Max significantly associated with reduced total LDL particle size after similar adjustments (P = 0.046). While stretch exercise associated with increased protective large high-density lipoprotein particle size, the overall effect was not sustained following adjustments for gender and age. However, changes in serum BDNF were associated with changes in triglyceride and cholesterol transport particle sizes (P < 0.051). Conclusion Promotion of stretch and aerobic exercise to increase CRF in elderly AA volunteers with MCI may also promote beneficial changes in lipoprotein particle profile. Because high BDNF concentration may reduce CVD risk, training-related improvements in BDNF levels are likely advantageous. Large randomized studies are needed to confirm our observations and to further elucidate the role for exercise therapy in reducing CVD risk in elderly AAs with MCI.
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Affiliation(s)
- Thomas V Fungwe
- Department of Nutritional Sciences, School of Nursing and Allied Health Sciences, Howard University, Washington, DC, USA
| | - Julius S Ngwa
- Division of Cardiology, Department of Medicine, Howard University, Washington, DC, USA
| | - Oyonumo E Ntekim
- Department of Nutritional Sciences, School of Nursing and Allied Health Sciences, Howard University, Washington, DC, USA
| | - Joanne S Allard
- Division of Cardiology, Department of Physiology and Biophysics, Howard University, Washington, DC, USA
| | - Sheeba Nadarajah
- Division of Nursing, College of Nursing and Allied Health Sciences, Howard University, Washington, DC, USA
| | - Saba Wolday
- Division of Geriatrics, Department of Medicine and Clinical, Howard University Hospital, Washington, DC, USA
| | - Oludolapo O Ogunlana
- Division of Geriatrics, Department of Medicine and Clinical, Howard University Hospital, Washington, DC, USA
| | - Steven P Johnson
- Division of Geriatrics, Department of Medicine and Clinical, Howard University Hospital, Washington, DC, USA
| | - Kakra Hughes
- Department of Surgery, Howard University College of Medicine, Washington, DC, USA
| | - Daniel Larbi
- Division of Geriatrics, Department of Medicine and Clinical, Howard University Hospital, Washington, DC, USA
| | - Richard F Gillum
- Department of Internal Medicine, Howard University Hospital, Washington, DC, USA
| | - Thomas O Obisesan
- Division of Geriatrics, Department of Medicine and Clinical, Howard University Hospital, Washington, DC, USA
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14
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Jeffers SL, Turner J, Ramirez M, Wolday S, Ogunlana O, Johnson S, Allard JS, Ntekim O, Fungwe TV, Castor C, Gillum RF, Obisesan TO. P3-453: NORMATIVE DATA ON THE MONTREAL COGNITIVE ASSESSMENT FOR AN OLDER AMERICAN POPULATION. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.3488] [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: 11/29/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Richard F. Gillum
- Howard University College of Medicine; Washington DC USA
- Howard University Hospital; Washington DC USA
- Howard University; Washington DC USA
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15
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Bedada FB, Ntekim O, Fungwe TV, Ngwa JS, Obisesan TO. P3-190: FBXO32 AND FOXO1 ARE COORDINATELY EXPRESSED IN A ONE-TO-ONE STOICHIOMETRIC PATTERN AT BASELINE, DURING EXERCISE AND IN BOTH GENDERS IN ELDERLY AFRICAN AMERICANS WITH MCI. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.3219] [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: 10/25/2022]
Affiliation(s)
| | | | | | - Julius S. Ngwa
- Howard University College of Medicine; Washington DC USA
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16
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Nadarajah SR, Turner J, Johnson S, Ngwa JS, Graham LA, Ogunlana O, Wolday S, Khan J, Castor C, Ramirezruiz M, Fungwe TV, Gillum RF, Ntekim O, Obisesan TO. P2-589: ASSOCIATION OF DIFFERENT TYPES OF PHYSICAL ACTIVITY WITH PERFORMANCE ON COGNITIVE TASKS IN A PREDOMINANTLY AFRICAN AMERICAN SAMPLE. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.2998] [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: 10/25/2022]
Affiliation(s)
| | | | | | - Julius S. Ngwa
- Howard University College of Medicine; Washington DC USA
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17
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Ngwa JS, Fungwe TV, Ntekim O, Allard JS, Johnson SM, Castor C, Graham L, Nadarajah S, Gillum RF, Obisesan TO. Associations of Pulse and Blood Pressure with Hippocampal Volume by APOE and Cognitive Phenotype: The Alzheimer's Disease Neuroimaging Initiative (ADNI). Dement Geriatr Cogn Disord 2018; 45:66-78. [PMID: 29694964 PMCID: PMC6143389 DOI: 10.1159/000486955] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 01/17/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND It is increasingly evident that high blood pressure can promote reduction in global and regional brain volumes. While these effects may preferentially affect the hippocampus, reports are inconsistent. METHODS Using data from the Alzheimer's Disease Neuroimaging Initiative (ADNI), we examined the relationships of hippocampal volume to pulse pressure (PPR) and systolic (SBP) and diastolic (DBP) blood pressure according to apolipoprotein (APOE) ɛ4 positivity and cognitive status. The ADNI data included 1,308 participants: Alzheimer disease (AD = 237), late mild cognitive impairment (LMCI = 454), early mild cognitive impairment (EMCI = 254), and cognitively normal (CN = 365), with up to 24 months of follow-up. RESULTS Higher quartiles of PPR were significantly associated with lower hippocampal volumes (Q1 vs. Q4, p = 0.034) in the CN and AD groups, but with increasing hippocampal volume (Q1, p = 0.008; Q2, p = 0.020; Q3, p = 0.017; Q4 = reference) in the MCI groups. In adjusted stratified analyses among non-APOE ɛ4 carriers, the effects in the CN (Q1 vs. Q4, p = 0.006) and EMCI groups (Q1, p = 0.002; Q2, p = 0.013; Q3, p = 0.002; Q4 = reference) remained statistically significant. Also, higher DBP was significantly associated with higher hippocampal volume (p = 0.002) while higher SBP was significantly associated with decreasing hippocampal volume in the EMCI group (p = 0.015). CONCLUSION Changes in PPR, SBP, and DBP differentially influenced hippocampal volumes depending on the cognitive and APOE genotypic categories.
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Affiliation(s)
- Julius S. Ngwa
- Division of Cardiovascular Medicine, Department of Medicine, Howard University College of Medicine, Washington, DC, USA
| | - Thomas V. Fungwe
- Department of Nutritional Sciences, School of Nursing and Allied Health Sciences, and Department of Medicine, Howard University College of Medicine, Washington, DC, USA
| | - Oyonumo Ntekim
- Department of Nutritional Sciences, School of Nursing and Allied Health Sciences, and Department of Medicine, Howard University College of Medicine, Washington, DC, USA
| | - Joanne S. Allard
- Department of Physiology and Biophysics, Howard University College of Medicine, Washington, DC, USA
| | - Sheree M. Johnson
- Department of Physiology and Biophysics, Howard University College of Medicine, Washington, DC, USA
| | - Chimene Castor
- Department of Nutritional Sciences, School of Nursing and Allied Health Sciences, and Department of Medicine, Howard University College of Medicine, Washington, DC, USA
| | - Lennox Graham
- Department of Health Education, School of Nursing and Allied Health Sciences, and Department of Medicine, Howard University College of Medicine, Washington, DC, USA
| | - Sheeba Nadarajah
- Division of Nursing, School of Nursing and Allied Health Sciences, and Department of Medicine, Howard University College of Medicine, Washington, DC, USA
| | - Richard F. Gillum
- Division of Geriatrics, Department of Medicine and Clinical/Translational Science Program, Howard University College of Medicine/ Hospital, Washington, DC, USA
| | - Thomas O. Obisesan
- Division of Geriatrics, Department of Medicine and Clinical/Translational Science Program, Howard University College of Medicine/ Hospital, Washington, DC, USA
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18
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Boada M, Anaya F, Ortiz P, Olazarán J, Shua-Haim JR, Obisesan TO, Hernández I, Muñoz J, Buendia M, Alegret M, Lafuente A, Tárraga L, Núñez L, Torres M, Grifols JR, Ferrer I, Lopez OL, Páez A. Efficacy and Safety of Plasma Exchange with 5% Albumin to Modify Cerebrospinal Fluid and Plasma Amyloid-β Concentrations and Cognition Outcomes in Alzheimer's Disease Patients: A Multicenter, Randomized, Controlled Clinical Trial. J Alzheimers Dis 2018; 56:129-143. [PMID: 27911295 PMCID: PMC5240541 DOI: 10.3233/jad-160565] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [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] [Indexed: 12/14/2022]
Abstract
Background: Studies conducted in animal models and humans suggest the presence of a dynamic equilibrium of amyloid-β (Aβ) peptide between cerebrospinal fluid (CSF) and plasma compartments. Objective: To determine whether plasma exchange (PE) with albumin replacement was able to modify Aβ concentrations in CSF and plasma as well as to improve cognition in patients with mild-moderate Alzheimer’s disease (AD). Methods: In a multicenter, randomized, patient- and rater-blind, controlled, parallel-group, phase II study, 42 AD patients were assigned (1 : 1) to PE treatment or control (sham) groups. Treated patients received a maximum of 18 PE with 5% albumin (Albutein®, Grifols) with three different schedules: two PE/weekly (three weeks), one PE/weekly (six weeks), and one PE/bi- weekly (12 weeks), plus a six-month follow-up period. Plasma and CSF Aβ1–40 and Aβ1–42 levels, as well as cognitive, functional, and behavioral measures were determined. Results: CSF Aβ1–42 levels after the last PE compared to baseline were marginally higher in PE-treated group versus controls (adjusted means of variation: 75.3 versus –45.5 pg/mL; 95% CI: –19.8, 170.5 versus 135.1, 44.2; p = 0.072). Plasma Aβ1–42 levels were lower in the PE-treated group after each treatment period (p < 0.05). Plasma Aβ1–40 levels showed a saw-tooth pattern variation associated with PE. PE-treated patients scored better in the Boston Naming Test and Semantic Verbal Fluency (p < 0.05) throughout the study. Neuropsychiatric Inventory scores were higher in controls during the PE phase (p < 0.05). Conclusion: PE with human albumin modified CSF and plasma Aβ1–42 levels. Patients treated with PE showed improvement in memory and language functions, which persisted after PE was discontinued.
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Affiliation(s)
- Mercè Boada
- Memory Clinic and Research Center of Fundació ACE, Institut Catalá de Neurociències Aplicades, Barcelona, Spain.,Neurology Service, Hospital General Universitari Vall d'Hebron, Barcelona, Spain
| | - Fernando Anaya
- Nephrology Service, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - Javier Olazarán
- Neurology Service, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Joshua R Shua-Haim
- Alzheimer's Research Corporation, Mid Atlantic Geriatric Association, Manchester, NJ, USA
| | - Thomas O Obisesan
- Department of Internal Medicine, Howard University, Washington, DC, USA
| | - Isabel Hernández
- Memory Clinic and Research Center of Fundació ACE, Institut Catalá de Neurociències Aplicades, Barcelona, Spain
| | - Joan Muñoz
- Banc de Sang i Teixits, Barcelona, Spain
| | - Mar Buendia
- Memory Clinic and Research Center of Fundació ACE, Institut Catalá de Neurociències Aplicades, Barcelona, Spain
| | - Montserrat Alegret
- Memory Clinic and Research Center of Fundació ACE, Institut Catalá de Neurociències Aplicades, Barcelona, Spain
| | - Asunción Lafuente
- Memory Clinic and Research Center of Fundació ACE, Institut Catalá de Neurociències Aplicades, Barcelona, Spain
| | - Lluís Tárraga
- Memory Clinic and Research Center of Fundació ACE, Institut Catalá de Neurociències Aplicades, Barcelona, Spain
| | - Laura Núñez
- Clinical Trials Department, Instituto Grifols S.A., Barcelona, Spain
| | - Mireia Torres
- Clinical Trials Department, Instituto Grifols S.A., Barcelona, Spain
| | | | - Isidre Ferrer
- Institut de Neuropatologia, Hospital Universitario Bellvitge, Barcelona, Spain
| | - Oscar L Lopez
- Departments of Neurology and Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, USA
| | - Antonio Páez
- Clinical Trials Department, Instituto Grifols S.A., Barcelona, Spain
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19
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Graham LA, Ngwa J, Ntekim O, Ogunlana O, Wolday S, Johnson S, Johnson M, Castor C, Fungwe TV, Obisesan TO. Best strategies to recruit and enroll elderly Blacks into clinical and biomedical research. Clin Interv Aging 2017; 13:43-50. [PMID: 29317809 PMCID: PMC5743176 DOI: 10.2147/cia.s130112] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background Historically, Blacks have been disproportionately underrepresented in clinical trials. Outcomes associated with low Blacks’ participation in research include poor understanding of the predictors and treatment of the disease, increasing health disparities, poor health equity, and suboptimal wellness of the nation as a whole. To address this gap in research participation, we analyzed our recruitment data to identify the most effective strategies for enrolling older Blacks in clinical trials. Methods Data used in these analyses were obtained from 3,266 potential volunteers, ages 50 or older, who completed a Mini-Mental State Exam as part of recruitment and screening for various clinical studies on Alzheimer’s disease. In order to determine the most effective strategies for engaging Blacks in clinical research, we used tests of proportion to assess significant differences in recruitment sources, counts, and percentages for optimal recruitment strategies by gender. Finally, we employed regression analyses to confirm our findings. Results Of the total 3,266 screened, 2,830 Black volunteers were identified for further analysis. Overall, more women than men (73.8% vs 26.2%) participated in our recruitment activities. However, a significantly higher proportion of men than women were engaged through family (3.86% vs 1.30%, p=0.0004) and referral sources (5.89% vs 2.59%, p=0.0005). Compared to other sources for recruitment, we encountered a higher proportion of volunteers at health fairs (42.95%), and through advertisements (14.97%). In our sample, years of education and age did not appear to influence the likelihood of an encounter, screening, and potential participation. Conclusion Our findings indicate Black men and women in our sample were predominantly recruited from health fairs and through advertisements tailored to their health needs and interests. Conversely, we mostly engaged Black men through family referrals and persons known to them, indicating a need for trust in their decision to engage study personnel and/or participate in clinical trials.
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Affiliation(s)
- Lennox A Graham
- Department of Health Management, College of Nursing and Allied Health Sciences, Howard University, Washington, DC, USA
| | - Julius Ngwa
- Division of Cardiovascular Medicine, College of Medicine, Howard University, Washington, DC, USA
| | - Oyonumo Ntekim
- Department of Nutritional Sciences, College of Nursing and Allied Health Sciences, Howard University, Washington, DC, USA
| | - Oludolapo Ogunlana
- Department of Internal Medicine, Howard University Teaching Hospital, Washington, DC, USA
| | - Saba Wolday
- Department of Internal Medicine, Howard University Teaching Hospital, Washington, DC, USA
| | - Steven Johnson
- Department of Nutritional Sciences, College of Nursing and Allied Health Sciences, Howard University, Washington, DC, USA
| | - Megan Johnson
- Department of Internal Medicine, Howard University Teaching Hospital, Washington, DC, USA
| | - Chimene Castor
- Department of Nutritional Sciences, College of Nursing and Allied Health Sciences, Howard University, Washington, DC, USA
| | - Thomas V Fungwe
- Department of Nutritional Sciences, College of Nursing and Allied Health Sciences, Howard University, Washington, DC, USA
| | - Thomas O Obisesan
- Department of Internal Medicine, Howard University Teaching Hospital, Washington, DC, USA
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Abstract
Alzheimer’s disease (AD) is the most common form of dementia that affects more than 5 million Americans. It is the only disease among the 10 causes of death that cannot be slowed or cured, thus raising the need for identification of early preclinical markers that could be the focus of preventative efforts. Although evidence is escalating that abnormalities in olfactory structure and function precede AD development and early cognitive impairments by one or more decades, the importance of olfaction is largely overlooked in AD, and such testing is not routinely performed in neurology clinics. Nevertheless, research using the olfactory model, has begun to advance our understanding of the preclinical pathophysiology of AD. Notably, an interesting series of studies is beginning to illuminate the relationship between Apolipoprotein E (ApoE) ε4 polymorphism and olfactory dysfunction and late-onset Alzheimer’s disease. In this article, we reviewed present research on the significance of ApoE and olfaction to AD, summarized current studies on the associations and mechanisms of ApoE and olfactory dysfunction, and highlighted important gaps for future work to further advance the translational application of the olfactory paradigm to early, preclinical diagnosis and treatment of AD.
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Affiliation(s)
- Magdalena M Misiak
- Department of Psychiatry and Behavioral Sciences, Howard University, Washington DC, USA.,Department of Physiology, Howard University, Washington DC, USA
| | - MariaMananita S Hipolito
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | - Habtom W Ressom
- Department of Medicine, Howard University, Washington DC, USA
| | | | | | - Evaristus A Nwulia
- Department of Psychiatry and Behavioral Sciences, Howard University, Washington DC, USA.,Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
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21
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Kurian P, Obisesan TO, Craddock TJA. Oxidative species-induced excitonic transport in tubulin aromatic networks: Potential implications for neurodegenerative disease. J Photochem Photobiol B 2017; 175:109-124. [PMID: 28865316 PMCID: PMC5610651 DOI: 10.1016/j.jphotobiol.2017.08.033] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 08/15/2017] [Accepted: 08/21/2017] [Indexed: 12/30/2022]
Abstract
Oxidative stress is a pathological hallmark of neurodegenerative tauopathic disorders such as Alzheimer's disease and Parkinson's disease-related dementia, which are characterized by altered forms of the microtubule-associated protein (MAP) tau. MAP tau is a key protein in stabilizing the microtubule architecture that regulates neuron morphology and synaptic strength. When MAP tau is degraded in tauopathic disorders, neuron dysfunction results. The precise role of reactive oxygen species (ROS) in the tauopathic disease process, however, is poorly understood. Classically, mitochondrial dysfunction has been viewed as the major source of oxidative stress and has been shown to precede tau and amyloid pathology in various dementias, but the exact mechanisms are not clear. It is known that the production of ROS by mitochondria can result in ultraweak photon emission (UPE) within cells. While of low intensity, surrounding proteins within the cytosol can still absorb these energetic photons via aromatic amino acids (e.g., tryptophan and tyrosine). One likely absorber of these photons is the microtubule cytoskeleton, as it forms a vast network spanning neurons, is highly co-localized with mitochondria, and shows a high density of aromatic amino acids. Functional microtubule networks may traffic this ROS-generated endogenous photon energy for cellular signaling, or they may serve as dissipaters/conduits of such energy to protect the cell from potentially harmful effects. Experimentally, after in vitro exposure to exogenous photons, microtubules have been shown to reorient and reorganize in a dose-dependent manner with the greatest effect being observed around 280nm, in the tryptophan and tyrosine absorption range. In this paper, recent modeling efforts based on ambient temperature experiment are presented, showing that tubulin polymers can feasibly absorb and channel these photoexcitations via resonance energy transfer, on the order of dendritic length scales and neuronal fine structure. Since microtubule networks are compromised in tauopathic diseases such as Alzheimer's and Parkinson's dementias, patients with these illnesses would be unable to support effective channeling of these photons for signaling or dissipation. Consequent emission surplus due to increased UPE production or decreased ability to absorb and transfer may lead to increased cellular oxidative damage, thus hastening the neurodegenerative process.
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Affiliation(s)
- P Kurian
- National Human Genome Center, Howard University College of Medicine, Washington, DC 20060, USA; Department of Medicine, Howard University College of Medicine, Washington, DC 20060, USA; Computational Physics Laboratory, Howard University, Washington, DC 20059, USA.
| | - T O Obisesan
- Georgetown-Howard Universities Center for Clinical and Translational Science Clinical Research Unit, Howard University College of Medicine, Washington, DC 20060, USA
| | - T J A Craddock
- Department of Psychology & Neuroscience, Nova Southeastern University, Fort Lauderdale, FL 33314, USA; Department of Computer Science, Nova Southeastern University, Fort Lauderdale, FL 33314, USA; Department of Clinical Immunology, Nova Southeastern University, Fort Lauderdale, FL 33314, USA; Clinical Systems Biology Group, Institute for Neuro-Immune Medicine, Nova Southeastern University, Fort Lauderdale, FL 33314, USA
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22
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Ntekim O, Ngwa JS, Allard JS, Fungwe TV, Lennox GA, Gillum RF, Castor C, Obisesan TO. [P3–187]: EFFECTS OF EXERCISE ON PLASMA NITRITE/NITRATE LEVELS, AND NITRIC OXIDE SYNTHASE ACTIVITY IN ELDERLY AFRICAN AMERICANS WITH MILD COGNITIVE IMPAIRMENT. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.1399] [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: 11/15/2022]
Affiliation(s)
| | | | | | | | - Graham A. Lennox
- Howard UniversityWashingtonDCUSA
- College of Nursing and Allied Health SciencesWashingtonDCUSA
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23
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Ngwa JS, Leong S, Graham LA, Ntekim O, Allard JS, Ogunlana O, Wolday S, Johnson S, Castor C, Fungwe TV, Obisesan TO. [P2–527]: NORMATIVE ANALYSIS OF MINI MENTAL STATE EXAMINATION: A CROSS SECTIONAL STUDY IN A PREDOMINANTLY AFRICAN AMERICAN SAMPLE. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.1185] [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: 10/18/2022]
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24
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Iyalomhe O, Swierczek S, Enwerem N, Chen Y, Adedeji MO, Allard J, Ntekim O, Johnson S, Hughes K, Kurian P, Obisesan TO. The Role of Hypoxia-Inducible Factor 1 in Mild Cognitive Impairment. Cell Mol Neurobiol 2016; 37:969-977. [PMID: 27858285 DOI: 10.1007/s10571-016-0440-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 10/26/2016] [Indexed: 01/16/2023]
Abstract
Neuroinflammation and reactive oxygen species are thought to mediate the pathogenesis of Alzheimer's disease (AD), suggesting that mild cognitive impairment (MCI), a prodromal stage of AD, may be driven by similar insults. Several studies document that hypoxia-inducible factor 1 (HIF-1) is neuroprotective in the setting of neuronal insults, since this transcription factor drives the expression of critical genes that diminish neuronal cell death. HIF-1 facilitates glycolysis and glucose metabolism, thus helping to generate reductive equivalents of NADH/NADPH that counter oxidative stress. HIF-1 also improves cerebral blood flow which opposes the toxicity of hypoxia. Increased HIF-1 activity and/or expression of HIF-1 target genes, such as those involved in glycolysis or vascular flow, may be an early adaptation to the oxidative stressors that characterize MCI pathology. The molecular events that constitute this early adaptation are likely neuroprotective, and might mitigate cognitive decline or the onset of full-blown AD. On the other hand, prolonged or overwhelming stressors can convert HIF-1 into an activator of cell death through agents such as Bnip3, an event that is more likely to occur in late MCI or advanced Alzheimer's dementia.
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Affiliation(s)
- Osigbemhe Iyalomhe
- Geriatrics Division, Department of Medicine, Howard University Hospital, 2041 Georgia Ave NW, Washington, DC, 20060, USA
| | - Sabina Swierczek
- Department of Hematology/BMT, University of Utah School of Medicine, 30 N Medical Dr, Salt Lake City, UT, 84132, USA
| | - Ngozi Enwerem
- Geriatrics Division, Department of Medicine, Howard University Hospital, 2041 Georgia Ave NW, Washington, DC, 20060, USA
| | - Yuanxiu Chen
- Geriatrics Division, Department of Medicine, Howard University Hospital, 2041 Georgia Ave NW, Washington, DC, 20060, USA
| | - Monica O Adedeji
- Geriatrics Division, Department of Medicine, Howard University Hospital, 2041 Georgia Ave NW, Washington, DC, 20060, USA
| | - Joanne Allard
- Geriatrics Division, Department of Medicine, Howard University Hospital, 2041 Georgia Ave NW, Washington, DC, 20060, USA
| | - Oyonumo Ntekim
- Geriatrics Division, Department of Medicine, Howard University Hospital, 2041 Georgia Ave NW, Washington, DC, 20060, USA
| | - Sheree Johnson
- Geriatrics Division, Department of Medicine, Howard University Hospital, 2041 Georgia Ave NW, Washington, DC, 20060, USA
| | - Kakra Hughes
- Division of Endovascular Surgery, Howard University Hospital, 2041 Georgia Ave NW, Washington, DC, 20060, USA
| | - Philip Kurian
- Geriatrics Division, Department of Medicine, Howard University Hospital, 2041 Georgia Ave NW, Washington, DC, 20060, USA.,Human Genome Center, Howard University, 2041 Georgia Ave NW, Washington, DC, 20060, USA
| | - Thomas O Obisesan
- Geriatrics Division, Department of Medicine, Howard University Hospital, 2041 Georgia Ave NW, Washington, DC, 20060, USA. .,Howard University Clinical Research Unit (GHUCCTS CTSA), 2041 Georgia Ave, NW, Washington, DC, 20060, USA.
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25
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Odeyemi Y, Meda E, Mehari A, Obisesan TO, Gillum RF. P3‐364: Chronic Obstructive Pulmonary Disease, Cognitive Function and Mortality in a U.S. National Cohort: Nhanes‐III. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.2030] [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: 10/20/2022]
Affiliation(s)
| | - Edris Meda
- Howard University HospitalWashington DCDC USA
| | - Alem Mehari
- Howard University HospitalWashington DCDC USA
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26
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Ghani M, Reitz C, Cheng R, Vardarajan BN, Jun G, Sato C, Naj A, Rajbhandary R, Wang LS, Valladares O, Lin CF, Larson EB, Graff-Radford NR, Evans D, De Jager PL, Crane PK, Buxbaum JD, Murrell JR, Raj T, Ertekin-Taner N, Logue M, Baldwin CT, Green RC, Barnes LL, Cantwell LB, Fallin MD, Go RCP, Griffith PA, Obisesan TO, Manly JJ, Lunetta KL, Kamboh MI, Lopez OL, Bennett DA, Hendrie H, Hall KS, Goate AM, Byrd GS, Kukull WA, Foroud TM, Haines JL, Farrer LA, Pericak-Vance MA, Lee JH, Schellenberg GD, St George-Hyslop P, Mayeux R, Rogaeva E. Association of Long Runs of Homozygosity With Alzheimer Disease Among African American Individuals. JAMA Neurol 2016; 72:1313-23. [PMID: 26366463 DOI: 10.1001/jamaneurol.2015.1700] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
IMPORTANCE Mutations in known causal Alzheimer disease (AD) genes account for only 1% to 3% of patients and almost all are dominantly inherited. Recessive inheritance of complex phenotypes can be linked to long (>1-megabase [Mb]) runs of homozygosity (ROHs) detectable by single-nucleotide polymorphism (SNP) arrays. OBJECTIVE To evaluate the association between ROHs and AD in an African American population known to have a risk for AD up to 3 times higher than white individuals. DESIGN, SETTING, AND PARTICIPANTS Case-control study of a large African American data set previously genotyped on different genome-wide SNP arrays conducted from December 2013 to January 2015. Global and locus-based ROH measurements were analyzed using raw or imputed genotype data. We studied the raw genotypes from 2 case-control subsets grouped based on SNP array: Alzheimer's Disease Genetics Consortium data set (871 cases and 1620 control individuals) and Chicago Health and Aging Project-Indianapolis Ibadan Dementia Study data set (279 cases and 1367 control individuals). We then examined the entire data set using imputed genotypes from 1917 cases and 3858 control individuals. MAIN OUTCOMES AND MEASURES The ROHs larger than 1 Mb, 2 Mb, or 3 Mb were investigated separately for global burden evaluation, consensus regions, and gene-based analyses. RESULTS The African American cohort had a low degree of inbreeding (F ~ 0.006). In the Alzheimer's Disease Genetics Consortium data set, we detected a significantly higher proportion of cases with ROHs greater than 2 Mb (P = .004) or greater than 3 Mb (P = .02), as well as a significant 114-kilobase consensus region on chr4q31.3 (empirical P value 2 = .04; ROHs >2 Mb). In the Chicago Health and Aging Project-Indianapolis Ibadan Dementia Study data set, we identified a significant 202-kilobase consensus region on Chr15q24.1 (empirical P value 2 = .02; ROHs >1 Mb) and a cluster of 13 significant genes on Chr3p21.31 (empirical P value 2 = .03; ROHs >3 Mb). A total of 43 of 49 nominally significant genes common for both data sets also mapped to Chr3p21.31. Analyses of imputed SNP data from the entire data set confirmed the association of AD with global ROH measurements (12.38 ROHs >1 Mb in cases vs 12.11 in controls; 2.986 Mb average size of ROHs >2 Mb in cases vs 2.889 Mb in controls; and 22% of cases with ROHs >3 Mb vs 19% of controls) and a gene-cluster on Chr3p21.31 (empirical P value 2 = .006-.04; ROHs >3 Mb). Also, we detected a significant association between AD and CLDN17 (empirical P value 2 = .01; ROHs >1 Mb), encoding a protein from the Claudin family, members of which were previously suggested as AD biomarkers. CONCLUSIONS AND RELEVANCE To our knowledge, we discovered the first evidence of increased burden of ROHs among patients with AD from an outbred African American population, which could reflect either the cumulative effect of multiple ROHs to AD or the contribution of specific loci harboring recessive mutations and risk haplotypes in a subset of patients. Sequencing is required to uncover AD variants in these individuals.
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Affiliation(s)
- Mahdi Ghani
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada
| | - Christiane Reitz
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, New York3Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York4
| | - Rong Cheng
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Badri Narayan Vardarajan
- Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Gyungah Jun
- Department of Medicine (Biomedical Genetics), Boston University, Boston, Massachusetts6Department of Biostatistics, Boston University, Boston, Massachusetts7Department of Ophthalmology, Boston University, Boston, Massachusetts
| | - Christine Sato
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada
| | - Adam Naj
- The John P. Hussman Institute for Human Genomics, University of Miami, Miami, Florida
| | - Ruchita Rajbhandary
- The John P. Hussman Institute for Human Genomics, University of Miami, Miami, Florida
| | - Li-San Wang
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Otto Valladares
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Chiao-Feng Lin
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Eric B Larson
- Department of Medicine, University of Washington, Seattle11Group Health Research Institute, Group Health, Seattle, Washington
| | - Neill R Graff-Radford
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida13Department of Neurology, Mayo Clinic, Jacksonville, Florida
| | - Denis Evans
- Rush Institute for Healthy Aging, Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois
| | - Philip L De Jager
- Program in Translational Neuropsychiatric Genomics, Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts16Harvard Medical School, Boston, Massachusetts17Program in Medical and Population Genetics, The Broad Institute, Cambridge, Ma
| | - Paul K Crane
- Department of Medicine, University of Washington, Seattle
| | - Joseph D Buxbaum
- Department of Psychiatry, Mount Sinai School of Medicine, New York, New York19Department of Genetics and Genomics Sciences, Mount Sinai School of Medicine, New York, New York20Department of Neuroscience, Mount Sinai School of Medicine, New York, New York2
| | - Jill R Murrell
- Department of Medical and Molecular Genetics, Indiana University, Indianapolis
| | | | - Nilufer Ertekin-Taner
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida13Department of Neurology, Mayo Clinic, Jacksonville, Florida
| | - Mark Logue
- Department of Medicine (Biomedical Genetics), Boston University, Boston, Massachusetts
| | - Clinton T Baldwin
- Department of Medicine (Biomedical Genetics), Boston University, Boston, Massachusetts
| | - Robert C Green
- Harvard Medical School, Boston, Massachusetts23Division of Genetics, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts24Partners Center for Personalized Genetic Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Lisa L Barnes
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois26Department of Behavioral Sciences, Rush University Medical Center, Chicago, Illinois
| | - Laura B Cantwell
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - M Daniele Fallin
- Department of Epidemiology, Johns Hopkins University School of Public Health, Baltimore, Maryland
| | - Rodney C P Go
- School of Public Health, University of Alabama at Birmingham
| | | | | | - Jennifer J Manly
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, New York4Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Kathryn L Lunetta
- Department of Biostatistics, Boston University, Boston, Massachusetts
| | - M Ilyas Kamboh
- Department of Human Genetics, University of Pittsburgh, Pittsburgh, Pennsylvania32Alzheimer's Disease Research Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Oscar L Lopez
- Alzheimer's Disease Research Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - David A Bennett
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois33Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois
| | - Hugh Hendrie
- Indiana University Center for Aging Research, Indianapolis35Department of Psychiatry, Indiana University School of Medicine, Indianapolis36Regenstrief Institute Inc, Indianapolis, Indiana
| | - Kathleen S Hall
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis
| | - Alison M Goate
- Hope Center Program on Protein Aggregation and Neurodegeneration, Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
| | - Goldie S Byrd
- Department of Biology, North Carolina A & T University, Greensboro
| | - Walter A Kukull
- National Alzheimer's Coordinating Center, Department of Epidemiology, University of Washington, Seattle
| | - Tatiana M Foroud
- Department of Behavioral Sciences, Rush University Medical Center, Chicago, Illinois
| | - Jonathan L Haines
- Vanderbilt Center for Human Genetics Research, Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, Tennessee
| | - Lindsay A Farrer
- Department of Medicine (Biomedical Genetics), Boston University, Boston, Massachusetts6Department of Biostatistics, Boston University, Boston, Massachusetts7Department of Ophthalmology, Boston University, Boston, Massachusetts41Department of Neurology, Bo
| | | | - Joseph H Lee
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, New York3Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York4
| | - Gerard D Schellenberg
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Peter St George-Hyslop
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada
| | - Richard Mayeux
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, New York3Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York4
| | - Ekaterina Rogaeva
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada
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Hohman TJ, Cooke-Bailey JN, Reitz C, Jun G, Naj A, Beecham GW, Liu Z, Carney RM, Vance JM, Cuccaro ML, Rajbhandary R, Vardarajan BN, Wang LS, Valladares O, Lin CF, Larson EB, Graff-Radford NR, Evans D, De Jager PL, Crane PK, Buxbaum JD, Murrell JR, Raj T, Ertekin-Taner N, Logue MW, Baldwin CT, Green RC, Barnes LL, Cantwell LB, Fallin MD, Go RCP, Griffith P, Obisesan TO, Manly JJ, Lunetta KL, Kamboh MI, Lopez OL, Bennett DA, Hardy J, Hendrie HC, Hall KS, Goate AM, Lang R, Byrd GS, Kukull WA, Foroud TM, Farrer LA, Martin ER, Pericak-Vance MA, Schellenberg GD, Mayeux R, Haines JL, Thornton-Wells TA. Global and local ancestry in African-Americans: Implications for Alzheimer's disease risk. Alzheimers Dement 2016; 12:233-43. [PMID: 26092349 PMCID: PMC4681680 DOI: 10.1016/j.jalz.2015.02.012] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Revised: 02/03/2015] [Accepted: 02/05/2015] [Indexed: 01/12/2023]
Abstract
INTRODUCTION African-American (AA) individuals have a higher risk for late-onset Alzheimer's disease (LOAD) than Americans of primarily European ancestry (EA). Recently, the largest genome-wide association study in AAs to date confirmed that six of the Alzheimer's disease (AD)-related genetic variants originally discovered in EA cohorts are also risk variants in AA; however, the risk attributable to many of the loci (e.g., APOE, ABCA7) differed substantially from previous studies in EA. There likely are risk variants of higher frequency in AAs that have not been discovered. METHODS We performed a comprehensive analysis of genetically determined local and global ancestry in AAs with regard to LOAD status. RESULTS Compared to controls, LOAD cases showed higher levels of African ancestry, both globally and at several LOAD relevant loci, which explained risk for AD beyond global differences. DISCUSSION Exploratory post hoc analyses highlight regions with greatest differences in ancestry as potential candidate regions for future genetic analyses.
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Christensen KD, Roberts JS, Whitehouse PJ, Royal CD, Obisesan TO, Cupples LA, Vernarelli JA, Bhatt DL, Linnenbringer E, Butson MB, Fasaye GA, Uhlmann WR, Hiraki S, Wang N, Cook-Deegan R, Green RC. Disclosing Pleiotropic Effects During Genetic Risk Assessment for Alzheimer Disease: A Randomized Trial. Ann Intern Med 2016; 164:155-63. [PMID: 26810768 PMCID: PMC4979546 DOI: 10.7326/m15-0187] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Increasing use of genetic testing raises questions about disclosing secondary findings, including pleiotropic information. OBJECTIVE To determine the safety and behavioral effect of disclosing modest associations between apolipoprotein E (APOE) genotype and coronary artery disease (CAD) risk during APOE-based genetic risk assessments for Alzheimer disease (AD). DESIGN Randomized, multicenter equivalence clinical trial. (ClinicalTrials.gov: NCT00462917). SETTING 4 teaching hospitals. PARTICIPANTS 257 asymptomatic adults were enrolled, 69% of whom had 1 AD-affected first-degree relative. INTERVENTION Disclosure of genetic risk information about AD and CAD (AD+CAD) or AD only (AD-only). MEASUREMENTS Primary outcomes were Beck Anxiety Inventory (BAI) and Center for Epidemiologic Studies Depression Scale (CES-D) scores at 12 months. Secondary outcomes were all measures at 6 weeks and 6 months and test-related distress and health behavior changes at 12 months. RESULTS At 12 months, mean BAI scores were 3.5 in both the AD-only and AD+CAD groups (difference, 0.0 [95% CI, -1.0 to 1.0]), and mean CES-D scores were 6.4 and 7.1 in the AD-only and AD+CAD groups, respectively (difference, 0.7 [CI, -1.0 to 2.4]). Both confidence bounds fell within the equivalence margin of ±5 points. Among carriers of the APOE ε4 allele, distress was lower in the AD+CAD groups (difference, -4.8 [CI, -8.6 to -1.0]) (P = 0.031 for the interaction between group and APOE genotype). Participants in the AD+CAD groups also reported more health behavior changes, regardless of APOE genotype. LIMITATIONS Outcomes were self-reported by volunteers without severe anxiety, severe depression, or cognitive problems. Analyses omitted 33 randomly assigned participants. CONCLUSION Disclosure of pleiotropic information did not increase anxiety or depression and may have decreased distress among persons at increased risk for 2 conditions. Providing risk modification information about CAD improved health behaviors. Findings highlight the potential benefits of disclosure of secondary genetic findings when options exist for decreasing risk. PRIMARY FUNDING SOURCE National Human Genome Research Institute.
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Affiliation(s)
- Kurt D. Christensen
- From Brigham and Women's Hospital and Boston University School of Public Health, Boston, Massachusetts; University of Michigan School of Public Health and University of Michigan Medical School, Ann Arbor, Michigan; Case Western Reserve University, Cleveland, Ohio; Duke University and Sanford School of Public Policy, Durham, North Carolina; Howard University Hospital, Washington, DC; Fairfield University, Fairfield, Connecticut; Washington University School of Medicine, St. Louis, Missouri
- Walter Reed National Military Medical Center, Bethesda, Maryland; and GeneDx, Gaithersburg, Maryland
| | - J. Scott Roberts
- From Brigham and Women's Hospital and Boston University School of Public Health, Boston, Massachusetts; University of Michigan School of Public Health and University of Michigan Medical School, Ann Arbor, Michigan; Case Western Reserve University, Cleveland, Ohio; Duke University and Sanford School of Public Policy, Durham, North Carolina; Howard University Hospital, Washington, DC; Fairfield University, Fairfield, Connecticut; Washington University School of Medicine, St. Louis, Missouri
- Walter Reed National Military Medical Center, Bethesda, Maryland; and GeneDx, Gaithersburg, Maryland
| | - Peter J. Whitehouse
- From Brigham and Women's Hospital and Boston University School of Public Health, Boston, Massachusetts; University of Michigan School of Public Health and University of Michigan Medical School, Ann Arbor, Michigan; Case Western Reserve University, Cleveland, Ohio; Duke University and Sanford School of Public Policy, Durham, North Carolina; Howard University Hospital, Washington, DC; Fairfield University, Fairfield, Connecticut; Washington University School of Medicine, St. Louis, Missouri
- Walter Reed National Military Medical Center, Bethesda, Maryland; and GeneDx, Gaithersburg, Maryland
| | - Charmaine D.M. Royal
- From Brigham and Women's Hospital and Boston University School of Public Health, Boston, Massachusetts; University of Michigan School of Public Health and University of Michigan Medical School, Ann Arbor, Michigan; Case Western Reserve University, Cleveland, Ohio; Duke University and Sanford School of Public Policy, Durham, North Carolina; Howard University Hospital, Washington, DC; Fairfield University, Fairfield, Connecticut; Washington University School of Medicine, St. Louis, Missouri
- Walter Reed National Military Medical Center, Bethesda, Maryland; and GeneDx, Gaithersburg, Maryland
| | - Thomas O. Obisesan
- From Brigham and Women's Hospital and Boston University School of Public Health, Boston, Massachusetts; University of Michigan School of Public Health and University of Michigan Medical School, Ann Arbor, Michigan; Case Western Reserve University, Cleveland, Ohio; Duke University and Sanford School of Public Policy, Durham, North Carolina; Howard University Hospital, Washington, DC; Fairfield University, Fairfield, Connecticut; Washington University School of Medicine, St. Louis, Missouri
- Walter Reed National Military Medical Center, Bethesda, Maryland; and GeneDx, Gaithersburg, Maryland
| | - L. Adrienne Cupples
- From Brigham and Women's Hospital and Boston University School of Public Health, Boston, Massachusetts; University of Michigan School of Public Health and University of Michigan Medical School, Ann Arbor, Michigan; Case Western Reserve University, Cleveland, Ohio; Duke University and Sanford School of Public Policy, Durham, North Carolina; Howard University Hospital, Washington, DC; Fairfield University, Fairfield, Connecticut; Washington University School of Medicine, St. Louis, Missouri
- Walter Reed National Military Medical Center, Bethesda, Maryland; and GeneDx, Gaithersburg, Maryland
| | - Jacqueline A. Vernarelli
- From Brigham and Women's Hospital and Boston University School of Public Health, Boston, Massachusetts; University of Michigan School of Public Health and University of Michigan Medical School, Ann Arbor, Michigan; Case Western Reserve University, Cleveland, Ohio; Duke University and Sanford School of Public Policy, Durham, North Carolina; Howard University Hospital, Washington, DC; Fairfield University, Fairfield, Connecticut; Washington University School of Medicine, St. Louis, Missouri
- Walter Reed National Military Medical Center, Bethesda, Maryland; and GeneDx, Gaithersburg, Maryland
| | - Deepak L. Bhatt
- From Brigham and Women's Hospital and Boston University School of Public Health, Boston, Massachusetts; University of Michigan School of Public Health and University of Michigan Medical School, Ann Arbor, Michigan; Case Western Reserve University, Cleveland, Ohio; Duke University and Sanford School of Public Policy, Durham, North Carolina; Howard University Hospital, Washington, DC; Fairfield University, Fairfield, Connecticut; Washington University School of Medicine, St. Louis, Missouri
- Walter Reed National Military Medical Center, Bethesda, Maryland; and GeneDx, Gaithersburg, Maryland
| | - Erin Linnenbringer
- From Brigham and Women's Hospital and Boston University School of Public Health, Boston, Massachusetts; University of Michigan School of Public Health and University of Michigan Medical School, Ann Arbor, Michigan; Case Western Reserve University, Cleveland, Ohio; Duke University and Sanford School of Public Policy, Durham, North Carolina; Howard University Hospital, Washington, DC; Fairfield University, Fairfield, Connecticut; Washington University School of Medicine, St. Louis, Missouri
- Walter Reed National Military Medical Center, Bethesda, Maryland; and GeneDx, Gaithersburg, Maryland
| | - Melissa B. Butson
- From Brigham and Women's Hospital and Boston University School of Public Health, Boston, Massachusetts; University of Michigan School of Public Health and University of Michigan Medical School, Ann Arbor, Michigan; Case Western Reserve University, Cleveland, Ohio; Duke University and Sanford School of Public Policy, Durham, North Carolina; Howard University Hospital, Washington, DC; Fairfield University, Fairfield, Connecticut; Washington University School of Medicine, St. Louis, Missouri
- Walter Reed National Military Medical Center, Bethesda, Maryland; and GeneDx, Gaithersburg, Maryland
| | - Grace-Ann Fasaye
- From Brigham and Women's Hospital and Boston University School of Public Health, Boston, Massachusetts; University of Michigan School of Public Health and University of Michigan Medical School, Ann Arbor, Michigan; Case Western Reserve University, Cleveland, Ohio; Duke University and Sanford School of Public Policy, Durham, North Carolina; Howard University Hospital, Washington, DC; Fairfield University, Fairfield, Connecticut; Washington University School of Medicine, St. Louis, Missouri
- Walter Reed National Military Medical Center, Bethesda, Maryland; and GeneDx, Gaithersburg, Maryland
| | - Wendy R. Uhlmann
- From Brigham and Women's Hospital and Boston University School of Public Health, Boston, Massachusetts; University of Michigan School of Public Health and University of Michigan Medical School, Ann Arbor, Michigan; Case Western Reserve University, Cleveland, Ohio; Duke University and Sanford School of Public Policy, Durham, North Carolina; Howard University Hospital, Washington, DC; Fairfield University, Fairfield, Connecticut; Washington University School of Medicine, St. Louis, Missouri
- Walter Reed National Military Medical Center, Bethesda, Maryland; and GeneDx, Gaithersburg, Maryland
| | - Susan Hiraki
- From Brigham and Women's Hospital and Boston University School of Public Health, Boston, Massachusetts; University of Michigan School of Public Health and University of Michigan Medical School, Ann Arbor, Michigan; Case Western Reserve University, Cleveland, Ohio; Duke University and Sanford School of Public Policy, Durham, North Carolina; Howard University Hospital, Washington, DC; Fairfield University, Fairfield, Connecticut; Washington University School of Medicine, St. Louis, Missouri
- Walter Reed National Military Medical Center, Bethesda, Maryland; and GeneDx, Gaithersburg, Maryland
| | - Na Wang
- From Brigham and Women's Hospital and Boston University School of Public Health, Boston, Massachusetts; University of Michigan School of Public Health and University of Michigan Medical School, Ann Arbor, Michigan; Case Western Reserve University, Cleveland, Ohio; Duke University and Sanford School of Public Policy, Durham, North Carolina; Howard University Hospital, Washington, DC; Fairfield University, Fairfield, Connecticut; Washington University School of Medicine, St. Louis, Missouri
- Walter Reed National Military Medical Center, Bethesda, Maryland; and GeneDx, Gaithersburg, Maryland
| | - Robert Cook-Deegan
- From Brigham and Women's Hospital and Boston University School of Public Health, Boston, Massachusetts; University of Michigan School of Public Health and University of Michigan Medical School, Ann Arbor, Michigan; Case Western Reserve University, Cleveland, Ohio; Duke University and Sanford School of Public Policy, Durham, North Carolina; Howard University Hospital, Washington, DC; Fairfield University, Fairfield, Connecticut; Washington University School of Medicine, St. Louis, Missouri
- Walter Reed National Military Medical Center, Bethesda, Maryland; and GeneDx, Gaithersburg, Maryland
| | - Robert C. Green
- From Brigham and Women's Hospital and Boston University School of Public Health, Boston, Massachusetts; University of Michigan School of Public Health and University of Michigan Medical School, Ann Arbor, Michigan; Case Western Reserve University, Cleveland, Ohio; Duke University and Sanford School of Public Policy, Durham, North Carolina; Howard University Hospital, Washington, DC; Fairfield University, Fairfield, Connecticut; Washington University School of Medicine, St. Louis, Missouri
- Walter Reed National Military Medical Center, Bethesda, Maryland; and GeneDx, Gaithersburg, Maryland
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Ngwa JS, Ntekim O, Fungwe TV, Johnson SM, Allard JS, Castor C, Gillum RF, Obisesan TO. P3‐258: Pulse pressure and systolic blood pressure associated with hippocampal volume by apolipoprotein (APO) carriers and Alzheimer disease status: Alzheimer's disease neuroimaging initiative (ADNI) study. Alzheimers Dement 2015. [DOI: 10.1016/j.jalz.2015.06.1631] [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: 10/22/2022]
Affiliation(s)
| | | | | | | | | | | | - Richard F. Gillum
- Howard University HospitalWashingtonDCUSA
- Howard University College of MedicineWashingtonDCUSA
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Graham LA, Ngwa JS, Johnson S, Johson M, Ogunlana O, Wolday S, Ntekim O, Obisesan TO. P2‐216: Best strategies to recruit and enroll african americans into clinical and biomedical research. Alzheimers Dement 2015. [DOI: 10.1016/j.jalz.2015.06.756] [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]
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Allard JS, Ntekim O, Ngwa JS, Fungwe TV, Johnson SM, Gillum RF, Obisesan TO. P3‐234: Exercise‐induced effects on serum and CSF BDNF levels in elderly african americans with mild cognitive impairment: Gene, exercise, and memory study (GEMS). Alzheimers Dement 2015. [DOI: 10.1016/j.jalz.2015.06.1606] [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: 10/22/2022]
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Chen Y, Obisesan TO. P3‐026: Inverse association between Alzheimer's disease and cancer? a study at the gene expression level. Alzheimers Dement 2015. [DOI: 10.1016/j.jalz.2015.06.892] [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: 11/27/2022]
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Obisesan TO. P4‐145: Gene, exercise, and memory study (GEMS): A randomized controlled clinical trial to evaluate the effects of standardized aerobic exercise on cognition and neurodegeneration in african americans with mild Alzheimer's disease. Alzheimers Dement 2015. [DOI: 10.1016/j.jalz.2015.06.1851] [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: 10/22/2022]
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Iyalomhe O, Chen Y, Allard J, Ntekim O, Johnson S, Bond V, Goerlitz D, Li J, Obisesan TO. A standardized randomized 6-month aerobic exercise-training down-regulated pro-inflammatory genes, but up-regulated anti-inflammatory, neuron survival and axon growth-related genes. Exp Gerontol 2015; 69:159-69. [PMID: 25981742 DOI: 10.1016/j.exger.2015.05.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Revised: 05/12/2015] [Accepted: 05/13/2015] [Indexed: 12/18/2022]
Abstract
There is considerable support for the view that aerobic exercise may confer cognitive benefits to mild cognitively impaired elderly persons. However, the biological mechanisms mediating these effects are not entirely clear. As a preliminary step towards informing this gap in knowledge, we enrolled older adults confirmed to have mild cognitive impairment (MCI) in a 6-month exercise program. Male and female subjects were randomized into a 6-month program of either aerobic or stretch (control) exercise. Data collected from the first 10 completers, aerobic exercise (n=5) or stretch (control) exercise (n=5), were used to determine intervention-induced changes in the global gene expression profiles of the aerobic and stretch groups. Using microarray, we identified genes with altered expression (relative to baseline values) in response to the 6-month exercise intervention. Genes whose expression were altered by at least two-fold, and met the p-value cutoff of 0.01 were inputted into the Ingenuity Pathway Knowledge Base Library to generate gene-interaction networks. After a 6-month aerobic exercise-training, genes promoting inflammation became down-regulated, whereas genes having anti-inflammatory properties and those modulating immune function or promoting neuron survival and axon growth, became up-regulated (all fold change≥±2.0, p<0.01). These changes were not observed in the stretch group. Importantly, the differences in the expression profiles correlated with significant improvement in maximal oxygen uptake (VO2max) in the aerobic program as opposed to the stretch group. We conclude that three distinct cellular pathways may collectively influence the training effects of aerobic exercise in MCI subjects. We plan to confirm these effects using rt-PCR and correlate such changes with the cognitive phenotype.
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Affiliation(s)
- Osigbemhe Iyalomhe
- Division of Geriatrics, Department of Medicine, Howard University Hospital, 2041 Georgia Ave NW, Washington, DC 20060, USA
| | - Yuanxiu Chen
- Clinical Translational Science Center, Howard University Hospital, 2041 Georgia Ave NW, Washington, DC 20060, USA
| | - Joanne Allard
- Howard University College of Medicine, 520 W Street NW, Washington, DC 20059, USA
| | - Oyonumo Ntekim
- Department of Health, Human Performance, and Leisure Studies, College of Arts and Science, Howard University College of Medicine, 520 W St NW, Washington, DC 20059, USA
| | - Sheree Johnson
- Howard University College of Medicine, 520 W Street NW, Washington, DC 20059, USA
| | - Vernon Bond
- Division of Geriatrics, Department of Medicine, Howard University Hospital, 2041 Georgia Ave NW, Washington, DC 20060, USA
| | - David Goerlitz
- Department of Molecular Biology and Informatics, Georgetown University Medical Center, 400 Reservoir Rd NW, Washington, DC 20057, USA
| | - James Li
- Department of Molecular Biology and Informatics, Georgetown University Medical Center, 400 Reservoir Rd NW, Washington, DC 20057, USA
| | - Thomas O Obisesan
- Division of Geriatrics, Department of Medicine, Howard University Hospital, 2041 Georgia Ave NW, Washington, DC 20060, USA; Clinical Translational Science Center, Howard University Hospital, 2041 Georgia Ave NW, Washington, DC 20060, USA.
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Green RC, Christensen KD, Cupples LA, Relkin NR, Whitehouse PJ, Royal CDM, Obisesan TO, Cook-Deegan R, Linnenbringer E, Butson MB, Fasaye GA, Levinson E, Roberts JS. A randomized noninferiority trial of condensed protocols for genetic risk disclosure of Alzheimer's disease. Alzheimers Dement 2014; 11:1222-30. [PMID: 25499536 DOI: 10.1016/j.jalz.2014.10.014] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2014] [Revised: 10/12/2014] [Accepted: 10/30/2014] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Conventional multisession genetic counseling is currently recommended when disclosing apolipoprotein E (APOE) genotype for the risk of Alzheimer's disease (AD) in cognitively normal individuals. The objective of this study was to evaluate the safety of brief disclosure protocols for disclosing APOE genotype for the risk of AD. METHODS A randomized, multicenter noninferiority trial was conducted at four sites. Participants were asymptomatic adults having a first-degree relative with AD. A standard disclosure protocol by genetic counselors (SP-GC) was compared with condensed protocols, with disclosures by genetic counselors (CP-GC) and by physicians (CP-MD). Preplanned co-primary outcomes were anxiety and depression scales 12 months after disclosure. RESULTS Three hundred and forty-three adults (mean age 58.3, range 33-86 years, 71% female, 23% African American) were randomly assigned to the SP-GC protocol (n = 115), CP-GC protocol (n = 116), or CP-MD protocol (n = 112). Mean postdisclosure scores on all outcomes were well below cut-offs for clinical concern across protocols. Comparing CP-GC with SP-GC, the 97.5% upper confidence limits at 12 months after disclosure on co-primary outcomes of anxiety and depression ranged from a difference of 1.2 to 2.0 in means (all P < .001 on noninferiority tests), establishing noninferiority for condensed protocols. Results were similar between European Americans and African Americans. CONCLUSIONS These data support the safety of condensed protocols for APOE disclosure for those free of severe anxiety or depression who are actively seeking such information.
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Affiliation(s)
- Robert C Green
- Division of Genetics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Partners Personalized Medicine, Boston, MA, USA.
| | - Kurt D Christensen
- Division of Genetics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - L Adrienne Cupples
- Departments of Biostatistics and Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Norman R Relkin
- Department of Neurology, Weill Medical College of Cornell University, New York, NY, USA
| | - Peter J Whitehouse
- Department of Neurology, Case Western Reserve University, Cleveland, OH, USA
| | - Charmaine D M Royal
- Department of African and African American Studies, Duke University, Durham, NC, USA
| | - Thomas O Obisesan
- Department of Medicine, Howard University School of Medicine, Washington, DC, USA
| | | | - Erin Linnenbringer
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | | | | | - Elana Levinson
- Department of Surgery, Columbia University, New York, NY, USA
| | - J Scott Roberts
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
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Rowe JS, Okafor C, Cudjoe T, Obisesan TO, Gillum RF. Alzheimer's Disease and Other Dementia in Sub-Saharan Africa and the Caribbean. J Am Geriatr Soc 2014; 62:1991-2. [DOI: 10.1111/jgs.13036] [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: 11/30/2022]
Affiliation(s)
- Jean S. Rowe
- College of Medicine; Howard University; Washington District of Columbia
| | - Chika Okafor
- College of Medicine; Howard University; Washington District of Columbia
| | - Thomas Cudjoe
- Department of Medicine; Howard University Hospital; Washington District of Columbia
| | | | - Richard F. Gillum
- College of Medicine; Howard University; Washington District of Columbia
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Pinette A, Obisesan TO, Shetty N, Tchiendji CS, Mehari A. Trends in hospitalization associated with Alzheimer's disease in the United States. J Am Geriatr Soc 2013; 61:1427-8. [PMID: 23937500 DOI: 10.1111/jgs.12386] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Reitz C, Jun G, Naj A, Rajbhandary R, Vardarajan BN, Wang LS, Valladares O, Lin CF, Larson EB, Graff-Radford NR, Evans D, De Jager PL, Crane PK, Buxbaum JD, Murrell JR, Raj T, Ertekin-Taner N, Logue M, Baldwin CT, Green RC, Barnes LL, Cantwell LB, Fallin MD, Go RCP, Griffith P, Obisesan TO, Manly JJ, Lunetta KL, Kamboh MI, Lopez OL, Bennett DA, Hendrie H, Hall KS, Goate AM, Byrd GS, Kukull WA, Foroud TM, Haines JL, Farrer LA, Pericak-Vance MA, Schellenberg GD, Mayeux R. Variants in the ATP-binding cassette transporter (ABCA7), apolipoprotein E ϵ4,and the risk of late-onset Alzheimer disease in African Americans. JAMA 2013; 309:1483-92. [PMID: 23571587 PMCID: PMC3667653 DOI: 10.1001/jama.2013.2973] [Citation(s) in RCA: 327] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
IMPORTANCE Genetic variants associated with susceptibility to late-onset Alzheimer disease are known for individuals of European ancestry, but whether the same or different variants account for the genetic risk of Alzheimer disease in African American individuals is unknown. Identification of disease-associated variants helps identify targets for genetic testing, prevention, and treatment. OBJECTIVE To identify genetic loci associated with late-onset Alzheimer disease in African Americans. DESIGN, SETTING, AND PARTICIPANTS The Alzheimer Disease Genetics Consortium (ADGC) assembled multiple data sets representing a total of 5896 African Americans (1968 case participants, 3928 control participants) 60 years or older that were collected between 1989 and 2011 at multiple sites. The association of Alzheimer disease with genotyped and imputed single-nucleotide polymorphisms (SNPs) was assessed in case-control and in family-based data sets. Results from individual data sets were combined to perform an inverse variance-weighted meta-analysis, first with genome-wide analyses and subsequently with gene-based tests for previously reported loci. MAIN OUTCOMES AND MEASURES Presence of Alzheimer disease according to standardized criteria. RESULTS Genome-wide significance in fully adjusted models (sex, age, APOE genotype, population stratification) was observed for a SNP in ABCA7 (rs115550680, allele = G; frequency, 0.09 cases and 0.06 controls; odds ratio [OR], 1.79 [95% CI, 1.47-2.12]; P = 2.2 × 10(-9)), which is in linkage disequilibrium with SNPs previously associated with Alzheimer disease in Europeans (0.8 < D' < 0.9). The effect size for the SNP in ABCA7 was comparable with that of the APOE ϵ4-determining SNP rs429358 (allele = C; frequency, 0.30 cases and 0.18 controls; OR, 2.31 [95% CI, 2.19-2.42]; P = 5.5 × 10(-47)). Several loci previously associated with Alzheimer disease but not reaching significance in genome-wide analyses were replicated in gene-based analyses accounting for linkage disequilibrium between markers and correcting for number of tests performed per gene (CR1, BIN1, EPHA1, CD33; 0.0005 < empirical P < .001). CONCLUSIONS AND RELEVANCE In this meta-analysis of data from African American participants, Alzheimer disease was significantly associated with variants in ABCA7 and with other genes that have been associated with Alzheimer disease in individuals of European ancestry. Replication and functional validation of this finding is needed before this information is used in clinical settings.
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Affiliation(s)
- Christiane Reitz
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Gertrude H. Sergievsky Center, Columbia University, 630 W 168th St, New York, NY 10032, USA
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Naqvi A, Gillum RF, Kwagyan J, Obisesan TO. Serum vitamin status profile and cognitive function in a national sample of older americans. J Am Geriatr Soc 2012; 60:2374-5. [PMID: 23231562 DOI: 10.1111/jgs.12022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Obisesan TO. Among elderly men, feelings of loneliness are associated with increased 10-year mortality risk, independent of social isolation and medical and psychiatric conditions. Evid Based Nurs 2012; 16:66-7. [PMID: 23125276 DOI: 10.1136/eb-2012-100892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Implications for practice and research: Clinicians should have heightened awareness and inquire about feelings of loneliness when providing care for older adults. More studies are needed to further elucidate gender-based differences on the relationship between loneliness and mortality.
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Affiliation(s)
- Thomas O Obisesan
- Department of Medicine, Howard University, 2041 Georgia Ave. NW, Washington, DC 20060, USA.
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Abstract
BACKGROUND Magnitudes, geographic and racial variation in trends in coronary heart disease (CHD) mortality within the US require updating for health services and health disparities research. Therefore the aim of this study is to present data on these trends through 2007. METHODS Data for CHD were analyzed using the US mortality files for 1999-2007 obtained from the US Centers for Disease Control and Prevention. Age-adjusted annual death rates were computed for non-Hispanic African Americans (AA) and European Americans (EA) aged 35-84 years. The direct method was used to standardize rates by age, using the 2000 US standard population. Joinpoint regression models were used to evaluate trends, expressed as annual percent change (APC). RESULTS For both AA men and women the magnitude in CHD mortality is higher compared to EA men and women, respectively. Between 1999 and 2007 the rate declined both in AA and in EA of both sexes in every geographic division; however, relative declines varied. For example, among men, relative average annual declines ranged from 3.2% to 4.7% in AA and from 4.4% to 5.5% in EA among geographic divisions. In women, rates declined more in later years of the decade and in women over 54 years. In 2007, age-adjusted death rate per 100,000 for CHD ranged from 93 in EA women in New England to 345 in AA men in the East North Central division. In EA, areas near the Ohio and lower Mississippi Rivers had above average rates. Disparities in trends by urbanization level were also found. For AA in the East North Central division, the APC was similar in large central metro (-4.2), large fringe metro (-4.3), medium metro urbanization strata (-4.4), and small metro (-3.9). APC was somewhat higher in the micropolitan/non-metro (-5.3), and especially the non-core/non-metro (-6.5). For EA in the East South Central division, the APC was higher in large central metro (-5.3), large fringe metro (-4.3) and medium metro urbanization strata (-5.1) than in small metro (-3.8), micropolitan/non-metro (-4.0), and non-core/non-metro (-3.3) urbanization strata. CONCLUSIONS Between 1999 and 2007, the level and rate of decline in CHD mortality displayed persistent disparities. Declines were greater in EA than AA racial groups. Rates were greater in the Ohio and Mississippi River than other geographic regions.
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Affiliation(s)
- Richard F Gillum
- Department of Medicine, Howard University College of Medicine, Washington, DC, USA
- Division of Geriatrics, Howard University Hospital, Towers Bldg. 2041 Georgia Ave, NW, Washington, DC 20060, USA
| | - Alem Mehari
- Department of Medicine, Howard University College of Medicine, Washington, DC, USA
| | - Bryan Curry
- Department of Medicine, Howard University College of Medicine, Washington, DC, USA
| | - Thomas O Obisesan
- Department of Medicine, Howard University College of Medicine, Washington, DC, USA
- Division of Geriatrics, Howard University Hospital, Towers Bldg. 2041 Georgia Ave, NW, Washington, DC 20060, USA
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Obisesan TO, Gillum RF, Johnson S, Umar N, Williams D, Bond V, Kwagyan J. Neuroprotection and neurodegeneration in Alzheimer's disease: role of cardiovascular disease risk factors, implications for dementia rates, and prevention with aerobic exercise in african americans. Int J Alzheimers Dis 2012; 2012:568382. [PMID: 22577592 PMCID: PMC3345220 DOI: 10.1155/2012/568382] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2011] [Revised: 02/09/2012] [Accepted: 02/12/2012] [Indexed: 12/17/2022] Open
Abstract
Prevalence of Alzheimer's disease (AD) will reach epidemic proportions in the United States and worldwide in the coming decades, and with substantially higher rates in African Americans (AAs) than in Whites. Older age, family history, low levels of education, and ɛ4 allele of the apolipoprotein E (APOE) gene are recognized risk factors for the neurodegeneration in AD and related disorders. In AAs, the contributions of APOE gene to AD risk continue to engender a considerable debate. In addition to the established role of cardiovascular disease (CVD) risk in vascular dementia, it is now believed that CVD risk and its endophenotype may directly comediate AD phenotype. Given the pleiotropic effects of APOE on CVD and AD risks, the higher rates of CVD risks in AAs than in Whites, it is likely that CVD risks contribute to the disproportionately higher rates of AD in AAs. Though the advantageous effects of aerobic exercise on cognition is increasingly recognized, this evidence is hardly definitive, and data on AAs is lacking. In this paper, we will discuss the roles of CVD risk factors in the development of AD and related dementias, the susceptibility of these risk factors to physiologic adaptation, and fitness-related improvements in cognitive function. Its relevance to AD prevention in AAs is emphasized.
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Affiliation(s)
- Thomas O. Obisesan
- Division of Geriatrics, Department of Medicine, Howard University Hospital, 2041 Georgia Avenue, NW, Washington, DC 20059, USA
| | - Richard F. Gillum
- Division of Geriatrics, Department of Medicine, Howard University Hospital, 2041 Georgia Avenue, NW, Washington, DC 20059, USA
| | - Stephanie Johnson
- Division of Geriatrics, Department of Medicine, Howard University Hospital, 2041 Georgia Avenue, NW, Washington, DC 20059, USA
| | - Nisser Umar
- Division of Geriatrics, Department of Medicine, Howard University Hospital, 2041 Georgia Avenue, NW, Washington, DC 20059, USA
| | - Deborah Williams
- Division of Cardiology, Department of Medicine, Howard University Hospital, 2041 Georgia Avenue, NW, Washington, DC 20059, USA
| | - Vernon Bond
- Department of Health and Human Performance, Howard University Hospital, 2041 Georgia Avenue, NW, Washington, DC 20059, USA
| | - John Kwagyan
- Howard University Hospital, Georgetown-Howard Universities Center for Clinical and Translational Science, 2041 Georgia Avenue, NW, Washington, DC 20059, USA
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Logue MW, Schu M, Vardarajan BN, Buros J, Green RC, Go RCP, Griffith P, Obisesan TO, Shatz R, Borenstein A, Cupples LA, Lunetta KL, Fallin MD, Baldwin CT, Farrer LA. A comprehensive genetic association study of Alzheimer disease in African Americans. ACTA ACUST UNITED AC 2012; 68:1569-79. [PMID: 22159054 DOI: 10.1001/archneurol.2011.646] [Citation(s) in RCA: 177] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To evaluate the association of genetic variation with late-onset Alzheimer disease (AD) in African Americans, including genes implicated in recent genome-wide association studies of whites. DESIGN We analyzed a genome-wide set of 2.5 million imputed markers to evaluate the genetic basis of AD in an African American population. SUBJECTS Five hundred thirteen well-characterized African American AD cases and 496 cognitively normal African American control subjects. SETTING Data were collected from multiple sites as part of the Multi-Institutional Research on Alzheimer Genetic Epidemiology (MIRAGE) Study and the Henry Ford Health System as part of the Genetic and Environmental Risk Factors for Alzheimer Disease Among African Americans (GenerAAtions) Study. RESULTS Several significant single-nucleotide polymorphisms (SNPs) were observed in the region of the apolipoprotein E gene (APOE). After adjusting for the confounding effects of APOE genotype, one of these SNPs, rs6859 in PVRL2, remained significantly associated with AD (P = .0087). Association was also observed with SNPs in CLU, PICALM, BIN1, EPHA1, MS4A, ABCA7, and CD33, although the effect direction for some SNPs and the most significant SNPs differed from findings in data sets consisting of whites. Finally, using the African American genome-wide association study data set as a discovery sample, we obtained suggestive evidence of association with SNPs for several novel candidate genes. CONCLUSIONS Some genes contribute to AD pathogenesis in both white and African American cohorts, although it is unclear whether the causal variants are the same. A larger African American sample will be needed to confirm novel gene associations, which may be population specific.
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Affiliation(s)
- Mark W Logue
- Department of Medicine, Boston University School of Medicine, Boston, MA 02118, USA
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Obisesan TO, Umar N, Paluvoi N, Gillum RF. Association of leisure-time physical activity with cognition by apolipoprotein-E genotype in persons aged 60 years and over: the National Health and Nutrition Examination Survey (NHANES-III). Clin Interv Aging 2012; 7:35-43. [PMID: 22334766 PMCID: PMC3278197 DOI: 10.2147/cia.s26794] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective To test the hypothesis that aerobic-related leisure-time physical activity (PA) is associated with better cognitive function and that the effect varies among apolipoprotein E (APOE) genotype groups. Design Cross-sectional study of persons examined in the Third National Health and Nutrition Examination Survey (NHANES-III; 1988–1994). Setting US noninstitutionalized population. Participants and methods From a sample of 7159, aged ≥60 years, we analyzed data for 1799 older American men and women who had information on PA, a short mental status examination (SMSE), and were genotyped at the apolipoprotein E gene locus. Results In the initial bivariate analysis, non-ɛ4 carriers and ɛ4-heterozygotes performed better than ɛ4-homozygotes in the 60–69 age group. After controlling for multiple confounders including mobility limitation, PA correlated with a higher SMSE score in non-ɛ4 carriers (P = 0.014), but not in ɛ4 carriers (P = 0.887). At ≥70 years, PA also correlated with higher adjusted SMSE scores in non-ɛ4 carriers (P = 0.02); but this association became nonsignificant after controlling for mobility limitation (P = 0.12). Conclusion In a nationally representative sample, PA was associated with enhanced cognition, an effect that was differentially influenced by apolipoprotein E genotype. Experimental studies are needed to determine whether or not PA can attenuate cognitive decline.
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Affiliation(s)
- Thomas O Obisesan
- Division of Geriatrics, Howard University Hospital, Washington, DC 20060, USA.
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Umar N, Aliyu MH, Otado J, Gillum RF, Obisesan TO. Ethnic-based differences in the association of self-perceived health status and doctor's office utilization: Longitudinal Study on Aging. Clin Interv Aging 2011; 6:295-301. [PMID: 22162645 PMCID: PMC3230583 DOI: 10.2147/cia.s19935] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background The purpose of this study was to determine whether self-perceived health status is predictive of a doctor’s office visit in the Longitudinal Study on Aging (LSOA). Methods This was a population-based longitudinal study of persons aged ≥70 years who participated in the Study on Aging in 1984 and a follow-up survey of the LSOA in 1986. The cohort for the study consisted of 560 blacks and 6880 whites who were 70 years or older in 1984. Multivariable logistic regression analysis was performed separately for blacks and for whites. Results The study sample was predominantly Caucasian (91.2%) with a mean age 76.8 ± 5.5 years and mean education grade 10 ± 3.7. The majority (82%) lived above the poverty level. Self-reported poor health status predicted the use of doctor’s office services among whites (odds ratio [OR] 5.15; 95% confidence interval [CI] 3.34–7.95), but not in blacks (OR 1.6; 95% CI 0.54–4.76). Conclusion Self-perceived health status predicted the use of doctor’s office services among older whites but not in older blacks in the LSOA.
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Affiliation(s)
- Nisser Umar
- Department of Internal Medicine, Division of Geriatrics, Howard University Hospital, Washington, DC 20060, USA
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Hurko O, Black SE, Doody R, Doraiswamy PM, Gamst A, Kaye J, Obisesan TO, Rusinek H, Scharre D, Sperling R, Weiner MW, Green RC. The ADNI Publication Policy: commensurate recognition of critical contributors who are not authors. Neuroimage 2011; 59:4196-200. [PMID: 22100665 DOI: 10.1016/j.neuroimage.2011.10.085] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2011] [Revised: 10/23/2011] [Accepted: 10/25/2011] [Indexed: 01/17/2023] Open
Abstract
An efficient approach to certain types of biomedical research requires a scale that precludes involvement of all critical contributors in all aspects of experimental design, execution, and as well as writing of most, if not all, derived works. Guarantors of both the integrity of the data and of its subsequent analyses are required. When separate groups are responsible for each of these activities, each should be readily identifiable both in the primary publication and in all subsequent citations. We describe the publication policy of the Alzheimer Disease Neuroimaging Initiative (ADNI), its origins and its acceptance by the editorial and scientific communities.
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Affiliation(s)
- Orest Hurko
- Biologics Consulting Group, Inc, 400 North Washington Street, Suite 100, Alexandria, VA 22314-2353, USA.
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Abstract
BACKGROUND AND PURPOSE Magnitude, geographic, and ethnic variation in trends in stroke within the United States require updating for health services and health disparities research. METHODS Data for stroke were analyzed from the US mortality files for 1999 to 2007. Age-adjusted death rates were computed for non-Hispanic African Americans and European Americans aged ≥45 years. RESULTS Between 1999 and 2007, the age-adjusted death rate per 100,000 for stroke declined both in African Americans and in European Americans of both genders. Among African American females, European American females, and European American males, rates declined by at least 2% annually in every division. Among African American males, rates declined little in the East and West South Central divisions where disparities in trends by urbanization level were found. CONCLUSIONS Between 1999 and 2007, the rate of decline in stroke mortality varied by geographic region and ethnic group.
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Affiliation(s)
- Richard F Gillum
- Division of Geriatrics, Howard University College of Medicine, Washington, DC, USA.
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Abstract
OBJECTIVES To test the hypothesis that the geographic pattern of mortality with dementia coded on the death certificate varies according to race and that racial differences vary according to geography in the United States. DESIGN Analysis of the U.S. multiple-cause-of-death files for 1999 to 2004. SETTING United States. PARTICIPANTS Decedents with dementia coded as underlying or contributing cause of death on the death certificate. MEASUREMENTS Age-adjusted death rates for U.S. Census geographic divisions for blacks and whites aged 65 and older. RESULTS From 1999 to 2004, the U.S. age-adjusted annual death rate per 100,000 for dementia was 628 in blacks and 647 in whites. The difference between rates in blacks and whites ranged from -130 deaths per 100,000 (-36%) in the Middle Atlantic region to +55 (+8%) in the South Atlantic division. Blacks had higher rates in three divisions and whites in five. In the Middle Atlantic and in the United States as a whole, blacks were relatively more likely to receive a diagnosis of unspecified dementia or senility (66%) than Alzheimer's disease (30%) than whites (58% and 41%, respectively). CONCLUSION Although overall rates were similar, geographic variation in racial differences in rates of death with dementia occurred between U.S. regions. Further research is needed to assess geographic and racial variation in artifacts of certification versus biological variation as possible causes of variation to enhance utility of mortality data for disease monitoring and health-disparities research.
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Affiliation(s)
- Richard F Gillum
- Division of Geriatrics, Department of Medicine, College of Medicine, Howard University, Washington, DC 20060, USA
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Akinleye I, Roberts JS, Royal CDM, Linnenbringer E, Obisesan TO, Fasaye GA, Green RC. Differences between African American and White research volunteers in their attitudes, beliefs and knowledge regarding genetic testing for Alzheimer's disease. J Genet Couns 2011; 20:650-9. [PMID: 21656311 DOI: 10.1007/s10897-011-9377-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2011] [Accepted: 05/26/2011] [Indexed: 01/09/2023]
Abstract
Genetic susceptibility testing for common diseases is expanding, but little is known about race group differences in test perceptions. The purpose of this study was to examine differences between African Americans and Whites in knowledge, attitudes, and motivations regarding genetic susceptibility testing for Alzheimer's disease (AD). Before enrolling in an AD genetic testing research trial, 313 first-degree relatives of AD patients (20% African American; 71% female; mean age = 58 years) were surveyed regarding: (1) knowledge about genetics and AD risk; (2) concerns about developing AD; and (3) reasons for seeking testing. In comparison to Whites, African Americans were less knowledgeable about genetics and AD risk (p < .01) and less concerned about developing AD (p < .05), with lower levels of perceived disease risk (p = .04). The results suggest that African Americans and Whites differ notably in their knowledge, beliefs, and attitudes regarding genetic testing for AD. Additional research with more representative samples is needed to better understand these differences.
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Affiliation(s)
- Ibidapo Akinleye
- Department of Epidemiology, University of Albany School of Public Health, Albany, NY, USA
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Gillum RF, Yorrick R, Obisesan TO. Population surveillance of dementia mortality. Int J Environ Res Public Health 2011; 8:1244-57. [PMID: 21695038 PMCID: PMC3118887 DOI: 10.3390/ijerph8041244] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2011] [Revised: 04/12/2011] [Accepted: 04/12/2011] [Indexed: 11/16/2022]
Abstract
Geographic and temporal variation in occurrence of dementia within the US has received little attention despite its importance for generation of new etiologic hypotheses and health services research. We examine methodological problems in the use of vital statistics data for assessing variation over time, among states and within states in the US. We analyzed the US multiple cause of death files for 2005-2006 and 1999-2000 US deaths with Alzheimer's Disease (International Classification of Disease 10th revision code G30) and other dementias (codes F01, F02, R54) coded as underlying or contributing cause of death based on the death certificate. Age-adjusted death rates were computed by year, state or county for persons aged 65 years and over. In 2005-2006 combined, 555,904 total deaths occurred with any dementia type (212,386 for Alzheimer's disease) coded as underlying or contributing cause. Among the states, age-adjusted rates per 100,000 per year varied by two fold ranging from 458 in New York to 921 in Oregon. Similar geographic patterns were seen for Alzheimer's disease. However, between 1999-2000 and 2005-2006 the US death rate for all dementia increased only from 559 to 695 (24%) while that for Alzheimer's disease doubled from 135 to 266. Use of specific (G30, F01) versus non-specific diagnoses (F02, R54) varied among states and over time, explaining most of the temporal increase in rate of Alzheimer's disease. Further research is needed to assess artifacts of diagnosis, certification or coding, utilization of health services, versus biological variation as possible causes of temporal and geographic variation to enhance utility of mortality data for dementia monitoring and research.
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Affiliation(s)
- Richard F. Gillum
- Department of Medicine, College of Medicine, Howard University, 2041 Georgia Ave., Washington, DC 20060, USA; E-Mails: (R.Y.); (T.O.O.)
| | - Ralston Yorrick
- Department of Medicine, College of Medicine, Howard University, 2041 Georgia Ave., Washington, DC 20060, USA; E-Mails: (R.Y.); (T.O.O.)
| | - Thomas O. Obisesan
- Department of Medicine, College of Medicine, Howard University, 2041 Georgia Ave., Washington, DC 20060, USA; E-Mails: (R.Y.); (T.O.O.)
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