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Pascart T, Wasik KA, Preda C, Chune V, Torterat J, Prud'homme N, Nassih M, Martin A, Le Masson J, Rodière V, Frogier S, Canova G, Pescheux JP, Shan Sei Fan C, Jauffret C, Claeys P, von Baeyer SL, Castel SE, Emde AK, Yerges-Armstrong L, Fox K, Leask M, Vitagliano JJ, Graf S, Norberciak L, Raynal J, Dalbeth N, Merriman T, Bardin T, Oehler E. The gout epidemic in French Polynesia: a modelling study of data from the Ma'i u'u epidemiological survey. Lancet Glob Health 2024; 12:e685-e696. [PMID: 38485432 DOI: 10.1016/s2214-109x(24)00012-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 12/22/2023] [Accepted: 01/09/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND Gout is the most common cause of inflammatory arthritis worldwide, particularly in Pacific regions. We aimed to establish the prevalence of gout and hyperuricaemia in French Polynesia, their associations with dietary habits, their comorbidities, the prevalence of the HLA-B*58:01 allele, and current management of the disease. METHODS The Ma'i u'u survey was epidemiological, prospective, cross-sectional, and gout-focused and included a random sample of adults from the general adult population of French Polynesia. It was conducted and data were collected between April 13 and Aug 16, 2021. Participants were randomly selected to represent the general adult population of French Polynesia on the basis of housing data collected during the 2017 territorial census. Each selected household was visited by a research nurse from the Ma'i u'u survey who collected data via guided, 1-h interviews with participants. In each household, the participant was the individual older than 18 years with the closest upcoming birthday. To estimate the frequency of HLA-B*58:01, we estimated HLA-B haplotypes on individuals who had whole-genome sequencing to approximately 5× average coverage (mid-pass sequencing). A subset of individuals who self-reported Polynesian ancestry and not European, Chinese, or other ancestry were used to estimate Polynesian-ancestry specific allele frequencies. Bivariate associations were reported for weighted participants; effect sizes were estimated through the odds ratio (OR) of the association calculated on the basis of a logistic model fitted with weighted observations. FINDINGS Among the random sample of 2000 households, 896 participants were included, 140 individuals declined, and 964 households could not be contacted. 22 participants could not be weighted due to missing data, so the final weighted analysis included 874 participants (449 [51·4%] were female and 425 [48·6%] were male) representing the 196 630 adults living in French Polynesia. The estimated prevalence of gout was 14·5% (95% CI 9·9-19·2), representing 28 561 French Polynesian adults, that is 25·5% (18·2-32·8) of male individuals and 3·5% (1·0-6·0) of female individuals. The prevalence of hyperuricaemia was estimated at 71·6% (66·7-76·6), representing 128 687 French Polynesian adults. In multivariable analysis, age (OR 1·5, 95% CI 1·2-1·8 per year), male sex (10·3, 1·8-60·7), serum urate (1·6, 1·3-2·0 per 1 mg/dL), uraturia (0·8, 0·8-0·8 per 100 mg/L), type 2 diabetes (2·1, 1·4-3·1), BMI more than 30 kg/m2 (1·1, 1·0-1·2 per unit), and percentage of visceral fat (1·7, 1·1-2·7 per 1% increase) were associated with gout. There were seven heterozygous HLA-B*58:01 carriers in the full cohort of 833 individuals (seven [0·4%] of 1666 total alleles) and two heterozygous carriers in a subset of 696 individuals of Polynesian ancestry (two [0·1%]). INTERPRETATION French Polynesia has an estimated high prevalence of gout and hyperuricaemia, with gout affecting almost 15% of adults. Territorial measures that focus on increasing access to effective urate-lowering therapies are warranted to control this major public health problem. FUNDING Variant Bio, the French Polynesian Health Administration, Lille Catholic University Hospitals, French Society of Rheumatology, and Novartis.
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Affiliation(s)
- Tristan Pascart
- Service de Rhumatologie, Hôpital Saint-Philibert, Lille, France.
| | | | - Cristian Preda
- Department of Methodology and Biostatistics, Hôpital Saint-Philibert, Lille, France
| | - Valérie Chune
- Department of Biology, Centre Hospitalier de Polynésie Française, Pape'ete, Tahiti, French Polynesia
| | - Jérémie Torterat
- Institut de la Statistique de Polynésie Française, Papeete, Tahiti, French Polynesia
| | - Nicolas Prud'homme
- Institut de la Statistique de Polynésie Française, Papeete, Tahiti, French Polynesia
| | - Maryline Nassih
- Lille Catholic University and Research Department, Hôpital Saint-Philibert, Lille, France
| | - Agathe Martin
- Lille Catholic University and Research Department, Hôpital Saint-Philibert, Lille, France
| | - Julien Le Masson
- Lille Catholic University and Research Department, Hôpital Saint-Philibert, Lille, France
| | - Vahinetua Rodière
- Lille Catholic University and Research Department, Hôpital Saint-Philibert, Lille, France; Direction de la Santé de Polynésie Française, Papeete, Tahiti, French Polynesia
| | - Sylvain Frogier
- Lille Catholic University and Research Department, Hôpital Saint-Philibert, Lille, France; Direction de la Santé de Polynésie Française, Papeete, Tahiti, French Polynesia
| | - Georges Canova
- Lille Catholic University and Research Department, Hôpital Saint-Philibert, Lille, France; Direction de la Santé de Polynésie Française, Papeete, Tahiti, French Polynesia
| | - Jean-Paul Pescheux
- Lille Catholic University and Research Department, Hôpital Saint-Philibert, Lille, France; Direction de la Santé de Polynésie Française, Papeete, Tahiti, French Polynesia
| | | | | | - Patrick Claeys
- Department of Biology, Centre Hospitalier de Polynésie Française, Pape'ete, Tahiti, French Polynesia
| | | | | | | | | | - Keolu Fox
- Global Health Program, Department of Anthropology and Indigenous Futures Institute, Division of Design and Innovation, University of California San Diego, San Diego, CA, USA; Native BioData Consortium, Eagle Butte, SD, USA
| | - Megan Leask
- Division of Clinical Rheumatology and Immunology, University of Alabama, Birmingham, AL, USA; Department of Microbiology and Immunology, University of Otago, Dunedin, New Zealand
| | | | - Sahara Graf
- Department of Methodology and Biostatistics, Hôpital Saint-Philibert, Lille, France
| | - Laurène Norberciak
- Department of Methodology and Biostatistics, Hôpital Saint-Philibert, Lille, France
| | - Jacques Raynal
- Ministère de la Santé de Polynésie Française, Papeete, Tahiti, French Polynesia
| | - Nicola Dalbeth
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Tony Merriman
- Division of Clinical Rheumatology and Immunology, University of Alabama, Birmingham, AL, USA; Department of Microbiology and Immunology, University of Otago, Dunedin, New Zealand
| | - Thomas Bardin
- National Institute of Health and Medical Research U1132, Université Paris-Cité, Hôpital Lariboisière, Paris, France
| | - Erwan Oehler
- Department of Internal Medicine and Infectious Diseases, Centre Hospitalier de Polynésie Française, Pape'ete, Tahiti, French Polynesia
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Adami G, Alarcon G, Albert D, Allen K, Aringer M, Arkema EV, Ashour HM, Atzeni F, Ayan G, Baer A, Baker J, Barber C, Bautista-Molano W, Beça S, Beamer B, Bergstra SA, Bermas B, Bilgin E, Boers M, Bolster M, Bosco J, Bowden JL, Buttgereit F, Calabrese L, Campochiaro C, Cappelli L, Carmona L, Carvalho J, Castañeda S, Chao Chao CM, Chatterjee S, Cherry L, Christensen R, Coates LC, Cohen SB, Collins JE, Cornec D, D'Agostino MA, Daikeler T, D'Angelo S, de Boysson H, de Jong P, de Wit M, Dellaripa P, Dessein P, Diekhoff T, Doumen M, Eckstein F, Elhai M, Fairley JL, Felson D, Amaro IF, Ferucci E, Fiorentino D, FitzGerald J, Fleischmann R, Galloway J, Salinas RG, Giorgi V, Golightly Y, Gono T, Gonzalez-Gay MA, Goules A, Gravallese E, Griffith M, Grosman S, Gupta L, Hamuryudan V, Hana C, Haschka J, Hawker G, Hervas-Perez JP, Hocevar A, Iudici M, Iyer P, Jasmin M, Judson M, Kerschbaumer A, Kiefer D, Kiltz U, Kivity S, Kremer JM, Kroon FPB, Kviatkovsky S, Lee BS, Liew D, Lim SY, Littlejohn G, Medina CL, Maksymowych W, March L, Marotte H, Navarro OM, Mavragani C, McInnes I, McMahan Z, Meara A, Mecoli C, Merriman T, Mikdashi J, Mikuls T, Misra DP, Mitchell BD, Moore T, Moutsopoulos H, Naredo E, Nash P, Nurmohamed M, Oddis C, Ojaimi S, Oliver M, Ozen S, Ozgocmen S, Palmowski A, Pascart T, Perelas A, Pile K, Pincus T, Poddubnyy D, Ramiro S, Reddy A, Regierer A, Roccatello D, Rookes T, Rosenthal A, Rubinstein T, Rudwaleit M, Rueda-Gotor J, Rus V, Saketkoo LA, Samson M, Schur P, Sepriano A, Shadmanfar S, Shmagel A, Sibbitt WL, de Souza AWS, Sims C, Singh N, Sjöwall C, Smith V, Song JJ, Soriano ER, Sparks J, Studenic P, Sugihara T, Suissa S, Szekanecz Z, Tascilar K, Taylor P, Terkeltaub R, Tiniakou E, Todd N, Vilarino GT, Treemarcki E, Tsuji H, Turesson C, Twilt M, Vassilopoulos D, Vojinovic T, Volkmann E, Vosse D, Wagner-Weiner L, Wallace ZS, Wallace D, Wang GC, Wei J, Weisman MH, Westhovens R, Winthrop K, Wysham KD, Xue J, Yang C, Yau M, Yazici Y, Yazici H, YIM ICW, Young J, Zhang W. Referees. Semin Arthritis Rheum 2024:152375. [PMID: 38245402 DOI: 10.1016/j.semarthrit.2024.152375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2024]
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Toomata Z, Leask M, Krishnan M, Cadzow M, Dalbeth N, Stamp LK, de Zoysa J, Merriman T, Wilcox P, Dewes O, Murphy R. Genetic testing for misclassified monogenic diabetes in Māori and Pacific peoples in Aōtearoa New Zealand with early-onset type 2 diabetes. Front Endocrinol (Lausanne) 2023; 14:1174699. [PMID: 37234800 PMCID: PMC10206310 DOI: 10.3389/fendo.2023.1174699] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 04/20/2023] [Indexed: 05/28/2023] Open
Abstract
Aims Monogenic diabetes accounts for 1-2% of diabetes cases yet is often misdiagnosed as type 2 diabetes. The aim of this study was to examine in Māori and Pacific adults clinically diagnosed with type 2 diabetes within 40 years of age, (a) the prevalence of monogenic diabetes in this population (b) the prevalence of beta-cell autoantibodies and (c) the pre-test probability of monogenic diabetes. Methods Targeted sequencing data of 38 known monogenic diabetes genes was analyzed in 199 Māori and Pacific peoples with BMI of 37.9 ± 8.6 kg/m2 who had been diagnosed with type 2 diabetes between 3 and 40 years of age. A triple-screen combined autoantibody assay was used to test for GAD, IA-2, and ZnT8. MODY probability calculator score was generated in those with sufficient clinical information (55/199). Results No genetic variants curated as likely pathogenic or pathogenic were found. One individual (1/199) tested positive for GAD/IA-2/ZnT8 antibodies. The pre-test probability of monogenic diabetes was calculated in 55 individuals with 17/55 (31%) scoring above the 20% threshold considered for diagnostic testing referral. Discussion Our findings suggest that monogenic diabetes is rare in Māori and Pacific people with clinical age, and the MODY probability calculator likely overestimates the likelihood of a monogenic cause for diabetes in this population.
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Affiliation(s)
- Zanetta Toomata
- Department of Medicine, Waipapa Taumata Rau, The University of Auckland, Auckland, New Zealand
- Maurice Wilkins Centre for Molecular Biodiscovery, Auckland, New Zealand
| | - Megan Leask
- Department of Biochemistry, University of Otago, Dunedin, New Zealand
- Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Mohanraj Krishnan
- Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pittsburgh, PA, United States
| | - Murray Cadzow
- Department of Biochemistry, University of Otago, Dunedin, New Zealand
| | - Nicola Dalbeth
- Department of Medicine, Waipapa Taumata Rau, The University of Auckland, Auckland, New Zealand
| | - Lisa K. Stamp
- Department of Medicine, University of Otago, Christchurch, Christchurch, New Zealand
| | - Janak de Zoysa
- Department of Medicine, Waipapa Taumata Rau, The University of Auckland, Auckland, New Zealand
| | - Tony Merriman
- Department of Biochemistry, University of Otago, Dunedin, New Zealand
- Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Phillip Wilcox
- Maurice Wilkins Centre for Molecular Biodiscovery, Auckland, New Zealand
- Department of Mathematics and Statistics, University of Otago, Dunedin, New Zealand
| | - Ofa Dewes
- Maurice Wilkins Centre for Molecular Biodiscovery, Auckland, New Zealand
- Langimalie Research Centre, Auckland, New Zealand
- Centre of Methods and Policy Application in the Social Sciences, The University of Auckland, Auckland, New Zealand
| | - Rinki Murphy
- Department of Medicine, Waipapa Taumata Rau, The University of Auckland, Auckland, New Zealand
- Maurice Wilkins Centre for Molecular Biodiscovery, Auckland, New Zealand
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Yokose C, McCormick N, Lu N, Tanikella S, Lin K, Joshi AD, Raffield LM, Warner E, Merriman T, Hsu J, Saag K, Zhang Y, Choi HK. Trends in Prevalence of Gout Among US Asian Adults, 2011-2018. JAMA Netw Open 2023; 6:e239501. [PMID: 37083663 PMCID: PMC10122173 DOI: 10.1001/jamanetworkopen.2023.9501] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Abstract
Importance Gout disparities among Black individuals in the US have recently been explained by socioclinical factors; however, no information is available among Asian individuals living in Western countries, despite their disproportionately worsening metabolic health. Objective To determine the prevalence of gout and serum urate concentrations according to race and ethnicity and to explore the association of social determinants of health and clinical factors. Design, Setting, and Participants This is a population-based, cross-sectional analysis. Data from a nationally representative sample of US adults were obtained from the National Health and Nutrition Examination Survey (NHANES) (2011-2018) in which Asian race data were collected (primary). Data from the UK Biobank (2006-2021) were used for replication of the Asian vs White differences. Data analysis was performed from December 2021 to September 2022. Main Outcomes and Measures Race-specific gout prevalence and serum urate levels. Results A total of 22 621 participants from NHANES (2011-2018) were included in the analysis (mean [SD] age, 49.8 [17.8] years; 10 948 male participants [48.4%]). In 2017 to 2018, gout affected 12.1 million US individuals, with its crude prevalence increasing from 3.6% (95% CI, 2.8%-4.5%) in 2011 to 2012 to 5.1% (95% CI, 4.2%-5.9%) in 2017 to 2018 (P for trend = .03); this trend was no longer significant after age adjustment (P for trend = .06) or excluding Asian individuals (P for trend = .11). During the same period, age- and sex-adjusted prevalence among Asian Americans doubled from 3.3% (95% CI, 2.1%-4.5%) to 6.6% (95% CI, 4.4%-8.8%) (P for trend = .007) to numerically exceed all other racial and ethnic groups in 2017 to 2018, with age- and sex-adjusted odds ratio (ORs) of 1.61 (95% CI, 1.03-2.51) and a socioclinical factor-adjusted multivariable OR of 2.62 (95% CI, 1.59-4.33) for Asian vs White individuals. The latest age- and sex-adjusted gout prevalence among US individuals aged 65 years and older was 10.0% among White individuals and 14.8% among Asian individuals (including 23.6% of Asian men). Serum urate concentrations also increased between 2011 and 2018 among US Asian individuals (P for trend = .009). The Asian vs White disparity was also present in the UK Biobank. Conclusions and Relevance The findings of this study suggest that the prevalence of gout among Asian individuals numerically surpassed that for all other racial and ethnic groups in 2017 to 2018. This Asian vs White disparity did not appear to be associated with socioclinical factors.
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Affiliation(s)
- Chio Yokose
- Clinical Epidemiology Program, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston
- The Mongan Institute, Department of Medicine, Massachusetts General Hospital, Boston
| | - Natalie McCormick
- Clinical Epidemiology Program, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston
- The Mongan Institute, Department of Medicine, Massachusetts General Hospital, Boston
- Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Na Lu
- Arthritis Research Canada, Vancouver, British Columbia, Canada
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Sruthi Tanikella
- Clinical Epidemiology Program, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston
- The Mongan Institute, Department of Medicine, Massachusetts General Hospital, Boston
| | - Kehuan Lin
- Clinical Epidemiology Program, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston
- The Mongan Institute, Department of Medicine, Massachusetts General Hospital, Boston
| | - Amit D Joshi
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
- Regeneron Pharmaceuticals, Tarrytown, New York
| | - Laura M Raffield
- Department of Genetics, University of North Carolina, Chapel Hill
| | - Erica Warner
- The Mongan Institute, Department of Medicine, Massachusetts General Hospital, Boston
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston
- Harvard/MGH Center on Genomics, Vulnerable Populations, and Health Disparities, Boston, Massachusetts
| | - Tony Merriman
- Division of Clinical Immunology and Rheumatology, the University of Alabama, Birmingham
- Department of Biochemistry, University of Otago, Dunedin, New Zealand
| | - John Hsu
- The Mongan Institute, Department of Medicine, Massachusetts General Hospital, Boston
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
| | - Kenneth Saag
- Division of Clinical Immunology and Rheumatology, the University of Alabama, Birmingham
| | - Yuqing Zhang
- Clinical Epidemiology Program, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston
- The Mongan Institute, Department of Medicine, Massachusetts General Hospital, Boston
| | - Hyon K Choi
- Clinical Epidemiology Program, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston
- The Mongan Institute, Department of Medicine, Massachusetts General Hospital, Boston
- Arthritis Research Canada, Vancouver, British Columbia, Canada
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Topless R, Green R, Morgan SL, Robinson P, Merriman T, Gaffo AL. Folic acid and methotrexate use and their association with COVID-19 diagnosis and mortality: a case-control analysis from the UK Biobank. BMJ Open 2022; 12:e062945. [PMID: 36002213 PMCID: PMC9412040 DOI: 10.1136/bmjopen-2022-062945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To determine if methotrexate or folic acid prescription was associated with differential risk for COVID-19 diagnosis or mortality. DESIGN Case-control analysis. SETTING The population-based UK Biobank (UKBB) cohort. PARTICIPANTS Data from 380 380 UKBB participants with general practice prescription data for 2019-2021. Updated medical information was retrieved on 13 December 2021. PRIMARY AND SECONDARY OUTCOME MEASURES The outcomes of COVID-19 diagnosis and COVID-19-related mortality were analysed by multivariable logistic regression. Exposures evaluated were prescription of folic acid and/or methotrexate. Criteria for COVID-19 diagnosis were (1) a positive SARS-CoV-2 test or (2) ICD-10 code for confirmed COVID-19 (U07.1) or probable COVID-19 (U07.2) in hospital records, or death records. By these criteria, 26 003 individuals were identified with COVID-19 of whom 820 were known to have died from COVID-19. Logistic regression statistical models were adjusted for age sex, ethnicity, Townsend deprivation index, body mass index, smoking status, presence of rheumatoid arthritis, sickle cell disease, use of anticonvulsants, statins and iron supplements. RESULTS Compared with people prescribed neither folic acid nor methotrexate, people prescribed folic acid supplementation had increased risk of diagnosis of COVID-19 (OR 1.51 (1.42-1.61)). The prescription of methotrexate with or without folic acid was not associated with COVID-19 diagnosis (p≥0.18). People prescribed folic acid supplementation had positive association with death after a diagnosis of COVID-19 (OR 2.64 (2.15-3.24)) in a fully adjusted model. The prescription of methotrexate in combination with folic acid was not associated with an increased risk for COVID-19-related death (1.07 (0.57-1.98)). CONCLUSIONS We report an association of increased risk for COVID-19 diagnosis and COVID-19-related death in people prescribed folic acid supplementation. Our results also suggest that methotrexate might attenuate these associations.
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Affiliation(s)
- Ruth Topless
- Department of Biochemistry, University of Otago, Dunedin, New Zealand
| | - Ralph Green
- Departments of Pathology and Medicine, University of California, Davis, Sacramento, California, USA
| | - Sarah L Morgan
- Division of Clinical Immunology and Rheumatology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Philip Robinson
- School of Clinical Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Tony Merriman
- Department of Biochemistry, University of Otago, Dunedin, New Zealand
- Division of Clinical Immunology and Rheumatology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Angelo L Gaffo
- Division of Clinical Immunology and Rheumatology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Birmingham VA Medical Center, Birmingham, Alabama, USA
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Mccormick N, Lu L, Yokose C, Joshi A, Merriman T, Saag K, Zhang Y, Choi H. POS0155 WHAT DRIVES RACIAL DISPARITIES IN GOUT IN THE US? – POPULATION-BASED, SEX-SPECIFIC, CASUAL MEDIATION ANALYSIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundTraditionally viewed as a disease of White men, global frequency and disability burden of female gout are rising disproportionately to male gout.1 Moreover, emerging US cohort data suggest gout and hyperuricemia impart larger burdens on Black adults than Whites.2 These racial disparities may be largely attributable to differences in non-genetic, mainly modifiable gout risk factors e.g., BMI, diet,3,4 and chronic kidney disease (CKD). However, national-level, general population data on racial differences in burden of gout, and potential mediators, are lacking.ObjectivesTo determine and quantify sex-specific mediators of racial disparities in gout prevalence among a nationally representative sample of US adults.MethodsUsing recent decadal data (2007-2016) on physician-diagnosed gout and hyperuricemia from the National Health and Nutrition Examination Survey, we compared contemporary sex- and race-specific prevalences and conducted sequential causal mediation analysis (adjusting for upstream mediators following causal pathways)5 to determine the proportion of the racial differences attributable to 7 potentially mediating social and clinical factors (see DAG in Figure 1): low education, poverty, body mass index (BMI), alcohol, poor quality diet (poor DASH adherence), diuretic use, and CKD (eGFR <60 mL/min, using the latest equations that do not include a coefficient for Black race6, per National Kidney Foundation and American Society of Nephrology recommendations.7)ResultsAge standardised prevalence of gout was 3.5% and 2.0% in Black and White women, respectively (age-adjusted OR =1.8 [95% CI: 1.3 to 2.5]), and 7.0% and 5.4% in Black and White men (age-adjusted OR =1.3 [1.0 to 1.6]). Most risk factors were more frequent/elevated in Blacks than Whites, except alcohol consumption, which was lower in Blacks (both sexes). BMI levels and poverty were higher in Black women, but similar between Black and White men.Largest mediating factor of excess gout cases among Black women was excess BMI, accounting for 56% of the racial difference (independent of education, poverty, diet, and alcohol), followed by CKD (24%), poverty (17%), and poor diet (12%) (see Table 1).Table 1.Indirect (mediation) effects of potential mediators, using sequential mediation analysis, for the association between Black race and odds of gout in US women and men.WOMENMENEffect Estimate (OR), 95% CIProportion Mediated, %Effect Estimate (OR), 95% CIProportion Mediated, %Indirect (Mediation) EffectEducation (high school or less)1.01 (0.98 to 1.03)2.4%1.01 (0.98 to 1.03)3.3%Poverty1.07 (1.04 to 1.10)16.9%1.00 (0.99 to 1.00)0.53%Alcohol consumption (# drinks/week, continuous)0.99 (0.96 to 1.01)-3.4%0.99 (0.98 to 1.00)-4.5%DASH diet score (continuous; higher scores = ↓ adherence)1.05 (0.96 to 1.01)12.0%1.05 (1.01 to 1.10)19.8%Body mass index (continuous)1.25 (1.14 to 1.37)55.9%1.03 (1.02 to 1.04)11.9%Diuretic use1.03 (1.01 to 1.05)7.6%1.04 (1.02 to 1.06)14.2%Chronic kidney disease1.10 (1.04 to 1.16)23.9%1.12 (1.08 to 1.17)45.6%Direct Effect0.94 (0.68 to 1.30)a−15.2%1.02 (0.83 to 1.26)b9.2%Total Effect1.49 (1.12 to 1.98)100%1.29 (1.05 to 1.57)100%DASH=Dietary Approaches to Stop Hypertension;ap=0.52,bp=0.83Among men, CKD was the largest mediator (46%), followed by poor diet (20%) and diuretic use (14%). BMI (12%) and poverty (0.5%) mediated smaller proportions of the racial difference among men compared to women. Mediators of racial differences in hyperuricemia closely agreed with gout results.ConclusionContrasting with historical views, gout is more frequent among Black adults in the US than their White counterparts, especially women (two-times greater in Black women vs. White). Culturally informed efforts to reduce these disparities should focus on excess adiposity, diet quality, and kidney disease while recognising the impact of poverty in female gout.References[1]Xia; PMID 31624843[2]PMID 24335384[3]Rai BMJ PMID 28487277[4]Yokose JAMA IM (2022)[5]VanderWeele; PMID 25580377[6]NEJM PMID 34554658[7]JASN PMID 34556489Disclosure of InterestsNatalie McCormick: None declared, Leo Lu: None declared, Chio Yokose: None declared, Amit Joshi: None declared, Tony Merriman: None declared, Kenneth Saag Consultant of: Arthrosi, Atom Bioscience, Horizon Therapeutics, LG Pharma, Mallinkrodt, SOBI, Takeda, Grant/research support from: Horizon Therapeutics, SOBI, Shanton, Yuqing Zhang: None declared, Hyon Choi Consultant of: Ironwood, Selecta, Horizon, Takeda, Kowa, and Vaxart.Grant/research support from: Ironwood, Horizon
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Topless R, Green R, Morgan S, Robinson P, Merriman T, Gaffo A. POS1222 FOLIC ACID AND METHOTREXATE USE AND THEIR ASSOCIATION WITH COVID-19 DIAGNOSIS AND MORTALITY: AN ANALYSIS FROM THE UK BIOBANK. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundFolate metabolism is implicated in SARS-CoV-2 infectivity (Ref).ObjectivesTo determine if methotrexate (an antifolate) or folic acid prescription were associated with a lowered and increased risk, respectively, for COVID-19 diagnosis or mortality in a large population-based cohort (UK Biobank).MethodsData from 380,380 UK Biobank participants with general practice prescription data were used. Criteria for COVID-19 diagnosis were 1) a positive SARS-CoV-2 test and / or 2) ICD-10 code for confirmed COVID-19 (U07.1) or probable COVID-19 (U07.2) in hospital records, or death records. This definition identified 26,003 individuals diagnosed with COVID-19 of whom 820 were known to have died from COVID-19. Logistic regression statistical models were adjusted for age group (4 categories), sex, ethnicity, Townsend deprivation index, BMI, smoking status, presence of rheumatoid arthritis, sickle cell disease, use of anticonvulsants, statins and iron supplements.ResultsCompared with people prescribed neither folic acid nor methotrexate, people prescribed folic acid supplementation had increased risk of diagnosis of COVID-19 (OR 1.51 [1.42; 1.61]). The prescription of methotrexate with or without folic acid was not associated with COVID-19 diagnosis (P≥0.18). Compared with people prescribed neither folic acid nor methotrexate, people prescribed folic acid supplementation had an increased risk of death after a diagnosis of COVID-19 (OR 2.64 [2.15; 3.24]) in a fully adjusted model. The prescription of methotrexate in combination with folic acid was not associated with an increased risk for death after a diagnosis of COVID-19 (1.07 [0.57; 1.98]). (Table 1)Table 1.COVID-19 diagnosis and associated death in people prescribed methotrexate and / or folic acid in the UKBB, compared to people not prescribed methotrexate or folic acid. Model 1 adjusted for age group, sex, ethnicity, Townsend deprivation index, BMI, smoking status Model 2 is model 1 plus adjustment by the presence of rheumatoid arthritis, sickle cell disease, use of statins, anticonvulsants and iron supplementation.UnadjustedModel 1Model 2OR[95% CI]POR[95% CI]POR[95% CI]PNeither Folic acid nor Methotrexate1.0-1.0-1.0-COVID-19 diagnosisFolic acid only1.58[1.49; 1.68]<0.0011.60[1.50; 1.70]<0.0011.51[1.42; 1.61]<0.001Methotrexate and Folic acid1.09[0.96; 1.23]0.181.15[1.02; 1.30]0.0211.09[0.96; 1.23]0.18COVID-19 associated deathFolic acid only5.14 [4.23; 6.24]<0.0012.91 [2.38; 3.55]<0.0012.64[2.15; 3.24]<0.001Methotrexate and folic acid1.47 [0.81; 2.67]0.211.26 [0.70; 2.30]0.441.07 [0.57; 1.98]0.84ConclusionWe report increased risk for COVID-19 diagnosis and COVID-19-related death for people prescribed folic acid supplementation. The prescription and use of supplemental folic acid may confer risk of infection with the SARS-CoV-2 virus as well as the risk of death resulting from COVID-19. Our results also suggest that methotrexate might attenuate an increased risk for COVID-19 diagnosis and death conferred by folic acid.References[1]Zhang Y, Guo R, Kim SH, et al. SARS-CoV-2 hijacks folate and one-carbon metabolism for viral replication. Nature Communications 2021;12(1):1676. doi: 10.1038/s41467-021-21903-zDisclosure of InterestsRuth Topless: None declared, Ralph Green: None declared, Sarah Morgan: None declared, Philip Robinson Consultant of: Abbvie, Atom Biosciences, Eli Lilly, Gilead, Janssen, Novartis, UCB, Roche, Pfizer, Grant/research support from: Janssen, Novartis, Pfizer and UCB Pharma, Tony Merriman: None declared, Angelo Gaffo Consultant of: SOBI, Selecta
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Paulino YC, Camacho F, Merriman T, Matisoo-Smith L, Paulino T, Chennaux JSN, Mori E, Gosling AL. 694Metabolic conditions have high prevalence in CHamoru men in a hyperuricemia feasibility study in Guam. Int J Epidemiol 2021. [DOI: 10.1093/ije/dyab168.527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
One-third of adults in the U.S. have metabolic syndrome, a combination of risk factors of chronic diseases such as heart disease, kidney disease, diabetes, and gout. These diseases are a burden for ethnic minorities, including Pacific Island peoples. Here, the metabolic conditions were described for a group of Pacific Island people, the CHamorus or natives of Guam, a U.S. Territory in the Mariana Islands in the Western Pacific.
Methods
A cross-sectional survey was conducted in Guam from August 2019 to January 2020. A non-random sample of 152 adults, ≥18 years old, with CHamoru ancestry were recruited and consented. Information collected included socio-demographics, metabolic history, lifestyle behaviors, height and weight, blood pressure, and non-fasting blood and urine. Statistical analyses included frequencies of metabolic conditions and Pearson’s Chi-square test for gender differences, alpha=0.05.
Results
Of the 152 CHamorus, 49.3% were male, 50% were female, and 0.7% was transgender. The mean age was 43±15.1 years. Mean education was 14.4±3.6 years and hyperuricemia he majority (69.7%) pursued postsecondary studies. Self-reported metabolic conditions included: diabetes (19.7%), gout (28.9%), hypertension (34.9%), dyslipidemia (17.8%), and heart conditions (9.9%). Compared to females, more males reported gout (40.5% versus 18.7%; P=.003) and measured to be hypertensive (48% versus 21.1%; P<.0001), hyperuricemic (58.9% versus 31.6%; P=.001), and obese (77.3% versus 46.1%; P<.0001).
Conclusion
Metabolic conditions were common among CHamorus, though gout, hypertension, hyperuricemia, and obesity were predominant in the men.
Key messages
Strategies to reduce the burden of metabolic conditions may be targeted to CHamoru men in this community.
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Te Morenga L, Kruimer D, McLean R, Sabadel AJM, van Hale R, Tatin X, Hindmarsh JH, Mann J, Merriman T. Associations Between Sugars Intakes and Urinary Sugars Excretion and Carbon Stable Isotope Ratios in Red Blood Cells as Biomarkers of Sugars Intake in a Predominantly Māori Population. Front Nutr 2021; 8:637267. [PMID: 34277677 PMCID: PMC8278019 DOI: 10.3389/fnut.2021.637267] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 05/21/2021] [Indexed: 12/31/2022] Open
Abstract
Determining the extent to which added sugars intake contribute to non-communicable disease in various populations is challenging because it is difficult to accurately measure intakes. Biomarkers may provide a reliable and easily measured method of assessing intakes. In a predominantly Māori population we compared various sugars intake estimates derived from a 36 item sugar-specific food frequency questionnaire (FFQ) with biomarkers of sugars intake; urinary sugars excretion in random spot collections (n = 153) and carbon stable isotope ratios (n = 36) in red blood cells (RBCs, δ13CRBC) and in the alanine fraction of the RBCs (δ13Calanine). Estimated 24 h urinary sucrose+fructose excretion was statistically significantly correlated with intakes of total sugars (r = 0.23), sucrose (r = 0.26) and added sugars from sugar-sweetened beverages (SSBs; r = 0.26). δ13Calanine was correlated with added sugars (r = 0.40). In log linear multiple regression models adjusted with HbA1C and eGFR δ13Calanine predicted added sugars intakes (r 2 = 0.29) and estimated 24 h urinary sucrose+fructose excretion predicted intakes of total sugars (r 2 = 0.14), sucrose (r 2 = 0.17), added sugars (r 2 = 0.17) and sugars from SSBs (r 2 = 0.14). These biomarkers have potential for improving assessment of sugars intake in New Zealand populations enabling monitoring of the effectiveness of sugar reduction strategies designed to reduce risk of NCDs. However, further validation is required to confirm these preliminary findings.
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Affiliation(s)
- Lisa Te Morenga
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand.,Riddet Centre of Research Excellence, University of Otago, Dunedin, New Zealand.,Edgar Diabetes and Obesity Research, University of Otago, Dunedin, New Zealand
| | - Devonia Kruimer
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand.,Riddet Centre of Research Excellence, University of Otago, Dunedin, New Zealand
| | - Rachael McLean
- Edgar Diabetes and Obesity Research, University of Otago, Dunedin, New Zealand.,Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | | | - Robert van Hale
- Department of Chemistry, University of Otago, Dunedin, New Zealand
| | | | | | - Jim Mann
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand.,Riddet Centre of Research Excellence, University of Otago, Dunedin, New Zealand.,Edgar Diabetes and Obesity Research, University of Otago, Dunedin, New Zealand.,Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Tony Merriman
- Edgar Diabetes and Obesity Research, University of Otago, Dunedin, New Zealand.,Department of Biochemistry, University of Otago, Dunedin, New Zealand
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10
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Coppell K, Freer T, Abel S, Whitehead L, Tipene-Leach D, Gray AR, Merriman T, Sullivan T, Krebs J, Perreault L. What predicts regression from pre-diabetes to normal glucose regulation following a primary care nurse-delivered dietary intervention? A study protocol for a prospective cohort study. BMJ Open 2019; 9:e033358. [PMID: 31822546 PMCID: PMC6924756 DOI: 10.1136/bmjopen-2019-033358] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Pre-diabetes is a high-risk state for the development of type 2 diabetes mellitus (T2DM) and cardiovascular disease. Regression to normoglycaemia, even if transient, significantly reduces the risk of developing T2DM. The primary aim of this mixed-methods study is to determine if there are clinically relevant differences among those with pre-diabetes and excess weight who regress to normoglycaemia, those who have persistent pre-diabetes and those who progress to T2DM following participation in a 6-month primary care nurse-delivered pre-diabetes dietary intervention. Incidence of T2DM at 2 years will be examined. METHODS AND ANALYSIS Four hundred participants with pre-diabetes (New Zealand definition glycated haemoglobin 41-49 mmol/mol) and a body mass index >25 kg/m2 will be recruited through eight primary care practices in Hawke's Bay, New Zealand. Trained primary care nurses will deliver a 6-month structured dietary intervention, followed by quarterly reviews for 18 months post-intervention. Clinical data, data on lifestyle factors and health-related quality of life (HR-QoL) and blood samples will be collected at baseline, 6 months, 12 months and 24 months. Sixty participants purposefully selected will complete a semi-structured interview following the 6-month intervention. Poisson regression with robust standard errors and clustered by practice will be used to identify predictors of regression or progression at 6 months, and risk factors for developing T2DM at 2 years. Qualitative data will be analysed thematically. Changes in HR-QoL will be described and potential cost savings will be estimated from a funder's perspective at 2 years. ETHICS AND DISSEMINATION This study was approved by the Northern A Health and Disability Ethics Committee, New Zealand (Ethics Reference: 17/NTA/24). Study results will be presented to participants, published in peer-reviewed journals and presented at relevant conferences. TRIAL REGISTRATION NUMBER ACTRN12617000591358; Pre-results.
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Affiliation(s)
- Kirsten Coppell
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | | | - Sally Abel
- Kaupapa Consulting Ltd, Napier, New Zealand
| | - Lisa Whitehead
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia
| | - David Tipene-Leach
- Faculty of Education, Humanities and Health Science, Eastern Institute of Technology, Napier, New Zealand
| | - Andrew R Gray
- Centre for Biostatistics, University of Otago, Dunedin, New Zealand
| | - Tony Merriman
- Department of Biochemistry, University of Otago, Dunedin, New Zealand
| | - Trudy Sullivan
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Jeremy Krebs
- Department of Medicine, University of Otago Wellington, Wellington, New Zealand
| | - Leigh Perreault
- Department of Medicine, University of Colorado, Denver, Colorado, USA
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11
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Bursill D, Taylor WJ, Terkeltaub R, Abhishek A, So AK, Vargas-Santos AB, Gaffo AL, Rosenthal A, Tausche AK, Reginato A, Manger B, Sciré C, Pineda C, van Durme C, Lin CT, Yin C, Albert DA, Biernat-Kaluza E, Roddy E, Pascual E, Becce F, Perez-Ruiz F, Sivera F, Lioté F, Schett G, Nuki G, Filippou G, McCarthy G, da Rocha Castelar Pinheiro G, Ea HK, Tupinambá HDA, Yamanaka H, Choi HK, Mackay J, ODell JR, Vázquez Mellado J, Singh JA, Fitzgerald JD, Jacobsson LTH, Joosten L, Harrold LR, Stamp L, Andrés M, Gutierrez M, Kuwabara M, Dehlin M, Janssen M, Doherty M, Hershfield MS, Pillinger M, Edwards NL, Schlesinger N, Kumar N, Slot O, Ottaviani S, Richette P, MacMullan PA, Chapman PT, Lipsky PE, Robinson P, Khanna PP, Gancheva RN, Grainger R, Johnson RJ, Te Kampe R, Keenan RT, Tedeschi SK, Kim S, Choi SJ, Fields TR, Bardin T, Uhlig T, Jansen T, Merriman T, Pascart T, Neogi T, Klück V, Louthrenoo W, Dalbeth N. Gout, Hyperuricaemia and Crystal-Associated Disease Network (G-CAN) consensus statement regarding labels and definitions of disease states of gout. Ann Rheum Dis 2019; 78:1592-1600. [PMID: 31501138 DOI: 10.1136/annrheumdis-2019-215933] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [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: 06/23/2019] [Revised: 08/09/2019] [Accepted: 08/11/2019] [Indexed: 11/04/2022]
Abstract
OBJECTIVE There is a lack of standardisation in the terminology used to describe gout. The aim of this project was to develop a consensus statement describing the recommended nomenclature for disease states of gout. METHODS A content analysis of gout-related articles from rheumatology and general internal medicine journals published over a 5-year period identified potential disease states and the labels commonly assigned to them. Based on these findings, experts in gout were invited to participate in a Delphi exercise and face-to-face consensus meeting to reach agreement on disease state labels and definitions. RESULTS The content analysis identified 13 unique disease states and a total of 63 unique labels. The Delphi exercise (n=76 respondents) and face-to-face meeting (n=35 attendees) established consensus agreement for eight disease state labels and definitions. The agreed labels were as follows: 'asymptomatic hyperuricaemia', 'asymptomatic monosodium urate crystal deposition', 'asymptomatic hyperuricaemia with monosodium urate crystal deposition', 'gout', 'tophaceous gout', 'erosive gout', 'first gout flare' and 'recurrent gout flares'. There was consensus agreement that the label 'gout' should be restricted to current or prior clinically evident disease caused by monosodium urate crystal deposition (gout flare, chronic gouty arthritis or subcutaneous tophus). CONCLUSION Consensus agreement has been established for the labels and definitions of eight gout disease states, including 'gout' itself. The Gout, Hyperuricaemia and Crystal-Associated Disease Network recommends the use of these labels when describing disease states of gout in research and clinical practice.
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Affiliation(s)
- David Bursill
- Department of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - William J Taylor
- Department of Medicine, University of Otago, Wellington, New Zealand.,Wellington Regional Rheumatology Unit, Hutt Valley District Health Board, Lower Hutt, New Zealand
| | - Robert Terkeltaub
- Department of Rheumatology, UCSD/ VA Medical Center, San Diego, California, USA
| | - Abhishek Abhishek
- Department of Academic Rheumatology, University of Nottingham, Nottingham, UK
| | - Alexander K So
- Department of Musculoskeletal Medicine, Service de RMR, Lausanne, Switzerland
| | - Ana Beatriz Vargas-Santos
- Department of Internal Medicine, Rheumatology Unit, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Angelo Lino Gaffo
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Ann Rosenthal
- Division of Rheumatology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.,Translational Research Unit, Clement J Zablocki VA Medical Center, Milwaukee, Wisconsin, USA
| | - Anne-Kathrin Tausche
- Department of Rheumatology, University Hospital 'Carl Gustav Carus' of the Technical University Dresden, Dresden, Germany
| | - Anthony Reginato
- Division of Rheumatology, The Warren Alpert School of Medicine at Brown University, Providence, Rhode Island, USA
| | - Bernhard Manger
- Rheumatology and Immunology, Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Carlo Sciré
- Section of Rheumatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy.,Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy
| | - Carlos Pineda
- Department of Rheumatology, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City, Mexico
| | - Caroline van Durme
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Ching-Tsai Lin
- Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Congcong Yin
- Department of Immunology and Dermatology, Henry Ford Health System, Detroit, Michigan, USA
| | - Daniel Arthur Albert
- Department of Rheumatology, Dartmouth-Hitchcock Medical Center, Hanover, New Hampshire, USA
| | - Edyta Biernat-Kaluza
- Outpatient Rheumatology Clinic, Nutritional and Lifestyle Medicine Centre, ORLIK, Warsaw, Poland
| | - Edward Roddy
- Research Institute for Primary Care and Health Sciences, Keele University, Keele, UK
| | - Eliseo Pascual
- Department of Rheumatology, Hospital General Universitario de Alicante, Alicante, Spain.,Departamento de Medicina Clínica, Universidad Miguel Hernández, Alicante, Spain
| | - Fabio Becce
- Department of Diagnostic and Interventional Radiology, University of Lausanne, Lausanne, Switzerland
| | - Fernando Perez-Ruiz
- Rheumatology Division, Cruces University Hospital, Baracaldo, Spain.,Department of Medicine, University of the Basque Country, Biscay, Spain.,Investigation Group for Arthritis, Biocruces Health Research Institute, Baracaldo, Spain
| | - Francisca Sivera
- Department of Rheumatology, Hospital General Universitario Elda, Elda, Spain
| | - Frédéric Lioté
- Department of Rhumatologie, Hôpital Lariboisière, Assistance Publique-Hopitaux de Paris, Paris, France.,Department of Rhumatologie, INSERM UMR-1132 and Université Paris Diderot, Paris, France
| | - Georg Schett
- Department of Internal Medicine III, Friedrich-Alexander University Erlangen-Nürnberg and Universitatsklinikum Erlangen, Erlangen, Germany
| | - George Nuki
- Insititute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Georgios Filippou
- Section of Rheumatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Geraldine McCarthy
- Department of Rheumatology, Mater Misericordiae University Hospital, Dublin, Ireland.,School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| | | | - Hang-Korng Ea
- Department of Rheumatology, Hôpital Lariboisière, Paris, France
| | | | - Hisashi Yamanaka
- Institute of Rheumatology, Tokyo Women's Medical University Hospital, Tokyo, Japan.,School of Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Hyon K Choi
- Section of Rheumatology and Clinical Epidemiology, Harvard Medical School and Massachusetts General Hospital, Boston, Massachusetts, USA
| | - James Mackay
- President and CEO, Aristea Therapeutics, San Diego, California, USA
| | - James R ODell
- Division of Rheumatology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Janitzia Vázquez Mellado
- Department of Rheumatology, Hospital General de Mexico and Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Jasvinder A Singh
- Department of Medicine at School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Medicine Service, Birmingham Veterans Affairs Medical Center, Birmingham, Alabama, USA.,Division of Epidemiology at School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - John D Fitzgerald
- Department of Medicine/Rheumatology, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, California, USA
| | - Lennart T H Jacobsson
- Department of Rheumatology and Inflammation Research, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Leo Joosten
- Department of Internal Medicine, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands
| | - Leslie R Harrold
- Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA.,Chief Scientific Officer, Corrona, LLC, Southborough, Massachusetts, USA
| | - Lisa Stamp
- Department of Medicine, Otago University, Christchurch, New Zealand
| | - Mariano Andrés
- Department of Rheumatology, Hospital Universitario de Alicante, Alicante, Spain.,Departamento de Medicina Clínica, Universidad Miguel Hernández, Alicante, Spain
| | - Marwin Gutierrez
- Division of Musculoskeletal and Rheumatic Diseases, Instituto Nacional Rehabilitación, México City, México
| | - Masanari Kuwabara
- Division of Renal Diseases and Hypertension, University of Colorado Denver School of Medicine, Aurora, Colorado, USA.,Department of Cardiology, Toranomon Hospital, Minato-ku, Japan
| | - Mats Dehlin
- Department of Rheumatology and Inflammation Research, Sahlgrenska Academy, University of Göteborg, Göteborg, Sweden
| | - Matthijs Janssen
- Department of Rheumatology, VieCuri Medical Centre, Venlo, The Netherlands
| | - Michael Doherty
- Department of Academic Rheumatology, University of Nottingham, Nottingham, UK
| | - Michael S Hershfield
- Division of Rheumatology, Duke University Medical Center, Durham, North Carolina, USA
| | - Michael Pillinger
- Department of Rheumatology/Medicine, New York University School of Medicine, New York City, New York, USA
| | | | - Naomi Schlesinger
- Department of Medicine, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - Nitin Kumar
- Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Detroit, Michigan, USA
| | - Ole Slot
- Department of Rheumatology, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spinal Disorders, Rigshospitalet Glostrup, Glostrup, Denmark
| | - Sebastien Ottaviani
- Department of Rheumatology, Bichat-Claude Bernard Hospital, University of Sorbonne Paris Cité, Paris, France
| | - Pascal Richette
- Service de Rhumatologie, Hôpital Lariboisière, Assistance Publique-Hopitaux de Paris, and INSERM UMR-1132 and Université de Paris, Paris, France
| | - Paul A MacMullan
- Division of Rheumatology, University of Calgary, Calgary, Alberta, Canada
| | - Peter T Chapman
- Department of Rheumatology, Immunology and Allergy, Canterbury District Health Board, Christchurch, New Zealand
| | - Peter E Lipsky
- CEO and CMO, AMPEL BioSolutions, LLC, Charlottesville, Virginia, USA
| | - Philip Robinson
- School of Clinical Medicine, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Puja P Khanna
- Department of Rheumatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Rada N Gancheva
- Clinic of Rheumatology, University Hospital 'St. Ivan Rilski', Sofia, Bulgaria
| | - Rebecca Grainger
- Department of Medicine, University of Otago, Wellington, Wellington, New Zealand.,Wellington Regional Rheumatology Unit, Hutt Valley District Health Board, Lower Hutt, New Zealand
| | - Richard J Johnson
- Division of Renal Diseases and Hypertension, University of Colorado Denver, Denver, Colorado, USA
| | - Ritch Te Kampe
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Robert T Keenan
- Division of Rheumatology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Sara K Tedeschi
- Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Arthritis Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Seoyoung Kim
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Sung Jae Choi
- Division of Rheumatology, Department of Internal Medicine, Korea University Medical College, Ansan, South Korea
| | - Theodore R Fields
- Weill Cornell Medical College, Hospital for Special Surgery, New York City, New York, USA
| | - Thomas Bardin
- Department of Rheumatology, Hôpital Lariboisière, Assistance Publique-Hopitaux de Paris, and INSERM UMR-1132 and Université de Paris, Paris, France
| | - Till Uhlig
- Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Tim Jansen
- Department of Rheumatology, VieCuri Medical Centre, Venlo, The Netherlands
| | - Tony Merriman
- Department of Biochemistry, University of Otago, Dunedin, New Zealand
| | - Tristan Pascart
- Department of Rheumatology, Lille Catholic University, Saint-Philibert Hospital, Lomme, France
| | - Tuhina Neogi
- Section of Rheumatology, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Viola Klück
- Department of Internal Medicine, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Worawit Louthrenoo
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nicola Dalbeth
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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Merriman T, Terkeltaub R. PPARGC1B: insight into the expression of the gouty inflammation phenotype: PPARGC1B and gouty inflammation. Rheumatology (Oxford) 2019; 56:323-325. [PMID: 28003496 DOI: 10.1093/rheumatology/kew453] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Accepted: 11/04/2016] [Indexed: 01/07/2023] Open
Affiliation(s)
- Tony Merriman
- Department of Biochemistry, University of Otago, Dunedin, New Zealand
| | - Robert Terkeltaub
- VA San Diego Healthcare System.,Department of Medicine, University of California San Diego, San Diego, CA, USA
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13
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Stamp LK, Topless R, Miner JN, Dalbeth N, Merriman T. No association between ATP-binding cassette transporter G2 rs2231142 (Q141K) and urate-lowering response to febuxostat. Rheumatology (Oxford) 2019; 58:547-548. [PMID: 30597115 DOI: 10.1093/rheumatology/key423] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2018] [Indexed: 11/14/2022] Open
Affiliation(s)
- Lisa K Stamp
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Ruth Topless
- Department of Biochemistry, University of Otago, Dunedin, New Zealand
| | | | - Nicola Dalbeth
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Tony Merriman
- Department of Biochemistry, University of Otago, Dunedin, New Zealand
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Vazirpanah N, Ottria A, van der Linden M, Wichers CGK, Schuiveling M, van Lochem E, Phipps-Green A, Merriman T, Zimmermann M, Jansen M, Radstake TRDJ, Broen JCA. mTOR inhibition by metformin impacts monosodium urate crystal-induced inflammation and cell death in gout: a prelude to a new add-on therapy? Ann Rheum Dis 2019; 78:663-671. [PMID: 30814053 DOI: 10.1136/annrheumdis-2018-214656] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [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: 10/27/2018] [Revised: 01/29/2019] [Accepted: 02/06/2019] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Gout is the most common inflammatory arthritis worldwide, and patients experience a heavy burden of cardiovascular and metabolic diseases. The inflammation is caused by the deposition of monosodium urate (MSU) crystals in tissues, especially in the joints, triggering immune cells to mount an inflammatory reaction. Recently, it was shown that MSU crystals can induce mechanistic target of rapamycin (mTOR) signalling in monocytes encountering these crystals in vitro. The mTOR pathway is strongly implicated in cardiovascular and metabolic disease. We hypothesised that inhibiting this pathway in gout might be a novel avenue of treatment in these patients, targeting both inflammation and comorbidities. METHODS We used a translational approach starting from ex vivo to in vitro and back to in vivo. RESULTS We show that ex vivo immune cells from patients with gout exhibit higher expression of the mTOR pathway, which we can mimic in vitro by stimulating healthy immune cells (B lymphocytes, monocytes, T lymphocytes) with MSU crystals. Monocytes are the most prominent mTOR expressers. By using live imaging, we demonstrate that monocytes, on encountering MSU crystals, initiate cell death and release a wide array of proinflammatory cytokines. By inhibiting mTOR signalling with metformin or rapamycin, a reduction of cell death and release of inflammatory mediators was observed. Consistent with this, we show that patients with gout who are treated with the mTOR inhibitor metformin have a lower frequency of gout attacks. CONCLUSIONS We propose mTOR inhibition as a novel therapeutic target of interest in gout treatment.
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Affiliation(s)
- Nadia Vazirpanah
- Department of Rheumatology and Clinical Immunology, Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Andrea Ottria
- Department of Rheumatology and Clinical Immunology, Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Maarten van der Linden
- Department of Rheumatology and Clinical Immunology, Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Catharina G K Wichers
- Department of Rheumatology and Clinical Immunology, Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Mark Schuiveling
- Department of Rheumatology and Clinical Immunology, Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Ellen van Lochem
- Medical Microbiology and Immunology, Rijnstate Hospital, Arnhem, The Netherlands
| | | | - Tony Merriman
- Department of Biochemistry, University of Otago, Dunedin, New Zealand
| | - Maili Zimmermann
- Department of Rheumatology and Clinical Immunology, Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Matthijs Jansen
- Department of Immunology, Rijnstate Hospital, Arnhem, The Netherlands
| | - Timothy R D J Radstake
- Department of Rheumatology and Clinical Immunology, Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht, The Netherlands.,Department of Rheumatology and Clinical Immunology, University Medical Center, Utrech, The Netherlands
| | - Jasper C A Broen
- Department of Rheumatology and Clinical Immunology, Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht, The Netherlands.,Department of Rheumatology and Clinical Immunology, University Medical Center, Utrech, The Netherlands
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Sew Hoy W, Antoun JS, Lin W, Chandler N, Merriman T, Farella M. Ecological momentary assessment of pain in adolescents undergoing orthodontic treatment using a smartphone app. Semin Orthod 2018. [DOI: 10.1053/j.sodo.2018.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Abstract
Genome-wide association studies (GWAS) have identified nearly 30 loci associated with urate concentrations that also influence the subsequent risk of gout. The ABCG2 Q141 K variant is highly likely to be causal and results in internalization of ABCG2, which can be rescued by drugs. Three other GWAS loci contain uric acid transporter genes, which are also highly likely to be causal. However identification of causal genes at other urate loci is challenging. Finally, relatively little is known about the genetic control of progression from hyperuricemia to gout. Only 4 small GWAS have been published for gout.
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Affiliation(s)
- Tony Merriman
- Department of Biochemistry, University of Otago, 710 Cumberland Street, Dunedin 9054, New Zealand.
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Pirro M, Bianconi V, Schiaroli E, Francisci D, Mannarino MR, Bagaglia F, Sahebkar A, Merriman T, Baldelli F. Elevated serum uric acid levels are associated with endothelial dysfunction in HIV patients receiving highly-active antiretroviral therapy. Atherosclerosis 2018; 272:101-107. [PMID: 29597116 DOI: 10.1016/j.atherosclerosis.2018.03.031] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 03/03/2018] [Accepted: 03/16/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND AIMS Elevated serum uric acid (SUA) levels may be associated with endothelial dysfunction. Increased rates of metabolic syndrome (MS) and elevated SUA levels were described in human immunodeficiency virus (HIV) infected patients. We investigated whether SUA levels are associated with endothelial dysfunction in HIV positive patients receiving highly-active antiretroviral therapy (HAART) irrespective of MS. METHODS In this cross-sectional study of 250 HIV positive patients receiving stable HAART, we evaluated the relationship between MS, SUA levels and endothelial function. SUA levels and brachial artery flow-mediated dilation (bFMD) were measured. The relationship between logarithmic (LG)-transformed SUA levels and bFMD was evaluated after correction for MS. RESULTS MS was detected in 28.4% of patients and elevated SUA levels (≥6 mg/dL) in 25.2%. MS was associated with higher LG-SUA levels (age-, gender- and glomerular filtration rate-adjusted beta = 0.204, p = 0.001). The crude linear association between LG-SUA levels and LG-bFMD (beta = -0.166, p = 0.008) was abolished after correction for MS (beta = -0.089, p = 0.172). When SUA levels were used as a categorical variable (≥6 mg/dL or <6 mg/dL and SUA quartiles, respectively), the association between LG-SUA levels and LG-bFMD remained significant after adjustment for MS (beta = -0.142, p = 0.022 and beta = -0.163, p = 0.010, respectively). CONCLUSIONS MS significantly affects SUA levels in HAART-treated HIV infected patients. The negative association between SUA and bFMD is independent of MS only for elevated SUA levels.
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Affiliation(s)
- Matteo Pirro
- Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, 06129, Italy.
| | - Vanessa Bianconi
- Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, 06129, Italy
| | - Elisabetta Schiaroli
- Unit of Infectious Diseases, Department of Medicine, University of Perugia, Perugia, 06129, Italy
| | - Daniela Francisci
- Unit of Infectious Diseases, Department of Medicine, University of Perugia, Perugia, 06129, Italy
| | - Massimo R Mannarino
- Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, 06129, Italy
| | - Francesco Bagaglia
- Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, 06129, Italy
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, 9177948564, Iran
| | - Tony Merriman
- Department of Biochemistry, University of Otago, Dunedin, 9054, New Zealand
| | - Franco Baldelli
- Unit of Infectious Diseases, Department of Medicine, University of Perugia, Perugia, 06129, Italy
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López-Isac E, Martín JE, Assassi S, Simeón CP, Carreira P, Ortego-Centeno N, Freire M, Beltrán E, Narváez J, Alegre-Sancho JJ, Fernández-Gutiérrez B, Balsa A, Ortiz AM, González-Gay MA, Beretta L, Santaniello A, Bellocchi C, Lunardi C, Moroncini G, Gabrielli A, Witte T, Hunzelmann N, Distler JHW, Riekemasten G, van der Helm-van Mil AH, de Vries-Bouwstra J, Magro-Checa C, Voskuyl AE, Vonk MC, Molberg Ø, Merriman T, Hesselstrand R, Nordin A, Padyukov L, Herrick A, Eyre S, Koeleman BPC, Denton CP, Fonseca C, Radstake TRDJ, Worthington J, Mayes MD, Martín J. Brief Report: IRF4 Newly Identified as a Common Susceptibility Locus for Systemic Sclerosis and Rheumatoid Arthritis in a Cross-Disease Meta-Analysis of Genome-Wide Association Studies. Arthritis Rheumatol 2017; 68:2338-44. [PMID: 27111665 DOI: 10.1002/art.39730] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 04/19/2016] [Indexed: 01/21/2023]
Abstract
OBJECTIVE Systemic sclerosis (SSc) and rheumatoid arthritis (RA) are autoimmune diseases that have similar clinical and immunologic characteristics. To date, several shared SSc-RA genetic loci have been identified independently. The aim of the current study was to systematically search for new common SSc-RA loci through an interdisease meta-genome-wide association (meta-GWAS) strategy. METHODS The study was designed as a meta-analysis combining GWAS data sets of patients with SSc and patients with RA, using a strategy that allowed identification of loci with both same-direction and opposite-direction allelic effects. The top single-nucleotide polymorphisms were followed up in independent SSc and RA case-control cohorts. This allowed an increase in the sample size to a total of 8,830 patients with SSc, 16,870 patients with RA, and 43,393 healthy controls. RESULTS This cross-disease meta-analysis of the GWAS data sets identified several loci with nominal association signals (P < 5 × 10(-6) ) that also showed evidence of association in the disease-specific GWAS scans. These loci included several genomic regions not previously reported as shared loci, as well as several risk factors that were previously found to be associated with both diseases. Follow-up analyses of the putatively new SSc-RA loci identified IRF4 as a shared risk factor for these 2 diseases (Pcombined = 3.29 × 10(-12) ). Analysis of the biologic relevance of the known SSc-RA shared loci identified the type I interferon and interleukin-12 signaling pathways as the main common etiologic factors. CONCLUSION This study identified a novel shared locus, IRF4, for the risk of SSc and RA, and highlighted the usefulness of a cross-disease GWAS meta-analysis strategy in the identification of common risk loci.
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Affiliation(s)
- Elena López-Isac
- Institute of Parasitology and Biomedicine López-Neyra CSIC, Granada, Spain
| | | | | | | | | | | | - Mayka Freire
- Complexo Hospitalario Universitario de Vigo, Vigo, Spain
| | - Emma Beltrán
- Hospital General Universitario de Valencia, Valencia, Spain
| | | | | | | | | | - Alejandro Balsa
- Hospital Universitario La Paz, Instituto de Investigación Sanitaria La Paz, Madrid, Spain
| | - Ana M Ortiz
- Hospital Universitario La Princesa, Instituto de Investigación Sanitaria La Princesa, Madrid, Spain
| | | | - Lorenzo Beretta
- Referral Center for Systemic Autoimmune Diseases, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | - Alessandro Santaniello
- Referral Center for Systemic Autoimmune Diseases, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | - Chiara Bellocchi
- Referral Center for Systemic Autoimmune Diseases, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | | | | | - Armando Gabrielli
- Università Politecnica delle Marche and Ospedali Riuniti, Ancona, Italy
| | | | | | | | | | | | | | | | | | - Madelon C Vonk
- Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Øyvind Molberg
- Oslo University Hospital Rikshospitalet and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | | | | | - Annika Nordin
- Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Leonid Padyukov
- Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Ariane Herrick
- University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Steve Eyre
- University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | | | - Christopher P Denton
- Centre for Rheumatology, Royal Free and University College Medical School, London, UK
| | - Carmen Fonseca
- Centre for Rheumatology, Royal Free and University College Medical School, London, UK
| | - Timothy R D J Radstake
- University Medical Center Utrecht, Utrecht, The Netherlands. Members of the Spanish Scleroderma Group are shown in Appendix A
| | - Jane Worthington
- University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | | | - Javier Martín
- Institute of Parasitology and Biomedicine López-Neyra CSIC, Granada, Spain
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Sika-Paotonu D, Azevedo P, Faatoese A, Wihongi H, Nuku H, Hudson M, Havea P, Parks T, Merriman T, Lennon D. Culturally appropriate advisory and governance oversight for the study of rheumatic fever and rheumatic heart disease in New Zealand. The Journal of Immunology 2017. [DOI: 10.4049/jimmunol.198.supp.125.30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Abstract
Acute rheumatic fever (ARF) is an autoimmune condition caused by untreated Group A Streptococcal (GAS) infection of the upper respiratory tract (and possibly skin). Multiple or severe attacks of ARF can cause cardiac damage, known as Rheumatic Heart Disease (RHD). RHD remains a significant cause of morbidity and mortality is rare in developed countries. In New Zealand, the disease burden of ARF and RHD amongst Indigenous Maori and Pasifika communities is one of the highest in the world, usually affecting children and young adults. Previous work carried out in New Zealand sought to explore the immunogenetics of ARF and RHD and involved candidate gene analysis techniques utilizing samples from individuals diagnosed with RHD where a functional variant in the gene encoding the interleukin IL-6 cytokine known as IL-6 rs1800797 was found to be significantly associated with RHD. Current work seeks to explore the genetic susceptibility to ARF/RHD in greater depth using more advanced genome-wide technology. An international genome wide association study (GWAS) is currently underway to further understand the genetics of ARF/RHD using data obtained from global sources. To undertake the proposed GWAS work and amend the original New Zealand study, an Advisory team comprised of Pasifika and Māori representatives comprised of community leaders, researchers, scientists, and academics is providing the appropriate governance, cultural support and guidance essential for the project work.
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Affiliation(s)
- Dianne Sika-Paotonu
- 1Victoria University of Wellington, New Zealand
- 2Telethon Kids Institute, Australia
| | | | | | | | - Hiueni Nuku
- 6Porirua Union & Community Health Service, New Zealand
| | | | | | - Tom Parks
- 9University of Oxford, United Kingdom
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Pirro M, Mannarino MR, Bianconi V, De Vuono S, Sahebkar A, Bagaglia F, Franceschini L, Scarponi AM, Mannarino E, Merriman T. Uric acid and bone mineral density in postmenopausal osteoporotic women: the link lies within the fat. Osteoporos Int 2017; 28:973-981. [PMID: 27725998 DOI: 10.1007/s00198-016-3792-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 09/26/2016] [Indexed: 12/14/2022]
Abstract
UNLABELLED The association between serum uric acid (SUA) levels and bone mineral density (BMD) is controversial. Fat accumulation is linked to SUA and BMD, thus possibly explaining the mixed results. We found that adiposity drives part of the association between SUA and BMD in women with postmenopausal osteoporosis. INTRODUCTION Both positive and negative associations between SUA and BMD have been reported. SUA levels and BMD increase with higher body weight and other indices of adiposity; hence, the association between SUA and BMD might be a consequence of the confounding effect of adiposity. We investigated in this cross-sectional study whether the association between SUA and BMD is independent of measures of fat accumulation and other potential confounders. METHODS SUA levels, femur BMD, markers of bone metabolism, body mass index (BMI), fat mass (FM), waist circumference (WC), and abdominal visceral fat area were measured in 180 treatment-naive postmenopausal osteoporotic women (mean age 66.3 ± 8.5 years, age range 48-81 years). RESULTS Women with higher SUA levels (third tertile) had significantly higher femur BMD and lower cross-linked C-terminal telopeptide of type I collagen (CTX) and bone alkaline phosphatase (bALP) levels. SUA levels were positively associated with all indices of adiposity. In multivariable analysis with femur BMD as dependent variable, the association between logarithmic (LG)-transformed SUA levels and BMD (beta = 0.42, p < 0.001) was lessened progressively by the different indices of adiposity, like LG-BMI (beta = 0.22, p = 0.007), LG-WC (beta = 0.21, p = 0.01), LG-FM (beta = 0.18, p = 0.01), and LG-abdominal visceral fat area (beta = 0.12, p = 0.05). The association between SUA levels and markers of bone metabolism was dependent on the effect of confounders. CONCLUSION In postmenopausal osteoporotic women, the strong univariable association between SUA levels and femur BMD is partly explained by the confounding effect of indices of adiposity.
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Affiliation(s)
- M Pirro
- Unit of Internal Medicine, Angiology and Arteriosclerosis Diseases, Department of Medicine, University of Perugia, Perugia, Italy.
- Hospital "Santa Maria della Misericordia", Piazzale Menghini, 1, 06129, Perugia, Italy.
| | - M R Mannarino
- Unit of Internal Medicine, Angiology and Arteriosclerosis Diseases, Department of Medicine, University of Perugia, Perugia, Italy
| | - V Bianconi
- Unit of Internal Medicine, Angiology and Arteriosclerosis Diseases, Department of Medicine, University of Perugia, Perugia, Italy
| | - S De Vuono
- Unit of Internal Medicine, Angiology and Arteriosclerosis Diseases, Department of Medicine, University of Perugia, Perugia, Italy
| | - A Sahebkar
- Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, 9177948564, Iran
- Metabolic Research Centre, Royal Perth Hospital, School of Medicine and Pharmacology, University of Western Australia, Perth, Australia
| | - F Bagaglia
- Unit of Internal Medicine, Angiology and Arteriosclerosis Diseases, Department of Medicine, University of Perugia, Perugia, Italy
| | - L Franceschini
- Unit of Internal Medicine, Angiology and Arteriosclerosis Diseases, Department of Medicine, University of Perugia, Perugia, Italy
| | - A M Scarponi
- Unit of Internal Medicine, Angiology and Arteriosclerosis Diseases, Department of Medicine, University of Perugia, Perugia, Italy
| | - E Mannarino
- Unit of Internal Medicine, Angiology and Arteriosclerosis Diseases, Department of Medicine, University of Perugia, Perugia, Italy
| | - T Merriman
- Department of Biochemistry, University of Otago, Otago, New Zealand
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Stamp LK, Merriman T, Frampton C, Zhang M, Wallace M, Miner JN, Dalbeth N. Plasma oxypurinol as a measure of adherence in clinical trials. Ann Rheum Dis 2017; 77:313-314. [DOI: 10.1136/annrheumdis-2016-210661] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Revised: 12/15/2016] [Accepted: 12/17/2016] [Indexed: 11/04/2022]
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Merriman T, Boocock J, Stahl E, Cadzow M, Phipps-Green A, Topless R, Harre Hindmarsh J, Mount D, Stamp L, Dalbeth N, Choi H, Tanner C. THU0539 Population-Specific Resequencing Reveals Association of The ABCC4/MRP4 Gene with Gout in New Zealand Māori and Pacific Men. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Roberts R, Wallace M, Harrison A, White D, Dalbeth N, Stamp L, Ching D, Highton J, Merriman T, Robinson P, Brown M, Stebbings S. THU0366 Association of Chromosome 1Q32 with Ankylosing Spondylitis Is Independent of Bowel Symptoms and Faecal Calprotectin. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Affiliation(s)
- Richard J Johnson
- Division of Renal Diseases and Hypertension, University of Colorado, Aurora, CO
| | - Tony Merriman
- Department of Biochemistry, University of Otago, Dunedin, New Zealand
| | - Miguel A Lanaspa
- Division of Renal Diseases and Hypertension, University of Colorado, Aurora, CO
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Bao Y, Curhan G, Merriman T, Plenge R, Kraft P, Choi HK. Lack of gene-diuretic interactions on the risk of incident gout: the Nurses' Health Study and Health Professionals Follow-up Study. Ann Rheum Dis 2015; 74:1394-8. [PMID: 25667207 DOI: 10.1136/annrheumdis-2014-206534] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [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: 08/25/2014] [Accepted: 01/15/2015] [Indexed: 11/04/2022]
Abstract
BACKGROUND Diuretic-induced gout might occur only among those with a genetic predisposition to hyperuricaemia, as suggested by a recent study with 108 self-reported gout cases. METHODS We examined the role of urate genes on the risk of diuretic-induced incident gout in 6850 women from the Nurses' Health Study (NHS) and in 4223 men from the Health Professionals Follow-up Study (HPFS). Two published genetic risk scores (GRSs) were calculated using urate-associated single-nucleotide polymorphisms for 8 (GRS8) and 29 genes (GRS29). RESULTS Our analyses included 727 and 354 confirmed incident gout cases in HPFS and NHS, respectively. The multivariate relative risk (RR) for diuretic use was 2.20 and 1.69 among those with GRS8 < and ≥ the median (p for interaction=0.27). The corresponding RRs using GRS29 were 2.19 and 1.88 (p for interaction=0.40). The lack of interaction persisted in NHS (all p values >0.20) and in our analyses limited to those with hypertension in both cohorts. SLC22A11 (OAT4) showed a significant interaction only among women but in the opposite direction to the recent study. CONCLUSIONS In these large prospective studies, individuals with a genetic predisposition for hyperuricaemia are not at a higher risk of developing diuretic-induced gout than those without.
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Affiliation(s)
- Ying Bao
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Gary Curhan
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA Renal Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Robert Plenge
- Renal Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Peter Kraft
- Harvard School of Public Health, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Hyon K Choi
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Merriman T, Topless R, Day R, Kannangara D, Williams K, Bradbury L, Brown M, Harrison A, Hill C, Jones G, Lester S, Littlejohn G, Rischmueller M, Shenstone B, Smith M, Andres M, Bardin T, Doherty M, Janssen M, Jansen T, Joosten L, Perez-Ruiz F, Radstake T, Riches P, Roddy E, Tausche AK, Stamp L, Dalbeth N, Liote F, So A, Rasheed H. THU0493 Association of the Toll-Like Receptor 4 (TLR4) Gene with Gout. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4781] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Merriman T, Phipps-Green A, Topless R, Merriman M, Franklin C, Jones G, van Rij A, Montgomery G, Chapman B, White D, Stamp L, Dalbeth N. THU0492 Association Analysis of 18 Recently Discovered Serum Urate Loci with Gout. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Holzinger D, Nippe N, Vogl T, Marketon K, Mysore V, Weinhage T, Dalbeth N, Pool B, Merriman T, Baeten D, Ives A, Busso N, Foell D, Bas S, Gabay C, Roth J. Myeloid-Related Proteins 8 and 14 Contribute to Monosodium Urate Monohydrate Crystal-Induced Inflammation in Gout. Arthritis Rheumatol 2014; 66:1327-39. [DOI: 10.1002/art.38369] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Accepted: 01/14/2014] [Indexed: 12/28/2022]
Affiliation(s)
- Dirk Holzinger
- University Hospital Muenster and University Children's Hospital Muenster; Muenster Germany
| | - Nadine Nippe
- University Hospital Muenster and University of Muenster; Muenster Germany
| | - Thomas Vogl
- University Hospital Muenster; Muenster Germany
| | | | | | - Toni Weinhage
- University Children's Hospital Muenster; Muenster Germany
| | | | | | | | - Dominique Baeten
- Academic Medical Center and University of Amsterdam; Amsterdam The Netherlands
| | | | | | - Dirk Foell
- University Children's Hospital Muenster; Muenster Germany
| | - Sylvette Bas
- University Hospitals of Geneva; Geneva Switzerland
| | - Cem Gabay
- University Hospitals of Geneva; Geneva Switzerland
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Sundborn G, Thornley S, Te Morenga L, Merriman T. FIZZ Sugary Drink Free Pacific by 2030--Symposium Declaration. N Z Med J 2014; 127:98-101. [PMID: 24806253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Gerhard Sundborn
- Section of Epidemiology and Biostatistics, University of Auckland, Auckland, New Zealand.
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Johnson RJ, Lanaspa MA, Sanchez-Lozada LG, Rivard CJ, Bjornstad PS, Merriman T, Sundborn G. Fat storage syndrome in Pacific peoples: a combination of environment and genetics? Pac Health Dialog 2014; 20:11-16. [PMID: 25928990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Pacific people (especially Micronesian and Polynesian) have some of the highest rates of obesity and diabetes in the world that largely developed since the introduction of western culture and diet. Recent studies suggest that much of the risk relates to the excessive intake of sugar (sucrose) and carbohydrates, leading to a type of fat storage syndrome (metabolic syndrome). Here we discuss some of the environmental. genetic and epigenetic reasons why this group might be especially prone to developing obesity and diabetes compared to other ethnic groups. Indirect evidence suggests that the higher endogenous uric acid levels in the Polynesian-Micronesian population may represent a predisposing factor for the development of obesity and diabetes in the context of Western diets and lifestyles. Pacific people may be an ideal group to study the role of "thrifty genes" in the pathogenesis of the current obesity epidemic.
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Bossini-Castillo L, de Kovel C, Kallberg H, van ‘t Slot R, Italiaander A, Coenen M, Tak PP, Posthumus MD, Wijmenga C, Huizinga T, van der Helm-van Mil AHM, Stoeken-Rijsbergen G, Rodriguez-Rodriguez L, Balsa A, González-Álvaro I, González-Gay MÁ, Gómez-Vaquero C, Franke B, Vermeulen S, van der Horst-Bruinsma IE, Dijkmans BAC, Wolbink GJ, Ophoff RA, Maehlen MT, van Riel P, Merriman M, Klareskog L, Lie BA, Merriman T, Crusius JBA, Brouwer E, Martin J, de Vries N, Toes R, Padyukov L, Koeleman BPC. A genome-wide association study of rheumatoid arthritis without antibodies against citrullinated peptides. Ann Rheum Dis 2014; 74:e15. [DOI: 10.1136/annrheumdis-2013-204591] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Holzinger D, Nippe N, Marketon K, Dalbeth N, Merriman T, Baeten D, Busso N, Vogl T, Foell D, Gabay C, Roth J. OP0099 Toll-like receptor 4 agonists MRP 8 and MRP 14 act as endogenous enhancers of MSU-crystal induced IL-1 secretion in vitro and reflect disease activity in gout patients in vivo. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2012-eular.1782] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Holzinger D, Nippe N, Vogl T, Marketon K, Mysore V, Weinhage T, Dalbeth N, Pool B, Merriman T, Baeten D, Ives A, Bagnoud N, Busso N, Foell D, Bas S, Gabay C, Roth J. OR6-004 – MRP8/14 promote MSU-crystal induced inflammation. Pediatr Rheumatol Online J 2013. [PMCID: PMC3952172 DOI: 10.1186/1546-0096-11-s1-a99] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Dalbeth N, Gow P, Stamp L, Merriman T, Stuart R, Winnard D, Lindsay K. New urate-lowering therapies in Aotearoa New Zealand: a response to Dr Lance Gravatt's letter on benzbromarone hepatotoxicity. N Z Med J 2013; 126:120-123. [PMID: 24154780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Teruel M, McKinney C, Balsa A, Pascual-Salcedo D, Rodriguez-Rodriguez L, Ortiz AM, Gómez-Vaquero C, González-Gay MA, Smith M, Witte T, Merriman T, Lie BA, Martin J. Association of CD247 polymorphisms with rheumatoid arthritis: a replication study and a meta-analysis. PLoS One 2013; 8:e68295. [PMID: 23861880 PMCID: PMC3702579 DOI: 10.1371/journal.pone.0068295] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Accepted: 05/28/2013] [Indexed: 11/18/2022] Open
Abstract
Given the role of CD247 in the response of the T cells, its entailment in autoimmune diseases and in order to better clarify the role of this gene in RA susceptibility, we aimed to analyze CD247 gene variants previously associated with other autoimmune diseases (rs1052237, rs2056626 and rs864537) in a large independent European Caucasian population. However, no evidence of association was found for the analyzed CD247 single-nucleotide polymorphisms (SNPs) with RA and with the presence/absence of anti-cyclic citrullinated polypeptide. We performed a meta-analysis including previously published GWAS data from the rs864537 variant, revealing an overall genome-wide significant association between this CD247 SNP and RA with anti-CCP (OR = 0.90, CI 95% = 0.87-0.93, Poverall = 2.1×10(-10)). Our results show for first time a GWAS-level association between this CD247 polymorphism and RA risk.
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Affiliation(s)
- María Teruel
- Instituto de Parasitología y Biomedicina López-Neyra, Granada, Spain.
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Wilsher M, Voight L, Milne D, Teh M, Good N, Kolbe J, Williams M, Pui K, Merriman T, Sidhu K, Dalbeth N. Prevalence of airway and parenchymal abnormalities in newly diagnosed rheumatoid arthritis. Respir Med 2012; 106:1441-6. [DOI: 10.1016/j.rmed.2012.06.020] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2012] [Revised: 06/24/2012] [Accepted: 06/26/2012] [Indexed: 12/17/2022]
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Sundborn G, Jackson R, Thornley S, Merriman T, Metcalf P. The ‘Endgame’ for sugar sweetened beverages. Obes Res Clin Pract 2012. [DOI: 10.1016/j.orcp.2012.08.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Abstract
Recent studies in diverse disciplines have led to significant advances in the understanding of the basic biology of hyperuricaemia and gout, with important implications for future treatment. These findings include genetic variation within SLC2A9 as a key regulator of urate homeostasis, and identification of urate-anion exchanger urate transporter 1 (URAT1) and other renal uric acid transporters. Recognition of urate as an endogenous danger signal and activator of the adaptive immune response suggests an important role for urate crystals in non-microbial immune surveillance. The central role of NALP3 inflammasome activation and IL-1beta signalling in the initiation of the acute gout attack raises the possibility of new therapeutic targets. Disordered osteoclastogenesis in patients with chronic gout highlights potential therapies for prevention of joint damage. This review summarizes these findings and the potential relevance for future management of gout.
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Affiliation(s)
- N Dalbeth
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, 85 Park Rd, Grafton, Private Bag 92019, Auckland, New Zealand.
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Winnard D, Kake T, Gow P, Barratt-Boyes C, Harris V, Hall DA, Mason H, Merriman T, Dalbeth N. Debunking the myths to provide 21st Century management of gout. N Z Med J 2008; 121:79-85. [PMID: 18535649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Epidemiologic and recent qualitative research suggests that the impact of under-treated gout is far more significant than many health professionals realise. The magnitude of this impact for Maaori and Pacific men of working age has been identified as a particular concern by the recently formed Maaori Gout Action Group in Counties Manukau District Health Board (South Auckland, New Zealand). The Group has identified that to achieve modern management of gout, those with gout need to be supported by primary care practitioners who are aware of the need for early intervention with allopurinol, as well as whaanau/families and communities who understand the impact and causes of gout and the lifestyle changes that are needed alongside long-term allopurinol. The Group wishes to support further research into the impact and causes of gout, particularly for Maaori, and to develop strategic alliances to ensure that the treatment and prevention of gout is advocated by those working with conditions such as diabetes and cardiovascular disease where gout is a frequent comorbidity.
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Affiliation(s)
- Doone Winnard
- Counties Manukau District Health Board, Private Bag 94052, South Auckland Mail Centre, Manukau City, New Zealand.
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Nasri S, More H, Graziano F, Ruzzo A, Wilson E, Dunbier A, McKinney C, Merriman T, Guilford P, Magnani M, Humar B. A novel diffuse gastric cancer susceptibility variant in E-cadherin (CDH1) intron 2: a case control study in an Italian population. BMC Cancer 2008; 8:138. [PMID: 18482459 PMCID: PMC2412889 DOI: 10.1186/1471-2407-8-138] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2007] [Accepted: 05/15/2008] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Inherited genetic factors such as E-cadherin (CDH1) promoter variants are believed to influence the risk towards sporadic diffuse gastric cancer (DGC). Recently, a new regulatory region essential for CDH1 transcription has been identified in CDH1 intron 2. METHODS We genotyped all known polymorphisms located within conserved sequences of CDH1 intron 2 (rs10673765, rs9932686, rs1125557, rs9282650, rs9931853) in an Italian population consisting of 134 DGC cases and 100 healthy controls (55 patient relatives and 45 unrelated, matched individuals). The influence of individual variants on DGC risk was assessed using chi2-tests and logistic regression. The relative contribution of alleles was estimated by haplotype analysis. RESULTS We observed a significant (p < 0.0004) association of the CDH1 163+37235G>A variant (rs1125557) with DGC risk. Odds ratios were 4.55 (95%CI = 2.09-9.93) and 1.38 (95%CI = 0.75-2.55) for AA and GA carriers, respectively. When adjusted for age, sex, smoking status, alcohol intake and H. pylori infection, the risk estimates remained largely significant for AA carriers. Haplotype analysis suggested the 163+37235A-allele contributes to disease risk independently of the other variants studied. CONCLUSION The CDH1 163+37235G>A polymorphism may represent a novel susceptibility variant for sporadic DGC if confirmed in other populations. Considering the broad expression of E-cadherin in epithelia, this exploratory study encourages further evaluation of the 163+37235A-allele as a susceptibility variant in other carcinomas.
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Affiliation(s)
- Soroush Nasri
- Cancer Genetics Laboratory, Department of Biochemistry, University of Otago, Dunedin 9054, Aotearoa New Zealand.
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Merriman T, Twells R, Merriman M, Eaves I, Cox R, Cucca F, McKinney P, Shield J, Baum D, Bosi E, Pozzilli P, Nistico L, Buzzetti R, Joner G, Ronningen KS, Thorsby E, Undlien D, Pociot F, Nerup J, Bain S, Barnett A, Todd J. Evidence by allelic association-dependent methods for a type 1 diabetes polygene (IDDM6) on chromosome 18q21. Hum Mol Genet 2007. [DOI: 10.1093/hmg/ddm307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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44
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Reed P, Cucca F, Jenkins S, Merriman M, Wilson A, McKinney P, Bosi E, Joner G, Ronningen KS, Thorsby E, Undlien D, Merriman T, Barnett A, Bain S, Todd J. Evidence for a type 1 diabetes susceptibility locus (IDDM10) on human chromosome 10p11-q11. Hum Mol Genet 2007. [DOI: 10.1093/hmg/ddm308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Merriman T, Cameron V. Risk-taking: behind the warrior gene story. N Z Med J 2007; 120:U2440. [PMID: 17339896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
In 2006, the monoamine oxidase-A gene was widely reported in the media as being associated with risk-taking and aggressive behaviour in Māori. We examine the scientific evidence underlying this claim. Whilst there is credible evidence for a contribution of a monoamine oxidase-A genetic variant to antisocial behaviour in Caucasians, there is no direct evidence to support such an association in Māori. Insufficient rigour in interpreting and applying the relevant literature, and in generating new data, has (in conjunction with a lack of scientific investigative journalism) done science and Māori a disservice.
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Affiliation(s)
- Tony Merriman
- Department of Biochemistry, Otago School of Medical Sciences, University of Otago, Dunedin.
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Humar B, Graziano F, Cascinu S, Catalano V, Ruzzo AM, Magnani M, Toro T, Burchill T, Futschik ME, Merriman T, Guilford P. Association of CDH1 haplotypes with susceptibility to sporadic diffuse gastric cancer. Oncogene 2002; 21:8192-5. [PMID: 12444556 DOI: 10.1038/sj.onc.1205921] [Citation(s) in RCA: 81] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2002] [Revised: 07/30/2002] [Accepted: 07/31/2002] [Indexed: 01/26/2023]
Abstract
Truncating mutations in the gene for the cell to cell adhesion protein E-cadherin are the most consistent genetic alterations observed in sporadic and hereditary diffuse gastric cancer (DGC). In addition to these inactivating mutations, a CDH1 promoter polymorphism at position -160 has been reported to lead to transcriptional downregulation of the gene in vitro. We therefore performed a case-control study to investigate whether this variant is associated with an increased susceptibility to DGC. The frequency of the -160A allele was significantly higher (P<0.005) in 53 diffuse gastric cancer cases compared to 70 matched controls. The odds ratio associated with the A-allele was 2.27 for CA-heterozygotes (95%CI 1.16-4.44) and 7.84 for AA-homozygotes (95%CI 2.89-21.24). Two additional polymorphisms (the 48+6T-->C and the 2076C-->T variant) were genotyped and shown to be equally distributed among cases and controls. Haplotype analysis with the three polymorphisms confirmed an association with disease (P<0.004). However, this analysis suggested the -160C-->A CDH1 promoter polymorphism may be in linkage disequilibrium with a distinct aetiological locus or acts in combination with other functional variants in or near the CDH1 region.
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Affiliation(s)
- Bostjan Humar
- Cancer Genetics Laboratory, University of Otago, Dunedin, Aotearoa, New Zealand
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48
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Humar B, Toro T, Graziano F, Müller H, Dobbie Z, Kwang-Yang H, Eng C, Hampel H, Gilbert D, Winship I, Parry S, Ward R, Findlay M, Christian A, Tucker M, Tucker K, Merriman T, Guilford P. Novel germline CDH1 mutations in hereditary diffuse gastric cancer families. Hum Mutat 2002; 19:518-25. [PMID: 11968084 DOI: 10.1002/humu.10067] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.4] [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] [Indexed: 12/15/2022]
Abstract
Hereditary diffuse gastric cancer (HDGC) is a recently defined cancer syndrome caused by inactivating, heterozygous germline mutations in the gene for the cell-to-cell adhesion protein E-cadherin (CDH1). Here, we describe the search for CDH1 mutations in 10 newly identified gastric cancer families. Seven of 10 families met the clinical criteria for HDGC. Germline mutations were identified in four of these seven families and one family that was borderline for the clinical criteria. Of the mutations identified in the five new families, four were previously unreported and consisted of two frameshift and two donor splice site mutations. One splice site mutation occurred at the 100% conserved +1 position. The second splice site mutation occurred at the +5 position and was shown to lead to abnormal splicing. Additional CDH1 variants detected include the heterozygous -160 C-->A promoter polymorphism, which has previously been reported to be associated with decreased CDH1 transcription. We, however, found this polymorphism to be common in a control population, suggesting that a major role for this polymorphism in gastric cancer susceptibility is unlikely.
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Affiliation(s)
- Bostjan Humar
- Cancer Genetics Laboratory, Department of Biochemistry, University of Otago, Dunedin, New Zealand
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Cullinan M, Merriman T. Oesophageal rupture resulting from airbag deployment during a motor vehicle accident. ANZ J Surg 2001; 71:554-5. [PMID: 11527270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Affiliation(s)
- M Cullinan
- Albury Base Hospital, Albury, New South Wales, Australia.
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Merriman T, Hutson JM. PAEDIATRIC SURGICAL TRAINING: REPLY. ANZ J Surg 1999. [DOI: 10.1046/j.1440-1622.1999.01533.x] [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: 11/20/2022]
Affiliation(s)
- T. Merriman
- Royal Children’s Hospital, Parkville, Victoria, Australia
| | - J. M. Hutson
- Royal Children’s Hospital, Parkville, Victoria, Australia
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