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Phillips TK, Kassanjee R, Maxwell N, Anderson K, Johnson L, Moolla H, Myer L, Chi BH, Euvrard J, Boulle A, Davies M, Cornell M, de Waal R. ART history prior to conception: trends and association with postpartum disengagement from HIV care in Khayelitsha, South Africa (2013-2019): a retrospective cohort study. J Int AIDS Soc 2024; 27:e26236. [PMID: 38566482 PMCID: PMC10988117 DOI: 10.1002/jia2.26236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 03/12/2024] [Indexed: 04/04/2024] Open
Abstract
INTRODUCTION In recent years, the expansion of HIV treatment eligibility has resulted in an increase in people with antiretroviral therapy (ART) experience prior to pregnancy but little is known about postpartum engagement in care in this population. We examined differences in disengagement from HIV care after delivery by maternal ART history before conception. METHODS We analysed data from people living with HIV (aged 15-49) in Khayelitsha, South Africa, with ≥1 live birth between April 2013 and March 2019. We described trends over time in ART history prior to estimated conception, classifying ART history groups as: (A) on ART with no disengagement (>270 days with no evidence of HIV care); (B) returned before pregnancy following disengagement; (C) restarted ART in pregnancy after disengagement; and (D) ART new start in pregnancy. We used Kaplan-Meier curves and proportional-hazards models (adjusted for maternal age, number of pregnancy records and year of delivery) to examine the time to disengagement from delivery to 2 years postpartum. RESULTS Among 7309 pregnancies (in 6680 individuals), the proportion on ART (A) increased from 19% in 2013 to 41% in 2019. The proportions of those who returned (B) and restarted (C) increased from 2% to 13% and from 2% to 10%, respectively. There was a corresponding decline in the proportion of new starts (D) from 77% in 2013 to 36% in 2019. In the first recorded pregnancy per person in the study period, 26% (95% CI 25-27%) had disengaged from care by 1 year and 34% (95% CI 33-36%) by 2 years postpartum. Individuals who returned (B: aHR 2.10, 95% CI 1.70-2.60), restarted (C: aHR 3.32, 95% CI 2.70-4.09) and newly started ART (D: aHR 2.41, 95% CI 2.12-2.74) had increased hazards of postpartum disengagement compared to those on ART (A). CONCLUSIONS There is a growing population of people with ART experience prior to conception and postpartum disengagement varies substantially by ART history. Antenatal care presents an important opportunity to understand prior ART experiences and an entry into interventions for strengthened engagement in HIV care.
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Affiliation(s)
- Tamsin Kate Phillips
- Centre for Infectious Disease Epidemiology & ResearchSchool of Public HealthUniversity of Cape TownCape TownSouth Africa
- Division of Epidemiology & BiostatisticsSchool of Public HealthUniversity of Cape TownCape TownSouth Africa
| | - Reshma Kassanjee
- Centre for Infectious Disease Epidemiology & ResearchSchool of Public HealthUniversity of Cape TownCape TownSouth Africa
| | - Nicola Maxwell
- Centre for Infectious Disease Epidemiology & ResearchSchool of Public HealthUniversity of Cape TownCape TownSouth Africa
| | - Kim Anderson
- Centre for Infectious Disease Epidemiology & ResearchSchool of Public HealthUniversity of Cape TownCape TownSouth Africa
| | - Leigh Johnson
- Centre for Infectious Disease Epidemiology & ResearchSchool of Public HealthUniversity of Cape TownCape TownSouth Africa
| | - Haroon Moolla
- Centre for Infectious Disease Epidemiology & ResearchSchool of Public HealthUniversity of Cape TownCape TownSouth Africa
| | - Landon Myer
- Division of Epidemiology & BiostatisticsSchool of Public HealthUniversity of Cape TownCape TownSouth Africa
| | - Benjamin H. Chi
- Department of Obstetrics and GynecologySchool of MedicineUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Jonathan Euvrard
- Centre for Infectious Disease Epidemiology & ResearchSchool of Public HealthUniversity of Cape TownCape TownSouth Africa
- Department of Health and WellnessProvincial Government of the Western CapeCape TownSouth Africa
| | - Andrew Boulle
- Centre for Infectious Disease Epidemiology & ResearchSchool of Public HealthUniversity of Cape TownCape TownSouth Africa
- Department of Health and WellnessProvincial Government of the Western CapeCape TownSouth Africa
| | - Mary‐Ann Davies
- Centre for Infectious Disease Epidemiology & ResearchSchool of Public HealthUniversity of Cape TownCape TownSouth Africa
- Department of Health and WellnessProvincial Government of the Western CapeCape TownSouth Africa
| | - Morna Cornell
- Centre for Infectious Disease Epidemiology & ResearchSchool of Public HealthUniversity of Cape TownCape TownSouth Africa
| | - Renee de Waal
- Centre for Infectious Disease Epidemiology & ResearchSchool of Public HealthUniversity of Cape TownCape TownSouth Africa
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Bermejo GA, Tjandra N, Clore GM, Schwieters CD. Xplor-NIH: Better parameters and protocols for NMR protein structure determination. Protein Sci 2024; 33:e4922. [PMID: 38501482 PMCID: PMC10962493 DOI: 10.1002/pro.4922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 01/26/2024] [Accepted: 01/28/2024] [Indexed: 03/20/2024]
Abstract
The present work describes an update to the protein covalent geometry and atomic radii parameters in the Xplor-NIH biomolecular structure determination package. In combination with an improved treatment of selected non-bonded interactions between atoms three bonds apart, such as those involving methyl hydrogens, and a previously developed term that affects the system's gyration volume, the new parameters are tested using structure calculations on 30 proteins with restraints derived from nuclear magnetic resonance data. Using modern structure validation criteria, including several formally adopted by the Protein Data Bank, and a clear measure of structural accuracy, the results show superior performance relative to previous Xplor-NIH implementations. Additionally, the Xplor-NIH structures compare favorably against originally determined NMR models.
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Affiliation(s)
- Guillermo A. Bermejo
- Laboratory of Chemical PhysicsNational Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of HealthBethesdaMarylandUSA
| | - Nico Tjandra
- Biochemistry and Biophysics Center, National Heart, Lung, and Blood Institute, National Institutes of HealthBethesdaMarylandUSA
| | - G. Marius Clore
- Laboratory of Chemical PhysicsNational Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of HealthBethesdaMarylandUSA
| | - Charles D. Schwieters
- Laboratory of Chemical PhysicsNational Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of HealthBethesdaMarylandUSA
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Schwarz JE, Sengupta A, Guevara C, Barber AF, Hsu CT, Zhang SL, Weljie A, Sehgal A. Age-regulated cycling metabolites are relevant for behavior. Aging Cell 2024; 23:e14082. [PMID: 38204362 PMCID: PMC11019118 DOI: 10.1111/acel.14082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 11/29/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
Circadian cycles of sleep:wake and gene expression change with age in all organisms examined. Metabolism is also under robust circadian regulation, but little is known about how metabolic cycles change with age and whether these contribute to the regulation of behavioral cycles. To address this gap, we compared cycling of metabolites in young and old Drosophila and found major age-related variations. A significant model separated the young metabolic profiles by circadian timepoint, but could not be defined for the old metabolic profiles due to the greater variation in this dataset. Of the 159 metabolites measured in fly heads, we found 17 that cycle by JTK analysis in young flies and 17 in aged. Only four metabolites overlapped in the two groups, suggesting that cycling metabolites are distinct in young and old animals. Among our top cyclers exclusive to young flies were components of the pentose phosphate pathway (PPP). As the PPP is important for buffering reactive oxygen species, and overexpression of glucose-6-phosphate dehydrogenase (G6PD), a key component of the PPP, was previously shown to extend lifespan in Drosophila, we asked if this manipulation also affects sleep:wake cycles. We found that overexpression in circadian clock neurons decreases sleep in association with an increase in cellular calcium and mitochondrial oxidation, suggesting that altering PPP activity affects neuronal activity. Our findings elucidate the importance of metabolic regulation in maintaining patterns of neural activity, and thereby sleep:wake cycles.
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Affiliation(s)
- Jessica E. Schwarz
- Howard Hughes Medical Institute, University of PennsylvaniaPhiladelphiaPennsylvaniaUSA
- Chronobiology and Sleep Institute, Perelman School of Medicine, University of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Arjun Sengupta
- Chronobiology and Sleep Institute, Perelman School of Medicine, University of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Camilo Guevara
- Chronobiology and Sleep Institute, Perelman School of Medicine, University of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Annika F. Barber
- Howard Hughes Medical Institute, University of PennsylvaniaPhiladelphiaPennsylvaniaUSA
- Chronobiology and Sleep Institute, Perelman School of Medicine, University of PennsylvaniaPhiladelphiaPennsylvaniaUSA
- Present address:
Waksman Institute and Department of Molecular Biology and Biochemistry, RutgersThe State University of New JerseyNew BrunswickNew JerseyUSA
| | - Cynthia T. Hsu
- Howard Hughes Medical Institute, University of PennsylvaniaPhiladelphiaPennsylvaniaUSA
- Chronobiology and Sleep Institute, Perelman School of Medicine, University of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Shirley L. Zhang
- Howard Hughes Medical Institute, University of PennsylvaniaPhiladelphiaPennsylvaniaUSA
- Chronobiology and Sleep Institute, Perelman School of Medicine, University of PennsylvaniaPhiladelphiaPennsylvaniaUSA
- Present address:
Department of Cell BiologyEmory University School of MedicineAtlantaGeorgiaUSA
| | - Aalim Weljie
- Chronobiology and Sleep Institute, Perelman School of Medicine, University of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Amita Sehgal
- Howard Hughes Medical Institute, University of PennsylvaniaPhiladelphiaPennsylvaniaUSA
- Chronobiology and Sleep Institute, Perelman School of Medicine, University of PennsylvaniaPhiladelphiaPennsylvaniaUSA
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Booman A, Stratton K, Vesco KK, O'Malley J, Schmidt T, Boone‐Heinonen J, Snowden JM. Insurance coverage and discontinuity during pregnancy: Frequency and associations documented in the PROMISE cohort. Health Serv Res 2024; 59:e14265. [PMID: 38123135 PMCID: PMC10915475 DOI: 10.1111/1475-6773.14265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVE To describe insurance patterns and discontinuity during pregnancy, which may affect the experiences of the pregnant person: their timely access to care, continuity of care, and health outcomes. DATA SOURCES AND STUDY SETTING Data are from the PROMISE study, which utilizes data from community-based health care organizations (CHCOs) (e.g., federally qualified health centers that serve patients regardless of insurance status or ability to pay) in the United States from 2005 to 2021. STUDY DESIGN This descriptive study was a cohort utilizing longitudinal electronic health record data. DATA COLLECTION/EXTRACTION METHODS Insurance type at each encounter was recorded in the clinical database and coded as Private, Public, and Uninsured. Pregnant people were categorized into one of several insurance patterns. We analyzed the frequency and timing of insurance changes and care utilization within each group. PRINCIPAL FINDINGS Continuous public insurance was the most common insurance pattern (69.2%), followed by uninsured/public discontinuity (11.8%), with 6.4% experiencing uninsurance throughout the entirety of pregnancy. Insurance discontinuity was experienced by 16.6% of pregnant people; a majority of these reflect people transitioning to public insurance. Those with continuous public insurance had the highest frequency of inadequate prenatal care (19.5%), while those with all three types of insurance during pregnancy had the highest percentage of intensive prenatal care (16.5%). The majority (71.7%-81.2%) of those with a discontinuous pattern experienced a single insurance change. CONCLUSIONS Insurance discontinuity and uninsurance are common within our population of pregnant people seeking care at CHCOs. Our findings suggest that insurance status should be regarded as a dynamic rather than a static characteristic during pregnancy and should be measured accordingly. Future research is needed to assess the drivers of perinatal insurance discontinuity and if and how these discontinuities may affect health care access, utilization, and birth outcomes.
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Affiliation(s)
- Anna Booman
- School of Public HealthOregon Health & Science University‐Portland State UniversityPortlandOregonUSA
| | - Kalera Stratton
- School of Public HealthOregon Health & Science University‐Portland State UniversityPortlandOregonUSA
| | | | | | | | - Janne Boone‐Heinonen
- School of Public HealthOregon Health & Science University‐Portland State UniversityPortlandOregonUSA
| | - Jonathan M. Snowden
- School of Public HealthOregon Health & Science University‐Portland State UniversityPortlandOregonUSA
- Department of Obstetrics and GynecologyOregon Health & Science UniversityPortlandOregonUSA
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Rosano C, Karikari TK, Cvejkus R, Bellaver B, Ferreira PCL, Zmuda J, Wheeler V, Pascoal TA, Miljkovic I. Sex differences in Alzheimer's disease blood biomarkers in a Caribbean population of African ancestry: The Tobago Health Study. Alzheimers Dement (N Y) 2024; 10:e12460. [PMID: 38617114 PMCID: PMC11010267 DOI: 10.1002/trc2.12460] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 02/02/2024] [Accepted: 02/09/2024] [Indexed: 04/16/2024]
Abstract
INTRODUCTION Alzheimer's disease (AD) is increasing in the Caribbean, especially for persons of African ancestry (PAA) and women. However, studies have mostly utilized surveys without AD biomarkers. METHODS In the Tobago Health Study (n = 309; 109 women, mean age 70.3 ± 6.6), we assessed sex differences and risk factors for serum levels of phosphorylated tau-181 (p-tau181), amyloid-beta (Aβ)42/40 ratio, glial fibrillary acidic protein (GFAP), and neurofilament light chain (NfL). Blood samples were from 2010 to 2013 for men and from 2019 to 2023 for women. RESULTS Women were more obese, hypertensive, and sedentary but reported less smoking and alcohol use than men (age-adjusted p < 0.04). Compared to men, women had worse levels of AD biomarkers, with higher p-tau181 and lower Aβ42/40, independent of covariates (p < 0.001). In sex-stratified analyses, higher p-tau181 was associated with older age in women and with hypertension in men. GFAP and NfL did not differ by sex. DISCUSSION Women had worse AD biomarkers than men, unexplained by age, cardiometabolic diseases, or lifestyle. Studying risk factors for AD in PAA is warranted, especially for women earlier in life.
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Affiliation(s)
- Caterina Rosano
- Department of EpidemiologySchool of Public HealthUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Thomas K. Karikari
- Department of PsychiatryUniversity of PittsburghPittsburghPennsylvaniaUSA
- Department of Psychiatry and NeurochemistryInstitute of Neuroscience and PhysiologyThe Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | - Ryan Cvejkus
- Department of EpidemiologySchool of Public HealthUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Bruna Bellaver
- Department of PsychiatryUniversity of PittsburghPittsburghPennsylvaniaUSA
| | | | - Joseph Zmuda
- Department of EpidemiologySchool of Public HealthUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Victor Wheeler
- Tobago Health Studies OfficeScarboroughTobagoTrinidad and Tobago
| | - Tharick A. Pascoal
- Department of NeurologySchool of MedicineUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Iva Miljkovic
- Department of EpidemiologySchool of Public HealthUniversity of PittsburghPittsburghPennsylvaniaUSA
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Yung C, Zhang Y, Kuhn M, Armstrong RJ, Olyaei A, Aloia M, Scottoline B, Andres SF. Neonatal enteroids absorb extracellular vesicles from human milk-fed infant digestive fluid. J Extracell Vesicles 2024; 13:e12422. [PMID: 38602306 PMCID: PMC11007820 DOI: 10.1002/jev2.12422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 02/20/2024] [Indexed: 04/12/2024] Open
Abstract
Human milk contains extracellular vesicles (HMEVs). Pre-clinical models suggest that HMEVs may enhance intestinal function and limit inflammation; however, it is unknown if HMEVs or their cargo survive neonatal human digestion. This limits the ability to leverage HMEV cargo as additives to infant nutrition or as therapeutics. This study aimed to develop an EV isolation pipeline from small volumes of human milk and neonatal intestinal contents after milk feeding (digesta) to address the hypothesis that HMEVs survive in vivo neonatal digestion to be taken up intestinal epithelial cells (IECs). Digesta was collected from nasoduodenal sampling tubes or ostomies. EVs were isolated from raw and pasteurized human milk and digesta by density-gradient ultracentrifugation following two-step skimming, acid precipitation of caseins, and multi-step filtration. EVs were validated by electron microscopy, western blotting, nanoparticle tracking analysis, resistive pulse sensing, and super-resolution microscopy. EV uptake was tested in human neonatal enteroids. HMEVs and digesta EVs (dEVs) show typical EV morphology and are enriched in CD81 and CD9, but depleted of β-casein and lactalbumin. HMEV and some dEV fractions contain mammary gland-derived protein BTN1A1. Neonatal human enteroids rapidly take up dEVs in part via clathrin-mediated endocytosis. Our data suggest that EVs can be isolated from digestive fluid and that these dEVs can be absorbed by IECs.
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Affiliation(s)
- Claire Yung
- Department of PediatricsPediatric GI Division, School of Medicine, Oregon Health and Science UniversityPortlandOregonUSA
| | - Yang Zhang
- Department of PediatricsPediatric GI Division, School of Medicine, Oregon Health and Science UniversityPortlandOregonUSA
| | - Madeline Kuhn
- Department of PediatricsPediatric GI Division, School of Medicine, Oregon Health and Science UniversityPortlandOregonUSA
| | - Randall J. Armstrong
- Knight Cancer InstituteOregon Health and Science UniversityPortlandOregonUSA
- Cancer Early Detection Advanced Research (CEDAR)Oregon Health and Science UniversityPortlandOregonUSA
| | - Amy Olyaei
- Division of Neonatology, Department of PediatricsOregon Health and Science UniversityPortlandOregonUSA
| | - Molly Aloia
- Division of Neonatology, Department of PediatricsOregon Health and Science UniversityPortlandOregonUSA
| | - Brian Scottoline
- Department of PediatricsPediatric GI Division, School of Medicine, Oregon Health and Science UniversityPortlandOregonUSA
- Division of Neonatology, Department of PediatricsOregon Health and Science UniversityPortlandOregonUSA
| | - Sarah F. Andres
- Department of PediatricsPediatric GI Division, School of Medicine, Oregon Health and Science UniversityPortlandOregonUSA
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Lu D, Wu Y, Acar A, Yao X, Wu JY, Kavoussi N, Oguz I. ASSIST-U: A system for segmentation and image style transfer for ureteroscopy. Healthc Technol Lett 2024; 11:40-47. [PMID: 38638492 PMCID: PMC11022208 DOI: 10.1049/htl2.12065] [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] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 11/22/2023] [Indexed: 04/20/2024] Open
Abstract
Kidney stones require surgical removal when they grow too large to be broken up externally or to pass on their own. Upper tract urothelial carcinoma is also sometimes treated endoscopically in a similar procedure. These surgeries are difficult, particularly for trainees who often miss tumours, stones or stone fragments, requiring re-operation. Furthermore, there are no patient-specific simulators to facilitate training or standardized visualization tools for ureteroscopy despite its high prevalence. Here a system ASSIST-U is proposed to create realistic ureteroscopy images and videos solely using preoperative computerized tomography (CT) images to address these unmet needs. A 3D UNet model is trained to automatically segment CT images and construct 3D surfaces. These surfaces are then skeletonized for rendering. Finally, a style transfer model is trained using contrastive unpaired translation (CUT) to synthesize realistic ureteroscopy images. Cross validation on the CT segmentation model achieved a Dice score of 0.853 ± 0.084. CUT style transfer produced visually plausible images; the kernel inception distance to real ureteroscopy images was reduced from 0.198 (rendered) to 0.089 (synthesized). The entire pipeline from CT to synthesized ureteroscopy is also qualitatively demonstrated. The proposed ASSIST-U system shows promise for aiding surgeons in the visualization of kidney ureteroscopy.
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Affiliation(s)
- Daiwei Lu
- Department of Computer ScienceVanderbilt UniversityNashvilleTennesseeUSA
| | - Yifan Wu
- Department of Computer ScienceVanderbilt UniversityNashvilleTennesseeUSA
| | - Ayberk Acar
- Department of Computer ScienceVanderbilt UniversityNashvilleTennesseeUSA
| | - Xing Yao
- Department of Computer ScienceVanderbilt UniversityNashvilleTennesseeUSA
| | - Jie Ying Wu
- Department of Computer ScienceVanderbilt UniversityNashvilleTennesseeUSA
| | - Nicholas Kavoussi
- Department of UrologyVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Ipek Oguz
- Department of Computer ScienceVanderbilt UniversityNashvilleTennesseeUSA
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Gorczyca AM, Washburn RA, Ptomey LT, Mayo MS, Krebill R, Sullivan DK, Gibson CA, Stolte S, Donnelly JE. Weight management in rural health clinics: Results from the randomized midwest diet and exercise trial. Obes Sci Pract 2024; 10:e753. [PMID: 38660371 PMCID: PMC11042259 DOI: 10.1002/osp4.753] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 04/01/2024] [Accepted: 04/03/2024] [Indexed: 04/26/2024] Open
Abstract
Introduction Rural living adults have higher rates of obesity compared with their urban counterparts and less access to weight management programs. Previous research studies have demonstrated clinically relevant weight loss in rural living adults who complete weight management programs delivered by university affiliated interventionists. However, this approach limits the potential reach, adoption, implementation, and maintenance of weight management programs for rural residents. Weight management delivered through rural health clinics by non-physician clinic associated staff, for example, nurses, registered dieticians, allied health professionals, etc. has the potential to improve access to weight management for rural living adults. This trial compared the effectiveness of a 6-month multicomponent weight management intervention for rural living adults delivered using group phone calls (GP), individual phone calls (IP) or an enhanced usual care control (EUC) by rural clinic associated staff trained by our research team. Methods Rural living adults with overweight/obesity (n = 187, age ∼ 50 years 82% female, body mass index ∼35 kg/m2) were randomized (2:2:1) to 1 of 3 intervention arms: GP, which included weekly ∼ 45 min sessions with 7-14 participants (n = 71), IP, which included weekly ∼ 15 min individual sessions (n = 80), or EUC, which included one-45 min in-person session at baseline. Results Weight loss at 6 months was clinically relevant, that is, ≥5% in the GP (-11.4 kg, 11.7%) and the IP arms (-9.1 kg, 9.2%) but not in the EUC arm (-2.6%, -2.5% kg). Specifically, 6 month weight loss was significantly greater in the IP versus EUC arms (-6.5 kg. p ≤ 0.025) but did not differ between the GP and IP arms (-2.4 kg, p > 0.025). The per participant cost per kg. weight loss for implementing the intervention was $93 and $60 for the IP and GP arms, respectively. Conclusions Weight management delivered by interventionists associated with rural health clinics using both group and IP calls results in clinically relevant 6 months weight loss in rural dwelling adults with overweight/obesity with the group format offering the most cost-effective strategy. Clinical trial registration: ClinicalTrials.gov (NCT02932748).
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Affiliation(s)
- Anna M. Gorczyca
- Division of Physical Activity and Weight ManagementDepartment of Internal MedicineThe University of Kansas Medical CenterKansas CityKansasUSA
| | - Richard A. Washburn
- Division of Physical Activity and Weight ManagementDepartment of Internal MedicineThe University of Kansas Medical CenterKansas CityKansasUSA
| | - Lauren T. Ptomey
- Division of Physical Activity and Weight ManagementDepartment of Internal MedicineThe University of Kansas Medical CenterKansas CityKansasUSA
| | - Matthew S. Mayo
- Department of Biostatistics & Data ScienceThe University of Kansas Medical CenterKansas CityKansasUSA
| | - Ron Krebill
- Department of Biostatistics & Data ScienceThe University of Kansas Medical CenterKansas CityKansasUSA
| | - Debra K. Sullivan
- Department of Dietetics and NutritionThe University of Kansas Medical CenterKansas CityKansasUSA
| | - Cheryl A. Gibson
- Department of Internal MedicineThe University of Kansas Medical CenterKansas CityKansasUSA
| | - Sarah Stolte
- Department of Internal MedicineThe University of Kansas Medical CenterKansas CityKansasUSA
| | - Joseph E. Donnelly
- Division of Physical Activity and Weight ManagementDepartment of Internal MedicineThe University of Kansas Medical CenterKansas CityKansasUSA
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Kyler KE, Gaedigk A, Abdel‐Rahman S, Staggs VS, Pearce RE, Toren P, Leeder JS, Shakhnovich V. Influence of novel CYP2C-haplotype on proton pump inhibitor pharmacokinetics in children. Clin Transl Sci 2024; 17:e13782. [PMID: 38629502 PMCID: PMC11022290 DOI: 10.1111/cts.13782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 03/04/2024] [Accepted: 03/14/2024] [Indexed: 04/19/2024] Open
Abstract
In this brief report, we provide an analysis of the influence of a novel CYP2C haplotype (CYP2C:TG) on proton pump inhibitor (PPI) pharmacokinetics (PK) in children. The CYP2C:TG haplotype has been proposed to be associated with increased CYP2C19 activity. We sought to determine if this CYP2C:TG haplotype resulted in similar alterations in metabolism for proton pump inhibitors, which are primarily metabolized by CYP2C19. In a cohort of 41 children aged 6-21 participating in a PPI pharmacokinetic study, effects of the CYP2C:TG allele were assessed by fitting two linear regression models for each of the six PK outcomes assessed, the second of which accounted for the presence of the CYP2C:TG allele. The difference in R2 values between the two models was computed to quantify the variability in the outcome that could be accounted for by the CYP2C:TG allele after adjustment for the CYP2C19 genotype. We found the CYP2C:TG haplotype to have no measurable additive impact on CYP2C19-mediated metabolism of PPIs in vivo in older children and adolescents. The findings of this study do not support the clinical utility of routine testing for the CYP2C:TG haplotype to guide PPI dose adjustments in children.
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Affiliation(s)
- Kathryn E. Kyler
- Division of Hospital MedicineChildren's Mercy Kansas CityKansas CityMissouriUSA
- School of MedicineUniversity of Missouri‐Kansas CityKansas CityMissouriUSA
| | - Andrea Gaedigk
- School of MedicineUniversity of Missouri‐Kansas CityKansas CityMissouriUSA
- Division of Clinical Pharmacology, Toxicology & Therapeutic InnovationChildren's Mercy Research InstituteKansas CityMissouriUSA
| | - Susan Abdel‐Rahman
- School of MedicineUniversity of Missouri‐Kansas CityKansas CityMissouriUSA
| | - Vincent S. Staggs
- IDDI, Inc. (Formerly Biostatistics & Epidemiology Core, Children's Mercy Research Institute, Kansas City, Missouri)RaleighNorth CarolinaUSA
| | - Robin E. Pearce
- School of MedicineUniversity of Missouri‐Kansas CityKansas CityMissouriUSA
- Division of Clinical Pharmacology, Toxicology & Therapeutic InnovationChildren's Mercy Research InstituteKansas CityMissouriUSA
| | - Paul Toren
- Division of Clinical Pharmacology, Toxicology & Therapeutic InnovationChildren's Mercy Research InstituteKansas CityMissouriUSA
| | - J. Steven Leeder
- School of MedicineUniversity of Missouri‐Kansas CityKansas CityMissouriUSA
- Division of Clinical Pharmacology, Toxicology & Therapeutic InnovationChildren's Mercy Research InstituteKansas CityMissouriUSA
| | - Valentina Shakhnovich
- School of MedicineUniversity of Missouri‐Kansas CityKansas CityMissouriUSA
- Division of Clinical Pharmacology, Toxicology & Therapeutic InnovationChildren's Mercy Research InstituteKansas CityMissouriUSA
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Ghiasi SM, Marchetti P, Piemonti L, Nielsen JH, Porse BT, Mandrup-Poulsen T, Rutter GA. Proinflammatory cytokines suppress nonsense-mediated RNA decay to impair regulated transcript isoform processing in pancreatic β cells. Front Endocrinol (Lausanne) 2024; 15:1359147. [PMID: 38586449 PMCID: PMC10995974 DOI: 10.3389/fendo.2024.1359147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/05/2024] [Indexed: 04/09/2024] Open
Abstract
Introduction Proinflammatory cytokines are implicated in pancreatic ß cell failure in type 1 and type 2 diabetes and are known to stimulate alternative RNA splicing and the expression of nonsense-mediated RNA decay (NMD) components. Here, we investigate whether cytokines regulate NMD activity and identify transcript isoforms targeted in ß cells. Methods A luciferase-based NMD reporter transiently expressed in rat INS1(832/13), human-derived EndoC-ßH3, or dispersed human islet cells is used to examine the effect of proinflammatory cytokines (Cyt) on NMD activity. The gain- or loss-of-function of two key NMD components, UPF3B and UPF2, is used to reveal the effect of cytokines on cell viability and function. RNA-sequencing and siRNA-mediated silencing are deployed using standard techniques. Results Cyt attenuate NMD activity in insulin-producing cell lines and primary human ß cells. These effects are found to involve ER stress and are associated with the downregulation of UPF3B. Increases or decreases in NMD activity achieved by UPF3B overexpression (OE) or UPF2 silencing raise or lower Cyt-induced cell death, respectively, in EndoC-ßH3 cells and are associated with decreased or increased insulin content, respectively. No effects of these manipulations are observed on glucose-stimulated insulin secretion. Transcriptomic analysis reveals that Cyt increases alternative splicing (AS)-induced exon skipping in the transcript isoforms, and this is potentiated by UPF2 silencing. Gene enrichment analysis identifies transcripts regulated by UPF2 silencing whose proteins are localized and/or functional in the extracellular matrix (ECM), including the serine protease inhibitor SERPINA1/α-1-antitrypsin, whose silencing sensitizes ß-cells to Cyt cytotoxicity. Cytokines suppress NMD activity via UPR signaling, potentially serving as a protective response against Cyt-induced NMD component expression. Conclusion Our findings highlight the central importance of RNA turnover in ß cell responses to inflammatory stress.
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Affiliation(s)
- Seyed M. Ghiasi
- Section of Cell Biology and Functional Genomics, Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, United Kingdom
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
- Development and Aging Program, and Human Genetics Program, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, United States
| | - Piero Marchetti
- Department of Clinical and Experimental Medicine, Islet Cell Laboratory, University of Pisa, Pisa, Italy
| | - Lorenzo Piemonti
- Diabetes Research Institute, Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS) Ospedale San Raffaele, Milano, Italy
| | - Jens H. Nielsen
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Bo T. Porse
- Biotech Research and Innovation Centre (BRIC), University of Copenhagen, Copenhagen, Denmark
- The Finsen Laboratory, Rigshospitalet, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
- Danish Stem Cell Center (DanStem) Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Guy A. Rutter
- Section of Cell Biology and Functional Genomics, Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, United Kingdom
- Centre Hospitalier de l'Université de Montréal (CHUM) Research Centre (CRCHUM) and Faculty of Medicine, University of Montreal, Montreal, QC, Canada
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
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11
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Echouffo‐Tcheugui JB, Zhang S, Florido R, Pankow JS, Michos ED, Goldberg RB, Nambi V, Gerstenblith G, Post WS, Blumenthal RS, Ballantyne CM, Coresh J, Selvin E, Ndumele CE. Galectin-3, Metabolic Risk, and Incident Heart Failure: The ARIC Study. J Am Heart Assoc 2024; 13:e031607. [PMID: 38471823 PMCID: PMC11010020 DOI: 10.1161/jaha.123.031607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 01/11/2024] [Indexed: 03/14/2024]
Abstract
BACKGROUND It is unclear how metabolic syndrome (MetS) and diabetes affect Gal-3 (galectin 3) levels and the resulting implications for heart failure (HF) risk. We assessed relationships of MetS and diabetes with Gal-3, and their joint associations with incident HF. METHODS AND RESULTS We included 8445 participants without HF (mean age, 63 years; 59% men; 16% Black race) at ARIC (Atherosclerosis Risk in Communities) study visit 4 (1996-1999). We categorized participants as having MetS only, MetS with diabetes, or neither, and by quartiles of MetS severity Z score. We assessed cross-sectional associations of metabolic risk categories with high Gal-3 level (≥75th percentile) using logistic regression. We used Cox regression to evaluate combined associations of metabolic risk categories and Gal-3 quartiles with HF. In cross-sectional analyses, compared with no MetS and no diabetes, MetS only (odds ratio [OR], 1.24 [95% CI, 1.10-1.41]) and MetS with diabetes (OR, 1.59 [95% CI, 1.32-1.92]) were associated with elevated Gal-3. Over a median follow-up of 20.5 years, there were 1749 HF events. Compared with individuals with neither diabetes nor MetS and with Gal-3 in the lowest quartile, the combination of MetS with diabetes and Gal-3 ≥75th percentile was associated with a 4-fold higher HF risk (hazard ratio, 4.35 [95% CI, 3.30-5.73]). Gal-3 provided HF prognostic information above and beyond MetS, NT-proBNP (N-terminal pro-B-type natriuretic peptide), high-sensitivity cardiac troponin T, and CRP (C-reactive protein) (ΔC statistic for models with versus without Gal-3: 0.003; P=0.004). CONCLUSIONS MetS and diabetes are associated with elevated Gal-3. The HF risk significantly increased with the combination of greater metabolic risk and higher Gal-3.
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Affiliation(s)
- Justin B. Echouffo‐Tcheugui
- Division of Endocrinology, Diabetes and Metabolism, Department of MedicineJohns Hopkins UniversityBaltimoreMD
| | - Sui Zhang
- Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical ResearchJohns Hopkins Bloomberg School of Public HealthBaltimoreMDUnited States
| | - Roberta Florido
- Division of Cardiology, Department of MedicineJohns Hopkins University School of MedicineBaltimoreMD
| | - James S. Pankow
- Department of Epidemiology at the University of MinnesotaMinneapolisMN
| | - Erin D. Michos
- Division of Cardiology, Department of MedicineJohns Hopkins University School of MedicineBaltimoreMD
| | - Ronald B. Goldberg
- Division of Endocrinology, Diabetes and Metabolism, Department of MedicineUniversity of MiamiMiamiFL
| | - Vijay Nambi
- Section of Cardiovascular ResearchBaylor College of Medicine and Houston Methodist DeBakey Heart and Vascular CenterHoustonTX
| | - Gary Gerstenblith
- Division of Cardiology, Department of MedicineJohns Hopkins University School of MedicineBaltimoreMD
| | - Wendy S. Post
- Division of Cardiology, Department of MedicineJohns Hopkins University School of MedicineBaltimoreMD
| | - Roger S. Blumenthal
- Division of Cardiology, Department of MedicineJohns Hopkins University School of MedicineBaltimoreMD
| | - Christie M. Ballantyne
- Section of Cardiovascular ResearchBaylor College of Medicine and Houston Methodist DeBakey Heart and Vascular CenterHoustonTX
| | - Josef Coresh
- Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical ResearchJohns Hopkins Bloomberg School of Public HealthBaltimoreMDUnited States
| | - Elizabeth Selvin
- Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical ResearchJohns Hopkins Bloomberg School of Public HealthBaltimoreMDUnited States
| | - Chiadi E. Ndumele
- Division of Cardiology, Department of MedicineJohns Hopkins University School of MedicineBaltimoreMD
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12
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Walther CP, Civitello AB, Lamba HK, Mondal NK, Navaneethan SD. Kidney Function Trajectories and Right Heart Failure Following LVAD Implantation. J Am Heart Assoc 2024; 13:e031305. [PMID: 38420763 PMCID: PMC10944080 DOI: 10.1161/jaha.123.031305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 12/01/2023] [Indexed: 03/02/2024]
Abstract
BACKGROUND Preoperative kidney dysfunction is a risk factor for right heart failure (RHF) after implantation of a left ventricular assist device (LVAD). However, characteristic kidney function trajectories before and after post-LVAD RHF are uncertain, so we investigated this. METHODS AND RESULTS We identified individuals who received primary continuous-flow LVAD implantation from July 1, 2014 to December 31, 2017 in the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) data set. Incident RHF was ascertained using the INTERMACS definition at 1 and 3 months and classified as transient or persistent. Kidney function trajectories before and after RHF onset, and relationships of baseline kidney function with RHF risk at the different time points, were assessed. We identified 8076 LVAD recipients who met inclusion criteria. Incident RHF was present at 1 month in 26.4%. There were 4850 individuals with follow-up at 3 months, with incident RHF in 4.2%. Kidney function trajectories differed from pre-LVAD implantation to 1-month follow-up by RHF category, with those developing persistent RHF having no improvement in baseline kidney function. For trajectories before the 3-month RHF ascertainment time, the shape was similar for those with and without RHF, with lower estimated glomerular filtration rate levels among those who developed RHF. Baseline estimated glomerular filtration rate levels below the normal range were associated with higher risk of RHF at 1 and 3 months. CONCLUSIONS In LVAD recipients, preimplantation kidney function and subsequent kidney function trajectories differed substantially by RHF at 1 and 3 months postimplantation, even after adjustment for several confounders. This may demonstrate bidirectional associations between kidney function and right ventricular function in LVAD recipients.
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Affiliation(s)
- Carl P. Walther
- Selzman Institute for Kidney Health, Section of Nephrology, Department of MedicineBaylor College of MedicineHoustonTX
| | - Andrew B. Civitello
- Section of Cardiology, Department of MedicineBaylor College of MedicineHoustonTX
- Advanced Heart Failure Center of ExcellenceBaylor College of MedicineHoustonTX
| | - Harveen K. Lamba
- Division of Cardiothoracic Transplantation and Circulatory Support, Department of SurgeryBaylor College of MedicineHoustonTX
| | - Nandan K. Mondal
- Division of Cardiothoracic Transplantation and Circulatory Support, Department of SurgeryBaylor College of MedicineHoustonTX
| | - Sankar D. Navaneethan
- Selzman Institute for Kidney Health, Section of Nephrology, Department of MedicineBaylor College of MedicineHoustonTX
- Section of NephrologyMichael E. DeBakey Veterans Affairs Medical CenterHoustonTX
- Institute of Clinical and Translational Research, Baylor College of MedicineHoustonTX
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13
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Nguyen S, Bellettiere J, Anuskiewicz B, Di C, Carlson J, Natarajan L, LaMonte MJ, LaCroix AZ. Prospective Associations of Accelerometer-Measured Machine-Learned Sedentary Behavior With Death Among Older Women: The OPACH Study. J Am Heart Assoc 2024; 13:e031156. [PMID: 38410939 PMCID: PMC10944026 DOI: 10.1161/jaha.123.031156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 11/14/2023] [Indexed: 02/28/2024]
Abstract
BACKGROUND Sedentary behavior is a recognized mortality risk factor. The novel and validated convolutional neural network hip accelerometer posture algorithm highly accurately classifies sitting and postural changes compared with accelerometer count cut points. We examined the prospective associations of convolutional neural network hip accelerometer posture-classified total sitting time and mean sitting bout duration with all-cause and cardiovascular disease (CVD) death. METHODS AND RESULTS Women (n=5856; mean±SD age, 79±7 years; 33% Black women, 17% Hispanic or Latina women, 50% White women) in the Women's Health Initiative Objective Physical Activity and Cardiovascular Health (OPACH) Study wore the ActiGraph GT3X+ for ~7 days from May 2012 to April 2014 and were followed through February 19, 2022 for all-cause and CVD death. The convolutional neural network hip accelerometer posture algorithm classified total sitting time and mean sitting bout duration from GT3X+ output. Over follow-up (median, 8.4 years; range, 0.1-9.9), there were 1733 deaths (632 from CVD). Adjusted Cox regression hazard ratios (HRs) comparing women in the highest total sitting time quartile (>696 min/d) to those in the lowest (<556.0 min/d) were 1.57 (95% CI; 1.35-1.83; P-trend<0.001) for all-cause death and 1.78 (95% CI; 1.36-2.31; P-trend<0.001) for CVD death. HRs comparing women in the longest mean sitting bout duration quartile (>15 minutes) to the shortest (<9.3 minutes) were 1.43 (95% CI; 1.23-1.66; P-trend<0.001) for all-cause death and 1.52 (95% CI; 1.18-1.96; P-trend<0.001) for CVD death. Apparent nonlinear associations for total sitting time suggested higher all-cause death (P nonlinear=0.009) and CVD death (P nonlinear=0.008) risk after ~660 to 700 min/d. CONCLUSIONS Higher total sitting time and longer mean sitting bout duration are associated with higher all-cause and CVD mortality risk among older women. These data support interventions aimed at reducing both total sitting time and interrupting prolonged sitting.
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Affiliation(s)
- Steve Nguyen
- Division of EpidemiologyHerbert Wertheim School of Public Health, University of California San DiegoLa JollaCAUSA
| | - John Bellettiere
- Division of EpidemiologyHerbert Wertheim School of Public Health, University of California San DiegoLa JollaCAUSA
| | - Blake Anuskiewicz
- Division of EpidemiologyHerbert Wertheim School of Public Health, University of California San DiegoLa JollaCAUSA
| | - Chongzhi Di
- Division of Public Health SciencesFred Hutchinson Cancer CenterSeattleWAUSA
| | - Jordan Carlson
- Center for Children’s Healthy Lifestyles and Nutrition, Children’s Mercy Kansas CityKansas CityMOUSA
| | - Loki Natarajan
- Division of EpidemiologyHerbert Wertheim School of Public Health, University of California San DiegoLa JollaCAUSA
| | - Michael J. LaMonte
- Department of Epidemiology and Environmental Health, School of Public Health and Health ProfessionsUniversity at Buffalo – SUNYBuffaloNYUSA
| | - Andrea Z. LaCroix
- Division of EpidemiologyHerbert Wertheim School of Public Health, University of California San DiegoLa JollaCAUSA
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14
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Cousineau CM, Loftus K, Churchill GA, Bridges D. Cross-sectional association between blood cholesterol and calcium levels in genetically diverse strains of mice. FEBS Open Bio 2024; 14:426-433. [PMID: 38129969 PMCID: PMC10909986 DOI: 10.1002/2211-5463.13757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 11/13/2023] [Accepted: 12/20/2023] [Indexed: 12/23/2023] Open
Abstract
Genetically diverse outbred mice allow for the study of genetic variation in the context of high dietary and environmental control. Using a machine learning approach, we investigated clinical and morphometric factors that associate with serum cholesterol levels in 840 genetically unique Diversity Outbred mice of both sexes (n = 417 male and 423 female), and on both a control chow (% kcals in diet: protein 22%, carbohydrate 62%, fat 16%, no cholesterol) and high fat high sucrose (% kcals in diet: protein 15%, carbohydrate 41%, fat 45%, 0.05% cholesterol). We find expected elevations of cholesterol in male mice, as well as in mice with elevated serum triglycerides and/or fed a high fat high sucrose diet. The third strongest predictor was serum calcium which correlated with serum cholesterol across both diets and sexes (r = 0.39-0.48) in both Diversity Outbred (P = 3.0 × 10-43 ) and BXD (P = 0.005) mice. This is in-line with several human cohort studies which show associations between calcium and cholesterol, and calcium as an independent predictor of cardiovascular events.
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Affiliation(s)
- Cody M. Cousineau
- Department of Nutritional SciencesUniversity of Michigan School of Public HealthAnn ArborMIUSA
| | - Kaelin Loftus
- Department of Nutritional SciencesUniversity of Michigan School of Public HealthAnn ArborMIUSA
| | | | - Dave Bridges
- Department of Nutritional SciencesUniversity of Michigan School of Public HealthAnn ArborMIUSA
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15
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Burton JJN, Alonso LC. Overnutrition in the early postnatal period influences lifetime metabolic risk: Evidence for impact on pancreatic β-cell mass and function. J Diabetes Investig 2024; 15:263-274. [PMID: 38193815 PMCID: PMC10906026 DOI: 10.1111/jdi.14136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 12/05/2023] [Indexed: 01/10/2024] Open
Abstract
Overconsumption of energy-rich foods that disrupt caloric balance is a fundamental cause of overweight, obesity and diabetes. Dysglycemia and the resulting cardiovascular disease cause substantial morbidity and mortality worldwide, as well as high societal cost. The prevalence of obesity in childhood and adolescence is increasing, leading to younger diabetes diagnosis, and higher severity of microvascular and macrovascular complications. An important goal is to identify early life conditions that increase future metabolic risk, toward the goal of preventing diabetes and cardiovascular disease. An ample body of evidence implicates prenatal and postnatal childhood growth trajectories in the programming of adult metabolic disease. Human epidemiological data show that accelerated childhood growth increases risk of type 2 diabetes in adulthood. Type 2 diabetes results from the combination of insulin resistance and pancreatic β-cell failure, but specific mechanisms by which accelerated postnatal growth impact one or both of these processes remain uncertain. This review explores the metabolic impact of overnutrition during postnatal life in humans and in rodent models, with specific attention to the connection between accelerated childhood growth and future adiposity, insulin resistance, β-cell mass and β-cell dysfunction. With improved knowledge in this area, we might one day be able to modulate nutrition and growth in the critical postnatal window to maximize lifelong metabolic health.
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Affiliation(s)
- Joshua JN Burton
- Division of Endocrinology, Diabetes and Metabolism and the Joan and Sanford I. Weill Center for Metabolic Health, Weill Cornell MedicineNew York CityNew YorkUSA
| | - Laura C Alonso
- Division of Endocrinology, Diabetes and Metabolism and the Joan and Sanford I. Weill Center for Metabolic Health, Weill Cornell MedicineNew York CityNew YorkUSA
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16
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Kannan S, Rutkowski JM. VEGFR-3 signaling in macrophages: friend or foe in disease? Front Immunol 2024; 15:1349500. [PMID: 38464522 PMCID: PMC10921555 DOI: 10.3389/fimmu.2024.1349500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 02/01/2024] [Indexed: 03/12/2024] Open
Abstract
Lymphatic vessels have been increasingly appreciated in the context of immunology not only as passive conduits for immune and cancer cell transport but also as key in local tissue immunomodulation. Targeting lymphatic vessel growth and potential immune regulation often takes advantage of vascular endothelial growth factor receptor-3 (VEGFR-3) signaling to manipulate lymphatic biology. A receptor tyrosine kinase, VEGFR-3, is highly expressed on lymphatic endothelial cells, and its signaling is key in lymphatic growth, development, and survival and, as a result, often considered to be "lymphatic-specific" in adults. A subset of immune cells, notably of the monocyte-derived lineage, have been identified to express VEGFR-3 in tissues from the lung to the gut and in conditions as varied as cancer and chronic kidney disease. These VEGFR-3+ macrophages are highly chemotactic toward the VEGFR-3 ligands VEGF-C and VEGF-D. VEGFR-3 signaling has also been implicated in dictating the plasticity of these cells from pro-inflammatory to anti-inflammatory phenotypes. Conversely, expression may potentially be transient during monocyte differentiation with unknown effects. Macrophages play critically important and varied roles in the onset and resolution of inflammation, tissue remodeling, and vasculogenesis: targeting lymphatic vessel growth and immunomodulation by manipulating VEGFR-3 signaling may thus impact macrophage biology and their impact on disease pathogenesis. This mini review highlights the studies and pathologies in which VEGFR-3+ macrophages have been specifically identified, as well as the activity and polarization changes that macrophage VEGFR-3 signaling may elicit, and affords some conclusions as to the importance of macrophage VEGFR-3 signaling in disease.
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Affiliation(s)
| | - Joseph M. Rutkowski
- Department of Medical Physiology, Texas A&M University School of Medicine, Bryan, TX, United States
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17
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Sheikh S, Stefanovski D, Kilberg MJ, Hadjiliadis D, Rubenstein RC, Rickels MR, Kelly A. Early-phase insulin secretion during mixed-meal tolerance testing predicts β-cell function and secretory capacity in cystic fibrosis. Front Endocrinol (Lausanne) 2024; 15:1340346. [PMID: 38444582 PMCID: PMC10912512 DOI: 10.3389/fendo.2024.1340346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 02/05/2024] [Indexed: 03/07/2024] Open
Abstract
Insulin secretion within 30 minutes of nutrient ingestion is reduced in people with cystic fibrosis (PwCF) and pancreatic insufficiency and declines with worsening glucose tolerance. The glucose potentiated arginine (GPA) test is validated for quantifying β-cell secretory capacity as an estimate of functional β-cell mass but requires technical expertise and is burdensome. This study sought to compare insulin secretion during mixed-meal tolerance testing (MMTT) to GPA-derived parameters in PwCF. Methods Secondary data analysis of CF-focused prospective studies was performed in PwCF categorized as 1) pancreatic insufficient [PI-CF] or 2) pancreatic sufficient [PS-CF] and in 3) non-CF controls. MMTT: insulin secretory rates (ISR) were derived by parametric deconvolution using 2-compartment model of C-peptide kinetics, and incremental area under the curve (AUC) was calculated for 30, 60 and 180-minutes. GPA: acute insulin (AIR) and C-peptide responses (ACR) were calculated as average post-arginine insulin or C-peptide response minus pre-arginine insulin or C-peptide under fasting (AIRarg and ACRarg), ~230 mg/dL (AIRpot and ACRpot), and ~340 mg/dL (AIRmax and ACRmax) hyperglycemic clamp conditions. Relationships of MMTT to GPA parameters were derived using Pearson's correlation coefficient. Predicted values were generated for MMTT ISR and compared to GPA parameters using Bland Altman analysis to assess degree of concordance. Results 85 PwCF (45 female; 75 PI-CF and 10 PS-CF) median (range) age 23 (6-56) years with BMI 23 (13-34) kg/m2, HbA1c 5.5 (3.8-10.2)%, and FEV1%-predicted 88 (26-125) and 4 non-CF controls of similar age and BMI were included. ISR AUC30min positively correlated with AIRarg (r=0.55), AIRpot (r=0.62), and AIRmax (r=0.46) and with ACRarg (r=0.59), ACRpot (r=0.60), and ACRmax (r=0.51) (all P<0.001). ISR AUC30min strongly predicted AIRarg (concordance=0.86), AIRpot (concordance=0.89), and AIRmax (concordance=0.76) at lower mean GPA values, but underestimated AIRarg, AIRpot, and AIRmax at higher GPA-defined β-cell secretory capacity. Between test agreement was unaltered by adjustment for study group, OGTT glucose category, and BMI. Conclusion Early-phase insulin secretion during MMTT can accurately predict GPA-derived measures of β-cell function and secretory capacity when functional β-cell mass is reduced. These data can inform future multicenter studies requiring reliable, standardized, and technically feasible testing mechanisms to quantify β-cell function and secretory capacity.
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Affiliation(s)
- Saba Sheikh
- Division of Pulmonary and Sleep Medicine, Children’s Hospital of Philadelphia and Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Darko Stefanovski
- Department of Clinical Studies-New Bolton Center, University of Pennsylvania School of Veterinary Medicine, Kennett Square, PA, United States
| | - Marissa J. Kilberg
- Division of Endocrinology and Diabetes, Children’s Hospital of Philadelphia and Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Denis Hadjiliadis
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Ronald C. Rubenstein
- Division of Allergy and Pulmonary Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, United States
| | - Michael R. Rickels
- Division of Endocrinology, Diabetes & Metabolism, Department of Medicine and Institute for Diabetes, Obesity & Metabolism, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Andrea Kelly
- Division of Endocrinology and Diabetes, Children’s Hospital of Philadelphia and Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
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18
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Smith CE, Sinclair KL, Erinosho T, Pickett AC, Martinez Kercher VM, Ciciolla L, Hawkins MAW. Associations between adverse childhood experiences and history of weight cycling. Obes Sci Pract 2024; 10:e736. [PMID: 38371174 PMCID: PMC10870800 DOI: 10.1002/osp4.736] [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] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 12/29/2023] [Accepted: 01/14/2024] [Indexed: 02/20/2024] Open
Abstract
Background Adverse childhood experiences (ACEs) predict obesity onset; however, the relationship between ACEs and history of weight cycling has not been adequately explored. This gap is problematic given the difficulty in weight loss maintenance and the impact of ACEs on obesity development, chronicity, and associated weight stigma. The objective of this study was to examine associations between self-reported history of ACEs and weight cycling in a sample of weight loss treatment-seeking adults with overweight/obesity. Methods The number of participants in the analyzed sample was 78, mostly white educated adult women (80% female, 81% Caucasian, 75% ≥ bachelor's degree) with excess adiposity enrolled in the Cognitive and Self-regulatory Mechanisms of Obesity Study. ACEs were measured at baseline using the ACEs Scale. History of weight cycling was measured using the Weight and Lifestyle Inventory that documented weight loss(es) of 10 or more pounds. Results Higher ACE scores were associated with a greater likelihood of reporting a history of weight cycling. Participants with four or more ACEs had 8 times higher odds (OR = 8.301, 95% CI = 2.271-54.209, p = 0.027) of reporting weight cycling compared with participants with no ACEs. The association of weight cycling for those who endorsed one to three ACEs was not significant (OR = 2.3, 95% CI = 0.771-6.857, p = 0.135) in this sample. Conclusions The role of ACEs in health may be related to associations with weight cycling. Results indicated that those who reported four or more ACEs had significantly higher odds of reporting weight cycling compared with those with no ACEs. Further research is needed to further explore how ACEs predict the likelihood of weight cycling, which may be prognostic for sustained weight loss treatment response and weight stigma impacts.
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Affiliation(s)
| | - Kelsey L. Sinclair
- Department of Health & Wellness DesignIndiana UniversityBloomingtonIndianaUSA
- Department of Applied Health ScienceIndiana UniversityBloomingtonIndianaUSA
| | - Temitope Erinosho
- Department of Applied Health ScienceIndiana UniversityBloomingtonIndianaUSA
| | - Andrew C. Pickett
- Department of Health & Wellness DesignIndiana UniversityBloomingtonIndianaUSA
| | | | - Lucia Ciciolla
- Department of PsychologyOklahoma State UniversityStillwaterOklahomaUSA
| | - Misty A. W. Hawkins
- Department of Health & Wellness DesignIndiana UniversityBloomingtonIndianaUSA
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19
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Braga Emidio N, Cheloha RW. Semi-synthetic nanobody-ligand conjugates exhibit tunable signaling properties and enhanced transcriptional outputs at neurokinin receptor-1. Protein Sci 2024; 33:e4866. [PMID: 38088474 PMCID: PMC10806929 DOI: 10.1002/pro.4866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 12/01/2023] [Accepted: 12/09/2023] [Indexed: 12/26/2023]
Abstract
Antibodies have proven highly valuable for therapeutic development; however, they are typically poor candidates for applications that require activation of G protein-coupled receptors (GPCRs), the largest collection of targets for clinically approved drugs. Nanobodies (Nbs), the smallest antibody fragments retaining full antigen-binding capacity, have emerged as promising tools for pharmacologic applications, including GPCR modulation. Past work has shown that conjugation of Nbs with ligands can provide GPCR agonists that exhibit improved activity and selectivity compared to their parent ligands. The neurokinin-1 receptor (NK1R), a GPCR targeted for the treatment of pain, is activated by peptide agonists such as Substance P (SP) and neurokinin A (NKA), which induce signaling through multiple pathways (Gs , Gq and β-arrestin). In this study, we investigated whether conjugating NK1R ligands with Nbs that bind to a separate location on the receptor would provide chimeric compounds with distinctive signaling properties. We employed sortase A-mediated ligation to generate several conjugates consisting of Nbs linked to NK1R ligands. Many of these conjugates exhibited divergent and unexpected signaling properties and transcriptional outputs. For example, some Nb-NKA conjugates showed enhanced receptor binding capacity, high potency partial agonism, prolonged cAMP production, and an increase in transcriptional output associated with Gs signaling; whereas other conjugates were virtually inactive. Nanobody conjugation caused only minor alterations in ligand-induced upstream Gq signaling with unexpected enhancements in transcriptional (downstream) responses. Our findings underscore the potential of nanobody conjugation for providing compounds with advantageous properties such as biased agonism, prolonged duration of action, and enhanced transcriptional responses. These compounds hold promise not only for facilitating fundamental research on GPCR signal transduction mechanisms but also for the development of more potent and enduring therapeutics.
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Affiliation(s)
- Nayara Braga Emidio
- Laboratory of Bioorganic Chemistry, National Institute of Diabetes, Digestive, and Kidney DiseasesNational Institutes of HealthBethesdaMarylandUSA
| | - Ross W. Cheloha
- Laboratory of Bioorganic Chemistry, National Institute of Diabetes, Digestive, and Kidney DiseasesNational Institutes of HealthBethesdaMarylandUSA
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Dorcely B, DeBermont J, Gujral A, Reid M, Vanegas SM, Popp CJ, Verano M, Jay M, Schmidt AM, Bergman M, Goldberg IJ, Alemán JO. Continuous glucose monitoring captures glycemic variability in obesity after sleeve gastrectomy: A prospective cohort study. Obes Sci Pract 2024; 10:e729. [PMID: 38187121 PMCID: PMC10768733 DOI: 10.1002/osp4.729] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 11/26/2023] [Accepted: 11/28/2023] [Indexed: 01/09/2024] Open
Abstract
Objective HbA1c is an insensitive marker for assessing real-time dysglycemia in obesity. This study investigated whether 1-h plasma glucose level (1-h PG) ≥155 mg/dL (8.6 mmol/L) during an oral glucose tolerance test (OGTT) and continuous glucose monitoring (CGM) measurement of glucose variability (GV) better reflected dysglycemia than HbA1c after weight loss from metabolic and bariatric surgery. Methods This was a prospective cohort study of 10 participants with type 2 diabetes compared with 11 participants with non-diabetes undergoing sleeve gastrectomy (SG). At each research visit; before SG, and 6 weeks and 6 months post-SG, body weight, fasting lipid levels, and PG and insulin concentrations during an OGTT were analyzed. Mean amplitude of glycemic excursions (MAGE), a CGM-derived GV index, was analyzed. Results The 1-h PG correlated with insulin resistance markers, triglyceride/HDL ratio and triglyceride glucose index in both groups before surgery. At 6 months, SG caused 22% weight loss in both groups. Despite a reduction in HbA1c by 3.0 ± 1.3% in the diabetes group (p < 0.01), 1-h PG, and MAGE remained elevated, and the oral disposition index, which represents pancreatic β-cell function, remained reduced in the diabetes group when compared to the non-diabetes group. Conclusions Elevation of GV markers and reduced disposition index following SG-induced weight loss in the diabetes group underscores persistent β-cell dysfunction and the potential residual risk of diabetes complications.
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Affiliation(s)
- Brenda Dorcely
- Laboratory of Translational Obesity ResearchNYU Langone HealthNew YorkNew YorkUSA
- Division of Endocrinology, Diabetes and MetabolismNYU Langone HealthNew YorkNew YorkUSA
| | - Julie DeBermont
- Division of Endocrinology, Diabetes and MetabolismNYU Langone HealthNew YorkNew YorkUSA
| | - Akash Gujral
- Comprehensive Program in Obesity ResearchNYU Langone HealthNew YorkNew YorkUSA
| | - Migdalia Reid
- Laboratory of Translational Obesity ResearchNYU Langone HealthNew YorkNew YorkUSA
- Division of Endocrinology, Diabetes and MetabolismNYU Langone HealthNew YorkNew YorkUSA
| | - Sally M. Vanegas
- Laboratory of Translational Obesity ResearchNYU Langone HealthNew YorkNew YorkUSA
- Comprehensive Program in Obesity ResearchNYU Langone HealthNew YorkNew YorkUSA
| | - Collin J. Popp
- Department of Population HealthNYU Langone HealthNew YorkNew YorkUSA
| | - Michael Verano
- Laboratory of Translational Obesity ResearchNYU Langone HealthNew YorkNew YorkUSA
- Division of Endocrinology, Diabetes and MetabolismNYU Langone HealthNew YorkNew YorkUSA
| | - Melanie Jay
- Comprehensive Program in Obesity ResearchNYU Langone HealthNew YorkNew YorkUSA
| | - Ann Marie Schmidt
- Division of Endocrinology, Diabetes and MetabolismNYU Langone HealthNew YorkNew YorkUSA
| | - Michael Bergman
- Division of Endocrinology, Diabetes and MetabolismNYU Langone HealthNew YorkNew YorkUSA
| | - Ira J. Goldberg
- Division of Endocrinology, Diabetes and MetabolismNYU Langone HealthNew YorkNew YorkUSA
| | - José O. Alemán
- Laboratory of Translational Obesity ResearchNYU Langone HealthNew YorkNew YorkUSA
- Division of Endocrinology, Diabetes and MetabolismNYU Langone HealthNew YorkNew YorkUSA
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Arroyo KM, Ross KM. Characterising individual variability in associations between self-monitoring and weight change during and after a behavioral weight management program. Obes Sci Pract 2024; 10:e699. [PMID: 38264006 PMCID: PMC10804320 DOI: 10.1002/osp4.699] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 07/10/2023] [Accepted: 07/16/2023] [Indexed: 01/25/2024] Open
Abstract
Objective Greater self-monitoring of caloric intake and weight has been associated with success at both initial weight loss and long-term maintenance. Given the existence of wide variability in weight loss outcomes and the key role of self-monitoring within behavioral weight management interventions, this study examined individual variability in associations between self-monitoring and weight change and whether demographic factors could predict who may best benefit from self-monitoring. Methods Participants were 72 adults with overweight or obesity (mean ± SD, age = 50.6 ± 10.3; body mass index = 31.2 ± 4.5 kg/m2; 71%Female; 83%White) enrolled in a 12-week weight loss program followed by a 40-week observational maintenance period. Participants were encouraged to self-monitor caloric intake and weight daily and to report these data via a study website each week. Multilevel mixed models were used to estimate week-to-week associations between self-monitoring and weight change, by individual and linear regressions and ANOVAs were used to explore demographic differences in these associations. Results Most participants (68%) demonstrated statistically significant negative associations between self-monitoring of either caloric intake or weight and weight change. Of these, 76% benefited from self-monitoring both caloric intake and weight, 18% from self-monitoring caloric intake only, and 6% from self-weighing only. The magnitude of associations between self-monitoring and weight change did not significantly differ by age, gender, race/ethnicity, education, or income, all ps > 0.05. Conclusions Differences in the effectiveness of self-monitoring for weight loss were not observed by demographic characteristics. Future research should examine if other factors may predict the effectiveness of self-monitoring.
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Affiliation(s)
- Kelsey M. Arroyo
- Department of Clinical & Health PsychologyCollege of Public Health and Health ProfessionsUniversity of FloridaGainesvilleFloridaUSA
| | - Kathryn M. Ross
- Department of Clinical & Health PsychologyCollege of Public Health and Health ProfessionsUniversity of FloridaGainesvilleFloridaUSA
- Center for Integrative Cardiovascular and Metabolic DiseasesUniversity of FloridaGainesvilleFloridaUSA
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Shamu T, Egger M, Mudzviti T, Chimbetete C, Manasa J, Anderegg N. Body weight and blood pressure changes on dolutegravir-, efavirenz- or atazanavir-based antiretroviral therapy in Zimbabwe: a longitudinal study. J Int AIDS Soc 2024; 27:e26216. [PMID: 38332525 PMCID: PMC10853595 DOI: 10.1002/jia2.26216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 01/23/2024] [Indexed: 02/10/2024] Open
Abstract
INTRODUCTION Dolutegravir (DTG) is widely used for antiretroviral therapy (ART). We compared weight and blood pressure trends and examined the association between high blood pressure and weight gain among people living with HIV (PLHIV) switching to or starting DTG-based, efavirenz (EFV)-based and ritonavir-boosted atazanavir (ATV/r)-based ART in Zimbabwe. METHODS PLHIV aged 18 years or older who started or switched to DTG, EFV or ATV/r-based ART between January 2004 and June 2022 at Newlands Clinic in Harare, Zimbabwe, were eligible. Weight was measured at all visits (Seca floor scales); blood pressure only at clinician-led visits (Omron M2 sphygmomanometer). We used Bayesian additive models to estimate trends in weight gain and the proportion with high blood pressure (systolic >140 mmHg or diastolic >90 mmHg) in the first 2 years after starting or switching the regimen. Finally, we examined whether trends in the proportion with high blood pressure were related to weight change. RESULTS We analysed 99,969 weight and 35,449 blood pressure records from 9487 adults (DTG: 4593; EFV: 3599; ATV/r: 1295). At 24 months after starting or switching to DTG, estimated median weight gains were 4.54 kg (90% credibility interval 3.88-5.28 kg) in women and 3.71 kg (3.07-4.45 kg) in men, around twice that observed for ATV/r and over four-times the gain observed for EFV. Prevalence of high blood pressure among PLHIV receiving DTG-based ART increased from around 5% at baseline to over 20% at 24 months, with no change in PLHIV receiving EFV- or ATV/r-based ART. High blood pressure in PLHIV switching to DTG was associated with weight gain, with stronger increases in the proportion with high blood pressure for larger weight gains. CONCLUSIONS Among PLHIV starting ART or switching to a new regimen, DTG-based ART was associated with larger weight gains and a substantial increase in the prevalence of high blood pressure. Routine weight and blood pressure measurement and interventions to lower blood pressure could benefit PLHIV on DTG-based ART. Further studies are needed to elucidate the mechanisms and reversibility of these changes after discontinuation of DTG.
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Affiliation(s)
- Tinei Shamu
- Newlands ClinicHarareZimbabwe
- Institute of Social and Preventive MedicineUniversity of BernBernSwitzerland
- Graduate School of Health SciencesUniversity of BernBernSwitzerland
| | - Matthias Egger
- Institute of Social and Preventive MedicineUniversity of BernBernSwitzerland
- Centre for Infectious Disease Epidemiology and ResearchSchool of Public HealthUniversity of Cape TownCape TownSouth Africa
- Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
| | - Tinashe Mudzviti
- Newlands ClinicHarareZimbabwe
- Department of Pharmacy and Pharmaceutical SciencesUniversity of ZimbabweHarareZimbabwe
| | | | | | - Nanina Anderegg
- Institute of Social and Preventive MedicineUniversity of BernBernSwitzerland
- Centre for Infectious Disease Epidemiology and ResearchSchool of Public HealthUniversity of Cape TownCape TownSouth Africa
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Zaman A, Grau L, Jeffers R, Steinke S, Catenacci VA, Cornier M, Rynders CA, Thomas EA. The effects of early time restricted eating plus daily caloric restriction compared to daily caloric restriction alone on continuous glucose levels. Obes Sci Pract 2024; 10:e702. [PMID: 38264001 PMCID: PMC10804344 DOI: 10.1002/osp4.702] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/14/2023] [Accepted: 07/18/2023] [Indexed: 01/25/2024] Open
Abstract
Background The median eating duration in the U.S. is 14.75 h, spread throughout the period of wakefulness and ending before sleep. Food intake at an inappropriate circadian time may lead to adverse metabolic outcomes. Emerging literature suggests that time restricted eating (TRE) may improve glucose tolerance and insulin sensitivity. The aim was to compare 24-h glucose profiles and insulin sensitivity in participants after completing 12 weeks of a behavioral weight loss intervention based on early TRE plus daily caloric restriction (E-TRE+DCR) or DCR alone. Methods Eighty-one adults with overweight or obesity (age 18-50 years, BMI 25-45 kg/m2) were randomized to either E-TRE+DCR or DCR alone. Each participant wore a continuous glucose monitor (CGM) for 7 days and insulin sensitivity was estimated using the homeostatic model assessment of insulin resistance (HOMA-IR) at Baseline and Week 12. Changes in CGM-derived measures and HOMA-IR from Baseline to Week 12 were assessed within and between groups using random intercept mixed models. Results Forty-four participants had valid CGM data at both time points, while 38 had valid glucose, insulin, HOMA-IR, and hemoglobin A1c (A1c) data at both timepoints. There were no significant differences in sex, age, BMI, or the percentage of participants with prediabetes between the groups (28% female, age 39.2 ± 6.9 years, BMI 33.8 ± 5.7 kg/m2, 16% with prediabetes). After adjusting for weight, there were no between-group differences in changes in overall average sensor glucose, standard deviation of glucose levels, the coefficient of variation of glucose levels, daytime or nighttime average sensor glucose, fasting glucose, insulin, HOMA-IR, or A1c. However, mean amplitude of glycemic excursions changed differently over time between the two groups, with a greater reduction found in the DCR as compared to E-TRE+DCR (p = 0.03). Conclusion There were no major differences between E-TRE+DCR and DCR groups in continuous glucose profiles or insulin sensitivity 12 weeks after the intervention. Because the study sample included participants with normal baseline mean glucose profiles and insulin sensitivity, the ability to detect changes in these outcomes may have been limited.
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Affiliation(s)
- Adnin Zaman
- Division of Endocrinology, Metabolism and DiabetesDepartment of MedicineUniversity of ColoradoAnschutz Medical CampusAuroraColoradoUSA
- Anschutz Health & Wellness Center at the University of ColoradoAnschutz Medical CampusAuroraColoradoUSA
| | - Laura Grau
- Department of Biostatistics and InformaticsColorado School of Public HealthUniversity of ColoradoAnschutz Medical CampusAuroraColoradoUSA
| | - Rebecca Jeffers
- Division of Endocrinology, Metabolism and DiabetesDepartment of MedicineUniversity of ColoradoAnschutz Medical CampusAuroraColoradoUSA
| | - Sheila Steinke
- Division of Endocrinology, Metabolism and DiabetesDepartment of MedicineUniversity of ColoradoAnschutz Medical CampusAuroraColoradoUSA
- Anschutz Health & Wellness Center at the University of ColoradoAnschutz Medical CampusAuroraColoradoUSA
| | - Victoria A. Catenacci
- Division of Endocrinology, Metabolism and DiabetesDepartment of MedicineUniversity of ColoradoAnschutz Medical CampusAuroraColoradoUSA
- Anschutz Health & Wellness Center at the University of ColoradoAnschutz Medical CampusAuroraColoradoUSA
| | - Marc‐Andre Cornier
- Division of Endocrinology, Metabolism and DiabetesDepartment of MedicineUniversity of ColoradoAnschutz Medical CampusAuroraColoradoUSA
- Anschutz Health & Wellness Center at the University of ColoradoAnschutz Medical CampusAuroraColoradoUSA
- Division of Endocrinology, Diabetes and Metabolic DiseasesDepartment of MedicineMedical University of South CarolinaCharlestonSouth CarolinaUSA
- Rocky Mountain Regional Veterans AdministrationAuroraColoradoUSA
| | - Corey A. Rynders
- Anschutz Health & Wellness Center at the University of ColoradoAnschutz Medical CampusAuroraColoradoUSA
| | - Elizabeth A. Thomas
- Division of Endocrinology, Metabolism and DiabetesDepartment of MedicineUniversity of ColoradoAnschutz Medical CampusAuroraColoradoUSA
- Anschutz Health & Wellness Center at the University of ColoradoAnschutz Medical CampusAuroraColoradoUSA
- Rocky Mountain Regional Veterans AdministrationAuroraColoradoUSA
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Bond DS, Smith KE, Schumacher LM, Vithiananthan S, Jones DB, Papasavas P, Webster J, Thomas JG. Associations of daily weight management-focused social support with weight loss, activity behaviors, and eating regulation in the context of metabolic and bariatric surgery. Obes Sci Pract 2024; 10:e717. [PMID: 38263993 PMCID: PMC10804323 DOI: 10.1002/osp4.717] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/03/2023] [Accepted: 10/12/2023] [Indexed: 01/25/2024] Open
Abstract
Objective Greater perceived social support (PSS) is associated with more favorable changes in weight loss, activity behaviors, and eating regulation after metabolic and bariatric surgery (MBS). However, studies have relied on generic, retrospective PSS measures, and stability of PSS levels and relations with weight loss and weight-related behaviors over time is unknown. Using smartphone-based Ecological Momentary Assessment, this study evaluated pre-to 1-year post-MBS changes in daily weight management-focused PSS and associations with weight loss, device-measured activity behaviors, and eating regulation before and during the initial year after MBS. Method Adult MBS patients (n = 71) received (1) an accelerometer to measure daily moderate-to-vigorous intensity physical activity (MVPA) and sedentary time (ST) minutes/day, and (2) a smartphone to complete morning weight-focused PSS ratings and eating regulation (dietary restraint/disinhibition) ratings at four semi-random times daily for 10 days at pre- and 3, 6, and 12-month postoperative. Generalized linear mixed models analyzed the associations of PSS with total weight loss (%TWL) and activity/eating outcomes. Results Participants on average reported relatively stable moderate-to-high PSS (3.98 on one to five scale) across assessments. Perceived social support was not related to %TWL, MVPA, or ST. Participants with higher PSS reported lower disinhibition and higher restraint than those with lower PSS (ps < 0.05); however, participants reported higher restraint on days that PSS was lower than their usual levels (p = 0.009). Conclusions MBS patients on average had stable PSS levels across time. Higher PSS levels were associated with greater resistance to overeating cues (disinhibition) and cognitive control to restrict food intake (restraint) over time. Additionally, participants reported higher restraint when PSS levels were lower than usual. Overall, weight-focused PSS appeared to hold greater importance in relation to regulating eating behavior than engaging in activity behaviors or weight loss among MBS patients during the initial postoperative year. Clinical Trial Registration NCT02777177.
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Affiliation(s)
- Dale S. Bond
- Department of SurgeryHartford HospitalHartfordConnecticutUSA
- Department of ResearchHartford HospitalHartfordConnecticutUSA
| | - Kathryn E. Smith
- Department of Psychiatry and Behavioral SciencesUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Leah M. Schumacher
- Department of Social and Behavioral SciencesCollege of Public HealthTemple UniversityPhiladelphiaPennsylvaniaUSA
- Center for Obesity Research and EducationCollege of Public HealthTemple UniversityPhiladelphiaPennsylvaniaUSA
| | | | - Daniel B. Jones
- Department of SurgeryRutgers New Jersey Medical SchoolNewarkNew JerseyUSA
| | | | - Jennifer Webster
- Department of Psychiatry and Human BehaviorWeight Control and Diabetes Research CenterThe Miriam HospitalProvidenceRhode IslandUSA
- Brown Alpert Medical SchoolProvidenceRhode IslandUSA
| | - J. Graham Thomas
- Department of Psychiatry and Human BehaviorWeight Control and Diabetes Research CenterThe Miriam HospitalProvidenceRhode IslandUSA
- Brown Alpert Medical SchoolProvidenceRhode IslandUSA
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Aversa Z, White TA, Heeren AA, Hulshizer CA, Saul D, Zhang X, Molina AJA, Redman LM, Martin CK, Racette SB, Huffman KM, Bhapkar M, Khosla S, Das SK, Fielding RA, Atkinson EJ, LeBrasseur NK. Calorie restriction reduces biomarkers of cellular senescence in humans. Aging Cell 2024; 23:e14038. [PMID: 37961856 PMCID: PMC10861196 DOI: 10.1111/acel.14038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 10/19/2023] [Accepted: 10/22/2023] [Indexed: 11/15/2023] Open
Abstract
Calorie restriction (CR) with adequate nutrient intake is a potential geroprotective intervention. To advance this concept in humans, we tested the hypothesis that moderate CR in healthy young-to-middle-aged individuals would reduce circulating biomarkers of cellular senescence, a fundamental mechanism of aging and aging-related conditions. Using plasma specimens from the Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy (CALERIE™) phase 2 study, we found that CR significantly reduced the concentrations of several senescence biomarkers at 12 and 24 months compared to an ad libitum diet. Using machine learning, changes in biomarker concentrations emerged as important predictors of the change in HOMA-IR and insulin sensitivity index at 12 and 24 months, and the change in resting metabolic rate residual at 12 months. Finally, using adipose tissue RNA-sequencing data from a subset of participants, we observed a significant reduction in a senescence-focused gene set in response to CR at both 12 and 24 months compared to baseline. Our results advance the understanding of the effects of CR in humans and further support a link between cellular senescence and metabolic health.
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Affiliation(s)
- Zaira Aversa
- Robert and Arlene Kogod Center on Aging, Mayo ClinicRochesterMinnesotaUSA
- Department of Physical Medicine and RehabilitationMayo ClinicRochesterMinnesotaUSA
| | - Thomas A. White
- Robert and Arlene Kogod Center on Aging, Mayo ClinicRochesterMinnesotaUSA
| | - Amanda A. Heeren
- Robert and Arlene Kogod Center on Aging, Mayo ClinicRochesterMinnesotaUSA
| | | | - Dominik Saul
- Robert and Arlene Kogod Center on Aging, Mayo ClinicRochesterMinnesotaUSA
- Department of Trauma and Reconstructive SurgeryEberhard Karls University Tübingen, BG Trauma Center TübingenTübingenGermany
| | - Xu Zhang
- Robert and Arlene Kogod Center on Aging, Mayo ClinicRochesterMinnesotaUSA
| | | | | | - Corby K. Martin
- Pennington Biomedical Research CenterBaton RougeLouisianaUSA
| | - Susan B. Racette
- College of Health SolutionsArizona State UniversityPhoenixArizonaUSA
- Program in Physical TherapyWashington University School of MedicineSt. LouisMissouriUSA
| | - Kim M. Huffman
- Duke Clinical Research Institute and Molecular Physiology Institute, School of MedicineDurhamNorth CarolinaUSA
| | - Manjushri Bhapkar
- Duke Clinical Research Institute and Molecular Physiology Institute, School of MedicineDurhamNorth CarolinaUSA
| | - Sundeep Khosla
- Robert and Arlene Kogod Center on Aging, Mayo ClinicRochesterMinnesotaUSA
- Division of EndocrinologyMayo Clinic College of MedicineRochesterMinnesotaUSA
| | - Sai Krupa Das
- Energy Metabolism Team, Jean Mayer USDA Human Nutrition Research Center on AgingTufts UniversityBostonMassachusettsUSA
| | - Roger A. Fielding
- Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on AgingTufts UniversityBostonMassachusettsUSA
| | | | - Nathan K. LeBrasseur
- Robert and Arlene Kogod Center on Aging, Mayo ClinicRochesterMinnesotaUSA
- Department of Physical Medicine and RehabilitationMayo ClinicRochesterMinnesotaUSA
- Paul F. Glenn Center for the Biology of Aging at Mayo ClinicRochesterMinnesotaUSA
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Rasmussen JM, Wang Y, Graham AM, Fair DA, Posner J, O'Connor TG, Simhan HN, Yen E, Madan N, Entringer S, Wadhwa PD, Buss C. Segmenting hypothalamic subunits in human newborn magnetic resonance imaging data. Hum Brain Mapp 2024; 45:e26582. [PMID: 38339904 PMCID: PMC10826633 DOI: 10.1002/hbm.26582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 11/15/2023] [Accepted: 11/26/2023] [Indexed: 02/12/2024] Open
Abstract
Preclinical evidence suggests that inter-individual variation in the structure of the hypothalamus at birth is associated with variation in the intrauterine environment, with downstream implications for future disease susceptibility. However, scientific advancement in humans is limited by a lack of validated methods for the automatic segmentation of the newborn hypothalamus. N = 215 healthy full-term infants with paired T1-/T2-weighted MR images across four sites were considered for primary analyses (mean postmenstrual age = 44.3 ± 3.5 weeks, nmale /nfemale = 110/106). The outputs of FreeSurfer's hypothalamic subunit segmentation tools designed for adults (segFS) were compared against those of a novel registration-based pipeline developed here (segATLAS) and against manually edited segmentations (segMAN) as reference. Comparisons were made using Dice Similarity Coefficients (DSCs) and through expected associations with postmenstrual age at scan. In addition, we aimed to demonstrate the validity of the segATLAS pipeline by testing for the stability of inter-individual variation in hypothalamic volume across the first year of life (n = 41 longitudinal datasets available). SegFS and segATLAS segmentations demonstrated a wide spread in agreement (mean DSC = 0.65 ± 0.14 SD; range = {0.03-0.80}). SegATLAS volumes were more highly correlated with postmenstrual age at scan than segFS volumes (n = 215 infants; RsegATLAS 2 = 65% vs. RsegFS 2 = 40%), and segATLAS volumes demonstrated a higher degree of agreement with segMAN reference segmentations at the whole hypothalamus (segATLAS DSC = 0.89 ± 0.06 SD; segFS DSC = 0.68 ± 0.14 SD) and subunit levels (segATLAS DSC = 0.80 ± 0.16 SD; segFS DSC = 0.40 ± 0.26 SD). In addition, segATLAS (but not segFS) volumes demonstrated stability from near birth to ~1 years age (n = 41; R2 = 25%; p < 10-3 ). These findings highlight segATLAS as a valid and publicly available (https://github.com/jerodras/neonate_hypothalamus_seg) pipeline for the segmentation of hypothalamic subunits using human newborn MRI up to 3 months of age collected at resolutions on the order of 1 mm isotropic. Because the hypothalamus is traditionally understudied due to a lack of high-quality segmentation tools during the early life period, and because the hypothalamus is of high biological relevance to human growth and development, this tool may stimulate developmental and clinical research by providing new insight into the unique role of the hypothalamus and its subunits in shaping trajectories of early life health and disease.
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Affiliation(s)
- Jerod M. Rasmussen
- Development, Health and Disease Research ProgramUniversity of CaliforniaIrvineCaliforniaUSA
- Department of PediatricsUniversity of CaliforniaIrvineCaliforniaUSA
| | - Yun Wang
- Department of Psychiatry and Behavioral SciencesDuke UniversityDurhamNorth CarolinaUSA
- New York State Psychiatric InstituteNew YorkNew YorkUSA
| | - Alice M. Graham
- Department of Behavioral NeuroscienceOregon Health & Science UniversityPortlandOregonUSA
| | - Damien A. Fair
- Masonic Institute for the Developing BrainUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Jonathan Posner
- Department of Psychiatry and Behavioral SciencesDuke UniversityDurhamNorth CarolinaUSA
- New York State Psychiatric InstituteNew YorkNew YorkUSA
| | - Thomas G. O'Connor
- Departments of Psychiatry, Psychology, Neuroscience and Obstetrics and GynecologyUniversity of Rochester Medical CenterRochesterNew YorkUSA
| | - Hyagriv N. Simhan
- Department of Obstetrics and GynecologyUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Elizabeth Yen
- Department of PediatricsTufts Medical CenterBostonMassachusettsUSA
| | - Neel Madan
- Department of RadiologyTufts Medical CenterBostonMassachusettsUSA
| | - Sonja Entringer
- Development, Health and Disease Research ProgramUniversity of CaliforniaIrvineCaliforniaUSA
- Department of PediatricsUniversity of CaliforniaIrvineCaliforniaUSA
- Department of Medical PsychologyCharité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
| | - Pathik D. Wadhwa
- Development, Health and Disease Research ProgramUniversity of CaliforniaIrvineCaliforniaUSA
- Department of PediatricsUniversity of CaliforniaIrvineCaliforniaUSA
- Department of Psychiatry and Human BehaviorUniversity of CaliforniaIrvineCaliforniaUSA
- Department of Obstetrics and GynecologyUniversity of CaliforniaIrvineCaliforniaUSA
- Department of EpidemiologyUniversity of CaliforniaIrvineCaliforniaUSA
| | - Claudia Buss
- Development, Health and Disease Research ProgramUniversity of CaliforniaIrvineCaliforniaUSA
- Department of PediatricsUniversity of CaliforniaIrvineCaliforniaUSA
- Department of Medical PsychologyCharité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
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Rozzell‐Voss KN, Klimek‐Johnson P, Eichen DM, Brown TA, Blashill AJ. Executive function differences as a function of parent-reported binge eating and weight: Results from the adolescent brain cognitive development study. Obes Sci Pract 2024; 10:e703. [PMID: 38263994 PMCID: PMC10804330 DOI: 10.1002/osp4.703] [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] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 07/16/2023] [Accepted: 07/31/2023] [Indexed: 01/25/2024] Open
Abstract
Background Binge eating is a relatively common disordered eating behavior among children, and is associated with poor health outcomes. Executive function (EF)-higher order cognitive abilities related to planning and impulse control-may be implicated in both binge eating and pediatric obesity. Although EF deficits are evident among individuals with obesity and/or binge eating, findings are mixed across the lifespan. Methods The present study examined differences in EF among children with varying weight statuses and parent-reported binge eating. The sample included 10,017 children from the Adolescent Brain Cognitive Development study, aged 9-10 years. Results Children with parent-reported binge eating-either with overweight/obesity or normal weight-had significantly lower EF than those with no binge eating and a normal weight status but did not differ from those with no binge eating and overweight/obesity. Children with no binge eating and overweight/obesity also had statistically significantly lower EF than those with normal weight status. Although all significant differences between groups were negligible to very small, results may indicate similar neurocognitive profiles among children with binge eating and those with overweight/obesity. Conclusions Alterations in EF among children with binge eating may not be solely related to weight-specific factors, as significant differences also emerged among children with normal weight status, with versus without parent-reported binge eating. Future research is needed to understand temporal associations between obesity, disordered eating, and neurocognition in children using multi-informant methods for assessing binge eating.
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Affiliation(s)
| | | | | | | | - Aaron J. Blashill
- San Diego State UniversitySan DiegoCaliforniaUSA
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical PsychologySan DiegoCaliforniaUSA
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Szalanczy AM, Fitzpatrick M, Beeson A, Bui T, Dyson C, Eller S, Landry J, Scott C, Grzybowski M, Klotz J, Geurts AM, Weiner JL, Redei EE, Solberg Woods LC. Chronic stress from adolescence to adulthood increases adiposity and anxiety in rats with decreased expression of Krtcap3. Front Genet 2024; 14:1247232. [PMID: 38323241 PMCID: PMC10844407 DOI: 10.3389/fgene.2023.1247232] [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] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 12/21/2023] [Indexed: 02/08/2024] Open
Abstract
We previously identified Keratinocyte-associated protein 3, Krtcap3, as a novel adiposity gene, but subsequently found that its impact on adiposity may depend on environmental stress. To more thoroughly understand the connection between Krtcap3, adiposity, and stress, we exposed wild-type (WT) and Krtcap3 knock-out (KO) rats to chronic stress then measured adiposity and behavioral outcomes. We found that KO rats displayed lower basal stress than WT rats under control conditions and exhibited metabolic and behavioral responses to chronic stress exposure. Specifically, stress-exposed KO rats gained more weight, consumed more food when socially isolated, and displayed more anxiety-like behaviors relative to control KO rats. Meanwhile, there were minimal differences between control and stressed WT rats. At study conclusion stress-exposed KO rats had increased corticosterone (CORT) relative to control KO rats with no differences between WT rats. In addition, KO rats, independent of prior stress exposure, had an increased CORT response to removal of their cage-mate (psychosocial stress), which was only seen in WT rats when exposed to chronic stress. Finally, we found differences in expression of the glucocorticoid receptor, Nr3c1, in the pituitary and colon between control and stress-exposed KO rats that were not present in WT rats. These data support that Krtcap3 expression affects stress response, potentially via interactions with Nr3c1, with downstream effects on adiposity and behavior. Future work is necessary to more thoroughly understand the role of Krtcap3 in the stress response.
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Affiliation(s)
- Alexandria M. Szalanczy
- Department of Internal Medicine, School of Medicine, Wake Forest University, Winston Salem, NC, United States
| | - Mackenzie Fitzpatrick
- Department of Internal Medicine, School of Medicine, Wake Forest University, Winston Salem, NC, United States
| | - Angela Beeson
- Department of Internal Medicine, School of Medicine, Wake Forest University, Winston Salem, NC, United States
| | - Trangdai Bui
- Department of Internal Medicine, School of Medicine, Wake Forest University, Winston Salem, NC, United States
| | - Christina Dyson
- Department of Physiology and Pharmacology, School of Medicine, Wake Forest University, Winston Salem, NC, United States
| | - Seth Eller
- Department of Internal Medicine, School of Medicine, Wake Forest University, Winston Salem, NC, United States
| | - Julia Landry
- Department of Internal Medicine, School of Medicine, Wake Forest University, Winston Salem, NC, United States
| | - Christina Scott
- Department of Internal Medicine, School of Medicine, Wake Forest University, Winston Salem, NC, United States
| | - Michael Grzybowski
- Department of Physiology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Jason Klotz
- Department of Physiology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Aron M. Geurts
- Department of Physiology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Jeff L. Weiner
- Department of Physiology and Pharmacology, School of Medicine, Wake Forest University, Winston Salem, NC, United States
| | - Eva E. Redei
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Leah C. Solberg Woods
- Department of Internal Medicine, School of Medicine, Wake Forest University, Winston Salem, NC, United States
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Vaitaitis G, Webb T, Webb C, Sharkey C, Sharkey S, Waid D, Wagner DH. Canine diabetes mellitus demonstrates multiple markers of chronic inflammation including Th40 cell increases and elevated systemic-immune inflammation index, consistent with autoimmune dysregulation. Front Immunol 2024; 14:1319947. [PMID: 38318506 PMCID: PMC10839093 DOI: 10.3389/fimmu.2023.1319947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 12/27/2023] [Indexed: 02/07/2024] Open
Abstract
Introduction Canine diabetes mellitus (CDM) is a relatively common endocrine disease in dogs. Many CDM clinical features resemble human type 1 diabetes mellitus (T1DM), but lack of autoimmune biomarkers makes calling the disease autoimmune controversial. Autoimmune biomarkers linking CDM and T1DM would create an alternative model for drug development impacting both human and canine disease. Methods We examined peripheral blood of diagnosed CDM dog patients comparing it to healthy control (HC) dogs. Dogs were recruited to a study at the Colorado State University Veterinary Teaching Hospital and blood samples collected for blood chemistry panels, complete blood counts (CBC), and immunologic analysis. Markers of disease progression such as glycated albumin (fructosamine, the canine equivalent of human HbA1c) and c-peptide were addressed. Results Significant differences in adaptive immune lymphocytes, innate immune macrophages/monocytes and neutrophils and differences in platelets were detected between CDM and HC based on CBC. Significant differences in serum glucose, cholesterol and the liver function enzyme alkaline phosphatase were also detected. A systemic immune inflammation index (SII) and chronic inflammation index (CII) as measures of dynamic changes in adaptive and innate cells between inflammatory and non-inflammatory conditions were created with highly significant differences between CDM and HC. Th40 cells (CD4+CD40+ T cells) that are demonstrably pathogenic in mouse T1DM and able to differentiate diabetic from non-diabetic subjects in human T1DM were significantly expanded in peripheral blood mononuclear cells. Conclusions Based on each clinical finding, CDM can be categorized as an autoimmune condition. The association of significantly elevated Th40 cells in CDM when compared to HC or to osteoarthritis, a chronic but non-autoimmune disease, suggests peripheral blood Th40 cell numbers as a biomarker that reflects CDM chronic inflammation. The differences in SII and CII further underscore those findings.
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Affiliation(s)
- Gisela Vaitaitis
- Department of Medicine, The University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Tracy Webb
- Department of Clinical Sciences, The Colorado State University Veterinary Teaching Hospital, Fort Collins, CO, United States
| | - Craig Webb
- Department of Clinical Sciences, The Colorado State University Veterinary Teaching Hospital, Fort Collins, CO, United States
| | - Christina Sharkey
- Department of Clinical Sciences, Montclaire Animal Clinic, Denver, CO, United States
| | - Steve Sharkey
- Department of Clinical Sciences, Montclaire Animal Clinic, Denver, CO, United States
| | - Dan Waid
- Op-T, LLC, Fitzsimmons Innovation Bioscience, Aurora, CO, United States
| | - David H. Wagner
- Department of Medicine, The University of Colorado Anschutz Medical Campus, Aurora, CO, United States
- Op-T, LLC, Fitzsimmons Innovation Bioscience, Aurora, CO, United States
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Popp Z, Low S, Igwe A, Rahman MS, Kim M, Khan R, Oh E, Kumar A, De Anda‐Duran I, Ding H, Hwang PH, Sunderaraman P, Shih LC, Lin H, Kolachalama VB, Au R. Shifting From Active to Passive Monitoring of Alzheimer Disease: The State of the Research. J Am Heart Assoc 2024; 13:e031247. [PMID: 38226518 PMCID: PMC10926806 DOI: 10.1161/jaha.123.031247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2024]
Abstract
Most research using digital technologies builds on existing methods for staff-administered evaluation, requiring a large investment of time, effort, and resources. Widespread use of personal mobile devices provides opportunities for continuous health monitoring without active participant engagement. Home-based sensors show promise in evaluating behavioral features in near real time. Digital technologies across these methodologies can detect precise measures of cognition, mood, sleep, gait, speech, motor activity, behavior patterns, and additional features relevant to health. As a neurodegenerative condition with insidious onset, Alzheimer disease and other dementias (AD/D) represent a key target for advances in monitoring disease symptoms. Studies to date evaluating the predictive power of digital measures use inconsistent approaches to characterize these measures. Comparison between different digital collection methods supports the use of passive collection methods in settings in which active participant engagement approaches are not feasible. Additional studies that analyze how digital measures across multiple data streams can together improve prediction of cognitive impairment and early-stage AD are needed. Given the long timeline of progression from normal to diagnosis, digital monitoring will more easily make extended longitudinal follow-up possible. Through the American Heart Association-funded Strategically Focused Research Network, the Boston University investigative team deployed a platform involving a wide range of technologies to address these gaps in research practice. Much more research is needed to thoroughly evaluate limitations of passive monitoring. Multidisciplinary collaborations are needed to establish legal and ethical frameworks for ensuring passive monitoring can be conducted at scale while protecting privacy and security, especially in vulnerable populations.
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Affiliation(s)
- Zachary Popp
- Department of Anatomy & NeurobiologyBoston University Chobanian & Avedisian School of MedicineBostonMAUSA
- Boston University Alzheimer’s Disease Research Center, Boston University Chobanian & Avedisian School of MedicineBostonMAUSA
| | - Spencer Low
- Department of Anatomy & NeurobiologyBoston University Chobanian & Avedisian School of MedicineBostonMAUSA
- Boston University Alzheimer’s Disease Research Center, Boston University Chobanian & Avedisian School of MedicineBostonMAUSA
- Department of EpidemiologyBoston University School of Public HealthBostonMAUSA
| | - Akwaugo Igwe
- Department of Anatomy & NeurobiologyBoston University Chobanian & Avedisian School of MedicineBostonMAUSA
- Boston University Alzheimer’s Disease Research Center, Boston University Chobanian & Avedisian School of MedicineBostonMAUSA
| | - Md Salman Rahman
- Department of Anatomy & NeurobiologyBoston University Chobanian & Avedisian School of MedicineBostonMAUSA
- Boston University Alzheimer’s Disease Research Center, Boston University Chobanian & Avedisian School of MedicineBostonMAUSA
| | - Minzae Kim
- Department of Anatomy & NeurobiologyBoston University Chobanian & Avedisian School of MedicineBostonMAUSA
- Boston UniversityBostonMAUSA
| | - Raiyan Khan
- Department of Anatomy & NeurobiologyBoston University Chobanian & Avedisian School of MedicineBostonMAUSA
- Boston UniversityBostonMAUSA
| | - Emily Oh
- Department of Anatomy & NeurobiologyBoston University Chobanian & Avedisian School of MedicineBostonMAUSA
- Boston UniversityBostonMAUSA
| | - Ankita Kumar
- Department of Anatomy & NeurobiologyBoston University Chobanian & Avedisian School of MedicineBostonMAUSA
- Boston UniversityBostonMAUSA
| | - Ileana De Anda‐Duran
- Department of EpidemiologyTulane University School of Public Health & Tropical MedicineNew OrleansLAUSA
| | - Huitong Ding
- Department of Anatomy & NeurobiologyBoston University Chobanian & Avedisian School of MedicineBostonMAUSA
- Framingham Heart StudyBoston University Chobanian & Avedisian School of Medicine School of MedicineBostonMAUSA
| | - Phillip H. Hwang
- Department of EpidemiologyBoston University School of Public HealthBostonMAUSA
| | - Preeti Sunderaraman
- Boston University Alzheimer’s Disease Research Center, Boston University Chobanian & Avedisian School of MedicineBostonMAUSA
- Framingham Heart StudyBoston University Chobanian & Avedisian School of Medicine School of MedicineBostonMAUSA
- Department of NeurologyBoston University Chobanian & Avedisian School of Medicine School of MedicineBostonMAUSA
| | - Ludy C. Shih
- Boston University Alzheimer’s Disease Research Center, Boston University Chobanian & Avedisian School of MedicineBostonMAUSA
- Framingham Heart StudyBoston University Chobanian & Avedisian School of Medicine School of MedicineBostonMAUSA
- Department of NeurologyBoston University Chobanian & Avedisian School of Medicine School of MedicineBostonMAUSA
| | - Honghuang Lin
- Department of MedicineUniversity of Massachusetts Chan Medical SchoolWorcesterMA
| | - Vijaya B. Kolachalama
- Boston University Alzheimer’s Disease Research Center, Boston University Chobanian & Avedisian School of MedicineBostonMAUSA
- Department of MedicineBoston University Chobanian & Avedisian School of Medicine School of MedicineBostonMAUSA
| | - Rhoda Au
- Department of Anatomy & NeurobiologyBoston University Chobanian & Avedisian School of MedicineBostonMAUSA
- Boston University Alzheimer’s Disease Research Center, Boston University Chobanian & Avedisian School of MedicineBostonMAUSA
- Department of EpidemiologyBoston University School of Public HealthBostonMAUSA
- Framingham Heart StudyBoston University Chobanian & Avedisian School of Medicine School of MedicineBostonMAUSA
- Department of NeurologyBoston University Chobanian & Avedisian School of Medicine School of MedicineBostonMAUSA
- Department of MedicineBoston University Chobanian & Avedisian School of Medicine School of MedicineBostonMAUSA
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Rosen F, Settel L, Irvine F, Koselka EPD, Miller JD, Young SL. Associations between food insecurity and child and parental physical, nutritional, psychosocial and economic well-being globally during the first 1000 days: A scoping review. Matern Child Nutr 2024; 20:e13574. [PMID: 37828823 PMCID: PMC10750018 DOI: 10.1111/mcn.13574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 09/05/2023] [Accepted: 09/19/2023] [Indexed: 10/14/2023]
Abstract
Food insecurity affects billions of individuals annually and contributes to myriad poor health outcomes. Experiences of food insecurity may be particularly harmful during the first 1000 days, but literature on the topic has not been synthesized. We therefore aimed to characterize all available studies examining associations between food insecurity and nutritional, psychosocial, physical and economic well-being among parents and children during this period. We implemented a standardized search strategy across 11 databases. Four researchers screened 10,257 articles, 120 of which met the inclusion criteria. Most studies were conducted in Sub-Saharan Africa (43.3%), followed by North America (20.8%). Studies were primarily quantitative (95.8%), cross-sectional (70.0%) and focused on women (pregnant or post-partum, 48.3%) or women and children (15.8%). Physical health outcomes were the most investigated (n = 87 studies), followed by nutritional (n = 69), psychosocial (n = 35) and economic well-being (n = 2). The most studied associations were between food insecurity and stunting (n = 15), maternal depression (n = 12), child dietary diversity (n = 7) and maternal body mass index (n = 6). The strength of evidence for the observed associations varied across populations as well as within and between examined outcomes. We recommend that future studies recruit more diverse study populations, consider temporality of relationships, use instruments that facilitate cross-site comparisons, measure individual-level food insecurity and outcomes most likely to be impacted by food insecurity, evaluate contextual factors that may modify the effects of food insecurity and employ analytic techniques that permit assessment of causal pathways.
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Affiliation(s)
- Francesca Rosen
- Department of Global Health StudiesNorthwestern UniversityEvanstonIllinoisUSA
| | - Lily Settel
- Department of Global Health StudiesNorthwestern UniversityEvanstonIllinoisUSA
- Department of AnthropologyNorthwestern UniversityEvanstonIllinoisUSA
| | - Faith Irvine
- Department of Global Health StudiesNorthwestern UniversityEvanstonIllinoisUSA
| | | | - Joshua D. Miller
- Department of AnthropologyNorthwestern UniversityEvanstonIllinoisUSA
- Department of NutritionUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Sera L. Young
- Department of AnthropologyNorthwestern UniversityEvanstonIllinoisUSA
- Institute for Policy ResearchNorthwestern UniversityEvanstonIllinoisUSA
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Jang B, Kim H, Lee S, Won Y, Kaji I, Coffey RJ, Choi E, Goldenring JR. Dynamic tuft cell expansion during gastric metaplasia and dysplasia. J Pathol Clin Res 2024; 10:e352. [PMID: 38117182 PMCID: PMC10766036 DOI: 10.1002/cjp2.352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 11/14/2023] [Accepted: 11/17/2023] [Indexed: 12/21/2023]
Abstract
Tuft cells are chemosensory cells associated with luminal homeostasis, immune response, and tumorigenesis in the gastrointestinal tract. We aimed to elucidate alterations in tuft cell populations during gastric atrophy and tumorigenesis in humans with correlative comparison to relevant mouse models. Tuft cell distribution was determined in human stomachs from organ donors and in gastric pathologies including Ménétrier's disease, Helicobacter pylori gastritis, intestinal metaplasia (IM), and gastric tumors. Tuft cell populations were examined in Lrig1-KrasG12D , Mist1-KrasG12D , and MT-TGFα mice. Tuft cells were evenly distributed throughout the entire normal human stomach, primarily concentrated in the isthmal region in the fundus. Ménétrier's disease stomach showed increased tuft cells. Similarly, Lrig1-Kras mice and mice overexpressing TGFα showed marked foveolar hyperplasia and expanded tuft cell populations. Human stomach with IM or dysplasia also showed increased tuft cell numbers. Similarly, Mist1-Kras mice had increased numbers of tuft cells during metaplasia and dysplasia development. In human gastric cancers, tuft cells were rarely observed, but showed positive associations with well-differentiated lesions. In mouse gastric cancer xenografts, tuft cells were restricted to dysplastic well-differentiated mucinous cysts and were lost in less differentiated cancers. Taken together, tuft cell populations increased in atrophic human gastric pathologies, metaplasia, and dysplasia, but were decreased in gastric cancers. Similar findings were observed in mouse models, suggesting that, while tuft cells are associated with precancerous pathologies, their loss is most associated with the progression to invasive cancer.
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Affiliation(s)
- Bogun Jang
- Section of Surgical SciencesVanderbilt University Medical CenterNashvilleTNUSA
- Jeju National University College of MedicineJejuRepublic of Korea
- Department of PathologyJeju National University HospitalJejuRepublic of Korea
| | - Hyesung Kim
- Section of Surgical SciencesVanderbilt University Medical CenterNashvilleTNUSA
- Jeju National University College of MedicineJejuRepublic of Korea
- Department of Cell and Developmental BiologyVanderbilt UniversityNashvilleTNUSA
| | - Su‐Hyung Lee
- Section of Surgical SciencesVanderbilt University Medical CenterNashvilleTNUSA
- Epithelial Biology CenterVanderbilt University Medical CenterNashvilleTNUSA
| | - Yoonkyung Won
- Section of Surgical SciencesVanderbilt University Medical CenterNashvilleTNUSA
- Epithelial Biology CenterVanderbilt University Medical CenterNashvilleTNUSA
| | - Izumi Kaji
- Section of Surgical SciencesVanderbilt University Medical CenterNashvilleTNUSA
- Department of Cell and Developmental BiologyVanderbilt UniversityNashvilleTNUSA
- Epithelial Biology CenterVanderbilt University Medical CenterNashvilleTNUSA
| | - Robert J Coffey
- Epithelial Biology CenterVanderbilt University Medical CenterNashvilleTNUSA
- Department of Internal MedicineVanderbilt University Medical CenterNashvilleTNUSA
| | - Eunyoung Choi
- Section of Surgical SciencesVanderbilt University Medical CenterNashvilleTNUSA
- Department of Cell and Developmental BiologyVanderbilt UniversityNashvilleTNUSA
- Epithelial Biology CenterVanderbilt University Medical CenterNashvilleTNUSA
| | - James R Goldenring
- Section of Surgical SciencesVanderbilt University Medical CenterNashvilleTNUSA
- Department of Cell and Developmental BiologyVanderbilt UniversityNashvilleTNUSA
- Epithelial Biology CenterVanderbilt University Medical CenterNashvilleTNUSA
- Nashville VA Medical CenterNashvilleTNUSA
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Jankowski CM, Konigsberg IR, Wilson MP, Sun J, Brown TT, Julian CG, Erlandson KM. Skeletal muscle DNA methylation: Effects of exercise and HIV. Aging Cell 2024; 23:e14025. [PMID: 37920126 PMCID: PMC10776118 DOI: 10.1111/acel.14025] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 10/13/2023] [Accepted: 10/15/2023] [Indexed: 11/04/2023] Open
Abstract
Aging, human immunodeficiency virus (HIV) infection, and antiretroviral therapy modify the epigenetic profile and function of cells and tissues, including skeletal muscle (SkM). In some cells, accelerated epigenetic aging begins very soon after the initial HIV infection, potentially setting the stage for the early onset of frailty. Exercise imparts epigenetic modifications in SkM that may underpin some health benefits, including delayed frailty, in people living with HIV (PWH). In this first report of exercise-related changes in SkM DNA methylation among PWH, we investigated the impact of 24 weeks of aerobic and resistance exercise training on SkM (vastus lateralis) DNA methylation profiles and epigenetic age acceleration (EAA) in older, virally suppressed PWH (n = 12) and uninfected controls (n = 18), and associations of EAA with physical function at baseline. We identified 983 differentially methylated positions (DMPs) in PWH and controls at baseline and 237 DMPs after training. The influence of HIV serostatus on SkM methylation was more pronounced than that of exercise training. There was little overlap in the genes associated with the probes most significantly differentiated by exercise training within each group. Baseline EAA (mean ± SD) was similar between PWH (-0.4 ± 2.5 years) and controls (0.2 ± 2.6 years), and the exercise effect was not significant (p = 0.79). EAA and physical function at baseline were not significantly correlated (all p ≥ 0.10). This preliminary investigation suggests HIV-specific epigenetic adaptations in SkM with exercise training but confirmation in a larger study that includes transcriptomic analysis is warranted.
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Affiliation(s)
| | - Iain R. Konigsberg
- Department of Biomedical InformaticsUniversity of Colorado Anschutz Medical CampusColoradoAuroraUSA
| | - Melissa P. Wilson
- Division of Infectious Diseases, Department of MedicineUniversity of Colorado Anschutz Medical CampusColoradoAuroraUSA
| | - Jing Sun
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthMarylandBaltimoreUSA
| | - Todd T. Brown
- Division of Endocrinology, Diabetes, & Metabolism, Department of MedicineJohns Hopkins UniversityMarylandBaltimoreUSA
| | - Colleen G. Julian
- Department of Biomedical InformaticsUniversity of Colorado Anschutz Medical CampusColoradoAuroraUSA
| | - Kristine M. Erlandson
- Division of Infectious Diseases, Department of MedicineUniversity of Colorado Anschutz Medical CampusColoradoAuroraUSA
- Division of Geriatric Medicine, Department of MedicineUniversity of Colorado Anschutz Medical CampusColoradoAuroraUSA
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Huwe M, Woolf B, David J, Seid M, Saeed S, Margolis P. Conceptualizing and redefining successful patient engagement in patient advisory councils in learning health networks. Learn Health Syst 2024; 8:e10377. [PMID: 38249844 PMCID: PMC10797569 DOI: 10.1002/lrh2.10377] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 05/28/2023] [Accepted: 06/01/2023] [Indexed: 01/23/2024] Open
Abstract
Introduction Patient engagement has historically referenced engagement in one's healthcare, with more recent definitions expanding patient engagement to encompass patient advocacy work in Learning Health Networks (LHNs). Efforts to conceptualize and define what patient engagement means-and what successful patient engagement means-are, however, lacking and a barrier to meaningful and sustainable patient engagement via patient advisory councils (PACs) across LHNs. Methods Several co-authors (Madeleine Huwe, Becky Woolf, Jennie David) are former ImproveCareNow (ICN) PAC members, and we integrate a narrative review of the extant literature and a case study of our lived experiences as former ICN PAC members. We present nuanced themes of successful patient engagement from our lived experiences on ICN's PAC, with illustrative quotes from other PAC members, and then propose themes and metrics to consider in patient engagement across LHNs. Results Successful patient engagement in our experiences with ICN's PAC reaches beyond the "levels of engagement" previously described in the literature. We posit that our successful patient/PAC engagement experiences with ICN represent key mechanisms that could be applied across LHNs, including (1) personal growth for PAC members, (2) PAC internal engagement/community, (3) PAC engagement and presence within the LHN, (4) local institutional engagement for those who participate in the LHN, and (5) tangible resources/products from PAC members. Conclusion Patient engagement in LHNs, like ICN, holds significant power to meaningfully shape and co-produce healthcare systems, and engagement is undervalued and conceptualized dichotomously (eg, engaged or not engaged). Reconceptualizing successful patient/PAC engagement is critical in ongoing efforts to study, support, and understand mechanisms of sustainable and successful patient engagement. Having a modern, multidimensional definition for successful patient engagement in LHNs can support efforts to increase underrepresented voices in PACs, measure and track successful multidimensional patient engagement, and study how successful patient engagement may impact outcomes for patients and LHNs.
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Affiliation(s)
- Madeleine Huwe
- George Fox University College of NursingNewbergOregonUSA
| | | | | | - Michael Seid
- Cincinnati Children's Hospital Medical CenterCincinnatiOhioUSA
| | | | - Peter Margolis
- Cincinnati Children's Hospital Medical CenterCincinnatiOhioUSA
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Evans EW, Darling KE, Egbert A, Hayes JF, Jelalian E, Warnick J, Topor LS, Goldschmidt AB. Leveraging seasonality and timing to optimize pediatric weight management interventions: Novel directions for future research. Obes Sci Pract 2023; 9:688-695. [PMID: 38090686 PMCID: PMC10712410 DOI: 10.1002/osp4.694] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 06/08/2023] [Accepted: 06/26/2023] [Indexed: 02/01/2024] Open
Abstract
National estimates suggest that more than 35% of American children, ages 2-19 years, are overweight or obese, which increases their risk for weight-related comorbidities including diabetes, cancer, cardiovascular disease risk factors, depression, and anxiety. While obesity prevention is most cost-effective, for youth with existing obesity, the United States Preventive Services Task Force recommends ≥26 h of comprehensive lifestyle intervention over 6-12 months. This include standard behavioral therapy, dietary counseling, and an emphasis on physical activity. Although such programs are effective in reducing weight status, there are many barriers to completing these programs. A novel consideration for both the prevention and treatment of childhood obesity is the recognition that the timing of intervention, both duration and time of the year, can impact family engagement and intervention effectiveness. This paper discusses the potential of targeting high-risk periods for weight gain and offering brief behavioral intervention, in hopes of inspiring research on novel approaches to the prevention and treatment of childhood obesity.
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Affiliation(s)
- E. Whitney Evans
- Weight Control and Diabetes Research CenterThe Miriam HospitalProvidenceRhode IslandUSA
- Alpert Medical School of Brown UniversityProvidenceRhode IslandUSA
| | - Katherine E. Darling
- Weight Control and Diabetes Research CenterThe Miriam HospitalProvidenceRhode IslandUSA
- Alpert Medical School of Brown UniversityProvidenceRhode IslandUSA
| | - Amy Egbert
- Department of Psychological SciencesUniversity of ConnecticutStorrsConnecticutUSA
| | - Jacqueline F. Hayes
- Weight Control and Diabetes Research CenterThe Miriam HospitalProvidenceRhode IslandUSA
- Alpert Medical School of Brown UniversityProvidenceRhode IslandUSA
| | - Elissa Jelalian
- Weight Control and Diabetes Research CenterThe Miriam HospitalProvidenceRhode IslandUSA
- Alpert Medical School of Brown UniversityProvidenceRhode IslandUSA
| | - Jennifer Warnick
- Weight Control and Diabetes Research CenterThe Miriam HospitalProvidenceRhode IslandUSA
- Alpert Medical School of Brown UniversityProvidenceRhode IslandUSA
| | - Lisa Swartz Topor
- Alpert Medical School of Brown UniversityProvidenceRhode IslandUSA
- Pediatric Endocrinology and Diabetes CenterHasbro Children's HospitalProvidenceRhode IslandUSA
| | - Andrea B. Goldschmidt
- Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
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Ehmann MM, LaFata EM, McCausland HC, Knudsen FM, Butryn ML. Perceived importance of moderate-to-vigorous physical activity as a weight control strategy in behavioral weight loss. Obes Sci Pract 2023; 9:631-640. [PMID: 38090685 PMCID: PMC10712407 DOI: 10.1002/osp4.695] [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] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 06/13/2023] [Accepted: 06/27/2023] [Indexed: 02/01/2024] Open
Abstract
Background Previous research has established the importance of moderate-to-vigorous physical activity (MVPA) for weight control. One area of unexplored investigation is the relationship between individuals' perceptions of the importance of MVPA for weight control and MVPA engagement. This study examined the associations between the perceived importance of MVPA and MVPA engagement, weight loss, barriers to PA, and exercise enjoyment in adults enrolled in a long-term behavioral weight loss (BWL) intervention. Methods Adults (N = 301) with overweight/obesity (BMI = 27-45 kg/m2) completed an 18-month BWL intervention, followed by a no-intervention 18-month follow-up. At baseline, 6 months, 18 months (i.e., post-treatment), and 36 months (i.e., follow-up), participants ranked the importance of six strategies for weight control: keeping a food record, MVPA, light PA, self-weighing, small portions, and low-calorie diet. Observed MVPA (measured by accelerometer), percent weight loss, perceived barriers to PA, and exercise enjoyment were also measured at each assessment. Results Results showed that most participants perceived MVPA as a primary weight control strategy (first, second, or third most important) throughout the intervention, regardless of the weight control goal (weight loss vs. maintenance). Individuals who ranked MVPA as a primary strategy for weight control at concurrent time points, compared to those who did not, engaged in significantly more MVPA at post-treatment, had greater weight loss at follow-up, endorsed fewer barriers to PA at post-treatment and follow-up, and reported greater exercise enjoyment at baseline and post-treatment. Conclusion Perceived importance of MVPA was related to subjective experiences of MVPA, MVPA adherence, and weight loss in a long-term BWL intervention.
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Affiliation(s)
- Marny M. Ehmann
- Department of Psychological and Brain Sciences and Center for WeightEating and Lifestyle Science (WELL Center)Drexel UniversityPhiladelphiaPennsylvaniaUSA
| | - Erica M. LaFata
- Department of Psychological and Brain Sciences and Center for WeightEating and Lifestyle Science (WELL Center)Drexel UniversityPhiladelphiaPennsylvaniaUSA
| | - Hannah C. McCausland
- Department of Psychological and Brain Sciences and Center for WeightEating and Lifestyle Science (WELL Center)Drexel UniversityPhiladelphiaPennsylvaniaUSA
| | - Francesca M. Knudsen
- Department of Psychological and Brain Sciences and Center for WeightEating and Lifestyle Science (WELL Center)Drexel UniversityPhiladelphiaPennsylvaniaUSA
| | - Meghan L. Butryn
- Department of Psychological and Brain Sciences and Center for WeightEating and Lifestyle Science (WELL Center)Drexel UniversityPhiladelphiaPennsylvaniaUSA
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Sassin AM, Sangi‐Haghpeykar H, Aagaard KM. Fetal sex and the development of gestational diabetes mellitus in gravidae with multiple gestation pregnancies. Acta Obstet Gynecol Scand 2023; 102:1703-1710. [PMID: 37786339 PMCID: PMC10619600 DOI: 10.1111/aogs.14625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 06/09/2023] [Accepted: 06/13/2023] [Indexed: 10/04/2023]
Abstract
INTRODUCTION There is an increasing incidence of pregnancies with twin gestations. One outcome more likely to occur with multiple gestations is gestational diabetes mellitus. Studies have suggested that in singleton pregnancies, fetal sex may affect insulin resistance. However, the effects of fetal sex in twins and the development of gestational diabetes mellitus are unknown. We hypothesized that rates of gestational diabetes mellitus and degree of insulin resistance might vary in twin gestations based on the fetal sex pairing: male-male, male-female or female-female. We aimed to employ a large population-based database to ascertain any correlations between fetal sex and gestational diabetes mellitus in multifetal gestations. MATERIAL AND METHODS A two-hospital, single academic institution database comprised of over 39 000 participants with pregnancy data from August 2011 to January 2022 was employed. All twin deliveries of live-born neonates >24 weeks' gestational age from gravidae without preexisting diabetes or twin-twin transfusion syndrome were included. Entries were then grouped based on the fetal sex of the pairing. The presence or absence of gestational diabetes and type of gestational diabetes - diet-controlled (gestational diabetes mellitus classification A1) vs medication-controlled (gestational diabetes mellitus classification A2) - were identified. Statistical analysis was performed using a generalized linear mixed method, and a P-value ≤0.05 was considered statistically significant. RESULTS We identified 1924 twin deliveries that met the inclusion criteria in our database (male-male =652; male-female = 638; female-female = 634). We found no association between fetal sex pairing and the development of gestational diabetes mellitus. There was a significant association between the fetal sex pairing and the type of gestational diabetes mellitus developed, with 32.0% of male-male twins, 33.3% of male-female twins and 58.3% of the female-female twin deliveries associated with medication-controlled gestational diabetes classification A2: male-female vs female-female (P = 0.05) and male-male vs female-female (P = 0.046). CONCLUSIONS While gestational diabetes mellitus is of multifactorial origin, we found a significant association between the fetal sex pairing and the treatment needed for gravidae with twins who develop gestational diabetes mellitus. A higher proportion of female-female twins was associated with gestational diabetes classification A2 compared with male-female or male-male deliveries. Further research on the physiology driving this association is warranted.
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Affiliation(s)
- Alexa M. Sassin
- Department of Obstetrics and GynecologyBaylor College of MedicineHoustonTexasUSA
| | | | - Kjersti M. Aagaard
- Department of Obstetrics and Gynecology, Division of Maternal‐Fetal Medicine, and Departments of Molecular and Human GeneticsMolecular and Cell Biology, and Molecular Physiology and Biophysics, Baylor College of MedicineHoustonTexasUSA
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Azar KMJ, Sudat S, Huang Q, Pressman AP, Szwerinski NK, Nasrallah C, Venditti EM, Romanelli RJ. Examining paradoxical session attendance and weight loss relationships in a clinic based lifestyle modification intervention. Obes Sci Pract 2023; 9:641-652. [PMID: 38090689 PMCID: PMC10712409 DOI: 10.1002/osp4.696] [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] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 06/28/2023] [Accepted: 06/30/2023] [Indexed: 02/01/2024] Open
Abstract
Objective Evaluations of lifestyle modification interventions (LMIs), modeled after the Diabetes Prevention Program, have repeatedly shown a dose-response relationship between session attendance and weight loss. Despite this, not all participants had "average" weight loss experiences. Nearly one-third of LMI participants experienced unexpected, paradoxical outcomes (i.e., high attendance with little weight loss, and low attendance with clinically significant weight loss). Paradoxical weight-loss outcomes were characterized based on session attendance among participants in a group-based LMI in a real-world healthcare setting. This group-based LMI was delivered over 1 year to participants with the possibility of attending up to 25 sessions total. Methods LMI participants identified in 2010-2017 from electronic health records were characterized as having low (<75%) or high (≥75%) session attendance. Weight-loss outcomes were defined as expected (≥5%, high-attendance; <5%, low-attendance) or paradoxical (≥5%, low-attendance; <5%, high-attendance). Paradoxical-outcome-associated characteristics were identified using logistic regression. Results Among 1813 LMI participants, 1498 (82.6%) had low and 315 (17.4%) high session attendance; 555 (30.6%) had paradoxical outcomes, comprising 415 (74.8%) responders (≥5% weight-loss) and 140 (25.2%) non-responders (<5% weight-loss). Among participants with high session attendance, paradoxical non-responders were more likely to be female (odds ratio [OR]: 2.76; 95% confidence interval [CI]: 1.32, 5.77) and have type 2 diabetes (OR: 3.32; 95% CI: 1.01, 10.95). Among low-attendance participants, paradoxical responders were more likely to be non-Hispanic White and less likely to be non-Hispanic Black (OR: 0.35; 95% CI: 0.18, 0.69), non-Hispanic Asian (OR: 0.40; 95% CI: 0.22, 0.73), or Hispanic (OR: 0.53; 95% CI: 0.35, 0.80). Conclusions In a healthcare setting, nearly one-third of LMI participants experienced paradoxical outcomes. More research is needed to understand the facilitators and barriers to weight loss above and beyond session attendance.
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Affiliation(s)
| | - Sylvia Sudat
- Sutter HealthCenter for Health Systems ResearchPalo AltoCaliforniaUSA
| | - Qiwen Huang
- Sutter HealthCenter for Health Systems ResearchPalo AltoCaliforniaUSA
| | - Alice P. Pressman
- Sutter HealthCenter for Health Systems ResearchPalo AltoCaliforniaUSA
| | | | | | - Elizabeth M. Venditti
- Department of Psychiatry & Department of EpidemiologyDiabetes Prevention Support CenterUniversity of PittsburghPittsburghPennsylvaniaUSA
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Yang Q, Huo E, Cai Y, Zhang Z, Dong C, Asara JM, Shi H, Wei Q. Myeloid PFKFB3-mediated glycolysis promotes kidney fibrosis. Front Immunol 2023; 14:1259434. [PMID: 38035106 PMCID: PMC10687406 DOI: 10.3389/fimmu.2023.1259434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 10/27/2023] [Indexed: 12/02/2023] Open
Abstract
Excessive renal fibrosis is a common pathology in progressive chronic kidney diseases. Inflammatory injury and aberrant repair processes contribute to the development of kidney fibrosis. Myeloid cells, particularly monocytes/macrophages, play a crucial role in kidney fibrosis by releasing their proinflammatory cytokines and extracellular matrix components such as collagen and fibronectin into the microenvironment of the injured kidney. Numerous signaling pathways have been identified in relation to these activities. However, the involvement of metabolic pathways in myeloid cell functions during the development of renal fibrosis remains understudied. In our study, we initially reanalyzed single-cell RNA sequencing data of renal myeloid cells from Dr. Denby's group and observed an increased gene expression in glycolytic pathway in myeloid cells that are critical for renal inflammation and fibrosis. To investigate the role of myeloid glycolysis in renal fibrosis, we utilized a model of unilateral ureteral obstruction in mice deficient of Pfkfb3, an activator of glycolysis, in myeloid cells (Pfkfb3 ΔMϕ ) and their wild type littermates (Pfkfb3 WT). We observed a significant reduction in fibrosis in the obstructive kidneys of Pfkfb3 ΔMϕ mice compared to Pfkfb3 WT mice. This was accompanied by a substantial decrease in macrophage infiltration, as well as a decrease of M1 and M2 macrophages and a suppression of macrophage to obtain myofibroblast phenotype in the obstructive kidneys of Pfkfb3 ΔMϕ mice. Mechanistic studies indicate that glycolytic metabolites stabilize HIF1α, leading to alterations in macrophage phenotype that contribute to renal fibrosis. In conclusion, our study implicates that targeting myeloid glycolysis represents a novel approach to inhibit renal fibrosis.
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Affiliation(s)
- Qiuhua Yang
- Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, GA, United States
| | - Emily Huo
- Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, GA, United States
- Augusta Preparatory Day School, Martinez, GA, United States
| | - Yongfeng Cai
- Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, GA, United States
| | - Zhidan Zhang
- Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, GA, United States
| | - Charles Dong
- Dental College of Georgia, Augusta University, Augusta, GA, United States
| | - John M. Asara
- Division of Signal Transduction, Beth Israel Deaconess Medical Center and Department of Medicine, Harvard Medical School, Boston, MA, United States
| | - Huidong Shi
- Department of Biochemistry and Molecular Biology, Medical College of Georgia, Augusta University, Augusta, GA, United States
- Georgia Cancer Center, Medical College of Georgia, Augusta University, Augusta, GA, United States
| | - Qingqing Wei
- Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, GA, United States
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Hong X, Rosenberg AZ, Heymann J, Yoshida T, Waikar SS, Ilori TO, Wang G, Rebuck H, Pearson C, Wang M, Winkler CA, Kopp JB, Wang X. Joint Associations of Pregnancy Complications and Postpartum Maternal Renal Biomarkers With Severe Cardiovascular Morbidities: A US Racially and Ethnically Diverse Prospective Birth Cohort Study. J Am Heart Assoc 2023; 12:e029311. [PMID: 37947096 PMCID: PMC10727285 DOI: 10.1161/jaha.122.029311] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 07/25/2023] [Indexed: 11/12/2023]
Abstract
Background Pregnancy complications are risk factors for cardiovascular disease (CVD). Little is known about the role of renal biomarkers measured shortly after delivery, individually or in combination with pregnancy complications, in predicting subsequent severe maternal CVD. Methods and Results This study included 566 mothers of diverse races and ethnicities from the Boston Birth cohort, enrolled at delivery and followed prospectively. Plasma creatinine and CysC (cystatin C) were measured 1 to 3 days after delivery. CVD during follow-up was defined by physician diagnoses in electronic medical records. Associations of renal biomarkers and pregnancy complications with time-to-CVD events were assessed using Cox proportional hazards models. During an average of 10.3±3.2 years of follow-up, 30 mothers developed 1 or more CVDs. Only a modest association was observed between creatinine and risk of CVD. In comparison, we found that per 0.1 mg/L increase of CysC was associated with a hazard ratio (HR) of 1.2 (95% CI, 1.1-1.4) for CVD after adjusting for covariates. Compared with those without preeclampsia and with normal CysC level (≤75th percentile), mothers with preeclampsia and elevated CysC (>75th percentile) had the highest risk of CVD (HR, 4.6 [95% CI, 1.7-17.7]), whereas mothers with preeclampsia only or with elevated CysC only did not have significantly increased CVD risk. Similar synergistic effects for CVD were observed between CysC and preterm delivery. Conclusions In this sample of US, traditionally underrepresented multiracial and multiethnic high-risk mothers, elevated maternal plasma CysC, independently and jointly with pregnancy complications, increased risk of CVD later in life. These findings warrant further investigation. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT03228875.
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Affiliation(s)
- Xiumei Hong
- Department of Population, Family and Reproductive Health, Center on the Early Life Origins of DiseaseJohns Hopkins University Bloomberg School of Public HealthBaltimoreMDUSA
| | | | - Jurgen Heymann
- Kidney Disease Section, National Institute of Diabetes and Digestive and Kidney Disease, National Institutes of HealthMDBethesdaUSA
| | - Teruhiko Yoshida
- Kidney Disease Section, National Institute of Diabetes and Digestive and Kidney Disease, National Institutes of HealthMDBethesdaUSA
| | - Sushrut S. Waikar
- Section of Nephrology, Department of MedicineBoston University Chobanian & Avedisian School of Medicine and Boston Medical CenterBostonMAUSA
| | - Titilayo O. Ilori
- Section of Nephrology, Department of MedicineBoston University Chobanian & Avedisian School of Medicine and Boston Medical CenterBostonMAUSA
| | - Guoying Wang
- Department of Population, Family and Reproductive Health, Center on the Early Life Origins of DiseaseJohns Hopkins University Bloomberg School of Public HealthBaltimoreMDUSA
| | - Heather Rebuck
- Clinical Chemistry Research LabUniversity of Maryland School of MedicineBaltimoreMDUSA
| | - Colleen Pearson
- Department of PediatricsBoston University Chobanian & Avedisian School of Medicine and Boston Medical CenterBostonMAUSA
| | - Mei‐Cheng Wang
- Department of BiostatisticsJohns Hopkins University Bloomberg School of Public HealthBaltimoreMDUSA
| | - Cheryl A. Winkler
- Cancer Innovation Laboratory, Center for Cancer ResearchNational Cancer Institute and Basic Research Program, Frederick National LaboratoryFrederickMDUSA
| | - Jeffrey B. Kopp
- Kidney Disease Section, National Institute of Diabetes and Digestive and Kidney Disease, National Institutes of HealthMDBethesdaUSA
| | - Xiaobin Wang
- Department of Population, Family and Reproductive Health, Center on the Early Life Origins of DiseaseJohns Hopkins University Bloomberg School of Public HealthBaltimoreMDUSA
- Division of General Pediatrics & Adolescent Medicine, Department of PediatricsJohns Hopkins University School of MedicineBaltimoreMDUSA
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Citterio CE, Kim K, Rajesh B, Pena K, Clarke OB, Arvan P. Structural features of thyroglobulin linked to protein trafficking. Protein Sci 2023; 32:e4784. [PMID: 37717261 PMCID: PMC10578121 DOI: 10.1002/pro.4784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 09/06/2023] [Accepted: 09/14/2023] [Indexed: 09/19/2023]
Abstract
Thyroglobulin must pass endoplasmic reticulum (ER) quality control to become secreted for thyroid hormone synthesis. Defective thyroglobulin, blocked in trafficking, can cause hypothyroidism. Thyroglobulin is a large protein (~2750 residues) spanning regions I-II-III plus a C-terminal cholinesterase-like domain. The cholinesterase-like domain functions as an intramolecular chaperone for regions I-II-III, but the folding pathway leading to successful thyroglobulin trafficking remains largely unknown. Here, informed by the recent three-dimensional structure of thyroglobulin as determined by cryo-electron microscopy, we have bioengineered three novel classes of mutants yielding three entirely distinct quality control phenotypes. Specifically, upon expressing recombinant thyroglobulin, we find that first, mutations eliminating a disulfide bond enclosing a 200-amino acid loop in region I have surprisingly little impact on the ability of thyroglobulin to fold to a secretion-competent state. Next, we have identified a mutation on the surface of the cholinesterase-like domain that has no discernible effect on regional folding yet affects contact between distinct regions and thereby triggers impairment in the trafficking of full-length thyroglobulin. Finally, we have probed a conserved disulfide in the cholinesterase-like domain that interferes dramatically with local folding, and this defect then impacts on global folding, blocking the entire thyroglobulin in the ER. These data highlight variants with distinct effects on ER quality control, inhibiting domain-specific folding; folding via regional contact; neither; or both.
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Affiliation(s)
- Cintia E. Citterio
- Division of Metabolism, Endocrinology & Diabetes, Department of Internal MedicineUniversity of MichiganAnn ArborMichiganUSA
- Department of Biomedical and Pharmaceutical SciencesChapman UniversityIrvineCaliforniaUSA
| | - Kookjoo Kim
- Departments of Anesthesiology, and Physiology and Cellular BiophysicsIrving Institute for Clinical and Translational Research, Columbia University Irving Medical CenterNew YorkNew YorkUSA
| | - Bhavana Rajesh
- Division of Metabolism, Endocrinology & Diabetes, Department of Internal MedicineUniversity of MichiganAnn ArborMichiganUSA
| | - Kevin Pena
- Division of Metabolism, Endocrinology & Diabetes, Department of Internal MedicineUniversity of MichiganAnn ArborMichiganUSA
| | - Oliver Biggs Clarke
- Departments of Anesthesiology, and Physiology and Cellular BiophysicsIrving Institute for Clinical and Translational Research, Columbia University Irving Medical CenterNew YorkNew YorkUSA
| | - Peter Arvan
- Division of Metabolism, Endocrinology & Diabetes, Department of Internal MedicineUniversity of MichiganAnn ArborMichiganUSA
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Bunn RC, Adatorwovor R, Smith RR, Ray PD, Fields SE, Keeble AR, Fry CS, Uppuganti S, Nyman JS, Fowlkes JL, Kalaitzoglou E. Pharmacologic Inhibition of Myostatin With a Myostatin Antibody Improves the Skeletal Muscle and Bone Phenotype of Male Insulin-Deficient Diabetic Mice. JBMR Plus 2023; 7:e10833. [PMID: 38025035 PMCID: PMC10652179 DOI: 10.1002/jbm4.10833] [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: 07/01/2023] [Revised: 09/18/2023] [Accepted: 10/01/2023] [Indexed: 12/01/2023] Open
Abstract
Type 1 diabetes (T1D) is associated with low bone and muscle mass, increased fracture risk, and impaired skeletal muscle function. Myostatin, a myokine that is systemically elevated in humans with T1D, negatively regulates muscle mass and bone formation. We investigated whether pharmacologic myostatin inhibition in a mouse model of insulin-deficient, streptozotocin (STZ)-induced diabetes is protective for bone and skeletal muscle. DBA/2J male mice were injected with low-dose STZ (diabetic) or vehicle (non-diabetic). Subsequently, insulin or palmitate Linbits were implanted and myostatin (REGN647-MyoAb) or control (REGN1945-ConAb) antibody was administered for 8 weeks. Body composition and contractile muscle function were assessed in vivo. Systemic myostatin, P1NP, CTX-I, and glycated hemoglobin (HbA1c) were quantified, and gastrocnemii were weighed and analyzed for muscle fiber composition and gene expression of selected genes. Cortical and trabecular parameters were analyzed (micro-computed tomography evaluations of femur) and cortical bone strength was assessed (three-point bending test of femur diaphysis). In diabetic mice, the combination of insulin/MyoAb treatment resulted in significantly higher lean mass and gastrocnemius weight compared with MyoAb or insulin treatment alone. Similarly, higher raw torque was observed in skeletal muscle of insulin/MyoAb-treated diabetic mice compared with MyoAb or insulin treatment. Additionally, muscle fiber cross-sectional area (CSA) was lower with diabetes and the combination treatment with insulin/MyoAb significantly improved CSA in type II fibers. Insulin, MyoAb, or insulin/MyoAb treatment improved several parameters of trabecular architecture (eg, bone volume fraction [BV/TV], trabecular connectivity density [Conn.D]) and cortical structure (eg, cortical bone area [Ct. Ar.], minimum moment of inertia [Imin]) in diabetic mice. Lastly, cortical bone biomechanical properties (stiffness and yield force) were also improved with insulin or MyoAb treatment. In conclusion, pharmacologic myostatin inhibition is beneficial for muscle mass, muscle function, and bone properties in this mouse model of T1D and its effects are both independent and additive to the positive effects of insulin. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- R Clay Bunn
- Department of Pediatrics and Barnstable Brown Diabetes CenterUniversity of KentuckyLexingtonKYUSA
| | - Reuben Adatorwovor
- Department of Biostatistics, College of Public HealthUniversity of KentuckyLexingtonKYUSA
| | - Rebecca R Smith
- Sanders‐Brown Center on AgingUniversity of KentuckyLexingtonKYUSA
| | - Philip D Ray
- Department of PediatricsUniversity of KentuckyLexingtonKYUSA
| | - Sarah E Fields
- College of Agriculture, Food and EnvironmentUniversity of KentuckyLexingtonKYUSA
| | | | | | - Sasidhar Uppuganti
- Department of Orthopaedic SurgeryVanderbilt University Medical CenterNashvilleTNUSA
| | - Jeffry S Nyman
- Department of Orthopaedic SurgeryVanderbilt University Medical CenterNashvilleTNUSA
- Department of Veterans AffairsTennessee Valley Healthcare SystemNashvilleTNUSA
| | - John L Fowlkes
- Department of Pediatrics and Barnstable Brown Diabetes CenterUniversity of KentuckyLexingtonKYUSA
| | - Evangelia Kalaitzoglou
- Department of Pediatrics and Barnstable Brown Diabetes CenterUniversity of KentuckyLexingtonKYUSA
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Tang H, Lu Y, Okun MS, Donahoo WT, Ramirez‐Zamora A, Wang F, Huang Y, Chen W, Virnig BA, Bian J, Guo J. Meta-analysis of Association between Newer Glucose-Lowering Drugs and Risk of Parkinson's Disease. Mov Disord Clin Pract 2023; 10:1659-1665. [PMID: 37982117 PMCID: PMC10654811 DOI: 10.1002/mdc3.13893] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 08/07/2023] [Accepted: 09/18/2023] [Indexed: 11/21/2023] Open
Abstract
Background The association between newer classes of glucose-lowering drugs (GLDs) and the risk of Parkinson's disease (PD) remains unclear. Objective The aim was to examine the effect of newer GLDs on the risk of PD through a meta-analysis of randomized outcome trials. Methods The methods included randomized placebo-controlled outcome trials that reported PD events associated with three newer classes of GLDs (ie, dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1 receptor agonists, and sodium-glucose co-transporter-2 inhibitors) in participants with or without type 2 diabetes. The pooled odds ratio (OR) and 95% confidence interval (CI) were estimated using Peto's method. Results The study included 24 trials involving 33 PD cases among 185,305 participants during a median follow-up of 2.2 years. Newer GLDs were significantly associated with a lower PD risk (OR: 0.50; 95% CI: 0.25-0.98) than placebo. Conclusion Newer GLDs may possibly be associated with a decreased risk of PD; however, larger datasets are required to confirm or refute this notion.
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Affiliation(s)
- Huilin Tang
- Department of Pharmaceutical Outcomes and PolicyUniversity of Florida College of PharmacyGainesvilleFloridaUSA
| | - Ying Lu
- Department of Pharmaceutical Outcomes and PolicyUniversity of Florida College of PharmacyGainesvilleFloridaUSA
| | - Michael S. Okun
- Department of Neurology, Norman Fixel Institute for Neurological DiseasesUniversity of FloridaGainesvilleFloridaUSA
| | - William T. Donahoo
- Division of Endocrinology, Diabetes and Metabolism, College of MedicineUniversity of FloridaGainesvilleFloridaUSA
| | - Adolfo Ramirez‐Zamora
- Department of Neurology, Norman Fixel Institute for Neurological DiseasesUniversity of FloridaGainesvilleFloridaUSA
| | - Fei Wang
- Department of Population Health SciencesWeill Cornell Medicine, Cornell UniversityNew YorkNew YorkUSA
| | - Yu Huang
- Department of Health Outcomes and Biomedical InformaticsCollege of Medicine, University of FloridaGainesvilleFloridaUSA
| | - Wei‐Han Chen
- Department of Pharmaceutical Outcomes and PolicyUniversity of Florida College of PharmacyGainesvilleFloridaUSA
| | - Beth A. Virnig
- College of Public Health and Health Professions Dean's Office, University of FloridaGainesvilleFloridaUSA
| | - Jiang Bian
- Department of Health Outcomes and Biomedical InformaticsCollege of Medicine, University of FloridaGainesvilleFloridaUSA
| | - Jingchuan Guo
- Department of Pharmaceutical Outcomes and PolicyUniversity of Florida College of PharmacyGainesvilleFloridaUSA
- Center for Drug Evaluation and Safety, University of FloridaGainesvilleFloridaUSA
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Lu W, Luo Y. Methionine restriction sensitizes cancer cells to immunotherapy. Cancer Commun (Lond) 2023; 43:1267-1270. [PMID: 37803877 PMCID: PMC10631477 DOI: 10.1002/cac2.12492] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 09/13/2023] [Accepted: 09/26/2023] [Indexed: 10/08/2023] Open
Affiliation(s)
- Weiqin Lu
- Department of Pharmaceutical SciencesSchool of Pharmacy, University of Texas at El PasoEl PasoUSA
| | - Yongde Luo
- School of Pharmacological Sciences & The First Affiliated HospitalWenzhou Medical UniversityWenzhouZhejiangP. R. China
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Du Y, de Jong IEM, Gupta K, Waisbourd-Zinman O, Har-Zahav A, Soroka CJ, Boyer JL, Llewellyn J, Liu C, Naji A, Polacheck WJ, Wells RG. Human vascularized bile duct-on-a chip: a multi-cellular micro-physiological system for studying cholestatic liver disease. Biofabrication 2023; 16:015004. [PMID: 37820623 PMCID: PMC10587873 DOI: 10.1088/1758-5090/ad0261] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/22/2023] [Accepted: 10/11/2023] [Indexed: 10/13/2023]
Abstract
Exploring the pathogenesis of and developing therapies for cholestatic liver diseases such as primary sclerosing cholangitis (PSC) remains challenging, partly due to a paucity ofin vitromodels that capture the complex environments contributing to disease progression and partly due to difficulty in obtaining cholangiocytes. Here we report the development of a human vascularized bile duct-on-a-chip (VBDOC) that uses cholangiocyte organoids derived from normal bile duct tissue and human vascular endothelial cells to model bile ducts and blood vessels structurally and functionally in three dimensions. Cholangiocytes in the duct polarized, formed mature tight junctions and had permeability properties comparable to those measured inex vivosystems. The flow of blood and bile was modeled by perfusion of the cell-lined channels, and cholangiocytes and endothelial cells displayed differential responses to flow. We also showed that the device can be constructed with biliary organoids from cells isolated from both bile duct tissue and the bile of PSC patients. Cholangiocytes in the duct became more inflammatory under the stimulation of IL-17A, which induced peripheral blood mononuclear cells and differentiated Th17 cells to transmigrate across the vascular channel. In sum, this human VBDOC recapitulated the vascular-biliary interface structurally and functionally and represents a novel multicellular platform to study inflammatory and fibrotic cholestatic liver diseases.
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Affiliation(s)
- Yu Du
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
- Key Laboratory of Microgravity (National Microgravity Laboratory), Center of Biomechanics and Bioengineering, and Beijing Key Laboratory of Engineered Construction and Mechanobiology, Institute of Mechanics, Chinese Academy of Sciences, Beijing 100190, People’s Republic of China
- NSF Science and Technology Center for Engineering MechanoBiology, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Iris E M de Jong
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
- NSF Science and Technology Center for Engineering MechanoBiology, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Kapish Gupta
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
- NSF Science and Technology Center for Engineering MechanoBiology, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Orit Waisbourd-Zinman
- Institute for Gastroenterology, Nutrition and Liver Diseases, Schneider Children’s Medical Center of Israel, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Adi Har-Zahav
- Institute for Gastroenterology, Nutrition and Liver Diseases, Schneider Children’s Medical Center of Israel, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Carol J Soroka
- Department of Internal Medicine, Section of Digestive Diseases and Liver Center, Yale University School of Medicine, New Haven, CT, United States of America
| | - James L Boyer
- Department of Internal Medicine, Section of Digestive Diseases and Liver Center, Yale University School of Medicine, New Haven, CT, United States of America
| | - Jessica Llewellyn
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
- NSF Science and Technology Center for Engineering MechanoBiology, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Chengyang Liu
- Department of Surgery, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Ali Naji
- Department of Surgery, University of Pennsylvania, Philadelphia, PA, United States of America
| | - William J Polacheck
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill, NC, United States of America
| | - Rebecca G Wells
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
- NSF Science and Technology Center for Engineering MechanoBiology, University of Pennsylvania, Philadelphia, PA, United States of America
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, PA, United States of America
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States of America
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Tian Q, Yang F, Jiang H, Bhattacharyya P, Xie T, Ali AA, Sun Y, You M. Imaging and detecting intercellular tensile forces in spheroids and embryoid bodies using lipid-modified DNA probes. Front Cell Dev Biol 2023; 11:1220079. [PMID: 37920824 PMCID: PMC10619156 DOI: 10.3389/fcell.2023.1220079] [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] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 10/09/2023] [Indexed: 11/04/2023] Open
Abstract
Cells continuously experience and respond to different physical forces that are used to regulate their physiology and functions. Our ability to measure these mechanical cues is essential for understanding the bases of various mechanosensing and mechanotransduction processes. While multiple strategies have been developed to study mechanical forces within two-dimensional (2D) cell culture monolayers, the force measurement at cell-cell junctions in real three-dimensional (3D) cell models is still pretty rare. Considering that in real biological systems, cells are exposed to forces from 3D directions, measuring these molecular forces in their native environment is thus highly critical for the better understanding of different development and disease processes. We have recently developed a type of DNA-based molecular probe for measuring intercellular tensile forces in 2D cell models. Herein, we will report the further development and first-time usage of these molecular tension probes to visualize and detect mechanical forces within 3D spheroids and embryoid bodies (EBs). These probes can spontaneously anchor onto live cell membranes via the attached lipid moieties. By varying the concentrations of these DNA probes and their incubation time, we have first characterized the kinetics and efficiency of probe penetration and loading onto tumor spheroids and stem cell EBs of different sizes. After optimization, we have further imaged and measured E-cadherin-mediated forces in these 3D spheroids and EBs for the first time. Our results indicated that these DNA-based molecular tension probes can be used to study the spatiotemporal distributions of target mechanotransduction processes. These powerful imaging tools may be potentially applied to fill the gap between ongoing research of biomechanics in 2D systems and that in real 3D cell complexes.
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Affiliation(s)
- Qian Tian
- Department of Chemistry, University of Massachusetts Amherst, Amherst, MA, United States
| | - Feiyu Yang
- Department of Mechanical and Industrial Engineering, University of Massachusetts Amherst, Amherst, MA, United States
| | - Han Jiang
- Department of Mechanical and Industrial Engineering, University of Massachusetts Amherst, Amherst, MA, United States
| | - Priyanka Bhattacharyya
- Department of Chemistry, University of Massachusetts Amherst, Amherst, MA, United States
| | - Tianfa Xie
- Department of Mechanical and Industrial Engineering, University of Massachusetts Amherst, Amherst, MA, United States
| | - Ahsan Ausaf Ali
- Department of Chemistry, University of Massachusetts Amherst, Amherst, MA, United States
| | - Yubing Sun
- Department of Mechanical and Industrial Engineering, University of Massachusetts Amherst, Amherst, MA, United States
- Molecular and Cellular Biology Program, University of Massachusetts Amherst, Amherst, MA, United States
| | - Mingxu You
- Department of Chemistry, University of Massachusetts Amherst, Amherst, MA, United States
- Molecular and Cellular Biology Program, University of Massachusetts Amherst, Amherst, MA, United States
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Zhang J, Katada K, Mosleh E, Yuhas A, Peng G, Golson ML. The leptin receptor has no role in delta-cell control of beta-cell function in the mouse. Front Endocrinol (Lausanne) 2023; 14:1257671. [PMID: 37850099 PMCID: PMC10577419 DOI: 10.3389/fendo.2023.1257671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 09/05/2023] [Indexed: 10/19/2023] Open
Abstract
Introduction Leptin inhibits insulin secretion from isolated islets from multiple species, but the cell type that mediates this process remains elusive. Several mouse models have been used to explore this question. Ablation of the leptin receptor (Lepr) throughout the pancreatic epithelium results in altered glucose homeostasis and ex vivo insulin secretion and Ca2+ dynamics. However, Lepr removal from neither alpha nor beta cells mimics this result. Moreover, scRNAseq data has revealed an enrichment of LEPR in human islet delta cells. Methods We confirmed LEPR upregulation in human delta cells by performing RNAseq on fixed, sorted beta and delta cells. We then used a mouse model to test whether delta cells mediate the diminished glucose-stimulated insulin secretion in response to leptin. Results Ablation of Lepr within mouse delta cells did not change glucose homeostasis or insulin secretion, whether mice were fed a chow or high-fat diet. We further show, using a publicly available scRNAseq dataset, that islet cells expressing Lepr lie within endothelial cell clusters. Conclusions In mice, leptin does not influence beta-cell function through delta cells.
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Affiliation(s)
- Jia Zhang
- Department of Genetics, University of Pennsylvania, Philadephia, PA, United States
| | - Kay Katada
- School of Medicine, University of Pennsylvania, Philadephia, PA, United States
| | - Elham Mosleh
- Department of Genetics, University of Pennsylvania, Philadephia, PA, United States
- School of Medicine, University of Pennsylvania, Philadephia, PA, United States
| | - Andrew Yuhas
- Department of Genetics, University of Pennsylvania, Philadephia, PA, United States
- School of Medicine, University of Pennsylvania, Philadephia, PA, United States
| | - Guihong Peng
- Department of Medicine, Divison of Endocrinology, Diabetes, and Metabolism, Johns Hopkins University, Baltimore, MD, United States
| | - Maria L. Golson
- Department of Genetics, University of Pennsylvania, Philadephia, PA, United States
- School of Medicine, University of Pennsylvania, Philadephia, PA, United States
- Department of Medicine, Divison of Endocrinology, Diabetes, and Metabolism, Johns Hopkins University, Baltimore, MD, United States
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Reyes M, Firat D, Hanna P, Khan M, Bruce M, Shvedova M, Kobayashi T, Schipani E, Gardella TJ, Jüppner H. Substantially Delayed Maturation of Growth Plate Chondrocytes in "Humanized" PTH1R Mice with the H223R Mutation of Jansen's Disease. JBMR Plus 2023; 7:e10802. [PMID: 37808400 PMCID: PMC10556264 DOI: 10.1002/jbm4.10802] [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: 03/20/2023] [Revised: 07/05/2023] [Accepted: 07/11/2023] [Indexed: 10/10/2023] Open
Abstract
Activating parathyroid hormone (PTH)/PTH-related Peptide (PTHrP) receptor (PTH1R) mutations causes Jansen's metaphyseal chondrodysplasia (JMC), a rare disease characterized by growth plate abnormalities, short stature, and PTH-independent hypercalcemia. Previously generated transgenic JMC mouse models, in which the human PTH1R allele with the H223R mutation (H223R-PTH1R) is expressed in osteoblasts via type Ia1 collagen or DMP1 promoters cause excess bone mass, while expression of the mutant allele via the type IIa1 collagen promoter results in only minor growth plate changes. Thus, neither transgenic JMC model adequately recapitulates the human disease. We therefore generated "humanized" JMC mice in which the H223R-PTH1R allele was expressed via the endogenous mouse Pth1r promoter and, thus, in all relevant target tissues. Founders with the H223R allele typically died within 2 months without reproducing; several mosaic male founders, however, lived longer and produced F1 H223R-PTH1R offspring, which were small and exhibited marked growth plate abnormalities. Serum calcium and phosphate levels of the mutant mice were not different from wild-type littermates, but serum PTH and P1NP were reduced significantly, while CTX-1 and CTX-2 were slightly increased. Histological and RNAscope analyses of the mutant tibial growth plates revealed markedly expanded zones of type II collagen-positive, proliferating/prehypertrophic chondrocytes, abundant apoptotic cells in the growth plate center and a progressive reduction of type X collagen-positive hypertrophic chondrocytes and primary spongiosa. The "humanized" H223R-PTH1R mice are likely to provide a more suitable model for defining the JMC phenotype and for assessing potential treatment options for this debilitating disease of skeletal development and mineral ion homeostasis. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Monica Reyes
- Endocrine UnitMassachusetts General Hospital and Harvard Medical SchoolBostonMAUSA
| | - Damla Firat
- Endocrine UnitMassachusetts General Hospital and Harvard Medical SchoolBostonMAUSA
| | - Patrick Hanna
- Endocrine UnitMassachusetts General Hospital and Harvard Medical SchoolBostonMAUSA
| | - Mohd Khan
- Department of Orthopedic SurgeryUniversity of Pennsylvania, Perelman Medical SchoolPhiladelphiaPAUSA
| | - Michael Bruce
- Endocrine UnitMassachusetts General Hospital and Harvard Medical SchoolBostonMAUSA
| | - Maria Shvedova
- Endocrine UnitMassachusetts General Hospital and Harvard Medical SchoolBostonMAUSA
| | - Tatsuya Kobayashi
- Endocrine UnitMassachusetts General Hospital and Harvard Medical SchoolBostonMAUSA
| | - Ernestina Schipani
- Department of Orthopedic SurgeryUniversity of Pennsylvania, Perelman Medical SchoolPhiladelphiaPAUSA
| | - Thomas J. Gardella
- Endocrine UnitMassachusetts General Hospital and Harvard Medical SchoolBostonMAUSA
| | - Harald Jüppner
- Endocrine UnitMassachusetts General Hospital and Harvard Medical SchoolBostonMAUSA
- Pediatric Nephrology UnitMassachusetts General Hospital and Harvard Medical SchoolBostonMAUSA
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Tavares LC, Zheng T, Kwicklis M, Mitchell E, Pandit A, Pullapantula S, Bernard C, Teder‐Laving M, Marques FZ, Esko T, Kuo B, Shulman RJ, Chumpitazi BP, Koch KL, Sarosiek I, Abell TL, McCallum RW, Parkman HP, Pasricha PJ, Hamilton FA, Tonascia J, Zawistowski M, Farrugia G, Grover M, D’Amato M. A pilot genome-wide association study meta-analysis of gastroparesis. United European Gastroenterol J 2023; 11:784-796. [PMID: 37688361 PMCID: PMC10576603 DOI: 10.1002/ueg2.12453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 06/15/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Gastroparesis (GP) is characterized by delayed gastric emptying in the absence of mechanical obstruction. OBJECTIVE Genetic predisposition may play a role; however, investigation at the genome-wide level has not been performed. METHODS We carried out a genome-wide association study (GWAS) meta-analysis on (i) 478 GP patients from the National Institute of Diabetes and Digestive and Kidney Diseases Gastroparesis Clinical Research Consortium (GpCRC) compared to 9931 population-based controls from the University of Michigan Health and Retirement Study; and (ii) 402 GP cases compared to 48,340 non-gastroparesis controls from the Michigan Genomics Initiative. Associations for 5,811,784 high-quality SNPs were tested on a total of 880 GP patients and 58,271 controls, using logistic mixed models adjusted for age, sex, and principal components. Gene mapping was obtained based on genomic position and expression quantitative trait loci, and a gene-set network enrichment analysis was performed. Genetic associations with clinical data were tested in GpCRC patients. Protein expression of selected candidate genes was determined in full thickness gastric biopsies from GpCRC patients and controls. RESULTS While no SNP associations were detected at strict significance (p ≤ 5 × 10-8 ), nine independent genomic loci were associated at suggestive significance (p ≤ 1 × 10-5 ), with the strongest signal (rs9273363, odds ratio = 1.4, p = 1 × 10-7 ) mapped to the human leukocyte antigen region. Computational annotation of suggestive risk loci identified 14 protein-coding candidate genes. Gene-set network enrichment analysis revealed pathways potentially involved in immune and motor dysregulation (pFDR ≤ 0.05). The GP risk allele rs6984536A (Peroxidasin-Like; PXDNL) was associated with increased abdominal pain severity scores (Beta = 0.13, p = 0.03). Gastric muscularis expression of PXDNL also positively correlated with abdominal pain in GP patients (r = 0.8, p = 0.02). Dickkopf WNT Signaling Pathway Inhibitor 1 showed decreased expression in diabetic GP patients (p = 0.005 vs. controls). CONCLUSION We report preliminary GWAS findings for GP, which highlight candidate genes and pathways related to immune and sensory-motor dysregulation. Larger studies are needed to validate and expand these findings in independent datasets.
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Affiliation(s)
| | - Tenghao Zheng
- School of Biological SciencesMonash UniversityMelbourneVictoriaAustralia
| | - Madeline Kwicklis
- Department of BiostatisticsUniversity of MichiganAnn ArborMichiganUSA
| | - Emily Mitchell
- Johns Hopkins University Bloomberg School of Public HealthJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Anita Pandit
- Department of BiostatisticsUniversity of MichiganAnn ArborMichiganUSA
| | | | | | | | - Francine Z. Marques
- School of Biological SciencesMonash UniversityMelbourneVictoriaAustralia
- Heart Failure Research GroupBaker Heart and Diabetes InstituteMelbourneVictoriaAustralia
| | - Tonu Esko
- Institute of GenomicsUniversity of TartuTartuEstonia
| | - Braden Kuo
- Massachusetts General HospitalBostonMassachusettsUSA
| | | | | | | | - Irene Sarosiek
- Texas Tech University Health Sciences CenterEl PasoTexasUSA
| | | | | | | | | | - Frank A. Hamilton
- National Institute of Diabetes and Digestive and Kidney DiseasesBethesdaMarylandUSA
| | - James Tonascia
- Johns Hopkins University Bloomberg School of Public HealthJohns Hopkins UniversityBaltimoreMarylandUSA
| | | | | | | | - Mauro D’Amato
- School of Biological SciencesMonash UniversityMelbourneVictoriaAustralia
- Gastrointestinal Genetics LabCIC BioGUNE—BRTADerioSpain
- IkerbasqueBasque Foundation for ScienceBilbaoSpain
- Department of Medicine and SurgeryLUM UniversityCasamassimaItaly
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Lin YK, Tanner E, Wang Y, Ye W, Ang L, Ju W, Pop‐Busui R. Urinary epidermal growth factor levels correlate with cardiovascular autonomic neuropathy indices in adults with type 1 diabetes. J Diabetes Investig 2023; 14:1183-1186. [PMID: 37395013 PMCID: PMC10512902 DOI: 10.1111/jdi.14049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 05/31/2023] [Accepted: 06/16/2023] [Indexed: 07/04/2023] Open
Abstract
The relationship between urinary endothelial growth factor (uEGF) and cardiovascular autonomic neuropathy (CAN) in adults with type 1 diabetes was evaluated. uEGF levels at baseline and standardized CAN measures were collected at baseline and annually for 3 years for type 1 diabetes adults. Linear regression analysis and linear mixed effects model were used for analysis. In this cohort (n = 44, 59% women, mean ± standard deviation age 34 ± 13 years and diabetes duration 14 ± 6 years), lower baseline uEGF levels correlated with lower baseline expiration : inspiration ratios (P = 0.03) and greater annual declines in Valsalva ratios (P = 0.02) in the unadjusted model, and correlated with lower low-frequency power : high-frequency power ratios (P = 0.01) and greater annual changes in low-frequency power : high-frequency power ratios (P = 0.01) after adjustment for age, sex, body mass index, and hemoglobin A1C. In conclusion, baseline uEGF levels correlate to baseline and longitudinal changes in CAN indices. A large-scale, long-term study is needed to validate uEGF as a reliable CAN biomarker.
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Affiliation(s)
- Yu Kuei Lin
- Division of Metabolism, Endocrinology and Diabetes, Department of Internal MedicineUniversity of MichiganAnn ArborMichiganUSA
| | - Emily Tanner
- Division of Nephrology, Department of Internal MedicineUniversity of MichiganAnn ArborMichiganUSA
| | - Yuee Wang
- Division of Nephrology, Department of Internal MedicineUniversity of MichiganAnn ArborMichiganUSA
| | - Wen Ye
- Department of Biostatistics, School of Public HealthUniversity of MichiganAnn ArborMichiganUSA
| | - Lynn Ang
- Division of Metabolism, Endocrinology and Diabetes, Department of Internal MedicineUniversity of MichiganAnn ArborMichiganUSA
| | - Wenjun Ju
- Division of Nephrology, Department of Internal MedicineUniversity of MichiganAnn ArborMichiganUSA
| | - Rodica Pop‐Busui
- Division of Metabolism, Endocrinology and Diabetes, Department of Internal MedicineUniversity of MichiganAnn ArborMichiganUSA
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