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Osazuwa-Peters OL, Deveaux A, Muehlbauer MJ, Ilkayeva O, Bain JR, Keku T, Berchuck A, Huang B, Ward K, Gates Kuliszewski M, Akinyemiju T. Racial Differences in Vaginal Fluid Metabolites and Association with Systemic Inflammation Markers among Ovarian Cancer Patients: A Pilot Study. Cancers (Basel) 2024; 16:1259. [PMID: 38610937 PMCID: PMC11011195 DOI: 10.3390/cancers16071259] [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: 02/16/2024] [Revised: 03/11/2024] [Accepted: 03/20/2024] [Indexed: 04/14/2024] Open
Abstract
The vaginal microbiome differs by race and contributes to inflammation by directly producing or consuming metabolites or by indirectly inducing host immune response, but its potential contributions to ovarian cancer (OC) disparities remain unclear. In this exploratory cross-sectional study, we examine whether vaginal fluid metabolites differ by race among patients with OC, if they are associated with systemic inflammation, and if such associations differ by race. Study participants were recruited from the Ovarian Cancer Epidemiology, Healthcare Access, and Disparities Study between March 2021 and September 2022. Our study included 36 study participants with ovarian cancer who provided biospecimens; 20 randomly selected White patients and all 16 eligible Black patients, aged 50-70 years. Acylcarnitines (n = 45 species), sphingomyelins (n = 34), and ceramides (n = 21) were assayed on cervicovaginal fluid, while four cytokines (IL-1β, IL-10, TNF-α, and IL-6) were assayed on saliva. Seven metabolites showed >2-fold differences, two showed significant differences using the Wilcoxon rank-sum test (p < 0.05; False Discovery Rate > 0.05), and 30 metabolites had coefficients > ±0.1 in a Penalized Discriminant Analysis that achieved two distinct clusters by race. Arachidonoylcarnitine, the carnitine adduct of arachidonic acid, appeared to be consistently different by race. Thirty-eight vaginal fluid metabolites were significantly correlated with systemic inflammation biomarkers, irrespective of race. These findings suggest that vaginal fluid metabolites may differ by race, are linked with systemic inflammation, and hint at a potential role for mitochondrial dysfunction and sphingolipid metabolism in OC disparities. Larger studies are needed to verify these findings and further establish specific biological mechanisms that may link the vaginal microbiome with OC racial disparities.
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Affiliation(s)
- Oyomoare L. Osazuwa-Peters
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC 27701, USA; (A.D.); (T.A.)
| | - April Deveaux
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC 27701, USA; (A.D.); (T.A.)
| | - Michael J. Muehlbauer
- Duke University School of Medicine, Duke Molecular Physiology Institute, Durham, NC 27701, USA; (M.J.M.); (O.I.); (J.R.B.)
| | - Olga Ilkayeva
- Duke University School of Medicine, Duke Molecular Physiology Institute, Durham, NC 27701, USA; (M.J.M.); (O.I.); (J.R.B.)
- Division of Endocrinology, Metabolism, and Nutrition, Department of Medicine, Duke University School of Medicine, Durham, NC 27710, USA
| | - James R. Bain
- Duke University School of Medicine, Duke Molecular Physiology Institute, Durham, NC 27701, USA; (M.J.M.); (O.I.); (J.R.B.)
- Division of Endocrinology, Metabolism, and Nutrition, Department of Medicine, Duke University School of Medicine, Durham, NC 27710, USA
| | - Temitope Keku
- Division of Gastroenterology and Hepatology, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA;
| | - Andrew Berchuck
- Duke Division of Gynecologic Oncology, Duke University School of Medicine, Durham, NC 27710, USA;
| | - Bin Huang
- Kentucky Cancer Registry, University of Kentucky, Lexington, KY 40506, USA;
| | - Kevin Ward
- Georgia Cancer Registry, Emory University, Atlanta, GA 30322, USA;
| | | | - Tomi Akinyemiju
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC 27701, USA; (A.D.); (T.A.)
- Duke Cancer Institute, Duke University School of Medicine, Durham, NC 27710, USA
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Mao X, Omeogu C, Karanth S, Joshi A, Meernik C, Wilson L, Clark A, Deveaux A, He C, Johnson T, Barton K, Kaplan S, Akinyemiju T. Association of reproductive risk factors and breast cancer molecular subtypes: a systematic review and meta-analysis. BMC Cancer 2023; 23:644. [PMID: 37430191 DOI: 10.1186/s12885-023-11049-0] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 06/08/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Associations between reproductive factors and breast cancer (BC) risk vary by molecular subtype (i.e., luminal A, luminal B, HER2, and triple negative/basal-like [TNBC]). In this systematic review and meta-analysis, we summarized the associations between reproductive factors and BC subtypes. METHODS Studies from 2000 to 2021 were included if BC subtype was examined in relation to one of 11 reproductive risk factors: age at menarche, age at menopause, age at first birth, menopausal status, parity, breastfeeding, oral contraceptive (OC) use, hormone replacement therapy (HRT), pregnancy, years since last birth and abortion. For each reproductive risk factor, BC subtype, and study design (case-control/cohort or case-case), random-effects models were used to estimate pooled relative risks and 95% confidence intervals. RESULTS A total of 75 studies met the inclusion criteria for systematic review. Among the case-control/cohort studies, later age at menarche and breastfeeding were consistently associated with decreased risk of BC across all subtypes, while later age at menopause, later age of first childbirth, and nulliparity/low parity were associated with increased risk of luminal A, luminal B, and HER2 subtypes. In the case-only analysis, compared to luminal A, postmenopausal status increased the risk of HER2 and TNBC. Associations were less consistent across subtypes for OC and HRT use. CONCLUSION Identifying common risk factors across BC subtypes can enhance the tailoring of prevention strategies, and risk stratification models can benefit from subtype specificity. Adding breastfeeding status to current BC risk prediction models can enhance predictive ability, given the consistency of the associations across subtypes.
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Affiliation(s)
- Xihua Mao
- Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, KY, USA
| | - Chioma Omeogu
- Department of Population Health Sciences, School of Medicine, Duke University, Durham, NC, USA
| | - Shama Karanth
- UF Health Cancer Canter, University of Florida, Gainesville, FL, USA
| | - Ashwini Joshi
- Department of Population Health Sciences, School of Medicine, Duke University, Durham, NC, USA
| | - Clare Meernik
- Department of Population Health Sciences, School of Medicine, Duke University, Durham, NC, USA
| | - Lauren Wilson
- Department of Population Health Sciences, School of Medicine, Duke University, Durham, NC, USA
| | - Amy Clark
- Department of Population Health Sciences, School of Medicine, Duke University, Durham, NC, USA
| | - April Deveaux
- Department of Population Health Sciences, School of Medicine, Duke University, Durham, NC, USA
| | - Chunyan He
- The Cancer Prevention and Control Research Program, University of Kentucky Markey Cancer Center, Lexington, KY, USA
| | - Tisha Johnson
- Department of Preventive Medicine and Environmental Health, College of Public Health, University of Kentucky, Lexington, KY, USA
| | - Karen Barton
- Duke University Medical Center Library & Archives, Duke University School of Medicine, Durham, NC, USA
| | - Samantha Kaplan
- Duke University Medical Center Library & Archives, Duke University School of Medicine, Durham, NC, USA
| | - Tomi Akinyemiju
- Department of Population Health Sciences, School of Medicine, Duke University, Durham, NC, USA.
- Duke Cancer Institute, Duke University, Durham, NC, USA.
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Akinyemiju TF, Wilson LE, Diaz N, Gupta A, Huang B, Pisu M, Deveaux A, Liang M, Previs RA, Moss HA, Joshi A, Ward KC, Schymura MJ, Berchuck A, Potosky AL. Associations of Healthcare Affordability, Availability, and Accessibility with Quality Treatment Metrics in Patients with Ovarian Cancer. Cancer Epidemiol Biomarkers Prev 2022; 31:1383-1393. [PMID: 35477150 PMCID: PMC9250633 DOI: 10.1158/1055-9965.epi-21-1227] [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: 11/02/2021] [Revised: 02/02/2022] [Accepted: 04/18/2022] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Differential access to quality care is associated with racial disparities in ovarian cancer survival. Few studies have examined the association of multiple healthcare access (HCA) dimensions with racial disparities in quality treatment metrics, that is, primary debulking surgery performed by a gynecologic oncologist and initiation of guideline-recommended systemic therapy. METHODS We analyzed data for patients with ovarian cancer diagnosed from 2008 to 2015 in the Surveillance, Epidemiology, and End Results-Medicare database. We defined HCA dimensions as affordability, availability, and accessibility. Modified Poisson regressions with sandwich error estimation were used to estimate the relative risk (RR) for quality treatment. RESULTS The study cohort was 7% NH-Black, 6% Hispanic, and 87% NH-White. Overall, 29% of patients received surgery and 68% initiated systemic therapy. After adjusting for clinical variables, NH-Black patients were less likely to receive surgery [RR, 0.83; 95% confidence interval (CI), 0.70-0.98]; the observed association was attenuated after adjusting for healthcare affordability, accessibility, and availability (RR, 0.91; 95% CI, 0.77-1.08). Dual enrollment in Medicaid and Medicare compared with Medicare only was associated with lower likelihood of receiving surgery (RR, 0.86; 95% CI, 0.76-0.97) and systemic therapy (RR, 0.94; 95% CI, 0.92-0.97). Receiving treatment at a facility in the highest quartile of ovarian cancer surgical volume was associated with higher likelihood of surgery (RR, 1.12; 95% CI, 1.04-1.21). CONCLUSIONS Racial differences were observed in ovarian cancer treatment quality and were partly explained by multiple HCA dimensions. IMPACT Strategies to mitigate racial disparities in ovarian cancer treatment quality must focus on multiple HCA dimensions. Additional dimensions, acceptability and accommodation, may also be key to addressing disparities.
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Affiliation(s)
- Tomi F. Akinyemiju
- Department of Population Health Sciences, Duke University School of Medicine, Durham NC
- Duke Cancer Institute, Duke University School of Medicine, Durham NC
| | - Lauren E. Wilson
- Department of Population Health Sciences, Duke University School of Medicine, Durham NC
| | - Nicole Diaz
- Department of Population Health Sciences, Duke University School of Medicine, Durham NC
| | - Anjali Gupta
- Department of Population Health Sciences, Duke University School of Medicine, Durham NC
| | - Bin Huang
- Department of Biostatistics and Kentucky Cancer Registry, Univ of Kentucky, Lexington KY
| | - Maria Pisu
- Division of Preventive Medicine and O’Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL
| | - April Deveaux
- Department of Population Health Sciences, Duke University School of Medicine, Durham NC
| | - Margaret Liang
- Division of Preventive Medicine and O’Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL
- Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, University of Alabama at Birmingham, Birmingham, AL
| | - Rebecca A. Previs
- Division of Gynecologic Oncology, Duke Cancer Institute, Duke University School of Medicine, Durham NC
| | - Haley A. Moss
- Division of Gynecologic Oncology, Duke Cancer Institute, Duke University School of Medicine, Durham NC
| | - Ashwini Joshi
- Department of Population Health Sciences, Duke University School of Medicine, Durham NC
| | - Kevin C. Ward
- Georgia Cancer Registry, Emory University, Atlanta GA
| | - Maria J. Schymura
- New York State Cancer Registry, New York State Department of Health, Albany NY
| | - Andrew Berchuck
- Division of Gynecologic Oncology, Duke Cancer Institute, Duke University School of Medicine, Durham NC
| | - Arnold L. Potosky
- Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington DC
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Gupta A, Saraiya V, Deveaux A, Oyekunle T, Jackson KD, Salako O, Daramola A, Hall A, Alatise O, Ogun G, Adeniyi A, Ayandipo O, Olajide T, Olasehinde O, Arowolo O, Adisa A, Afuwape O, Olusanya A, Adegoke A, Tollefsbol TO, Arnett D, Muehlbauer MJ, Newgard CB, Akinyemiju T. Association of lipid profile biomarkers with breast cancer by molecular subtype: analysis of the MEND study. Sci Rep 2022; 12:10631. [PMID: 35739205 PMCID: PMC9226351 DOI: 10.1038/s41598-022-13740-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 05/27/2022] [Indexed: 02/07/2023] Open
Abstract
There is conflicting evidence on the role of lipid biomarkers in breast cancer (BC), and no study to our knowledge has examined this association among African women. We estimated odds ratios (ORs) and 95% confidence intervals (95% CI) for the association of lipid biomarkers-total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglycerides-with odds of BC overall and by subtype (Luminal A, Luminal B, HER2-enriched and triple-negative or TNBC) for 296 newly diagnosed BC cases and 116 healthy controls in Nigeria. Each unit standard deviation (SD) increase in triglycerides was associated with 39% increased odds of BC in fully adjusted models (aOR: 1.39; 95% CI: 1.03, 1.86). Among post-menopausal women, higher total cholesterol (aOR: 1.65; 95% CI: 1.06, 2.57), LDL cholesterol (aOR: 1.59; 95% CI: 1.04, 2.41), and triglycerides (aOR: 1.91; 95% CI: 1.21, 3.01) were associated with increased odds of BC. Additionally, each unit SD increase in LDL was associated with 64% increased odds of Luminal B BC (aOR 1.64; 95% CI: 1.06, 2.55). Clinically low HDL was associated with 2.7 times increased odds of TNBC (aOR 2.67; 95% CI: 1.10, 6.49). Among post-menopausal women, higher LDL cholesterol and triglycerides were significantly associated with increased odds of Luminal B BC and HER2 BC, respectively. In conclusion, low HDL and high LDL are associated with increased odds of TN and Luminal B BC, respectively, among African women. Future prospective studies can definitively characterize this association and inform clinical approaches targeting HDL as a BC prevention strategy.
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Affiliation(s)
- Anjali Gupta
- Trinity College of Arts and Sciences, Duke University, Durham, NC, USA
- Department of Population Health Sciences, School of Medicine, Duke University, 215 Morris Street, Durham, NC, 27708, USA
| | - Veeral Saraiya
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - April Deveaux
- Department of Population Health Sciences, School of Medicine, Duke University, 215 Morris Street, Durham, NC, 27708, USA
| | - Taofik Oyekunle
- Department of Population Health Sciences, School of Medicine, Duke University, 215 Morris Street, Durham, NC, 27708, USA
| | - Klarissa D Jackson
- Divison of Pharmacotherapy and Experimental Therapeutics, University of North Carolina at Chapel Hill Eshelman School of Pharmacy, Chapel Hill, NC, USA
| | - Omolola Salako
- College of Medicine &, Lagos University Teaching Hospital, University of Lagos, Lagos, Lagos State, Nigeria
| | - Adetola Daramola
- College of Medicine &, Lagos University Teaching Hospital, University of Lagos, Lagos, Lagos State, Nigeria
| | - Allison Hall
- Department of Pathology, School of Medicine, Duke University, Durham, NC, USA
| | - Olusegun Alatise
- Obafemi Awolowo University Teaching Hospital, Ile-Ife, Osun State, Nigeria
| | - Gabriel Ogun
- Unversity College Hospital, University of Ibadan, Ibadan, Oyo State, Nigeria
| | | | - Omobolaji Ayandipo
- Unversity College Hospital, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Thomas Olajide
- College of Medicine &, Lagos University Teaching Hospital, University of Lagos, Lagos, Lagos State, Nigeria
| | | | - Olukayode Arowolo
- Obafemi Awolowo University Teaching Hospital, Ile-Ife, Osun State, Nigeria
| | - Adewale Adisa
- Obafemi Awolowo University Teaching Hospital, Ile-Ife, Osun State, Nigeria
| | - Oludolapo Afuwape
- Unversity College Hospital, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Aralola Olusanya
- Unversity College Hospital, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Aderemi Adegoke
- Our Lady of Apostle Catholic Hospital, Ibadan, Oyo State, Nigeria
| | | | - Donna Arnett
- College of Public Health, University of Kentucky, Lexington, KY, USA
| | | | | | - Tomi Akinyemiju
- Department of Population Health Sciences, School of Medicine, Duke University, 215 Morris Street, Durham, NC, 27708, USA.
- Duke Cancer Institute, School of Medicine, Duke University, Durham, NC, USA.
- Duke Global Health Institute, Duke University, Durham, NC, USA.
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Deveaux A, Islam J, Akinyemiju T. Abstract PO-113: Overall survival in ovarian cancer patients seeking care at more than one treatment facility. Cancer Epidemiol Biomarkers Prev 2022. [DOI: 10.1158/1538-7755.disp21-po-113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
Purpose: Ovarian cancer is the most lethal gynecological cancer and despite advances in treatment, most patients are diagnosed at an advanced stage with poor prognosis. Black women have a lower 5 year survival than White women when diagnosed at the same stage, and while there are a number of contributing factors, quality of treatment center may play a significant role. Choice in treatment facility may be limited by insurance coverage, availability of high-volume hospitals or specialists, or ability to access high-quality facilities, and it is unclear how a change in treatment facility may impact ovarian cancer survival. Methods: Participant usage files from the National Cancer Database were used to interrogate the characteristics of patients that seek treatment at more than one Commission on Cancer accredited facility in the United States to determine the effect on overall survival. Multivariable Cox regression analysis models were used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CI) to determine risk of mortality for patients receiving all of their first course treatment at one facility vs those receiving first course treatment at more than one facility. The fully-adjusted model was then stratified by race/ethnicity (Non-Hispanic White, Non-Hispanic Black, Hispanic) and by facility type (Community, Comprehensive Community, Academic/Research, Integrative Network). Results: A total of 211,937 women were included in the analysis. Patients were more likely to receive all of their first course treatment at one facility (81%). Patents treated at more than one facility had a 26% increase in ovarian cancer mortality compared with those treated at a single facility (HR: 1.26, 95% CI: 1.24-1.28). When stratified by race, NH-Black patients had the lowest increase in overall survival (HR: 1.08, 95% CI: 1.03-1.14) when compared with NH-White (HR: 1.27, 95% CI: 1.25-1.29) and Hispanic (HR: 1.33, 95% CI: 1.28-1.39) patients. Stratification by facility type showed that among women receiving treatment at more than one facility, those switching to an academic research center had the highest mortality (HR: 1.31, 95% CI: 1.28-1.34). Conclusions: Ovarian cancer patients that received treatment at more than one facility had a higher rate of mortality than those who were treated at a single center. Our findings suggest the need for further investigation into the effects of continuity of care, including how race, facility type, and other socioeconomic factors may modulate those effects.
Citation Format: April Deveaux, Jessica Islam, Tomi Akinyemiju. Overall survival in ovarian cancer patients seeking care at more than one treatment facility [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-113.
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Akinyemiju T, Oyekunle T, Salako O, Gupta A, Alatise O, Ogun G, Adeniyi A, Deveaux A, Hall A, Ayandipo O, Olajide T, Olasehinde O, Arowolo O, Adisa A, Afuwape O, Olusanya A, Adegoke A, Tollefsbol TO, Arnett D, Muehlbauer MJ, Newgard CB, Daramola A. Metabolic Syndrome and Risk of Breast Cancer by Molecular Subtype: Analysis of the MEND Study. Clin Breast Cancer 2021; 22:e463-e472. [PMID: 34980540 PMCID: PMC9641637 DOI: 10.1016/j.clbc.2021.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 11/06/2021] [Accepted: 11/15/2021] [Indexed: 12/17/2022]
Abstract
Metabolic syndrome is a cluster of biological irregularities that is a known risk factor for cardiovascular disease, stroke, and diabetes. In a case-control study of 555 West African women, we observed that metabolic syndrome was strongly associated with breast cancer and the aggressive triple-negative molecular subtype, highlighting a need for clinical and lifestyle interventions targeting metabolic syndrome to reduce breast cancer risk in this population.
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Affiliation(s)
- Tomi Akinyemiju
- Department of Population Health Sciences, School of Medicine, Duke University, Durham, NC; Duke Cancer Institute, School of Medicine, Duke University, Durham, NC; Duke Global Health Institute, Duke University, Durham, NC.
| | - Taofik Oyekunle
- Department of Population Health Sciences, School of Medicine, Duke University, Durham, NC
| | - Omolola Salako
- College of Medicine and Lagos University Teaching Hospital, University of Lagos, Lagos, Nigeria
| | - Anjali Gupta
- Department of Population Health Sciences, School of Medicine, Duke University, Durham, NC
| | - Olusegun Alatise
- Obafemi Awolowo University Teaching Hospital, Ile-Ife, Osun State, Nigeria
| | - Gabriel Ogun
- Unversity College Hospital, University of Ibadan, Ibadan, Oyo State, Nigeria
| | | | - April Deveaux
- Department of Population Health Sciences, School of Medicine, Duke University, Durham, NC
| | - Allison Hall
- Department of Pathology, School of Medicine, Duke University, Durham, NC
| | - Omobolaji Ayandipo
- Unversity College Hospital, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Thomas Olajide
- College of Medicine and Lagos University Teaching Hospital, University of Lagos, Lagos, Nigeria
| | | | - Olukayode Arowolo
- Obafemi Awolowo University Teaching Hospital, Ile-Ife, Osun State, Nigeria
| | - Adewale Adisa
- Obafemi Awolowo University Teaching Hospital, Ile-Ife, Osun State, Nigeria
| | - Oludolapo Afuwape
- Unversity College Hospital, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Aralola Olusanya
- Unversity College Hospital, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Aderemi Adegoke
- Our Lady of Apostle Catholic Hospital, Ibadan, Oyo State, Nigeria
| | | | - Donna Arnett
- College of Public Health, University of Kentucky, Lexington, KY
| | - Michael J Muehlbauer
- Duke Molecular Physiology Institute, School of Medicine, Duke University, Durham, NC
| | - Christopher B Newgard
- Duke Molecular Physiology Institute, School of Medicine, Duke University, Durham, NC
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- University of Kansas Medical Center, Kansas City, KS
| | - Adetola Daramola
- College of Medicine and Lagos University Teaching Hospital, University of Lagos, Lagos, Nigeria; University of Kansas Medical Center, Kansas City, KS
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Akinyemiju T, Deveaux A, Wilson L, Gupta A, Joshi A, Bevel M, Omeogu C, Ohamadike O, Huang B, Pisu M, Liang M, McFatrich M, Daniell E, Fish LJ, Ward K, Schymura M, Berchuck A, Potosky AL. Ovarian Cancer Epidemiology, Healthcare Access and Disparities (ORCHiD): methodology for a population-based study of black, Hispanic and white patients with ovarian cancer. BMJ Open 2021; 11:e052808. [PMID: 34607872 PMCID: PMC8491419 DOI: 10.1136/bmjopen-2021-052808] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 09/10/2021] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Less than 40% of patients with ovarian cancer (OC) in the USA receive stage-appropriate guideline-adherent surgery and chemotherapy. Black patients with cancer report greater depression, pain and fatigue than white patients. Lack of access to healthcare likely contributes to low treatment rates and racial differences in outcomes. The Ovarian Cancer Epidemiology, Healthcare Access and Disparities study aims to characterise healthcare access (HCA) across five specific dimensions-Availability, Affordability, Accessibility, Accommodation and Acceptability-among black, Hispanic and white patients with OC, evaluate the impact of HCA on quality of treatment, supportive care and survival, and explore biological mechanisms that may contribute to OC disparities. METHODS AND ANALYSIS We will use the Surveillance Epidemiology and Ends Results dataset linked with Medicare claims data from 9744 patients with OC ages 65 years and older. We will recruit 1641 patients with OC (413 black, 299 Hispanic and 929 white) from cancer registries in nine US states. We will examine HCA dimensions in relation to three main outcomes: (1) receipt of quality, guideline adherent initial treatment and supportive care, (2) quality of life based on patient-reported outcomes and (3) survival. We will obtain saliva and vaginal microbiome samples to examine prognostic biomarkers. We will use hierarchical regression models to estimate the impact of HCA dimensions across patient, neighbourhood, provider and hospital levels, with random effects to account for clustering. Multilevel structural equation models will estimate the total, direct and indirect effects of race on treatment mediated through HCA dimensions. ETHICS AND DISSEMINATION Result dissemination will occur through presentations at national meetings and in collaboration with collaborators, community partners and colleagues across othercancer centres. We will disclose findings to key stakeholders, including scientists, providers and community members. This study has been approved by the Duke Institutional Review Board (Pro00101872). Safety considerations include protection of patient privacy. All disseminated data will be deidentified and summarised.
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Affiliation(s)
- Tomi Akinyemiju
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
- Duke University School of Medicine, Duke Cancer Institute, Durham, North Carolina, USA
| | - April Deveaux
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Lauren Wilson
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Anjali Gupta
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Ashwini Joshi
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Malcolm Bevel
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Chioma Omeogu
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Onyinye Ohamadike
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Bin Huang
- Department of Biostatistics and Kentucky Cancer Registry, University of Kentucky, Lexington, Kentucky, USA
| | - Maria Pisu
- Division of Preventive Medicine, The University of Alabama, Birmingham, Alabama, USA
| | - Margaret Liang
- Division of Preventive Medicine, The University of Alabama, Birmingham, Alabama, USA
- Division of Hematology and Supportive Care, University of Alabama, Birmingham, Alabama, USA
| | - Molly McFatrich
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Erin Daniell
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Laura Jane Fish
- Duke University School of Medicine, Duke Cancer Institute, Durham, North Carolina, USA
| | - Kevin Ward
- Georgia Cancer Registry, Emory University, Atlanta, Georgia, USA
| | - Maria Schymura
- New York State Cancer Registry, New York State Department of Health, Albany, New York, USA
| | - Andrew Berchuck
- Division of Gynecologic Oncology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Arnold L Potosky
- Georgetown University Medical Center, Washington, District of Columbia, USA
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Akinyemiju T, Jones K, Gupta A, Oyekunle T, Saraiya V, Deveaux A, Salako O, Hall A, Alatise O, Ogun G, Adeniyi A, Ayandipo O, Olajide T, Olasehinde O, Arowolo O, Adisa A, Afuwape O, Olusanya A, Adegoke A, Tollefsbol TO, Arnett D, Daramola A. Association of body composition with odds of breast cancer by molecular subtype: analysis of the Mechanisms for Established and Novel Risk Factors for Breast Cancer in Nigerian Women (MEND) study. BMC Cancer 2021; 21:1051. [PMID: 34563146 PMCID: PMC8464100 DOI: 10.1186/s12885-021-08775-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 08/31/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND The association between obesity and breast cancer (BC) has been extensively studied among US, European and Asian study populations, with often conflicting evidence. However, despite the increasing prevalence of obesity and associated conditions in Africa, the continent with the highest age-standardized BC mortality rate globally, few studies have evaluated this association, and none has examined in relation to molecular subtypes among African women. The current analysis examines the association between body composition, defined by body mass index (BMI), height, and weight, and BC by molecular subtype among African women. METHODS We estimated odds ratios (ORs) and 95% confidence intervals (95% CI) for the association between measures of body composition and BC and molecular subtypes among 419 histologically confirmed cases of BC and 286 healthy controls from the Mechanisms for Established and Novel Risk Factors for Breast Cancer in Women of Nigerian Descent (MEND) case-control study. RESULTS Higher BMI (aOR: 0.79; 95% CI: 0.67, 0.95) and weight (aOR: 0.83; 95% CI: 0.69, 0.98) were associated with reduced odds of BC in adjusted models, while height was associated with non-statistically significant increased odds of BC (aOR: 1.07, 95% CI: 0.90, 1.28). In pre/peri-menopausal, but not post-menopausal women, both higher BMI and weight were significantly associated with reduced odds of BC. Further, higher BMI was associated with reduced odds of Luminal A, Luminal B, and HER2-enriched BC among pre/peri-menopausal women, and reduced odds of triple-negative BC among post-menopausal women. CONCLUSIONS Higher BMI and weight were associated with reduced odds of BC overall and by molecular subtype among West African women. Larger studies of women of African descent are needed to definitively characterize these associations and inform cancer prevention strategies.
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Affiliation(s)
- Tomi Akinyemiju
- Department of Population Health Sciences, School of Medicine, Duke University, Durham, NC, USA.
- Duke Cancer Institute, School of Medicine, Duke University, Durham, NC, USA.
- Duke Global Health Institute, Duke University, Durham, NC, USA.
| | - Kelley Jones
- Department of Population Health Sciences, School of Medicine, Duke University, Durham, NC, USA
| | - Anjali Gupta
- Department of Population Health Sciences, School of Medicine, Duke University, Durham, NC, USA
- Trinity College of Arts and Sciences, Duke University, Durham, NC, USA
| | - Taofik Oyekunle
- Department of Population Health Sciences, School of Medicine, Duke University, Durham, NC, USA
| | - Veeral Saraiya
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - April Deveaux
- Department of Population Health Sciences, School of Medicine, Duke University, Durham, NC, USA
| | - Omolola Salako
- College of Medicine & Lagos University Teaching Hospital, University of Lagos, Lagos, Lagos State, Nigeria
| | - Allison Hall
- Department of Pathology, School of Medicine, Duke University, Durham, NC, USA
| | - Olusegun Alatise
- Obafemi Awolowo University Teaching Hospital, Ile-Ife, Osun State, Nigeria
| | - Gabriel Ogun
- University College Hospital, University of Ibadan, Ibadan, Oyo State, Nigeria
| | | | - Omobolaji Ayandipo
- University College Hospital, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Thomas Olajide
- College of Medicine & Lagos University Teaching Hospital, University of Lagos, Lagos, Lagos State, Nigeria
| | | | - Olukayode Arowolo
- Obafemi Awolowo University Teaching Hospital, Ile-Ife, Osun State, Nigeria
| | - Adewale Adisa
- Obafemi Awolowo University Teaching Hospital, Ile-Ife, Osun State, Nigeria
| | - Oludolapo Afuwape
- University College Hospital, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Aralola Olusanya
- University College Hospital, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Aderemi Adegoke
- Our Lady of Apostle Catholic Hospital, Ibadan, Oyo State, Nigeria
| | | | | | - Adetola Daramola
- College of Medicine & Lagos University Teaching Hospital, University of Lagos, Lagos, Lagos State, Nigeria
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Gupta A, Oyekunle T, Salako O, Daramola A, Alatise O, Ogun G, Adeniyi A, Deveaux A, Saraiya V, Hall A, Ayandipo O, Olajide T, Olasehinde O, Arowolo O, Adisa A, Afuwape O, Olusanya A, Adegoke A, Tollefsbol TO, Arnett D, Muehlbauer MJ, Newgard CB, Akinyemiju T. Association of high-sensitivity C-reactive protein and odds of breast cancer by molecular subtype: analysis of the MEND study. Oncotarget 2021; 12:1230-1242. [PMID: 34194621 PMCID: PMC8238238 DOI: 10.18632/oncotarget.27991] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 06/02/2021] [Indexed: 12/24/2022] Open
Abstract
Breast cancer (BC) in Nigeria is characterized by disproportionately aggressive molecular subtypes. C-reactive protein (CRP) is associated with risk and aggressiveness for several types of cancer. We examined the association of high-sensitivity CRP (hsCRP) with odds of BC by molecular subtype among Nigerian women. Among 296 newly diagnosed BC cases and 259 healthy controls, multivariable logistic regression models were used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (CI) for the association between hsCRP and odds of BC overall and by molecular subtype (luminal A, luminal B, HER2-enriched and triple-negative or TNBC). High hsCRP (> 3 mg/L) was observed in 57% of cases and 31% of controls and was associated with 4 times the odds of BC (aOR: 4.43; 95% CI: 2.56, 7.66) after adjusting for socio-demographic, reproductive, and clinical variables. This association persisted regardless of menopausal status and body mass index (BMI) category. High hsCRP was associated with increased odds of TNBC (aOR: 3.32; 95% CI: 1.07, 10.35), luminal A BC (aOR: 4.03; 95% CI: 1.29, 12.64), and HER2-enriched BC (aOR: 6.27; 95% CI: 1.69, 23.25). Future studies are necessary in this population to further evaluate a potential role for CRP as a predictive biomarker for BC.
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Affiliation(s)
- Anjali Gupta
- Trinity College of Arts and Sciences, Duke University, Durham, NC, USA
- Department of Population Health Sciences, School of Medicine, Duke University, Durham, NC, USA
| | - Taofik Oyekunle
- Department of Population Health Sciences, School of Medicine, Duke University, Durham, NC, USA
| | - Omolola Salako
- College of Medicine & Lagos University Teaching Hospital, University of Lagos, Lagos State, Nigeria
| | - Adetola Daramola
- College of Medicine & Lagos University Teaching Hospital, University of Lagos, Lagos State, Nigeria
| | - Olusegun Alatise
- Obafemi Awolowo University Teaching Hospital, Ile-Ife, Osun State, Nigeria
| | - Gabriel Ogun
- University College Hospital, University of Ibadan, Ibadan, Oyo State, Nigeria
| | | | - April Deveaux
- Department of Population Health Sciences, School of Medicine, Duke University, Durham, NC, USA
| | - Veeral Saraiya
- Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Allison Hall
- Department of Pathology, School of Medicine, Duke University, Durham, NC, USA
| | - Omobolaji Ayandipo
- University College Hospital, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Thomas Olajide
- College of Medicine & Lagos University Teaching Hospital, University of Lagos, Lagos State, Nigeria
| | | | - Olukayode Arowolo
- Obafemi Awolowo University Teaching Hospital, Ile-Ife, Osun State, Nigeria
| | - Adewale Adisa
- Obafemi Awolowo University Teaching Hospital, Ile-Ife, Osun State, Nigeria
| | - Oludolapo Afuwape
- University College Hospital, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Aralola Olusanya
- University College Hospital, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Aderemi Adegoke
- Our Lady of Apostle Catholic Hospital, Ibadan, Oyo State, Nigeria
| | - Trygve O. Tollefsbol
- Department of Biology, College of Arts and Sciences, University of Alabama at Birmingham, AL, USA
| | - Donna Arnett
- College of Public Health, University of Kentucky, Lexington, KY, USA
| | | | | | | | - Tomi Akinyemiju
- Department of Population Health Sciences, School of Medicine, Duke University, Durham, NC, USA
- Duke Cancer Institute, School of Medicine, Duke University, Durham, NC, USA
- Duke Global Health Institute, Duke University, Durham, NC, USA
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Islam JY, Deveaux A, Previs RA, Akinyemiju T. Racial disparities in palliative care utilization among metastatic gynecological cancer patients living at last follow-up: An analysis of the National Cancer Data Base. Data Brief 2020; 34:106705. [PMID: 33473361 PMCID: PMC7803651 DOI: 10.1016/j.dib.2020.106705] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 12/24/2020] [Accepted: 12/28/2020] [Indexed: 02/02/2023] Open
Abstract
The National Comprehensive Cancer Network recommends palliative care should be integrated in to cancer care starting from cancer diagnosis. However, traditionally palliative care is prioritized for cancer patients at the end-of-life. In our main article titled “Racial and Ethnic Disparities in Palliative Care Utilization Among Gynecological Cancer Patients” we present data describing racial/ethnic disparities among metastatic gynecological cancer patients who were deceased at last follow-up. Here, we expand our population to evaluate racial disparities in palliative care utilization among (1) all metastatic gynecologic cancer patients, regardless of vital status (alive or deceased) (n = 176,899) and (2) among only patients who were alive at last follow-up (n = 66,781). We used data from the 2016 National Cancer Database (NCDB) and included patients between ages 18–90 years with metastatic (stage III-IV) gynecologic cancers including, ovarian, cervical and uterine cancer. Palliative care was defined by NCDB as non-curative treatment, and could include surgery, radiation, chemotherapy, and pain management or any combination. We used multivariable logistic regression to evaluate racial disparities in palliative care use among our two populations of interest. Overall, the mean age of gynecologic cancer patients utilizing palliative care was 66 years. Five percent of all metastatic gynecologic oncology patients utilized palliative care overall; and by cancer site palliative care use was as follows: 4% among ovarian, 9% among cervical, and 11% among uterine cancer patients. Among patients who utilized palliative care, 62% utilized surgery, radiation or chemotherapy only and 12% utilized pain management as a form of palliative care. Among ovarian cancer patients, Hispanic ovarian cancer patients were less likely to utilize palliative care compared to their NH-White counterparts (aOR: 0.79, 95% CI: 0.68–0.91). Among cervical cancer patients, we observed that Hispanic (aOR: 0.65, 95% CI: 0.56–0.75) and Asian (aOR: 0.74, 95% CI: 0.59–0.93) were less likely to utilize palliative care than NH-White cervical cancer patients. We observed no racial disparities in palliative care utilization among uterine cancer patients. When we focused on patients who were alive at last follow-up we found that only 3% of patients utilized palliative care. We also conducted multivariable analyses of racial/ethnic disparities among ovarian and cervical cancer patients who were alive at last follow-up. We were unable to conduct multivariable analyses of uterine cancer patients who were alive at last follow-up due to limited sample size of those who utilized palliative care. We observed no racial/ethnic disparities among this patient population of metastatic gynecologic patients.
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Affiliation(s)
- Jessica Y Islam
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC, United States.,Department of Population Health, Duke Health System, Durham, NC, United States
| | - April Deveaux
- Department of Population Health, Duke Health System, Durham, NC, United States
| | - Rebecca A Previs
- Division of Gynecological Oncology, Duke Cancer Institute, Durham, NC, United States
| | - Tomi Akinyemiju
- Department of Population Health, Duke Health System, Durham, NC, United States
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Deveaux A, Wang BD, Lacroix B, Patierno B, Zhang D, Owzar K, Lee N, George D, Freedman J, Patierno S. Abstract B59: Race-related differential splicing of the insulin receptor: A novel target underlying prostate cancer disparities. Cancer Epidemiol Biomarkers Prev 2018. [DOI: 10.1158/1538-7755.disp17-b59] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
Background: Age-adjusted incidence and mortality rates for prostate cancer (PCa) among African American (AA) men are significantly greater than among white men. Much of this disparity remains after controlling for behavioral, social, and neighborhood determinants of health, which is consistent with a biologic contribution. Evidence suggests that the genetic etiology and molecular progression of PCa are different in AAs versus whites. Our laboratory has identified novel alternatively spliced genes in AA versus white PCa biopsy tissue that track with population-based prostate tumor aggressiveness. This work addresses the urgent need to interrogate novel molecular mechanisms driving more aggressive PCa in AAs to aid in development of new biomarkers and therapeutic targets for improved prognosis and treatment of aggressive disease.
Methods: We have analyzed RNA from human PCa biopsy tissue from 20 AA and 15 white patients using exon arrays. From these data, we prioritized targets for further study by identifying those associated with androgen signaling and PCa and those that have also been shown to be alternatively spliced in breast, lung, and liver cancer. To validate race-related alternative splicing of the insulin receptor (INSR) gene, we have used qPCR and targeted sequencing of RNA from population-specific PCa cell lines and patient-derived explants. In addition, we have knocked down the INSR splice variants in population-specific PCa cell lines using isoform-specific siRNAs and assessed resulting alterations in proliferation using a WST-1 proliferation assay. Current studies include assessing additional resulting alterations in expression of selected key targets in INSR signaling using Western blot analysis. In addition, studies are under way to treat population-specific PCa cell lines with INSR signaling inhibitors and assess resulting alterations in PCa cell biology.
Results: Exon array analysis of RNA from AA and white PCa biopsy tissue revealed 934 differentially expressed exons in 861 corresponding genes. Thirty-nine targets have been prioritized for further study. We have validated race-related alternative splicing of INSR, involving differential exon inclusion/skipping of exon 11, in population-specific PCa cell lines and patient-derived explants, with the exclusion of exon 11 occurring more often in preclinical models of white PCa. Knockdown of INSR splice variants in population-specific PCa cell lines has shown that decreased expression of the isoform excluding exon 11 inhibits proliferation while decreased expression of the isoform including exon 11 has no effect on proliferation. Further studies to assess additional resulting alterations in expression of selected key targets in INSR signaling are under way. In addition, studies are under way to treat population-specific PCa cell lines with INSR signaling inhibitors and assess resulting alterations in PCa cell biology.
Conclusions: These studies identify differential splicing of INSR in AA and white PCa and the INSR isoform excluding exon 11 as contributors to prostate tumor aggressiveness. Further interrogation of this mechanism underlying PCa disparities and its effect on targeted therapeutics has the potential to reduce PCa disparities for AA men and improve outcomes for men of all races with aggressive disease driven by this mechanism.
Citation Format: April Deveaux, Bi-Dar Wang, Bonnie Lacroix, Brendon Patierno, Dadong Zhang, Kouros Owzar, Norman Lee, Daniel George, Jennifer Freedman, Steven Patierno. Race-related differential splicing of the insulin receptor: A novel target underlying prostate cancer disparities [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr B59.
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Affiliation(s)
| | - Bi-Dar Wang
- 2George Washington University, Washington, D.C
| | | | | | | | | | - Norman Lee
- 2George Washington University, Washington, D.C
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Abstract
The human gut is home to a complex and diverse microbiota that contributes to the overall homeostasis of the host. Increasingly, the intestinal microbiota is recognized as an important player in human illness such as colorectal cancer (CRC), inflammatory bowel diseases, and obesity. CRC in itself is one of the major causes of cancer mortality in the Western world. The mechanisms by which bacteria contribute to CRC are complex and not fully understood, but increasing evidence suggests a link between the intestinal microbiota and CRC as well as diet and inflammation, which are believed to play a role in carcinogenesis. It is thought that the gut microbiota interact with dietary factors to promote chronic inflammation and CRC through direct influence on host cell physiology, cellular homeostasis, energy regulation, and/or metabolism of xenobiotics. This review provides an overview on the role of commensal gut microbiota in the development of human CRC and explores its association with diet and inflammation.
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Affiliation(s)
- Temitope O. Keku
- 1Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill, North Carolina; ,2Center for Gastrointestinal Biology and Disease, School of Medicine, University of North Carolina, Chapel Hill, North Carolina; and
| | - Santosh Dulal
- 1Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill, North Carolina; ,2Center for Gastrointestinal Biology and Disease, School of Medicine, University of North Carolina, Chapel Hill, North Carolina; and
| | - April Deveaux
- 1Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill, North Carolina; ,2Center for Gastrointestinal Biology and Disease, School of Medicine, University of North Carolina, Chapel Hill, North Carolina; and
| | - Biljana Jovov
- 1Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill, North Carolina; ,2Center for Gastrointestinal Biology and Disease, School of Medicine, University of North Carolina, Chapel Hill, North Carolina; and
| | - Xuesong Han
- 3Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia
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Balloy V, Deveaux A, Lebeaux D, Tabary O, le Rouzic P, Ghigo JM, Busson PF, Boëlle PY, Guez JG, Hahn U, Clement A, Chignard M, Corvol H, Burnet M, Guillot L. Azithromycin analogue CSY0073 attenuates lung inflammation induced by LPS challenge. Br J Pharmacol 2014; 171:1783-94. [PMID: 24417187 DOI: 10.1111/bph.12574] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Revised: 12/16/2013] [Accepted: 01/07/2014] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND AND PURPOSE Azithromycin is a macrolide antibiotic with anti-inflammatory and immunomodulating effects. Long-term azithromycin therapy in patients with chronic lung diseases such as cystic fibrosis has been associated with increased antimicrobial resistance, emergence of hypermutable strains, ototoxicity and cardiac toxicity. The aim of this study was to assess the anti-inflammatory effects of the non-antibiotic azithromycin derivative CSY0073. EXPERIMENTAL APPROACH We compared the effects of CSY0073 with those of azithromycin in experiments on bacterial cultures, Pseudomonas aeruginosa biofilm, lung cells and mice challenged intranasally with P. aeruginosa LPS. KEY RESULTS In contrast to azithromycin, CSY0073 did not inhibit the growth of P. aeruginosa, Staphylococcus aureus or Haemophilus influenzae and had no effect on an established P. aeruginosa biofilm. Bronchoalveolar lavage (BAL) fluids and lung homogenates collected after the LPS challenge in mice showed that CSY0073 and azithromycin (200 mg·kg(-1), i.p.) decreased neutrophil counts at 24 h and TNF-α, CXCL1 and CXCL2 levels in the BAL fluid after 3 h and IL-6, CXCL2 and IL-1β levels in the lung after 3 h compared with the vehicle. However, only azithromycin reduced IL-1β levels in the lung 24 h post LPS challenge. CSY0073 and azithromycin similarly diminished the production of pro-inflammatory cytokines by macrophages, but not lung epithelial cells, exposed to P. aeruginosa LPS. CONCLUSIONS AND IMPLICATIONS Unlike azithromycin, CSY0073 had no antibacterial effects but it did have a similar anti-inflammatory profile to that of azithromycin. Hence, CSY0073 may have potential as a long-term treatment for patients with chronic lung diseases.
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Affiliation(s)
- V Balloy
- INSERM, UMR_S 938, CDR Saint-Antoine, Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMR_S 938, CDR Saint-Antoine, Paris, France; Inserm U874, Paris, France; Unité de défense Innée et Inflammation, Institut Pasteur, Paris, France
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Lucas G, Delabrusse B, Deveaux A, Grossetête A. Coopération clinique en santé au travail. ARCH MAL PROF ENVIRO 2012. [DOI: 10.1016/j.admp.2012.03.181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Deveaux A, Huez D. Transports et postes de sécurité. Approche critique des réglementations. Médecine du travail et/ou médecine d’expertise. ARCH MAL PROF ENVIRO 2006. [DOI: 10.1016/s1775-8785(06)78109-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Bardot F, Deveaux A. Santé mentale et travail : quelle pratique clinique pour le médecin du travail ? ARCH MAL PROF ENVIRO 2004. [DOI: 10.1016/s1775-8785(04)93122-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Glomaud D, Jehanne MC, Deveaux A, Pouliquen Y, Salamagne JC. [Variations in intraocular pressure during controlled hypotension with sodium nitroprusside]. Anesth Analg (Paris) 1978; 35:161-7. [PMID: 354431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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