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Tily H, Patridge E, Cai Y, Gopu V, Gline S, Genkin M, Lindau H, Sjue A, Slavov I, Perlina A, Klitgord N, Messier H, Vuyisich M, Banavar G. Gut Microbiome Activity Contributes to Prediction of Individual Variation in Glycemic Response in Adults. Diabetes Ther 2022; 13:89-111. [PMID: 34799839 PMCID: PMC8776936 DOI: 10.1007/s13300-021-01174-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 10/12/2021] [Indexed: 12/31/2022] Open
Abstract
Limiting postprandial glycemic response (PPGR) is an important intervention in reducing the risk of chronic metabolic diseases and has been shown to impart significant health benefits in people with elevated levels of blood sugar. In this study, we collected gut microbiome activity data by assessing the metatranscriptome, and we measured the glycemic responses of 550 adults who consumed more than 30,000 meals, collectively, from omnivore or vegetarian/gluten-free diets. We demonstrate that gut microbiome activity, anthropometric factors, and food macronutrients modulate individual variation in glycemic response. We employ two predictive models, including a mixed-effects linear regression model (R = 0.77) and a gradient boosting machine model (Rtrain = 0.80/R2train = 0.64; Rtest = 0.64/R2test = 0.40), which demonstrate variation in PPGR between individuals when ingesting the same foods. All features in the final mixed-effects linear regression model were significant (p < 0.05) except for two features which were retained as suggestive: glutamine production pathways (p = 0.08) and the interaction between tyrosine metabolizers and carbs (p = 0.06). We introduce molecular functions as features in these two models, aggregated from microbial activity data, and show their statistically significant contributions to glycemic control. In summary, we demonstrate for the first time that metatranscriptomic activity of the gut microbiome is correlated with PPGR among adults.
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Affiliation(s)
- Hal Tily
- Viome Research Institute, Viome Life Sciences, Inc, New York City, USA
| | - Eric Patridge
- Viome Research Institute, Viome Life Sciences, Inc, New York City, USA
| | - Ying Cai
- Viome Research Institute, Viome Life Sciences, Inc, New York City, USA
| | - Vishakh Gopu
- Viome Research Institute, Viome Life Sciences, Inc, New York City, USA
| | - Stephanie Gline
- Viome Research Institute, Viome Life Sciences, Inc, New York City, USA
| | - Matvey Genkin
- Viome Research Institute, Viome Life Sciences, Inc, New York City, USA
| | - Haely Lindau
- Viome Research Institute, Viome Life Sciences, Inc, Seattle, USA
| | - Alisson Sjue
- Viome Research Institute, Viome Life Sciences, Inc, Seattle, USA
| | - Iordan Slavov
- Viome Research Institute, Viome Life Sciences, Inc, New York City, USA
| | - Ally Perlina
- Viome Research Institute, Viome Life Sciences, Inc, Seattle, USA
| | - Niels Klitgord
- Viome Research Institute, Viome Life Sciences, Inc, Seattle, USA
| | - Helen Messier
- Viome Research Institute, Viome Life Sciences, Inc, Seattle, USA
| | | | - Guruduth Banavar
- Viome Research Institute, Viome Life Sciences, Inc, New York City, USA.
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Abstract
OBJECTIVE Prior studies of hypochondriasis demonstrated benefits for pharmacotherapy and for cognitive-behavioral therapy (CBT). This study examined whether joint treatment offers additional benefit. METHOD Patients with DSM-IV hypochondriasis (N=195) were randomly assigned to one of four treatments-placebo, CBT, fluoxetine, or joint treatment with both fluoxetine and CBT. Evaluations assessed hypochondriasis, other psychopathology, adverse events, functional status, and quality of life. The primary analysis assessed outcome at week 24 among the intent-to-treat sample, with responders defined as having a 25% or greater improvement over baseline on both the Whiteley Index and a modified version of the Yale-Brown Obsessive Compulsive Scale for hypochondriasis (H-YBOCS-M). The Cochran-Armitage trend test assessed the hypothesized pattern of response: joint treatment > CBT or fluoxetine treatment > placebo treatment. RESULTS The predicted pattern of response was statistically significant, as shown by the following responder rates: joint treatment group, 47.2%; single active treatment group, 41.8%; and placebo group, 29.6%. Responder rates for each active treatment were not significantly different from the rate for placebo. Secondary analyses of the Whiteley Index as a continuous measure revealed that, compared with placebo, fluoxetine (but not CBT) was significantly more effective at week 24 in reducing hypochondriasis and had a significantly faster rate of improvement over 24 weeks. Fluoxetine also resulted in significantly less anxiety and better quality of life than placebo. Dropout rates did not differ between groups, and treatment-emergent adverse events were evenly distributed. CONCLUSIONS This study supports the safety, tolerance, and efficacy of fluoxetine for hypochondriasis. Joint treatment provided a small incremental benefit. Because approximately 50% of patients did not respond to the study treatments, new or more intensive approaches are needed.
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Affiliation(s)
- Brian A Fallon
- From the New York State Psychiatric Institute, New York; and Brigham and Women's Hospital, Boston
| | - David K Ahern
- From the New York State Psychiatric Institute, New York; and Brigham and Women's Hospital, Boston
| | - Martina Pavlicova
- From the New York State Psychiatric Institute, New York; and Brigham and Women's Hospital, Boston
| | - Iordan Slavov
- From the New York State Psychiatric Institute, New York; and Brigham and Women's Hospital, Boston
| | - Natalia Skritskya
- From the New York State Psychiatric Institute, New York; and Brigham and Women's Hospital, Boston
| | - Arthur J Barsky
- From the New York State Psychiatric Institute, New York; and Brigham and Women's Hospital, Boston
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Fallon BA, Lipkin RB, Corbera KM, Yu S, Nobler MS, Keilp JG, Petkova E, Lisanby SH, Moeller JR, Slavov I, Van Heertum R, Mensh BD, Sackeim HA. Regional cerebral blood flow and metabolic rate in persistent Lyme encephalopathy. ACTA ACUST UNITED AC 2009; 66:554-63. [PMID: 19414715 DOI: 10.1001/archgenpsychiatry.2009.29] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CONTEXT There is controversy regarding whether objective neurobiological abnormalities exist after intensive antibiotic treatment for Lyme disease. OBJECTIVES To determine whether patients with a history of well-characterized Lyme disease and persistent cognitive deficit show abnormalities in global or topographic distributions of regional cerebral blood flow (rCBF) or cerebral metabolic rate (rCMR). DESIGN Case-controlled study. SETTING A university medical center. PARTICIPANTS A total of 35 patients and 17 healthy volunteers (controls). Patients had well-documented prior Lyme disease, a currently reactive IgG Western blot, prior treatment with at least 3 weeks of intravenous cephalosporin, and objective memory impairment. MAIN OUTCOME MEASURES Patients with persistent Lyme encephalopathy were compared with age-, sex-, and education-matched controls. Fully quantified assessments of rCBF and rCMR for glucose were obtained while subjects were medication-free using positron emission tomography. The CBF was assessed in 2 resting room air conditions (without snorkel and with snorkel) and 1 challenge condition (room air enhanced with carbon dioxide, ie, hypercapnia). RESULTS Statistical parametric mapping analyses revealed regional abnormalities in all rCBF and rCMR measurements that were consistent in location across imaging methods and primarily reflected hypoactivity. Deficits were noted in bilateral gray and white matter regions, primarily in the temporal, parietal, and limbic areas. Although diminished global hypercapnic CBF reactivity (P < .02) was suggestive of a component of vascular compromise, the close coupling between CBF and CMR suggests that the regional abnormalities are primarily metabolically driven. Patients did not differ from controls on global resting CBF and CMR measurements. CONCLUSIONS Patients with persistent Lyme encephalopathy have objectively quantifiable topographic abnormalities in functional brain activity. These CBF and CMR reductions were observed in all measurement conditions. Future research should address whether this pattern is also seen in acute neurologic Lyme disease.
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Affiliation(s)
- Brian A Fallon
- Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, New York 10032, USA.
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McKinley PS, King AR, Shapiro PA, Slavov I, Fang Y, Chen IS, Jamner LD, Sloan RP. The impact of menstrual cycle phase on cardiac autonomic regulation. Psychophysiology 2009; 46:904-11. [PMID: 19386049 DOI: 10.1111/j.1469-8986.2009.00811.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
This study investigated menstrual cycle phase differences in heart rate (HR) and RR interval variability (RRV) in 49 healthy, premenopausal, eumenorrheic women (age 30.2+/-6.2 years). HR and RRV were computed from ambulatory 24-h electrocardiogram, collected for up to 6 days, with at least 1 day each during early to midfollicular and midluteal menstrual phases. Phase effects on HR and RRV were assessed using linear mixed effects models with a random intercept to account for the correlation of observations within each subject as well as intrasubject variation. During follicular phase monitoring, women had significantly lower average HR (-2.33 bpm), and higher standard deviation, the root mean squared successive difference, and high frequency (0.04-0.15 Hz) and low frequency (0.15-0.40 Hz) RRV than during the luteal phase. These results provide strong support for the influence of menstrual phase on cardiac autonomic regulation in premenopausal women.
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Affiliation(s)
- Paula S McKinley
- Division of Behavioral Medicine, Department of Psychiatry, Columbia University, New York, New York 10032, USA.
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Sloan RP, Shapiro PA, DeMeersman RE, Bagiella E, Brondolo EN, McKinley PS, Slavov I, Fang Y, Myers MM. The effect of aerobic training and cardiac autonomic regulation in young adults. Am J Public Health 2009; 99:921-8. [PMID: 19299682 DOI: 10.2105/ajph.2007.133165] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVES We tested the effect of aerobic exercise on autonomic regulation of the heart in healthy young adults. METHODS Healthy, sedentary young adults (n = 149; age = 30.4 +/- 7.53 years) were randomized to receive 12 weeks of either aerobic conditioning or strength training. Primary outcomes were heart rate and RR interval variability (RRV) measured before and after training and after 4 weeks of sedentary deconditioning. RRV, a noninvasive index of cardiac autonomic regulation, reflects variability in the intervals between consecutive R waves of the electrocardiogram. RESULTS Aerobic conditioning but not strength training led to a significant increase in aerobic capacity (3.11 mL/kg/min), a decrease in heart rate (-3.49 beats per minute), and an increase in high-frequency RRV (0.25 natural log msec2), each of which returned to pretraining levels after deconditioning. Significant 3-way interactions, however, revealed autonomic effects only in men. CONCLUSIONS In sedentary, healthy young adults, aerobic conditioning but not strength training enhances autonomic control of the heart, but post hoc analyses suggested that gender plays a significant role in this exercise-related cardioprotection.
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Affiliation(s)
- Richard P Sloan
- Division of Behavioral Medicine, Department of Psychiatry, Columbia University, 1150 St Nicholas Ave, Suite 121, New York, NY 10032, USA.
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Fallon BA, Keilp JG, Corbera KM, Petkova E, Britton CB, Dwyer E, Slavov I, Cheng J, Dobkin J, Nelson DR, Sackeim HA. A randomized, placebo-controlled trial of repeated IV antibiotic therapy for Lyme encephalopathy. Neurology 2007; 70:992-1003. [PMID: 17928580 DOI: 10.1212/01.wnl.0000284604.61160.2d] [Citation(s) in RCA: 220] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Optimal treatment remains uncertain for patients with cognitive impairment that persists or returns after standard IV antibiotic therapy for Lyme disease. METHODS Patients had well-documented Lyme disease, with at least 3 weeks of prior IV antibiotics, current positive IgG Western blot, and objective memory impairment. Healthy individuals served as controls for practice effects. Patients were randomly assigned to 10 weeks of double-masked treatment with IV ceftriaxone or IV placebo and then no antibiotic therapy. The primary outcome was neurocognitive performance at week 12-specifically, memory. Durability of benefit was evaluated at week 24. Group differences were estimated according to longitudinal mixed-effects models. RESULTS After screening 3368 patients and 305 volunteers, 37 patients and 20 healthy individuals enrolled. Enrolled patients had mild to moderate cognitive impairment and marked levels of fatigue, pain, and impaired physical functioning. Across six cognitive domains, a significant treatment-by-time interaction favored the antibiotic-treated group at week 12. The improvement was generalized (not specific to domain) and moderate in magnitude, but it was not sustained to week 24. On secondary outcome, patients with more severe fatigue, pain, and impaired physical functioning who received antibiotics were improved at week 12, and this was sustained to week 24 for pain and physical functioning. Adverse events from either the study medication or the PICC line were noted among 6 of 23 (26.1%) patients given IV ceftriaxone and among 1 of 14 (7.1%) patients given IV placebo; these resolved without permanent injury. CONCLUSION IV ceftriaxone therapy results in short-term cognitive improvement for patients with posttreatment Lyme encephalopathy, but relapse in cognition occurs after the antibiotic is discontinued. Treatment strategies that result in sustained cognitive improvement are needed.
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Affiliation(s)
- B A Fallon
- Columbia University, 1051 Riverside Drive, Unit 69, New York, NY 10032, USA.
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Sloan RP, Shapiro PA, Demeersman RE, McKinley PS, Tracey KJ, Slavov I, Fang Y, Flood PD. Aerobic exercise attenuates inducible TNF production in humans. J Appl Physiol (1985) 2007; 103:1007-11. [PMID: 17626836 DOI: 10.1152/japplphysiol.00147.2007] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Aerobic exercise reduces coronary heart disease risk, but the mechanisms of this protection are not fully understood. Atherosclerosis is an inflammatory disease mediated by monocyte-derived macrophages, which accumulate in arterial plaques and become activated to release factors, including cytokines, that cause damage. Here we studied the effects of aerobic training on monocyte production of tumor necrosis factor (TNF) in whole blood ex vivo. Healthy young sedentary adults (n = 61, age 20-45 yr) were randomized to a moderate- (M) or a high- (H) intensity 12-wk training program. Whole blood was extracted before and after training, and then it was stimulated by addition of lipopolysaccharide (LPS); inducible TNF was measured in the plasma. Data were analyzed according to intention to treat principles using a random-effect model to determine the impact of training group on maximal aerobic capacity and LPS-stimulated TNF after correcting for covariates. Analyses revealed improvement in aerobic capacity in both the H (9%) and the M (7%) groups. However, aerobic training led to significant (P < 0.001) decreases in TNF release only in the H group. These data suggest that in healthy young adults, a 12-wk high-intensity aerobic training program downregulates blood monocyte production of stimulated cytokine release.
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Affiliation(s)
- Richard P Sloan
- Division of Behavioral Medicine, Department of Psychiatry, Columbia University, New York, NY 10032, USA.
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Keilp JG, Corbera K, Slavov I, Taylor MJ, Sackeim HA, Fallon BA. WAIS-III and WMS-III performance in chronic Lyme disease. J Int Neuropsychol Soc 2006; 12:119-29. [PMID: 16433951 DOI: 10.1017/s1355617706060231] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2005] [Revised: 08/25/2005] [Accepted: 08/28/2005] [Indexed: 11/06/2022]
Abstract
There is controversy regarding the nature and degree of intellectual and memory deficits in chronic Lyme disease. In this study, 81 participants with rigorously diagnosed chronic Lyme disease were administered the newest revisions of the Wechsler Adult Intelligence Scale (WAIS-III) and Wechsler Memory Scale (WMS-III), and compared to 39 nonpatients. On the WAIS-III, Lyme disease participants had poorer Full Scale and Performance IQ's. At the subtest level, differences were restricted to Information and the Processing Speed subtests. On the WMS-III, Lyme disease participants performed more poorly on Auditory Immediate, Immediate, Auditory Delayed, Auditory Recognition Delayed, and General Memory indices. Among WMS-III subtests, however, differences were restricted to Logical Memory (immediate and delayed) and Family Pictures (delayed only), a Visual Memory subtest. Discriminant analyses suggest deficits in chronic Lyme are best characterized as a combination of memory difficulty and diminished processing speed. Deficits were modest, between one-third and two-thirds of a standard deviation, consistent with earlier studies. Depression severity had a weak relationship to processing speed, but little other association to test performance. Deficits in chronic Lyme disease are consistent with a subtle neuropathological process affecting multiple performance tasks, although further work is needed to definitively rule out nonspecific illness effects.
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Affiliation(s)
- John G Keilp
- Columbia University College of Physicians and Surgeons, Department of Psychiatry, New York, New York 10032, USA.
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