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Hayes D, Olsson A, Begum S, Bertotti M, Jarvis-Beesley P, Stapley E. Barriers and facilitators to social prescribing in child and youth mental health: perspectives from the frontline. Eur Child Adolesc Psychiatry 2024; 33:1465-1479. [PMID: 37405485 PMCID: PMC11098893 DOI: 10.1007/s00787-023-02257-x] [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: 09/16/2022] [Accepted: 06/27/2023] [Indexed: 07/06/2023]
Abstract
There is growing interest in the role of Social Prescribing (SP) to help promote mental well-being and support individuals with mental health difficulties. Yet, implementation of SP to children and young people (CYP) has proved slow and underdeveloped compared with adult populations. Understanding the barriers and facilitators will help key stakeholders to better embed SP for CYP into practice. Using the Theoretical Domains Framework (TDF), a comprehensive, theoretical-led framework, underpinned by 33 behaviour change theories and 128 constructs, perceived barriers and facilitators to SP were investigated. The sample comprised of 11 Link Workers and 9 individuals involved in facilitating SP with CYP, who took part in semi-structured interviews. Transcripts were analysed using a deductive thematic analysis, and themes were coded under each theoretical domain. Overall, 33 barriers and facilitators for SP were identified across 12 domains of the TDF. Under capability, barriers and facilitators were found for knowledge, skills, memory/attention/decision making processes, and behavioural regulation. For opportunity, barriers and facilitators were found for social/professional influences, as well as environmental context and resources. Finally, for motivation, domains covered included: beliefs about consequences, beliefs about capabilities, optimism, motivations/goals, reinforcement, and emotions. Findings suggest that a wide range of barriers and facilitators affect the implementation of CYP SP to improve mental health and well-being. Interventions which target different domains related to capability, opportunity and motivation should be developed to better facilitate CYP SP.
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Affiliation(s)
- D Hayes
- Evidence Based Practice Unit (EBPU), University College London and the Anna Freud National Centre for Children and Families, London, England.
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, London, England.
| | - A Olsson
- Evidence Based Practice Unit (EBPU), University College London and the Anna Freud National Centre for Children and Families, London, England
- The Healthcare Improvement Studies (THIS) Institute, University of Cambridge, Cambridge, England
| | - S Begum
- Evidence Based Practice Unit (EBPU), University College London and the Anna Freud National Centre for Children and Families, London, England
| | - M Bertotti
- Institute for Connected Communities, University of East London, London, England
| | - P Jarvis-Beesley
- Social Prescribing Youth Network (SPYN), Streetgames, Manchester, England
| | - E Stapley
- Evidence Based Practice Unit (EBPU), University College London and the Anna Freud National Centre for Children and Families, London, England
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Mendez KM, Begum S, Tiwari A, Sharma R, Chen Q, Kelly RS, Prince N, Huang M, Kachroo P, Chu SH, Chen Y, Lee-Sarwar K, Broadhurst DI, Reinke SN, Gerszten R, Clish C, Avila L, Celedón JC, Wheelock CE, Weiss ST, McGeachie M, Lasky-Su JA. Metabolite signatures associated with microRNA miR-143-3p serve as drivers of poor lung function trajectories in childhood asthma. EBioMedicine 2024; 102:105025. [PMID: 38458111 PMCID: PMC10937568 DOI: 10.1016/j.ebiom.2024.105025] [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: 07/07/2023] [Revised: 01/29/2024] [Accepted: 02/05/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND Lung function trajectories (LFTs) have been shown to be an important measure of long-term health in asthma. While there is a growing body of metabolomic studies on asthma status and other phenotypes, there are no prospective studies of the relationship between metabolomics and LFTs or their genomic determinants. METHODS We utilized ordinal logistic regression to identify plasma metabolite principal components associated with four previously-published LFTs in children from the Childhood Asthma Management Program (CAMP) (n = 660). The top significant metabolite principal component (PCLF) was evaluated in an independent cross-sectional child cohort, the Genetic Epidemiology of Asthma in Costa Rica Study (GACRS) (n = 1151) and evaluated for association with spirometric measures. Using meta-analysis of CAMP and GACRS, we identified associations between PCLF and microRNA, and SNPs in their target genes. Statistical significance was determined using an false discovery rate-adjusted Q-value. FINDINGS The top metabolite principal component, PCLF, was significantly associated with better LFTs after multiple-testing correction (Q-value = 0.03). PCLF is composed of the urea cycle, caffeine, corticosteroid, carnitine, and potential microbial (secondary bile acid, tryptophan, linoleate, histidine metabolism) metabolites. Higher levels of PCLF were also associated with increases in lung function measures and decreased circulating neutrophil percentage in both CAMP and GACRS. PCLF was also significantly associated with microRNA miR-143-3p, and SNPs in three miR-143-3p target genes; CCZ1 (P-value = 2.6 × 10-5), SLC8A1 (P-value = 3.9 × 10-5); and TENM4 (P-value = 4.9 × 10-5). INTERPRETATION This study reveals associations between metabolites, miR-143-3p and LFTs in children with asthma, offering insights into asthma physiology and possible interventions to enhance lung function and long-term health. FUNDING Molecular data for CAMP and GACRS via the Trans-Omics in Precision Medicine (TOPMed) program was supported by the National Heart, Lung, and Blood Institute (NHLBI).
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Affiliation(s)
- Kevin M Mendez
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Centre for Integrative Metabolomics & Computational Biology, School of Science, Edith Cowan University, Perth, Australia
| | - Sofina Begum
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Anshul Tiwari
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN, USA
| | - Rinku Sharma
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Qingwen Chen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Rachel S Kelly
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Nicole Prince
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Mengna Huang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Priyadarshini Kachroo
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Su H Chu
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Yulu Chen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Kathleen Lee-Sarwar
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Division of Allergy and Clinical Immunology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - David I Broadhurst
- Centre for Integrative Metabolomics & Computational Biology, School of Science, Edith Cowan University, Perth, Australia
| | - Stacey N Reinke
- Centre for Integrative Metabolomics & Computational Biology, School of Science, Edith Cowan University, Perth, Australia
| | - Robert Gerszten
- Department of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | | | - Lydiana Avila
- Division of Pediatric Pulmonary Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA, USA
| | - Juan C Celedón
- Division of Pediatric Pulmonary Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA, USA
| | - Craig E Wheelock
- Unit of Integrative Metabolomics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Stockholm, Sweden
| | - Scott T Weiss
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Michael McGeachie
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Jessica A Lasky-Su
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
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Chen Y, Checa A, Zhang P, Huang M, Kelly RS, Kim M, Chen YCS, Lee-Sarwar KA, Prince N, Mendez KM, Begum S, Kachroo P, Chu SH, Stokholm J, Bønnelykke K, Litonjua AA, Bisgaard H, Weiss ST, Chawes BL, Wheelock CE, Lasky-Su JA. Sphingolipid classes and the interrelationship with pediatric asthma and asthma risk factors. Allergy 2024; 79:404-418. [PMID: 38014461 DOI: 10.1111/all.15942] [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: 02/28/2023] [Revised: 10/10/2023] [Accepted: 10/15/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND While dysregulated sphingolipid metabolism has been associated with risk of childhood asthma, the specific sphingolipid classes and/or mechanisms driving this relationship remain unclear. We aimed to understand the multifaceted role between sphingolipids and other established asthma risk factors that complicate this relationship. METHODS We performed targeted LC-MS/MS-based quantification of 77 sphingolipids in plasma from 997 children aged 6 years from two independent cohorts (VDAART and COPSAC2010 ). We examined associations of circulatory sphingolipids with childhood asthma, lung function, and three asthma risk factors: functional SNPs in ORMDL3, low vitamin D levels, and reduced gut microbial maturity. Given racial differences between these cohorts, association analyses were performed separately and then meta-analyzed together. RESULTS We observed elevations in circulatory sphingolipids with asthma phenotypes and risk factors; however, there were differential associations of sphingolipid classes with clinical outcomes and/or risk factors. While elevations from metabolites involved in ceramide recycling and catabolic pathways were associated with asthma and worse lung function [meta p-value range: 1.863E-04 to 2.24E-3], increased ceramide levels were associated with asthma risk factors [meta p-value range: 7.75E-5 to .013], but not asthma. Further investigation identified that some ceramides acted as mediators while some interacted with risk factors in the associations with asthma outcomes. CONCLUSION This study demonstrates the differential role that sphingolipid subclasses may play in asthma and its risk factors. While overall elevations in sphingolipids appeared to be deleterious overall; elevations in ceramides were uniquely associated with increases in asthma risk factors only; while elevations in asthma phenotypes were associated with recycling sphingolipids. Modification of asthma risk factors may play an important role in regulating sphingolipid homeostasis via ceramides to affect asthma. Further function work may validate the observed associations.
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Affiliation(s)
- Yulu Chen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Antonio Checa
- Unit of Integrative Metabolomics, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
- Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Stockholm, Sweden
| | - Pei Zhang
- Unit of Integrative Metabolomics, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
- Gunma University Initiative for Advanced Research (GIAR), Gunma University, Maebashi, Gunma, Japan
| | - Mengna Huang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Rachel S Kelly
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Min Kim
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
| | - Yih-Chieh S Chen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Division of Allergy and Clinical Immunology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Kathleen A Lee-Sarwar
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Division of Allergy and Clinical Immunology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Nicole Prince
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Kevin M Mendez
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Sofina Begum
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Priyadarshini Kachroo
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Su H Chu
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Jakob Stokholm
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
| | - Klaus Bønnelykke
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
| | - Augusto A Litonjua
- Division of Pediatric Pulmonary Medicine, Department of Pediatrics, Golisano Children's Hospital and University of Rochester Medical Center, Rochester, New York, USA
| | - Hans Bisgaard
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
| | - Scott T Weiss
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Bo L Chawes
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
| | - Craig E Wheelock
- Unit of Integrative Metabolomics, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
- Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Stockholm, Sweden
- Gunma University Initiative for Advanced Research (GIAR), Gunma University, Maebashi, Gunma, Japan
| | - Jessica A Lasky-Su
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
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Chatelaine HAS, Chen Y, Braisted J, Chu SH, Chen Q, Stav M, Begum S, Diray-Arce J, Sanjak J, Huang M, Lasky-Su J, Mathé EA. Nucleotide, Phospholipid, and Kynurenine Metabolites Are Robustly Associated with COVID-19 Severity and Time of Plasma Sample Collection in a Prospective Cohort Study. Int J Mol Sci 2023; 25:346. [PMID: 38203516 PMCID: PMC10779247 DOI: 10.3390/ijms25010346] [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: 10/19/2023] [Revised: 11/28/2023] [Accepted: 12/04/2023] [Indexed: 01/12/2024] Open
Abstract
Understanding the molecular underpinnings of disease severity and progression in human studies is necessary to develop metabolism-related preventative strategies for severe COVID-19. Metabolites and metabolic pathways that predispose individuals to severe disease are not well understood. In this study, we generated comprehensive plasma metabolomic profiles in >550 patients from the Longitudinal EMR and Omics COVID-19 Cohort. Samples were collected before (n = 441), during (n = 86), and after (n = 82) COVID-19 diagnosis, representing 555 distinct patients, most of which had single timepoints. Regression models adjusted for demographics, risk factors, and comorbidities, were used to determine metabolites associated with predisposition to and/or persistent effects of COVID-19 severity, and metabolite changes that were transient/lingering over the disease course. Sphingolipids/phospholipids were negatively associated with severity and exhibited lingering elevations after disease, while modified nucleotides were positively associated with severity and had lingering decreases after disease. Cytidine and uridine metabolites, which were positively and negatively associated with COVID-19 severity, respectively, were acutely elevated, reflecting the particular importance of pyrimidine metabolism in active COVID-19. This is the first large metabolomics study using COVID-19 plasma samples before, during, and/or after disease. Our results lay the groundwork for identifying putative biomarkers and preventive strategies for severe COVID-19.
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Affiliation(s)
- Haley A. S. Chatelaine
- Division of Preclinical Innovation, National Center for Advancing Translational Sciences, National Institutes of Health, Rockville, MD 20850, USA; (H.A.S.C.)
| | - Yulu Chen
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - John Braisted
- Division of Preclinical Innovation, National Center for Advancing Translational Sciences, National Institutes of Health, Rockville, MD 20850, USA; (H.A.S.C.)
| | - Su H. Chu
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Qingwen Chen
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Meryl Stav
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Sofina Begum
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Joann Diray-Arce
- Precision Vaccines Program, Boston Children’s Hospital and Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA
| | - Jaleal Sanjak
- Division of Preclinical Innovation, National Center for Advancing Translational Sciences, National Institutes of Health, Rockville, MD 20850, USA; (H.A.S.C.)
| | - Mengna Huang
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Jessica Lasky-Su
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Ewy A. Mathé
- Division of Preclinical Innovation, National Center for Advancing Translational Sciences, National Institutes of Health, Rockville, MD 20850, USA; (H.A.S.C.)
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Wong MSH, Pons A, De Sousa P, Proli C, Jordan S, Begum S, Buderi S, Anikin V, Finch J, Asadi N, Beddow E, Lim E. Determining the optimal time to report mortality after lobectomy for lung cancer: An analysis of the time-varying risk of death. JTCVS Open 2023; 16:931-937. [PMID: 38204618 PMCID: PMC10774977 DOI: 10.1016/j.xjon.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 06/10/2023] [Accepted: 07/31/2023] [Indexed: 01/12/2024]
Abstract
Objective Surgical mortality has traditionally been assessed at arbitrary intervals out to 1 year, without an agreed optimum time point. The aim of our study was to investigate the time-varying risk of death after lobectomy to determine the optimum period to evaluate surgical mortality rate after lobectomy for lung cancer. Methods We performed a retrospective study of patients undergoing lobectomy for lung cancer at our institution from 2015 to 2022. Parametric survival models were assessed and compared with a nonparametric kernel estimate. The hazard function was plotted over time according to the best-fit statistical distribution. The time points at which instantaneous hazard rate peaked and stabilized in the 1-year period after surgery were then determined. Results During the study period, 2284 patients underwent lobectomy for lung cancer. Cumulative mortality at 30, 90, and 180 days was 1.3%, 2.9%, and 4.9%, respectively. Log-logistic distribution showed the best fit compared with other statistical distribution, indicated by the lowest Akaike information criteria value. The instantaneous hazard rate was greatest during the immediate postoperative period (0.129; 95% confidence interval, 0.087-0.183) and diminishes rapidly within the first 30 days after surgery. Instantaneous hazard rate continued to decrease past 90 days and stabilized only at approximately 180 days. Conclusions In-hospital mortality is the optimal follow-up period that captures the early-phase hazard during the immediate postoperative period after lobectomy. Thirty-day mortality is not synonymous to "early mortality," as instantaneous hazard rate remains elevated well past the 90-day time point and only stabilizes at approximately 180 days after lobectomy.
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Affiliation(s)
- Matthew Shiu Hang Wong
- Academic Division of Thoracic Surgery, Royal Brompton Hospital, London, United Kingdom
- Department of Thoracic Surgery, Royal Brompton and Harefield Hospitals, London, United Kingdom
| | - Aina Pons
- Academic Division of Thoracic Surgery, Royal Brompton Hospital, London, United Kingdom
- Department of Thoracic Surgery, Royal Brompton and Harefield Hospitals, London, United Kingdom
| | - Paulo De Sousa
- Academic Division of Thoracic Surgery, Royal Brompton Hospital, London, United Kingdom
- Department of Thoracic Surgery, Royal Brompton and Harefield Hospitals, London, United Kingdom
| | - Chiara Proli
- Academic Division of Thoracic Surgery, Royal Brompton Hospital, London, United Kingdom
- Department of Thoracic Surgery, Royal Brompton and Harefield Hospitals, London, United Kingdom
| | - Simon Jordan
- Department of Thoracic Surgery, Royal Brompton and Harefield Hospitals, London, United Kingdom
| | - Sofina Begum
- Department of Thoracic Surgery, Royal Brompton and Harefield Hospitals, London, United Kingdom
| | - Silviu Buderi
- Department of Thoracic Surgery, Royal Brompton and Harefield Hospitals, London, United Kingdom
| | - Vladimir Anikin
- Department of Thoracic Surgery, Royal Brompton and Harefield Hospitals, London, United Kingdom
| | - Jonathan Finch
- Department of Thoracic Surgery, Royal Brompton and Harefield Hospitals, London, United Kingdom
| | - Nizar Asadi
- Department of Thoracic Surgery, Royal Brompton and Harefield Hospitals, London, United Kingdom
| | - Emma Beddow
- Department of Thoracic Surgery, Royal Brompton and Harefield Hospitals, London, United Kingdom
| | - Eric Lim
- Academic Division of Thoracic Surgery, Royal Brompton Hospital, London, United Kingdom
- Department of Thoracic Surgery, Royal Brompton and Harefield Hospitals, London, United Kingdom
- National Heart and Lung Institution, Imperial College London, London, United Kingdom
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6
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Moll M, Sordillo JE, Ghosh AJ, Hayden LP, McDermott G, McGeachie MJ, Dahlin A, Tiwari A, Manmadkar MG, Abston ED, Pavuluri C, Saferali A, Begum S, Ziniti JP, Gulsvik A, Bakke PS, Aschard H, Iribarren C, Hersh CP, Sparks JA, Hobbs BD, Lasky-Su JA, Silverman EK, Weiss ST, Wu AC, Cho MH. Polygenic risk scores identify heterogeneity in asthma and chronic obstructive pulmonary disease. J Allergy Clin Immunol 2023; 152:1423-1432. [PMID: 37595761 PMCID: PMC10841234 DOI: 10.1016/j.jaci.2023.08.002] [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: 01/11/2023] [Revised: 07/27/2023] [Accepted: 08/08/2023] [Indexed: 08/20/2023]
Abstract
BACKGROUND Asthma and chronic obstructive pulmonary disease (COPD) have distinct and overlapping genetic and clinical features. OBJECTIVE We sought to test the hypothesis that polygenic risk scores (PRSs) for asthma (PRSAsthma) and spirometry (FEV1 and FEV1/forced vital capacity; PRSspiro) would demonstrate differential associations with asthma, COPD, and asthma-COPD overlap (ACO). METHODS We developed and tested 2 asthma PRSs and applied the higher performing PRSAsthma and a previously published PRSspiro to research (Genetic Epidemiology of COPD study and Childhood Asthma Management Program, with spirometry) and electronic health record-based (Mass General Brigham Biobank and Genetic Epidemiology Research on Adult Health and Aging [GERA]) studies. We assessed the association of PRSs with COPD and asthma using modified random-effects and binary-effects meta-analyses, and ACO and asthma exacerbations in specific cohorts. Models were adjusted for confounders and genetic ancestry. RESULTS In meta-analyses of 102,477 participants, the PRSAsthma (odds ratio [OR] per SD, 1.16 [95% CI, 1.14-1.19]) and PRSspiro (OR per SD, 1.19 [95% CI, 1.17-1.22]) both predicted asthma, whereas the PRSspiro predicted COPD (OR per SD, 1.25 [95% CI, 1.21-1.30]). However, results differed by cohort. The PRSspiro was not associated with COPD in GERA and Mass General Brigham Biobank. In the Genetic Epidemiology of COPD study, the PRSAsthma (OR per SD: Whites, 1.3; African Americans, 1.2) and PRSspiro (OR per SD: Whites, 2.2; African Americans, 1.6) were both associated with ACO. In GERA, the PRSAsthma was associated with asthma exacerbations (OR, 1.18) in Whites; the PRSspiro was associated with asthma exacerbations in White, LatinX, and East Asian participants. CONCLUSIONS PRSs for asthma and spirometry are both associated with ACO and asthma exacerbations. Genetic prediction performance differs in research versus electronic health record-based cohorts.
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Affiliation(s)
- Matthew Moll
- Department of Medicine, Channing Division of Network Medicine, Division of Pulmonary and Critical Care Medicine, Harvard Medical School, Boston, Mass; Harvard Medical School, Brigham and Women's Hospital, Boston, Mass
| | - Joanne E Sordillo
- Department of Population Medicine, PRecisiOn Medicine Translational Research (PROMoTeR) Center, Harvard Medical School and Harvard Pilgrim Health Care, Boston, Mass
| | - Auyon J Ghosh
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, SUNY Upstate Medical Center, Syracuse, NY
| | - Lystra P Hayden
- Department of Pediatrics, Division of Pulmonary Medicine, Boston Children's Hospital, Harvard Medical School, Massachusetts General Hospital, Boston, Mass; Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital, Massachusetts General Hospital, Boston, Mass
| | - Gregory McDermott
- Harvard Medical School, Brigham and Women's Hospital, Boston, Mass; Department of Medicine, Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, Mass
| | - Michael J McGeachie
- Harvard Medical School, Brigham and Women's Hospital, Boston, Mass; Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital, Massachusetts General Hospital, Boston, Mass
| | - Amber Dahlin
- Harvard Medical School, Brigham and Women's Hospital, Boston, Mass; Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital, Massachusetts General Hospital, Boston, Mass
| | - Anshul Tiwari
- Harvard Medical School, Brigham and Women's Hospital, Boston, Mass; Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital, Massachusetts General Hospital, Boston, Mass
| | - Monica G Manmadkar
- Harvard Medical School, Brigham and Women's Hospital, Boston, Mass; Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital, Massachusetts General Hospital, Boston, Mass
| | - Eric D Abston
- Department of Thoracic Surgery, Massachusetts General Hospital, Boston, Mass
| | - Chandan Pavuluri
- Department of Medicine, Channing Division of Network Medicine, Division of Pulmonary and Critical Care Medicine, Harvard Medical School, Boston, Mass; Harvard Medical School, Brigham and Women's Hospital, Boston, Mass
| | - Aabida Saferali
- Harvard Medical School, Brigham and Women's Hospital, Boston, Mass; Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital, Massachusetts General Hospital, Boston, Mass
| | - Sofina Begum
- Harvard Medical School, Brigham and Women's Hospital, Boston, Mass; Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital, Massachusetts General Hospital, Boston, Mass
| | - John P Ziniti
- Harvard Medical School, Brigham and Women's Hospital, Boston, Mass; Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital, Massachusetts General Hospital, Boston, Mass
| | - Amund Gulsvik
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Per S Bakke
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Hugues Aschard
- Department of Computational Biology, Institut Pasteur, Universit de Paris, Paris, France
| | - Carlos Iribarren
- Division of Research, Kaiser Permanente Northern California, Oakland, Calif
| | - Craig P Hersh
- Department of Medicine, Channing Division of Network Medicine, Division of Pulmonary and Critical Care Medicine, Harvard Medical School, Boston, Mass; Harvard Medical School, Brigham and Women's Hospital, Boston, Mass
| | - Jeffrey A Sparks
- Harvard Medical School, Brigham and Women's Hospital, Boston, Mass; Department of Medicine, Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, Mass
| | - Brian D Hobbs
- Department of Medicine, Channing Division of Network Medicine, Division of Pulmonary and Critical Care Medicine, Harvard Medical School, Boston, Mass; Harvard Medical School, Brigham and Women's Hospital, Boston, Mass
| | - Jessica A Lasky-Su
- Harvard Medical School, Brigham and Women's Hospital, Boston, Mass; Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital, Massachusetts General Hospital, Boston, Mass
| | - Edwin K Silverman
- Harvard Medical School, Brigham and Women's Hospital, Boston, Mass; Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital, Massachusetts General Hospital, Boston, Mass
| | - Scott T Weiss
- Harvard Medical School, Brigham and Women's Hospital, Boston, Mass; Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital, Massachusetts General Hospital, Boston, Mass
| | - Ann Chen Wu
- Department of Population Medicine, PRecisiOn Medicine Translational Research (PROMoTeR) Center, Harvard Medical School and Harvard Pilgrim Health Care, Boston, Mass
| | - Michael H Cho
- Department of Medicine, Channing Division of Network Medicine, Division of Pulmonary and Critical Care Medicine, Harvard Medical School, Boston, Mass; Harvard Medical School, Brigham and Women's Hospital, Boston, Mass.
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Chen Q, Dwaraka VB, Carreras-Gallo N, Mendez K, Chen Y, Begum S, Kachroo P, Prince N, Went H, Mendez T, Lin A, Turner L, Moqri M, Chu SH, Kelly RS, Weiss ST, Rattray NJ, Gladyshev VN, Karlson E, Wheelock C, Mathé EA, Dahlin A, McGeachie MJ, Smith R, Lasky-Su JA. OMICmAge: An integrative multi-omics approach to quantify biological age with electronic medical records. bioRxiv 2023:2023.10.16.562114. [PMID: 37904959 PMCID: PMC10614756 DOI: 10.1101/2023.10.16.562114] [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] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
Biological aging is a multifactorial process involving complex interactions of cellular and biochemical processes that is reflected in omic profiles. Using common clinical laboratory measures in ~30,000 individuals from the MGB-Biobank, we developed a robust, predictive biological aging phenotype, EMRAge, that balances clinical biomarkers with overall mortality risk and can be broadly recapitulated across EMRs. We then applied elastic-net regression to model EMRAge with DNA-methylation (DNAm) and multiple omics, generating DNAmEMRAge and OMICmAge, respectively. Both biomarkers demonstrated strong associations with chronic diseases and mortality that outperform current biomarkers across our discovery (MGB-ABC, n=3,451) and validation (TruDiagnostic, n=12,666) cohorts. Through the use of epigenetic biomarker proxies, OMICmAge has the unique advantage of expanding the predictive search space to include epigenomic, proteomic, metabolomic, and clinical data while distilling this in a measure with DNAm alone, providing opportunities to identify clinically-relevant interconnections central to the aging process.
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Affiliation(s)
- Qingwen Chen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | | | | | - Kevin Mendez
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Yulu Chen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Sofina Begum
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Priyadarshini Kachroo
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Nicole Prince
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | | | | | - Aaron Lin
- TruDiagnostic, Inc., Lexington, KY USA
| | | | - Mahdi Moqri
- Division of Genetics, Dept. of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Department of Genetics, School of Medicine, Stanford University, Stanford, CA, USA
| | - Su H. Chu
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Rachel S. Kelly
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Scott T. Weiss
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Nicholas J.W Rattray
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK
- Strathclyde Centre for Molecular Bioscience, University of Strathclyde, Glasgow, UK
| | - Vadim N. Gladyshev
- Division of Genetics, Dept. of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Elizabeth Karlson
- Department of Personalized Medicine, Mass General Brigham and Harvard Medical School, Boston, MA, USA
| | - Craig Wheelock
- Division of Physiological Chemistry 2, Dept of Medical Biochemistry and Biophysics, Karolinska Institute, Stockholm, Sweden
| | - Ewy A. Mathé
- Division of Preclinical Innovation, National Center for Advancing Translational Science, National Institutes of Health, Rockville, MD, USA
| | - Amber Dahlin
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Michae J. McGeachie
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | | | - Jessica A. Lasky-Su
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
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Faysal MR, Akter T, Hossain MS, Begum S, Banu M, Sarkar S, Krishna SP, Sultana I, Hoque MR. Study of Serum Zinc Level in Patients with Type 2 Diabetes Mellitus. Mymensingh Med J 2023; 32:992-997. [PMID: 37777891] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/02/2023]
Abstract
A major global public health concern is the prevalence of diabetes mellitus, especially in developing countries like Bangladesh. While still battling communicable diseases, Bangladesh is already inundated with non-communicable diseases. Type 2 diabetes has been found in almost 90.0% of all instances of diabetes. The main risk factors for type 2 diabetes are an excessively caloric diet, advanced age, sedentary behavior and obesity. Along with preexisting risk factors, many micro-nutrients have been related to a rise in the incidence of diabetes. The study's objective was to measure and contrast the zinc levels in serum between individuals with type 2 diabetes mellitus and healthy controls. This cross-sectional study was conducted from July 2018 to June 2019 at the Mymensingh Medical College, Mymensingh, Bangladesh. Based on inclusion and exclusion criteria, the subjects were chosen using a purposeful (non-random) sample method. In total, 100 people participated in this study. They were divided into two groups: 50 individuals who had been diagnosed with type 2 diabetes mellitus were chosen as cases and 50 individuals who appeared to be in generally excellent health were chosen as controls. For the analytical aims of this investigation, serum zinc levels were examined. All values were expressed as the mean SD. The statistical analyses were carried out using the Windows program statistics package for social science (SPSS). The statistical significance of the difference between the case and control groups was evaluated using the Student's unpaired 't' test. A thorough research revealed that type 2 diabetes mellitus patients had significantly lower mean serum zinc levels than healthy controls (case group was 110.96±13.60 and control group 130.18±9.95μg/dl). Cross-sectional research was used in this study. The current study's findings showed that type 2 diabetes mellitus patients had dramatically changed serum zinc levels. The study's hypothesis was verified as a result.
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Affiliation(s)
- M R Faysal
- Dr Mohammad Robin Faysal, Assistant Professor, Department of Biochemistry, Mymensingh Medical College (MMC), Mymensingh, Bangladesh; E-mail:
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9
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Chen Y, Mendez K, Begum S, Dean E, Chatelaine H, Braisted J, Fangal VD, Cote M, Huang M, Chu SH, Stav M, Chen Q, Prince N, Kelly R, Christopher KB, Diray-Arce J, Mathé EA, Lasky-Su J. The value of prospective metabolomic susceptibility endotypes: broad applicability for infectious diseases. EBioMedicine 2023; 96:104791. [PMID: 37734204 PMCID: PMC10518609 DOI: 10.1016/j.ebiom.2023.104791] [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: 03/28/2023] [Revised: 08/22/2023] [Accepted: 08/23/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND As new infectious diseases (ID) emerge and others continue to mutate, there remains an imminent threat, especially for vulnerable individuals. Yet no generalizable framework exists to identify the at-risk group prior to infection. Metabolomics has the advantage of capturing the existing physiologic state, unobserved via current clinical measures. Furthermore, metabolomics profiling during acute disease can be influenced by confounding factors such as indications, medical treatments, and lifestyles. METHODS We employed metabolomic profiling to cluster infection-free individuals and assessed their relationship with COVID severity and influenza incidence/recurrence. FINDINGS We identified a metabolomic susceptibility endotype that was strongly associated with both severe COVID (ORICUadmission = 6.7, p-value = 1.2 × 10-08, ORmortality = 4.7, p-value = 1.6 × 10-04) and influenza (ORincidence = 2.9; p-values = 2.2 × 10-4, βrecurrence = 1.03; p-value = 5.1 × 10-3). We observed similar severity associations when recapitulating this susceptibility endotype using metabolomics from individuals during and after acute COVID infection. We demonstrate the value of using metabolomic endotyping to identify a metabolically susceptible group for two-and potentially more-IDs that are driven by increases in specific amino acids, including microbial-related metabolites such as tryptophan, bile acids, histidine, polyamine, phenylalanine, and tyrosine metabolism, as well as carbohydrates involved in glycolysis. INTERPRETATIONS These metabolites may be identified prior to infection to enable protective measures for these individuals. FUNDING The Longitudinal EMR and Omics COVID-19 Cohort (LEOCC) and metabolomic profiling were supported by the National Heart, Lung, and Blood Institute and the Intramural Research Program of the National Center for Advancing Translational Sciences, National Institutes of Health.
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Affiliation(s)
- Yulu Chen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Kevin Mendez
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Sofina Begum
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Emily Dean
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Haley Chatelaine
- Division of Preclinical Innovation, National Center for Advancing Translational Science, National Institutes of Health, Rockville, MD, USA
| | - John Braisted
- Division of Preclinical Innovation, National Center for Advancing Translational Science, National Institutes of Health, Rockville, MD, USA
| | - Vrushali D Fangal
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Margaret Cote
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Mengna Huang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Su H Chu
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Meryl Stav
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Qingwen Chen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Nicole Prince
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Rachel Kelly
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Kenneth B Christopher
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Division of Renal Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Joann Diray-Arce
- Precision Vaccines Program, Division of Infectious Diseases, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - Ewy A Mathé
- Division of Preclinical Innovation, National Center for Advancing Translational Science, National Institutes of Health, Rockville, MD, USA.
| | - Jessica Lasky-Su
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
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10
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Luo Q, Dwaraka VB, Chen Q, Tong H, Zhu T, Seale K, Raffaele JM, Zheng SC, Mendez TL, Chen Y, Carreras N, Begum S, Mendez K, Voisin S, Eynon N, Lasky-Su JA, Smith R, Teschendorff AE. A meta-analysis of immune-cell fractions at high resolution reveals novel associations with common phenotypes and health outcomes. Genome Med 2023; 15:59. [PMID: 37525279 PMCID: PMC10388560 DOI: 10.1186/s13073-023-01211-5] [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: 03/08/2023] [Accepted: 07/10/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Changes in cell-type composition of tissues are associated with a wide range of diseases and environmental risk factors and may be causally implicated in disease development and progression. However, these shifts in cell-type fractions are often of a low magnitude, or involve similar cell subtypes, making their reliable identification challenging. DNA methylation profiling in a tissue like blood is a promising approach to discover shifts in cell-type abundance, yet studies have only been performed at a relatively low cellular resolution and in isolation, limiting their power to detect shifts in tissue composition. METHODS Here we derive a DNA methylation reference matrix for 12 immune-cell types in human blood and extensively validate it with flow-cytometric count data and in whole-genome bisulfite sequencing data of sorted cells. Using this reference matrix, we perform a directional Stouffer and fixed effects meta-analysis comprising 23,053 blood samples from 22 different cohorts, to comprehensively map associations between the 12 immune-cell fractions and common phenotypes. In a separate cohort of 4386 blood samples, we assess associations between immune-cell fractions and health outcomes. RESULTS Our meta-analysis reveals many associations of cell-type fractions with age, sex, smoking and obesity, many of which we validate with single-cell RNA sequencing. We discover that naïve and regulatory T-cell subsets are higher in women compared to men, while the reverse is true for monocyte, natural killer, basophil, and eosinophil fractions. Decreased natural killer counts associated with smoking, obesity, and stress levels, while an increased count correlates with exercise and sleep. Analysis of health outcomes revealed that increased naïve CD4 + T-cell and N-cell fractions associated with a reduced risk of all-cause mortality independently of all major epidemiological risk factors and baseline co-morbidity. A machine learning predictor built only with immune-cell fractions achieved a C-index value for all-cause mortality of 0.69 (95%CI 0.67-0.72), which increased to 0.83 (0.80-0.86) upon inclusion of epidemiological risk factors and baseline co-morbidity. CONCLUSIONS This work contributes an extensively validated high-resolution DNAm reference matrix for blood, which is made freely available, and uses it to generate a comprehensive map of associations between immune-cell fractions and common phenotypes, including health outcomes.
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Affiliation(s)
- Qi Luo
- CAS Key Laboratory of Computational Biology, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, 320 Yue Yang Road, Shanghai, 200031, China
| | - Varun B Dwaraka
- TruDiagnostics, 881 Corporate Dr., Lexington, KY, 40503, USA
| | - Qingwen Chen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA
| | - Huige Tong
- CAS Key Laboratory of Computational Biology, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, 320 Yue Yang Road, Shanghai, 200031, China
| | - Tianyu Zhu
- CAS Key Laboratory of Computational Biology, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, 320 Yue Yang Road, Shanghai, 200031, China
| | - Kirsten Seale
- Institute for Health and Sport (iHeS), Victoria University, Footscray, VIC, 3011, Australia
| | - Joseph M Raffaele
- PhysioAge LLC, 30 Central Park South / Suite 8A, New York, NY, 10019, USA
| | - Shijie C Zheng
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Tavis L Mendez
- TruDiagnostics, 881 Corporate Dr., Lexington, KY, 40503, USA
| | - Yulu Chen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA
| | | | - Sofina Begum
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA
| | - Kevin Mendez
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA
| | - Sarah Voisin
- Institute for Health and Sport (iHeS), Victoria University, Footscray, VIC, 3011, Australia
| | - Nir Eynon
- Australian Regenerative Medicine Institute, Monash University, Clayton, VIC, 3800, Australia
| | - Jessica A Lasky-Su
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA.
| | - Ryan Smith
- TruDiagnostics, 881 Corporate Dr., Lexington, KY, 40503, USA.
| | - Andrew E Teschendorff
- CAS Key Laboratory of Computational Biology, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, 320 Yue Yang Road, Shanghai, 200031, China.
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11
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Alam MS, Karim MB, Mazumder MW, Begum S, Benzamin M, Rahman MH, Hassan MM, Rahman MA, Mondal M, Saha D, Biswas SA. Comparison of Serum Zinc in Children of Wilson Disease and Non-Wilsonian Volunteers in Bangladesh. Mymensingh Med J 2023; 32:681-689. [PMID: 37391960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/02/2023]
Abstract
Wilson disease (WD) is an autosomal recessive disorder of copper metabolism with diverse clinical manifestations. Zinc (Zn) has been used for treatment of WD. Recent studies showed low serum zinc level in patients suffering from WD than the normal. This cross-sectional analytical study has been designed to compare the serum zinc level between paediatric patients suffering from WD but yet not started treatment and children who have normal ALT level. This study was carried out at the Department of Pediatric Gastroenterology and Nutrition, BSMMU, Dhaka, Bangladesh from July 2018 to June 2019. Total 51 children were included in this study. Among them 27 were diagnosed case of WD aged between three to eighteen years and 24 children of same ages who were suffering from other than liver disease having normal ALT were included as volunteers. The patients of WD were divided into four groups according to their presentation as acute hepatitis, chronic liver disease (CLD), acute liver failure & neuropsychiatric manifestation. Informed written consent was obtained from all patients and volunteers for participation in this study. Along with other physical findings and laboratory investigations 3 ml of venous blood were collected for estimation of serum zinc level. After estimation of serum zinc level results were analyzed statistically. The difference in serum zinc levels were compared between the groups. Serum zinc level was significantly lower in Wilson disease patients (43.8±19.7μg/dl; range: 13-83) compared to volunteers group (67.8±11.8μg/dl; range: 47-97) p<0.001. Among the diseased group, serum zinc level were significantly lower in 18 CLD (38.4±17.4μg/dl) and in 4 acute liver failure (33.1±3.7μg/dl) compared to 4 acute hepatitis (71.8±4.3μg/dl) (p=0.001) and (p<0.001) respectively. Mean serum zinc level was low in 4 Wilsonian acute liver failure (33.1±3.7μg/dl), which was significant compared to those (23) who presented as Wilson disease non acute liver failure (45.7±20.8μg/dl) (p=0.013). Serum zinc level was significantly lower in Wilson disease children compared to the volunteers. Zinc level was also found significantly low in Wilson disease presented as CLD and acute liver failure in comparison to Wilson disease presented as acute hepatitis.
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Affiliation(s)
- M S Alam
- Dr Md Shafiul Alam, Department of Pediatric Gastroenterology and Nutrition, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh; E-mail:
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12
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Prince N, Kelly RS, Chu SH, Kachroo P, Chen Y, Mendez KM, Begum S, Bisgaard H, Bønnelykke K, Kim M, Levy O, Litonjua AA, Wheelock CE, Weiss ST, Chawes BL, Lasky-Su JA. Elevated third trimester corticosteroid levels are associated with fewer offspring infections. Sci Rep 2023; 13:10461. [PMID: 37380711 PMCID: PMC10307773 DOI: 10.1038/s41598-023-36535-0] [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: 03/07/2023] [Accepted: 06/06/2023] [Indexed: 06/30/2023] Open
Abstract
Respiratory infections are a leading cause of morbidity and mortality in early life, and recurrent infections increase the risk of developing chronic diseases. The maternal environment during pregnancy can impact offspring health, but the factors leading to increased infection proneness have not been well characterized during this period. Steroids have been implicated in respiratory health outcomes and may similarly influence infection susceptibility. Our objective was to describe relationships between maternal steroid levels and offspring infection proneness. Using adjusted Poisson regression models, we evaluated associations between sixteen androgenic and corticosteroid metabolites during pregnancy and offspring respiratory infection incidence across two pre-birth cohorts (N = 774 in VDAART and N = 729 in COPSAC). Steroid metabolites were measured in plasma samples from pregnant mothers across all trimesters of pregnancy by ultrahigh-performance-liquid-chromatography/mass-spectrometry. We conducted further inquiry into associations of steroids with related respiratory outcomes: asthma and lung function spirometry. Higher plasma corticosteroid levels in the third trimester of pregnancy were associated with lower incidence of offspring respiratory infections (P = 4.45 × 10-7 to 0.002) and improved lung function metrics (P = 0.020-0.036). Elevated maternal androgens were generally associated with increased offspring respiratory infections and worse lung function, with some associations demonstrating nominal significance at P < 0.05, but these trends were inconsistent across individual androgens. Increased maternal plasma corticosteroid levels in the late second and third trimesters were associated with lower infections and better lung function in offspring, which may represent a potential avenue for intervention through corticosteroid supplementation in late pregnancy to reduce offspring respiratory infection susceptibility in early life.Clinical Trial Registry information: VDAART and COPSAC were originally conducted as clinical trials; VDAART: ClinicalTrials.gov identifier NCT00920621; COPSAC: ClinicalTrials.gov identifier NCT00798226.
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Affiliation(s)
- Nicole Prince
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA
| | - Rachel S Kelly
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA
| | - Su H Chu
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA
| | - Priyadarshini Kachroo
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA
| | - Yulu Chen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA
| | - Kevin M Mendez
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA
| | - Sofina Begum
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA
| | - Hans Bisgaard
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, 2820, Gentofte, Denmark
| | - Klaus Bønnelykke
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, 2820, Gentofte, Denmark
| | - Min Kim
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, 2820, Gentofte, Denmark
| | - Ofer Levy
- Precision Vaccines Program, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - Augusto A Litonjua
- Division of Pediatric Pulmonary Medicine, Department of Pediatrics, Golisano Children's Hospital and University of Rochester Medical Center, Rochester, NY, USA
| | - Craig E Wheelock
- Unit of Integrative Metabolomics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Stockholm, Sweden
- Gunma University Initiative for Advanced Research (GIAR), Gunma University, Maebashi, Japan
| | - Scott T Weiss
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA
| | - Bo L Chawes
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, 2820, Gentofte, Denmark
| | - Jessica A Lasky-Su
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA.
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Begum S, Lodge S, Hall D, Johnson BZ, Bong SH, Whiley L, Gray N, Fear VS, Fear MW, Holmes E, Wood FM, Nicholson JK. Cardiometabolic disease risk markers are increased following burn injury in children. Front Public Health 2023; 11:1105163. [PMID: 37333522 PMCID: PMC10275366 DOI: 10.3389/fpubh.2023.1105163] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 05/11/2023] [Indexed: 06/20/2023] Open
Abstract
Introduction Burn injury in children causes prolonged systemic effects on physiology and metabolism leading to increased morbidity and mortality, yet much remains undefined regarding the metabolic trajectory towards specific health outcomes. Methods A multi-platform strategy was implemented to evaluate the long-term immuno-metabolic consequences of burn injury combining metabolite, lipoprotein, and cytokine panels. Plasma samples from 36 children aged 4-8 years were collected 3 years after a burn injury together with 21 samples from non-injured age and sex matched controls. Three different 1H Nuclear Magnetic Resonance spectroscopic experiments were applied to capture information on plasma low molecular weight metabolites, lipoproteins, and α-1-acid glycoprotein. Results Burn injury was characterized by underlying signatures of hyperglycaemia, hypermetabolism and inflammation, suggesting disruption of multiple pathways relating to glycolysis, tricarboxylic acid cycle, amino acid metabolism and the urea cycle. In addition, very low-density lipoprotein sub-components were significantly reduced in participants with burn injury whereas small-dense low density lipoprotein particles were significantly elevated in the burn injured patient plasma compared to uninjured controls, potentially indicative of modified cardiometabolic risk after a burn. Weighted-node Metabolite Correlation Network Analysis was restricted to the significantly differential features (q <0.05) between the children with and without burn injury and demonstrated a striking disparity in the number of statistical correlations between cytokines, lipoproteins, and small molecular metabolites in the injured groups, with increased correlations between these groups. Discussion These findings suggest a 'metabolic memory' of burn defined by a signature of interlinked and perturbed immune and metabolic function. Burn injury is associated with a series of adverse metabolic changes that persist chronically and are independent of burn severity and this study demonstrates increased risk of cardiovascular disease in the long-term. These findings highlight a crucial need for improved longer term monitoring of cardiometabolic health in a vulnerable population of children that have undergone burn injury.
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Affiliation(s)
- Sofina Begum
- Harvard Medical School, Harvard University, Boston, MA, United States
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA, United States
- Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, United Kingdom
- Australian National Phenome Centre, Computational and Systems Medicine, Health Futures Institute, Perth, WA, Australia
- School of Biomedical Sciences, The University of Western Australia, Perth, WA, Australia
| | - Samantha Lodge
- Australian National Phenome Centre, Computational and Systems Medicine, Health Futures Institute, Perth, WA, Australia
| | - Drew Hall
- Australian National Phenome Centre, Computational and Systems Medicine, Health Futures Institute, Perth, WA, Australia
| | - Blair Z. Johnson
- School of Biomedical Sciences, The University of Western Australia, Perth, WA, Australia
| | - Sze How Bong
- Australian National Phenome Centre, Computational and Systems Medicine, Health Futures Institute, Perth, WA, Australia
| | - Luke Whiley
- Australian National Phenome Centre, Computational and Systems Medicine, Health Futures Institute, Perth, WA, Australia
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia
- Centre for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Perth, WA, Australia
| | - Nicola Gray
- Australian National Phenome Centre, Computational and Systems Medicine, Health Futures Institute, Perth, WA, Australia
- Centre for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Perth, WA, Australia
| | - Vanessa S. Fear
- Translational Genetics, Telethon Kids Institute, Perth, WA, Australia
| | - Mark W. Fear
- School of Biomedical Sciences, The University of Western Australia, Perth, WA, Australia
| | - Elaine Holmes
- Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, United Kingdom
- Australian National Phenome Centre, Computational and Systems Medicine, Health Futures Institute, Perth, WA, Australia
- Centre for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Perth, WA, Australia
| | - Fiona M. Wood
- School of Biomedical Sciences, The University of Western Australia, Perth, WA, Australia
- WA Department of Health, Burns Service of Western Australia, Perth, WA, Australia
| | - Jeremy K. Nicholson
- Australian National Phenome Centre, Computational and Systems Medicine, Health Futures Institute, Perth, WA, Australia
- Centre for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Perth, WA, Australia
- Faculty of Medicine, Institute of Global Health Innovation, London, United Kingdom
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14
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Kathirvalu G, Chandramathi S, S A A, Atiya N, Begum S, Christophe W, Sulaiman M, Abdullah N, Mani RR, Jindal HM, Zulkipli M. Antibacterial and antibiotic potentiating capabilities of extracts isolated from Burkillanthus malaccensis, Diospyros hasseltii and Cleisthanthus bracteosus against human pathogenic bacteria. Trop Biomed 2023; 40:152-159. [PMID: 37650400 DOI: 10.47665/tb.40.2.004] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Antibiotics which once a boon in medicine and saved millions of lives are now facing an ever-growing menace of antibacterial resistance, which desperately needs new antibacterial drugs which are innovative in chemistry and mode of action. For many years, the world has turned to natural plants with antibacterial properties to combat antibiotic resistance. On that basis, we aimed to identify plants with antibacterial and antibiotic potentiating properties. Seventeen different extracts of 3 plants namely Burkillanthus malaccensis, Diospyros hasseltii and Cleisthanthus bracteosus were tested against multi-drug resistant Acinetobacter baumannii, Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, Methicillinresistant Staphylococcus aureus (MRSA) and methicillin-susceptible Staphylococcus aureus (MSSA). Antibacterial activity of hexane, methanol and chloroform extracts of bark, seed, fruit, flesh and leaves from these plants were tested using, disk diffusion assay, minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) assays. Antibiotic potentiating capabilities were tested using time-kill assay. B. malaccensis fruit chloroform extract showed the biggest zone of inhibition against MRSA (13.00±0.0 mm) but C. bracteosus bark methanol extract showed the biggest inhibition zone against MSSA (15.33±0.6 mm). Interestingly, bark methanol extract of C. bracteosus was active against MRSA (8.7±0.6 mm), MSSA (7.7±0.6 mm) (Gram-positive) and A. baumannii (7.7±0.6 mm) (Gram-negative). Overall, the leaf methanol and bark methanol extract of C. bracteosus warrants further investigation such as compound isolation and mechanism of action for validating its therapeutic use as antibiotic potentiator importantly against MRSA and A. baumannii.
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Affiliation(s)
- G Kathirvalu
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - S Chandramathi
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Azahar S A
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - N Atiya
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - S Begum
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - W Christophe
- Institute of Tropical Biology and Conservation, University Malaysia Sabah, Sabah, Malaysia
| | - M Sulaiman
- Chemistry Faculty, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - N Abdullah
- Natural Product Division, Forest Research Institute Malaysia (FRIM), 52109 Kepong, Selangor
| | - R R Mani
- Department of Pharmaceutical Biology, Faculty of Pharmaceutical Sciences, UCSI University, Cheras, 56000, Kuala Lumpur, Malaysia
| | - H M Jindal
- Miller School of Medicine, University of Miami, Florida, United States
| | - M Zulkipli
- School of Pharmacy, Faculty of Science and Engineering, University of Nottingham Malaysia, Jalan Broga, 43500, Semenyih, Selangor
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15
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Prince N, Begum S, Mínguez-Alarcón L, Génard-Walton M, Huang M, Soeteman DI, Wheelock C, Litonjua AA, Weiss ST, Kelly RS, Lasky-Su J. Corrigendum to "Plasma concentrations of per- and polyfluoroalkyl substances are associated with perturbations in lipid and amino acid metabolism" [Chemosphere 324 (2023)138228]. Chemosphere 2023; 327:138420. [PMID: 36996501 DOI: 10.1016/j.chemosphere.2023.138420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Affiliation(s)
- Nicole Prince
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Sofina Begum
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Lidia Mínguez-Alarcón
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | - Mengna Huang
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Djøra I Soeteman
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Center for Health Decision Science, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Craig Wheelock
- Department of Medical Biochemistry and Biophysics, Division of Physiological Chemistry 2, Karolinska Institute, Stockholm, Sweden
| | - Augusto A Litonjua
- Golisano Children's Hospital, Division of Pulmonary Medicine, University of Rochester, Rochester, NY, USA
| | - Scott T Weiss
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Rachel S Kelly
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Jessica Lasky-Su
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
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16
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Prince N, Begum S, Mínguez-Alarcón L, Génard-Walton M, Huang M, Soeteman DI, Wheelock C, Litonjua AA, Weiss ST, Kelly RS, Lasky-Su J. Plasma concentrations of per- and polyfluoroalkyl substances are associated with perturbations in lipid and amino acid metabolism. Chemosphere 2023; 324:138228. [PMID: 36878362 PMCID: PMC10080462 DOI: 10.1016/j.chemosphere.2023.138228] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
Exposure to per- and polyfluoroalkyl substances (PFAS) through the environment can lead to harmful health outcomes and the development of disease. However, little is known about how PFAS impact underlying biology that contributes to these adverse health effects. The metabolome represents the end product of cellular processes and has been used previously to understand physiological changes that lead to disease. In this study, we investigated whether exposure to PFAS was associated with the global, untargeted metabolome. In a cohort of 459 pregnant mothers and 401 children, we quantified plasma concentrations of six individual PFAS- PFOA, PFOS, PFHXS, PFDEA, and PFNA- and performed plasma metabolomic profiling by UPLC-MS. In adjusted linear regression analysis, we found associations between plasma PFAS and perturbations in lipid and amino acid metabolites in both mothers and children. In mothers, metabolites of 19 lipid pathways and 8 amino acid pathways were significantly associated with PFAS exposure at an FDR<0.05 threshold; in children, metabolites of 28 lipid pathways and 10 amino acid pathways exhibited significant associations at FDR<0.05 with PFAS exposure. Our investigation found that metabolites of the Sphingomyelin, Lysophospholipid, Long Chain Polyunsaturated Fatty Acid (n3 and n6), Fatty Acid- Dicarboxylate, and Urea Cycle showed the most significant associations with PFAS, suggesting these may be particular pathways of interest in the physiological response to PFAS. To our knowledge, this is the first study to characterize associations between the global metabolome and PFAS across multiple periods in the life course to understand impacts on underlying biology, and the findings presented here are relevant in understanding how PFAS disrupt normal biological function and may ultimately give rise to harmful health effects.
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Affiliation(s)
- Nicole Prince
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Sofina Begum
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Lidia Mínguez-Alarcón
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | - Mengna Huang
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Djøra I Soeteman
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Center for Health Decision Science, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Craig Wheelock
- Department of Medical Biochemistry and Biophysics, Division of Physiological Chemistry 2, Karolinska Institute, Stockholm, Sweden
| | - Augusto A Litonjua
- Golisano Children's Hospital, Division of Pulmonary Medicine, University of Rochester, Rochester, NY, USA
| | - Scott T Weiss
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Rachel S Kelly
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Jessica Lasky-Su
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
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17
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Banu M, Rahaman MM, Hoque MR, Akhter S, Sultana I, Begum S, Hossain MS, Jenea AT. Relationship of Serum Creatinine Level in Heart Failure Patients in Bangladesh. Mymensingh Med J 2023; 32:293-295. [PMID: 37002736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Abstract
Heart failure means that the heart is unable to pump blood around the body properly. It usually happens because the heart has become too weak or stuff. In collaboration with department of Cardiology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh this cross-sectional study from January to December 2018 was performed in the department of Biochemistry in Mymensingh Medical College, Mymensingh, Bangladesh. The aim of this study was to explore the relationship of serum creatinine in patients with heart failure (HF) for management purpose. In this study 120 subjects were included, where 60 patients of diagnosed HF acts as case group and 60 individuals were normal healthy acts as control group. Serum creatinine was determined by colorimetric method from each sample. Statistical analysis was performed by SPSS windows package, version 21. Among the study groups the mean serum creatinine levels were 2.20±0.87mg/dl and 0.92±0.26mg/dl in case and control group respectively. Analysis showed that the mean serum creatinine level was highly significantly (p<0.001) increased in HF patients in comparison to that of control group.
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Affiliation(s)
- M Banu
- Dr Motahera Banu, Lecturer, Department of Biochemistry, Mymensingh Medical College (MMC), Mymensingh, Bangladesh; E-mail:
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18
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Jeyin N, Desai SR, Padley SPG, Wechalekar K, Gregg S, Sousa T, Shah PL, Allinson JP, Hopkinson NS, Begum S, Jordan S, Kemp SV, Ridge CA. Dual-energy Computed Tomographic Pulmonary Angiography Accurately Estimates Lobar Perfusion Before Lung Volume Reduction for Severe Emphysema. J Thorac Imaging 2023; 38:104-112. [PMID: 36162074 DOI: 10.1097/rti.0000000000000675] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To assess if dual-energy computed tomographic pulmonary angiography (DECTPA) derived lobar iodine quantification can provide an accurate estimate of lobar perfusion in patients with severe emphysema, and offer an adjunct to single-photon emission CT perfusion scintigraphy (SPECT-PS) in assessing suitability for lung volume reduction (LVR). MATERIALS AND METHODS Patients with severe emphysema (forced expiratory volume in 1 s <49% predicted) undergoing evaluation for LVR between May 2018 and April 2020 imaged with both SPECT-PS and DECTPA were included in this retrospective study. DECTPA perfused blood volume maps were automatically segmented and lobar iodine mass was estimated and compared with lobar technetium (Tc99m) distribution acquired with SPECT-PS. Pearson correlation and Bland-Altman analysis were used for intermodality comparison between DECTPA and SPECT-PS. Univariate and adjusted multivariate linear regression were modelled to ascertain the effect sizes of possible confounders of disease severity, sex, age, and body mass index on the relationship between lobar iodine and Tc99m values. Effective radiation dose and adverse reactions were recorded. RESULTS In all, 123 patients (64.5±8.8 y, 71 men; mean predicted forced expiratory volume in 1 s 32.1 ±12.7%,) were eligible for inclusion. There was a linear relationship between lobar perfusion values acquired using DECTPA and SPECT-PS with statistical significance ( P <0.001). Lobar relative perfusion values acquired using DECTPA and SPECT-PS had a consistent relationship both by linear regression and Bland-Altman analysis (mean bias, -0.01, mean r2 0.64; P <0.0001). Individual lobar comparisons demonstrated moderate correlation ( r =0.79, 0.78, 0.84, 0.78, 0.8 for the right upper, middle, lower, left upper, and lower lobes, respectively, P <0.0001). The relationship between lobar iodine and Tc99m values was not significantly altered after controlling for confounders including symptom and disease severity, age, sex, and body mass index. CONCLUSIONS DECTPA provides an accurate estimation of lobar perfusion, showing good agreement with SPECT-PS and could potentially streamline preoperative assessment for LVR.
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Affiliation(s)
| | - Sujal R Desai
- National Heart and Lung Institute, Imperial College London
- Departments of Imaging
| | - Simon P G Padley
- National Heart and Lung Institute, Imperial College London
- Departments of Imaging
| | | | | | | | - Pallav L Shah
- Respiratory Medicine, Royal Brompton Hospital, London, UK
| | | | - Nicholas S Hopkinson
- National Heart and Lung Institute, Imperial College London
- Respiratory Medicine, Royal Brompton Hospital, London, UK
| | | | | | - Samuel V Kemp
- National Heart and Lung Institute, Imperial College London
- Respiratory Medicine, Royal Brompton Hospital, London, UK
| | - Carole A Ridge
- National Heart and Lung Institute, Imperial College London
- Departments of Imaging
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19
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Kelly RS, Cote MF, Begum S, Lasky-Su J. Pharmacometabolomics of Asthma as a Road Map to Precision Medicine. Handb Exp Pharmacol 2023; 277:247-273. [PMID: 36271166 PMCID: PMC10116407 DOI: 10.1007/164_2022_615] [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: 04/22/2023]
Abstract
Pharmacometabolomics applies the principles of metabolomics to therapeutics in order to elucidate the biological mechanisms underlying the variation in responses to drugs between groups and individuals. Asthma is associated with broad systemic effects and heterogeneity in treatment response and as such is ideally suited to pharmacometabolomics. In this chapter, we discuss the state of the emerging field of asthma pharmacometabolomics, with a particular focus on studies of steroids, bronchodilators, and leukotriene inhibitors. We also consider those studies concerned with subtyping cases to better understand the pharmacology of those groups and those looking to leverage pharmacometabolomics for asthma prevention. We finish with a discussion of the challenges and opportunities of asthma pharmacometabolomics and reflect upon where this field must go next in order to realize its precision medicine potential.
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Affiliation(s)
- Rachel S Kelly
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
| | - Margaret F Cote
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Sofina Begum
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Jessica Lasky-Su
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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20
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Faysal MR, Akter T, Hossain MS, Begum S, Banu M, Tasnim J, Sultana I, Krishna SP, Alam S, Akter T, Jenea AT. Study of Serum Calcium and Magnesium Levels in Type 2 Diabetes Mellitus Patients. Mymensingh Med J 2023; 32:54-60. [PMID: 36594301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The prevalence of diabetes mellitus is a significant global public health concern, particularly in emerging nations like Bangladesh. Bangladesh is already overrun with non-communicable diseases while still battling communicable diseases. About 90.0% of all cases of diabetes that have been diagnosed are type 2 diabetes. High calorie diet, age, sedentary lifestyle and obesity are the main risk factors for type 2 diabetes. Different micronutrients have been linked to an increased incidence of diabetes in addition to existing risk factors. The goal of the study was to assess the serum levels of calcium and magnesium in people with type 2 diabetes mellitus and compare them to those in healthy controls. This cross-sectional study was conducted from July 2018 to June 2019 at the Mymensingh Medical College, Mymensingh, Department of Biochemistry in cooperation with the Department of Endocrinology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh. Purposive (non-random) sampling was used to pick the subjects based on inclusion and exclusion criteria. This study had 100 individuals in total. Out of them, 50 people with type 2 diabetes mellitus who had been diagnosed were chosen as cases, and another 50 people who appeared to be in generally good health were chosen as controls. Serum calcium and magnesium levels were measured for this study's analytical purposes. The mean±SD was used to express all values. The statistical package for social science (SPSS), a Windows application, was used to conduct the statistical analyses. Using the Student's unpaired 't' test, the statistical significance of the difference between the case and control groups was assessed. Following comprehensive analysis, it was discovered that type 2 diabetes mellitus patients had considerably lower mean serum calcium (in case group was 8.46±0.63 and control group 8.86±0.64mg/dl) and magnesium levels (in case group was 2.09±0.42 and control group 2.24±0.16mg/dl) than healthy controls. According to the results of the current investigation, patients with type 2 diabetes mellitus had significantly altered serum calcium and magnesium levels. As a result, the study's hypothesis was accepted.
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Affiliation(s)
- M R Faysal
- Dr Mohammad Robin Faysal, Assistant Professor, Department of Biochemistry, Mymensingh Medical College (MMC), Mymensingh, Bangladesh; E-mail:
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21
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Martinez-Gili L, Pechlivanis A, McDonald JA, Begum S, Badrock J, Dyson JK, Jones R, Hirschfield G, Ryder SD, Sandford R, Rushbrook S, Thorburn D, Taylor-Robinson SD, Crossey MM, Marchesi JR, Mells G, Holmes E, Jones D. Bacterial and metabolic phenotypes associated with inadequate response to ursodeoxycholic acid treatment in primary biliary cholangitis. Gut Microbes 2023; 15:2208501. [PMID: 37191344 PMCID: PMC10190197 DOI: 10.1080/19490976.2023.2208501] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 01/20/2023] [Revised: 04/06/2023] [Accepted: 04/21/2023] [Indexed: 05/17/2023] Open
Abstract
Primary biliary cholangitis (PBC) is a chronic cholestatic liver disease with ursodeoxycholic acid (UDCA) as first-line treatment. Poor response to UDCA is associated with a higher risk of progressing to cirrhosis, but the underlying mechanisms are unclear. UDCA modulates the composition of primary and bacterial-derived bile acids (BAs). We characterized the phenotypic response to UDCA based on BA and bacterial profiles of PBC patients treated with UDCA. Patients from the UK-PBC cohort (n = 419) treated with UDCA for a minimum of 12-months were assessed using the Barcelona dynamic response criteria. BAs from serum, urine, and feces were analyzed using Ultra-High-Performance Liquid Chromatography-Mass Spectrometry and fecal bacterial composition measured using 16S rRNA gene sequencing. We identified 191 non-responders, 212 responders, and a subgroup of responders with persistently elevated liver biomarkers (n = 16). Responders had higher fecal secondary and tertiary BAs than non-responders and lower urinary bile acid abundances, with the exception of 12-dehydrocholic acid, which was higher in responders. The sub-group of responders with poor liver function showed lower alpha-diversity evenness, lower abundance of fecal secondary and tertiary BAs than the other groups and lower levels of phyla with BA-deconjugation capacity (Actinobacteriota/Actinomycetota, Desulfobacterota, Verrucomicrobiota) compared to responders. UDCA dynamic response was associated with an increased capacity to generate oxo-/epimerized secondary BAs. 12-dehydrocholic acid is a potential biomarker of treatment response. Lower alpha-diversity and lower abundance of bacteria with BA deconjugation capacity might be associated with an incomplete response to treatment in some patients.
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Affiliation(s)
- Laura Martinez-Gili
- Division of Systems Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
- Division of Digestive Diseases, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Alexandros Pechlivanis
- Division of Systems Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
- Biomic_Auth, Bioanalysis and Omics Laboratory, Center for Interdisciplinary Research and Innovation (CIRI-AUTH), Balkan Centre, Thessaloniki, Greece
| | - Julie A.K. McDonald
- Division of Digestive Diseases, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Sofina Begum
- Division of Digestive Diseases, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Jonathan Badrock
- Academic Department of Medical Genetics, Cambridge University, Cambridge, UK
| | - Jessica K. Dyson
- Liver Unit, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
- Institute of Translational and Clinical Research, Newcastle University, Newcastle upon Tyne, UK
| | - Rebecca Jones
- Leeds Liver Unit, St James’s University Hospital, Leeds, UK
| | - Gideon Hirschfield
- Center for Liver and Gastroenterology Research and National Institute for Health Research (NIHR) Birmingham Biomedical Research Centre, University of Birmingham, Birmingham, UK
| | - Stephen D. Ryder
- NIHR Biomedical Research Centre at Nottingham University Hospitals NHS Trust, University of Nottingham, Nottingham, UK
| | - Richard Sandford
- Academic Department of Medical Genetics, Cambridge University, Cambridge, UK
| | - Simon Rushbrook
- Department of Gastroenterology, Norfolk and Norwich University Hospital, Norwich, UK
| | - Douglas Thorburn
- UCL Royal Free Campus, Royal Free Hospital, University College London Institute of Liver and Digestive Health, London, UK
| | | | - Mary M.E. Crossey
- Division of Digestive Diseases, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Julian R. Marchesi
- Division of Digestive Diseases, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - George Mells
- Academic Department of Medical Genetics, Cambridge University, Cambridge, UK
- Department of Hepatology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Elaine Holmes
- Division of Digestive Diseases, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
- Center for Computational & Systems Medicine, Murdoch University, Perth, Australia
| | - David Jones
- Liver Unit, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
- Institute of Translational and Clinical Research, Newcastle University, Newcastle upon Tyne, UK
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22
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Selina F, Hasan MF, Talha KA, Al-Muhaimin M, Momo FR, Debnath J, Begum S, Ahmad J. Assessing the Effectiveness of Clinical Skills Laboratory and Traditional Lecture in Teaching Basic Life Support and Performance Evaluation According to Different Domains of Revised Bloom's Taxonomy. Mymensingh Med J 2023; 32:207-212. [PMID: 36594322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Sudden cardiac arrest out-side hospital is serious global concern. If non-medical people are taught to initiate the basic life support (BLS) training with cardiopulmonary resuscitation (CPR) then the mortality could be reduced significantly. This was a non-randomized controlled study to evaluate clinical skills laboratory (CSL) as teaching tool for basic life support (BLS) training in comparison to traditional lecture. Sample size was 68 and performed in Sylhet Women's Medical College from July 2022 to September 2022. All the participants were third year nursing students. They were enrolled in to two groups. Group-A were taught BLS by clinical skills laboratory (CSL) and Group-B were taught by traditional lecture (TL). At the end of the teaching all of them were tested by a vetted multiple choice question (MCQ) set. The questions were set according the 5 levels of revised Blood's taxonomy. Mean score of Group-A (CSL) were higher the TL group (p=0.0003). Among the revised Bloom's taxonomy understand, apply and evaluate domains were significantly better taught (p<0.05) by CSL. The sensitivity of CSL was 0.559 in comparison to TL for BLS training. In the modern medical education teaching and assessment should be focused on the higher levels of learning taxonomy. Introducing CSL in medical education could boost up the psychomotor and cognition both in the medical education.
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Affiliation(s)
- F Selina
- Dr Farhana Selina, Associate Professor, Department of Anesthesiology, Sylhet Women's Medical College (SWMC), Sylhet, Bangladesh; E-mail:
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23
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Hossain MS, Sharmin F, Sultana I, Faysal MR, Begum S, Banu M, Rahaman MM, Sarkar S, Tuli JZ, Akhter S, Jenea AT. HbA1c and Troponin-I Levels and Their Relationship in Patients with Acute Coronary Syndrome. Mymensingh Med J 2023; 32:28-34. [PMID: 36594296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Acute coronary syndrome is a growing public health concern. Diabetic patients are more vulnerable to develop acute coronary syndrome due to accelerated atherosclerosis. Acute coronary syndrome is common in diabetes mellitus and is a major cause of mortality and morbidity in these patients. Troponin-I is a biochemical marker for cardiac muscle injury. Elevated glycated hemoglobin (HbA1c) is also regarded as an independent risk factor for acute coronary syndrome in patients with diabetes mellitus.The aim of this study was to assess the relationship of HbA1c and Troponin-I level in patients with acute coronary syndrome. This cross-sectional study was conducted in the Department of Biochemistry, Dhaka Medical College, Dhaka, Bangladesh from July 2018 to June 2019. Total study subjects were ninety five of both gender selected from the admitted patients of the cardiology department of the National Institute of Cardiovascular Diseases (NICVD), Dhaka. Diagnosis of acute coronary syndrome was confirmed by cardiologist. Diagnosis of diabetes mellitus was confirmed by Random Blood Glucose (RBG) level. Study subjects were grouped, acute coronary syndrome with diabetes mellitus as Group A and acute coronary syndrome without diabetes mellitus as Group B. Baseline parameters was recorded in data collection sheet. HbA1c, Troponin-I level of all study subjects were analyzed and recorded. Mean age of the study subjects in Group A and Group B were 51.06 years and 51.66 years respectively. Male gender was predominant in both groups. Mean SBP and DBP were significantly higher in Group A than Group B. Mean HbA1c level of the study subjects in Group A was significantly higher than Group B (p=0.001). Mean Troponin-I level in Group A was also significantly higher than Group B (p=0.023). HbA1c and Troponin-I levels were positively correlated in Group A (r=0.471, p=0.001). The present study demonstrated significant positive correlation of HbA1c and Troponin-I level in diabetic patients with acute coronary syndrome.
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Affiliation(s)
- M S Hossain
- Dr Muhammad Shakhawat Hossain, Lecturer, Department of Biochemistry, Mymensingh Medical College (MMC), Mymensingh, Bangladesh;
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Begum S, Sultana I, Faysal MR, Alam S, Tasnim J, Akter T, Hossain MS, Banu M, Jenea AT, Hasan M, Krishna SP, Tuli JZ, Sarkar S, Akhter S. Study of Changes in Serum Copper Level in Patients with Acute Myocardial Infarction. Mymensingh Med J 2023; 32:39-43. [PMID: 36594298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Acute myocardial infarction (AMI) commonly known as heart attack is defined pathologically as the irreversible death of myocardial cells caused by ischemia. Risk factors include high blood pressure, smoking, diabetes, lack of exercise, obesity, high blood cholesterol and excessive alcohol intake. The major cause of acute MI is coronary atherosclerosis with superimposed luminal thrombus, which accounts for more than 80% of all infarcts. Micronutrients and trace elements are very essential for normal functioning of the body. Even though they are required in very small amount, an alteration in the level of this element may lead to serious diseases like CAD and its consequences. The injury induced by reperfusion of the ischemic myocardium could result partially from the cytotoxic effects of oxygen free radicals. Copper is involved in several of the reactions in the protection from free radical damage. So, this study was designed to evaluate serum cupper level in AMI patients. This case-control study was conducted in the Department of Biochemistry, Mymensingh Medical College, Mymensingh, Bangladesh from July 2016 to June 2017. Total number of subjects was 120 in number. Among them 60 were diagnosed case of acute myocardial infarction and 60 were apparently healthy volunteers. Data were collected using pre-designed data collection sheets. After proper counseling informed written consent was taken from the study population. The study revealed that mean serum copper level was higher in case group as compared to control group. The mean±SD values of copper were 105.44±24.15μg/dl and 146.49±23.52μg/dl in control and case group respectively. The level of significance was 0.001 (p<0.05). After analyzing the results of the study it is concluded that serum copper level was significantly higher in Acute Myocardial Infarction patients than normal individuals. Therefore, estimation of serum copper level in AMI patients might be useful to take appropriate measure to prevent free radical induced reperfusion injury.
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Affiliation(s)
- S Begum
- Dr Sumaiya Begum, Lecturer, Department of Biochemistry, Mymensingh Medical College (MMC), Mymensingh, Bangladesh; E-mail:
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Khan SR, Masood S, Yousuf M, Raheel A, Begum S, Sattar SA, Tauseef S, Dastagir J. Complexation, Antifungal, Antioxidant Activities, and In Silico Studies of Metals Cu(II), Co(II), and Mn(II) with 3,5-Dinitrobenzoic Acid. Russ J Bioorg Chem 2022. [DOI: 10.1134/s1068162022060139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Sultana I, Sultana N, Rabbany MA, Banu M, Begum S, Alam S, Tasnim J, Akter T, Hossain MS, Akter S, Faysal MR. Evaluation of Liver Function Tests in β-Thalassemia Major Children. Mymensingh Med J 2022; 31:894-899. [PMID: 36189529] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Thalassemia is the most prevalent single gene defect in human beings worldwide. Repeated blood transfusions along with chelation therapy are mainstay of treatment in thalassemia patients. However these recurrent blood transfusions result in iron overload which along with chelation therapy causes deterioration of liver function. Aim of the study was to evaluate the liver function tests in β-thalassemia major patients. This cross sectional study was conducted in the Department of Biochemistry, Dhaka Medical College, Dhaka, Bangladesh from January 2017 to December 2017. In this study, 50 diagnosed patients of β Thalassemia major (Group A) and 50 apparently healthy children (Group B) of both sexes were selected from the department of Paediatrics, Dhaka medical college. The study parameters were serum ferritin, bilirubin, AST, ALT, ALP. The results were compared statistically between groups. Serum ferritin level (mean±SD) in thalassemic major patients in Group A (890±446.38 microgram/L) which is significantly higher above normal level. Serum bilirubin in Group A (3.27±2.62 mg/dl) and in Group B (0.48±0.24 mg/dl), Serum ALT in Group A (53.06±34.0 U/L) and in Group B (16.70±4.81 U/L), AST in Group A (84.56±33.54 U/L) and in Group B (11.60±2.72 U/L) and ALP levels in Group A (422.42±226.99 IU/L) and in Group B (221.86±80.54 IU/L). All the values were significantly higher (p<0.001) in β-thalassemia patient than that of normal children. This study concludes that liver function parameters are significantly higher in β thalassemia major patients. So routine evaluation of liver function tests may be advocated for thalassemic patients to predict early onset of hepatic dysfunction.
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Affiliation(s)
- I Sultana
- Dr Irin Sultana, Assistant Professor, Department of Biochemistry, Mymensingh Medical College (MMC), Mymensingh, Bangladesh; E-mail:
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Zhang Y, Sherlock S, Brambilla C, MacMahon S, Thompson L, Rice A, Robertus J, Lim E, Begum S, Buderi S, Jordan S, Anikin V, Finch J, Asadi N, Beddow E, McDonald F, Antoniou G, Moffatt M, Cookson W, Shah P, Devaraj A, Popat S, Nicholson A. EP11.03-003 Adenocarcinoma Grade Correlates with PD-L1 and TP53, but not EGFR/KRAS Status and Diagnostic Yield: Analysis of 346 Cases. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.916] [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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Begum S, Johnson BZ, Morillon AC, Yang R, Bong SH, Whiley L, Gray N, Fear VS, Cuttle L, Holland AJA, Nicholson JK, Wood FM, Fear MW, Holmes E. Systemic long-term metabolic effects of acute non-severe paediatric burn injury. Sci Rep 2022; 12:13043. [PMID: 35906249 PMCID: PMC9338081 DOI: 10.1038/s41598-022-16886-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 07/18/2022] [Indexed: 11/10/2022] Open
Abstract
A growing body of evidence supports the concept of a systemic response to non-severe thermal trauma. This provokes an immunosuppressed state that predisposes paediatric patients to poor recovery and increased risk of secondary morbidity. In this study, to understand the long-term systemic effects of non-severe burns in children, targeted mass spectrometry assays for biogenic amines and tryptophan metabolites were performed on plasma collected from child burn patients at least three years post injury and compared to age and sex matched non-burn (healthy) controls. A panel of 12 metabolites, including urea cycle intermediates, aromatic amino acids and quinolinic acid were present in significantly higher concentrations in children with previous burn injury. Correlation analysis of metabolite levels to previously measured cytokine levels indicated the presence of multiple cytokine-metabolite associations in the burn injury participants that were absent from the healthy controls. These data suggest that there is a sustained immunometabolic imprint of non-severe burn trauma, potentially linked to long-term immune changes that may contribute to the poor long-term health outcomes observed in children after burn injury.
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Affiliation(s)
- Sofina Begum
- Harvard Medical School, Harvard University, 25 Shattuck Street, Boston, MA, 02115, USA.,Channing Division of Network Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA, 02115, USA.,Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, Sir Alexander Fleming Building, South Kensington, London, SW7 2AZ, UK.,Australian National Phenome Centre, Health Futures Institute, Murdoch University, Harry Perkins Institute, Perth, WA, 6150, Australia
| | - Blair Z Johnson
- School of Biomedical Sciences, The University of Western Australia, Perth, WA, Australia
| | - Aude-Claire Morillon
- Australian National Phenome Centre, Health Futures Institute, Murdoch University, Harry Perkins Institute, Perth, WA, 6150, Australia
| | - Rongchang Yang
- Australian National Phenome Centre, Health Futures Institute, Murdoch University, Harry Perkins Institute, Perth, WA, 6150, Australia
| | - Sze How Bong
- Australian National Phenome Centre, Health Futures Institute, Murdoch University, Harry Perkins Institute, Perth, WA, 6150, Australia
| | - Luke Whiley
- Australian National Phenome Centre, Health Futures Institute, Murdoch University, Harry Perkins Institute, Perth, WA, 6150, Australia.,Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Harry Perkins Institute, Perth, WA, 6150, Australia
| | - Nicola Gray
- Australian National Phenome Centre, Health Futures Institute, Murdoch University, Harry Perkins Institute, Perth, WA, 6150, Australia.,Centre for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Harry Perkins Institute, Perth, WA, 6150, Australia
| | - Vanessa S Fear
- Translational Genetics, Telethon Kids Institute, Perth, WA, Australia
| | - Leila Cuttle
- Faculty of Health, Centre for Children's Health Research, School of Biomedical Sciences, Queensland University of Technology (QUT), South Brisbane, QLD, Australia
| | - Andrew J A Holland
- The Children's Hospital at Westmead Burns Unit, Department of Paediatrics and Child Health, Sydney Medical School, Kids Research Institute, The University of Sydney, Sydney, NSW, Australia
| | - Jeremy K Nicholson
- Australian National Phenome Centre, Health Futures Institute, Murdoch University, Harry Perkins Institute, Perth, WA, 6150, Australia.,Centre for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Harry Perkins Institute, Perth, WA, 6150, Australia.,Medical School, University of Western Australia, Harry Perkins Institute, Murdoch, Perth, WA, 6150, Australia.,Faculty of Medicine, Institute of Global Health Innovation, Imperial College London, Level 1, Faculty Building South Kensington Campus, London, SW7 2AZ, UK
| | - Fiona M Wood
- School of Biomedical Sciences, The University of Western Australia, Perth, WA, Australia.,WA Department of Health, Burns Service of Western Australia, Perth, WA, 6150, Australia
| | - Mark W Fear
- School of Biomedical Sciences, The University of Western Australia, Perth, WA, Australia.
| | - Elaine Holmes
- Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, Sir Alexander Fleming Building, South Kensington, London, SW7 2AZ, UK. .,Australian National Phenome Centre, Health Futures Institute, Murdoch University, Harry Perkins Institute, Perth, WA, 6150, Australia. .,Centre for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Harry Perkins Institute, Perth, WA, 6150, Australia.
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Hassan SN, Tilottoma B, Begum S, Kabir S, Khan AH, Rahman RN, Ahmed MS, Chowdhury FQ, Islam MR. Ocular Manifestation and Correlation with CD4+ T Cell Count among Adult HIV/AIDS Patients in Bangladesh. Mymensingh Med J 2022; 31:779-789. [PMID: 35780364] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Patients with HIV or AIDS suffer from wide varieties of complications that are related to infection. The eye as an organ is not spared from HIV-related manifestations. The ocular manifestations can be the presenting sign of a systemic infection in an otherwise asymptomatic HIV-positive person. The disease can have adnexal, anterior segment, posterior segment, orbital and neuro-ophthalmic manifestations. The objective of the study was to evaluate the ophthalmological manifestations among adult HIV infected patients of Bangladesh and co-relate the findings with CD-4+ T cell count. This cross sectional study was conducted in the department of Community Ophthalmology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2013 to September 2015. Purposive sampling technique was applied to enroll the patients. Total 110 patients were enrolled regardless of their immunological status by inclusion and exclusion criteria. Relevant clinical evaluation including history & physical examinations, laboratory investigations and some ocular examinations like- visual acuity, slit lamp biomicroscopy, IOP, indirect ophthalmoscopy with +90D (diopter) and +20D were done. The age of the study population ranged from 20-58 years with mean±SD 37.63±8.16 years. Among the study population 67(60.9%) were male and 43(39.1%) were female. According to ART status, 58(52.7%) were on ART and 52(47.3%) were ART naive. The mean CD4+ T- cells count was 410±281.65 with minimum to maximum was 6-1266 cells/μl. Among them 53(48.2%) had HIV related ocular findings and 57(51.8%) had no HIV related ocular manifestation. In relation with CD+ T- cells count, highly significant relation was found with lower CD4+ T- cells count and ocular manifestation (p=0.001).
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Affiliation(s)
- S N Hassan
- Dr Shah-Noor Hassan, Associate Professor, Department of Ophthalmology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh; E-mail:
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Ludwig D, Higgs F, Allotey N, Begum S, Burton J. POS1547-HPR CREATION OF A MULTI-DISCIPLINARY TEAM (MDT) RHEUMATOLOGY CLINIC AT UNIVERSITY COLLEGE LONDON HOSPITAL (UCLH) TO TACKLE THE BACKLOG OF PATIENTS WAITING FOR TREATMENT AS A RESULT OF THE COVID-19 PANDEMIC. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundCovid-19 has consumed hospital resources since January 2020. In the UK, routine care has been disrupted with an estimated 30 million fewer outpatient attendances (2020/21) and over 6 million patients waiting for consultant led care (1). The British Society for Rheumatology ‘Rheumatology Workforce: a crisis in numbers (2021)’ highlights the challenges facing National Health Service rheumatology departments in managing rising caseloads (2). In 2021, UCLH wait time for follow up rheumatology appointments was 9 months. We were inundated with patients requiring urgent treatment. Innovative ways of running outpatients were required which led to the formation of an MDT clinic.ObjectivesCreate a Rheumatology MDT clinic to:Reduce follow up timeIncrease clinic capacityReduce number of hospital attendancesAdd value to each clinic encounterMethodsThe consultant lead identified an existing clinical nurse specialist (CNS) interested in supporting the MDT. With a UCLH Outpatient Transformation grant of £15,000 we recruited an advanced physiotherapy practitioner (APP) and administrator for a 6 month trial period. Managerial support was provided by the board. We met weekly to agree aims and allocate responsibilities. We did the following:•Reviewed clinic lists for 6 months to identify duplicate appointments.•Identified patients with CNS and consultant follow up scheduled in a short time frame and cancelled unnecessary appointments.•Reviewed the clinic list weekly to identify patients suitable for APP management. This allowed overbooking of urgent cases.•Embedded hand ultrasound appointments in the clinic template.•Created CNS ‘Zoom’ virtual drop-ins for routine enquiries to reduce the administrative burden of patient emails/phone calls occurring outside the clinic.•Organised patient participation sessions to help shape the service and collected patient feedback questionnaires.ResultsWe reduced our waiting time for follow up appointments from 9 months to 2 months. Pre-MDT the average wait from consultant referral to physiotherapist appointment was 55 days. The MDT allows for same day assessment (reducing 2-3 patient journeys a clinic) and where suitable, facilitates discharge or onwards referral to the appropriate service i.e. pain management, hand therapy, APP-led hypermobility programme. A dedicated MDT CNS has shortened treatment times, reduced email traffic between CNS and consultant and allows for same day, joint decision making resulting in fewer appointments. Patients welcomed the Zoom sessions as an efficient, reliable method of raising concerns/queries. Our administrator helps to facilitate communication between patients and clinicians and streamline MDT processes. Embedding point of care ultrasound reduces hospital visits and enhances treatment decision making thereby reducing follow up attendances.ConclusionOur MDT model has reduced waiting lists, decreased treatment delays and cut the number of hospital visits. Performing ultrasound in clinic helped prevent patients being sent for scans at private providers. This cost saving likely covers the APP, ensuring the project is close to cost neutral. Shared decision making added value to outpatient attendances, reflected in patients positive feedback. The MDT enhances the role of APP and CNS, utilising their unique skill set. Administrative support is crucial, enhances team working and places added value on this often underappreciated role. We encourage other Rheumatology departments to adopt an MDT approach to tackle the backlog of patients awaiting treatment, add value to clinic encounters and maximise the skill set of clinicians involved in patient care.References[1]NHS backlog data analysis. British Medical Association. Online; NHS backlog data analysis (bma.org.uk)[2]Rheumatology workforce: a crisis in numbers. British Society for Rheumatology. Workforce Policy Report 2021. BSR-workforce-report-crisis-numbers.pdf (rheumatology.org.uk)AcknowledgementsI would like to thank the UCLH Outpatient Transformation Team for their support and funding to carry out this pilot project.Disclosure of InterestsNone declared
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Sultana S, Begum S, Ferdousi S. Comparative Effect of Losartan and Atenolol on Heart Rate Variability in Untreated Essential Hypertensive Patients by Power Spectral Analysis. Mymensingh Med J 2022; 31:506-511. [PMID: 35383773] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Autonomic balance in untreated essential hypertension is altered and antihypertensive drugs may improve autonomic balance. Losartan and atenolol is drug of choice to treat essential hypertension. Power spectral analysis of Heart Rate Variability (HRV) is a tool for detecting autonomic balance. This study aimed to compare the effect of losartan and atenolol on autonomic balance in essential hypertensive patients. This longitudinal study was conducted in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from July 2012 to June 2013. For this study, 120 diagnosed male hypertensive patients without any treatment (age 30-55 years) were selected from the Out Patients Department of Cardiology, BSMMU, Dhaka on their first day of visit. Sixty apparently healthy normotensive male subjects with similar age were also studied as control. Patients were divided into two equal groups. Sixty (60) patients received 50 mg losartan (oral) and 60 patients received 50 mg atenolol (oral) daily. Autonomic balance was assessed by power spectral analysis of HRV and HRV data were recorded by a polyrite D. HRV data of the patients were measured at baseline, after 3 months and 6 months of medication and data of control were recorded at baseline. For statistical analysis ANOVA, independent sample 't' test and paired sample 't' were performed. High frequency normalized units (HF n.u), total power (TP) were significantly lower (p<0.001) and low frequency normalized unit (LF n.u), LF/HF ratio were significantly higher (p<0.001) in all patients before treatment compared to control. In both drug groups HF n.u and total power were found significantly higher (p<0.001) whereas LF n.u and LF/HF ratio were found significantly lower (p<0.001) after 3 months of treatment compared to their baseline values. After 6 months of treatment, data demonstrated significant further increase (p<0.001) in HF n.u and total power compared to their values after 3 months of treatment. Again these values were found significantly higher in atenolol treated patients compared to losartan group at the end of 6 months of treatment. These result concluded that cardiac autonomic nerve functions may be impaired in essential hypertensive patients before treatment which may improve by treatment with both drugs but the effect is more pronounced in atenolol treatment after longer duration.
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Affiliation(s)
- S Sultana
- Dr Shamima Sultana, Associate Professor, Department of Physiology, BSMMU, Dhaka, Bangladesh; E-mail:
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Battisti N, McGinn M, Ashurst I, Snuggs N, Crimmin J, Cowan-Dickie S, Pessoa Silva M, Eldridge L, Tomlins E, Roe J, Lister S, Grayer J, Stanley P, Mann L, Spurgeon H, Droney J, McGrath S, Hill N, Farthing L, Begum S, Waller J, Bateman E, Kipps E, Sinclair S, Johnston S, Ring A. Evaluating the needs of older adults with cancer: baseline clinical activity and considerations for the development of a Senior Adult Oncology Programme at The Royal Marsden. J Geriatr Oncol 2021. [DOI: 10.1016/s1879-4068(21)00424-0] [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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Battisti N, McGinn M, Ashurst I, Snuggs N, Crimmin J, Cowan-Dickie S, Pessoa Silva M, Eldridge L, Tomlins E, Roe J, Lister S, Grayer J, Stanley P, Mann L, Spurgeon H, Droney J, McGrath S, Hill N, Farthing L, Begum S, Joanna Waller J, Bateman E, Kipps E, Sinclair S, Johnston S, Ring A. Pioneering comprehensive oncogeriatric care in the United Kingdom: the development of a multidisciplinary Senior Adult Oncology Programme at The Royal Marsden. J Geriatr Oncol 2021. [DOI: 10.1016/s1879-4068(21)00423-9] [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: 11/24/2022]
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Fraser S, Baranowski R, Patrini D, Nandi J, Al-Sahaf M, Smelt J, Hoffman R, Santhirakumaran G, Lee M, Wali A, Dickinson H, Jadoon M, Harrison-Phipps K, King J, Pilling J, Bille A, Okiror L, Stamenkovic S, Waller D, Wilson H, Jordan S, Begum S, Buderi S, Tan C, Hunt I, Vaughan P, Jenkins M, Hayward M, Lawrence D, Beddow E, Anikin V, Mani A, Finch J, Maheswaran H, Lim E, Routledge T, Lau K, Harling L. Maintaining safe lung cancer surgery during the COVID-19 pandemic in a global city. EClinicalMedicine 2021; 39:101085. [PMID: 34430839 PMCID: PMC8376626 DOI: 10.1016/j.eclinm.2021.101085] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 07/27/2021] [Accepted: 07/27/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND SARS-CoV-2 has challenged health service provision worldwide. This work evaluates safe surgical pathways and standard operating procedures implemented in the high volume, global city of London during the first wave of SARS-CoV-2 infection. We also assess the safety of minimally invasive surgery(MIS) for anatomical lung resection. METHODS This multicentre cohort study was conducted across all London thoracic surgical units, covering a catchment area of approximately 14.8 Million. A Pan-London Collaborative was created for data sharing and dissemination of protocols. All patients undergoing anatomical lung resection 1st March-1st June 2020 were included. Primary outcomes were SARS-CoV-2 infection, access to minimally invasive surgery, post-operative complication, length of intensive care and hospital stay (LOS), and death during follow up. FINDINGS 352 patients underwent anatomical lung resection with a median age of 69 (IQR: 35-86) years. Self-isolation and pre-operative screening were implemented following the UK national lockdown. Pre-operative SARS-CoV-2 swabs were performed in 63.1% and CT imaging in 54.8%. 61.7% of cases were performed minimally invasively (MIS), compared to 59.9% pre pandemic. Median LOS was 6 days with a 30-day survival of 98.3% (comparable to a median LOS of 6 days and 30-day survival of 98.4% pre-pandemic). Significant complications developed in 7.3% of patients (Clavien-Dindo Grade 3-4) and 12 there were re-admissions(3.4%). Seven patients(2.0%) were diagnosed with SARS-CoV-2 infection, two of whom died (28.5%). INTERPRETATION SARS-CoV-2 infection significantly increases morbidity and mortality in patients undergoing elective anatomical pulmonary resection. However, surgery can be safely undertaken via open and MIS approaches at the peak of a viral pandemic if precautionary measures are implemented. High volume surgery should continue during further viral peaks to minimise health service burden and potential harm to cancer patients. FUNDING This work did not receive funding.
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Affiliation(s)
- Stephanie Fraser
- Department of Thoracic Surgery, Guy's Hospital, London, United Kingdom
| | - Ralitsa Baranowski
- Department of Thoracic Surgery, St Bartholomew's Hospital, London, United Kingdom
| | - Davide Patrini
- Department of Thoracic Surgery, University College London Hospital, London, United Kingdom
| | - Jay Nandi
- Department of Thoracic Surgery, Hammersmith Hospital, London, United Kingdom
| | - May Al-Sahaf
- Department of Thoracic Surgery, Hammersmith Hospital, London, United Kingdom
| | - Jeremy Smelt
- Department of Thoracic Surgery, St George's Hospital, London, United Kingdom
| | - Ross Hoffman
- Department of Thoracic Surgery, Royal Brompton Hospital, London, United Kingdom
| | | | - Michelle Lee
- Department of Thoracic Surgery, St Bartholomew's Hospital, London, United Kingdom
| | - Anuj Wali
- Department of Thoracic Surgery, Guy's Hospital, London, United Kingdom
| | | | - Mehmood Jadoon
- Department of Thoracic Surgery, Hammersmith Hospital, London, United Kingdom
| | | | - Juliet King
- Department of Thoracic Surgery, Guy's Hospital, London, United Kingdom
| | - John Pilling
- Department of Thoracic Surgery, Guy's Hospital, London, United Kingdom
| | - Andrea Bille
- Department of Thoracic Surgery, Guy's Hospital, London, United Kingdom
| | - Lawrence Okiror
- Department of Thoracic Surgery, Guy's Hospital, London, United Kingdom
| | - Sasha Stamenkovic
- Department of Thoracic Surgery, St Bartholomew's Hospital, London, United Kingdom
| | - David Waller
- Department of Thoracic Surgery, St Bartholomew's Hospital, London, United Kingdom
| | - Henrietta Wilson
- Department of Thoracic Surgery, St Bartholomew's Hospital, London, United Kingdom
| | - Simon Jordan
- Department of Thoracic Surgery, Royal Brompton Hospital, London, United Kingdom
| | - Sofina Begum
- Department of Thoracic Surgery, Royal Brompton Hospital, London, United Kingdom
| | - Silviu Buderi
- Department of Thoracic Surgery, Royal Brompton Hospital, London, United Kingdom
| | - Carol Tan
- Department of Thoracic Surgery, St George's Hospital, London, United Kingdom
| | - Ian Hunt
- Department of Thoracic Surgery, St George's Hospital, London, United Kingdom
| | - Paul Vaughan
- Department of Thoracic Surgery, St George's Hospital, London, United Kingdom
| | - Melanie Jenkins
- Department of Thoracic Surgery, St George's Hospital, London, United Kingdom
| | - Martin Hayward
- Department of Thoracic Surgery, University College London Hospital, London, United Kingdom
| | - David Lawrence
- Department of Thoracic Surgery, University College London Hospital, London, United Kingdom
| | - Emma Beddow
- Department of Thoracic Surgery, Harefield Hospital, London, United Kingdom
| | - Vladimir Anikin
- Department of Thoracic Surgery, Harefield Hospital, London, United Kingdom
| | - Aleksander Mani
- Department of Thoracic Surgery, Harefield Hospital, London, United Kingdom
| | - Jonathan Finch
- Department of Thoracic Surgery, Harefield Hospital, London, United Kingdom
| | | | - Eric Lim
- Department of Thoracic Surgery, Royal Brompton Hospital, London, United Kingdom
| | - Tom Routledge
- Department of Thoracic Surgery, Guy's Hospital, London, United Kingdom
| | - Kelvin Lau
- Department of Thoracic Surgery, St Bartholomew's Hospital, London, United Kingdom
| | - Leanne Harling
- Department of Thoracic Surgery, Guy's Hospital, London, United Kingdom
- Department of Surgery and Cancer, Imperial College London, United Kingdom
- Corresponding author.
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35
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Holmes E, Wist J, Masuda R, Lodge S, Nitschke P, Kimhofer T, Loo RL, Begum S, Boughton B, Yang R, Morillon AC, Chin ST, Hall D, Ryan M, Bong SH, Gay M, Edgar DW, Lindon JC, Richards T, Yeap BB, Pettersson S, Spraul M, Schaefer H, Lawler NG, Gray N, Whiley L, Nicholson JK. Incomplete Systemic Recovery and Metabolic Phenoreversion in Post-Acute-Phase Nonhospitalized COVID-19 Patients: Implications for Assessment of Post-Acute COVID-19 Syndrome. J Proteome Res 2021; 20:3315-3329. [PMID: 34009992 PMCID: PMC8147448 DOI: 10.1021/acs.jproteome.1c00224] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [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: 03/19/2021] [Indexed: 12/15/2022]
Abstract
We present a multivariate metabotyping approach to assess the functional recovery of nonhospitalized COVID-19 patients and the possible biochemical sequelae of "Post-Acute COVID-19 Syndrome", colloquially known as long-COVID. Blood samples were taken from patients ca. 3 months after acute COVID-19 infection with further assessment of symptoms at 6 months. Some 57% of the patients had one or more persistent symptoms including respiratory-related symptoms like cough, dyspnea, and rhinorrhea or other nonrespiratory symptoms including chronic fatigue, anosmia, myalgia, or joint pain. Plasma samples were quantitatively analyzed for lipoproteins, glycoproteins, amino acids, biogenic amines, and tryptophan pathway intermediates using Nuclear Magnetic Resonance (NMR) spectroscopy and mass spectrometry. Metabolic data for the follow-up patients (n = 27) were compared with controls (n = 41) and hospitalized severe acute respiratory syndrome SARS-CoV-2 positive patients (n = 18, with multiple time-points). Univariate and multivariate statistics revealed variable patterns of functional recovery with many patients exhibiting residual COVID-19 biomarker signatures. Several parameters were persistently perturbed, e.g., elevated taurine (p = 3.6 × 10-3 versus controls) and reduced glutamine/glutamate ratio (p = 6.95 × 10-8 versus controls), indicative of possible liver and muscle damage and a high energy demand linked to more generalized tissue repair or immune function. Some parameters showed near-complete normalization, e.g., the plasma apolipoprotein B100/A1 ratio was similar to that of healthy controls but significantly lower (p = 4.2 × 10-3) than post-acute COVID-19 patients, reflecting partial reversion of the metabolic phenotype (phenoreversion) toward the healthy metabolic state. Plasma neopterin was normalized in all follow-up patients, indicative of a reduction in the adaptive immune activity that has been previously detected in active SARS-CoV-2 infection. Other systemic inflammatory biomarkers such as GlycA and the kynurenine/tryptophan ratio remained elevated in some, but not all, patients. Correlation analysis, principal component analysis (PCA), and orthogonal-partial least-squares discriminant analysis (O-PLS-DA) showed that the follow-up patients were, as a group, metabolically distinct from controls and partially comapped with the acute-phase patients. Significant systematic metabolic differences between asymptomatic and symptomatic follow-up patients were also observed for multiple metabolites. The overall metabolic variance of the symptomatic patients was significantly greater than that of nonsymptomatic patients for multiple parameters (χ2p = 0.014). Thus, asymptomatic follow-up patients including those with post-acute COVID-19 Syndrome displayed a spectrum of multiple persistent biochemical pathophysiology, suggesting that the metabolic phenotyping approach may be deployed for multisystem functional assessment of individual post-acute COVID-19 patients.
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Affiliation(s)
- Elaine Holmes
- Australian National Phenome Centre, Health Futures
Institute, Murdoch University, Harry Perkins Building, 5 Robin
Warren Drive, Perth, WA 6150, Australia
- Center for Computational and Systems Medicine, Health
Futures Institute, Murdoch University, 5 Robin Warren Drive,
Perth, WA 6150, Australia
- Department of Metabolism, Digestion, and Reproduction,
Faculty of Medicine, Imperial College London, Sir Alexander
Fleming Building, South Kensington, London SW7 2AZ, U.K.
| | - Julien Wist
- Australian National Phenome Centre, Health Futures
Institute, Murdoch University, Harry Perkins Building, 5 Robin
Warren Drive, Perth, WA 6150, Australia
- Center for Computational and Systems Medicine, Health
Futures Institute, Murdoch University, 5 Robin Warren Drive,
Perth, WA 6150, Australia
- Chemistry Department, Universidad del
Valle, 76001 Cali, Colombia
| | - Reika Masuda
- Australian National Phenome Centre, Health Futures
Institute, Murdoch University, Harry Perkins Building, 5 Robin
Warren Drive, Perth, WA 6150, Australia
| | - Samantha Lodge
- Australian National Phenome Centre, Health Futures
Institute, Murdoch University, Harry Perkins Building, 5 Robin
Warren Drive, Perth, WA 6150, Australia
- Center for Computational and Systems Medicine, Health
Futures Institute, Murdoch University, 5 Robin Warren Drive,
Perth, WA 6150, Australia
| | - Philipp Nitschke
- Australian National Phenome Centre, Health Futures
Institute, Murdoch University, Harry Perkins Building, 5 Robin
Warren Drive, Perth, WA 6150, Australia
| | - Torben Kimhofer
- Australian National Phenome Centre, Health Futures
Institute, Murdoch University, Harry Perkins Building, 5 Robin
Warren Drive, Perth, WA 6150, Australia
- Center for Computational and Systems Medicine, Health
Futures Institute, Murdoch University, 5 Robin Warren Drive,
Perth, WA 6150, Australia
| | - Ruey Leng Loo
- Center for Computational and Systems Medicine, Health
Futures Institute, Murdoch University, 5 Robin Warren Drive,
Perth, WA 6150, Australia
| | - Sofina Begum
- Department of Metabolism, Digestion, and Reproduction,
Faculty of Medicine, Imperial College London, Sir Alexander
Fleming Building, South Kensington, London SW7 2AZ, U.K.
| | - Berin Boughton
- Australian National Phenome Centre, Health Futures
Institute, Murdoch University, Harry Perkins Building, 5 Robin
Warren Drive, Perth, WA 6150, Australia
- Center for Computational and Systems Medicine, Health
Futures Institute, Murdoch University, 5 Robin Warren Drive,
Perth, WA 6150, Australia
| | - Rongchang Yang
- Australian National Phenome Centre, Health Futures
Institute, Murdoch University, Harry Perkins Building, 5 Robin
Warren Drive, Perth, WA 6150, Australia
| | - Aude-Claire Morillon
- Australian National Phenome Centre, Health Futures
Institute, Murdoch University, Harry Perkins Building, 5 Robin
Warren Drive, Perth, WA 6150, Australia
| | - Sung-Tong Chin
- Australian National Phenome Centre, Health Futures
Institute, Murdoch University, Harry Perkins Building, 5 Robin
Warren Drive, Perth, WA 6150, Australia
| | - Drew Hall
- Australian National Phenome Centre, Health Futures
Institute, Murdoch University, Harry Perkins Building, 5 Robin
Warren Drive, Perth, WA 6150, Australia
| | - Monique Ryan
- Australian National Phenome Centre, Health Futures
Institute, Murdoch University, Harry Perkins Building, 5 Robin
Warren Drive, Perth, WA 6150, Australia
| | - Sze-How Bong
- Australian National Phenome Centre, Health Futures
Institute, Murdoch University, Harry Perkins Building, 5 Robin
Warren Drive, Perth, WA 6150, Australia
| | - Melvin Gay
- Bruker Pty. Ltd., Preston,
VIC 3072, Australia
| | - Dale W. Edgar
- State Adult Burn Unit, Fiona Stanley
Hospital, Murdoch, WA 6150, Australia
- Burn Injury Research Node, The University
of Notre Dame, Fremantle, WA 6160, Australia
| | - John C. Lindon
- Department of Surgery and Cancer, Faculty of
Medicine, Imperial College London, London SW7 2AZ,
U.K.
| | - Toby Richards
- Department of Surgery, Fiona Stanley Hospital, Medical
School, University of Western Australia,Harry Perkins Building,
Murdoch, Perth, WA 6150, Australia
| | - Bu B. Yeap
- Department of Endocrinology and Diabetes, Fiona
Stanley Hospital, Medical School, University of Western
Australia, Harry Perkins Building, Murdoch, Perth, WA 6150,
Australia
| | - Sven Pettersson
- Singapore National NeuroScience
Centre, Mandalay Road, Singapore 308232,
Singapore
- Lee Kong Chian School of Medicine.
Nanyang Technological University, Mandalay Road, Singapore
308232, Singapore
- Department of Life Science Centre,
Sunway University, Kuala Lumpur 47500,
Malaysia
| | | | | | - Nathan G. Lawler
- Australian National Phenome Centre, Health Futures
Institute, Murdoch University, Harry Perkins Building, 5 Robin
Warren Drive, Perth, WA 6150, Australia
- Center for Computational and Systems Medicine, Health
Futures Institute, Murdoch University, 5 Robin Warren Drive,
Perth, WA 6150, Australia
| | - Nicola Gray
- Australian National Phenome Centre, Health Futures
Institute, Murdoch University, Harry Perkins Building, 5 Robin
Warren Drive, Perth, WA 6150, Australia
- Center for Computational and Systems Medicine, Health
Futures Institute, Murdoch University, 5 Robin Warren Drive,
Perth, WA 6150, Australia
| | - Luke Whiley
- Australian National Phenome Centre, Health Futures
Institute, Murdoch University, Harry Perkins Building, 5 Robin
Warren Drive, Perth, WA 6150, Australia
- Perron Institute for Neurological and
Translational Science, Nedlands, WA 6009,
Australia
| | - Jeremy K. Nicholson
- Australian National Phenome Centre, Health Futures
Institute, Murdoch University, Harry Perkins Building, 5 Robin
Warren Drive, Perth, WA 6150, Australia
- Center for Computational and Systems Medicine, Health
Futures Institute, Murdoch University, 5 Robin Warren Drive,
Perth, WA 6150, Australia
- Institute of Global Health Innovation,
Imperial College London, Level 1, Faculty Building, South
Kensington Campus, London SW7 2AZ, U.K.
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36
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Lawler NG, Gray N, Kimhofer T, Boughton B, Gay M, Yang R, Morillon AC, Chin ST, Ryan M, Begum S, Bong SH, Coudert JD, Edgar D, Raby E, Pettersson S, Richards T, Holmes E, Whiley L, Nicholson JK. Systemic Perturbations in Amine and Kynurenine Metabolism Associated with Acute SARS-CoV-2 Infection and Inflammatory Cytokine Responses. J Proteome Res 2021; 20:2796-2811. [PMID: 33724837 PMCID: PMC7986977 DOI: 10.1021/acs.jproteome.1c00052] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Indexed: 01/06/2023]
Abstract
We performed quantitative metabolic phenotyping of blood plasma in parallel with cytokine/chemokine analysis from participants who were either SARS-CoV-2 (+) (n = 10) or SARS-CoV-2 (-) (n = 49). SARS-CoV-2 positivity was associated with a unique metabolic phenotype and demonstrated a complex systemic response to infection, including severe perturbations in amino acid and kynurenine metabolic pathways. Nine metabolites were elevated in plasma and strongly associated with infection (quinolinic acid, glutamic acid, nicotinic acid, aspartic acid, neopterin, kynurenine, phenylalanine, 3-hydroxykynurenine, and taurine; p < 0.05), while four metabolites were lower in infection (tryptophan, histidine, indole-3-acetic acid, and citrulline; p < 0.05). This signature supports a systemic metabolic phenoconversion following infection, indicating possible neurotoxicity and neurological disruption (elevations of 3-hydroxykynurenine and quinolinic acid) and liver dysfunction (reduction in Fischer's ratio and elevation of taurine). Finally, we report correlations between the key metabolite changes observed in the disease with concentrations of proinflammatory cytokines and chemokines showing strong immunometabolic disorder in response to SARS-CoV-2 infection.
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Affiliation(s)
- Nathan G. Lawler
- Australian National Phenome Centre, Computational and
Systems Medicine, Health Futures Institute, Murdoch University,
Harry Perkins Building, Perth, WA 6150, Australia
| | - Nicola Gray
- Australian National Phenome Centre, Computational and
Systems Medicine, Health Futures Institute, Murdoch University,
Harry Perkins Building, Perth, WA 6150, Australia
| | - Torben Kimhofer
- Australian National Phenome Centre, Computational and
Systems Medicine, Health Futures Institute, Murdoch University,
Harry Perkins Building, Perth, WA 6150, Australia
| | - Berin Boughton
- Australian National Phenome Centre, Computational and
Systems Medicine, Health Futures Institute, Murdoch University,
Harry Perkins Building, Perth, WA 6150, Australia
| | - Melvin Gay
- Bruker Pty Ltd., Preston,
VIC 3072, Australia
| | - Rongchang Yang
- Australian National Phenome Centre, Computational and
Systems Medicine, Health Futures Institute, Murdoch University,
Harry Perkins Building, Perth, WA 6150, Australia
| | - Aude-Claire Morillon
- Australian National Phenome Centre, Computational and
Systems Medicine, Health Futures Institute, Murdoch University,
Harry Perkins Building, Perth, WA 6150, Australia
| | - Sung-Tong Chin
- Australian National Phenome Centre, Computational and
Systems Medicine, Health Futures Institute, Murdoch University,
Harry Perkins Building, Perth, WA 6150, Australia
| | - Monique Ryan
- Australian National Phenome Centre, Computational and
Systems Medicine, Health Futures Institute, Murdoch University,
Harry Perkins Building, Perth, WA 6150, Australia
| | - Sofina Begum
- Australian National Phenome Centre, Computational and
Systems Medicine, Health Futures Institute, Murdoch University,
Harry Perkins Building, Perth, WA 6150, Australia
- Department of Metabolism Digestion and Reproduction,
Faculty of Medicine, Imperial College London, Sir Alexander
Fleming Building, South Kensington, London SW7 2AZ, U.K.
| | - Sze How Bong
- Australian National Phenome Centre, Computational and
Systems Medicine, Health Futures Institute, Murdoch University,
Harry Perkins Building, Perth, WA 6150, Australia
| | - Jerome D. Coudert
- Centre for Molecular Medicine & Innovative
Therapeutics, Murdoch University, Perth, WA 6150,
Australia
| | - Dale Edgar
- State Adult Burn Unit, Fiona Stanley
Hospital, Murdoch, WA 6150, Australia
- Burn Injury Research Node, The University of
Notre Dame, Fremantle, WA 6160, Australia
- Fiona Wood Foundation,
Murdoch, WA 6150, Australia
| | - Edward Raby
- Department of Microbiology, PathWest
Laboratory Medicine, Perth, WA 6009, Australia
- Department of Infectious Diseases, Fiona
Stanley Hospital, Perth, WA 6150, Australia
| | - Sven Pettersson
- Singapore National Neuro Science
Centre, Singapore Mandalay Road, Singapore 308232,
Singapore
- Lee Kong Chian School of Medicine,
Nanyang Technological University, Mandalay Road, Singapore
308232, Singapore
- Department of Life Science Centre,
Sunway University, 55100 Kuala Lumpur,
Malaysia
| | - Toby Richards
- Medical School, Faculty of Health and Medical
Sciences, University of Western Australia, Nedlands, WA 6009,
Australia
| | - Elaine Holmes
- Australian National Phenome Centre, Computational and
Systems Medicine, Health Futures Institute, Murdoch University,
Harry Perkins Building, Perth, WA 6150, Australia
- Department of Metabolism Digestion and Reproduction,
Faculty of Medicine, Imperial College London, Sir Alexander
Fleming Building, South Kensington, London SW7 2AZ, U.K.
| | - Luke Whiley
- Australian National Phenome Centre, Computational and
Systems Medicine, Health Futures Institute, Murdoch University,
Harry Perkins Building, Perth, WA 6150, Australia
- Perron Institute for Neurological and
Translational Science, Nedlands, WA 6009,
Australia
| | - Jeremy K. Nicholson
- Australian National Phenome Centre, Computational and
Systems Medicine, Health Futures Institute, Murdoch University,
Harry Perkins Building, Perth, WA 6150, Australia
- Medical School, Faculty of Health and Medical
Sciences, University of Western Australia, Nedlands, WA 6009,
Australia
- Institute of Global Health Innovation,
Imperial College London, Level 1, Faculty Building South
Kensington Campus, London SW7 2AZ, U.K.
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37
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Kimhofer T, Lodge S, Whiley L, Gray N, Loo RL, Lawler NG, Nitschke P, Bong SH, Morrison DL, Begum S, Richards T, Yeap BB, Smith C, Smith KGC, Holmes E, Nicholson JK. Correction to "Integrative Modeling of Quantitative Plasma Lipoprotein, Metabolic, and Amino Acid Data Reveals a Multiorgan Pathological Signature of SARS-CoV-2 Infection". J Proteome Res 2021; 20:3400. [PMID: 33949867 PMCID: PMC8504796 DOI: 10.1021/acs.jproteome.1c00273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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38
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Lodge S, Nitschke P, Kimhofer T, Wist J, Bong SH, Loo RL, Masuda R, Begum S, Richards T, Lindon JC, Bermel W, Reinsperger T, Schaefer H, Spraul M, Holmes E, Nicholson JK. Diffusion and Relaxation Edited Proton NMR Spectroscopy of Plasma Reveals a High-Fidelity Supramolecular Biomarker Signature of SARS-CoV-2 Infection. Anal Chem 2021; 93:3976-3986. [PMID: 33577736 PMCID: PMC7908063 DOI: 10.1021/acs.analchem.0c04952] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 01/28/2021] [Indexed: 12/13/2022]
Abstract
We have applied nuclear magnetic resonance spectroscopy based plasma phenotyping to reveal diagnostic molecular signatures of SARS-CoV-2 infection via combined diffusional and relaxation editing (DIRE). We compared plasma from healthy age-matched controls (n = 26) with SARS-CoV-2 negative non-hospitalized respiratory patients and hospitalized respiratory patients (n = 23 and 11 respectively) with SARS-CoV-2 rRT-PCR positive respiratory patients (n = 17, with longitudinal sampling time-points). DIRE data were modelled using principal component analysis and orthogonal projections to latent structures discriminant analysis (O-PLS-DA), with statistical cross-validation indices indicating excellent model generalization for the classification of SARS-CoV-2 positivity for all comparator groups (area under the receiver operator characteristic curve = 1). DIRE spectra show biomarker signal combinations conferred by differential concentrations of metabolites with selected molecular mobility properties. These comprise the following: (a) composite N-acetyl signals from α-1-acid glycoprotein and other glycoproteins (designated GlycA and GlycB) that were elevated in SARS-CoV-2 positive patients [p = 2.52 × 10-10 (GlycA) and 1.25 × 10-9 (GlycB) vs controls], (b) two diagnostic supramolecular phospholipid composite signals that were identified (SPC-A and SPC-B) from the -+N-(CH3)3 choline headgroups of lysophosphatidylcholines carried on plasma glycoproteins and from phospholipids in high-density lipoprotein subfractions (SPC-A) together with a phospholipid component of low-density lipoprotein (SPC-B). The integrals of the summed SPC signals (SPCtotal) were reduced in SARS-CoV-2 positive patients relative to both controls (p = 1.40 × 10-7) and SARS-CoV-2 negative patients (p = 4.52 × 10-8) but were not significantly different between controls and SARS-CoV-2 negative patients. The identity of the SPC signal components was determined using one and two dimensional diffusional, relaxation, and statistical spectroscopic experiments. The SPCtotal/GlycA ratios were also significantly different for control versus SARS-CoV-2 positive patients (p = 1.23 × 10-10) and for SARS-CoV-2 negatives versus positives (p = 1.60 × 10-9). Thus, plasma SPCtotal and SPCtotal/GlycA are proposed as sensitive molecular markers for SARS-CoV-2 positivity that could effectively augment current COVID-19 diagnostics and may have value in functional assessment of the disease recovery process in patients with long-term symptoms.
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Affiliation(s)
- Samantha Lodge
- Australian
National Phenome Center, and Center for Computational and Systems
Medicine, Health Futures Institute, Murdoch
University, Harry Perkins Building, Perth WA6150, Australia
| | - Philipp Nitschke
- Australian
National Phenome Center, and Center for Computational and Systems
Medicine, Health Futures Institute, Murdoch
University, Harry Perkins Building, Perth WA6150, Australia
| | - Torben Kimhofer
- Australian
National Phenome Center, and Center for Computational and Systems
Medicine, Health Futures Institute, Murdoch
University, Harry Perkins Building, Perth WA6150, Australia
| | - Julien Wist
- Australian
National Phenome Center, and Center for Computational and Systems
Medicine, Health Futures Institute, Murdoch
University, Harry Perkins Building, Perth WA6150, Australia
- Chemistry
Department, Universidad del Valle, Cali 76001, Colombia
| | - Sze-How Bong
- Australian
National Phenome Center, and Center for Computational and Systems
Medicine, Health Futures Institute, Murdoch
University, Harry Perkins Building, Perth WA6150, Australia
| | - Ruey Leng Loo
- Australian
National Phenome Center, and Center for Computational and Systems
Medicine, Health Futures Institute, Murdoch
University, Harry Perkins Building, Perth WA6150, Australia
| | - Reika Masuda
- Australian
National Phenome Center, and Center for Computational and Systems
Medicine, Health Futures Institute, Murdoch
University, Harry Perkins Building, Perth WA6150, Australia
| | - Sofina Begum
- Australian
National Phenome Center, and Center for Computational and Systems
Medicine, Health Futures Institute, Murdoch
University, Harry Perkins Building, Perth WA6150, Australia
- Department
of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, Sir Alexander Fleming Building, South Kensington, London SW7 2AZ, U.K.
| | - Toby Richards
- Division
of Surgery, Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Harry Perkins Building, Murdoch, Perth WA6150, Australia
| | - John C. Lindon
- Department
of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, Sir Alexander Fleming Building, South Kensington, London SW7 2AZ, U.K.
| | - Wolfgang Bermel
- Bruker
Biospin GmbH, Silberstreifen, Ettlingen 76275, Germany
| | | | | | - Manfred Spraul
- Bruker
Biospin GmbH, Silberstreifen, Ettlingen 76275, Germany
| | - Elaine Holmes
- Australian
National Phenome Center, and Center for Computational and Systems
Medicine, Health Futures Institute, Murdoch
University, Harry Perkins Building, Perth WA6150, Australia
- Department
of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, Sir Alexander Fleming Building, South Kensington, London SW7 2AZ, U.K.
| | - Jeremy K. Nicholson
- Australian
National Phenome Center, and Center for Computational and Systems
Medicine, Health Futures Institute, Murdoch
University, Harry Perkins Building, Perth WA6150, Australia
- Division
of Surgery, Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Harry Perkins Building, Murdoch, Perth WA6150, Australia
- Institute
of Global Health Innovation, Faculty of Medicine, Imperial College London, Level 1, Faculty Building, South Kensington Campus, London SW7 2NA, U.K.
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39
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Lodge S, Nitschke P, Kimhofer T, Coudert JD, Begum S, Bong SH, Richards T, Edgar D, Raby E, Spraul M, Schaefer H, Lindon JC, Loo RL, Holmes E, Nicholson JK. NMR Spectroscopic Windows on the Systemic Effects of SARS-CoV-2 Infection on Plasma Lipoproteins and Metabolites in Relation to Circulating Cytokines. J Proteome Res 2021; 20:1382-1396. [PMID: 33426894 PMCID: PMC7805607 DOI: 10.1021/acs.jproteome.0c00876] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Indexed: 02/08/2023]
Abstract
To investigate the systemic metabolic effects of SARS-CoV-2 infection, we analyzed 1H NMR spectroscopic data on human blood plasma and co-modeled with multiple plasma cytokines and chemokines (measured in parallel). Thus, 600 MHz 1H solvent-suppressed single-pulse, spin-echo, and 2D J-resolved spectra were collected on plasma recorded from SARS-CoV-2 rRT-PCR-positive patients (n = 15, with multiple sampling timepoints) and age-matched healthy controls (n = 34, confirmed rRT-PCR negative), together with patients with COVID-19/influenza-like clinical symptoms who tested SARS-CoV-2 negative (n = 35). We compared the single-pulse NMR spectral data with in vitro diagnostic research (IVDr) information on quantitative lipoprotein profiles (112 parameters) extracted from the raw 1D NMR data. All NMR methods gave highly significant discrimination of SARS-CoV-2 positive patients from controls and SARS-CoV-2 negative patients with individual NMR methods, giving different diagnostic information windows on disease-induced phenoconversion. Longitudinal trajectory analysis in selected patients indicated that metabolic recovery was incomplete in individuals without detectable virus in the recovery phase. We observed four plasma cytokine clusters that expressed complex differential statistical relationships with multiple lipoproteins and metabolites. These included the following: cluster 1, comprising MIP-1β, SDF-1α, IL-22, and IL-1α, which correlated with multiple increased LDL and VLDL subfractions; cluster 2, including IL-10 and IL-17A, which was only weakly linked to the lipoprotein profile; cluster 3, which included IL-8 and MCP-1 and were inversely correlated with multiple lipoproteins. IL-18, IL-6, and IFN-γ together with IP-10 and RANTES exhibited strong positive correlations with LDL1-4 subfractions and negative correlations with multiple HDL subfractions. Collectively, these data show a distinct pattern indicative of a multilevel cellular immune response to SARS CoV-2 infection interacting with the plasma lipoproteome giving a strong and characteristic immunometabolic phenotype of the disease. We observed that some patients in the respiratory recovery phase and testing virus-free were still metabolically highly abnormal, which indicates a new role for these technologies in assessing full systemic recovery.
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Affiliation(s)
- Samantha Lodge
- Australian National Phenome Centre, Health Futures
Institute, Murdoch University, Harry Perkins Building, Perth,
Western Australia 6150, Australia
- Centre for Computational and Systems Medicine, Health
Futures Institute, Murdoch University, Murdoch, Western
Australia 6150, Australia
| | - Philipp Nitschke
- Australian National Phenome Centre, Health Futures
Institute, Murdoch University, Harry Perkins Building, Perth,
Western Australia 6150, Australia
| | - Torben Kimhofer
- Australian National Phenome Centre, Health Futures
Institute, Murdoch University, Harry Perkins Building, Perth,
Western Australia 6150, Australia
- Centre for Computational and Systems Medicine, Health
Futures Institute, Murdoch University, Murdoch, Western
Australia 6150, Australia
| | - Jerome D. Coudert
- Centre for Molecular Medicine and Innovative
Therapeutics, Murdoch University, Harry Perkins Building,
Perth, Western Australia 6150, Australia
- Perron Institute for Neurological and
Translational Science, Nedlands, Western Australia 6009,
Australia
- School of Medicine, University of Notre
Dame, Fremantle, Western Australia 6160,
Australia
| | - Sofina Begum
- Australian National Phenome Centre, Health Futures
Institute, Murdoch University, Harry Perkins Building, Perth,
Western Australia 6150, Australia
- Section of Nutrition Research , Department of Metabolism,
Nutrition and Reproduction, Faculty of Medicine, Sir Alexander Fleming Building,
Imperial College London, London SW7 2AZ,
U.K.
| | - Sze-How Bong
- Australian National Phenome Centre, Health Futures
Institute, Murdoch University, Harry Perkins Building, Perth,
Western Australia 6150, Australia
| | - Toby Richards
- Division of Surgery, Medical School, Faculty of Health
and Medical Sciences, University of Western Australia, Harry
Perkins Building, Robert Warren Drive, Murdoch, Perth, Western Australia 6150,
Australia
| | - Dale Edgar
- Faculty of Health and Medical Sciences,
University of Western Australia, Harry Perkins Building,
Robert Warren Drive, Murdoch, Perth, Western Australia 6150,
Australia
| | - Edward Raby
- Department of Clinical Microbiology,
PathWest Laboratory Medicine WA, Murdoch, Perth, Western
Australia 6150, Australia
| | | | | | - John C. Lindon
- Division of Systems Medicine, Department of
Metabolism, Nutrition and Reproduction, Faculty of Medicine, Sir Alexander Fleming
Building, Imperial College London, London SW7 2AZ,
U.K.
| | - Ruey Leng Loo
- Australian National Phenome Centre, Health Futures
Institute, Murdoch University, Harry Perkins Building, Perth,
Western Australia 6150, Australia
- Centre for Computational and Systems Medicine, Health
Futures Institute, Murdoch University, Murdoch, Western
Australia 6150, Australia
| | - Elaine Holmes
- Australian National Phenome Centre, Health Futures
Institute, Murdoch University, Harry Perkins Building, Perth,
Western Australia 6150, Australia
- Centre for Computational and Systems Medicine, Health
Futures Institute, Murdoch University, Murdoch, Western
Australia 6150, Australia
- Section of Nutrition Research , Department of Metabolism,
Nutrition and Reproduction, Faculty of Medicine, Sir Alexander Fleming Building,
Imperial College London, London SW7 2AZ,
U.K.
| | - Jeremy K. Nicholson
- Australian National Phenome Centre, Health Futures
Institute, Murdoch University, Harry Perkins Building, Perth,
Western Australia 6150, Australia
- Centre for Computational and Systems Medicine, Health
Futures Institute, Murdoch University, Murdoch, Western
Australia 6150, Australia
- Division of Surgery, Medical School, Faculty of Health
and Medical Sciences, University of Western Australia, Harry
Perkins Building, Robert Warren Drive, Murdoch, Perth, Western Australia 6150,
Australia
- Institute of Global Health Innovation,
Imperial College London, Level 1, Faculty Building South
Kensington Campus, London SW7 2NA, U.K.
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40
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Lodge S, Nitschke P, Loo RL, Kimhofer T, Bong SH, Richards T, Begum S, Spraul M, Schaefer H, Lindon JC, Holmes E, Nicholson JK. Low Volume in Vitro Diagnostic Proton NMR Spectroscopy of Human Blood Plasma for Lipoprotein and Metabolite Analysis: Application to SARS-CoV-2 Biomarkers. J Proteome Res 2021; 20:1415-1423. [PMID: 33491459 PMCID: PMC7857136 DOI: 10.1021/acs.jproteome.0c00815] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Indexed: 11/29/2022]
Abstract
The utility of low sample volume in vitro diagnostic (IVDr) proton nuclear magnetic resonance (1H NMR) spectroscopic experiments on blood plasma for information recovery from limited availability or high value samples was exemplified using plasma from patients with SARS-CoV-2 infection and normal controls. 1H NMR spectra were obtained using solvent-suppressed 1D, spin-echo (CPMG), and 2-dimensional J-resolved (JRES) spectroscopy using both 3 mm outer diameter SampleJet NMR tubes (100 μL plasma) and 5 mm SampleJet NMR tubes (300 μL plasma) under in vitro diagnostic conditions. We noted near identical diagnostic models in both standard and low volume IVDr lipoprotein analysis (measuring 112 lipoprotein parameters) with a comparison of the two tubes yielding R2 values ranging between 0.82 and 0.99 for the 40 paired lipoprotein parameters samples. Lipoprotein measurements for the 3 mm tubes were achieved without time penalty over the 5 mm tubes as defined by biomarker recovery for SARS-CoV-2. Overall, biomarker pattern recovery for the lipoproteins was extremely similar, but there were some small positive offsets in the linear equations for several variables due to small shimming artifacts, but there was minimal degradation of the biological information. For the standard untargeted 1D, CPMG, and JRES NMR experiments on the same samples, the reduced signal-to-noise was more constraining and required greater scanning times to achieve similar differential diagnostic performance (15 min per sample per experiment for 3 mm 1D and CPMG, compared to 4 min for the 5 mm tubes). We conclude that the 3 mm IVDr method is fit-for-purpose for quantitative lipoprotein measurements, allowing the preparation of smaller volumes for high value or limited volume samples that is common in clinical studies. If there are no analytical time constraints, the lower volume experiments are equally informative for untargeted profiling.
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Affiliation(s)
- Samantha Lodge
- Australian
National Phenome Centre, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA 6150, Australia
| | - Philipp Nitschke
- Australian
National Phenome Centre, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA 6150, Australia
| | - Ruey Leng Loo
- Australian
National Phenome Centre, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA 6150, Australia
- Centre
for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA 6150, Australia
| | - Torben Kimhofer
- Australian
National Phenome Centre, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA 6150, Australia
- Centre
for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA 6150, Australia
| | - Sze-How Bong
- Australian
National Phenome Centre, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA 6150, Australia
| | - Toby Richards
- Division
of Surgery, Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Harry Perkins Building, Robert Warren
Drive, Murdoch, Perth, WA 6150, Australia
| | - Sofina Begum
- Australian
National Phenome Centre, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA 6150, Australia
- Division
of Systems Medicine, Department of Metabolism, Nutrition and Reproduction,
Sir Alexander Fleming Building, Imperial
College London, London SW7 2AZ, U.K.
| | | | | | - John C. Lindon
- Division
of Systems Medicine, Department of Metabolism, Nutrition and Reproduction,
Sir Alexander Fleming Building, Imperial
College London, London SW7 2AZ, U.K.
| | - Elaine Holmes
- Australian
National Phenome Centre, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA 6150, Australia
- Centre
for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA 6150, Australia
- Division
of Systems Medicine, Department of Metabolism, Nutrition and Reproduction,
Sir Alexander Fleming Building, Imperial
College London, London SW7 2AZ, U.K.
| | - Jeremy K. Nicholson
- Australian
National Phenome Centre, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA 6150, Australia
- Centre
for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA 6150, Australia
- Institute
of Global Health Innovation, Imperial College
London, Level 1, Faculty Building South Kensington Campus, London SW7 2NA, U.K.
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41
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Kimhofer T, Lodge S, Whiley L, Gray N, Loo RL, Lawler NG, Nitschke P, Bong SH, Morrison DL, Begum S, Richards T, Yeap BB, Smith C, Smith KGC, Holmes E, Nicholson JK. Integrative Modeling of Quantitative Plasma Lipoprotein, Metabolic, and Amino Acid Data Reveals a Multiorgan Pathological Signature of SARS-CoV-2 Infection. J Proteome Res 2020; 19:4442-4454. [PMID: 32806897 PMCID: PMC7489050 DOI: 10.1021/acs.jproteome.0c00519] [Citation(s) in RCA: 115] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Indexed: 02/06/2023]
Abstract
The metabolic effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on human blood plasma were characterized using multiplatform metabolic phenotyping with nuclear magnetic resonance (NMR) spectroscopy and liquid chromatography-mass spectrometry (LC-MS). Quantitative measurements of lipoprotein subfractions, α-1-acid glycoprotein, glucose, and biogenic amines were made on samples from symptomatic coronavirus disease 19 (COVID-19) patients who had tested positive for the SARS-CoV-2 virus (n = 17) and from age- and gender-matched controls (n = 25). Data were analyzed using an orthogonal-projections to latent structures (OPLS) method and used to construct an exceptionally strong (AUROC = 1) hybrid NMR-MS model that enabled detailed metabolic discrimination between the groups and their biochemical relationships. Key discriminant metabolites included markers of inflammation including elevated α-1-acid glycoprotein and an increased kynurenine/tryptophan ratio. There was also an abnormal lipoprotein, glucose, and amino acid signature consistent with diabetes and coronary artery disease (low total and HDL Apolipoprotein A1, low HDL triglycerides, high LDL and VLDL triglycerides), plus multiple highly significant amino acid markers of liver dysfunction (including the elevated glutamine/glutamate and Fischer's ratios) that present themselves as part of a distinct SARS-CoV-2 infection pattern. A multivariate training-test set model was validated using independent samples from additional SARS-CoV-2 positive patients and controls. The predictive model showed a sensitivity of 100% for SARS-CoV-2 positivity. The breadth of the disturbed pathways indicates a systemic signature of SARS-CoV-2 positivity that includes elements of liver dysfunction, dyslipidemia, diabetes, and coronary heart disease risk that are consistent with recent reports that COVID-19 is a systemic disease affecting multiple organs and systems. Metabolights study reference: MTBLS2014.
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Affiliation(s)
- Torben Kimhofer
- Australian National Phenome Centre, Computational and
Systems Medicine, Health Futures Institute, Murdoch University,
Harry Perkins Building, Perth, Western Australia 6150, Australia
| | - Samantha Lodge
- Australian National Phenome Centre, Computational and
Systems Medicine, Health Futures Institute, Murdoch University,
Harry Perkins Building, Perth, Western Australia 6150, Australia
| | - Luke Whiley
- Australian National Phenome Centre, Computational and
Systems Medicine, Health Futures Institute, Murdoch University,
Harry Perkins Building, Perth, Western Australia 6150, Australia
- Perron Institute for Neurological and
Translational Science, Nedlands, Western Australia 6009,
Australia
| | - Nicola Gray
- Australian National Phenome Centre, Computational and
Systems Medicine, Health Futures Institute, Murdoch University,
Harry Perkins Building, Perth, Western Australia 6150, Australia
| | - Ruey Leng Loo
- Australian National Phenome Centre, Computational and
Systems Medicine, Health Futures Institute, Murdoch University,
Harry Perkins Building, Perth, Western Australia 6150, Australia
| | - Nathan G. Lawler
- Australian National Phenome Centre, Computational and
Systems Medicine, Health Futures Institute, Murdoch University,
Harry Perkins Building, Perth, Western Australia 6150, Australia
| | - Philipp Nitschke
- Australian National Phenome Centre, Computational and
Systems Medicine, Health Futures Institute, Murdoch University,
Harry Perkins Building, Perth, Western Australia 6150, Australia
| | - Sze-How Bong
- Australian National Phenome Centre, Computational and
Systems Medicine, Health Futures Institute, Murdoch University,
Harry Perkins Building, Perth, Western Australia 6150, Australia
| | - David L. Morrison
- Australian National Phenome Centre, Computational and
Systems Medicine, Health Futures Institute, Murdoch University,
Harry Perkins Building, Perth, Western Australia 6150, Australia
| | - Sofina Begum
- Section for Nutrition Research, Imperial
College London, Sir Alexander Fleming Building, South Kensington, London
SW7 2AZ, U.K.
| | - Toby Richards
- Medical School, Faculty of Health and Medical
Sciences, University of Western Australia, and Department of Endocrinology and Diabetes,
Fiona Stanley Hospital, Harry Perkins Building, Murdoch,
Perth, Western Australia 6150, Australia
| | - Bu B. Yeap
- Medical School, Faculty of Health and Medical
Sciences, University of Western Australia, and Department of Endocrinology and Diabetes,
Fiona Stanley Hospital, Harry Perkins Building, Murdoch,
Perth, Western Australia 6150, Australia
| | - Chris Smith
- The Cambridge Institute of Therapeutic Immunology and
Infectious Disease, Department of Medicine, University of Cambridge,
Addenbrooke’s Hospital, Cambridge CB2 0QQ,
U.K.
| | - Kenneth G. C. Smith
- The Cambridge Institute of Therapeutic Immunology and
Infectious Disease, Department of Medicine, University of Cambridge,
Addenbrooke’s Hospital, Cambridge CB2 0QQ,
U.K.
| | - Elaine Holmes
- Australian National Phenome Centre, Computational and
Systems Medicine, Health Futures Institute, Murdoch University,
Harry Perkins Building, Perth, Western Australia 6150, Australia
- Section for Nutrition Research, Imperial
College London, Sir Alexander Fleming Building, South Kensington, London
SW7 2AZ, U.K.
| | - Jeremy K. Nicholson
- Australian National Phenome Centre, Computational and
Systems Medicine, Health Futures Institute, Murdoch University,
Harry Perkins Building, Perth, Western Australia 6150, Australia
- Medical School, Faculty of Health and Medical
Sciences, University of Western Australia, and Department of Endocrinology and Diabetes,
Fiona Stanley Hospital, Harry Perkins Building, Murdoch,
Perth, Western Australia 6150, Australia
- Institute of Global Health Innovation, Imperial
College London, Level 1, Faculty Building South Kensington Campus, London
SW7 2AZ, U.K.
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Loo RL, Lodge S, Kimhofer T, Bong SH, Begum S, Whiley L, Gray N, Lindon JC, Nitschke P, Lawler NG, Schäfer H, Spraul M, Richards T, Nicholson JK, Holmes E. Quantitative In-Vitro Diagnostic NMR Spectroscopy for Lipoprotein and Metabolite Measurements in Plasma and Serum: Recommendations for Analytical Artifact Minimization with Special Reference to COVID-19/SARS-CoV-2 Samples. J Proteome Res 2020; 19:4428-4441. [PMID: 32852212 PMCID: PMC7640974 DOI: 10.1021/acs.jproteome.0c00537] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Indexed: 12/14/2022]
Abstract
Quantitative nuclear magnetic resonance (NMR) spectroscopy of blood plasma is widely used to investigate perturbed metabolic processes in human diseases. The reliability of biochemical data derived from these measurements is dependent on the quality of the sample collection and exact preparation and analysis protocols. Here, we describe systematically, the impact of variations in sample collection and preparation on information recovery from quantitative proton (1H) NMR spectroscopy of human blood plasma and serum. The effects of variation of blood collection tube sizes and preservatives, successive freeze-thaw cycles, sample storage at -80 °C, and short-term storage at 4 and 20 °C on the quantitative lipoprotein and metabolite patterns were investigated. Storage of plasma samples at 4 °C for up to 48 h, freezing at -80 °C and blood sample collection tube choice have few and minor effects on quantitative lipoprotein profiles, and even storage at 4 °C for up to 168 h caused little information loss. In contrast, the impact of heat-treatment (56 °C for 30 min), which has been used for inactivation of SARS-CoV-2 and other viruses, that may be required prior to analytical measurements in low level biosecurity facilities induced marked changes in both lipoprotein and low molecular weight metabolite profiles. It was conclusively demonstrated that this heat inactivation procedure degrades lipoproteins and changes metabolic information in complex ways. Plasma from control individuals and SARS-CoV-2 infected patients are differentially altered resulting in the creation of artifactual pseudo-biomarkers and destruction of real biomarkers to the extent that data from heat-treated samples are largely uninterpretable. We also present several simple blood sample handling recommendations for optimal NMR-based biomarker discovery investigations in SARS CoV-2 studies and general clinical biomarker research.
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Affiliation(s)
- Ruey Leng Loo
- Australian
National Phenome Centre, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA 6150, Australia
- Center
for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Murdoch, Perth, WA 6150, Australia
| | - Samantha Lodge
- Australian
National Phenome Centre, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA 6150, Australia
- Center
for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Murdoch, Perth, WA 6150, Australia
| | - Torben Kimhofer
- Australian
National Phenome Centre, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA 6150, Australia
- Center
for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Murdoch, Perth, WA 6150, Australia
| | - Sze-How Bong
- Australian
National Phenome Centre, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA 6150, Australia
| | - Sofina Begum
- Section
for Nutrition Research, Imperial College
London, Sir Alexander Fleming Building, South Kensington, London SW72AZ, U.K.
| | - Luke Whiley
- Australian
National Phenome Centre, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA 6150, Australia
- Center
for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Murdoch, Perth, WA 6150, Australia
- Perron
Institute for Neurological and Translational Science, Nedlands, WA 6009, Australia
| | - Nicola Gray
- Australian
National Phenome Centre, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA 6150, Australia
- Center
for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Murdoch, Perth, WA 6150, Australia
| | - John C. Lindon
- Center
for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Murdoch, Perth, WA 6150, Australia
- Department
of Metabolism, Nutrition and Reproduction, Imperial College London, Sir Alexander Fleming Building, London SW72AZ, U.K.
| | - Philipp Nitschke
- Australian
National Phenome Centre, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA 6150, Australia
- Center
for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Murdoch, Perth, WA 6150, Australia
| | - Nathan G. Lawler
- Australian
National Phenome Centre, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA 6150, Australia
- Center
for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Murdoch, Perth, WA 6150, Australia
| | | | - Manfred Spraul
- Biospin
GmbH, Silberstreifen, 76287 Rheinstetten, Germany
| | - Toby Richards
- Division
of Surgery, Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Harry Perkins Building, Robert Warren Drive, Murdoch, Perth, WA 6150, Australia
- Department
of Endocrinology and Diabetes, Fiona Stanley
Hospital, Harry Perkins
Building, Murdoch, Perth, WA 6150, Australia
| | - Jeremy K. Nicholson
- Australian
National Phenome Centre, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA 6150, Australia
- Center
for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Murdoch, Perth, WA 6150, Australia
- Division
of Surgery, Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Harry Perkins Building, Robert Warren Drive, Murdoch, Perth, WA 6150, Australia
- Institute
of Global Health Innovation, Imperial College
London, Level 1, Faculty Building, South Kensington Campus, London SW72NA, U.K.
| | - Elaine Holmes
- Australian
National Phenome Centre, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA 6150, Australia
- Center
for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Murdoch, Perth, WA 6150, Australia
- Section
for Nutrition Research, Imperial College
London, Sir Alexander Fleming Building, South Kensington, London SW72AZ, U.K.
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Bartlett EC, Kemp SV, Ridge CA, Desai SR, Mirsadraee S, Morjaria JB, Shah PL, Popat S, Nicholson AG, Rice AJ, Jordan S, Begum S, Mani A, Derbyshire J, Morris K, Chen M, Peacock C, Addis J, Martins M, Kaye SB, Padley SPG, Devaraj A. Baseline Results of the West London lung cancer screening pilot study - Impact of mobile scanners and dual risk model utilisation. Lung Cancer 2020; 148:12-19. [PMID: 32771715 DOI: 10.1016/j.lungcan.2020.07.027] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/15/2020] [Accepted: 07/24/2020] [Indexed: 12/23/2022]
Abstract
OBJECTIVES The West London lung screening pilot aimed to identify early-stage lung cancer by targeting low-dose CT (LDCT) to high risk participants. Successful implementation of screening requires maximising participant uptake and identifying those at highest risk. As well as reporting pre-specified baseline screening metrics, additional objectives were to 1) compare participant uptake between a mobile and hospital-based CT scanner and 2) evaluate the impact on cancer detection using two lung cancer risk models. METHODS From primary care records, ever-smokers aged 60-75 were invited to a lung health check at a hospital or mobile site. Participants with PLCOM2012 6-yr risk ≥1.51 % and/or LLPv2 5-yr risk ≥2.0 % were offered a LDCT. Lung cancer detection rate, stage, and recall rates are reported. Participant uptake was compared at both sites (chi-squared test). LDCT eligibility and cancer detection rate were compared between those recruited under each risk model. RESULTS Of 8366 potential participants invited, 1047/5135 (20.4 %) invitees responded to an invitation to the hospital site, and 702/3231 (21.7 %) to the mobile site (p = 0.14). The median distance travelled to the hospital site was less than to the mobile site (3.3 km vs 6.4 km, p < 0.01). Of 1159 participants eligible for a scan, 451/1159 (38.9 %) had a LLPv2 ≥2.0 % only, 71/1159 (6.1 %) had a PLCOM2012 ≥1.5 % only; 637/1159 (55.0 %) met both risk thresholds. Recall rate was 15.9 %. Lung cancer was detected in 29/1145 (2.5 %) participants scanned (stage 1, 58.6 %); 5/29 participants with lung cancer did not meet a PLCOM2012 threshold of ≥1.51 %; all had a LLPv2 ≥2.0 %. CONCLUSION Targeted screening is effective in detecting early-stage lung cancer. Similar levels of participant uptake at a mobile and fixed site scanner were demonstrated, indicating that uptake was driven by factors in addition to scanner location. The LLPv2 model was more permissive; recruitment with PLCOM2012 alone would have missed several cancers.
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Affiliation(s)
- Emily C Bartlett
- Royal Brompton and Harefield NHS Foundation Trust, Department of Radiology, Sydney Street, London, SW3 6NP, UK
| | - Samuel V Kemp
- Royal Brompton and Harefield NHS Foundation Trust, Department of Respiratory Medicine, Sydney Street, London, SW3 6NP, UK; National Heart and Lung Institute, Imperial College, London, SW3 6LY, UK
| | - Carole A Ridge
- Royal Brompton and Harefield NHS Foundation Trust, Department of Radiology, Sydney Street, London, SW3 6NP, UK
| | - Sujal R Desai
- Royal Brompton and Harefield NHS Foundation Trust, Department of Radiology, Sydney Street, London, SW3 6NP, UK; National Heart and Lung Institute, Imperial College, London, SW3 6LY, UK
| | - Saeed Mirsadraee
- Royal Brompton and Harefield NHS Foundation Trust, Department of Radiology, Sydney Street, London, SW3 6NP, UK; National Heart and Lung Institute, Imperial College, London, SW3 6LY, UK
| | - Jaymin B Morjaria
- Royal Brompton and Harefield NHS Foundation Trust, Department of Respiratory Medicine, Harefield Hospital, Hill End Road, Harefield, UB9 6JH, UK
| | - Pallav L Shah
- Royal Brompton and Harefield NHS Foundation Trust, Department of Respiratory Medicine, Sydney Street, London, SW3 6NP, UK; National Heart and Lung Institute, Imperial College, London, SW3 6LY, UK
| | - Sanjay Popat
- National Heart and Lung Institute, Imperial College, London, SW3 6LY, UK; Lung Unit, Royal Marsden Hospital, Fulham Road, London, SW6 3JJ, UK; Institute of Cancer Research, 123 Old Brompton Road, London, SW7 3RP, UK
| | - Andrew G Nicholson
- National Heart and Lung Institute, Imperial College, London, SW3 6LY, UK; Royal Brompton and Harefield NHS Foundation Trust, Department of Histopathology, Sydney Street, London, SW3 6NP, UK
| | - Alexandra J Rice
- Royal Brompton and Harefield NHS Foundation Trust, Department of Histopathology, Sydney Street, London, SW3 6NP, UK
| | - Simon Jordan
- Royal Brompton and Harefield NHS Foundation Trust, Department of Thoracic Surgery, Sydney Street, London, SW3 6NP, UK
| | - Sofina Begum
- Royal Brompton and Harefield NHS Foundation Trust, Department of Thoracic Surgery, Sydney Street, London, SW3 6NP, UK
| | - Aleksander Mani
- Royal Brompton and Harefield NHS Foundation Trust, Department of Thoracic Surgery, Sydney Street, London, SW3 6NP, UK
| | - Jane Derbyshire
- RM Partners, The West London Cancer Alliance, 5th Floor, Alliance House, 12 Caxton Street, London, SW1H 0QS, UK
| | - Katie Morris
- RM Partners, The West London Cancer Alliance, 5th Floor, Alliance House, 12 Caxton Street, London, SW1H 0QS, UK
| | - Michelle Chen
- RM Partners, The West London Cancer Alliance, 5th Floor, Alliance House, 12 Caxton Street, London, SW1H 0QS, UK
| | - Christine Peacock
- Royal Brompton and Harefield NHS Foundation Trust, Department of Radiology, Sydney Street, London, SW3 6NP, UK
| | - James Addis
- Royal Brompton and Harefield NHS Foundation Trust, Department of Radiology, Sydney Street, London, SW3 6NP, UK
| | - Maria Martins
- Respiratory Biomedical Research Unit, Royal Brompton Hospital and Harefield NHS Foundation Trust, Sydney Street, London, SW3 6NP, UK
| | - Stan B Kaye
- RM Partners, Sycamore House, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, SM2 5PT, UK
| | - Simon P G Padley
- Royal Brompton and Harefield NHS Foundation Trust, Department of Radiology, Sydney Street, London, SW3 6NP, UK; National Heart and Lung Institute, Imperial College, London, SW3 6LY, UK
| | - Anand Devaraj
- Royal Brompton and Harefield NHS Foundation Trust, Department of Radiology, Sydney Street, London, SW3 6NP, UK; National Heart and Lung Institute, Imperial College, London, SW3 6LY, UK.
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Shejuty TR, Shamsi S, Mirza TT, Nigar K, Nahar S, Begum S, Sharmin T, Panna LK, Sarna IZ, Sharmin F. A Young Girl with a Complex Female Genital Tract Malformation. Mymensingh Med J 2020; 29:725-729. [PMID: 32844817] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Complex malformations of the female genital tract are not as uncommon as they are thought to be. But because of their heterogeneous presentation they often pose a diagnostic dilemma and thus their management plan is crucial. Here we express a case report of a 12 year old girl with a rare and complex female genital tract malformation of uterine didelphys with obstructed hemi uterus due to unilateral cervical agenesis with ipsilateral renal agenesis and contralateral cervical dysgenesis. The girl presented to us with severe lower abdominal pain and progressive pelvic lump. In order to preserve menstrual function and fertility, a cervical fistula was made and the patient has been kept under follow up since then.
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Affiliation(s)
- T R Shejuty
- Dr Tasneema Rahman Shejuty, Assistant Registrar, Department of Obs. & Gynae, Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh; E-mail:
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45
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Shamsi S, Mirza TT, Shejuti TR, Nigar K, Nahar S, Begum S, Sharmin T, Panna LK, Islam N, Jahan T. An Overview of Unsafe Abortion: Patterns and Outcomes in a Tertiary Level Hospital. Mymensingh Med J 2020; 29:523-529. [PMID: 32844789] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Unsafe abortion is one of the most critical global public health concerns and human rights challenges of the current time. The complications arising from unsafe abortion account for the death of almost 192 women each day; that is one woman every eight minutes and nearly all of them in developing countries. It is a descriptive type of observational study where all abortion related admissions from July 2017 to June 2018 in Obstetrics & Gynaecology department of Mymensingh Medical College Hospital were analyzed. Cases of unsafe abortion were identified as missed abortion, incomplete abortion and septic abortion. Total 2396 abortion related cases were admitted in one year. Among them 2173 cases were unsafe abortion (90.69%). The commonest mode of unsafe abortion was by taking improper regimen of different types of oral abortifacients either by self-administration or by improper prescriptions of local medical dispensers in 90% women. The commonest clinical presentation was per vaginal moderate to heavy bleeding in 88.5% women. After evaluation, the commonest diagnosis made was incomplete abortion in 92.87% women. The first line of intervention taken was recommended dose of medications like Misoprostol alone or Misoprostol followed by Mifepristone in 96.3% women to avoid unnecessary endometrial injury by surgical procedure. Further 44.2% women underwent Manual Vacuum Aspiration and thus reducing hospital stay to around 3.0±0.25 days. Almost all the patients (94%) were given post abortion contraceptives along with long acting family planning services to 20% patients. The miserable complication was septic abortion in 1.29% women and they were mainly done by insertion of foreign bodies which contribute to total 4.4% of maternal death. The impact of unsafe abortion on the woman and her family is intimidating. Timely and proper management of unsafe abortions and their complications with adequate provision for post abortion care may reduce the morbidity and mortality related to it. Moreover, use of long acting contraceptives to prevent unintended pregnancy and access to safe abortion may reduce the burden of unsafe abortions on public health system.
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Affiliation(s)
- S Shamsi
- Dr Shanjida Shamsi, Junior Consultant, Obs & Gynae, Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh
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46
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Zhang YZ, Brambilla C, Molyneaux PL, Rice A, Robertus JL, Jordan S, Lim E, Lang-Lazdunski L, Begum S, Dusmet M, Anikin V, Beddow E, Finch J, Asadi N, Popat S, Quesne JL, Husain AN, Cookson WOCM, Moffatt MF, Nicholson AG. Presence of pleomorphic features but not growth patterns improves prognostic stratification of epithelioid malignant pleural mesothelioma by 2-tier nuclear grade. Histopathology 2020; 77:423-436. [PMID: 32333813 DOI: 10.1111/his.14127] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 04/22/2020] [Indexed: 12/11/2022]
Abstract
AIMS Nuclear grade has been recently validated as a powerful prognostic tool in epithelioid malignant pleural mesothelioma (E-MPM). In other studies histological parameters including pleomorphic features and growth patterns were also shown to exert prognostic impact. The primary aims of our study are (i) externally validate the prognostic role of pleomorphic features in E-MPM and (ii) investigate if evaluating growth pattern in addition to 2-tier nuclear grade improves prognostication. METHODS AND RESULTS 614 consecutive cases of E-MPM from our institution over a period of 15 years were retrospectively reviewed, of which 51 showed pleomorphic features. E-MPM with pleomorphic features showed significantly worse overall survival compared to those without (5.4 versus 14.7 months). Tumours with predominantly micropapillary pattern showed the worst survival (6.2 months) followed by solid (10.5 months), microcystic (15.3 months), discohesive (16.1 months), trabecular (17.6 months) and tubulo-papillary (18.6 months). Sub-classification of growth patterns into high grade (solid, micropapillary) and low grade (all others) led to good separation of overall survival (10.5 versus 18.0 months) but did not predict survival independent of 2-tier nuclear grade. A composite score comprised of growth pattern and 2-tier nuclear grade did not improve prognostication compared with nuclear grade alone. Intra-tumoural heterogeneity in growth patterns is ubiquitous. CONCLUSIONS Our findings support the incorporation of E-MPM with pleomorphic features in the epithelioid subtype as a highly aggressive variant distinct from 2-tier nuclear grade. E-MPM demonstrates extensive heterogeneity in growth pattern but its evaluation does not offer additional prognostic utility to 2-tier nuclear grade.
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Affiliation(s)
- Yu Z Zhang
- National Centre for Mesothelioma Research, National Heart & Lung Institute, Imperial College London, London, UK.,Department of Histopathology, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Cecilia Brambilla
- Department of Histopathology, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Philip L Molyneaux
- National Heart & Lung Institute, Imperial College London, London, UK.,NIHR Respiratory Clinical Research Facility, Royal Brompton Hospital, London, UK
| | - Alexandra Rice
- Department of Histopathology, Royal Brompton and Harefield NHS Foundation Trust, London, UK.,National Heart & Lung Institute, Imperial College London, London, UK
| | - Jan L Robertus
- Department of Histopathology, Royal Brompton and Harefield NHS Foundation Trust, London, UK.,National Heart & Lung Institute, Imperial College London, London, UK
| | - Simon Jordan
- Department of Thoracic Surgery, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Eric Lim
- National Heart & Lung Institute, Imperial College London, London, UK.,Department of Thoracic Surgery, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | | | - Sofina Begum
- Department of Thoracic Surgery, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Michael Dusmet
- Department of Thoracic Surgery, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Vladimir Anikin
- Department of Thoracic Surgery, Royal Brompton and Harefield NHS Foundation Trust, London, UK.,Department of Oncology and Reconstructive Surgery, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Emma Beddow
- Department of Thoracic Surgery, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Jonathan Finch
- Department of Thoracic Surgery, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Nizar Asadi
- Department of Thoracic Surgery, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Sanjay Popat
- National Heart & Lung Institute, Imperial College London, London, UK.,Department of Medicine, Royal Marsden Hospital NHS Foundation Trust, London, UK.,Institute of Cancer Research, London, UK
| | - John L Quesne
- MRC Toxicology Unit, University of Cambridge, Leicester, UK.,Leicester Cancer Research Centre, University of Leicester, Leicester, UK.,Department of Cellular Pathology, University Hospitals Leicester NHS Trust, Leicester, UK
| | - Aliya N Husain
- Department of Pathology, University of Chicago Medical Centre, Chicago, USA
| | - William O C M Cookson
- National Centre for Mesothelioma Research, National Heart & Lung Institute, Imperial College London, London, UK.,National Heart & Lung Institute, Imperial College London, London, UK
| | - Miriam F Moffatt
- National Centre for Mesothelioma Research, National Heart & Lung Institute, Imperial College London, London, UK.,National Heart & Lung Institute, Imperial College London, London, UK
| | - Andrew G Nicholson
- Department of Histopathology, Royal Brompton and Harefield NHS Foundation Trust, London, UK.,National Heart & Lung Institute, Imperial College London, London, UK
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Dey SK, Islam S, Jahan I, Shabuj KH, Begum S, Chisti MJ, Mannan MA, Shahidullah M, Chowdhury S. Association of Hyperbilirubinemia Requiring Phototherapy or Exchange Transfusion with Hearing Impairment among Admitted Term and Late Preterm Newborn in a NICU. Mymensingh Med J 2020; 29:405-413. [PMID: 32506097] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Hearing impairment is one of the deleterious ramifications of neonatal hyperbilirubinemia, but its impact during the newborn period has not been well studied in Bangladesh. This prospective observational study was conducted during January 2016 to December 2017 in the Department of Neonatology and Otolaryngology-Head and Neck Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh to identify the relationship between hyperbilirubinemia requiring phototherapy or exchange transfusion with hearing impairment in term and late preterm neonates. Admitted term and late preterm neonates with hyperbilirubinemia requiring either phototherapy or exchange transfusion were taken as hyperbilirubinemia group. Neonates without hyperbilirubinemia from postnatal ward were taken as control. All newborn were screened with Distortion Product Otoacoustic Emissions (DPOAE) prior to discharge from hospital. A second screen was done in referred newborn after one month of first screen. A diagnostic Auditory Brainstem Response (ABR) was performed in both the ears prior to 3 months of postnatal age if referred in both 1st and 2nd screen. Total 264 neonates included in this study; 132 in the hyperbilirubinemia and 132 in the control group. In the hyperbilirubinemia group 74(56.06%) were male and 58(43.94) were female. Mean gestational ages in the hyperbilirubinemia group and control group were 36.95±1.60 weeks and 37.01±1.67 weeks respectively. Newborn in the hyperbilirubinemia group, 4(3.03%) had hearing impairment and none had hearing impairment in the control group. Peak Total Serum Bilirubin (TSB) 23mg/dl was found as best cut off value with a sensitivity of 100% and specificity of 93% for the development hearing impairment. Hearing impairment was significantly more frequent among newborn with TSB level >23mg/dl when compared to those having TSB level ≤23mg/dl (20% vs. 0.9%, p=0.009; OR=29, 95% CI 2.79, 301). Hearing impairment was associated with newborns with hyperbilirubinemia requiring phototherapy or exchange transfusion. Peak TSB level >23mg/dl can be predictive for the development of hearing impairment.
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Affiliation(s)
- S K Dey
- Professor Dr Sanjoy Kumer Dey, Professor, Department of Neonatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh; E-mail:
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48
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Ahmed NU, Begum S, Ali T, Suhana M. Home Based Pulmonary Rehabilitation on Oxygenation Status, Dyspnea and Fatigue in Stable Patients with COPD. Mymensingh Med J 2020; 29:424-430. [PMID: 32506100] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Pulmonary rehabilitation (PR) program of a sufficient duration has impact on consequence of COPD. To evaluate the effects of combination of pursed lip breathing (PLB), diaphragmatic breathing (DB) and lower extremity endurance training (LEET) as part of PR program in stable patients with COPD on oxygenation status, dyspnea and fatigue. This prospective interventional study was performed in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from July 2010 to June 2011 and was performed on 116 male stable moderate COPD patients aged 50 to 65 years. Among them, 56 patients were without PR (control group) and 60 patients were intervened with PR (experimental group). The experimental patients were advised to perform the home based PR program (PLB, DB and LEET) for 30 minutes duration per session at home twice per day, along with standard drug treatment of COPD for uninterrupted 60 days. The control patients continued their treatment of COPD with standard drug for successive 60 days were advised. To evaluate the effects of PR, Peripheral capillary oxygen saturation (SpO₂, by pulse Oximeter), level of dyspnea and level of fatigue by Modified Borg Scale from baseline to end of six minute walk test (6MWT) of all subjects were recorded on day 0 and day 60 for both the groups. Independent sample 't' test and paired Student's 't' test were done with SPSS software. In the interpretation of results, p value of <0.05 was considered as statistically significant. In the present study, we found less decrement of SpO₂ and less increment of level of dyspnea as well as level of fatigue after 6MWT in the COPD patients with PR on 60th day of follow up. The study reveals that oxygenation status, dyspnea and fatigue improve after execution of regular home based PR program in patients with moderate stable COPD.
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Affiliation(s)
- N U Ahmed
- Major (Dr) Mohammad Nesar Uddin Ahmed, Medical Officer, 21 Field Ambulance, Bogura Cantonment, Bogura, Bangladesh. E-mail ID:
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49
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Begum S, Fleurov V, Kagalovsky V, Yurkevich IV. Sliding Luttinger liquid with alternating interwire couplings. J Phys Condens Matter 2019; 31:425601. [PMID: 31207581 DOI: 10.1088/1361-648x/ab2a56] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
We study a phase diagram for the sliding Luttinger liquid (SLL) of coupled one-dimensional quantum wires packed in a two-dimensional array in the absence of a magnetic field. We analyse whether the nearest-neighbour inter-wire interactions, stabilise the SLL phase. We construct an analogue of a Su-Schriefer-Heeger (SSH) model (allowing alternating couplings between wires). Calculating the scaling dimensions of the two most relevant perturbations, charge-density wave, and superconducting inter-wire couplings, but excluding the inter-wire single-particle hybridisation, we find a finite stability region for the SLL. It emerges due to the inter-wire forward scattering interaction, and remains stable up to a significant asymmetry between alternating couplings.
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Affiliation(s)
- S Begum
- Aston University, School of Engineering & Applied Science-Birmingham B4 7ET, United Kingdom
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50
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Sultana R, Nessa A, Begum S, Yesmin F, Khanam A, Nasreen S, Asrin M. Fasting Serum Glucose Level in Male Cigarette Smoker. Mymensingh Med J 2019; 28:808-810. [PMID: 31599244] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Cigarette smoking is a practice in which tobacco (leaf of Nicotina Tabacum) is burned and the smoke (heterogeneous aerosol) is tasted or inhaled. Smoking may be linked to insulin resistance that leads to impaired glucose and lipid metabolism. Aim of the study was to assess the levels of fasting serum glucose level in healthy male cigarette smokers in order to compare this parameter with healthy non smokers. This comparative study was carried out in the Department of Physiology, Mymensingh Medical College, Mymensingh, Bangladesh from July 2013 to June 2014. One hundred healthy male subjects (75 male were cigarette smokers as study group and 25 male were non smokers as control group) aged between 16 to 40 years were enrolled in this study. Fasting serum glucose was estimated by GOD-PAP Method. Data were expressed as mean±SD and statistical significance of difference among the group was calculated by unpaired students''t' test. The mean±SD fasting serum glucose (FSG) levels were higher in smoker group in comparison to the non smoker group. There were gradual increases in FSG levels in the smokers as the duration of smoking was increased and these were 4.75±0.88, 5.12±0.67, 5.29±0.47 and 5.58±2.05mmol/L in group I, IIA, IIB and IIC respectively. This study concludes cigarette smoking impair the carbohydrate metabolism and increase fasting serum glucose level in accordance with the duration of smoking.
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Affiliation(s)
- R Sultana
- Dr Razia Sultana, Assistant Professor, Department of Physiology, Popular Medical College, Dhaka, Bangladesh; E-mail:
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