Identification of inflammatory genes involved in the pathogenesis of human and experimental atherosclerosis

Atherosclerosis is a chronic systemic inflammatory disease of large and medium sized arteries, developing slowly and silently over decades. The disease is usually not apparent until occurrence of a sudden clinical symptom, such as myocardial infarction (MI) or stroke. Several classical risk factors have been established to play a role in the progression of disease over a long period of time. However, markers recognizing vulnerable patients being at risk of having an event in the near future are lacking. Thus, more knowledge about the ongoing complex pathogenesis is needed for identification of potential biomarkers and therapeutic targets of atherosclerosis. Patients with carotid atherosclerosis experiencing cerebral symptoms within one month before undergoing carotid endarterectomy (CEA) are classified having vulnerable plaques. Based on the classification above, I show in this thesis that mRNA levels of enzymes in the leukotriene 5-lipoxygenase pathway, 5-lipoxygenase (5-LO) and leukotriene A4 hydrolase (LTA4H), are associated with plaque vulnerability. Gene expression can be investigated on a single target level using real-time PCR or by analyzing thousands of genes simultaneously, using global transcription microarrays. Based on correlations to microarrays we argue for using total RNA mass in normalization of real-time PCR data, when analyzing heterogeneous human specimen. To identify new candidates of plaque vulnerability an unbiased approach was used - transcript profiles of symptomatic plaques were compared to asymptomatic plaques, demonstrating an increase of fatty acid binding protein 4 (FABP4), which was associated with vulnerability, independent of age or gender. FABP4 localize mainly to the numerous macrophages present in the atherosclerotic plaque. This study suggests FABP4 to play a role in plaque vulnerability and to be a potential valuable biomarker within the carotid atherosclerotic plaque. To determine if any atherosclerosis-related changes can be detected in circulating cells the transcriptome of leukocytes in the circulation from an experimental atherosclerotic model Apoe-/-was analyzed. Surprisingly, we also here identify FABP4 as a marker in neutrophils and monocytes reflecting atherosclerotic lesion progression. Moreover, I observe human monocytes and neutrophils from the circulation to be positive for FABP4. Our findings make FABP4 in circulating cells interesting for functional investigations, and an appealing and easy accessible biomarker target for potential future translation into clinical purposes. In conclusion, I have studied inflammatory genes being involved in the pathogenic process during atherosclerosis using human and experimental models. In brief, we demonstrate that human vulnerable plaques display increased mRNA levels of 5-LO and LTA4H, and FABP4. In addition, the latter is shown in an experimental model, to be a potential valuable biomarker in circulating leukocytes reflecting the extent of atherosclerotic lesion. Our discoveries in the human plaque may be of future clinical relevance to identify vulnerable plaques, whereas FABP4 in leukocytes potentially could be useful for recognizing asymptomatic patients before onset of symptoms

Giving or Receiving Something for Sex: A Cross-Sectional Study of Transactional Sex among Ugandan University Students.

OBJECTIVE: This study sought to determine the prevalence of transactional sex among university students in Uganda and to assess the possible relationship between transactional sex and sexual coercion, physical violence, mental health, and alcohol use. METHODS: In 2010, 1954 undergraduate students at a Ugandan university responded to a self-administered questionnaire that assessed mental health, substance use, physical violence and sexual behaviors including sexual coercion and transactional sex. The prevalence of transactional sex was assessed and logistic regression analysis was performed to measure the associations between various risk factors and reporting transactional sex. RESULTS: Approximately 25% of the study sample reported having taken part in transactional sex, with more women reporting having accepted money, gifts or some compensation for sex, while more men reporting having paid, given a gift or otherwise compensated for sex. Sexual coercion in men and women was significantly associated with having accepted money, gifts or some compensation for sex. Men who were victims of physical violence in the last 12 months had higher probability of having accepted money, gifts or some compensation for sex than other men. Women who were victims of sexual coercion reported greater likelihood of having paid, given a gift or otherwise compensated for sex. Respondents who had been victims of physical violence in last 12 months, engaged in heavy episodic drinking and had poor mental health status were more likely to have paid, given a gift or otherwise compensated for sex. CONCLUSIONS: University students in Uganda are at high risk of transactional sex. Young men and women may be equally vulnerable to the risks and consequences of transactional sex and should be included in program initiatives to prevent transactional sex. The role of sexual coercion, physical violence, mental health, and alcohol use should be considered when designing interventions for countering transactional sex

The role of childhood social position in adult type 2 diabetes: Evidence from the English Longitudinal Study of Ageing

Copyright @ 2014 Pikhartova et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.This article has been made available through the Brunel Open Access Publishing Fund.Background: Socioeconomic circumstances in childhood and early adulthood may influence the later onset of chronic disease, although such research is limited for type 2 diabetes and its risk factors at the different stages of life. The main aim of the present study is to examine the role of childhood social position and later inflammatory markers and health behaviours in developing type 2 diabetes at older ages using a pathway analytic approach. Methods. Data on childhood and adult life circumstances of 2,994 men and 4,021 women from English Longitudinal Study of Ageing (ELSA) were used to evaluate their association with diabetes at age 50 years and more. The cases of diabetes were based on having increased blood levels of glycated haemoglobin and/or self-reported medication for diabetes and/or being diagnosed with type 2 diabetes. Father's job when ELSA participants were aged 14 years was used as the measure of childhood social position. Current social characteristics, health behaviours and inflammatory biomarkers were used as potential mediators in the statistical analysis to assess direct and indirect effects of childhood circumstances on diabetes in later life. Results: 12.6 per cent of participants were classified as having diabetes. A disadvantaged social position in childhood, as measured by father's manual occupation, was associated at conventional levels of statistical significance with an increased risk of type 2 diabetes in adulthood, both directly and indirectly through inflammation, adulthood social position and a risk score constructed from adult health behaviours including tobacco smoking and limited physical activity. The direct effect of childhood social position was reduced by mediation analysis (standardised coefficient decreased from 0.089 to 0.043) but remained statistically significant (p = 0.035). All three indirect pathways made a statistically significantly contribution to the overall effect of childhood social position on adulthood type 2 diabetes. Conclusions: Childhood social position influences adult diabetes directly and indirectly through inflammatory markers, adulthood social position and adult health behaviours. © 2014Pikhartova et al.; licensee BioMed Central Ltd.Economic and Social Research Council-funded International Centre for Life Course Studies in Society and Health (RES-596-28-0001)

Endogenous control genes in complex vascular tissue samples

<p>Abstract</p> <p>Background</p> <p>Gene expression microarrays and real-time PCR are common methods used to measure mRNA levels. Each method has a fundamentally different approach of normalization between samples. Relative quantification of gene expression using real-time PCR is often done using the 2^(-ΔΔCt) method, in which the normalization is performed using one or more endogenous control genes. The choice of endogenous control gene is often arbitrary or bound by tradition. We here present an analysis of the differences in expression results obtained with microarray and real-time PCR, dependent on different choices of endogenous control genes.</p> <p>Results</p> <p>In complex tissue, microarray data and real-time PCR data show the best correlation when endogenous control genes are omitted and the normalization is done relative to total RNA mass, as measured before reverse transcription.</p> <p>Conclusion</p> <p>We have found that for real-time PCR in heterogeneous tissue samples, it may be a better choice to normalize real-time PCR Ct values to the carefully measured mass of total RNA than to use endogenous control genes. We base this conclusion on the fact that total RNA mass normalization of real-time PCR data shows better correlation to microarray data. Because microarray data use a different normalization approach based on a larger part of the transcriptome, we conclude that omitting endogenous control genes will give measurements more in accordance with actual concentrations.</p

Adopting 3-Year Screening Intervals for Sight-Threatening Retinal Vascular Lesions in Type 2 Diabetic Subjects Without Retinopathy

OBJECTIVE-To report the incidence of sight-threatening vascular lesions in type 2 diabetic subjects without retinopathy after adopting a 3-year interval screening program. RESEARCH DESIGN AND METHODS-In all, 1,691 type 2 diabetic subjects with no detectable retinopathy in two 50 degrees red-free fundus photographs were scheduled for follow-up with photography 3 years later. Age at diabetes diagnosis was 60 +/- 12 years, and known duration of diabetes was 6 +/- 6 years. Treatment consisted of diet only (26%), oral agents (54%), and oral agents and/or insulin (20%). Glycated hemoglobin A(1c) was 6.4 +/- 1.5%. RESULTS-Of the 1,322 subjects available for follow-up, 73% were still without retinopathy after 3 years, and 28% had developed mild or moderate retinopathy, but none developed severe nonproliferative or proliferative retinopathy. Macular edema requiring laser coagulation occurred in only one eye. CONCLUSIONS-Three-year retinal screening intervals can be recommended in subjects with mild type 2 diabetes and no retinopathy

Alcohol control policy and alcohol-attributable disease burden in Finland and the Baltic countries:A longitudinal study 1995–2019

Introduction: Alcohol remains a significant contributor to mortality and morbidity in Finland and the Baltic countries, particularly among men. This study aimed to assess alcohol policy restrictiveness in this region from 1995 to 2019 using a modified version of the Bridging the Gap (BtG-M) policy scale and examine its association with alcohol-related disease burden. Methods: The study utilised national laws to score policy restrictiveness (higher BtG-M scores mean stricter policies) and age-standardised rates of disability-adjusted life years (DALY), years of life lost, years lived with disability and deaths per 100,000 from the 2019 Global Burden of Disease Study (GBD). Spearman correlation tests and panel data regression models were applied to assess the association between policy score and burden of disease. Results: Finland maintained a high BtG-M score, while the Baltic countries experienced recent increases from initially lower scores. Alcohol-related disease burden showed an inverse association with policy changes in these countries. Strongest association was seen between the BtG-M score and DALY rates attributed to injuries. Premature mortality among men constituted the largest proportion of disease burden. Discussion and Conclusions: Despite challenges in accessing and comparing policy data over time, we showed a strong association between alcohol policy and alcohol-related harm in Finland and the Baltic countries. This study is one of the first to use the BtG-M scale to monitor changes in alcohol policies over time and their relationship to alcohol-related harm using GBD methodology. The study highlights the effects of national alcohol policies on levels of alcohol-related harm.</p

HLA Genes, Islet Autoantibodies and Residual C-Peptide at the Clinical Onset of Type 1 Diabetes Mellitus and the Risk of Retinopathy 15 Years Later

HLA genes, islet autoantibodies and residual C-peptide were studied to determine the independent association of each exposure with diabetic retinopathy (DR), 15 years after the clinical onset of type 1 diabetes in 15-34 year old individuals.The cohort was identified in 1992 and 1993 by the Diabetes Incidence Study in Sweden (DISS), which investigates incident cases of diabetes for patients between 15 and 34 years of age. Blood samples at diagnosis were analyzed to determine HLA genotype, islet autoantibodies and serum C-peptide. In 2009, fundus photographs were obtained from patient records. Study measures were supplemented with data from the Swedish National Diabetes Registry.The prevalence of DR was 60.2% (148/246). Autoantibodies against the 65 kD isoform of glutamate decarboxylase (GADA) at the onset of clinical diabetes increased the risk of DR 15 years later, relative risk 1.12 for each 100 WHO units/ml, [95% CI 1.02 to 1.23]. This equates to risk estimates of 1.27, [95% CI 1.04 to 1.62] and 1.43, [95% CI 1.06 to 1.94] for participants in the highest 25(th) (GADA>233 WHO units/ml) and 5(th) percentile (GADA>319 WHO units/ml) of GADA, respectively. These were adjusted for duration of diabetes, HbA(1c), treated hypertension, sex, age at diagnosis, HLA and C-peptide. Islet cell autoantibodies, insulinoma-antigen 2 autoantibodies, residual C-peptide and the type 1 diabetes associated haplotypes DQ2, DQ8 and DQ6 were not associated with DR.Increased levels of GADA at the onset of type 1 diabetes were associated with DR 15 years later. These results, if confirmed, could provide additional insights into the pathogenesis of the most common microvascular complication of diabetes and lead to better risk stratification for both patient screenings and DR treatment trials

Association between LTA, TNF and AGER Polymorphisms and Late Diabetic Complications

BACKGROUND: Several candidate genes on the short arm of chromosome 6 including the HLA locus, TNF, LTA and AGER could be associated with late diabetic complications. The aim of our study was therefore to explore whether polymorphisms (TNF -308 G-->A, LTA T60N C-->A and AGER -374 T-->A) in these genes alone or together (as haplotypes) increased the risk for diabetic complications. METHODOLOGY/PRINCIPAL FINDINGS: The studied polymorphisms were genotyped in 742 type 1 and 2957 type 2 diabetic patients as well as in 206 non-diabetic control subjects. The Haploview program was used to analyze putative linkage disequilibrium between studied polymorphisms. The TNF, LTA and AGER polymorphisms were associated with the HLA-DQB1 risk genotypes. The AGER -374 A allele was more common in type 1 diabetic patients with than without diabetic nephropathy (31.2 vs. 28.4%, p = 0.007). In a logistic regression analysis, the LTA but not the AGER polymorphism was associated with diabetic nephropathy (OR 2.55[1.11-5.86], p = 0.03). The AGER -374 A allele was associated with increased risk of sight threatening retinopathy in type 2 diabetic patients (1.65[1.11-2.45], p = 0.01) and also with increased risk for macrovascular disease in type 1 diabetic patients (OR 2.05[1.19-3.54], p = 0.01), but with decreased risk for macrovascular disease in type 2 diabetic patients (OR 0.66[0.49-0.90], p = 0.009). The TNF A allele was associated with increased risk for macrovascular complications in type 2 (OR 1.53 [1.04-2.25], p = 0.03, but not in type 1 diabetic patients. CONCLUSIONS/SIGNIFICANCE: The association between diabetic complications and LTA, TNF and AGER polymorphisms is complex, with partly different alleles conferring susceptibility in type 1 and type 2 diabetic patients. We can not exclude the possibility that the genes are part of a large haplotype block that also includes HLA-DQB1 risk genotypes

A new species of Achnanthes (Bacillariophyceae) from a freshwater habitat in a karst landform from south‐central China

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/151953/1/pre12381.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/151953/2/pre12381_am.pd